The Children's Psychological Health Center, Inc. of San Francisco is reporting progress of trainings on how to serve autistic children with Reflective Network Therapy. It is an evidence-based, manualized, video-documented method for preschoolers with autism spectrum disorders.  CPHC Medical Director, Gilbert Kliman, M.D. returned on September 25th from Wellspring Family Services, Seattle's oldest family agency and The Seattle Psychoanalytic Institute, which are enthused and participating in seminars and institutes.  Wellspring Family Services of Seattle has opened a new building, begun major funding and working with the method. Wellspring is training new therapists and teachers in one preschool class, and places are available for teachers and therapists. Three brand new preschool classes have been built for these purposes at Wellspring Family Services' recently opened new three story building, 1900 Rainer Avenue South, Seattle, and the remaining two are planned to open late this year.  Each classroom will use Reflective Network Therapy and will include children on the autism spectrum. Remote videoconferencing functions will be available for communication among multiple sites and remote seminars. [For an update on recent developments, visit the Sister Sites section of this website.]

Crisis Response for the Sichuan Earthquake—The work of Gilbert Kliman MD

by David Trimble, PhD − Netletter  http://netletter.se/node/89

I want to share with you the exciting work that Gilbert Kliman, MD has been doing. A child psychoanalyst, he has long been very interested in the network approach. He renamed his preventive preschool program, Reflective Network Therapy (originally called the Cornerstone Therapeutic Preschool Method). Reflective Network Therapy weaves together a network of preschool children, many of them with serious mental health problems, their families, and their teachers, to form a healing community. The therapist, usually a child psychoanalyst, conducts play therapy in the classroom over the course of the school day, with the other children and the teachers observing and sometimes participating. After the therapy session, the analyst and child report on the session to the teacher, again in the middle of regular classroom activity. I enjoy how it uses both networks and reflective functions.His workbook approach to help children cope with traumatic stress of the disaster relies heavily on natural helping networks for its implementation, and the text itself stresses for the child the importance of drawing on network supports.

HELP FOR TROUBLED CHILDREN by Ron Alexander, New York Times, December 11, 1983

−New York Times article about the Center for Preventive Psychiatry, founded by Gilbert Kliman, MD in 1965. The Cornerstone Therapeutic Preschool Method—now known as Reflective Network Therapy—(originated and developed by Dr. Kliman) was first practiced in this White Plains, New York community based mental health agency. 

The four-story red-brick Georgian building on the residential street in White Plains was built in the 1920's and looks no different from the other pleasant houses on the tree- lined block. In fact, it is quite special.

Originally a private home, it is now headquarters of the Center for Preventive Psychiatry. The primary focus of the center - a licensed nonprofit community mental health clinic - is on the prevention of mental illness in preschool children who have begun to display evidence of psychological and emotional disorders.

Its unofficial motto might be ''a stitch in time,'' a phrase that its 50 or so staff members are fond of repeating. Dr. Arthur Zelman, the medical director, says that virtually from birth the behavior of children can, and sometimes does, show signs of stress. If these signs are picked up, Dr. Zelman says, ''intervention can make an enormous difference.''

Dr. Zelman said that while infant development and mother-infant relationships have been studied increasingly, he believes the center is one of the few clinics that focus on preschool children.

''The children we treat are, directly or indirectly, victims of our culture,'' he said, ''and from a numerical point of view we are seeing just the tip of the iceberg.''

To date, the center in White Plains and its branch in Yonkers have treated some 1,600 preschool children. Fees are on a sliding scale, depending on ability to pay. As an agency of the Westchester County Department of Community Mental Health, the center receives some state financing; additional money comes from private contributions.

The center was founded in 1965 by Dr. Gilbert Kliman, a psychoanalyst who had become concerned about the reaction of children to bereavement and loss after the assassination of President John F. Kennedy in 1963. Dr. Kliman, who is in private practice, is now a consultant to the center.

''Psychological first aid is essential for so vulnerable a group as children when loss is involved,'' said Sylvia Bloom, director of community relations. The aid her organization offers includes crisis therapy for families or individuals of any age faced with stressful events such as the death of a parent or spouse, marital breakdown, abuse, accidents or loss of a job. The center also serves children in day-care and prekindergarten programs.

20 Children in Therapeutic Unit

But the cornerstone of the Center for Preventive Psychiatry is its therapeutic unit, which, on weekdays from 9 A.M. to noon, treats preschool children with emotional difficulties in a nursery-like group setting. There are now 20 in treatment, from 3 to 6 years old, in the White Plains and Yonkers units. Most come from impoverished backgrounds and have, at best, loose ties to the adults around them.

Many of their birth parents are alcoholic, absent, abusive or psychotic. Most of the youngsters, who also receive individual counseling, are living with other relatives or foster parents. Treatment in the unit usually lasts two or three years.

''Unless children such as these are helped at an early age,'' Mrs. Bloom said, ''they could well become petty criminals or worse. Fortunately, there is far less of a stigma attached to seeking psychiatric help for children than 10 years ago.''

On a recent Monday morning six boys and three girls gathered in a room cluttered with low tables, chairs, toys and books and settled down on floor mats. Half a dozen staff members did the same, talking to them earnestly, occasionally stretching out their arms in welcome.

The initial half-hour was noisy and chaotic (Fridays and Mondays, the days just before and after the weekend, are the times when the youngsters' problems are most apparent). The children were alternately angry, friendly, wary. Gradually, a structure began taking shape.

''O.K., what did you do this weekend?'' Norma Balter, a social worker, asked the group. Some of the replies were deliberately silly and were followed by giggles; one boy's answer was shockingly obscene.

Therapist Sees a Contradiction

''When you say those things and have that smile on your face, it must have been a rough time,'' Rita Stewart, a staff psychotherapist, told him.

He turned away, but then he said, ''My grandma was busy and didn't come to pick me up.'' He slid over to Mrs. Stewart's lap and the group, or some of them, discussed the problem.

Later, one girl said she had taken a pair of scissors and cut her hair ''because I was mad at my mother.''

Another boy, his face filled with hurt, complained, ''My mother says one thing and does another, and that's a lie.''

One boy suddenly began to cry. ''Anyone crying has their own sad feelings and we should listen,'' Susan Howard, another therapist, told the group.

A hot lunch of macaroni and carrots was served. Some of the food was eaten, some was left on the plates, some was thrown. Later, the group went out to the backyard, which was filled with bikes, sandboxes, rubber tires, swings, a jungle gym and an overturned wading pool.

One of the children smashed a supermarket shopping cart into a tricycle. He was collared and admonished. The girl who had cut her hair, her normally soft voice taking on a frightening growl, screamed out ''Leave him alone!'' Then, her small fists clenched, she began hitting one of the staff members.

Two of the children reached the top of the jungle gym while a third was restrained while he tried to shake the structure. One of the boys joined Miss Howard for a soaring, smile-filled swing ride.

In a corner of the playground, Thomas Lopez, the therapeutic unit's chief psychologist, was comforting a solemn-faced boy. ''You really had a bad weekend,'' Dr. Lopez said. ''Oh man, you're laying all your bad feelings on me.''

Tentatively, the youngster nodded in agreement, and then he slowly put his arms around the psychologist's neck.