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Updated May 2009

Reflective Network Therapy − The Cornerstone Method

    help for young children with mild to moderate autism spectrum disorders,

    pervasive developmental disorders and serious emotional disturbances

  
The Cornerstone Method of Reflective Network Therapy creates a powerful synergy between in-classroom psychological treatment and inclusive preschool education. It has been widely applied, with measurable success, for seriously emotionally disturbed and/or pervasively developmentally disordered young children, two to seven years old. In a Cornerstone classroom, right in the midst of preschool educational classroom activities, a psychodynamically trained therapist intensely focuses on and attunes to each child in turn, for about a quarter an hour at a time. During that attunement, the therapist tactfully verbalizes his or her reflections  about the child’s feelings and behavior, especially the therapist’s thoughts about what the child is doing and thinking in the here and now of the classroom.  Children’s resistances to education, refusal of affection, and inhibited or inappropriate socialization are interpreted on the spot. Teachers, parents and the Cornerstone therapist touch base during daily short briefings with and about each child in the classroom and parents are given weekly conferences in private, where they get support and share insights. The network on which the method depends is comprised of a classroom team of parents, child pupils who are patients, their classroom teachers and a classroom therapist. This interactive network is dynamically engaged with each child, one at a time in the classroom, every day the class meets. Results include improved relational skills, positive behavioral changes and substantially increased learning capacity.
 
Compared to other methods, these improvements commonly occur quite rapidly:

  • Significant and sustained IQ rise 
  • Improved sociability and development of empathy
  • Transformation of behavioral symptoms into dialogue and play
  • Increased vocabulary and increasingly elaborate communication over time
  • Increased understanding of the mental lives of others
  • Positive behavioral changes and mental health gains
 
Learning becomes based in part on intensive exercising of positive self-perceptions experienced through in-classroom and team-guided family relationships. The term network also takes into account respect for the value of an interdisciplinary and multi-generational team. A Cornerstone child’s treatment situation is deliberately designed as a network of children, parents, teachers and therapists with mental and emotional mirroring and reflections among all of them right in the children’s real life classroom space. Rather than focusing on whether the child’s behavior is socially acceptable or on task, this method quickly generates internal rewards, motivation for social and cognitive tasks and develops skills which are emotionally positively charged by interpersonal transactions.

Here and now in-classroom therapy for preschool children:

In other methods, children are treated psychodynamically and individually but in no other method does intensive psychotherapy by a psychodynamically trained psychotherapist take place exclusively within the learning and play activities of their classroom groups. With Reflective Network Therapy, no pull-out therapy is involved. The child is simply not removed from the classroom. The child’s interpersonal relational problems with parents and other children that come up in the moment are seen in the real life space of the classroom. Here and now problems can be addressed therapeutically in the immediacy of the moment.
 

Children are routinely able to transition successfully into regular public school classrooms.

Children with mild to moderate autism as well as children with other or multiple diagnoses routinely achieve mental health gains, develop cognitively and become able to transition successfully into regular public school classrooms after treatment. Children are never pulled out of class for individual therapy; it takes place right in the classroom. The child's here-and-now feelings, behavior, symbolic expressions and responses to other children and classroom events are all opportunities for therapeutic action and become the subjects of therapy sessions.

Autism: The need for cost-effective means of treating preschool children with autism spectrum disorders or psychiatrically disturbed children is enormous. The rising incidence of autism is now one in 150 children, a personal and social epidemic burdening families, schools and tax payers. Our evidence-based treatment method is cost effective.

Trauma: Psychiatric disorders among U.S. children are on the rise.  So are traumatic experiences such as family break-ups and break-downs in family care for children.  As a sign of such traumas, there are 500,000 foster children in the United States. Our treatment method is showing that cost effective treatment is possible among foster children with measurable results in placement stabilization, leading to reduction of administratively and emotionally costly transfers among foster homes.

Cost effectiveness for public school special education classrooms:

 
In a public school, this method can be carried out in preschool special education classrooms for 1/6th the cost of using one-on-one behavioral aides for children with pervasive developmental disorders. Behavioral aides are not needed to achieve results. One on one behavioral aides are not used. However, a child’s existing aide is welcome to come at the beginning of a child’s treatment. Behavioral aides are rarely required after a few days. Medication is hardly ever prescribed and children are often able to have medications previously prescribed eliminated entirely as they improve.
 

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