Scattergood Foundation

Advancing Innovative Strategies for Change in Behavioral Health


Name of Innovative Program: 
Sponsoring Organization
Name of Innovative Program Lead: 
Risa M. Mandell
E-mail Address of Innovative Program Lead:
Project Description: 
WeBePlay integrates parenting skills, child development and Special Play Time into obstetric and early childhood pediatric settings consistent with family-centered care to build and strengthen secure attachment as a protective factor in the presence of adverse experience.   WeBePlay is both prevention and intervention as the quality of the filial relationship is a root factor in both maladaptive behavior and adaptive conduct. WeBePlay offers evidence-based guidance from support staff who have learned core competencies to engage in therapeutic relationships and to model, role play, coach and teach parenting skills, child development and Special Play Time using supportive psychological education and motivational interviewing.The interpersonal developmental needs of our youngest are only spottily addressed despite the rise in pre-school expulsion. This is a public health concern.  The road to Juvenile Justice begins early.  Additionally, strong families need support to reclaim the primacy of family life in child development.  
Creativity and Innovation: 
WeBePlay synthesizes the Adverse Childhood Experiences (ACE) Study, attachment studies, child-centered and filial play therapy, the work of Erik Erickson, Peter Fonagy, Claudia Gold, Stanley Greenspan, Rise van Fleet, Garry Landreth, Donald Winnicott and others, including organizations such as Zero to Three and this applicant’s limit-setting technique, ELeCt (empathy, limit, choice) to promote behavioral health by integrating it with primary care.   The motivation, opportunity and capacity is available to work through the challenges of actualizing parity to achieve integration.The applicant will develop training modules for support staff and for parents and will engage with insurance plans for adapting codes and billing structures for the newly created reality.  Quadrants of clinical need will be developed.  Ben Franklin’s common sense dictum lauding the worth of a proactive ounce of prevention over an expensive, reactive pound of cure is anticipated to be borne out in outcome data.
Center City Pediatrics, Fairmount Pediatrics and Lower Bucks Pediatrics are practices which share the goal of integrating behavioral care with primary care and have expressed the willingness to explore piloting the service.  How to be empathic and set limits, how to pretend play within a structured setting and how to strengthen the child’s attachment, affect regulation, mentalization and self-discipline are skillspromoted through WeBePlay.  Parents learn to become therapeutic agents with their child during Special Play Time; some parents have internalized the skills and subsequently use them in daily living with beneficial results. Organizations will be influenced to adopt the service following itseffective demonstration.From whence the name, WeBePlay? 
  • We emphasizes relationship.
  • Be connotes relating and communicating in the-here-and-now.
  • Play because emotional safety and spontaneity imbue the child with fortitude to adaptively negotiate inevitable life struggles; moreover, to flourish.
See Supporting Links:See Attachment:
  • The Efficacy of Play Therapy and Filial Therapy with Children: Summary of the Meta-Analytic Findings
WeBePlay will use the award in its inception year to finance the service g &uided by financial structures drawn from the attached SAMHSA models.Relationships with organizations such as Georgetown University Center for Child and Human Development, National Center for Medical Home Implementation, Patient Centered Primary Care Collaborative, National Committee for Quality Assurance, Primary Care Progress and the American Academy of Pediatrics will be cultivated for best practice evidence-based measures to chart performance and to determine recommended financial structuring.WeBePlay will invite parents to participate in research investigating integrated care using observation, questionnaires and rating scales.  The goal is to spare all stakeholders long term costs, both financial and emotional.  Relationships will be initiated with payors to inform them of the pilot’s inception. The local mental health community will be kept informed of the pilot’s progress towards promoting legislative activity for implementing a system of integrated behavioral and primary healthcare.
Models of integrated care have been reviewed and the fully integrated (vs collaborative) model of behavioral and primary care is determined as the model of choice since it best expresses the aspired  for quality of care.  In this model, infant and early childhood mental health care will be incorporated into routine primary care visits and follow a step-up progression as needed in the child’s medical home by their devoted health care team.  A continuum of models from basic on-site collaborative to partially integrated to fully integrated is thought to be a realistic progression to proceed from inception to the fully realized service. No service exists to this applicant’s knowledge integrating evidence-based practice in infant and early childhood mental health in primary care settings.   WeBePlay will serve Philadelphia by actualizing mental health parity locally in a model suitable for national replication.  
Quadrants modeled in Mauer 2006 will be developed for infants and early childhood.Electronic templates for case notes will be created which will be analyzed for outcome data.  Observation, rating scales and questionnaires will be used before, during and after the service to measure and evaluate performance.  These will be devoted to the three components of WeBePlay: Parenting Skills, Child Development and Special Play Time.  Additionally, measures will be used to calculate staff knowledge and skills before and after learning core competencies.  Assessment of data will be ongoing to hone the service for improvement.  An article suitable for publication will be submitted once complete data sets are analyzed.