ELKTON — At first glance, the room at Upper Bay Counseling & Support Services office on Route 40 in Elkton is crammed with toys. Exercise balls, oversized pillows and a collapsible tunnel all are enough to inspire hours of play.
But for Jessica Brenneman, the manager of UBCSS’s Early Childhood Mental Health Program, they’re all tools to help her address whatever sensory needs her young clients may have.
“It’s very fun, and when children walk in that room, they really enjoy it,” Brenneman said. “It gets them to explore what their body needs.”
Sensory motor arousal regulation treatment (SMART) therapy is one of many options that UBCSS offers for young clients in the northern Chesapeake Bay region. Brenneman started seeing children at UBCSS in 2015, and two years later, a formal program was established.
With four therapists based in the two offices in Elkton, and one in the Havre de Grace office, the UBCSS Early Childhood Mental Health Program has served 100 children so far. Children who come through the program are typically dealing with early signs of anxiety, attention deficit hyperactivity disorder (ADHD) or trauma.
This program offers play therapy, where children ages 3 to 11 can express themselves with a variety of toys, with clear limits, and filial therapy, where parents are taught to administer play therapy.
“Play is the language of children,” Brenneman said. “With therapy at a young age, it can be a lot easier to change a maladaptive pattern that’s only been in place for a year as opposed to using it as a coping skill for six years.”
The SMART therapeutic approach is the latest addition to UBSCC’s programming as of this year, and is one of the few institutes in Maryland that offers it.
SMART therapy uses a combination of movement and sensory equipment to help children learn how to regulate, or manage, feelings of distress. On the surface, it’s similar to play therapy, although the “toys” include weighted blankets and bounce balls rather than swords and dolls.
The therapy model combines equipment from occupational therapy, that focus on gross motor functions, as well as mental health therapy to engage children’s senses, fully and safely engaging their senses using equipment like mats, pillows, balls, balance beams, and shared play.
With fully-embodied play, it also allows children to regulate and learn to manage their emotions and experiences, process their emotions and develop new skills to cope.
“In the past, when a child was in occupational therapy, the therapists were seeing some traumatic responses and talking about their trauma. Some mental health therapists were seeing children with trauma that were constantly moving around,” Brenneman said.
SMART is typically targeted for children between 2 and 5 years old, specifically with complex trauma. But at UBCSS, it’s used for children with a variety of needs and those who ask for it.
UBCSS had among the first therapists trained in SMART in 2010. After many left the organization, however, the program fell to the wayside.
With the financial support of the Cecil County Judy Center, Brenneman and three other therapists were able to get trained at the Justice Resource Institute in Massachusetts in late 2018 and revive the program.
“It involves all the child’s senses, and lets the child explore what they need at various times,” she said. “What helps them feel calm when they’re off-the-charts excitable and what brings them up when they’re feeling down. Then, they can continue to explore it with a therapist and their parents.”
When a child explores the SMART room, a therapist is following their body to see how they are regulating themselves in the moment. If the therapist allows a child to continue to experience what they need to experience, then they will be able to tell when their body is satiated.
Therapists do account for safety. If a child is doing something potentially dangerous, then the therapist can intervene — or regulate the client —and help them redirect their energy to a different activity.
“We’re exploring the room with them, either myself or a parent,” Brenneman said. “Sometimes we talk about things that happened that week while we’re in there. Some get just tired of it, so we transition to play or talk therapy. But sometimes the work is in the regulation.”
As SMART and the UBCSS Early Childhood Mental Health Program gains ground in the northern Chesapeake Bay region, the hope is to become a resource for parents across the board.
The UBCSS child services programs, which accept private and state insurance, see clients from Harford and Cecil counties as well as nearby Middletown, Del., and others from Pennsylvania.
In the end, the ultimate goal at UBCSS is to help children build healthy relationships, and help their caregivers meet their emotional needs to prepare them for the years ahead, no matter what they faced in their past.
“Cecil County is fortunate to have child services and SMART available here, since it can be life changing for the children who move forward with it,” UBCSS CEO Suanne Blumberg said. “The trauma will always be with them, but with the help of programs like this and our dedicated staff, it won’t be making their life decisions for them.”
For more information about enrollment in Upper Bay Counseling & Support Services child programs, go to upperbay.org or call 410-996-5104, and select the “intake” prompt.