Monday, June 26, 2006

A Week of Miracles

This was the week that school ended, and because there were many awards and celebrations, it became the week of miracles.

A nine year old boy who has such terrible aggressive outbursts in the morning got an award for most improved reading as he has actually learned to read this year.

A shy and social uneasy girl got a drama award for her small part in the Wizard of Oz which represented such courage on her part.

Tabitha is thirteen year old girl with no active family connections. When she came to us she was entrenched in a pattern of running away to the most self destructive and dangerous situations she could find. She had already endangered her health and her life. She hasn’t run for several months now, and is even beginning to express doubts as to whether the 30-year-old man she met up with “really loves her”. She has a new relationship with a boy her own age. She received three school awards, including most improved in her class.

Then there is Mark. His background included some of the most horrific abuse I have ever heard. He came to us at fourteen so primitive, eating with his hands, unable to handle bathroom and self care, socially inept, demanding and aggressive. Yesterday he received the Principal‘s Award! He is helping younger kids, working in the vocational program, and learning computer skills.

Of our four high school graduates, two were kids we didn't even think we could keep at various points. I have written about Sandra and Rob previously in this blog. Another child has lived three quarters of his life in residential, and had no sense of autonomy and no ability to make choices. Now he is an assistant to the PE teacher and may have found a vocational direction. Bob has a history of problem sexual behavior, and has grown partially through participating in the Poetry Club.

These children changed and grew because they were able to relax. They grew through developing trusting relationships, through being noticed and validated. They changed because the gradually shared their hearts, their fears, their dreams, and they were met with encouragement and understanding. The structure and safety around them were essential. People- staff, therapist, teacher- engaging them around their behaviors and emotions was an expression of caring that drew them out of their isolation. In some cases the family work played a huge part in the child’s recovery.

We all had tears in our eyes and new sense of hope and commitment in our hearts

Of course, some other younger kids, dysregulated by the end of school with its losses and changes in the routines, had a big crisis in the afternoon, lest we think we could spend our whole day resting on our laurels. But some of them had received awards as well, and although they had a bad afternoon, the healing has begun.

Thursday, June 22, 2006

True Words from a Parent

I subscribe to a list serve for parents of attachment challenged children (http://groups.yahoo.com/group/DailyParentingReflections/) who are trying to implement Bryan Post’s method of parenting (http://www.beyondconsequences.com/)

A mother named Mia had these important words to help us understand the experiences of these children:
“I used to try and figure out what my daughter was afraid of but I have come to realize that the real problem lies in the way her brain learned to react to stress a long time ago. Because her stress level was severe at a very young age she learned things like: people cause pain, people that come in and out of a room cause pain, noise in the room means more pain, an open door means more pain, raised voices means pain, women mean pain and aren't safe, the world isn't safe, I'm not safe anywhere... etc.

So I have learned that even when I can't always figure out what is stressing her, she is reacting to something I don't recognize as stressful and she reacts in a different way than I do. She is on high alert and is in a fight for her life. Little things (to me) put her in survival mode. She can't help it. The connections in her brain were formed before she was able to make a safe and secure bond with a parent. The challenge is to heal her brain and make new connections. That is a very big challenge and something that isn't coming easily. To change pathways in the brain, is it even possible? I certainly hope so. We need knowledge and strength for such a challenge.”

I hope we can keep this description in mind as we open our hearts to the children we treat.

Sunday, June 18, 2006

Earning Everything

Another phrase that is common in our work is that the kids should “earn privileges”. Many activities, events, later bed times, TV time, use of games, and special treats are earned. This is another part of our thinking that has to change.

Like many aspects of our current system this started as a good idea. The plan was to motivate the children to behave better by showing them that positive behavior led to better things in life than negative behavior. Of course, they probably already knew that, and if they could have changed their behavior they would have.

We don’t have to earn all our positive experiences, thank heavens. We can watch TV whether or not we have been “good” that day. We can stay up as late as we want, or go on a trip. Of course it could be said that we do earn these things by being productive citizens and by making money, but we are not evaluated minute-by-minute as to whether we have earned the right to have fun.

Children should get many things just because they are alive and they are people. These should include many types of fun, treats, extras, and playful times.

We would be better served to look at our children’s problems through the analogy of a physical ailment. Suppose a child named Bob was in a car accident (not his fault- he was in the back seat, just along for the ride). Both his legs were multiply broken. Now he is in a rehab facility and is learning to walk again. Bob is receiving physical therapy, medications, a doctor’s care, and the help of a social worker for the emotional effects of the accident.

The treatment team knows that Bob’s recovery will be slow, involve many ups and downs, and will require effort and patience on their parts and on Bob’s. They do not assume that Bob could just walk better if he wanted to. They do not intervene primarily by setting up rewards for walking long distances and punishments for falling down.

They structure Bob’s day carefully. They encourage him to walk short distances at first, between bars, and then always with someone with him to catch him if he falls. They break the activity of walking down into many little steps and teach them to him one by one. They praise effort, not results. They only expect him to do what they know he can currently do. The physical therapist does not tell Bob that because he falls when he tries to walk a long ways he is not allowed to go on a trip. If Bob needs to go somewhere that is further than he can currently walk, they get him a wheel chair. A trip might be just what he needs to have some fun and get some more hope and energy for his recovery.

They do offer much encouragement, and remind him what is at stake, and try to show him what will be possible as he learns more walking. But they do not make current enjoyment contingent on his daily progress, because they know his progress is affected by many things and is only partially within his control. They know that enjoyment, people who love him and encourage him, and a sense of the possibility of change will get him through the hard, discouraging effort of regaining what should be rightfully his.

Our children are as damaged by trauma as Bob was by his car accident. Their recovery is as slow and difficult and takes as much energy and patience. We should not make them earn activities and privileges. Instead we should provide whatever supports are possible to help them experience the delights of life. We should evaluate their current skills and invite them to do just a tiny bit more than they can currently do easily, with us there to catch them when they fall. With a combination of joy, relationships, and fun our children will have the hope and energy to continue their hard work of growing and changing.

Thursday, June 15, 2006

Taking Responsibility

One phrase that is commonly heard in children’s treatment programs is: the children have to learn to take responsibility for their actions. This inevitably means, of course, taking responsibility for their mistakes and negative behaviors- although actually our kids don’t take much responsibility for the positive things they do either.

I’m in favor of taking responsibility for ones’ actions. It is part of working through mistakes that one makes. For example, recently when I forgot about a meeting and thus caused others to scramble around to get the work done, I felt it was important to admit I had messed up and apologize personally to the people I inconvenienced.

Yet when I hear this phrase I cringe because it usually seems to be associated with a punitive response in which we tell the children what they did wrong and they admit it.

Why do we imagine that kids deny what they did, blame others, claim extenuating circumstances? Is it actually because they do not know what they have done? Or is it because they are so ashamed, and feel so hopeless about their behavior that they can not bear to face it? Maybe denial is the only mechanism they know. Certainly they have not learned that one can make a mistake and then work it out- which is a very important skill in life. In the past mistakes may have led to abuse. In fact, in many cases physical abuse came randomly and it was in fact difficult to figure out which mistake had caused it- but the child is sure that they must have done something wrong.

When we punish children by isolation and restriction, does this increase the likelihood that they will take responsibility for their actions in the future? The idea of such systems is that as the child experiences consistently that punishments are associated with certain behaviors and rewards with others, they will make the link and learn to admit and understand their mistakes. Yet this ignores the role of shame. When a child is banished she feels hopeless and lost, and cannot bear to sit and think about what happened. So she may become even more entrenched in blaming others to lessen the pain.

In a Restorative Approach the child does some task in which he makes amends to the person or people his behavior impacted. During this task the child will get an emotional sense of how his behavior did affect the other, developing a deeper internal sense of responsibility. The teenage boy who was threatening to blow up the school has to go to the elementary classrooms and apologize and tell them he will not blow up the school. In doing so he can see that these little kids were actually scared by what he was doing- that his behavior mattered to them. And equally importantly, he learns that when he has messed up there is something he can do about it. He can reassure them. He can work it through. So, instead of feeling worse, more ashamed, and thus insisting more vehemently that it wasn’t his fault, he feels better, knowing that it was his fault, and that he has done something to fix it.

We can help our children learn that what they do does impact others, both positively and negatively. Through creating strong relationships we can help them learn to care whether they affect others. And we can teach them what we all practice every day- that you can make a mistake, the world doesn’t end, your relationships don’t end, and you can do something to make it better.

©2006 The Restorative Approach is a servicemark of the Klingberg Family Centers, Inc.

Thursday, June 08, 2006

Socks and the Restorative Approach

I observed an interaction today that captured the Restorative Approach.

In the Main Hall outside my office door Cassidy, age 12, was yelling and swearing. She had burst out of the dining room and was agitated and upset.

A staff approached her and said: “what’s wrong?”

Cassidy yelled that she had not worn socks to school today, and now a boy was saying that she had stinky feet and that she smelled. Now no one was going to want to sit next to her and she would not have any friends ever again.

There were many educational and responsible things the staff could have said. She could have said “that’s why you have to wear socks” or “you have to stop swearing or get a fine” or “you are out of bounds now” or “you can’t let that boy upset you and you have to go back to the dining room” or “I’m sure it’s not that bad and you will still have friends”.

Instead, she said: “I can see how you would feel that way”.

Stop.

No: but you have to… you must… you will get….

Cassidy’s voice went down two decibels immediately. The next thing I heard the staff say was “I don’t think not wearing socks is really such a big deal. Look, I’m not wearing socks right now.”

After that I couldn’t hear them because they were talking in normal conversational tones. I think they were discussing how to get back to dinner and what to do about the rude boy. When I left to go home they were both eating.

I left with a feeling of pride from having seen the Restorative Approach in action.

©2006 The Restorative Approach is a servicemark of the Klingberg Family Centers, Inc.

Sunday, June 04, 2006

What a Restorative Approach is NOT

I have the opportunity through Risking Connection training to meet many people in different agencies who are starting the switch to a trauma-informed treatment approach. At the beginning staff have many mistaken assumptions about what a relational model would mean. It is important that we address these directly.

A Restorative Approach does not mean no limits or rules. The adults are responsible to create a safe, orderly setting that maximizes the safety and success of the children. This means clear expectations, organized schedules, plenty to do, and immediate intervention when things start to go wrong. Unsafe behavior should be stopped. Restraints will some times be necessary (although less often). Children will need to be separated from each other or from the group at times.

A Restorative Approach does not mean that staff does not have or use authority. It means we use our authority honestly, directly, and with respect. We use our teams to make sure of our direction. We are in charge of the children, and responsible for their well being. We become the kind of authority that we appreciate in those that have authority over us. For example, we have supervisors who have the authority to correct our behavior at work. Yet it would be easy to describe both respectful and disrespectful ways they could exercise that authority. The same applies to our work with the children.

A Restorative Approach does not mean that staff ignore maladaptive behavior. It is one more form of neglect of these kids if we just ignore their behaviors because it is easier for us, or because we don’t know how to intervene. We must have the strength to be direct with them about what they are doing and how it is affecting us, others, the community. We do so in a context of our own self-awareness and emotional regulation. We engage with the kids in a respectful, collaborative manner that is based in our complete conviction that behaviors are adaptations and have been learned for self protection. And we know that the child needs to learn new, more effective behaviors.

A Restorative Approach does not mean that our prime intervention is constantly asking the child how they are feeling. It is rarely helpful to ask the kids how they are feeling. They usually don’t know unless it is obvious to us all (i.e. furious), and they react to the “therapy sounding” question. Instead we use the art of engagement, exploration, humor, distraction, looking for patterns, listening, repeating, until we and they discover what is going on.

A Restorative Approach is not something that can only be employed when everything is calm and we have plenty of time. If that were the case, it wouldn’t be much use in residential treatment. Whether we are intervening in a crisis, whether we have to fill out a form for external requirements, whether we are in a hurry and only have ten minutes, we can still be respectful and collaborative with the children. We can be honest and share directly what our constraints are. We can speak from our hearts. We can convey our certainty that the child is doing the best she can, and that together we can learn ways to do better.

As we explore the misconceptions about the Restorative Approach and learn what it is not we will have a better ability to discover and practice what it actually is.

©2006 The Restorative Approach is a servicemark of the Klingberg Family Centers, Inc.