Sunday, September 30, 2007
Instead, let’s go back to our theory of what is wrong, and what do we actually think will promote change.
Why are the children hitting people and throwing chairs and running away and cutting themselves? Is it because they lack motivation to change- that the previous punishments they have received for doing so have been inadequate?
No, it is because they are doing the best they can to solve current intolerable problems.
They do not have safe, strong trustworthy attachments in which they can relax and learn new skills, and they never have. They do not know how to resolve problems that arise within relationships. Trauma has changed their biology, sensitized their nervous systems, and left them hyper-reactive. They have not been taught the basic human feelings skills: how to hold onto the belief that someone loves you; believing that you are worth the air you breathe; and what we do when we experience strong emotions.
Because of this, they over-react to current setbacks, do not believe that anyone can or will help them, and have no way to manage their emotions. So they act out.
Will punishment help all this? No. The children have already been punished. If that would solve these problems they would be over them by now.
The Restorative Approach™ is designed to provide what will help:
Attachment- safe, regulated relationships in which people speak from their heart and are honest about the relationship effects of behaviors, and are Respectful, Informative, Connected and Hopeful.
Containment of hyper-reactivity: an environment structured for success with available regulated adults helping children become regulated.
Teaching of feelings management skills: Opportunities to develop relationships. Active effort towards creating inner representations of those relationships. Many different methods to experience competence, help others, examine shame, surface what is shameful, and to see delight in another’s eyes when they look at you. And feelings management: active teaching of noticing, naming, soothing, distracting, and utilizing feelings.
Teaching of relationship repair skills: when something goes wrong between me and another, there is something I can do about it.
The power of change happens in these areas. The restorative tasks should be designed to take a small step in one of these tasks- it could be in any area. Often, the learning piece is in the area of feelings management: what was I feeling? What happened? Or, it could be feeling worthy of life: make a list of my skills and good points.
The amends piece works in the area of attachment, relationship skills, and also contributes to self worth.
So the idea is not to make up a task for every thing the child does wrong. The idea is to figure out what we think is going on in a given event, what skills is the child lacking, and assign a task that will help develop these skills. It does not have to be aversive. It has to be our best guess at something that will work- help the child learn a little something new, and be a little more connected with the people around him.
It is not fear of punishment that will change the child. It is developing the relationships and skills that will allow her to weather current set backs without having to resort to such desperate behavior.
Sunday, September 23, 2007
The fact is that a child’s trauma history is never an excuse. It is always a reason. The child’s daily life, emotions, and thoughts are always affected by their past. The child’s biologically different, hyper-responsive nervous system does not change from day to day. His distrust of others is always present. His fear of being weak or vulnerable remains a part of his choices. His lack of emotion management skills, his sense that he is not worth while, that he is to blame for everything bad that happens, his inability to maintain a connection with others, stay present in every day life.
However, this does not mean that the child cannot change. He can begin to feel safe and to relax. He can slowly learn to trust a few people. Through experiences of success and approval from others, he can discover positive parts of himself. He can learn feeling management skills.
If a child had diabetes, we would not refer to his diabetes as an "excuse" for his reaction to sugary foods. We would not speak of his diabetes as an "excuse" to avoid eating certain foods. We would hope that the child would gradually increase in his competence in managing his diabetes, and would use the skills and technology available from others, and would lead a largely normal life. And, the diabetes would be always present as a reason for some actions and choices.
Even if a child had a broken leg, we would not call his broken leg an "excuse" to avoid a hike. If we were taking the child some where, we would make adaptations to promote the child’s success on the trip. We might bring a wheel chair for long distances. We would plan frequent stops to rest. We would teach him how to use crutches and bring them along with us. We would not be blaming the child for needing these adaptations.
At the same time, we would expect the child to get better. We might enroll him in physical therapy and encourage him to work hard at the exercises. We would gradually do less and less for him as he healed. His whole leg cast would be reduces to a smaller cast and then to a bandage. There would be a constant balance between understanding his pain and incapacity, and supporting his efforts to heal.
How we speak about kids can strongly influence how we feel about them and thus how we act towards them. When we speak of their trauma histories as an excuse, we imply that kids should have no responsibility and that what will help them is to simultaneously blame them for their incapacity and to have low expectations. This is, in fact, the opposite of what will help. If instead we understand the child’s trauma history as a reason, a fact, a condition they have been given, we will both not blame them, and we will have hope for their potential to heal and to achieve greatness.
Wednesday, September 19, 2007
Congratulations, you won a Thinking Blogger Award! The participation rules are simple:
If, and only if, you get tagged, write a post with links to 5 blogs that make you think,
Link to this post so that people can easily find the exact origin of the meme,That was that! Please, remember to tag blogs with real merits, i.e. relative content, and above all - blogs that really get you thinking!
This all started at:
The blog that tagged me is:
And I was very interested to discover this blog and add it to my reading list.
This is the link to the entry in which I was tagged:
I was also fascinated by another blog that was tagged, Sunshine Girl On A Rainy Day. She's a former foster child who now writes about foster care issues and how kids in foster care could be better served. Very interesting!
So now I have to tag 5 blogs that make me think. I have not been able to find many blogs in the therapy world, so if any one knows good ones please post in comments. I read a lot of blogs about promoting change, and non profit management.
One of them is: Change This
"ChangeThis is creating a new kind of media. A form of media that uses existing tools (like PDFs, blogs and the web) to challenge the way ideas are created and spread. We're on a mission to spread important ideas and change minds." Since I am working on changing how treatment is provided to children, this blog often gives me good ideas.
World of Psychology
Dr. John Grohol's daily update on all things in psychology and mental health. Since 1999.
This blog is part of Psych Central, "the Internet's largest and oldest mental health social network created and run by mental health professionals to guarantee reliable, trusted information and support communities to you, for over 12 years." It contains updates of the latest news and information in the mental health field, which can be very helpful.
The Trouble With Spikol
is a blog by Liz Spikol, "managing editor of Philadelphia Weekly. She writes the award-winning column which began as a chronicle of her struggle with mental illness, and has since expanded into humorous musings on everything from graphic novels to how to use a mop. This blog is about mental illness- policy, news, personal journeys and more." I like the combination of personal experience and news updates.
New Squared is a central site for the non-profit community which introduces us to Web 2.0. They state that: "Our mission is to spur responsible adoption of social web tools by social benefit organizations. There's a whole new generation of online tools available - tools that make it easier than ever before to collaborate, share information and mobilize support. These tools include blogs, wikis, RSS feeds, podcasting, and more. Some people describe them as "Web 2.0"; we call them the social web, because their power comes from the relationships they enable." I have gained much useful information here.
Descibes its content as: "Tips and ideas on nonprofit communications, publications, marketing and PR. As a nonprofit consultant, I love helping organizations communicate more effectively with their members, donors, volunteers and other supporters, so they can make the world a better place." I like the fact that each entry is a "carnival"; a compilation of many articles on a certain subject. It is a wealth of information.
Then here is a bonus blog. I love Mind Mapping and use Mind Manager for all my planning, writing and thinking. Therefore I also love the official Mind Jet blog:
"This is the blog of the Mindjet Corporation, the makers of MindManager® software. Mindjet Corporation is the leading provider of productivity software for visualizing and managing information, allowing individuals and teams to more effectively think, plan, and collaborate. The Mindjet® MindManager® enables users to visually connect and synthesize ideas and information to improve decision making, shorten business planning processes, and harness the intellectual capital in their organizations."
I get many ideas as to how people are using Mind Manager in new and creative ways.
I hope this post leads you to some interesting reading. Please add your own favorite blogs in our field in the comments. Thanks!
Saturday, September 15, 2007
"Help us Pat!" the call comes in.
"We need you. Ever since we moved away from points and levels, the children don’t care what they do. They are getting worse and worse, rude, defiant, acting out. Since they don’t lose points they have no deterrents to bad behavior. A two-minute apology letter means nothing to them. We need to put back some more consequences."
What are the assumptions behind this plea for help? That the main reason that the kids ever acted politely was because they would lose points if they didn’t. And that the only response we have to address problem behavior is consequences.
Do we really believe this? I don’t.
What about the relationships?I think what happens is that when the behavior management system of a program is changed, if we are not careful a staff paralysis sets in. If I cannot take away points or drop levels, what can I do? So I do nothing, and sit by helplessly, another sort of neglect.
In fact, points, levels and consequences are a small part of our arsenal of tools to impact the kids’ behaviors.
Here are some other tools:
· Talk about it. Say you don’t like it. Describe how the behavior affects you and the other community members. Express hopes that change will happen.
· Work hard and constantly to form caring relationships with the kids so they care what you think.
· Validate the feelings behind the behavior.
· Express an understanding that this is the best the kid knows at the time- and the hope and confidence they will learn better.
· Develop in the child the basic feelings management skills of maintaining an inner connection to others, feeling worthy of life, and feelings management.
· Teach specific feelings management skills to do things differently.
· Use feelings management skills your self and label out loud that you are doing so.
· Have group meetings about what kind of place we want here.
· Have group meetings about bad things that happened and how everyone felt and how we can support each other to do better.
· As a team, discuss how we understand this behavior. What is our formulation about what is going on here? What problem is this behavior solving for this child? How can we teach her to solve that problem a better way?
· With the kid, develop a treatment theme- what is the basic thing this kid is working on? Examples would be: feeling emotion without acting to make the situation worse. Learning to trust. Growing up. Then relate all behavior to that theme.
· As a team support each other in the long, difficult process of doing this work.
· Work on developing self worth.
· Address shame.
· Use (possibly as restorative tasks) exercises that help the child understand and manage his behavior, such as mood charts, emotion thermometers, collages of how they are feeling and/or things they can do differently, interviewing others about how they handle emotions, etc.
· In treatment team develop restorative ideas for each child that are significant, require thought, and are related to their treatment.
· Don’t take the kid on trips when they have just hurt you- and explain why you don’t want to.
· Make sure you have enough fun and interesting things going on so that kids who can’t participate because they are working or restorative tasks will be missing something they want to do.
· Make sure your structure and planning supports success.
· And- TALK ABOUT IT. Address every problem. Take the kids on. Tell them what kind of behavior you expect. Tell them how different actions make you feel.
· And tell them, and show them, over and over again, all the good things you see in them and how delighted you are by everything positive (and even neutral) that happens.
Points and levels are so insignificant when compared with these (and other) more powerful tools. Changing to a trauma focused approach does NOT mean paralysis in the face of destructive behavior. It means active, complete and relationship based engagement. And then both the staff and the kids will be co-running a programs that supports growth and change in all.