Sunday, January 06, 2008

Time to Think

I am resuming blogging after a hectic pre-holiday and holiday schedule and a nice recovery vacation. I am also trying a new experiment of pictures in the blog. I am recently trying the idea of improving my presentations with pictures so I thought I would try it here as well. As usual, I would love feed back- just click the word "comments" at the end of the entry.

As we do more and more training and consulting I am struck ever more deeply with the importance of one variable: that the line staff have time to think and talk about their work. I am becoming convinced that a congregate care treatment program cannot provide excellent trauma informed care if the line staff are expected to be on the floor for all the time they are at work. It is crucial that staffing schedules be created to allow every full time staff person (and preferably the part time and per deim staff as well) to have time to:

Receive supervision that is scheduled, reliable and actually happens most of the time it is scheduled. This supervision should be more than administrative and correcting mistakes. It should include a focus on the person in the work: how are you doing? Which kids are getting on your nerves? Which do you want to kill? Which do you want to adopt? How are you with VT- how is the job affecting you? And it should have a focus on helping the staff member grow and develop, improve their strengths, learn more, progress on their chosen career path, and explore and utilize their interests.

Learn about the children- and reading the record is not enough. Staff need time to meet with the therapist and come to understand the child’s background and how it is currently influencing the present. Staff need to know the goals and objectives and the proposed discharge path for this child. They need a clear sense of the formulation of the treatment- how do we understand what is going on with this child and what are we focusing on? What problems is this child trying to solve with her symptoms? What self capacities does she need to develop? What social supports does he have? What are his strengths?

Discuss current issues and dilemmas with the team, and develop strategies based on the formulation. What have others found that helps? What can we add to the child’s Individual Crisis Management Plan? What are the early signs of distress that we should watch for- and what helps at those times? Who is doing well with this child and can become more involved? Who is struggling?

And relax- get away from the work for a few minutes, take a break, laugh, eat, talk, share stories of their weekend, form and strengthen relationships with other staff members.

Although it may appear daunting, expensive or even impossible to design staffing schedules that include regular meetings and down time, if fact it is possible. And it is less expensive in the long run because these are the things that result in satisfied staff, people who understand what they are doing, have a road map, and know that their own individual contribution is important and appreciated. Also, staff will have a feeling that they are growing and learning, and that their development is important to the agency. This will result in less staff turnover.

I believe these components are crucial to developing self aware, committed staff who can provide excellent trauma informed treatment for the kids.