Tuesday, April 15, 2008

Thoughts from the MASOC Conference

Last week I presented at the Massachusetts Adolescent Sex Offender Coalition Tenth Annual Joint Conference on The Assessment, Treatment and Safe Management of Sexually Abusing Children, Adolescents, and Adults in Marlborough, MA. (http://www.masoc.net/) I highly recommend this annual conference to anyone with an interest in this subject. You know you are at a good conference when you can’t decide which of several interesting work shops to attend.

In this conference as in others I have attended I was struck by the convergence of thinking in our field. More and more treatment programs are learning about trauma and altering their approach to include that knowledge. There is increasing recognition of the bodily alterations caused by trauma, which can be summarized (and over simplified) by describing the trauma survivor as living in a hyper-aroused state. Programs are increasingly incorporating body-based interventions such as sensory integration, brain gym, bio-feedback and neuro-feedback. We understand we must actively teach the skills that the children have never learned: everything from establishing rhythms in life, to learning about personal space and touch, to self regulation, to social skills and working through relationship difficulties.

Programs are changing- adding body-based adjunct interventions, working more through art, music and drama, and providing skills training. I have come to see the Restorative Approach(tm) as a way of aligning our day-to-day operations with our current understanding of trauma. We understand more now about how trauma survivors live in a danger mode, and how when a person is in danger made they cannot think. Yet we run our programs based largely on cognitive interventions: discussing with the upset child the consequences of his actions; talking about safety plans and relapses prevention plans; explaining to the child how her life will go better if she stops hitting people.

The Restorative Approach(tm) utilizes our understanding of the brain through encouraging staff to simply help the upset child calm down, through listening, physical activity, distraction, sensory interventions, etc. Staff are asked to use their relationships with the kids to demonstrate coping skills, to use attachment to manage distress (as humans do) and to create new templates for the possibility of trustworthy help from adults. The child collaborates in developing a tool kit of strategies to manage their own symptoms. When something serious goes wrong, staff do not focus on punishment and thus increase shame. Instead they focus on the relationship effects and the possibility of redemption through making amends and working it through.

Our day-to-day interactions with the kids we treat provide our most powerful tool for healing. Let’s find more and creative ways to utilize what we are beginning to understand about trauma and the brain. Let our behavior management systems exemplify and make real our basic values. The system can recognize that the children are doing the best they can at any given time. We understand that they have been specifically wounded and have learned how to treat these wounds. Our children need healing through skillful training, interventions and love.

1 comment:

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