Saturday, July 25, 2009

Maybe It’s Not the Consequences

Think about a child in your program who has significantly improved. Maybe it would be that boy who recently came back for a visit after a successful discharge. Or maybe it’s the girl who has finally stopped hurting herself and running away and who is excelling in African drumming.

What do you think made the difference for this child? What actually helped him or her change and heal?

Most likely you think of the relationships, the patience, the caring. It’s the fact that your team was able to stick with him through the hard times. Maybe you were able to make some progress in connecting her with her family. You noticed that after a while she started to feel safe in the program and began to relax and play more. Probably you taught her some skills- now she asks for her crisis kit when she gets upset, and uses her distress tolerance skills. Maybe he experienced some success- it was when he started doing well on the basketball team that he began his turn around, or when he had that work study job in the kitchen and connected with the cook and started to enjoy cooking. When he finally trusted his therapist enough to tell her that he hated feeling like an idiot when it came to math, that helped too.

In short, we all know that what changes children is the web of loving, patient relationships combined with many repetitive specific skill building activities.

Yet, when we are anxious and upset about a certain child or a certain behavior, our thoughts automatically turn first to consequences.

Janessa keeps running away. Maybe we should give her a longer restriction when she comes back.

Sam continues to be mean to the other boys. Maybe we should give him a reward for every day he is not mean.

How would our programs be if we operated from the assumption that the actions we take after a behavior occurs have NO EFFECT on that behavior? That when we are concerned about a behavior, all our creativity and effort should go into creating the safety and teaching the skills that will enable a child not to need that behavior any more?

Of course this is an exaggeration, our response to a behavior does have some effect on it. But it is actually not our most powerful point of intervention.

What then would we do when a behavior occurred?

What if we thought of that moment as a time to teach a kid what you do when you screw up. This is something we all need to know (I use my skills in this area regularly). This is also something our kids do not know. When they screw up they plunge into an abyss of hopelessness, think all is lost, and prepare to be kicked out.

So we have an opportunity to teach how to repair a mistake. How do we repair our own mistakes with our friends? Apologize, explain what happened, listen to the other person’s experience and take in how they felt, do something nice for them, and make an effort not to make the same mistake again.

Of course our kids can’t do all this. Shame and self hatred make it difficult. But we can lead them to do small steps, small parts and thus gradually and slowly increase their ability to right their wrongs.

And at the same time, we continue the day to day work of helping them develop the self capacities that will diminish the number of mistakes they need to make.

What do you think of this idea? Click on comment and share your response.


Darryl said...

I think this is a fantastic way to think and operate, I work at a RTC and it is so common and easy for me and other staff to think about the consequence first. What makes that more frustrating is that the whole system is so used to thinking that way which limits the impact we have on children.

Patricia Wilcox, LCSW said...

We do a lot of training and consultation to help agencies change their approach. It is not an easy change to make, but when they do agencies are experiencing significant decreases in restraints and seclusion, and decreases in staff turn over.