Sunday, August 02, 2009

The Crucial Question

I was doing some training this week, and had just finished saying that if a child trashed the playroom, then worked to set it right, he should then be allowed to go to the movies once he was done, if he seemed calm and safe. He should not have a restriction that lasts beyond his having fixed the problem.

One child care worker obviously thought this was nuts. "You mean he should be able to go to the movies just because he fixed the room up? But then the kids will think they can do anything they want, and all they have to do is clean it up, and everything will be fine. They will be going crazy destroying this place. The child care workers will have no control at all."

The therapist was skeptical too. "Won’t we be setting them up?" she asks. "What about when they get to public school, where there are consequences for behaviors. We will have given them unrealistic expectations."

I think these are the crucial questions we must answer if we are going to actually change the way children are managed within treatment programs.

And what are the assumptions behind these questions?
1. That children are eager to misbehave and will choose to do so whenever they can "get away with it".
2. That only the fear of consequences prevents them from acting up constantly.
3. That a child care worker’s most significant source of influence on a child is the wielding of punishments and rewards.
4. That our reward and punishment systems will teach the children to stop doing disruptive behaviors and that learning will transfer to their next settings.

Do we actually believe these assumptions? I know I don’t.

I believe that children do well if they can. Children do not want to fail, to anger the adults around them, to be kicked out of programs, to be placed in residential. They do not WANT to trash the playroom, and they are not looking for opportunities to do so when they can get away with it.

What prevents you from acting up constantly? What prevents you from destroying your agency’s play room? Well, some of it may be fear of punishments, such as losing your job. But I’ll bet there is a lot more to it. For example, you have people and goals that you care about. You have hope. You have a sense that there are people who love you and would be disappointed if you got arrested. You have a positive idea of what kind of person you are. And when you are extremely frustrated (and I know you can be VERY frustrated at your job) you have skills to manage these emotions. You talk to someone, you take a break, and you go for a walk, whatever. You have other options other than room-trashing.

Child care workers have a chance to have a powerful and long lasting impact on a child’s life. They can rebuild a child’s brain. However, I do not think they do so mainly through their use of rewards and consequences. They change children through connected, caring relationships in which children build new ideas of how adults can be, how trust is possible, and how people can care about their needs. Through many, many repetitions of attuned caretaking, a child care worker creates a new view of the world for a child. And, the child care worker actively teaches the child skills through that relationship. She teaches the child that others care about her even when they are not physically present; that she is worthwhile and special; and how to recognize and manage her emotions.

This brings us to the question of what will help the child when he gets to public school. It isn’t that the child has to learn that there are negative consequences when he trashes a room. He already knows that. He has experienced a lot of negative consequences in his young life. The problem is: when he experiences a set back, he is not able to get help from others or draw on an image of anyone who cares about him. He is already convinced he is a lousy no-good person. His biology is over activated and over reactive. And he has no idea how to recognize his emotions and soothe himself. So he is plummeted into despair, fear and hopelessness. And his brain stops working. He is in danger mode, feeling like his very life is under attack. He has to do something to get away from all this pain- so he trashes a room.

In order to help him not get kicked out of public school, we need to teach him that he matters, people care, and he can get help. We need to help him calm down and feel safe. And we need to teach him specific emotion management skills.

This is where our power is. This is what will make a difference. This is where we have the ability to influence (rather than control) a child’s life.

So, help him clean up the room. Have a brief discussion of what he was feeling that led up to this event. Validate his feelings as much as possible. Talk a little about what else he can do when he feels this way. And then take him to the movies.


Jonathan said...

Hi Patricia,

I wonder if I could bother you to watch the following short trailer for an animation that we are making to help children who have suffered trauma. We originally developed this as a 5-day camp for children in evacuation centers after natural disasters. It has been successfully implemented in China during the last two summers. What we are wondering is how practitioners in local settings with children who have experienced personal trauma might use the material. Any ideas?

Pete's Arctic Adventure


Jonathan Wilson

Patricia Wilcox, LCSW said...

The trailer is cute- I'd like to learn more about your work and how you are going to use this movie. Great idea to produce a cartoon to share these healing messages with kids!

Jonathan said...

The story follows a little penguin who goes through personal tragedy (separation from parents during disaster) and learns in each episode five key principles

1. I am Not Alone (safe, stable)
2. Everyone is Important (affirmation, telling story)
3. Follow and Believe (facilitate understanding, hope)
4. Be Strong and Courageous (encourage, asking for help)
5. You are Loved (recovery, referral)

We do this with large groups of children (250+) combined with songs, games, and crafts and find it very useful in screening which children are at risk for PTSD so that we can refer them to counselors.

We are thinking that the animated version might have potential to be used in a setting such as yours with small groups of children or even individuals to allow the counselors to start talking about issues obliquely while giving the child comfort at the same time.


Jonathan Wilson