Sunday, September 20, 2009

Power and Trauma Informed Care

Many times both in my own agency and in agencies I have trained I have encountered staff who are paralyzed. They are trying to change their practice with the clients. Often, the environment around them has changed the rules for restraint. No longer is it permissible to restrain children for lack of compliance. There must be imminent physical danger. And/or the agency is implementing trauma informed care and is looking differently at the use of consequences.

However, in the midst of this change, staff become confused and over react. For example, Mark is taking the books out of the bookcase and throwing them to the floor. Joe, a child care worker, knows that he will not be able to restrain Mark for this behavior, so he does nothing, just stands by and watches Mark become more and more escalated. Joe pleads weakly for Mark to stop. Mark feels more and more unsafe as he senses that Joe feels powerless and ineffectual. He does not know how to stop his own escalation. Thus he acts out more to draw a response and to elicit some control from the adults.

There are many things you can do to stop a behavior without restraint. One of them is to say in a strong, powerful voice: "Stop it! You can’t do that!" It is amazing how often forbidding a child to do something stops them, even when you have no idea how you would enforce this dictate. Another is to say in a calm but intense voice: "Mark! What is wrong?" and to actively listen to the response.

People some times think that if you are no longer supposed to slam a child with consequences, you must ignore their obnoxious behavior. No! This would be just another form of neglect. Throughout the children’s lives, many people have ignored them rather than take the time and energy to engage with them. And if we ignore actions because we are scared of the behavioral result if we confront them, the child notices this and feels even more unsafe. To the child it seems that the adults cannot handle his intense emotions- so how will he possibly be able to handle them?

Dan is one of the best staff. He has a personal power, centeredness and strength. He speaks to the children in a calm, straightforward way. He is sure of his own values and able to tell a child when the child’s actions hurt him. He speaks from his heart, steps up to the children and engages deeply with them. He feels sure of the rules and expectations and does not hesitate to give directions. However, he also is interested in them, celebrates their successes, and knows their lives and preferences. He is able to relax and have fun with the children.

Staff have many sources of power with the children in addition to their power to dispense privileges, consequences and to physically restrain. After all, staff control everything that happens in the program. They can say; "I am not feeling safe enough to take you for a trip" or "We’ve all been getting along so well let’s go to the go karts!" They control access to much of the rest of the world, and regularly report on the child’s progress to those who are making decisions about her life.

And the most effective form of power is influence. Relationships. Danita cares about her team mate (primary staff contact) Lucy. Lucy has high expectations of Danita and eagerly waits to hear how each day of school goes. Lucy expects that Danita will be successful. When Danita has problems Lucy talks with her about them and together they try to figure out what went wrong and how things could go better next time. Lucy heard that Danita was mean to a new staff member Jennifer over the weekend. When Danita saw Lucy she asked to speak to her, and said she was disappointed by Lucy’s behavior. Danita said that she does not like Jennifer, she is not cool like Danita. Danita replied: "I expect you to be polite to all staff members, whether you like them or not." Because Danita cares what Lucy thinks, she is slightly nicer to Jennifer from then on, giving them a chance to form their own relationship.

Relationships are far more powerful than consequences. How many books have you read in which someone describes their life being turned around by earning 15 minutes later bed? How many describe the profound influence of one other person who changed someone’s life by being active and caring?

Trauma informed care has nothing to do with letting the children run the program. It does not instruct staff to be wimpy. Trauma informed care demands strong human beings who have the courage to open their hearts to these wounded children, to stay engaged and active through all the symptoms, and to celebrate growth and triumph. These valuable people have true power to create life long change.

Please click "comment" and let me know your reaction to these ideas.

1 comment:

S. Freeze Vonderweidt said...

You have a great way of putting things into perspective. I have been regularly e-mailing my staff the link to your blog.
Thanks for taking the time to write these.
-S. Freeze Vonderweidt
Program Supervisor
Home Of The Innocents
Lousville KY