Tuesday, October 25, 2011

Patricia Wilcox to Attend Carter Symposium on Mental Health

This year’s 27th Rosalynn Carter Symposium will focus trauma and its long-term effect on children. It will be webcast live.

The National Association of Children's Behavioral Health (NACBH) will be ably represented by Beth Chadwick, President and Pat Wilcox, Klingberg Family Centers Traumatic Stress Institute who will be joining an illustrious gathering of national leaders, advocates, policy makers, practitioners and researchers as they meet to bring this most pressing issue into greater focus and resolution.


Estimates suggest that millions of American children and adolescents experience trauma each year, through exposure to physical or sexual abuse, a life-threatening illness, natural disaster, or the loss of a loved one. Although effective treatments are available to prevent the long-term impacts of trauma on a child’s intellectual development and physical well-being, most traumatized children do not have access to these services.

On Oct. 26-27, the invitation-only, 27th annual Rosalynn Carter Symposium on Mental Health Policy will bring together more than 200 health advocates, policy-makers, practitioners, educators and researchers from across the country to discuss ways to remove barriers to providing mental health services for children at greatest risk for trauma—especially those exposed to domestic violence, child welfare, and the juvenile justice system.

The event is open to the media and will be webcast live on www.cartercenter.org on Oct. 26 starting at 1:00 p.m. (EDT) and on Oct. 27 starting at 8:30 a.m.

Oct. 26 Agenda Highlights:

For a full schedule: http://cartercenter.org/resources/pdfs/health/mental_health/2011-mental-health-symposium-agenda.pdf

• 1:00 – 1:05 p.m., Welcome: Thomas Bornemann, Ed.D., director, Carter Center Mental Health Program
• 1:05 – 1:15 p.m., Opening remarks: former U.S. First Lady Rosalynn Carter

• 1:15 – 2:15 p.m., Keynote: “Childhood Trauma in America: Findings from the National Child Traumatic Stress Network”

o John Fairbank, Ph.D., co-director, National Center for Child Traumatic Stress, Duke University Medical Center; and

o Ernestine Briggs-King, Ph.D., director, Data and Evaluation Program, National Center for Child Traumatic Stress, Duke University Medical Center

Background on the Rosalynn Carter Symposium on Mental Health Policy:

The Rosalynn Carter Symposium on Mental Health Policy is part of the Carter Center’s Mental Health Program, which works to decrease stigma and discrimination against people with mental illnesses as well as promote positive policy change on mental health issues.

Visit www.cartercenter.org to learn more about the Carter Center’s Mental Health Program, access resource material such as reports, the Center’s mental health journalism archive, and expert Q&As.

"Waging Peace. Fighting Disease. Building Hope."

A not-for-profit, nongovernmental organization, The Carter Center has helped to improve life for people in more than 70 countries by resolving conflicts; advancing democracy, human rights, and economic opportunity; preventing diseases; improving mental health care; and teaching farmers in developing nations to increase crop production. The Carter Center was founded in 1982 by former U.S. President Jimmy Carter and his wife, Rosalynn, in partnership with Emory University, to advance peace and health worldwide. Please visit www.cartercenter.org to learn more about The Carter Center

Sunday, October 16, 2011

Where are My Glasses?!?

Carlos storms into the nurse’s office. “Are my glasses here yet?” He demands in a loud voice.
“No” Amy, the nurse, says. “I haven’t heard from them. I’ll call you when I get them.”

“Well did you call them?” Carlos asks.

“No, they will call us when they come in, Carlos.” Amy replies.

“You should call them! I’ll bet they have them already!” Carlos is becoming more agitated.

“Carlos I’ll let you know if I hear from them.”

“No! Call them now! Give me the number! I’ll call them! Why can’t I call them? Give me the number!” Carlos was becoming angrier. His staff starts to move in. As the staff starts to encourage his return to the unit Carlos yells “I’ll bet they are already made! Give me the number! No one understands that I need those glasses! I can’t see! Doesn’t anyone care?”

After Carlos leaves, Amy can be heard saying “that child is so demanding! He thinks the world revolves around him and no one has anything else to do besides call about his glasses. He has to learn to be more patient and respectful.”

The problem is that Amy and Carlos live in different worlds, and hence have developed different world views.

Amy’s world is orderly. If you send a prescription to a glasses company they make the glasses. As soon as they are done they call you. You pick up the glasses right away and deliver them to the child.

Carlos’ world is quite different. In his world, what he needs is no one’s priority. If he needs new glasses, no one will pay attention. If by some chance the prescription makes it to the company and the glasses are made, they will languish in some back room for months. If they get to the doctor, no one will call for weeks; when they call, no one will pick them up. The only way that the glasses will get to him is if he takes it on himself to call and remind them, and calls often.

Carlos does not think that the world revolves around him. He in fact thinks that the world does not notice or care about him at all, unless (maybe) he yells loudly.

Understanding this will help us reassure Carlos, tell him how long it takes to make glasses, exactly when we will call, and keep him updated often about progress.

Maybe we can be the adults that teach Carlos that some adults can be trusted and do care.

Monday, October 10, 2011

Vicarious Transformation

I have had the privilege of hearing Dr. Laurie Pearlman speak twice in the last month. The first time was at the ATTACh conference, where she was a keynote speaker. The second was in a distance learning training that the Traumatic Stress Institute did for its trainers. This was an interview with Dr. Pearlman by Dr. Steve Brown of TSI.

Laurie is developing the concept of “vicarious transformation”. We always discuss vicarious traumatization (a term she also invented) which refers to the negative effects on helpers of working with trauma survivors. Vicarious transformation refers to the positive changes in the helper which come about through empathetic engagement with traumatized people and active engagement with the changes in ourselves.

In Risking Connection© training we do an exercise which draws from participants both the negative and the positive ways that their work has affected them. In the positive section, people often say that they have grown as a person, become more patient, more tolerant, a better listener, a better parent. They also report that they are more grateful for what they have been given, and that they are inspired by the courage and resilience of the people they work with.

It is these effects which Laurie is naming vicarious transformation. She says: “through opening ourselves to the darker parts of the human experience, we may grow. When our hearts and minds are open to whatever we encounter, our humanity is enhanced.”

Dr. Pearlman stresses that in order to experience this growth, it is necessary that we turn towards the suffering we see. We of course want to deny it, to diminish it, to turn away, We convince ourselves that this could never happen to us. But when we are receptive, it is easier to care, and to enter into a genuine reciprocal relationship with our clients. Just as we feel their pain more acutely, we appreciate their strengths more directly. We experience the human potential in a deeply heartfelt way.

Dr. Pearlman recommends some techniques that can help us maximize the potential for vicarious transformation. These include receiving psychotherapy, journaling, yoga, meditating, praying, symbolizing our experiences creatively, and befriending emotion.

This exciting new concept helps us articulate why we stay in these difficult jobs. I look forward to further exploration by Dr. Pearlman, and by all of us in the treatment community.

Sunday, October 02, 2011

The Adult Attachment Interview

As part of the same ATTACh Conference workshop with Michael Trout, Karen Buckwalter, LCSW from Chaddock presented the Adult Attachment Scale. The Adult Attachment Interviewis a twenty question guided clinical interview with a specific scoring protocol. It was developed by Mary Main and her colleagues, and has extensive research validation to support it. A parent’s score on the Adult Attachment Interview is highly correlated with the attachmenmt reaction of their child in the strange person test.

The questions themselves can be the beginning of thoughtful discussions. They include questions such as:

• Choose five adjectives or words that reflect your relationship with your mother starting from as far back as you can remember in early childhood.

• To which parent did you feel the closest, and why?

• When you were upset as a child, what would you do?

• Did you ever feel rejected as a young child?

• What is your relationship with your parents (or remaining parent) like for you now as an adult?

The carefully trained administrator who understands the scoring system can group the adult into one of five categories:

• Autonomous: They value attachment relationships, describe them in a balanced way and as influential.

• Earned autonomous: Someone whose childhood does not contain good relationship experiences, but who has nevertheless achieved some autonomy, probably through other non-family caring relationships.

• Dismissing: They show memory lapses, minimize negative aspects of their childhoods and deny personal impact on relationships. Their positive descriptions are often contradicted or unsupported. This Karen called act and don’t feel

• Preoccupied: Experience continuing preoccupation with their own parents, have angry or ambivalent representations of the past. This would be feel and don’t act

• Unresolved/Disorganized: Show trauma resulting from unresolved loss or abuse.

Karen was careful to point out that people’s scores and types can evolve through positive adult relationships.

Karen presented several possible uses for this interview. Testing therapists and staff who work with traumatized children helps them become more self aware of their own backgrounds and styles. This will help them understand some of their reactions to individual children and families. Testing foster parents has the same benefits. Some audience members have been using the interview with some foster parents, and reported that others are very resistant to doing it.

This interview offers fascinating ways to develop the self-reflection that is so essential in our work.