Sunday, September 09, 2012

It Ain't Easy Being RICH- Part Three: Connection

Any one who has taken the Risking Connections â training knows that a key element is that the path to healing is through a RICH relationship- one that includes Respect, Information, Connection and Hope. This is such a central point that the publisher, Sidran, has copy write protected the concept independently. In our training we ask participants to share ways in which they are currently demonstrating RICH with the clients, and also with each other in their team. Because amazingly it turns out that what the clients need in a relationship is the same as what we need for ourselves.

For four weeks or so I am going to right about the dark side of RICH- by which I mean the difficult and complex aspects of creating RICH relationships. These are the areas where we struggle, stumble, and sometimes become less than helpful to our clients and each other. Let’s look at each part of RICH and discover what is hard about it and how we can overcome the challenges.
This third week I will focus on Connection

Connection is the central concept in a trauma-informed approach. People heal within relationships. Our programs should offer our clients RICH relationships and train staff how to utilize these relationships for the most powerful healing.
Some of the complexities of this approach become clear when we talk about the fact that relationships have two sides- the clients and ours. These relationships affect us too, and all of who we are shapes the relationship.

On April 9, 2009 I wrote about the Restorative Approach and Boundaries. In this post I discussed some of the common complexities that arise from our caring for the children and wanting to help them. People sometimes assume that because the Restorative Approach emphasizes relationships and speaking from the heart, we are throwing out the idea of boundaries. Quite the opposite is true! For relationships to be safe and healing, the boundaries must be clear, reliable and trustworthy.
Because abuse is in its essence a violation of boundaries, it is especially important that we pay attention to boundaries when working with abused clients. Our children have experienced major boundary violations, such as sexual abuse. They have also experienced many other chronic, less obvious boundary problems. Many of our children have had to handle responsibilities far beyond was is reasonable for their age, such as an eight year old being responsible for her two year old sister. They have been way too involved in adult issues, such as being worried about the rent or finding food. They have been exposed to adult sexuality and to relationship worries. They have had to parent their parents- care for a sick mother, listen to parental problems, help ease a parent’s depression.

So many tem[potations can arise for staff. We may want to give the kids gifts; take them to lunch; give things or money to the family; etc. The family may give the therapist a gift. We consider sharing personal information, either because we feel close to the client or we think it would help them. The client may tell us a secret, on the condition that we don’t tell the rest of the team. When the child is leaving, we may consider giving her our email address. We wonder if we should give this boy a hug.
In our training, we emphasize that as a staff you should TALK ABOUT every decision that is outside your job description before saying anything to the child or family. Talk with your supervisor or your team. It may be just the thing to do; it may be dangerous to the child or the group. But it is much easier to make the right choice when you step back, take time to think, and talk with someone else.

That we even have these dilemmas illustrates how much the kids and family matter to each of us. And so, with each of these real connections comes our exposure to the pain the child is feeling.  When a sad thing happens to the child, we feel it too. It is often hard to stay with that pain- we often just wish to fix it. Part of that impulse is to sheil ourselves from really experiencing the painful worlld of the child.

And we experience losses. We don’t talk much about what it is like to take these children into our hearts, and then have to discharge them- often to a less-than-optimal situations. One person in my agency used to say (when we had residential) “You know they are ready when you don’t want them to leave.” But they do leave, and staff are expected to be ready to open their hearts to the newest snarling child. It’s a hard thing to do, and one aspect of Vicarious Traumatization. It’s good to talk about this in our teams, especially every time there is a significant positive or negative discharge.
One more thing about connection and our part of the relationship. We cannot open our hearts to these clients if we are feeling lousy. If we feel hopeless and incompetent; if we feel mistreated by our boss or the agency; if recent encounters with clients have been scary or hurtful. We will not be available for new relationships. A new admission will be greeted with cynicism or distant formal interactions. This is why a trauma-informed relationship based approach cannot work unless we take care of our staff. How do we do that? Imbed discussion of VT. Schedule time to think, reflect and get support. Provide regular supervision for everyone. Utilize a clinical road map to make sense of the behavior. Have retreats, Have many systems for staff recognition. Do fun things together like potluck lunches and sports.  Time spent in these activities will be completely repaid in more effective treatment, less physical interventions, and less turnover.

Connection. It’s been a scary thing in the children’s lives. It has its complications in our own lives. Yet it is what makes us human and what builds our brains. Let’s look at our settings and consider how we are supporting connections in the way we do things.

I’d love to hear your ideas about ties. Just click on “comment.”





 

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