Sunday, October 21, 2012

The Restorative Approach Training

I have been working very hard on completely revising my Restorative Approach one day training. It now follows the order of my book (Trauma Informed Care- The Restorative Approach www, The exercises consist mainly of scenarios. The training includes many useful tools. I strongly urge anyone who is interested in the approach to attend my day long training at Klingberg on the 29th, even if you have attended a previous one. Besides, everyone who attends that training will get a copy of my book! If you can’t do that, I hope to see you at a training in the future. As you can see I am very excited about this new presentation. 

Here is the outline:

I.              The trauma framework, a useful road map to understanding both the effects of trauma and how people can heal.

II.            The Treatment Model

a)                  Overview
b)                 Use of Brain Science
c)                  Day-to-day Operation (Attunement exercise)
d)                 Common concerns

III.           Case examples demonstrating the daily workings of a trauma-informed treatment program. Handout: Scenarios

a)                  Defining and discussing behavior: Cassidy, Sarita and Dahlia
b)                 Managing challenges: Marcus, LaTasha, Juan, Young Love, Jesse, Taking Responsibility
c)                  Holding our values during hard times: Kathy, Katrina, Aaron, Trevor and Mario

IV.          Responding when children hurt others.

a)                  Theory of change
b)                 Rewards and punishments
c)                  Joquim Plays Basketball
d)                 Exercise: Becoming More Like You (Handout)
e)                  The Restorative Task, a response that incorporates opportunities for healing and for making amends. Handout: Formulation and the Restorative Task
f)                   Exercise: Formulation Jeffrey and Alexandra
g)                  Exercise: Restorative Task: Jeffrey and Alexandra
h)                 Taking Responsibility
i)                     When the program feels like a war zone  (Handout)

V.           The role of the clinician in trauma-informed care

a)                  Characteristics of clinicians who will succeed in this system
b)                 Necessary training
c)                  The clinician and the team
d)                 Treatment planning
e)                  Supervision and Support

VI.          Trauma-informed care and families.

a)                  Parents as trauma survivors. Exercise: Laura
b)                  Need to feel safe and to build trust. Exercises: Jaquanda, the Johnson family
c)                  Recognize and honor their strengths
d)                 Family fun and joy.
e)                  Psycho-education
f)                   RA at home

VII.         The Restorative Approach and Foster Care

a)                  Training
b)                 Special Needs of Relative Foster Parents (Handout)
c)                  Defining Behavior
d)                 Not Giving Up
e)                  Handling Problem Behaviors Handout: Exercise:  Joseph Visits his Bio Mom, the Contingent Life, Handout: Behavior Management in Foster Care
f)                   VT

VIII.       Agency support for trauma-informed care.

a)                  Leadership Exercise: Problems in the Treatment Team
b)                 Structure
c)                  Culture Exercise: Boundary Questions
d)                 Physical plant

IX.           Staff development.

a)                  Hiring
b)                 Training
c)                  Supervision
d)                  Promotion
e)                  Skill building
f)                   Staff turnover
g)                  Attention to vicarious traumatization

X.           Sustaining the change

a)                  Forces pushing towards a punitive approach
b)                 Predicting and addressing challenges
c)                  Measuring and celebrating progress
d)                 Celebrating success will help sustain the transformation

Sunday, October 14, 2012

The Book Everyone is Talking About

I just finished the book How Children Succeed: Grit, Curiosity and the Hidden Power of Character by Paul Tough, Houghton Mifflin Harcourt, Boston New York 2012. This book has received a lot of media attention. For example, was reviewed in the NY Times Book Review ( )  Paul Tough was also featured on This American Life. ( ).

To give an overview of the book I’ll quote the New York Times: “This book challenges the belief that success today depends primarily on cognitive skills — the kind of intelligence that gets measured on I.Q. tests, including the abilities to recognize letters and words, to calculate, to detect patterns — and that the best way to develop these skills is to practice them as much as possible, beginning as early as possible. In his new book, “How Children Succeed,” Tough sets out to replace this assumption with what might be called the character hypothesis: the notion that noncognitive skills, like persistence, self-control, curiosity, conscientiousness, grit and self-confidence, are more crucial than sheer brainpower to achieving success….” These skills can actually be taught, but a significant factor is that “Character is created by encountering and overcoming failure.”
However, I’d like to concentrate on the ways that this message interacts with our work. In his attempt to discover what factors actually contribute to adult success, Tough first describes the ACES study, and give an excellent concise report of the correlations discovered in that study between childhood traumatic events and later psychological and medical problems. Interestingly Tough reports that even when only the subjects who didn’t smoke, were not overweight and did not use drugs were examined, there was still a high direct correlation between the number of ACEs and the incidence of heart disease. Tough explains the biochemistry that produces this result through the stress response. He makes the connection between traumatic events, stress and poverty. So, this underscores our growing understanding how early childhood traumatic events change children’s biology and affect the rest of their lives.

Then Tough reports on the science of attachment, which shows beyond a doubt that attachment with a caring adult predicts future success. In fact, Tough states later that attachment can overcome the stress of traumatic events (connection is the antidote to trauma). He specifically describes how the chemistry of attachment counteracts the chemistry of stress.
Tough moves on to the central point of his book, which is the importance of teaching the executive functioning skills, which he names character. As mentioned above, these are persistence, self-control, curiosity, conscientiousness, grit and self-confidence. I think this fits in with our teaching by underscoring the importance of specifically teaching skills; through curriculums, experiences, and through modeling and demonstrating. He gives many specific ideas for doing so (one of which is playing chess). An interesting point is that children learn partly from experiencing and triumphing over failure. Affluent kids, he postulates, don’t go through enough failure or demand for hard work because everything is set up for them to succeed. Poor kids, on the other hand, don’t get enough help triumphing over failure and seeing it as temporary and not because of a character failure.

I would have liked more exploration of how these various factors interact with each other. Maybe that’s the next book. But it is great that this book is getting so much attention, and publicizing the ACEs study and the importance of attachment. I highly recommend it.