Sam's Difficult Day

Today Sam had a melt down. He broke several windows in our beautiful new school, and he trashed the library. Throughout the agency people were asking: what's upsetting Sam? He hasn't done anything like this for many months. What is hurting him? Sam used to lash out regularly, seriously assaulting people. We were not sure we could keep him and others safe. But he has gradually begun to connect, to talk, to explore his complex self. He hasn't had any behavioral problems for a long time, and he even says hello and asks others how they are doing now. When his therapist and staff asked him about today, he started out by complaining about various adult decisions. But gradually he started to talk about his mom. She has steadfastly stated he can never come home and live with her. But now she is opening the door a little, saying maybe she will consider having him home. Sam said he is scared- scared he will let her down. He said: "I don't want to go there if she doesn't really want me". After some more discussion he said "so tomorrow I will fix the library, and what can I do to earn money to pay for the windows? I will have to apologize to some of the teachers". Staff added that he would have to do something restorative to make amends to the other students he scared, and that he would be on a hold (loss of extra fun privileges) until this work was done. Also, they wanted to keep him near them (no off-grounds trips) while he was struggling with these big issues in his life. He accepted this readily.

This is the Restorative Approach in action.

©2006 The Restorative Approach is a servicemark of the Klingberg Family Centers, Inc.

Training and Thinking

Yesterday we did a training for fifteen people from the Andrus Center in Yonkers, New York (http://www.andruschildren.org/). It was great to meet this group of intelligent, receptive people. Included in the training on the Restorative Approach was a presentation by our adolescent Boys' Unit, a meeting with school staff, and a discussion of the DBT adolescent Girls' Unit- and lunch, of course! There were so many questions and so much discussion it was hard to keep the day moving along.

As I do these trainings, it becomes clearer that we are suggesting a new way of looking at the kids and their symptoms- not just a new method of behavioral control. People often start out wanting to simply substitute restorative consequences for restrictive consequences. But the difference in approach became clear in a couple of examples. In the school, a teacher spoke of a boy who refused to go into his classroom. She tried to figure out how she could help him- what was wrong? What was bothering him? and arranged for him to spend the day in another class, with a plan to work towards returning to his own. It wasn't about compliance- you must get into your classroom because that is where you are supposed to be. It was about understanding- how can we help you? The Boys' Unit staff demonstrated a similar approach to a child who was escalating around refusing to take a shower. Their reactions were completely informed by an understanding of the relationship of trauma, low self esteem, and hygiene problems.

Every time we do a training I come to understand the Restorative Approach more deeply.

©2006 The Restorative Approach is a servicemark of the Klingberg Family Centers, Inc.

How Should We Respond to Harmful Actions?

If we are not using time-based restrictions, isolation, and loss of privileges when the child acts out, what should we do?

When children do something that hurts others, the adult response is two-fold: the tasks given to the child as “consequences” should provide an opportunity to make amends, and they should provide teaching of skills that will help the child avoid similar problems in the future.

How can a child who has assaulted a staff and damaged property make amends? There are many possibilities. He can do something for that staff: write an apology, talk over what was going on, make him a picture, write and sing him a song, pick him a bouquet of flowers. He can make popcorn for all the kids on the unit to pay back for the disruption he caused. He can help fix the property he damaged.

How can a child who has had a fight with a peer learn skills to avoid future fights? She can be assigned practice in getting along, like playing a game positively for half an hour. She can role-play a relationship problem with a staff. She can interview three people and find out how they handle it when a friend lets them down.

The theme here is that instead of “doing time” the child is learning skills and reconnecting with people.

What's Wrong with Points and Levels?

Almost all group treatment programs for children use points and level systems. These systems started as a good thing, an attempt to make concrete for the kids the concept that if you do better you get more profiled and responsibility. (This is sometimes, but not always, true in life.) However, the systems grow, multiply and become more complex. They actually interfere with relationships between children and adults. For one thing, the point system becomes the language people use to speak to each other- asking "how many points did you earn today" instead of "how are you?" Adults react to things children say and do with threats of the potential consequences, rather than with curiosity and empathy. Adults spend a lot of time filling out point cards when they could be interacting with kids. One advantage claimed for such systems is that they are consistent across staff, but any child in a program can tell you that isn't true, and tell you which staff is more lenient or generous with points. And they are often inaccurate as busy staff try to fill out cards hours after the time period has passed. Many restraints start over a power struggle that begins with a child losing (or not earning) one point, and then feeling that their entire day, and in fact the entire self, is ruined and useless. So, what started as an admirable attempt to organize rewards and punishments has grown to interfere with relationships, change and growth.

Use of Self

The use of self is central to a relationship based approach. Staff and therapists speak from their hearts. Instead of saying "If you run away you will be restricted for a week and lose your privileges" staff will say "if you run away I will be scared, I will worry about your safety. I will have to keep you closer to me because our trust will be broken". Staff is encouraged to evaluate their work by what they do, not by what the kids do. We utilize The Attitude, described by Daniel Hughes in Building the Bonds of Attachment (http://danielahughes.homestead.com/). The elements of The Attitude are: Playful, Loving, Accepting, Curious and Empathetic. PLACE. Staff explore what these elements mean to them, which are easier, which harder. Any day in which staff have approached the children with the Attitude is a successful day. It is up to the adults to structure an environment around the children which maximizes their chance for success: organized, predictable, reliable, calm.
Developing related teams is essential every effort is made to nurture teams in which people can talk freely about their own reactions to the children, and can challenge each other. If one team member seems caught in a power struggle or stressed out, another team member will tag them out and take over for a while. It is considered a strength for a team member to say they know they have lost their sense of what to do and ask for help. This type of team work is enhanced through meetings, retreats, parties, recognition events, staff recognition boxes which are read out weekly, and individual and group supervision.
We can only relate to the kids as well as we relate to each other. Or, to quote a phrase I heard at a training once: if you don't feed the caretakers they will eat the children.

Theory of Change

In creating this new approach to treatment, we had to consider our theory of change. Why do people change? What helps us to change when we notice something in our lives that we wish to improve? What inspires us to achieve, to do well at our jobs, to further our education, to live as responsible members of society? Motivations are many and complex, and include fear of punishment, monetary and other material rewards, etc. However, the basic tenet of this approach is that relationships provide the strongest motivation to people.

Relationships include wanting to please some one, not wanting to not let someone down, feeling warmed by another person’s caring, looking forward to bringing an achievement to the attention of another ("Watch this, mom!").

The restorative approach concentrates on the relationship effects of behavior. What behaviors bring you closer to another; earn you the respect of your community? What behaviors hurt and alienate others and distance you from your community? When you have hurt others, how can you make amends?

If we believe that relationships are our strongest tool in creating change, then everything we do should be informed by our understanding of what will strengthen relationships.

©2006 The Restorative Approach is a servicemark of the Klingberg Family Centers, Inc.

Restorative Approach (sm)

I am a social worker who is currently a Vice President of a large child welfare agency in New Britain, CT. Klingberg Family Centers (http://www.klingberg.org/). We are pioneering a newly developed, trauma informed approach to congregate care of children with serious emotional disorders. Many of the children we treat have suffered early trauma- physical and sexual abuse, domestic violence, multiple moves- within their biological families. Then when they enter the child welfare system they often suffer more abuse, and experience many more moves. They present to us with serious problems of aggression, suicidality, self harm, property destruction, and unsafe choices. We are a highly clinical program, and we treat the children in our state with the most serious difficulties. We used to use a traditional points-and-levels approach in our congregate care programs (residential, acute residential, extended day after school treatment, special ed therapeutic school). But we found that these approaches were not working, and also were not transferable to a home setting.
We have learned a lot about trauma and about attachment, and have been influenced by the work of Daniel Hughes (especially Building the Bonds of Attachment, a wonderful book), Jon G. Allen and Judith Herman.
We have been trained using the Risking Connection trauma based training curriculum (http://www.riskingconnection.com/) and are now involved in delivering this training.
So, we have invented and are using the Restorative Approach.

What is the restorative approach to treatment? The basic tenet of this approach is that relationships provide the strongest motivation to people. The restorative approach concentrates on the relationship effects of behavior.

This approach emphasizes the importance of shame. Most of our children have been seriously abused, which they have felt is their own fault. Therefore they are shame based: completely sure in their hearts that they are no good worthless people. Any set back reaffirms this basic belief. Punishment that includes isolation and public humiliation further reinforces this internal certainty.Therefore, the first step in the restorative approach is to understand that it is our job to form a relationship with every child and family we treat. It is our responsibility to reach out to them to find the good in them, to learn about them.

Then, when they do something that hurts others, the approach of the consequences is two-fold: the consequences should provide an opportunity to make amends, and they should provide teaching of skills that will help the child avoid similar problems in the future.

The theme here is that instead of "doing time" the child is learning skills and reconnecting with people.

If a child has injured or had difficulty with a particular staff, that staff should be central in establishing and working through the restorative work.

Because the restorative approach requires more flexibility and creativity of the part of the staff, it also demands a high degree of self-awareness, and the ability of a team to talk honestly with each other. Each child does NOT have to receive the same response for the same action. We should not hold consistency (in the sense of sameness) as our goal. Instead, we should be consistent in our values and our purpose. The response to each child and each instance of misbehavior will consistently be personalized, related to their goals and what they need to learn.

In addition it is important for staff to recognize and discuss with others their own thoughts and feelings about the child, how these get triggered in many ways, their own concept of justice (related to their early parenting) etc.

A restorative approach offers hope for a more healing environment, and a more meaningful experience for both staff and children. It is also more transferable to the outside world, where levels and points do not exist. A restorative approach restores our focus to the most important and powerful aspects of our work with the children and each other, which are our mutual and respectful caring relationships.

I hope to write more about this approach, our use of it and our thinking about it in this blog.

©2006 The Restorative Approach is a servicemark of the Klingberg Family Centers, Inc.