Sunday, September 16, 2012

It Ain't Easy Being RICH- Hope


Anyone 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 fourth week I will focus on Hope.

Hope is the foundation on which all the other qualities rest. In the dictionary hope is defined as: “to cherish a desire with anticipation;” “to desire with expectation of obtainment;” and “the feeling that what is wanted can be had or that events will turn out for the best.”
I previously posted on Hope on 4/15/12. The focus of that post was the ways that a RICH relationship in itself creates hope, independently of the external reality.
Not surprisingly, the Risking Connection curriculum (Saakvitne, K., Pearlman, L., Gamble, S., & Lev, B. (2000). Risking connection: A training curriculum for working with survivors of childhood abuse. Lutherville, MD: Sidran) has quite a bit to say on hope. The authors maintain that holding hope is a key responsibility of the therapist. Our clients come to us hopeless, and they often experience setbacks that discourage them further. Meanwhile, we are doing this difficult work in the middle of an ineffective and inadequate child welfare system. So, it is possible for both the treater and the client to become hopeless. It is the treater’s responsibility to take care of him/herself and do whatever is needed to fight vicarious trauma in order to maintain hope. The treater’s job is to “Hold onto vision of the survivor’s potential future self,” and to “serve as trustees for the survivor’s future possibilities.” (RC pp.15-16) The treater is at her best when she can see clearly the client healed, living a productive life. The treater must maintain the tension between seeing that version of the client’s potential and also seeing the current reality of the client. The authors ask us to direct our attention to evidence of hope and resiliency in our client’s stories. When presenting or discussing a case, talk about strengths in a real rather than pro forma way. They also point out that hope is fueled by compassion for our clients. If we understand the adaptive nature of their symptoms, we feel less exasperated and less personally attacked. In other words, having a theory, a road map, that helps you understand the behavior and plan your next treatment intervention creates hope that counteracts the bewilderment and discouragement we usually feel in the face of extreme behaviors.

What is the meaning we ascribe to our client’s behaviors? When Aisha ran away and became involved in dangerous situations, Louis reacted: “How can she be so stupid! We have explained a thousand times that she is putting herself at risk. In fact, I just had a great talk with her last night about this! I told her how worried I was about her when she put herself in such danger. She told me she understood and would not run away again, and she thanked me for spending time with her. I guess she was just manipulating me to be able to stay up longer. She doesn’t care about me or anyone else. She doesn’t even want to get better. She’ll probably end up being kicked out of here just like our last two clients. Sometimes I wonder why we even bother.”
Mario was also affected by Aisha’s running away. He said: “I am so scared for Aisha. She still doesn’t value herself enough to keep herself safe. And we haven’t yet been able to teach her an alternative to running, or to make her safe enough to try it. I wonder if we set up a place on grounds where she could run and stay until she calmed down enough to come back if that would help her. And when I think of it, I realize that Aisha has been forming some close connections with both me and Louis. I wonder if that is scary to her, especially since we are guys? I’m going to talk to Tracy, her therapist, about that, and bring it to team. I don’t  know what we should do differently but maybe there is something. Aisha is so bright and has so much spunk. I know she has a great future if we can just find a way to get her there.”
The enemy of hope is vicarious traumatization (VT). Since it is the treater’s responsibility to maintain hope, it is essential that we combat this aspect of VT specifically. Some strategies, largely taken from the Ricking Connection curriculum, include:
·         Challenging negative thoughts and looking for evidence of resiliency
·         Celebrating all kinds of successes
·         Collaboration with others, within our agency, outside, and even outside our treatment community. For example, when a local business joins us and gives backpacks to all the students returning to school, it helps to know that there are others outside our world who care.
·         Noticing the advances in understanding trauma and in treatment that are being discovered through science and new technology.
·         Appreciating the gifts of the consumer movement.
·         Cultivating our spirituality, whatever that may be
·         Look for meaning and inspiration in everyday events and in natural beauty
·         Seeking and embracing the personal transformation that comes with this work. How has this job, and being involved with these clients, changed you for the better? What have you learned from them? In what ways have you grown?
There are also many ways the agency can help workers fight VT and remain hopeful- another time, another post.

Hope is an essential element of every moment of our work. In fact, our work defines hope- we embody a conviction that people can heal and change. We have seen it happen many times.  As we are presented with each new scared, snarly, obnoxious, difficult client it is our job to shine with the hope of all that they can become.

 

 

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