Long post- please read and comment.
I would like to write about the way my thinking has changed
over time about what we like to call “behavior management”, I am referring to
treatment programs in which, in addition to providing treatment, staff have to
respond to behavior that hurts others. The idea hopefully is that we respond in
a way that helps the youth decrease such behaviors. This applies to any group
care program, such as a hospital, a residential, a day program, a special ed
school, an after school program…in short, many programs.
First of all, I wonder if we could invent another term. What
could we call our attempt to change behavior in the day-to-day setting:
behavior support? Learning to be kinder? Any thoughts?
Anyway, once upon a time I worked in a traditional points
and levels residential treatment program. In fact, when I first got there it
had points, level, phases, and many punishments. The most severe was called
“Sub” level because it was below all the other levels. As I recall it involved
spending days in a small room without stimulation. The kids were supposed to be
thinking about what they did wrong and how they could do better. They weren’t.
I began to have thoughts about this being a bad plan. One of
many issues was that when one kid hurt another kid, the victim looked to staff
to punish the hurter. No learning what so ever about how to work things out
with each other. And we were punishing the kids by ordering them to do things
they couldn’t do, like stay in their room quietly for hours. When they popped out
trying to re-engage staff, we would order them back in and restart their time.
It was the whack-a-mole method of discipline.
We were telling the kids what not to do, but we were not
teaching them what to do instead. We struggled to consider things like the
function of behavior.
Even in those dark ages, we had wonderful staff who cared
about the kids and who formed strong relationships with them. But this was
harder when you had to rate their points every half an hour, which took quite a
bit of time. And like every place else, we had our own elaborate jargon, which
the kids picked up quickly. The behavior management system became the way we
talked. Instead of asking “how was your day?” we asked “How many points did you
earn today?” When a child became agitated, staff would often react by telling
them the consequences that would occur if they kept that up or got worse. They
would not ask what was going on. We were embarrassed when we told an outside
consultant that our kids earned up to 180 points in school, and he said “You do
know that Marcus can only count to 8?” Consistency was highly praised, although
rarely achieved. There was no room for individualization.
My colleague Leeora Netter and I, as well as some other Klingberg
staff, began to learn about attachment and trauma. We discovered and learned
from Daniel Hughes. We knew that what we were doing was not sufficiently
healing. And yet everyone was doing some version of the same thing. We had no
idea what to do instead.
A neighboring treatment center, Wellspring in Bethlehem CT
gave us our first glimpses of alternatives. They gave us ideas as to how to
include making amends and learning skills into our responses. They served a
different population, so we had to modify their methods, but they were invaluable
in getting us started.
So, we began to invent a system that responded to behavior
that hurt others in a new way. We wanted to incorporate the concept of making
amends from the Restorative Justice movement. We wanted to include skill
building, and incorporate an understanding that the kids were doing these
things for a reason. In the lives of the clients there had been trauma,
attachment disruptions, and neglect and we wanted to understand how that
history influenced current actions. We felt our responses had to be
individualized. We tried to get away from time-based restrictions and move
towards restrictions that ended when a child had made amends and was
cooperating with the program. We called our new system the Restorative
Approach©.
This was a hard sell. Staff were sure that chaos would break
out as soon as we lifted long punishments.
I made a huge book of worksheets and tasks, organized by
type and origin of problems. We needed concrete tasks to replace our
punishments. This led to kids basically being sent to their rooms to do
worksheets. They were allowed to “work off” their earned punishment time by
doing tasks. But the tasks had to take as long as the punishment would have. I
began to see that the tasks were being used as punishments in disguise. Staff
without realizing it believed that the tasks would work by being aversive, the
way punishments do. That was not how it is supposed to be.
We were lucky enough to encounter the Risking Connectionâ foundational trauma
training. This gave us the language and theory that we needed behind the
Restorative Approach. I now believe that it is very hard if not impossible to
implement a new way of acting in the day-to-day program without extensive
teaching of theory. It is hard enough to make this change. Without changing how
you understand the behavior, it is impossible.
Later we became a training center for Risking Connection.
Gradually this way of thinking made more and more inroads into our daily life.
There were so many ups and downs- but that is another story. But mostly when I
heard a kid yelling in the front hall I would NOT hear someone say “you are
earning out of bounds time and won’t be able to…” Instead I would hear them
say:”What’s wrong?”
So at this point I was advocating that when a youth did
something that hurt others, we assign them a restorative task. I suggested that
the task contain two elements. One was the learning element. This was supposed
to help them explore anything about the behavior, with the idea of helping them
learn not to do it again. I had a lot of ideas for this, from research, to role
plays, to interviewing others how they handle similar dilemmas, etc. The second
part was the making amends part. That involved figuring out whose life they had
made more difficult and do something to make their life easier. Here, too, we
had a list of suggestions. The underlying idea of making amends was to teach
the youth that if they hurt a relationship, it could be mended. They did not
have to give up.
It is important that the response should arise from the case
formulation. What had happened to this child? How did we understand his current
behavior? What did we think was needed in order for him to change? And
furthermore, that the response had to be individualized, based on each child’s
needs and abilities.
As I trained treatment centers and people began to implement
the Restorative Approach, some problems began to emerge. Most people saw the
tasks as punishments in disguise. The kids would get task after task, and end
up feeling as hopeless as they did with previous punishing systems. People
often assigned tasks in a perfunctory way, using standard worksheets that had
no relation to the child or her actions, or having everyone make a card for the
person they hurt and apologize. The idea of the tasks having meaning was being
lost.
Then, in a conference, I experienced an a-ha moment. After I
presented on the Restorative Approach, a woman asked for my help. She said: “We
have a girl in our program, Andrea, who is incredibly mean to others. She
always says just the perfect thing to really hurt someone’s feelings. We don’t
know what kind of Restorative Tasks to give her. We assigned her to research
Martin Luther King Jr. and do an essay about him, because we thought he would
be a good model for her. She did a very nice job on the essay. But she is just
as mean as ever.”
That made me stop and think. We have to go back to our
theory of behavior and our theory of change. Why do we think that Andrea is
being mean to others? I don’t know her, but I will guess that it is because she
feels horrible about herself, and wants to share that with others; and that
people have always hurt her, she has not had any good friends, and so she has
developed a self-protective strategy to strike first.
So what does this essay about Martin Luther King Jr. do for Andrea?
This is exactly the sort of intervention I had been recommending, but I now
feel that it misses the point. The essay teaches her that there are people who
are good to others, and they can have a profound influence. But if Andrea takes
this in at all, I doubt that she relates it to herself. If anything, it would
probably be: “I wish I were a good person like Martin Luther King, but instead
I am a rotten nasty person.”
Now I feel that our intervention has to be more complicated.
If we have a theory that Andrea is being mean to others because people have
been mean to her; is hurting others because she has been repeatedly hurt; is
protecting herself from further pain, and is sure she cannot ever have real
friends, what would the antidote be? It would be to be good to Andrea, to help
her discover her own worth, to support her in positive friendships, and to give
her experiences that show her (with repetition over time) that people can be
kind.
What! My audience would say. Respond to her meanness with
kindness? How is she ever going to know that you can’t just do this in the real
world? She will get beaten up if she continues to act like this. When will she
being to take responsibility for her behaviors?
Not only is this new thinking counter-intuitive, it is
harder. Andrea would have to learn skills, and we would have to teach them to
her. How do you make a friend? What can you say to people that isn’t mean? What
is she good at, in which she can lead or teach others?
So am I saying that we ignore her meanness? Sometimes that
might be a good idea. But when possible people can also speak from their hearts
and say “that hurt my feelings, Andrea. I am much happier when we are having
fun together so do you want to go for a walk?” Andrea’s mean comments are a
sign that she is dysregulated, that she is scared. If adults can move closer to
her at these times, be more affectionate, they will help her learn to regulate
her emotions and not spiral far into her fear.
Another evolution in my thinking is coming to see fear
everywhere. When our kids attack, insult, damage property, run away, they are
afraid. They are confused and overwhelmed. They have no feelings management
skills or trusted relationships to help manage their feelings. So they fall
into deep pits of hopelessness. These symptoms are their way to climb out.
Another a-ha moment came when I was training at an agency,
and during a kids pickup basketball game one boy was taunting another. The
victim hit the taunter. (I wrote about this incident on 7/2/11.) The men in my
training came up with ways they would handle this without hitting, and all
agreed that in order to do so, one would have to have confidence. You would
have to be sure that these insults were not necessarily true and didn’t
represent the views of the entire world. How do we give our boys (and girls)
the confidence these men have? Not by confining them to their rooms, and not,
unfortunately, by having them write essays.
I came up with some questions to ask after an incident:
1.
What led up to the incident?
2.
What do we imagine the child was feeling?
3.
What do we want the child to do when he or she
is feeling this way?
4.
What skills, knowledge, attitudes, beliefs…would
the child have to have to act that way?
5.
How can we assist the child to take one small
step towards acquiring what he or she needs?
So I was already getting too radical as I began to see
punishment as largely irrelevant. Then I became involved in studying Bruce
Perry’s new work on the developmental evolution of the brain. The most
important part for me was the idea that for kids with early preverbal trauma,
words didn’t reach the problems. Now I was starting to doubt the efficacy of
verbal therapy, at least for some of our most damaged kids. Instead, I began
advocating positive rhythmic play with an engaged happy adult. The template of
relationships is also stored pre-verbally. So, if we engage in rewarding,
repetitive play with our kids, we can reach both the reorganization of the body
and the reprogramming of the relationship template.
What? These kids are so wild and crazy, so aggressive and
destructive, and you want us to have fun with them?
I began to think that the most important job we have is to
reprogram the relationship template. I draw on the words of my friend Martha
Holden- the child care worker’s most important job is to make sure than child
has a wonderful day. If what is practiced grows, should we help our kids to
practice being happy? What if we believe that everyone, all of us, act better
when we feel better- safer, more connected, more effective? Many agree with
that statement but we do not act that way in our programs.
So now I am balancing at the extreme ends of these two
continuums:
Do you think that most misbehavior is related to disrespect,
disobedience, manipulation, selfishness….. or that it is related to fear, hopelessness,
overwhelm and despair?
What do you think will be most likely to reduce hurtful behavior:
is it rules, punishments, rewards, lectures…. Or is it love, fun, safety, and belonging?
You might think these answers are obvious, but our day-to-day
actions show otherwise. And as my thinking evolves I am worried that people might
think I am a bit nuts. Oh well there is no going back now. I would love to know your thoughts on this journey
and where you are. Just click “comments”……. Thank you.
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