The Real World

I have not written anything in this blog for a while because I have been working on a SAMHSA grant application that has demanded every bit of free time and writing energy I could dredge up.

However, in a Risking Connection® training we were doing recently, a participant made the familiar objection: "we are not preparing these kids for the Real World". I’ve heard this a lot. The idea is that if we do not punish the kids for their behaviors they will never learn that these behaviors are not tolerated in the Real World- we are coddling them, spoiling them, and giving them an unrealistic view of life.

Consider the following analogy:
My 8 year old friend Ryan is in Instructional Little League this year. In this league the kids get five strikes, some times more if the coaches decide that the ball throwing machine isn’t working right. Everyone always says encouraging things to them: "good swing Cameron" (Ryan's team has three kids named Cameron, two girls and a boy) for a strike; "nice try" for a throw to a completely unpredicted part of the field. And the coaches constantly teach the kids skills: move your foot up a little. Keep your eye on the ball. Move your body to catch the ball, don’t just stretch. Every thing the kids do that is even remotely in the direction of what they are supposed to do is highly praised. They can only run two bases (otherwise everyone would get a home run every time, as no one ever catches the ball) and the innings are over when a team gets 5 runs. Obviously, the idea here is to begin teaching the kids the skills, and to limit the humiliation/ disappointment/ frustration they feel so they will want to play again. The game is set up to encourage success and limit damage.

And no one ever says: "we aren’t preparing these kids for the Real World if we give them special treatment like this".

Maybe we can consider our treatment centers to be instructional real life.

In the actual Real World ideas of Restorative Justice are gaining ground, and many more court systems are using them.

I would also hope, however, that the Real World that our kids live in will contain (as mine does) people willing to negotiate, and flexibility, and understanding. I hope that they will not in fact be punished for everything they do wrong (luckily, I am not). When they hurt someone, I hope they will have a chance to make up for it and heal the relationship. I hope that their Real Worlds will not be characterized by unremitting harshness.

In the mean time, maybe we can continue with the Instructional level and teach them skills, encourage them, and limit the damage so they will want to continue to play.

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Just Ask What’s the Matter

I want to remind you that there is a major way you can implement trauma informed care without needing any committees, any program change, and without eliminating your points and levels system.

When a kid is upset, ask them what is the matter.

Don’t talk about consequences. Don’t talk about better ways they could be handling it. Don’t try to get them to take responsibility for their actions.

When you ask, be prepared that their response will be about something that someone has done wrong at your "stupid place" (that’s if they are putting it mildly). Don’t argue. Don’t tell them why the person was right to do what they did- even though you know they were.

Paraphrase what the kid said: so you are very angry about being sent up from school? It doesn’t seem fair to you? You can add an element of the possibility of change by introducing such phrases as: "Right now" as in: "right now you don’t like any thing about this place?" or "at the moment it seems impossible that you will ever have any friends?"

Emphasize any feelings they impart, especially any besides anger: you are discouraged, you are sad, you are frustrated, you were hurt.

Ask what else is upsetting them?

Stay for as long as you possibly can at the exploring and paraphrasing stage. No suggestions of how they could have handled it better, no mention of consequences that will happen, no taking responsibility for their action, just explore what are they upset about.

During all this keep your breathing slow, your voice calm, yourself regulated.

And this takes patience. You may have to keep doing this for a long time.

And then when (and only when) you notice some de-escalation on their part, some slowing of breath, and reduction of yelling, willingness to talk, then start considering: so where can we go from here? The kid is upset and wants this, the adults think this is necessary, how can we go forward? Where ever you can compromise, be creative, use unique solutions, do so.

At this point also slip in some discussion of other, non-problem related things: how the room floor is hard, how its cold in here, how you remember they had their basketball game yesterday, how did it go- chit chat. If the child is really much calmer, some humor can often help.

Once the child has regained some sort of regulation, you will often be surprised how easily the next steps can be figured out.

Try this today.

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Recent Conference Presentations

I have just returned from presenting at the Black Administrators in Child Welfare Conference in Baltimore and at the Child Welfare League of America Conference in Washington, DC.

At BACW I was struck by the power of inspirational stories and of invoking past heroes and heroines to create courage for the current struggle. Presenters repeatedly told their own and others’ stories of triumph after trauma, prejudice and adversity. Heroes such as Rose Parks, Sojourner Truth, and Martin Luther King were called forth to bring energy to current problems. How can we use these methods more in our own agencies, and in our own change efforts? All of us in this field know inspirational stories of kids and families who have changed, programs that have been transformed, and treatment that has been effective. Many agencies have their own founding heroes and heroines. While we do turn to these rich legacies for help, I felt after attending this conference that we could do so more and with greater emphasis. Also, in this conference I experienced more acknowledgment of the struggle of this work, and the need to comfort and care for each other.

In my presentation I referred to the kids we treat as "damaged". Joanne V. Rhone, Ph.D., Professor at Clark Atlanta University suggested I would be better served by referring to them as "wounded" because as we know, wounds can heal. Damage, she stated, sounds more permanent and unchangeable. I thought this was an excellent point and will adapt my language in the future.

I attended a workshop on "Working Between Circles & Lines: Using the Restorative Circles Process to Create Effective Collaborative-An African Centered Construct for Organizational Prosperity". This workshop includes an introduction to Restorative Justice as a best practice in Child Welfare and how to use it to create paradigm shifts in organizational culture and practice. Restorative Justice is a set of values that guide decisions on policy, programs and practice. The Circles process restores the collaborative effort of agencies working together for the greater good. It was led by Saleem Hylton, CEO, President; K. Ivy Hylton, MSW, LICSW, Youth & Families in Crisis, LLC, Washington, DC They described and demonstrated the power of a Circle to bring people together and hold meaningful discussion. They gave examples of the use of this circle in creating agency collaborations, as well as in offender/victim encounters. I hope to utilize this technique further.

I also purchased two useful small books: The Little Book of Restorative Justice (Little Books of Justice & Peacebuilding Series) by Howard Zehr and The Little Book of Restorative Discipline for Schools: Teaching Responsibility; Creating Caring Climates (Little Books of Justice and Peacebuilding) by Lorraine Stutzman Amstutz and Judy H. Mullet. Both have clear explanations and many practical implementation ideas.

At my presentation at CWLA I had participants from all over the country, and it was very interesting to experience this national change in treatment approach. Many agencies are starting to implement trauma informed treatment and to move away from point and level systems. One agency expressed concern about whether such a change led to longer lengths of stay. Others talked about child care workers indoctrinating each other to "be tough" and not show feelings. It was clearly helpful to connect with others doing this work, and reinforced my hope to start more email net works and communication mechanisms.

Altogether it was a very interesting and inspiring trip.

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Upcoming Conference Presentations

Is any one attending either the Black Administrators in Child Welfare (in Baltimore) or the Child Welfare of America (in Washington D.C.) conferences next week? I am presenting at both and would love to see you there. If you read this blog, please introduce yourself to me at the conferences.

My workshops are:

BACW
Friday afternoon
C-4 Creating a Culture of Connection in Residential Treatment

This workshop explores the transformation of a Residential Treatment Center into a trauma-informed, relationship-based treatment program. It explains the Restorative
Approach theory of change, new language used, specific treatment techniques and response to acting-out behaviors. The Risking Connection Curriculum-trauma framework, therapeutic relationships, counter-transference and vicarious
traumatization-will be introduced.
Moderator: Dr. Sharlyn Bobo, Washington, DC
Presenters: Patricia D. Wilcox, Vice President of Strategic Development; T’Kai Howard, Coordinator, Nia Sage House, Klingberg Family Centers, New Britain, CT


CWLA
Tuesday morning
C11 Creating a Culture of Connection in Residential Treatment
This presentation explores the transformation of a residential treatment center into a trauma-informed, relationship-based treatment program. It explains the restorative approach theory of change, the new language used, specific treatment techniques, and the response to acting-out behaviors and it introduces the Risking Connection Curriculum. Presenter: Patricia Wilcox, Vice President of Strategic Development, Klingberg Family Centers, New Britain, CT

Hope to meet you there!

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A Wonderful Example of a RICH Interaction

I am in the midst of a Risking Connection training with two co-trainers, Michele May LCSW and Richard Nicastro, Ph.D. Michele is the Clinical Director of Natchaug Hospital’s Journey House Program. Richard is a therapist specializing in trauma with offices in Glastonbury, CT. He is also a life coach, and his blog can be found at http://www.relationshiptuneup.typepad.com/

Richard gave a wonderful example of how even a brief interaction can be RICH.

A few years ago Richard was running an anger management group for boys at a local community center. He noticed that one boy was standing near by imitating his movements and mocking him. After the group, Richard went up to the boy and say: "You know, I am looking for some new members for this group, so if you or any one you know would like to join I’d welcome new people. But you know what, I am looking for someone who is a real wise-ass, because we need some humor in this group. Even though we deal with some serious topics we need some comic relief and I’d like someone like that in the group. So, if you know any one..."

The boy did not join the group, and in fact Richard didn’t see him again for over a year. He learned from others that the boy had been in a lot of trouble and a lot of programs, and that since he was young he had been living with his father’s serious illness and constant near death.

Much later someone called Richard with a referral of an adolescent boy whose father had just died. Richard accepted the referral and was astonished to find the same boy in his waiting room. It seems that when the boy needed to go to therapy he remembered Richard’s name and asked if he could see him.

Think how completely Richard displayed a RICH relationship in those few minutes. He demonstrated Respect for the boy in his approach, and in his assumption that a sense of humor could be an asset. He gave Information: the group is available, you could join, and you could help others. He established Connection (more than he realized) by appreciating the boy and his skills. And he conveyed to the boy the Hope that there is some one out there who wouldn’t judge or dismiss him, who might see the good in him and who maybe could really help.

And look at the power that one moment of RICH interaction can have in someone’s life.

Many thanks to Richard for this excellent example.

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Asking Directly for What We Want

Asking directly for what we want is very difficult.

First of all you have to know what you want. That is not always easy. It involves noticing your own distress or need, and correctly diagnosing a possible solution. Many times we feel vaguely unhappy or sad and have no idea what would help.

Then, you have to have in your heart the concept of needs being met, the possibility of improvement. You have to have some experience of feeling bad, then feeling better. When you need help, some times people help you.

And which people would that be? You have to have people you can trust around to receive your requests. You have to experience them being willing, pleasant, and regularly saying yes to you. Your experience must also be that they are gracious and generous about helping you, and do not extract a high price.

Also, to ask for help you have to feel enough okay about your self that you can handle not being perfect. I need help, I cannot manage everything myself, but I am a good enough person over all. I actually deserve help. I help others.

That deserving is a big thing. You have to think there is some reason that some one would actually be willing to do something for you.

Asking for help directly makes you vulnerable. The other person could say no. They could make fun of you. By telling them what you need you are showing how they could hurt you.

I know a lot of very competent people (especially women) who cannot ask for help. I know many professionals that have trouble delegating and work from an "I-can-do-everything-myself" stance. I know women who take on every responsibility in their family, and men who can’t share worries about work. I know a man who overwhelms his friends by doing things for them until they become annoyed, because he can’t imagine they would like him unless he "bought" their friendship. I myself often have difficulty asking for and accepting help.

When we work with treatment systems we try to teach staff willingness to step back from an interaction with a kid and accept help from a peer when you are stuck. People say that this is hard. Harder still is identifying the kid you are struggling with and asking the team members to help you figure out what is going on for you and thus do better treatment with that kid.

So...

When we focus with our kids on "asking appropriately" we are demanding a very high level of functioning, maybe more than we ourselves can do. How many times have I heard a staff saying "you didn’t ask appropriately" or "she is only doing that for attention". Manipulation, as we have seen, is the essence of asking indirectly and dishonestly for what one needs.

If we believe that symptoms are adaptations and solve a problem, we cannot wait until our kids can "ask appropriately" to meet their needs. None of the above conditions have been true in their lives. Instead, we have to guess and use observation and trial and error to figure out what their needs are. Then we have to meet them. We have to volunteer help, give graciously and generously to them as best we can. Then, maybe, after much time, they can relax, trust, and feel safe enough to ask for what they need.

Maybe even appropriately.

And maybe if we also create environments in which we can relax, trust and feel safe, we can also learn to ask for and accept help from each other.

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Non Profit Blog Exchange

I am writing as part of the Non-Profit Blog Exchange, a method of connecting the non-profit blogging world and further spreading our work. The blog I am reviewing is Marion Conways’ Consultant to Non Profits Blog, at http://marionconwaynonprofitconsultant.blogspot.com/. This blog covers many aspects of non-profit leadership, including fundraising, finding volunteers, on line donations, promoting your web site, and Board responsibilities. I recommend it because it contains information that is helpful across many types of non-profits. It is very interesting to learn skills from say, museums, and apply them to behavioral health. It helps us identify the commonalities in our struggles. Marion offers very useful help for non-profits of all kinds.

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