Services for Juveniles in Nebraska Changes?

An article in the Lincoln Journal Star on January 24, 2013 caught my eye. The title of the article was “Juvenile justice system overhaul is proposed”. Senators Brad Ashford and Bob Krist of Omaha and Kathy Campbell and Amanda McGill of Lincoln co-sponsored a bill (LB561) which would reorganize the juvenile justice system to focus on mental health treatment instead of punishment. They propose closing the centers at Kearney and Geneva and move to a treatment based system. Senator Ashford reported that 70% of the children in the juvenile justice system have a history of physical abuse and 40% of the girls have a history of sexual abuse. He also states that 70% of the juveniles in the juvenile justice system have a major mental illness which is undiagnosed, untreated or inappropriately treated. Senator Ashford is quoted as saying “Trauma in these children is not systematically screened or treated. We reap what we sow.” He also stated “Children who end up in the juvenile justice system were victims long before they became offenders.”  I think that it is great that the senators have realized that there are youth in Kearney and Geneva who are in need of mental health services. Perhaps if they had received the services they needed, they may not have ended up in the juvenile justice system. Many times children who have been traumatized demonstrate acting out behaviors (defiant to authority figures, anger outbursts and may have an excessive need for control). If they do not receive treatment, their behaviors may escalate to the point that they end up in the juvenile justice system. It will be interesting to follow this bill and see what, if anything, changes.

Laurie Patton

More About Validation

 

One of the factors contributing to the development of borderline personality is living in an invalidating environment during childhood.   Growing up in a home where you are told what you think and feel rather than being allowed to think and feel for yourself.  An all too common example is “stop crying or I’ll give you something to cry about.” You can probably think of other parental statements that communicate that what the child experiences is unacceptable.  These have the effect of undermining a child’s ability identify what they do think, feel, want, fear.   This can create big problems that last into adulthood. 

The alternative is a validating parenting approach in which the child is told “I know that you want that”, I understand that you don’t want to go to bed”, “I can see that you feel sad”, “that makes you angry”.  This does not mean that you agree with the child or allow the child to do harmful things.  It does not impair your ability to discipline or direct.  It does communicate to the child that she is heard and that she is a person who has feelings, wants and preferences.  This is essential learning for children.

Bill

Mindfulness and Marines

 

On Sunday I read an article in the local newspaper that described mindfullness experiments that are being conducted by the Marine Corps.  A goal is understanding the differences in stress responses between groups of Marines trained in mindfulness techniques and those of a control group not trained in the techniques.  The article also addressed the misunderstanding that mindfulness training includes a religious element.  This mistaken belief has kept some people from learning this valuable information.

I have been very impressed with the usefulness of mindfulness in psychotherapy since learning about Dialectical Behavior Therapy (DBT) many years ago.  The work of Jon Kabat-Zinn in researching mindfulness at the University of Massachusetts Medical School has also been important.    I recommend his books, especially Coming To Our Senses.    

Bill

Recovery Bill of Rights Part 4

A Recovery Bill of Rights for Trauma Survivors Part 4

For safety in your personal dependency in therapy you have the right to…

Hire a therapist or counselor as coach, not boss, of your recovery.

Receive expert and faithful assistance in healing from your therapist.

Know that your therapist will never have any other relationship with you – business, social, or sexual.

Be secure against any disclosure by your therapist, except with your consent or under court order.

Hold your therapist’s undivided loyalty in relation to all abusers.

Obtain informative answers to questions about your condition, your therapist’s qualifications, and any proposed treatment.

Have your safety given priority by your therapist, to the point of readiness to use all lawful means to neutralize an imminent threat to your life or that of someone else.

Receive a commitment from your therapist that is not conditional on your “good behavior” (habitual crime and endangerment excepted).

Make clear and reliable agreements about the times of sessions and of you therapist’s availability.

Telephone your therapist between scheduled sessions, in urgent need, and receive a return call within a reasonable time.

Be taught skills that lessen the risk of re-traumatization:

                Containment (boundaries for recovery work);

                Control of attention and mental imagery;

                Systematic relaxation.

Enjoy reasonable physical comfort during sessions.

 

This concludes the Bill of Rights for Trauma Survivors series.  I welcome any responses or reactions that you would like to share.

 

Bill

Crisis Managemet Questions

The Three “What” Questions of Crisis Management

I recently attended a meeting of Mental Health care providers who provide parenting classes for divorcing couples with children. During the meeting, one of the participants shared one of the tools that she uses to help the parents conceptualize how to manage the stress of “crisis” moments. She called it one of the principles of “Reflective Practice,” and to think of it as the most important three “what” questions to ask yourself when something distressing occurs. Specifically, the three questions are: “WHAT happened?”; “So WHAT?”; and “WHAT now?” 

WHAT HAPPENED? This refers to an honest, objective assessment of the event without adding value judgment or other extraneous thoughts about it. Not minimizing or catastrophizing about the event, but describing it realistically. For example, if there has been an accident, describe it. Describe injuries if they occurred. If there has been a fight or disagreement, just describe it. What happened, who did what to whom? Stick to the facts. 

SO WHAT? This refers to the actual consequences of the event, not how you feel about it. If you had an argument with someone and the two of you are not talking, describe it. Refrain from using energy thinking about how the person is a jerk or much you wish you could get even with him or her for treating you badly. If you or someone you care about suffered a financial hardship and paying bills is going to be a problem, describe it. It does not include feelings and judgments such as how unfair it is. Those things might seem very important to you, but they don’t help you actually manage or cope with the situation. 

NOW WHAT? This stage refers to planning what you need to do now given the situation that results from what has already passed. If there is a rift in a relationship that you want to repair, what steps can you take to repair it? If someone has hurt you and is likely to hurt you again, what steps are needed to keep yourself safe? If there has been an accident with injuries, what steps are needed to help heal the injuries in the best manner possible? If you are facing a financial hardship, what steps are needed to cope with it?

Dealing with events or crisis in such a way will free you from the chains that emotional crisis (different from the actual physical effects of the event) place on you. If it helps, write it down using the three “what” questions to help you sort out your response. You will find that a lot of what we think about in stressful situations keeps us from being effective, and actually helps keep the stress, and therefore the suffering, going.

Mark E. Hankla, MA

Children and Trauma

Do children react differently to trauma than adults?

The answer is yes. In adults some of the symptoms of trauma include night mares, flash backs, avoiding thoughts or feelings associated with trauma, detachment, feeling numb, depression, and anxiety.

When children experience a trauma, their reactions may look much different from adults. Younger children may regress. They may revert back to immature behaviors. For instance a child may begin bed wetting, having accidents during the day, or use baby talk. They may act out their scary situation with toys. They may also become clingy. Older children who experience trauma may act out, be defiant to authority, and have an excessive need to control things (and people) around them. They may have anger outbursts, they may steal or hoard items like food or lie. They may lash out at the very people who are attempting to help them. Sometimes, people who don’t understand what is happening in this situation, view the child as a trouble maker, they may think that the child is choosing to be “bad”.

If a child was abused by someone they knew or loved, they may have difficulty having trusting, loving relationships with their safe caregivers. They may unconsciously feel the need to test these relationships to see if the caregiver will protect them. Sometimes they may actually set themselves up to be rejected. For example, a child (who was abused in the home by a family member) may feel distrust of the remaining parent even though that parent stopped the abuse as soon as it was discovered. The child may focus his or her anger at the remaining parent, testing the limits, saying hurtful things, and at the same time be very clingy and dependent upon that parent. As a parent or caregiver in this situation, it can be very frustrating and exhausting.
 

If you are caring for or parenting a child who has been traumatized, please be patient and understanding.  While kids need consistent limits, they also need nurturance, kindness and understanding.

Laurie Patton

 

Coming soon: Tips on how to deal with a traumatized child.

Bill of Rights Part 3

A Recovery Bill of Rights for Trauma Survivors, Part 3

 

Here is our lastest installment in the series.  I found this worthwhile for therapists as well as clients and hope you do too. 

For the integrity of your personal communication you have the right to…

Ask for explanation of communications you do not understand.

Express a contrary view when you do understand and you disagree.

Acknowledge your feelings, without having to justify them.

Ask for changes when your needs are not being met.

Speak of your experience, without apology for your uncertainties.

Resolve doubt without deferring to the views or wishes of anyone.

 

Bill