Using consequences with traumatized youth

Lorraine, 

I've done a search for possible resources and I'm finding mostly school-based guidelines for disciplining traumatized children. I'm not sure that would necessarily work for your setting, but if so, it looks like PBIS and Safe Supportive Learning are the best bets from what I've seen thus far. Perhaps others have different recommendations. 

Hi Rebecca - thank you so much. Yes all the info I have been able to find is mostly school related. This is very relevant in relation to strategies etc., just a different setting to apply the practices within.

I'm just trying to find a more effective wayof offering alternative behaviours and from my own experience it largley depends on the relationship between staff and young people. That's why we are trying to have conversations instead of applying consequences. This 'forces' (for lack of a better word) the child into having those conversations that they normally refuse to engage in. Then we can get to what's underneath the behaviour.

I guess I have a bit of difficulty getting a 'buy in' from some of the staff which is why I am looking for 'evidence'.

Thanks for your help - very much appreciated!

Cheers

:)

Hi, Lorraine: I haven't, but will check around. Leisa Irwin, director of the Paladin Academy, might be a good resource. The Paladin Academy is a charter high school for at-risk kids, so y'all might have some issues in common. 

I'll add your request to tomorrow's daily digest, and in the next newsletter.

Cheers, Jane

Hi Lorraine!

Your question goes to the heart of our nonviolent philosophy of child raising, which we teach parents as well as service providers. A good place to start is "Beyond Discipline" by Alfie Kohn. http://www.alfiekohn.org/books/bd.htm

Here's a taster, written for educators: http://www.alfiekohn.org/teaching/edweek/discipline.htm

And here's one for parenting: http://www.alfiekohn.org/parenting/punishment.htm

Another good book is "Beyond Consequences" by Heather Forbes. She applies this perspective to traumatized kids.

Short article here: http://www.beyondconsequences.com/freearticle.pdf

Let me know if you need more help!

Louise Godbold

Co-Executive Director

Echo Parenting & Education

www.echoparenting.org

Hello Lorraine,

You are right to think that something isn't right in going with a punitive approach within a trauma-informed environment.

You nailed it when recognizing that it depends on the relationships of the staff and children. However, I would be careful about using the alternative of forced conversations. Forced conversations will rarely be productive. I often say that relationships are the most efficient and effective behavior intervention for staff.

I understand your dilemma as in my position I work with supporting and teaching the staff during a philosophical change. I work within a private special education school and residential campus where all of the residential clients attend the school and a large number of students from surrounding school districts attend. 

A couple quick thoughts on punishment in these environments...

• If we look at many of the behaviors that are displayed as result of neurological changes and responses to prior trauma, why would we punish a child for being traumatized?
• A common thing I hear is, "In the real world X is going to happen..." "They have to learn to X" I often tell staff and teachers that anytime we say "they have to learn" we should rephrase it to "I have to teach them..."
• If our job is to teach them new skills in various environments and situations, we cannot punish new skills into them. If I do not know, and just cannot grasp a math concept...or if I cannot read, you cannot punish me into having the skill.

When looking at consequences, and teaching that things can happen as a result of behaviors, look for natural consequences and provide feedback and help them see the connection. When I say look for them, I don't mean because they did something and they have to be punished, but when they are apparent and directly linked as a result and they need help making the connection.

The "old way" of doing things with punishments, time outs, seclusion are hard habits to break. We are a few years in to a trauma-informed approach and there are staff that feel that they cannot do their work without those old methods. There are two ways of looking at it...1) They need more training in what to do when those old ways are not there for them, and 2) Even with all the training in the world, we often go back on our beliefs. If someone's belief is so strong that children should only be "dealt with" in a certain way (punishment), and that cannot be changed, we have staff that will continue to do it their way. In many articles that I have read on systematic change, this is when it should be considered to council people out. With that, I hold a strong belief that there needs to be a trauma-informed element in the hiring process. There should be no surprise to the staff when they start working there as to what our intentions are in our way of working with kids. 

As for your question, we use the Mandt System and trauma-informed care as our philosophical umbrella. Under that, we use Collaborative and Proactive Solutions (CPS) http://livesinthebalance.org/  which has an evidence base showing reduction in office referrals, seclusion & restraint, and teacher stress. 

As for PBIS in residential settings, this slideshow on the subject has a number of citations of studies with evidence http://www.pbis.org/common/cms/files/Forum_09_Presentations/E2_PBS_2009.pptx

One thing to be cautious about that I see often is to be sure that if following an approach, make sure it is done with fidelity and not "half way." With PBIS, sometimes it will be looked at as all we need to do is put a sticker chart system together. While something like that may be a part of it, only using that assumes that motivation is the problem. as we know with working with kids with trauma, it is much deeper than "they just need to try harder.." 

Please let me know if you would like more help finding resources, I would be happy to.

“The explicit assumption of the Sanctuary Model is that traumatized children

cannot heal within traumatizing – or traumatized – organizations, and that instead such

organizations can make children’s problems worse.” 

 

http://www.sanctuaryweb.com/PDFs_new/Bloom%20TC%20Sanctuary%20Model%20Organization%20Development.pdf

As a "Youthful Offender" (No permanent Criminal Record), I had an index card on the wall of my prison cell, with a quote from someone whose name I do not now recall:

"To Punish a Man, you must injure him; To Reform a Man, you must improve him; and Men are not improved by Injuries."

If your favorite Librarian has access to Bartlett's Familiar Quotations...I just asked my favorite Librarian, who "googled" it, and is e-mailing it to me. The actual Quote is from George Bernard Shaw, but it appears in a Book about Philosophical Perspectives on Punishment edited by Gertrude ______. He's e-mailing me with particulars including the link. I'll try to get back to you, as the Library (and this public access computer terminal) is about to close.

Hi Lee,

Thanks so much - yes I agree that forcing a conversation is not effective, but during these cnversations we are uncovering a lot of the trauma that hides beneath the behaviour. So it has has some success - although we are still in the early stages at the moment.

Getting staff buy-in is probably the most difficult part because, as you say, the old way is really stuck and some staff refuse to acknowledge that there is a better way. Our training is quite rigorous nowadays, but there are some staff members that have been around for many years, before the organisation had taken on a trauma-informed model of care - Sanctuary. However, we ar emaking headway in changing this mindset and our recruitment processes are now much more selective. Ongoing training is definitely the key. Time to offer that to my staff is a challenge, but the results are definitley worth the effort!

The 'Mandt' system you describe is virtually the same as TCI (Therapeutic Crisis Intervention) that we use here in Western Australia. We have been using TCI for about 6 years now and have found it to be veyr effective. It also works in harmony with the Sanctuary model which the organisation is adopting (still in the early stages).  Because our department has seen many different models, programs and general changes, the staff are not fully committed to anything new.. But it's here to stay and they are beginning to see our work in a new light.

Thanks for the links you supplied, much appreciated. I iwll have a better look at these and hopefully be able to provide a clearer direction for my staff.

Cheers

:)

Hi Rick

Everyone here has offered some awesome readings that are right in line with what I was asking. Such a fabulous response - I am so impressed.

You may have seen in an earlier post that we use the Sanctuary model as a guiding philosophy and we train yearly in therapeutic crisis intervention techniques. Both of these are trauma informed models and work really well together. It has been a long process that has seen a great deal of success and a real turn around for our department. In 2008 when I first began with CPFS (Child Protection and Family Support - State Govt department) we had a hostel system that housed a minimum of 8 young people with 2 - 3 staff on each shift. The facilitites were purpose built and resembled more of a prison than a home and we expected young people to feel safe there... Not very effective. As a staff memeber it was like walking into a war zone and there was a real 'us and them' attitude from both the kids and staff. Shortly after I started we changed from 8 bed hostels to 4 bed group homes. More thought was put into placing particular children together to minimise issues of dynamics and the department began a rigorous staff training regime - Therapeutic Crisis Intervention. This was taken on by staff quite well as it was really effective. Then about 4 years ago the Dept took on the Sanctuary model. Staff resisted this  - probably a number of reasons... Firstly they were still getting used to TCI and felt we didn't need anything else, but mostly because it was introduced quite rapidly and there really wasn't a great deal of training for staff to understand the fundamentals of the model. This was of course due to budget constraints. However, as a Manager, I have supported Sanctuary and endeavoured to provide significant training for my staff in the model and slowly I have made some progress.

So my search for documents pertaining to the use of consequences is an effort to provide 'evidence' to my staff so they realsie that it's not just me harping on about using trauma-informed practices, it is actually a world-wide movement and we best get on board now - for our benefit as well as the vulnerable young people with whom we work.

Hope this has been helpful for you too.

Cheers

:)

Hi Lorraine,

I recommend looking at Pat Wilcox's blog. You will find many relevant blog posts there on this and many other topics related to Trauma-Informed Care and treatment of youth in residential, foster care, and child welfare. Go to www.traumaticstressinstitute.org and click on her blog. She also has a book called Trauma Informed Care: The Restorative Approach published by NEARI press that would be very relevant.

Steve Brown, Director Traumatic Stress Institute

Lorraine,

I know that I have read articles in the past that support your conversation, but I am unable to go directly to any of them.  I will keep my eye out for some readings for you.

-Marina

You might also try the Council of State Governments' Criminal Justice/Mental Health Consensus Project.

Lorraine,

Thanks for expressing this concern.  I, too, share your sentiments.  I operator a therapeutic boarding school for teens, and we are committed to being a trauma-informed facility.  As you are aware, helping the staff make that paradigm shift away from punishment as been an interesting journey.  Sharing the research around Restorative Practices from the International Institute For Restorative Practices was helpful in that process. Also, as mentioned before, the Beyond Consequences books were extremely helpful.  We had taken those principles and designed our own set of practices that fit our needs.  We now have mandatory staff training that incorporates those practices.  If you find anything that works for you, I would appreciate you letting us know. We are always looking to improve. 

Thanks Robert - what a great quote! Cheers :)

"But it's here to stay"

That is what you have to keep expressing. 

Good luck.

Lee - Well said! My leadership staff would add to that by saying the philosophy is here to stay but the staff aren't always.

They borrow a Jim Collins reference from his book Good to Great, "Get the right people on the bus and the wrong people off!" I wish that I had the courage to step out with confidence to follow that advise. In my heart, I know the risk of harming an individual in our care with old strategies is a risk not worth taking. But, my scarcity mentality kicks in when I think of losing otherwise dedicated staff members.

If we all keep up the good work, soon there will be a large enough pool of qualified and quality staff for us all to share.

Lorraine, I also avail myself of a Canadian Evidence Base on-line, known as the Evidence Exchange Network (EENet acronym). If that also serves to inspire your staff, I hope it helps. Best Regards

Thanks Louise - this is a great article! Cheers :)

Thank you Steve I will have an in depth look at this - looks very interesting! Cheers :)

Cheers Marina :)

Thanks Rick and Lee - very inspiring words... I am feeling so much more encouraged!

Yes the philosophy is here to stay, but the staff aren't always - never a truer word spoken!

Cheers

:)

Hi Lorraine,

I would imagine that your staff don't believe that they have experienced good examples of these discussions themselves and may not feel confident that they are moving the discussion down the right path of thought.  I would recommend that one step toward encouraging improvement in discussions (even discussions that go along with the current consequences process) would be to train your staff in reflective listening skills.  Even asking the youth how they feel about the consequence will give the youth a focal point to center their reaction.  They may find that they can voice why the consequence doesn't fit.  

I'm guessing that if you start with this, two things will happen.  First, your staff might start identifying where safe changes can be made and, second, the youth will start seeing the safe moment to speak and reflect.  Some guided reflection could be useful too. . . .

Hi,

If you aren't familiar with the Building Bridges Initiative, I would suggest you check out their webiste since they have some resources and products that you might be able to use with your staff.  http://www.buildingbridges4youth.org/.

Hope this is helpful!

The Explosive Child is an excellent resource.  

Thank you for the Ross Greene link. I just looked him up and it sounds as if his approach is very similar to our nonviolent child raising philosophy (www.echoparenting.org). Nice to know there are other people around the country doing this work. I heard Bessel van der Kolk say the same thing about consequences and how they obviously don't work with these kids (or any kids for that matter, if you're looking to foster emotional intelligence and an inner locus of control rather than blind obedience). Bessel will be at our Changing the Paradigm conference March 5 & 6, 2015 for anyone who is able to get to Los Angeles.

Ross Greene's collaborative problem solving approach works really well with adolescents and younger kids. You can look him up on line and watch videos of the practice. We use it in our programs with kids with considerabe trauma histories. He also is clear that consequences just don't work for these kids or they would have changed already.

I like Julian Ford's TARGET and FREEDOM steps (From the University of Connecticut)

http://www.ptsdfreedom.org/julian_ford.html