debor016

In our Risking Connection© training, we emphasize the importance of vicarious traumatization (VT). Because VT can destroy our hope and optimism, and because hope and optimism are so crucial to our work, paying attention to VT is an ethical imperative. One aspect of the discussion is: what can we do at work to decrease VT? There are many answers, and one is: take breaks. I have recently been experimenting with actually trying to take a break for lunch. Instead of eating while I do email, write or talk, I am trying to sit and eat my lunch. I brought in a placemat and a nice bowl, and I sit away from my desk. And what I have discovered is that this is extraordinarily difficult. Some of the difficulties are within me. I am jumpy and want to keep working. I am thinking about what I have to do. I am responsive to all interruptions. I am interested in what I am doing and do not want to stop. I feel guilty. This segment on NPR (http://www.npr.org/templates/story/story.php?storyId=129384107...

This week I visited an agency in Massachusetts named the Seven Hills Foundation. This organization is helping us create and run our new unit, Webster House, which will serve children with both psychiatric and medical disabilities. The staff at Seven Hills have been universally generous, helpful, kind and knowledgeable with us. We visited the Seven Hills Pediatric Center, which provides long-term care. Children enrolled in their long-term care receive all the necessary medical, nursing, therapy, and leisure services to enhance their quality of life. Many residents come to them with a history of congenital birth defects, past infections, or trauma. Cognitively, residents are under the age of 12 months and non-ambulatory. The staff at SHPC has many years of experience working with residents who are ventilator-dependent, have tracheostomies, or require gastrointestinal feeding. For children who require additional monitoring, they have a state-of-the-art individual monitoring system. We als...

In response to a previous post about our restraint and seclusion reduction initiative, one reader wanted to learn more about youth reaction to the experience of restraint. We asked several of our kids of all ages to fill in the end of open sentences about both being restrained and seeing others be restrained. We then recorded oth kids reading these aloud, and played them at our kickoff event for our “Got Restraint? More healing, less holding” initiative. Answers from children to open ended sentences about their experiences of restraint and seclusion When I get restrained, I feel scared. When I am in a seclusion, I feel trapped. When I get restrained, it reminds me of when they had to hold my uncle back. When I am in a seclusion, it reminds me of watching my mom get in the police car. When I get restrained, staff try to help. When I am in a seclusion, staff ignore. After a restraint I feel guilty. After a seclusion I feel guilty. When other kids get restrained I feel like I need to be i...

A central idea in the Risking Connection© approach to dealing with vicarious traumatization is the concept of transforming the pain. One important way that human beings deal with pain is to look for the good within it, to notice how going through a difficult experience changed our lives or strengthened us as people. An example of this would be the woman who says: "I certainly didn’t want to go through that breast cancer scare last year. But it did sharpen my sense of my priorities, and so I have gone back to school to finish my degree." If we can notice the transformative effects of the pain we experience in our work, we will be able to appreciate how the work changes us in positive as well as negative ways, and will build on those positive changes. This is an powerful way that we can combat vicarious traumatization and stay engaged and hopeful in our work. One author and healer who has deepened our understanding of this process is Rachel Naomi Remen. Rachel Naomi Remen is me...

As part of our new restraint and seclusion reduction initiative, I recently completed two focus groups with clients to ask them what they felt staff could do to decrease restraints and seclusions. Their answers can be summed up in the directive: ask me what is wrong and listen to my response. I was dismayed by the feeling that the kids had that the staff did not really like them or enjoy being with them. They spoke of staff wanting to get away from them, have breaks from them. They said staff were at times involved in their own interests and not willing to be interrupted by the kids. They noticed staff sitting and talking together. On the other hand, they described how much it meant when staff participated in games and activities with them. They felt close to staff who listened when they spoke, remembered what they said and asked them about it later. They were quick to blame themselves for staff not wanting to be with them, because of the way they acted. But they described acting bette...