debor016

I have just returned from presenting at the 2011 National Association of Therapeutic Schools and Programs (NATSAP) Annual Conference in Tucson, Arizona. NATSAP was created in January of 1999 to serve as a national resource for programs and professionals assisting young people beleaguered by emotional and behavioral difficulties. Their members include therapeutic schools, residential treatment programs, wilderness programs, outdoor therapeutic programs, young adult programs and home-based residential programs. For me, this is somewhat of a new world. Instead of the child welfare/ mental health world, this is the private school, wilderness program, self pay plus insurance pay world. Yet the children we all treat have remarkably similar symptoms and behaviors, despite some differences in socio-economic backgrounds. Like child welfare programs, the schools and programs within this organization are learning about trauma and adapting their treatment accordingly. And they face familiar diffic...

Brittany has been part of our agency for many years. She started on the Junior Unit, graduated to the Girls Unit, and then transferred to one of our Group Homes. She has had many ups and downs. But right now she is driving the staff crazy. Brittany has been completely defiant. She will use the phone whenever she wants to for as long as she wants to. Whenever anyone asks her to do anything she swears at them and tells them she doesn’t need them, they cannot tell her what to do. She is nasty, calls staff names, and is threatening. She led several peers on an AWOL a few nights ago. The other girls are complaining- how come Brittany is getting away with this behavior? Maybe they should begin to act like she does. Leah, the supervisor, talked with Brittany. Brittany maintained that she does not want anything from the house or anyone in it. She said: “You cannot change me. This is who I am.” The staff is frustrated. Brittany is making them feel disrespected, ineffectual and useless. They are...

A crucial factor in the success of any transformation to trauma informed care is the support of the leadership. There are many ways this support much be demonstrated, including financial support for training. One important way is the administration’s response to behavioral incidents. Expectations are conveyed in many ways throughout an agency. Does the administration value control and lack of disruption more than anything else? Can the administration tolerate certain level of organizational disruption in making the transition, including such things as staff confusion, conflict within treatment team, resistance to change, and increased property destruction? Trauma informed practice encourages staff to be flexible and to offer choices to the clients, even when the result is that the client is not immediately brought under control. Can the administrators support this? In one residential agency trauma informed care champions had been working with the staff to be more flexible and to ask th...