Becoming Centered

Welcome to the first episode of Becoming Centered.  This episode begins the Residential Counselor Orientation series, designed for the new Residential Counselor.  It introduces a way to understand your role, your relationship with clients and other counselors, and introduces some basic tools for becoming a skilled Residential Counselor.  Episode 1 focuses on a specific understanding of the role of a Residential Counselor.  For related resources check out the Bear Clan, llc website at www.BearClanllc.com.     There's different types of residential treatment programs for serving school-age children.  The length of treatment and the setting can greatly vary.   The extent to which residential treatment is a therapeutic and transformational experience will greatly depend on the quality of the relationships formed between residential staff and the clients. Staying in a professional role can be challenging for a variety of reasons.  However, that's the ideal for which to strive. “Counseling” can be thought of as helping people improve their ability to become centered. It's helpful to understand the brain and personal psychology in terms of four domains of functioning: Emotions Cognitions Behaviors Executive Skills Possible areas on which to focus during your orientation period include: ·       Assist clients with becoming emotionally centered by presenting yourself in a calm and organized fashion.  It's okay if that feels like you're just acting; give yourself time to grow into this complex role. ·       Assist clients with becoming cognitively centered by learning the daily schedule and helping clients be organized and prepared for the tasks associated with the different parts of the schedule. ·         Assist clients with becoming behaviorally centered by attending to their basic physical needs for hydration, food, rest, sleep, exercise, etc.  Also take care to attend to your own basic needs so that you're able to function at a high level despite the difficult hours of your work day.  Help clients learn to co-regulate their nervous system with yours by playing with them and having fun with them. ·         Assist clients with their developing executive skills by supporting their self-regulation of their own emotions, cognitions, and behaviors.  Asking clients what comes next in the schedule and what preparation is needed, is a simple way to get them to think ahead and practice their executive skills.

Professional boundaries includes: 1.         the schedule of when you'll have contact with the kids, 2.         limits on physical touch, 3.         limits on personal disclosure, and 4.         the general tone of the professional relationship.   1.  Your contact with clients is during scheduled hours.         Be polite but minimize any accidental contact with clients outside of work.          Don't talk about your clients in public. 2.  Limits on physical touch.          Providing Physical Assistance:  If your clients require physical assistance with hygiene, always be business-like and clinical.          Affectionate Touch:  Kids thrive on affectionate touch but because of the treatment issues common in residential programs your organization likely has guidelines to avoid types of affectionate touch that are too intimate.          Sexualized Touch:  Sexualized behaviors toward clients is clearly a boundary violation.  You may have to set limits on sexualized clients trying to relate to you in a sexualized or harassing fashion.          Directive Touch:  If your clients require physical assistance with hygiene, always be business-like and clinical.  Only use directive touch in a manner consistent with your organization's trainings, policies, procedures, and practices. 3.  Limits on personal disclosure.          Your relationships with the kids are based on the time you spend together, not on your personal history, your life outside of work, or the type of information you might exchange with peers in order to develop a relationship.          Kids will test to see if you have professional personal disclosure boundaries, so have in mind some respectful ways to not answer questions about your life outside of work.          Don't disclose personal issues that overlap with issues that the kids bring into treatment, such as drug use, unless your program directly trains and supports you in how to use that sort of disclosure in a therapeutic way. 4.  The general tone of the professional relationship.          Dress like a professional.  Speak like a professional.  Carry yourself in a confident fashion.          Don't promise to keep any secrets.  You're part of a treatment team and may be professionally obligated to share any information you learn from a client.          Allow yourself to develop genuine caring feelings for the kids, but maintain a level of clinical distance to create an important professional emotional boundary.

Therapeutic relationships help your clients become centered in four domains of psychological functioning.  This can be visualized using The Domain Compass: ·       In the East, there's the domain of emotions, consisting of feeling and moods. ·       In the South, there's the domain of cognitions, consisting of thoughts and beliefs. ·       In the West, there's the domain of behaviors, consisting of both all external actions and the internal actions of the physical body. ·       In the North, there's the domain of executive skills and self-regulation.  1.  Three relationship qualities to strive for within the domain of emotions. ·         Focus on increasing clients' awareness of their own emotions. o   The Check-In technique helps clients express their feelings and moods in words or in various kinds of rating scales. ·         Help sooth emotions that become too powerful or chaotic. o   The Low and Slow approach helps to cool down an overheating nervous system. o   The Organized Activities approach helps to structure a chaotic nervous system. ·         Build up clients' fragile and/or low self-esteem. o   Praise works through high frequency repetition to help kids see their own strengths and worth. o   Attention helps kids feel their own worth.  Often times, older kids in residential treatment still need the intense level of attention that people appear to intuitively give to pre-schoolers. 2.  Two relationship qualities that help kids within the domain of cognitions. ·         Increase external structures to reduce cognitive chaos. ·         Break sequences down into smaller chunks. 3.  Three relationship qualities that help kids become behaviorally and physiologically centered. ·         Attend to kids' basic physiological needs (water, food, sleep, exercise, rest). ·         Become an active and skilled listener. ·         Co-regulate with kids through joining them in play. 4.  One key relationship quality that helps kids in the domain of executive skills. ·         Help each kid make and keep friends. 

High level team work is an absolutely essential aspect of being an effective Residential Counselor.  There's a classic way to think about the formation of effective teams.  It breaks team development into 5 over-lapping phases:  Forming, Storming, Norming, Performing, Adjourning. (1)  Forming refers to all the dynamics that happen between team-mates when you're relatively new to working with one another.  ·         The key to moving through the forming phase is constant communication among team members.  Let your partners know where you are, what you're doing, and which kids, or zone, you're covering. (2)  In the Storming Phase, little conflicts among your team-mates have appeared.  ·         The key to moving through the storming phase is feedback.  Make giving you feedback as easy as possible.  Make it clear to your teammates that you want to know how to excel at being an effective teammate.  At least at first, focus on getting feedback on how you're doing as a member of team, rather than your work directly with the kids.     (3)  In the Norming Phase routine tasks, including transitioning through all the different parts of the daily schedule, are generally going smoothly.  ·         The key to supporting this normative level of teamwork is appreciation.  Don't take for granted when parts of the shift go well.  That only happened because of you and your team-mates.  Be generous in expressing your appreciation for your fellow staff do. T  (4)  The Performing Phase of team development.  Now, it's not just the routine parts of the shift that are going well, but the team skillful adapts and overcomes various challenges.  ·         Find ways to recognize and celebrate when your team performs at a high level. 5  (5)  The Adjourning Phase in residential treatment is most relevant in the context of how each shift is ended.  That's when you're most likely able to speak with one another.  That's when you can ask for feedback, express appreciation, and celebrate the team's successes.  However, there's also a really important team function that should be prioritized – and that's debriefing; specifically what's known as “Critical Incident Stress Debriefing”. ·         Residential treatment work frequently exposes staff to extreme situations that can have trauma-like effects.  Checking-in with fellow staff at the end of the shift and sometimes telling the story of what happened, in a calm fashion, can blunt the neurological effects on your brain of intense experiences with clients. Residential work is highly stressful and the skilled Residential Counselors attend to their own self-care.  You can't effectively take care of others if you're not also taking care of yourself.

This episode reviews The Domain Compass, which is a way to visualize four domains of psychological functioning. In the East, there's the domain of emotions, consisting of feelings and moods.  In the South, there's the domain of cognitions, consisting of thoughts and beliefs. In the West, there's the domain of behaviors.  That's includes both external behaviors and all the internal workings of your physical body and nervous system. In the North, there's the domain of executive skills.  That's where self-control is found. Another helpful way to visualize personal psychology is captured by The Aspect Compass. The Artist expresses emotions to communicate to others and experiences the world, largely in terms of emotions. The Scout is in charge of exploring the world, trying to make sense of it, and reporting its findings to the rest of your brain.  The Warrior includes the parts of your brain that control your muscles and entire physical body. The Chief gets feedback from the other aspects of your personal psychology and provides regulation through executive skills. Labeling is a key technique for giving each kid's inner Chief the feedback it needs to do its job of self-regulation of emotions, cognitions, and behaviors.  It begins with increasing each kid's awareness of their own behaviors. Labeling is simply stating, with no attached judgment or direction, what a kid is doing, that specific moment.  Attentive adults instinctively do this with very young kids; however, even older youth in residential treatment tend to have developmentally delayed executive skills. Labeling develops kid's inner Chief through repetition.  Eventually, the clients will replace your voice with an internal voice (their inner Chief's) that helps them monitor their own behaviors.  As that ability strengthens, their inner Chief will also become more skilled at monitoring, at maintaining awareness of, their own emotions and thoughts as well. 

This episode uses The Aspect Compass to frame the role of a Residential Counselor as serving as The Chief function with the clients to set limits, to help regulate, the kids' emotions, cognitions, and behaviors. When residential staff don't set enough limits, you'll see a phenomenon called contagion.  This comes from firefighting and describes how a fire will spread from one tree to another.  It's also used to describe how a disease will spread from one organism to another. The Artist responds to emotional appeals, highly dependent on your relationship with each kid.  This can work quickly to regulate kids, but has the downside of “do it for me” and so doesn't necessarily lead to inner growth in self-control.  The Scout responds to questions.  This can lead to more thoughtful behaviors but is dependent on the kid being cognitively organized enough to think before acting (or speaking).    The Warrior responds to commands.  This can work quickly, and may be crucial in a behavior crisis.  However, cooperation is preferable to compliance.  The goal is always for the clients to become more independent and to learn more self-control, rather than just obeying.  Check-In's help each kid's inner Artist learn how to use words, or a rating scale, to express emotions, rather than acting out.  Likewise, being a skilled listener, asking for clarification, getting kids to use different ways to express themselves, develops their inner Artist's abilities to communicate. The Low & Slow approach and Organized Activity help each kid's inner Scout become organized enough to think before acting.  Every time they “practice” becoming more cognitively organized, it becomes easier to do (on a neurological level).  Implementing program structures in a consistent and predictable fashion allows kids to make the connection between their own choices, their own  behaviors, and positive and negative consequences that are enforced by staff.  This trains their inner Scout in understanding a key way in which the world works, rather than believing that things just happen to them. Playing with the kids allows them to co-regulate their neurology with your own.  This helps emotionally soothe them and cognitively organizes them.  When you do have to blatantly be directive, two excellent related strategies are the Forced-Choice and Weighted-Choice techniques. The Forced-Choice Technique is when a counselor presents the client with two choices, and won't engage in any unrelated discussion. The Weighted-Choice Technique is when the counselor presents one of the choices as being more attractive.  Nevertheless, the client still gets to choose and may decide on the larger consequence.  That's unfortunate, so don't make the weighted choice too disproportionate to the situation, but either way you're still developing the client's executive skills, forcing them to exercise their inner Chief.

Physical Restraints are a complex and controversial subject that might be triggering for some people.  There are scholarly articles on this subject and many national organizations have expressed opinions on the use of physical restraint.  My perspective is primarily driven by my professional experiences participating in physical restraints, mechanical restraints, chemical restraints, and seclusion; and reviewing and reporting on thousands of these sorts of incidents. Ethical concerns around the use of  physical restraints, per Scheurmann in the Journal of Disability Policy Studies 27(2), include: 1.  Potential for death or injury. 2.  Failure to use the least intrusive intervention. 3.  Inappropriate restrictions on liberty and removal of access to education. 4.  Repeated use of a potentially dangerous and ineffective intervention. 5.  Disproportionate use with certain critical groups. 6.  Insufficient professional training, supervision, and monitoring. I would add that some kids who get restrained probably would not become that aggressive if they weren't living in programs where extreme behaviors are commonplace. Physical intimidation and force are contrary to treatment. However, if residential treatment programs simply don't accept, or simply discharge, clients with aggressive behaviors the alternatives for these kids are even more problematic.  Children and youth end up back at home where their parents, siblings, and the community are terrorized by their violent behaviors and their own safety is at greater risk. The police and public schools end up having to address these behaviors, and they are less specifically trained than residential staff in how to help these kids. Psychiatric hospitalizations are used, but the result is, all too often, the use of medications that have unwanted side effects such as flattening emotions and physical discomforts.  Medication has to be continually monitored and changed as kids grow.  Often times, these kids will cycle in and out of short-term psychiatric hospitalizations with no sense of the child having actually changed and learned new levels of self-control. Juvenile incarceration will be the path that some of these kids face.  These setting seem to struggle even more than residential treatment programs with becoming abusive toward the kids.  It's even harder to provide these kids with effective treatment that will change the trajectory of their lives for the positive. In my opinion, the ethical concerns around the use of physical restraints are best addressed in a treatment program setting.   

Physical Restraints are, in my opinion, the best option for safely dealing with violent behaviors among children and youth in residential treatment. Self-injurious behaviors need to be stopped before they lead to permanent, or at least significant, damage.  Assaultive behaviors need to be stopped before they lead to harm. Runaway behavior is a more nuanced judgement call.  Sometimes staff can continue to monitor a runaway child or youth.  However, allowing a troubled kid to be on their own in a wilderness, urban, or other environment can place them in serious danger. Property damage can sometimes be monitored without physically intervening.  However, in my experience, when kids are allowed to rage they tend to escalate to the point where they are creating a real safety risk to themselves and others.  There are also practical limits to how much damage a facility can financially endure.  There are alternatives to physical restraint, including mechanical restraint, chemical restraint, and seclusion.  However, each typically are preceded by a physical restraint. In addition, mechanical restraints tend to be very frightening for the child or youth, require a separate type of training for the staff, require constant monitoring, and the transition into the mechanical restraint frequently requires more directed force than a physical restraint.  They also lack any tactile feedback for staff to help determine when the level of restrictiveness on the restraint can be lessened.  Chemical restraints require specifically trained personnel, and most residential treatment programs are not licensed to use them.  Seclusion tends to result in either the client raging in the seclusion room to the point where a physical restraint may have to be re-established to prevent self-harm, or the client calming down which implies that they don't really need seclusion.  In my experience seclusion can be an effective tool to ending a violent situation; however, in most cases I have not seen it provide enough advantages to outweigh the added risks and the dehumanizing treatment of the client.  Some physical restraint systems train staff in the use of pain compliance holds.  These can greatly shorten a physical restraint and may be a legitimate tool for programs that can't bring enough staff into a restraint situation (such as wilderness therapy programs that are in isolated setting rather than operating as part of a multi-unit campus).  However, inflicting pain on children is morally repugnant and it may be that programs that can't, when needed, devote four or five staff to a physical restraint simply can't serve some clients.  Performing physical restraints subjects staff to “small t” trauma.  There are things staff can do to minimize the effects of that trauma on their nervous system, which will make the staff person more resilient to this stress. 

Physical Restraints tend to be in response to intense, often times violent, situations and will have some degree of traumatizing effect on both the staff and the client. The neurochemical changes in the brain that are caused by traumatic incidents don't automatically reset.  Instead, memories of the incident are stored in your brain with the emotional content that the incident evoked.  Parts of your body, your muscles and nervous system, also store the stress caused by the incident, long after the incident has ended. It can be very tempting to turn to coercion, essentially intimidation and force, to try and change the extreme behaviors that many children in residential treatment exhibit.  That's because we instinctively understand that human beings will change their behaviors most quickly in order to avoid pain and unwanted consequences. However, behavioral change motivated by a coercive environment tends to not be internalized or generalized by clients.  That means that upon leaving a residential treatment program, the old behaviors reappear. Instead of using coercion, even though it “works” more quickly, an effective treatment program encourages the growth of executive skills in children and youth and fosters cooperation from clients rather obedience. As a staff person your attitude toward the clients impacts their functioning.  The Pygmalion Effect (aka the Rosenthal Effect) refers to the observation that people will change their demonstrated abilities based on the expectations of other people.  Kids will perform down to any low expectations you have for them.  Likewise, the Stanford Prisoner Experiment demonstrated that if you think of yourself as a tough authority figure, such as a guard, and you think about your clients as something akin to prisoners, then sadistic tendencies will be more likely to emerge in you. It helps to keep in mind that people are not their behaviors.  The children and youth in your care are complex human beings with emotions, cognitions, behaviors, executive skills, relationships with others and tasks for which they've taken responsibility.  All behavior happens for a reason.  You may not know what that reason is, but give the kids in your care credit for even their most unpleasant behaviors being an attempt to get their needs met. Anticipation and training are two qualities that will protect you from some of the traumatizing effects of restraint situations.  Try to anticipate the various emotional reactions you might have to a restraint – including you might go frosty and not feel a lot during the actual process.  Alternatively, you might feel elated at a restraint that goes well, or you might feel devastated by a restraint that doesn't go well.  Try to balance your feelings afterwards. Your program should have a formal training program in the actual physical techniques used in physical restraint.  However, you may benefit from extra coaching and practice.  You might have to seek that out. Once a restraint has been fully established, pay attention to your body and breathing.  Relax any muscle groups that aren't necessary to maintain the hold.  Pay particularly attention to your grip, which may be much harder than is needed.  Pay attention to your breathing.  Perhaps do some simple breathing exercises such as focusing on exhaling first and then relaxing and letting the inhalations happen automatically.  Check-in with the other members of your team.  Someone simply asking if everyone is okay, needs to shift, needs to sub out, produces neurochemicals that counter the stress hormones that are flooding everyone's bodies.  Talking to the client, while the restraint is going on, can be very agitating for some clients, especially kids who struggle with processing words.  In other cases, simple soothing statements appear to be helpful.  In some cases, staff conversing among themselves has seemed to help a kid calm down.  There's no universal formula for this. Don't forget about the other kids.  If other children in the program have been impacted by the restraint situtation, checking-in with them, and reassuring them around safety helps minimize the trauma effects they might be experiencing just from what they've seen or heard.

This podcast episode is part four of a series addressing the use of physical restraints and interventions in response to extreme client behaviors, particularly in residential treatment settings. The previous episodes discussed the uncomfortable nature of these interventions and the necessity of their use for the safety of both staff and clients. The focus of this final episode is on post-restraint procedures to protect staff from the traumatic effects of such incidents. After a physical hold, staff are advised to relax their muscles, engage in deep breathing, and attend to basic needs like drinking water. These self-care measures help counter the lingering stress chemicals in their system. Debriefing is emphasized as a crucial step, occurring ideally before the shift ends. It involves clinically recounting the incident to overwrite traumatic memories with a calm recounting. Debriefing should be facilitated by a colleague or supervisor to be most effective. Processing, which delves into emotions and thoughts before and after each behavior in the restraint sequence, can follow debriefing. This helps clients understand their actions and take responsibility for them.  It helps staff to further overwrite traumatic memories of an incident with the memory of calmly talking about their emotional reactions and thoughts. The podcast suggests various techniques for clients and staff, like relaxation, meditation, and mindfulness, to regain self-control and reduce trauma effects. These techniques are only truly effective when they are practiced in advance. Furthermore, supporting and appreciating colleagues is highlighted for staff well-being. Expressing gratitude and providing opportunities for relaxation also reduces the damaging impact of stress. The episode also touches on administrative reviews of incidents, which are stressful for staff. Anticipating emotional reactions, maintaining honesty, and adhering to strong values like respect, love, honesty, bravery, humility, wisdom, and integrity are recommended for resilience in such situations. This episode emphasizes the importance of self-care, debriefing, and processing as essential tools for staff to cope with the emotional toll of physical restraints and protect themselves from trauma.

This podcast discusses the importance of coregulation in residential treatment settings for children who are emotionally, cognitively, and behaviorally disorganized. Coregulation refers to the process where an adult's nervous system synchronizes with a child's, helping the child learn self-control and emotional regulation. Coregulation starts from infancy when a baby's nervous system is linked with the mother's. Over time, babies learn to independently regulate their bodily functions, but they still rely on coregulation for emotional stability, and for learning how to organize thoughts, and regulate behaviors. Human Beings use coregulation before they learn self-regulation. Self-regulation involves controlling the electrical and chemical activity within one's brain. It includes skills like reaction inhibition (thinking before acting) and stress tolerance (tolerating stressful situations). Residential staff play a crucial role in teaching executive skills like reaction inhibition and stress tolerance to children in their care. They achieve this by actively engaging with the children, whether through play, games, daily chores, and all the other scheduled activities. Some executive skills directly regulate behaviors, such as self-awareness and metacognition (thinking about one's own thoughts), while other executive skills organize thinking, such as planning and prioritizing. These skills are also developed through coregulation and practice. Various activities, such as playing games, watching movies, and relaxation exercises, are all opportunities for coregulation. Staff should actively participate in these activities with the children, creating shared experiences that foster emotional and neurological coregulation. Coregulation, coaching, and cheerleading by residential staff help children develop self-control, emotional stability, and cognitive executive skills. The goal is to gradually transition children from dependence on coregulation to independent self-regulation, ultimately preparing them to leave residential treatment with improved emotional and cognitive abilities.

This podcast delves into the fundamental structures of residential treatment programs and the concept of structural interventions. While theoretically residential treatment could customize programs for each individual, practicality dictates the need for a standardized framework designed to meet the overall needs of a group of kids.  The concept of program structures includes physical aspects like room configurations and the flow of rooms, as well as how clients are allowed to move throughout a program.  Other major structures are elements such as the daily schedule, analogous to a class schedule in school.  Additionally, program structures include rules, expectations, and traditions that govern clients' interactions and behaviors.    Structural interventions are adjustments made within these structures to positively influence resident behavior. These can range from changing room arrangements to introducing rules or   Personal cleanliness, really basic hygiene routines are also critical, and different levels of structure may be necessary for different children and treatment populations. The concept of "key staff" is introduced, wherein a specific staff member is assigned to work closely with individual residents, addressing their unique needs and fostering a supportive relationship. This structure facilitates oversight tasks, communication with parents, and helps nurture a sense of care and stability. The podcast concludes by emphasizing that the effectiveness of structures and structural interventions relies on their enforcement. The next episode is set to delve into the art of setting limits in a therapeutic manner.

This podcast episode explores the crucial role of structure and firm, yet respectful, limit-setting in residential care for troubled children. Structures and external boundaries are essential for creating order in a group environment, especially when dealing with children facing various challenges such as trauma, ADHD, developmental delays, and mental health issues. A core value in a treatment setting is that respect should not be something earned but freely given, as it is a gift that helps build trust and facilitates change in child-clients. The podcast stresses the need for residential staff to be firm but not harsh when setting limits. A lower-pitched tone of voice, neutral body language, and presenting clients with a choice can convey firmness without intimidation. The goal is to create an environment where children feel safe and can learn and grow. This can be difficult in part because children may try to recreate familiar, disrespectful environments, making it essential for staff to remain emotionally, cognitively, and behaviorally centered. Many children have grown up with too much inconsistency and unpredictability.  In order for clients to truly feel safe, and to learn how to take responsibility for their own actions and choices, it's essential that staff set consistent and predictable limits.  Various techniques, such as planned persistence and labeling, can be effective for setting limits, and can be used to reinforce directives without getting caught up in a control-battle argument.  Some limits, though, are always going to be difficult or tricky when working with a residential treatment population.  These include sexualized behaviors and swearing.  However, consistency and predictability, along with strategic use of warnings and proportional consequences can be used to effectively shape these sorts of behaviors. In conclusion, the podcast underscores that maintaining firm yet respectful boundaries and structures is essential in residential care for troubled children. By doing so, staff can create a safe environment that fosters learning and self-regulation, ultimately helping children overcome their challenges and develop internal controls over their behavior and language.

This podcast episode discusses the use of timeouts as a common and effective technique in residential treatment programs working with children and adolescents. Timeouts are employed to manage disruptive behaviors and prevent the spread of problematic behaviors and emotions within a group, similar to containing a fire's spread. The episode emphasizes the importance of setting limits in a firm but non-harsh manner to encourage cooperation and internalization. While timeouts can be used as a purely behavioral intervention, their effectiveness can be enhanced by targeting cognitive development. Warnings and timeouts can be combined, encouraging self-awareness and self-control while providing specific advice for calming down. Time Outs can also be effectively used without warning.  These Automatic Time Outs are based on written rules that are regularly reviewed with the group. Processing timeouts with children is discussed, focusing on helping them take responsibility for their actions, consider the impact on others, and engage in relationship repair or restitution when necessary. The episode also highlights the benefits of group explanations, where clients review their timeouts with the group, fostering accountability and constructive feedback. The concept of "chaining" or "linking" is introduced as a technique to help children map out the sequence of events leading to a timeout, identify thoughts and feelings associated with each step, and recognize choice points where alternative actions could have been taken. Different approaches to determining timeout duration are explored, emphasizing the goal of reintegrating the child when they are calm and the group is ready. Techniques for aiding children in calming down, including organizing tasks and physiological centering exercises, are mentioned. Lastly, the concept of "resets" is introduced, which are self-timeouts that allow children to regain control and rejoin the group, promoting self-control and self-determination. Overall, timeouts are seen as a versatile tool that can serve both as a behavioral management technique and as a means of teaching children to become centered and self-regulated.

This episode explores various techniques for helping children process their feelings and develop emotional regulation skills. The episode begins with a recap of previous discussions on physiological coregulation and processing aimed at helping kids become cognitively centered. The focus then shifts to processing feelings, which can be more difficult, because emotions are challenging for children to articulate. Check-in's are a basic tool for helping kids express their emotions. These check-in's involve asking children about their current emotional state. It often times is a good practice to focus on basic needs like hunger, thirst, and fatigue as potential sources of emotional distress.  Helping children monitor these needs is also developing their executive skill of self-monitoring.   The episode also introduces two valuable tools: the Emotional Intensity Thermometer and the Feelings Map. The Emotional Intensity Thermometer is used to assess and rate the strength of different emotions, allowing children to better understand and express their feelings. The Feelings Map helps children identify and separate complex, simultaneous emotions, providing a visual aid for discussing their feelings. Empathic Listening is presented as a powerful technique for counselors to connect with children on an emotional level. The importance of mirroring body language and tone, asking clarifying questions, and avoiding problem-solving during empathic listening sessions is emphasized. Some cautions include anticipating the potential for disclosures of abuse or trauma during empathic listening and the importance of communicating such disclosures to the child's therapist.  There is also a risk that Empathic Listening will lead a child to assume that you agree with all of their framing, including negative views of other people.  Ways to address that possibility are addressed. The episode concludes with guidance on transitioning from Empathic Listening back to structured activities and routines, highlighting the role of the counselor in providing emotional support and fostering a sense of belonging in children. Throughout the episode, there's a focus on the development of executive skills, self-monitoring, and stress tolerance as crucial components of helping children process their feelings and achieve emotional centeredness.

This podcast presents a powerful perspective for helping your child-clients become centered.  It's based on understanding your kids' needs through The Aspect Compass, a model representing four aspects of the psyche: The Artist (emotions), The Scout (cognitions), The Warrior (behaviors), and The Chief (executive skills). Each aspect has unique needs that, when addressed, can help children become centered and balanced: For the inner Artist:         Getting sufficient attention.         Experiencing a full range of feelings.         Achieving emotional stability.         Expressing feelings.         Facing fears.         Grieving. Attention and validation are essential for children's emotional well-being. Offering appropriate outlets for expressing emotions through words or art is encouraged. Support in facing fears and containing grief, while directing processing of grief to a therapist, are all important ways residentials staff support The Artist feeling centered.  For the inner Scout:          Developing awareness.          Observing skills.          Acquiring knowledge.          Navigating effectively.          Reporting skills. Engaging in activities that focus on sensory perception and cognitive exploration helps children become cognitively centered.  Physically exploring and navigating an environment will help kids experience behaving like a scout.  Encouraging accurate reporting will develop their abilities to be an effective scout, and will help their inner Scout feel centered.  For the inner Warrior:          Having a mission and plan.          Feeling a sense of agency, achievement, and accomplishment.          Sense that one's behaviors are meaningful.          Meeting basic physical and psychological safety needs.          Maintaining physical health.          Relaxation. Helping children establish goals, fostering a sense of agency, and recognizing their achievements are essential for their behavioral well-being. Ensuring physical safety, health, and relaxation are also key components of centering the inner Warrior.  Structured time for relaxing is an important part of helping the inner Warrior feel centered. For the inner Chief:          Enhancing self-awareness.          Maintaining integrity.          Cultivating wisdom.          Fostering a state of appreciation.          Building a sense of tribe/community.          Encouraging service to others. The Chief plays a crucial role in coordinating the other aspects and needs self-awareness, integrity, and wisdom. Developing a sense of appreciation, belonging to a community, and engaging in service to others are vital for the Chief to feel centered. This podcast emphasizes that understanding and addressing these needs can help residential staff design therapeutic programs and create environments that promote positive learning and growth for child clients, ultimately helping them become emotionally, cognitively, behaviorally, and physiologically centered while fostering a sense of community and belonging.

This podcast episode discusses the challenging issue of dealing with suicidal ideation among child-clients in residential treatment. The podcast offers insights into different scenarios where staff may encounter suicidal ideation in child-clients and explains the unique challenges residential staff face, such as having to be the front-line mental health professionals, despite formal training. The episode introduces the Columbia Protocol, a set of questions used to assess suicidal ideation, and discusses the importance of empathetic listening and creating a safe space for clients to express their thoughts and emotions. The speaker emphasizes that the goal is not to uncover why clients have suicidal thoughts but to understand when, how often, in what situations, and what triggers these thoughts. Additionally, the podcast highlights the importance of assessing risk and rescue factors associated with suicidal plans and gestures. The episode also touches on the role of different aspects of a client's psyche, such as the Artist, Scout, Warrior, and Chief, in processing suicidal ideation and emphasizes the importance of strengthening the client's stress tolerance and sense of belonging. In conclusion, the podcast offers valuable insights and guidance for residential staff on how to approach and respond to suicidal ideation among child-clients, emphasizing empathy, assessment, and creating a supportive environment. It also encourages seeking professional help when needed through resources like the National Suicide and Crisis Lifeline (988).

This podcast episode is the second part of a series that addresses how to intervene when dealing with suicidal ideation in children and youth. It emphasizes the importance of training for counselors and aims to make discussing this sensitive subject more approachable. An important focus is for counselors is to help clients understand suicidal ideation as a symptom rather than delving into the "why" behind it, which is a task for therapists. The episode emphasizes the need to distance clients from these thoughts and work on developing their executive skills, especially stress tolerance. The counselor's role involves empathetic listening, establishing a sense of belonging, and helping the client tolerate their negative feelings and thoughts without using harmful behaviors.  If suicidal ideation includes gestures, attempts, or plans, the counselor should assess the situation in terms of risk and rescue factors and consult with an on-call clinician. After a check-in around suicidal ideation, there are important communications and documentation to the rest of the team.  There may also be structural interventions put in place such as Scheduled Check-Ins, Increased Structure, Staff Shadowing, Re-entry Plans, and various restrictions that can be documented on a Safety Watch form.  That documentation helps everyone on the immediate team, and involved in follow up the next day, to work as a team to help keep the client feeling and acting safe. Another powerful intervention is the creation of a Safety Contract, which serves as a formal agreement between the at-risk client and staff to ensure safety and offers personalized support. The episode also underscores the partnership between therapy and counseling, with therapy addressing the "why" and counseling addressing the "how" of maladaptive behaviors. Lastly, the podcast reminds listeners of the National Suicide and Crisis Lifeline (988) as a resource for those needing guidance and emotional support outside of their work lives.

This podcast episode discusses the importance of management and delegation within residential treatment programs for children and youth. It highlights the different levels of management within such organizations, including Executive Management responsible for overall leadership, Senior Management overseeing major aspects of the agency's operations, Middle Managers handling specific service units, and Frontline Managers leading shifts. It emphasizes that effective management is essential to provide quality care to the clients. The episode explores various roles within residential programs, such as coordinators responsible for specific tasks like organizing activities or managing facility supplies. It also delves into the role of Key Staff, who work directly with clients, helping with activities of daily living, treatment programming, and more. Delegation is a central theme in the podcast, and it stresses the importance of role clarity, administrative infrastructure, and a strong process for successful delegation and for program development. A five-step model for a delegation process is explained, involving (1) task explanation, including clarification of deliverables, (2) checking the person's understanding of the delegated task or project, (3) reviewing what resources the person can use to achieve the task or project, (4) collaboratively establish a deadline and understanding around asking for an extension if needed, and (5) feedback afterwards on how the project or task delegation went.  The episode underscores the need for management to empower staff by clearly defining roles and responsibilities and creating a shared vision for the organization. It also touches on different sources of influences beyond the Authority-Influence that comes from having any particular position within the organization.  Additional sources of influence, and power to achieve one's responsibilities, include Relationship-Influence, Power Broker-Influence, Charismatic-Influence, Expert-Influence, and Fame-Influence.  Ultimately, this podcast provides insights into the challenges and best practices of managing residential treatment programs, with an emphasis on effective delegation as a key tool for success. It encourages a collaborative and organized approach to improve the quality of care and empower staff at all levels of management.

This episode is a departure from the usual format by sharing original teaching stories.  Storytelling and stories are a fundamental modality for learning.  Our brains are wired to process experiences in the form of a narrative. Telling stories builds connections between adults and children, whether the adult is the storyteller or the child. Telling stories, or listening to stories together, fosters a sense of shared experience and strengthens the therapeutic alliance. Stories engage various parts of the brain, both verbal and nonverbal, conscious and unconscious, effecting every part of the psyche.  Several Bear Clan stories illustrate coping skills, teach relaxation techniques, address problem-solving, and explore character development. Some stories aim to facilitate discussions about traumatic issues, acknowledging the challenge many children face in expressing emotions associated with negative events. A central theme in the Bear Clan stories revolves around courage and the importance of finding balance for transformation. The values portrayed in this episode's stories draw from Native American teachings, specifically The Seven Gifts of the Grandfathers. The episode introduces the Bear Clan Origin Story arc, drawing inspiration from a traditional Native American story called "The Boy Who Lived With the Bears." The narrative involves a child being adopted by bears after being mistreated by an uncle, emphasizing the importance of treating children with respect and love. This episode shares the first three parts of the Bear Clan Origin Story.  It is built around the Native American parable of two wolves existing within every person.  In the Bear Clan version these wolves are “good” and “bad” but rather "courageous" and "fearsome." Overall, the episode highlights the therapeutic benefits of storytelling in connecting with clients, addressing trauma, and imparting valuable life lessons.

This episode focuses on how to help child-clients become physiologically centered.  Previous episodes have focused on helping children become emotionally and  cognitively centered. Emotional centering involves regulating extremes of emotions, and developing reaction inhibition and stress tolerance. Various tools, such as the Check-in and Empathic Listening can be really useful for helping kids become emotionally centered.  Cognitive centering techniques include the use of tools like the Feelings Thermometer and Feelings Maps to help kids describe their feelings.  A complimentary approach focuses on leveraging clients' physiology to help them become centered.  Afterall, every emotion is expressed in various ways throughout a person's body.  Co-regulation, achieved through shared activities and physical engagement, is a basic way in which a counselor can help a client become centered on a physiological level.  Changing a child's physiology is a powerful way to influence regulate their emotions and thoughts.  Techniques such as sitting down, drinking water, engaging in physical activities, and going on walks are explored. Food also powerfully impacts physiology but in many ways it's too powerful and overusing it as a way to change a kids mood or attitude can cause unwanted negative consequences. Likewise, touch, hugs, and hand-holding can be very physiological centering, but again there's a need for judgment and clear program guidelines. Various techniques, including sensory meditation, breathing exercises, and mindfulness, are recommended to help children become physiologically centered. The challenges of implementing these techniques are explored, including the need for months of daily practice and potential boredom of some exercises. This episode concludes by introducing the Owl Eyes technique, a form of sensory walking meditation involving maintaining peripheral vision.

This podcast presents a way to understand the brain's ability to use reasoning to become cognitively centered.  Emotional centering involves regulating the intensity and switching between emotional states. Behavioral centering, particularly physiological centering, focuses on transitioning from extremes to a calm baseline. It's a little harder to understand the concept of becoming cognitively centered, but a good place to start is with a look at how the brain employs reasoning. A traditional dictionary definition of reasoning states that it has to be logical in nature.  However, reasoning is better understood as a broader action of figuring out reasons why the world is the way it is.  Early in life, before the parts of your brain that are capable of logical reasoning have sufficiently developed, parts of your brain understand the world in terms of emotions.  The Artist parts of your brain process sensory information as feelings and find patterns and associations between your experiences and your feelings. Your feelings and your Emotional-Reasoning evolve as you mature, accommodating more nuanced and contradictory feelings.  Emotional-Reasoning doesn't go away as your mature.  It's the only kind of reasoning that some sections of your brain are capable of doing.  Other parts of your brain, the more cognitively sophisticated parts I call The Scout, develop the ability to do Magical-Reasoning.  This develops out of experiencing correlations and connections between people, objects, and places, often based on imitation and symbolism. Magical-Reasoning also persists into adulthood, coexisting with Logical-Reasoning.  Magical-Reasoning becomes the basis for much of how you make sense of social situations and social rules. As your frontal cortex develops, Logical-Reasoning becomes better at moving beyond correlation and predicting cause and effect.  Logical-Reasoning takes more energy.  It doesn't take the place of Emotional- and Magical-Reasoning; instead it exists simultaneously in different parts of your brain.  The Chief parts of your brain, that specialize in regulating the rest of your brain and body, use yet a fourth type of reasoning that I call Influencer-Reasoning.  This type of reasoning guides you in who to copy and follow.  There's six sources of influence: Relationship, Authority, Power-Broker, Charismatic, Expert, and Fame influences. By blending the four types of reasoning, you'll become more centered.  You can also help your child-clients to become more skilled at using each of the four types of reasoning.  That's the focus of the next episode. 

This podcast episode builds off of the concept of four different types of reasoning simultaneously performed by distinct parts of the brain. The inner Artist engages in Emotional-Reasoning, associating experiences with emotions. The inner Scout employs Magical-Reasoning, finding patterns and correlations to make sense of the world. The inner Warrior relies on Logical-Reasoning, basing actions on evidence and logic. The inner Chief, responsible for regulating the brain, uses Influencer-Reasoning, considering factors like relationships, authority, power, charisma, expertise, and fame. Despite the common perception of Logical-Reasoning's superiority, it's Emotional-Reasoning that often determines choices after weighing the different types of reasoning. The skilled residential counselor can help child-clients become more skilled at each of the four types of reasoning, and at blending the four types together to arrive at a richer understanding of how the world works.  Emotional-Reasoning can be improved by assisting clients with Affect-Labeling, which involves clients using words to describe their emotions, contributing to a calming effect on the brain. Other tools, such as Feelings Maps, Feelings Word Banks, and the Feelings Thermometer can help clients with Affect-Labeling.  Residential Counselors can nurture Magical-Reasoning in children, especially those on the autism spectrum, through copying games and pretend play. Magical-Reasoning is often times the basis of social principles and friendships. Logical-Reasoning can be helped along by teaching the use of pro-con lists, the scientific method, and activities that exercise executive functions such as planning, prioritizing, organizing, working memory, and flexibility. Influencer-Reasoning is addressed through positive role modeling and awareness of peer influence. The episode concludes by highlighting the importance of cognitive flexibility and practicing all four reasoning types for the developmental growth of children.

This podcast presents a system of eight values and fits them within the Meta-Compass Model.  This podcast explores the interplay between executive functions, values, and emotional, cognitive, and behavioral health, offering a practical framework for understanding and fostering these aspects in individuals, particularly children and youth. Values, separate from Executive Skills, serve as a mechanism for your inner Chief to regulate the other cardinal aspects of your psyche, the Artist, the Scout, and especially the Warrior by providing boundaries for behaviors.  A values system is presented that is inspired by Native American traditions, particularly the Seven Gifts of The Grandfathers, which include Respect, Love, Truth, Honesty, Bravery, Humility, and Wisdom.  An eight gift, Integrity, is added to represent the Eight Gifts of The Elders. Each "gift" is associated with a specific direction on the Meta-Compass Model. For instance, the Gift of Respect, associated with the East, involves recognizing and attending to basic needs, fostering empathy, and countering the Fear-of-the-Cold. The Gift of Love, also in the East, is portrayed as a broad sense of caring, countering the Fear-of-Being-Alone. Other gifts, such as Truth and Honesty, are linked to the South and counter the Fear-of-The-Woods and Fear-of-the-Dark, respectively. The West represents the Gifts of Bravery and Humility, countering Fear-of-Animals and Fear-of-Water. The North encompasses the Gifts of Integrity and Wisdom, countering the Fear-of-Rot. A concrete code of conduct derived from the Eight Gifts, which turns each value into actionable behaviors, is available on the resources page of the website (www.BearClanllc.com). The episode wraps up with an original story titled "Buffalo and The Eight Gifts of the Elders."

In this podcast episode, the focus is on aiding children and youth in residential treatment to develop executive skills, which are crucial for regulating emotions, thinking, and behavior. Developing residents executive skills is essential because it's their deficits in being able to regulate their own feelings, thoughts, and behaviors that accounts for why they need to live at a treatment program in order to receive services, instead of living in the community / with their families.  Executive skills begin developing in childhood but can be delayed or overwhelmed by environmental challenges, trauma, deprivation, insufficient parenting, or neurological conditions. The key to improving executive skills lies in practice, with the brain becoming more adept at whatever skills it regularly engages in. The podcast introduces 13 executive skills, two of which are primarily focused on regulating emotions, eight of which are primarily focused on regulating thinking, and 3 of which are focused on regulating behaviors.  Strategies are presented for developing reaction inhibition and stress tolerance, crucial for emotional regulation, include labeling and check-ins. Stress tolerance is further fostered through empathic listening, creative arts, journaling, and coping activities. Cognitive executive skills such as planning, prioritizing, organizing, sustained attention, time management, task initiation, working memory, and flexibility are explored. Practical techniques involve fostering autonomy in planning, using a choice model for prioritization, engaging in organizing tasks, and employing coping activities to enhance stress tolerance and several cognitive executive skills. Coping activities are divided into eight categories, including diversions, tension releasers, organizing tasks, cognitive coping skills, social coping skills, physical maintenance strategies, limit setting, and spiritually fulfilling activities. The podcast emphasizes the importance of teaching children positive coping activities while being aware of negative coping actions. Negative coping actions do work, in-the-moment, to help a person tolerate stress, however, they have longer-term self-destructive effects.  These are things such as drug use, self-injurious behaviors, over-eating, and blaming people and yourself. Lastly, the podcast touches on additional executive skills such as goal-directed persistence, self-awareness, and meta-cognition. It highlights the role of residential staff in supporting children to stick to goals, improve self-awareness through labeling, and encourage meta-cognitive thinking by exploring motivations and intentions. Overall, the episode provides a comprehensive guide to helping children in residential treatment enhance their executive skills through intentional and practical interventions.

This podcast episode is intended to increase your awareness of Self-Talk and how you can coach your clients to use more effective and healthier Self-Talk.  It uses the Aspect Compass (part of the Meta-Compass Model) to present different qualities of Self-Talk that appeal to the four cardinal aspects of your psyche called The Artist, The Scout, The Warrior, and The Chief. Using the Aspect Compass begins with the Artist (in the East), representing the domain of emotions.  As children explore the world, the Scout (in the South) emerges, making associations and developing thoughts. The Warrior (in the West) handles challenging behaviors, responding to emotional cues from the Artist and thoughts from the Scout.  Finally the Chief (in the North) emerges to coordinate and regulate the four aspects of your psyche.  The Chief uses executive skills, like Reaction Inhibition and Stress Tolerance, to regulate the Artist.  The Chief uses other executive skills, like planning, prioritizing, time management, and sustained attention to regulate the Scout. The Chief also regulates the Warrior with skills like goal-directed persistence, self-awareness, and meta-cognition. The Chief using Self-Talk, begins with caregiver messages early in life. The Chief internalizes this caregiver talk which turns into Self-Talk.  For the Artist, with its limited vocabulary, tone of voice and simple words work best.  On the other hand, The Scout responds best to coaching Self-Talk, which can be delivered in several different styles.  The Warrior parts of the brain and psyche also don't have a lot of vocabulary.  The Warrior responds best to Self-Talk that is simple, direct, and directive. Residential staff using the Labeling technique support the development of the clients' Chief aspect, which has to learn to monitor the other aspects, in other words to be self-aware of feelings, thoughts, and behaviors.  Clients also benefit from increased awareness of negative Self-Talk.  The Scout parts of the brain are designed to come up with observations, theories, and beliefs that explain the world.  Asking yourself negative questions, like “Why am I so stupid?” will cause The Scout to look for explanations, evidence, and an answer.  That answer is not based on any kind of objective truth and is likely to be demoralizing, disempowering, and self-destructive. The skilled residential counselor models empowering self-talk and uses it for personal stress management. The Chief's Self-Talk encouraging you to perceive others as whole beings, to act with integrity, and to encourage kindness teaches clients to develop their own Self-Talk to manage their own feelings, thoughts, and behaviors. 

This episode focuses on Beliefs as a powerful regulatory mechanism. Beliefs act as filters through which individuals perceive reality, and the host emphasizes the importance of consciously choosing beliefs. The key idea is that beliefs need not be evaluated based on their imagined truth, but on their usefulness and how well they serve an individual. Empowering and healthy beliefs can be consciously cultivated through two main strategies:  tasking your brain to find evidence supporting the new belief, and taking action as if the belief were already true. Twelve Transformational Beliefs are presented:   People are not their behaviors.   All behavior happens for a reason. People are my most valuable resource. Everything happens for a reason and somehow serves me. There's no such thing as failure, only unintended results. I can take responsibility for everything I impact. I don't have to completely understand something to use it. Work can be fun. Commitment and hard work makes for a better product. We're all works in progress. Intentions matter. We're all spiritual beings on a physical journey. Overall, the podcast encourages listeners to adopt empowering beliefs, actively seek evidence supporting them, and act in alignment with these beliefs for personal and professional growth.

This podcast episode presents a system for managing behavior problems, utilizing a variety of interconnected tools and techniques.  The concept of contagion is introduced, explaining how behaviors, feelings, and thoughts can spread among individuals. The importance of interrupting behavioral patterns is highlighted, particularly using a technique known as "pattern interrupts." These interrupts aim to prevent escalation and promote a return to baseline functioning.  A detailed example of a structural pattern interrupt is provided, involving a campaign to reduce swearing among middle-school boys in a residential cottage. The podcast suggests the use of three types of time-outs: Structured Centering Break, Independent Centering Break, and Resets. Each type serves as a therapeutic consequence for a lack of self-control, allowing individuals to practice coping activities and centering exercises. The importance of tailoring interventions to individual needs, avoiding shaming, and promoting consistency is emphasized. Additionally, the establishment of a clear Code of Conduct based on values is recommended, with examples provided. The distinction between major and minor violations of the Code is discussed, along with a range of staff responses to minor violations. The goal is to intervene effectively while minimizing disruption to the group and the activity. The podcast underscores the developmental importance of allowing individuals to progress from Structured Centering Breaks to Independent Centering Breaks and Resets. The ultimate aim is to empower clients to independently manage their behaviors and develop self-control, contributing to their growth and success outside the treatment program. Structured Centering Breaks, which are used for all instances where major violations of the Code of Conduct have occurred, include a processing of the incident that focuses on taking responsibility for one's actions and feelings, followed by a discussion on relationship repair, restitution, fines, group explanations, and executive skills development as ways to achieve higher responsibility levels. This episode also takes a look at the use of restrictions, differentiating between those related to safety concerns and those as direct consequences of problem behaviors. The goal is to frame restrictions in a way that aligns with program goals beyond punishment, connecting them to therapeutic and treatment-driven objectives.

This podcast aims to guide residential staff taking on the role of supervising a shift, emphasizing the complexities involved in managing a group of kids and supporting a team of direct care staff. The role of a Residential Supervisor involves overseeing shifts, and in some agencies includes providing one-on-one office-based supervision, which includes conducting performance appraisals, managing personnel issues, and facilitating communication between staff and management. To organize this wide-ranging topic, the 7-Directions Meta-Compass Model, inspired by Native American concepts, is used as a framework to explore different aspects of the supervisor's role. The East represents emotions, focusing on the importance of emotional support, resilience, and passion for leadership. Values associated with the East are Respect and Caring.  The Supervisor provides the staff team with executive functions, including Reaction Inhibition and Stress Tolerance.  This sets the tone for their using those same executive skills with the kids.  The importance of debriefing after intense experiences and fostering Stress Tolerance is highlighted. Moving to the South, which represents cognitions, the podcast emphasizes the role of the supervisor in imparting knowledge about program structures, schedules, behavior management, and treatment components. The Values associated with the South are Truth and Honesty. This episode delves into team-building, emphasizing the role of communication, feedback, appreciation, and celebration in developing a high-performing team. The Values associated with the South are Truth and Honesty. The Supervisor is responsible for providing the team with cognitive executive functions like Planning, Prioritizing, Organizing, Sustained Attention, Working Memory, Time Management, Task Initiation, and Flexibility. These functions are crucial for effective shift supervision. Upcoming episodes will explore the West, North, Upward, Downward, and Inward directions, covering behaviors, physiology, setting goals, relationships, tasks, and self-care. This mini-series provides guidance for Residential Supervisors, acknowledging the challenges and growth opportunities associated with the role.

In this podcast episode, looking at the role of the Residential Supervisor shifts to the perspective of the West cardinal direction in the Meta-Compass Model.  The West is the direction of behaviors, physiology, and for this podcast, especially is concerned with setting behavioral goals for supervisees.  It's suggested that setting behavioral goals be based on encouraging Residential Counselors to develop their own executive skills.  Focusing on executive skills, and using the language of executive skills, helps separate out asking supervisees to develop their professional skills, versus language that makes supervisees feel like their supervisor is judging their character or personal development. Thus the supervisor encourages specific behaviors in staff members that correspond with exercising executive skills such as reaction inhibition and stress tolerance, crucial for maintaining emotional control during challenging situations.  Likewise, the supervisor focuses on helping their supervisees improve their own planning, prioritizing, organizing, time management, initiation, and other cognitive executive skills.  This focus on executive skills development, and really breaking it down to the behaviors that demonstrate an exercising of these skills, continues with helping supervisees with their goal-directed persistence (highly relevant to the reality that a lot of residential interventions only work after hundreds of repetitions), their self-awareness (which is the foundation of self-directed development), and meta-cognition (which corresponds with understanding the “thinking” of the program – its philosophy, treatment approaches, etc.). The podcast then shifts to the North cardinal position perspective on the Meta-Compass.  The North, the domain of the Chief, is very concerned with teamwork and the well-being of their team-mates.  Guidelines are presented for effectively encouraging the development of a high-functioning team.  The Chief also has to, sometimes, set limits.  It falls on the supervisor to monitor staff interactions with both clients and colleagues to ensure safety and adherence to workplace laws and program policies, procedures, and practices.

This podcast mini-series aims to aid residential staff who find themselves supervising shifts and providing individual supervision for residential counselors. It explores various aspects of these roles through the Seven-Directions Meta-Compass Model. Each episode focuses on a cardinal direction, representing different perspectives. Episode one emphasized supportive supervision (East) and the role of the supervisor as teacher (South).  Episode two focused on coaching (West) and focused on teamwork (North). The current episode delves into the Upward perspective, addressing the relationship challenges of transitioning from peer to supervisor and maintaining professional boundaries.  The importance of refraining from participating in negative venting among staff and instead focusing on problem-solving and promoting teamwork is stressed. The supervisor must navigate new boundaries and ensure that relationships with colleagues remain professional. The podcast then shifts to the Downward perspective of task responsibilities. It emphasizes the importance of checklists to keep track of various tasks, the importance of delegating effectively,  and potentially addressing personnel issues involving productivity, attendance, and conduct. Next, it explores the Inward perspective, emphasizing self-care and professional development for both supervisors and supervisees. It highlights the role of the supervisor in supporting staff well-being and facilitating their growth. Finally, it offers a model for conducting individual supervision meetings, incorporating elements from all cardinal directions. It suggests starting with emotional support, moving to teaching and coaching, and then addressing teamwork, engagement with clients, and any other issues specific to any one supervisee. The series concludes by acknowledging the complexity of the supervisor role and the transformative impact it can have on both staff and clients in a residential treatment setting. It emphasizes the importance of continuous learning and growth in this role.

Effective residential treatment for troubled children and youth depends upon teamwork among both staff and residents. The goal is to transform a group of struggling kids into a supportive team. Many kids in these programs crave friendship, which is often lacking due to their life challenges and the displacement of residential treatment. A major goal in treatment programs is to help the child and youth clients learn how to make and keep friends.  Residential treatment does a lot of that teaching through various group activities, including recreational, therapy-based, and house meetings. These gatherings require active participation from staff, beyond just facilitating. Staff members play roles like maintaining order, offering support to individual kids, and helping resolve conflicts. They also assist in therapeutic activities, like group explanations, where kids take responsibility for their actions and receive feedback. In recreational activities, staff involvement goes beyond observation. They engage as cheerleaders, referees, coaches, or announcers, aiming to boost kids' confidence and social skills. The concept of "therapeutic error" guides staff to adapt their participation level to the kids' abilities, fostering a positive experience for them. In therapy-based groups, staff provide support and modeling, helping kids manage their emotions and engage in the therapeutic process. While therapists lead these sessions, staff contribute by creating a supportive environment and assisting kids in staying focused. The most effective groups combine the role of the therapist in uncovering emotional pain with the role of the counselor in helping clients tolerate that pain.  Overall, effective residential treatment relies on staff members actively engaging in various group settings, contributing to the therapeutic process, and fostering a sense of teamwork and support among the residents. Staff involvement goes beyond facilitation; it involves actively participating in activities, providing support, and guiding kids towards positive interactions and growth.

The Role of a Residential Counselor:  Care and Treatment CARE: Relationships:  A core responsibility is to attend to the care, well-being, and safety of the clients.  This requires caring and respectful relationships between staff and clients.   Self:  In order to take care of the clients, you have to be able to take care of yourself.  This work is very stressful and your ability to become centered will strongly effect your ability to help the kids become centered.   Task Responsibilities:  A Residential Counselor has numerous core tasks related to the implementation of program structures, care of the facility, and reporting requirements. TREATMENT: Emotions:  In the East cardinal position of the treatment compass, this domain represents the parts of the brain, and the parts of the mind or psyche, that understand the world and communicate in terms of emotions.  Part of a counselor's treatment role is to help clients become emotionally centered when their feelings and moods become too extreme, too intense, too unstable, or too restricted.  Cognitions:  In the South, this domain represents the parts of the brain and psyche that understand the world and communicate in terms of thinking.  Part of a counselor's treatment role is to help clients become cognitively centered when their thinking is disorganized. Behaviors:   In the West, this domain represents the parts of the brain and psyche that understand the world and communicate in terms of both external actions and internal physiological activity.  Part of a counselor's treatment role is to help clients become behaviorally and physiologically centered when their actions and bodies become too extreme or chaotic.  Executive Skills:  In the North, this domain represents the parts of the brain and psyche that regulate the other parts of the brain and body.  Part of a counselor's treatment role is to serve as the kids' executive skills, support their emerging skills, and inspire the development of their executive skills so that they can successfully self-regulate and no longer need residential treatment.     Self:  At the center of the treatment compass is the self.  In addition to needing to take care of themselves, so that they can care effectively for the kids, from a treatment perspective residential counselors need to be skilled at becoming centered themselves.  Those abilities, to be highly resilient and to set the tone, will help the kids learn how to become centered.  Other Key Concepts Counseling:  Where therapy is has a strong interest in helping people make connections between their past and present, and tends to directly focus on issues related to grief and trauma; counseling tends to be more focused on the present – on how the client is functioning in-the-moment. Neuropsychology:  Neurology is the study of the brain and nervous system.  Psychology is the study of the mind or psyche.  Neuropsychology studies and explains the connections between neurology and psychology.  The Human Brain:  This complex organ is made up of different parts that have unique shapes, functions, and ways of processing sensory data.  Likewise, different parts of the brain have different ways of communicating to rest of the brain.  Via the spine, nerve pathways, and blood vessels, the brain is connected to all the other parts of the body.  There are glands throughout the body that produce various chemicals that change how the brain functions.  Although only a metaphor, you can think of these chemicals as corresponding with feelings and moods, while the electrical system of the brain corresponds with thinking. The Practice Effect:  Anything you practice, your brain gets better at doing.  This not only applies to actions, like bouncing a ball, but to feelings and moods.  Practice getting angry and you'll more easily be able to get into that state-of-mind.  Practice being happy and you'll ore easily be able to get into that state-of-mind.  Co-Regulating:  This term refers to how two people who are doing the same activity, side-by-side, will start to synchronize their nervous systems.  Human Beings start out life dependent on co-regulation to manage their infant feelings, thoughts, and behaviors.  As those parts of the brain get used, the practice effect kicks in, and a person starts being able to better self-regulate. The Artist:  This is what I call the parts of the brain, and the parts of the psyche, that only understand the world and communicate in terms of emotions.  The Artist wants to be seen, and the artist wants to be heard.  The Artist communicates, via feelings and moods, to get its needs met, using the only “language” it has – emotions.      

The vertical axis of the Seven-Directions Meta-Compass Model, represents the core functions involved in caring for children who are literally placed in the care of a residential treatment program.  The Upward direction (Relationships) involves all the activities a Residential Counselor does to care for the kids.  These are things that have to happen simply because the clients are children, regardless of whatever individual treatment issues a client presents.  The Downward direction (Task Responsibilities) involves all the tasks involved in caring for the kids, caring for the facility, and being an employee.  The Inward (Self) direction involves caring for oneself, so that you have the energy to care for the kids.  Although there's an overlap between Care and Treatment; the horizontal plane of the compass represents four aspects of treatment involved in being a residential counselor. The East cardinal position represents the domain of emotions.  It's symbolized by the aspect of The Artist.  The Artist is made up of those parts of the brain and psyche that only process the world and communicate in terms of emotions.  That's how those parts of the brain work.  The South cardinal position represents the domain of cognitions.  It's symbolized by the aspect of The Scout.  Unlike The Artist, The Scout possesses lots of words and engages in thinking, analysis, and has a purpose of exploring the world, interpreting what it finds, and reporting back to the rest of the brain. The West cardinal position represents the domain of behaviors (both external actions and internal physiological actions).  It's symbolized by the aspect of The Warrior.  The Warrior expresses all The Artist's feelings and all the Scout's thoughts as external and internal behaviors.  The North cardinal position represents the domain of executive skills that are used to regulate the rest of the brain.  It's symbolized by the aspect of The Chief.  The Chief is concerned with centering The Artist, The Scout, and The Warrior.  The Chief regulates the tribe (the different parts of the psyche) and also is concerned with a person's relationships with other people (the external tribe).  The podcast delves into understanding the brain's functioning, emphasizing the practice effect wherein repeated actions reinforce neural pathways. It stresses the importance of fostering calm feelings, thoughts, and behaviors in children through positive experiences and repetition. The discussion outlines the interconnectedness of different aspects of the psyche: emotions (East), cognitions (South), behaviors (West), and executive skills (North). It highlights the role of residential staff in creating a therapeutic milieu and inspiring internal changes in children's brains to manage problem behaviors effectively. Respectful treatment is emphasized as essential for creating a therapeutic environment, contrasting coercive approaches that may yield short-term compliance but hinder long-term transformation. The episode concludes with a preview of forthcoming tools and techniques to help children achieve emotional centeredness, laying the foundation for further cognitive and behavioral growth. Other Key Concepts The Practice Effect:  Feelings, moods, and even thinking, work the same way in the brain as behaviors.  Whatever states-of-mind are practiced become easier to achieve.  Practicing becoming emotionally, cognitively, and behaviorally centered will transform a person's brain. The Intensity Effect:  Intense feelings create lasting changes in the brain.  This is why a single traumatic incident, let alone the multiple traumas that are common among kids in residential treatment, have a lasting effect on the kids' brains (unless effective treatment occurs). Respect Doesn't Have to Be Earned:  In a treatment environment it's important that staff consistently treat the kids with respect.  It is likely that many of the kids will not consistently treat staff respectfully.  That makes being respectful to the kids a challenge that requires personal maturity and professionalism.  Kids experiencing the adults consistently treating them with respect will, over time, be a key component to the clients feeling safe enough and trusting enough to try new behaviors.  The Artist part of each child's psyche has a primal fear that the world is too harsh to survive.  Counselors will be most effective at treatment when they respect that fear and don't add to it with harsh interactions. Seeking Compliance is Behavior Management, not Treatment:  Sometimes kids in residential treatment exhibit such outrageous and unsafe behaviors that managing those behaviors has to take priority over treatment.  However, effective behavior management only trains kids in how to be successful within the artificial environment of an institutional setting.  Treatment involves transformational change that carries over to when kids are living back in the community.          

Posture:  The parts of the brain that control the physical body (the inner Warrior) and the parts of the brain that operate in terms of emotions (the inner Artist) are tightly linked in the brain.  Changes in one automatically trigger changes in the other.  So, getting kids to become more aware of their posture, and to habitually adopt good posture, supports being in a positive emotionally state-of-mind.  The art is being able to frequently help kids improve their posture without it becoming obnoxious.   Co-Regulation:  When you synchronize your nervous system and a client's nervous system.  This is most easily done through high energy activities such as playing an active game together; however, it can also happen in quieter moments such as watching something engaging together.  When kids co-regulate with a relatively organized adult, they are exercising the same parts of their brain that are involved in self-regulating.  If they get skilled enough at self-regulation, they still may require treatment, but would no longer need to receive that treatment in an institutional setting. Empathic Listening:  The goals of Empathic Listening are two-fold.  The first is to create a co-regulating experience for the client.  The second is to leave the client feeling like their feelings are understood by you.  That's the heart of empathy – being able to feel what another person is feelings.  There's seven steps to Empathic Listening: 1. Mirroring – match the client's general body language and speech (speed and tonality).  Slightly lead the client toward lower and slower physiology and speech. 2. Intense listening – use body language, gestures, and small verbal cues to convey that you are intensely listening.  One “trick” you can use to help yourself slip into conveying intense listening is to speak and carry yourself as if you were trying to memorize what the client is saying. 3. Ask clarifying questions in a non-judgmental fashion – convey that your interest is in understanding the client.  Do not just repeat what the kid has said; rephrase the highlights or key points, taking care to not distort the meaning.      a.       Can I just clarify?  You're saying that …      b.      Am I understanding you correctly; you're saying…      c.       Let me make sure I've got this right; you're saying …      d.      A lot of times people use the same word a little differently.  What do you mean by… 4. Focusing on emotions – ask clarifying questions to inspire the client to share the emotional content of what they're saying.  Take care to not tell kids how they are feeling.  Often times, adopting an air of curious confusion can be helpful for getting kids to elaborate on their emotions.  Adopting a non-judgmental tone is again crucial.  Remember, feelings don't have to be logical, they just are.  You're trying to get the client to talk about their feelings.      a.       When you said that made you “angry”… what do you mean by that?  Is that something you feel in your body?      b.      When you say you're “upset”… I'm not sure I really know quite what you mean?  Help me understand better….      c.       When you say “it's unfair,” I could kind of guess at what exactly you mean, but I don't really want to guess.  Could you explain that? 5. Avoid problem-solving – it can be incredibly tempting to steer the conversation into problem-solving.  Don't do that.  That shifts the kid from speaking from an emotional place to using the more analytical parts of the brain.  That's a key point of Processing, which is a separate tool, from Empathic Listening.  The goal of Empathic Listening is to create a sense of connection and a therapeutic alliance.  It's much more powerful, and in most situations more therapeutic, to simply leave the client with a feeling of being understood, and sitting together with the feelings, than thinking that your role is to help them solve some problems. 6. Avoid the “empathizing equals agreeing with” trap – sometimes an Empathic Listening session can include a kid complaining about other adults.  It is wise to be explicit that while you think you understand what they're saying, that doesn't necessarily mean that you agree with their characterizations of others.  Done skillfully, if you've established a rapport, this distinction will be accepted by kids without breaking the rapport you've established. 7. Plug the client back into program structures – while it's not necessarily “wrong” to end an Empathic Listening session with Problem Solving, that can take away from the power of the Empathic Listening.  Instead, it is often times preferable to end the session by acknowledging that the emotional issues that were shared are not something that can be solved, and then directing / assisting them to engage in whatever scheduled structures are currently the group's focus (e.g. “I really appreciate you sharing some really difficult feelings with me; I hope on some level you also found that helpful.  I think the best thing to do now is to switch gears to the schedule, which right now would be bed prep.”).  

Executive Skills are abilities that part of the brain can develop that used to regulate other parts of the brain.  There's two Executive Skills that describe ways that the emotional parts of the brain are regulated. Reaction Inhibition is the ability to stop yourself from automatically reacting.  More specifically, it's the ability to stop the action-focused parts of the brain, what I call the inner Warrior, from mindlessly reacting to the emotions being communicated by the parts of the brain I call the inner Artist.  Your body will have internal behaviors in reaction to every feeling you have.  However, developing Reaction Inhibition means not externally acting out every feeling.  It means giving yourself a split second to think before acting. Stress Tolerance is the ability to sit with various emotions without acting them out.  It's the ability to experience feelings, even potentially strong feelings, without becoming so overwhelmed that you can no longer think straight.  Kids in residential treatment have had difficult lives and their emotional states reflect that.  As a counselor, you can't change their past and you can't “fix” their feelings.  What you can do is help them develop their ability to tolerate their own feelings in a way where they continue to be able to make thoughtful choices about their behaviors. There's several executive abilities that help you control, modulate, and regulate your thoughts. Planning is being able to map out how to reach your goals or complete a task.  It includes being able to make decisions about what to focus on and what's not so important.  Like other skills, exercise / practice leads to development.  So cue your clients to plan ahead, to think about what's next on the schedule and how to prepare for it.  This isn't developed through the creation of large multi-day complex tasks.  Instead, it's developed through the everyday little changes in the schedule that can be done thoughtfully instead of mindlessly. Prioritizing is being able to weigh two or more different choices and then picking one.  Again, it's exercised through all the small decisions – it's teaching kids to make thoughtful choices.  Organizing is creating and maintaining systems to keep track of information or materials.  It doesn't matter what you're having kids organize – whether it's their bedroom, their backpack, an activity, or putting away toys.  The act of organizing exercises their inner Chief. Sustained Attention is being able to maintain your attention despite distractibility, fatigue, or boredom.  There'll be large differences among kids in their ability to do this, and for any one kid it can be different at different times.  However, it's like a muscle – when you inspire kids to pay attention a little bit longer, a little bit better than what comes naturally to them – they will get better at it. Time Management is being able to estimate how long various tasks will take, and how to stay within time limits and deadlines.  This is a part of the Chief's self-monitoring ability; however, it's directed outward (at the passage of time) rather than inward.  Having kids be aware of how much time is left in an activity, of when another part of the schedule is due to begin, or how long it takes to complete various tasks, exercises their inner Chief and will contribute to the Chief becoming better at self-regulation.  Task Initiation is being able to begin projects without undue procrastination, in an efficient and timely fashion.  In general, most kids are not great at task initiation and living in a residential program can actually make that situation even worse.  Typically, there's a lot more structure and there's a whole bunch of adults to cue kids to start various tasks.  It's easier to just wait for someone else to tell you what to do or how to start.  However, like other skills, it's through practice that kids get better at task initiation.  So, as a counselor, ask questions like “What needs to happen to start this activity?”, rather than just telling kids what to do. Flexibility is being able to revise plans and adapt to changed circumstances.  Residential treatment can become so structured that it becomes inflexible.  That's not helpful for developing thoughtful kids.  So, encourage some amount of flexibility in the how kids think and in how they act.  Typically, there's plenty of disruptions to the usual routine, so there's lots of opportunities to encourage and praise flexibility.  Self-Awareness is being able to monitor yourself in real time.  This skill involves having one part of your mind that is observing other parts of your mind that are generating and experiencing feelings, thoughts, and behaviors.  Self-Awareness is the foundational skill for a person being able to take charge of their own brain.  Labeling is a great technique for increasing Self-Awareness and for helping clients become more thoughtful people.  Labeling can be thought of as narrating what kids are doing as they're doing it – sort of play-by-play announcing.  Another way to think of this technique to imagine the a snapshot of what a kid is doing and the labeling is the descriptive caption underneath the picture. There's variations on the labeling technique, but in its purest form it can be thought of as labeling observable behaviors.  This is done without any judgmental tone, without praise or criticism.  It's simply stating what you see kids doing, in-the-moment.  It's probably the single tool that should be used the most by Residential Counselors. You can combine labeling with praise, although that's going to be less targeted at increasing self-awareness, but might be better at increasing self-esteem.  You can also label behaviors in a way that intended to promote social skills or character development. You can also label feelings – however, keep in mind that most people don't like being told by someone else how they feel.  So when labeling feelings, it's generally best to do it in the form of a question.  The goal of that question is to increase the client's self-awareness, not to solve some problem.  Finally, one of the most powerful uses of labeling is to use it instead of directives or directly setting limits.  Labeling can be a really powerful way to get kids to be thoughtfully cooperative rather than mindlessly compliant.

The Aspect Compass, part of the Meta-Compass Model, divides areas of the brain and aspects of the psyche into four parts called:  The Artist, The Scout, The Warrior, and The Chief. The Artist represents those parts of the brain and psyche that understand the world in terms of emotions.  The Artist communicates, in terms of feelings and moods, to the rest of the brain.  Helping The Artist feel centered involves making The Artist feel heard and seen.  Creative arts activities can be emotionally centering activities.  Co-Regulating with others and Experiencing empathy from others is especially centering.  Empathic Listening is a great technique for helping clients to experience empathy. The Scout represents those parts of the brain and psyche that are tasked with exploring the world, trying to make sense of it, and reporting back to the rest of the brain.  The Scout tends to over-analyze and can become very disorganized (in other words, thinking becomes disorganized).  Having clients exercise the Scout skills of Accurate Listening and Accurate Reporting are centering for this part of the psyche.  Listening Checks are an effective tool for teaching Accurate Listening.   Teaching Accurate Reporting often times involves using Clarifying Questions to help them describe a full sequence of events in the proper chronological order.  It includes encouraging kids to report whatever happened in a calm tone of voice (exercising Reaction Inhibition and Stress Tolerance).  Having kids Identify More Than One Possible Explanation for why something has occurred or someone has done something helps them exercise the executive skill of Flexibility. The Warrior represents those parts of the brain and psyche that are in charge of both external behaviors and internal physiological actions.  If The Warrior is heightened, it is very difficult for the Scout to function (in other words, if a kid is still agitated they're not going to be able to access their best thinking).  The Warrior tends to automatically react (especially internally) to whatever The Artist is communicating.  So to help The Scout improve at processing events, The Warrior and The Artist need to first be relatively calm. The Chief represents those parts of the brain and psyche that are in charge of regulating The Artist, The Scout, and The Warrior.  The Chief uses Executive Skills (and some other abilities such as Beliefs and Values) to influence a person's feelings, thinking, and behaviors.  Processing is a technique designed to strengthen a kid's inner Chief and inner Scout.  It can be done throughout the residential day, but especially makes sense to use after an incident involving problem behaviors.  Once a kid has been separated from the group and has generally calmed down, Processing provides a structured way to turn what happened into a learning experience.  Processing is customized to the developmental level of the client.  Some clients may only do the first step of processing, while other clients are capable of doing much more. 1.      The first step in Processing an incident is to get the client to own up to their own behaviors.  That's literally admitting to having done what problem behaviors resulted in their being separated from the group.  This is best done without evoking feelings of shame and guilt.  Those feelings get in the way of cognitive processing.  In other words, those feelings make it harder to the kid to think about what happened and to learn from it. 2.      The second step in Processing is done with clients who developmentally are able to identify some feelings and/or thoughts that were part of the problem behavior incident.  The goal is the same as step 1 – to get the kid's inner Chief to accept Responsibility for their own behaviors, feelings, and thoughts. 3.      The third step in Processing, to the extent the client is developmentally able, is to help them identify what they could have done differently and what they could do next time a similar situation arises. 4.      The fourth step switches from a focus on personal responsibility to looking at Social Responsibility.  This step involves having the kid identify what impact they think their behaviors had on people around them. 5.      The fifth step moves beyond verbally accepting Responsibility to performing some action related to Relationship Repair.  That might be a simple verbal apology, an apology card, or might be a Restitution such as beautifying a space, doing an extra chore that benefits others, or any other symbolic gesture showing that they want to be a positive member of the group.  Restitution systems can be a powerful structure within a residential treatment program but need to be designed for a general level of consistency.  The basic rationale behind Restitution is that you did something that made it more unpleasant for other people to live and work here; so now do something that makes it more pleasant for others.  This is largely a symbolic action and shouldn't take more than 10 to 15 minutes (in general).  It provides kids with a great sense of closure that an incident has been resolved and that they can get a fresh start. 6.      The sixth step goes even further in holding kids accountable to their living group, by having them review their processing with a group of peers and staff in a Group Explanation.  The main purpose of the group is for the client to publicly accept responsibility for their own problem behaviors and to check the accuracy of their thoughts on how they impacted others.  Two to five peers, who've been coached in some boundaries on giving feedback, then share how they were actually impacted and potentially give some constructive advice.  It takes a certain level of skill to facilitate a Group Explanation group; however, this skill can be learned by any residential staff.  Setting  up a Group Explanation system requires programmatic support so that this extremely powerful intervention is run in a consistent and productive fashion.  If a physical Processing Form is used, that paper can serve as a helpful guide for a client to present at a Group Explanation.  It can work well to have some restriction on privileges in place until a client completes any Relationship Repair / Restitution or Group Explanation expectations.

Coping Activities Diversions – any hobby or activity that engages your attention.        Writing, drawing, painting, crafts        Listening to music, playing an instrument, singing, dancing, acting        Gardening        Taking a walk, or going for a drive        Watching television or a movie        Guided Imagery Meditations        Playing a game        Shopping        Reading       Taking a break or vacation Tension Releasers         Going on a walk        Exercising        Breathing Exercises        Playing sports        Systematic Muscle Relaxation        Playing a musical instrument        Taking a hot shower or bath        Eating a little chocolate        Crying        Laughing        Singing   Organizing Tasks – any activity that involves ordering things.        Cleaning        Organizing your environment        Putting things away        Sudoku, Crossword puzzles, Jigsaw puzzles        Update your calendar       Outline the steps in a project Cognitive Coping Skills        Making lists (Pro-Con, Goals, Ideas)        Brainstorming solutions        Managing your expectations        Considering an inspirational quote        Being flexible        Consciously changing your attitude        Rewarding yourself for successes        Analyzing a situation       Reframing a problem to be an opportunity Social or Interpersonal Coping Strategies         Talking to someone you trust        Writing a note to someone you care about        Spending time with friends or family        Serving someone in need        Caring for or play with a pet        Role-playing challenging situations with others       Encouraging others Physical Maintenance Strategies        Getting enough sleep        Eating healthy foods        Getting into a good routine        Limiting caffeine and alcohol        Taking medication as prescribed        Deep / slow breathing   Limit Setting        Dropping some activities if you're over-extended        Setting boundaries and saying "no"        Prioritizing important tasks        Scheduling time for yourself       Being assertive to the demands of others Spiritually Fulfilling Activities         Praying        Meditating        Enjoying nature        Getting involved in a worthy cause       Experiencing appreciation or gratitude   Negative Coping Actions Diversions        Procrastination – putting off important tasks        Misusing drugs or alcohol as self-medicating       Wasting time on unimportant tasks Tension Releasers        Tantrums        Throwing things at people        Hitting people        Yelling at others        Destroying property       Speeding or driving recklessly Social or Interpersonal Strategies        Blaming others        Isolating or withdrawing        Mean or hostile joking        Putting down others behind their back        Criticizing others to their face        Manipulating others        Refusing help from others        Lying to other people        Sabotaging other people's plans        Being late to appointments        Provoking violence from others       Enabling others to take advantage of you Physical        Suicidal Gestures        Self-harm        Excessive exercise        Developing illnesses       Abusing drugs or alcohol Over-Indulging        Spending too much        Gambling        Eating too much       Continually crying Cognitive Strategies        Denying any problem        Stubbornness or inflexibility        All or nothing, black or white, thinking        Blaming yourself and others        Catastrophizing        Unproductive Repetitive Thoughts        Hiding or Burying Your Feelings        Withdrawing or Isolating       Name-Calling Self-Diminishing        Making excessive fun of yourself        Self-sabotaging behaviors        Blaming yourself        Thoughts and behaviors that suggest that you deserve to feel bad or overwhelmed  

Psychological Debriefing is a technique for reducing the impact of traumatic stress after a neurologically intense experience.  On a neuropsychological level that experience could be anything that triggers a release of certain hormones such as cortisol (known as “the stress hormone”) and adrenaline.  On a behavioral level that typically includes situations such as being involved in a physical intervention, being exposed to aggressive posturing, being yelled at, or really any situation that triggers significant danger signals in your body.  Exactly what moves a person significantly out of their comfort zone is going to differ from person to person based on individual physiology and psychology.  Exposure to traumatic stress does not automatically result in serious mental health conditions such as Post Traumatic Stress Disorder.  However, traumatic stress has a cumulative effect and can trigger pre-existing PTSD.  Symptoms of PTSD include: Aggressive or emotional outbursts Nightmares and/or flashbacks Heart palpitations, trembling hands, or sweating A sense of self-blame, worthlessness, shame, or guilt Acute or chronic unexplained physical pain Avoidance of people, things, or situations related to traumatic event Jumpiness Difficulty with sleep, eating, or physical intimacy Digestion disruptions Weakened immune system Low mood Headaches Social isolation Feeling empty or hopeless Loss of interest in activities Irritability Distrust of others or the world Dissociation The symptoms of traumatic stress are less extreme.  However, because stress is stored in the body, impacting all sorts of neurological and physiological regulatory systems, it's important to take steps to reduce its impact on staff.  There's something about being exposed to intense negative experiences that parts of the brain have great difficulty processing.  Typically, during such incidents the parts of the brain that are responsible for your sense of time do not function at 100%.  Thus, an objectively short incident might feel like it was much longer and have a bigger impact on you.  Likewise, your ability to remember the exact sequence of what happened becomes impaired.  The result is that afterwards, there's parts of your brain that feel confused about what just happened. That sense of confusion can lead to perseverative thoughts.  So, as you commute home, you keep running the incident over and over again in your head.  Part of you is trying to process, to make sense of, what happened.  However, memories of intense situations are stored based on their emotional impact.  So, you start to feel emotional in thinking about what happened earlier, and that in turn impairs your ability to process it.  Round and round your thoughts go, without any real resolution.  In the meantime, the stress builds up, and is stored, in your muscles and nervous system, eventually impacting your immune system and other regulatory mechanisms in your body. One of the most effective and practical ways to lessen that effect is through the regular use of Psychological Debriefing. There's four things that help reduce the impact of traumatic stress. Overwriting the emotional load of the traumatic memories. Clarifying the sequence of events.   Feeling cared for and respected. Use of self-centering techniques. Neuropsychological research supports practice-wisdom suggesting that the exact timing of debriefing doesn't matter, in terms of its effectiveness.  Sometimes, it can be done right after an incident.  However, it also works to reduce the impact of traumatic stress even hours later.  Nevertheless, as a rule of thumb, it's best if Psychological Debriefing can occur before the shift ends.  Otherwise, perseverating, repeatedly running through what happened in your own head, tends to reinforce the traumatic emotions tied to the memory.  You can try to debrief outside of work, but you'll soon learn that family and friends can't really relate to what you're describing and are left simply questioning why you would do such work in the first place! Instead, what's most helpful is to have a fellow staff person, ideally a shift leader or supervisor, but really it can be any staff person, simply attentively listen as you describe what happened.  Overwriting the emotional load of traumatic memories: When you describe, in a relatively calm fashion, what happened in a stressful incident, you begin the process of overwriting the emotional load of traumatic memories.  Essentially what's happening in your brain is that you are taking the memory of the stressful event, with it's intense emotional load, and overwriting that memory with a new memory of describing the incident to someone else, with a much reduced emotional load. In this way, some of the emotional power, the sting, of the memory is reduced.  Later, recalling what happened is less likely to trigger the intense emotions originally experienced.  Instead, that recall is tempered by the memory of calmly describing what happened to a colleague. To some extent, writing up the incident can serve the same purpose.  However, on an emotional level, the memory of calmly writing an incident report is not as powerful as a memory of verbally describing what happened.  Debriefing with an attentive colleague works best.  The key is that the description of what happened should, at least initially, focus on the behaviors and not on the staff person's emotions.  The idea is to be able to recount what happened while experiencing a relatively calm state-of-mind. Clarifying the Sequence of Events: Because the parts of the brain that keep track of time tend to get shut off during intense situations, the more cognitive parts of the brain can be left feeling somewhat confused about the exact sequence of events that took place.  Again, sticking to a description of the actions that occurred during the incident being debriefed can be helpful for restoring that sense of sequence which helps the person being debriefed feel more oriented and centered. It's not uncommon to debrief a group of people simultaneously who were all involved in some intense incident.  Often times some staff people will not have been aware of what was happening with others on the team.  Again, a review of that together is orienting and centering. It should be a clear expectation that shift leaders will debrief any critical incidents before sending staff home.  Debriefing can, sometimes, be done very briefly, in just a minute or two.  It can also be done as a small group, and sometimes can be blended with the writing of the incident report. Feeling Cared For and Respected: To some extent simply attentively listening to a staff person's description of what occurred will make them feel cared for and respected.  That has a huge impact on reducing the impact of traumatic stress. However, it may make sense to ask a few questions.  After incidents that involved physical intervention, it's helpful to ask the staff if anyone was hurt or injured.  Frequently, staff members will ignore minor scrapes and bruises that don't require medical attention.  However, being able to share these sorts of minor injuries has psychological / emotional benefit.  In some cases, staff will have become injured to an extent that should be reported and they need to be encouraged to do that follow through.  Sometimes a staff person will be embarrassed that they received some minor injury.  Normalizing that performing physical interventions are difficult can be helpful.  Likewise, sometimes a staff person is very unhappy about some aspect of their own performance during a physical intervention.  Again, normalizing that this is an extremely difficult part of the job can be emotionally supportive and helpful. Simply asking the staff person how they're doing can be helpful.  From a trauma mitigation perspective, their answer is less important than their experiencing being asked.  Having supportive teammates who care about your well-being is a huge trauma protective factor. As the debriefer, it is not your role to solve any problems, to brainstorm other things the staff person could have done in the incident, or to analyze the actions or motivations of the clients involved in the incident.  Instead, it is the debriefer's role to attentively listen and to be generally emotionally supportive.  Sometimes a staff person may be so emotionally impacted by an incident that follow up in individual supervision would be helpful.  Psychological Debriefing is intended to help, but is intended to be relatively brief.  Suggesting that a staff person bring up what happened in their next supervision may be good advice, or in some cases letting the person's supervisor know that some follow up would be helpful is part of being a caring and professional colleague. Use of Centering Techniques: The impact of traumatic stress can be greatly lessened by the use of various centering techniques.  Staff members should be encouraged to use these sorts of strategies to help manage their own stress.  Psychological Debriefing can reinforce the use these actions and of acquiring a sophisticated understanding of traumatic stress. Immediately after a traumatically stressful incident, it's helpful for staff to attend to their own basic needs.  Sometimes, it's helpful to be cued to do this by a colleague.  Basic needs include things like hydrating, using a bathroom, stretching a little, or perhaps taking a short break.  These things signal your body that the crisis is over and that your physiology can return to baseline. During Psychological Debriefing, the debriefer can ask if the incident took that staff person by surprise or was something they were able to partly anticipate.  Intense situations that occur without anticipation tend to be more traumatically stressful. Likewise, the debriefer can ask if the staff person felt that their training prepared them for the incident.  Feeling trained and some level of competence in an intense situation will tend to result in less traumatic stress being experienced.  Gaps in training can be brought to the attention of supervisors for future improved training. Asking the staff person about their own body awareness during the incident can be helpful.  Maintaining an awareness of your own muscle tension, breathing, heart rate, and other internal reactions can help you feel in control and can reduce the impact of the traumatic stress. Asking the staff person if they felt supported by their teammates during the incident can also be helpful.  Many times the staff person will report that they did feel supported and their recognition of that will help to lessen some of the lingering effects of the traumatic stress.  If a staff person didn't feel supportive, that's important information for the rest of the team and for supervisors so that teamwork improvements can be made. There are numerous relaxation, meditation, and mindfulness exercises that can be helpful after exposure to traumatic stress.  Staff members should be taught some of these techniques and encouraged to use them after being exposed to traumatic stress. 

Episode 41 of the Becoming Centered Podcast kicks off season 2 of this effort to spread knowledge about professional residential treatment of children and youth.  This season is organized into two different educational pathways, mirroring consulting work being done. The Processing pathway is all about how to help kids process their own use of problem-behaviors.  Typically, their own incidents and experiences leave parts of their brains confused about what has happened.  They will come up with some way to understand, but often times their framing of what led to their misbehaviors doesn't support positive character development and increased self-regulation.  With structured guidance from staff, they can learn how to understand their own patterns of behaviors in a way that leads to increased self-control and self-regulation of feelings, thoughts, and behaviors. The Unit Supervision pathway starts with a focus on how to create the time for all direct-care staff to receive several hours of individual supervision each month.  It then moves on to how to structure the supervision time and then what content to cover in supervision.  It presents a combination of management training and techniques, tools, and perspectives for how to teach counseling skills.  This pathway recognizes that in-service trainings, and podcasts, are not the most effective way to promote professional development among residential staff.  Rather, in-the-moment coaching and regularly individual supervision sessions are, by far, the most effective way to raise the skill levels and performance of direct-care staff.  This series will focus on the management and counseling skills needed to provide quality individual supervision. This episode also presents a couple concepts for residential staff to consider.  The first is the distinction between providing Care and providing Treatment.  The second is a way to distinguish between providing Counseling and providing Therapy. While the podcast episodes will continue to be available on most podcast hosting sites, this season's episodes will tend to have more written support materials that listeners can download from the www.BearClanllc.com website Podcast page.  

Episode 42 of the Becoming Centered Podcast is the first episode on the Processing Pathway.  Processing involves a structured approach to helping children and youth to mentally process their incidents of problem-behaviors.  This episode introduces the concept of there being different ways that different parts of the brain process sensory data, personal experience, and the communications received from the other parts of the brain.  This can result in various parts of the brain experiencing different types of confusion after a significant incident of problem-behaviors.  Processing is intended to clear up that confusion.  It's intended to help kids become more thougtful people who think before they automatically react to their own strong feelings with extreme behaviors.   This is achieved through leading kids, once they are generally calm, through a structured process of analyzing their own incidents.  In formal processing, there's typically a written form that guides children and youth through a meaningful way to understand an episode of problem-behaviors.  The formal approach focuses on four goals:  having kids own their own problem-behaviors, identifying feelings that drove those behaviors, identifying how those behaviors may have impacted people around them, and developing a plan for handling themselves better in the future.  Residential Treatment Programs are encouraged to require formal processing, at a level appropriate for each individual child, for incidents involving serious problem-behaviors such as violence, major threats, and major disruptions.    Informal processing typically doesn't use a form but has the same general goals.  Informal processing makes sense for less significant problem-behaviors like instigating and refusing to follow basic program expectations.  Informal processing is likely to be conducted only on a verbal level, and the counselor uses their judgement to decide how many of the four processing goals will be a focus of the conversation.     

Episode 43 of The Becoming Centered Podcast is the second episode in the Processing Pathway series.  This episode introduces a 4-question outline for formal cognitive processing.  Basically, the four parts include helping the child or youth to take responsibility for the behaviors that resulted in their being separated from their peers; identify at least some of the feelings that drove the probelm-behaviors; identify how those behaviors might have impacted peers and staff around them; and identify a possible plan for how to handle things better in the future.  One size doesn't fit all, and there are several factors covered that will change how much detail and how much time a counselor should devote to processing with a client.  There are also some general goals of processing presented to the listener, that also apply for informal cognitive processing (that doesn't use a written form and likely only covers some of the outline of formal processing). Perhaps the most over-arching goal of cognitive processing is to help kids become more thoughtful human beings (who think before simply reacting to their own emotional states).  There are several supporting goals of processing that are covered in this episode that can also be found in handouts available at https://www.bearclanllc.com/podcasts/the-processing-pathway/.    

Episode 44 of the Becoming Centered podcast presents the third installment of the Processing Pathway, covering the technique known as "chaining."  Chaining is a great way to add a visual element to cognitive processing.  It lays out a series of links representing a chain of behaviors and feelings that led to a child or youth having to be separated from their peers.  Once the sequence of links has been clarified, the key link that represents a realistic "choice point" is identified.  This link represents the point in the sequence where the client could have made a different choice that likely would have resulted in a better outcome.  Typical choice point behaviors include things like, asking for a check-in, asking to take space, or using some established coping mechanism.  An explanatory handout and illustration is available at https://www.bearclanllc.com/podcasts/the-processing-pathway/.  

In residential treatment programs by far the most effective way to train direct-care staff in how to effectively care for the kids and to provide counseling is through on-the-job coaching and individual supervision.  However, there's a lot of very real barriers to providing quality supervision. The nature of the work, especially at more intensive programs, means that there is a high frequency of behavior-problems on the residential unit.  This drives staff toward a short-term focus on getting through the shift, or perhaps through the week, with as few safety issues as possible.  The kids needs are essentially infinite and supervisory staff easily get pulled into intervening with the children and youth and just trying to provide all the care they need. The first managerial challenge to providing quality supervision involves carving out the time for a supervisor and a direct care staff person to regularly meet in an office, away from the kids.  I advocate for staff responsible for unit supervision to devote at least four hours per week to providing individual supervision.  The best way to do that is to delegate as many routine administrative tasks to direct care staff as is possible.  The best way to achieve that level of delegation is to clearly define unit coordinator and other roles.  This approach both frees up time for unit supervisors to provide coaching and supervision, and provides real training to direct care counselors in how to organize and implement various components of the residential program, from keeping track of hygiene supplies, to designing and scheduling activities, to planning birthday celebrations, and hundreds of other necessary parts to running a quality residential treatment unit.  

Episode 46 of the Becoming Centered Podcast focuses on the essential managerial and coaching skill of giving feedback to others.  Individual supervision and individual coaching is, by far, the most effective way to inspire and guide the professional development of direct care child care counselors.  This individual attention is much more powerful than in-service training, articles, podcasts, or other ways to train staff.  The heart of coaching is being able to give feedback to supervisees in a way that effectively influences how a staff person thinks about their work, how they feel about their efforts and experience, and how they develop their own executive skills and counseling skills.  Giving feedback to others, in a way that the other person can process and incorporate into their own professional development, is both a core leadership skill and is very difficult to do.  Defensiveness when receiving feedback is normal and natural.  In this podcast I set out to raise the listeners awareness of techniques for compensating for that normal level of defensiveness and techniques for making positive feedback more sophisticated and effective.   

This episode, the third in the Unit Supervisor Pathway, focuses on the essential managerial skills of effectively delegating tasks and projects and keeping organized.  I'm hoping that you've already followed advice in previous episodes and created clearly defined Unit Coordinator roles for all the residential staff on the unit.  Residential treatment is a team sport; and you need every member of your team to not only work directly with the kids, but to also help administer a quality program.  However, even with clear role descriptions outlining various administrative and operational responsibilities, a Unit Supervisor still has to become effective at verbally delegating tasks and projects.  Effective delegation will make a huge difference with how many tasks and projects the residential team can simultaneously be addressing, a huge difference in the quality and timeliness of task completion, and a huge difference in how direct-care staff are lead in developing their professional skills.  This episode presents a 5-step model for effective delegation.  Now that you've delegated scores of tasks and projects, a Unit Supervisor has to keep all these tasks, deliverables, projects, and deadlines organized.  This is a major way in which a Unit Supervisor sets up their people for success!   

Today's episode, which is the fourth on the Unit Supervisory Learning Pathway, focuses on a model for how to structure the typical supervision session. In the context of working on a residential treatment unit for children and youth, there are many sub-roles that define an effective relationship between a supervisor and their supervisees.  A Supervisor encompasses the roles of Counselor, Teacher, Coach, Leader, Superior, Boss, and Mentor.  This episode focuses on starting supervision meetings with the Supervisor focuses on the role of Counselor.  In that role, the Supervisor is most concerned about the emotional well-being of the direct-care staff being supervised.   This initial focus on emotional wellness, which starts with simply asking a person how they're doing this week, makes sense as a basic display of good social skills.  However, the Counselor sub-role goes far beyond good manners and tries to attend to helping your Supervisees manage the high level of exposure to traumatic stress that is a big part of their jobs.  Just expressing concern helps.  Beyond that, there will be times when engaging in psychological debriefing will be an appropriate way to help your Supervisees take the edge off of the more stressful encounters they've had that week.  Attending to the basic human emotional needs of your Supervisees also means trying to help them find inspiration and meaning in the work, celebrating their successes, and reinforcing examples of their good teamwork and their demonstrating strong executive skills in their work. Sometimes, it makes sense to spend an entire supervision meeting primarily in that Counselor sub-role.  However, that should be the exception and not the rule.  Supervision meeting time is incredible valuable and a skilled Supervisor consciously designs their supervision time to be strategic about how many minutes to devote to the domain of emotions, before moving on to the other sub-roles (Teacher, Coach, Leader, Superior, Boss, and Mentor) that are also essential aspects of being an effective Supervisor.  

This episode continues to present a model for how to structure a supervision meeting.  Last episode focused on how a Unit Supervisor sometimes functions primarily as a Counselor.  In that  sub-role, the Supervisor is most concerned with the emotional well-being of their Supervisees.  Although that can fill the entire supervision meeting, generally, after five to ten minutes the meeting agenda will usually move on to the Supervisor sub-role of functioning primarily as a Teacher. Being an effective Teacher means having an organized curriculuum that typically draws from your agency's policies and procedures manual.  The Supervisor is tasked with making sure that each staff person has the necessary knowledge to properly implement the program.  Some of that can be addressed in staff meetings, however, becuase new staff are hired throughout the year, the supervision meeting serves as a place to individually make sure that every staff has the necessary familiarity with the program's and the residential unit's policies, procedures, practices, and philosophy of care and treatment. However, the bulk of the supervision meeting time is typically best spent with the Supervisor in the sub-role of a Coach.  As a Coach, the Supervisor focuses on the skills that each staff person needs to excel at their job.  The fundamentals of residential care and treatment can be divided up into three categories:  Executive Skills, Engagement Skills, and Teamwork Skills.  Work on these skills, especially for newer staff is the foundation for their professional development as caregivers. These fundamental skills are different than specific counseling skills that will be the focus of a future podcast episode.  Those counselor skills, such as Verbal Redirection, Labeling, Change of Environment, Limit Setting, Forced Choice, Weighted Choice, and Centering Breaks are treatment skills that will also need coaching to learn and master.  However, the use of fundamental skills (Executive Skills, Engagement Skills, and Teamwork Skills) are a great place for a Unit Supervisor to start with coaching since their use will create a therapeutic environment on the residential unit. 

This episode is the sixth on the Unit Supervisor Learning Pathway.  It's also the third of a three-episode arc that focuses on how to structure an individual supervision meeting.  It also goes beyond the supervision meeting and explores the seven different roles Unit Supervisors have with their Supervisees. As a Counselor, the Supervisor is concerned with the emotional well-being of their Supervisees. As a Teacher, the Supervisor keeps a checklist of subjects (primarily policies, procedures, practicies, and training topics) that are reviewed with each Supervisee over the course of their tenure as a direct-care Child Care Counselor. As a Coach, the Supervisor individualizes their focus to address each Supervisee's professional development.  Fundamental residential staff skills include Executive Skills, Engagement Skills, and Teamwork Skills.  More advanced counseling skills are the focus of the next episode arc on the Unit Supervisor Learning Pathway. As a Leader, the Supervisor takes a strategic approach to presenting each supervisee with an inspiring vision, an analysis of current skills and a plan for what skills to work on in the next short-term period.  That plan is then implemented on the floor of the residential unit, directly in working with the kids.  In the next supervision meeting there's feedback and collaboration around the next steps. As an organizational Superior, the Supervisor has to represent the agency.  Any problems with basic employment expectations, such as professionalism, basic performance expecations, adherence to company policies, and dependability need to be addressed in the supervision meeting.  In consultation with the Unit Supervisor's superior, and potentially H.R. department, it might be appropriate to take some personnel action.  Solid boundaries are the biggest help in balancing the role of Superior with the other Unit Supervisor roles. As their Boss, the Supervisor has to give out assignments and coordinate a large number of tasks that all are necessary for the professional administration of the residential program.  In crisis situations, the Supervisor often times needs to function as a direct and clear Boss, which can create a balancing challenge with the other roles. As a Mentor, the Supervisor expresses some level of interest in their Supervisees' career and life outside of work.  It's up to each Supervisee how much they will come to see their Supervisor as a Mentor, but spending some time relating as a Mentor helps balance the seven roles that define the relationship between a Unit Supervisor and their Supervisees.

This episode on the Unit Supervisor Learning Pathway moves away from a focus on managerial skills and switches to a focus on counseling skills to be taught to direct-care Child Care Counselors.  It presents 10 interventions, or techniques, for Counselors to use with kids when they become off-track, dysregulated, and uncentered.  Skillful use of this package of interventions starts with understanding the ways in which they can be thought of as forming a hierarchy.  That includes the higher up interventions being increasingly disruptive to the group environment of the residential unit, being an increasingly heavy-handed display of the staff being in charge, and requiring more judgement and skill from staff so that the intervention de-escalates the situation rather than causing an ecalation.  However, these ten interventions are not like a true hierarchy in that staff can start anywhere on the scale, can use the interventions in various combinations, and even that some of the interventions can be thought of as just examples of the other interventions.  This episode goes on to take a closer look at three interventions at the bottom of the hierarchy: distraction, engaging, and verbal redirections.  Distraction is frequently the first intervention used for interrupting an emerging pattern of dysregulation.  Engaging is the most frequent intervention that should be used by residential staff in that it provides the kids with practice at co-regulating with a calmer and more psychologically and neurologically organized person.  Improved co-regulation skills leads to improved self-regulation skills.  Verbal Redirection is regularly used to support the development of kids' self-awareness, and is frequently used with having kids Practice or Over-Practice a desired behavior and in combination with Listening Checks.  

This episode is the second in a three-episode arc that presents the Hierarchy of Interventions.  This grouping of 10 interventions forms a core curriculum of counseling skills used by residential staff to encourage the development of kids' self-regulation abilities.  Last episode focused on using Distraction, Engaging, and Verbal Redirection to interrupt and prevent kids from going down an off-track path toward increased emotional, cognitive, and behavioral dysregulation.  This episode introduces the Aspect Compass model of the human mind.  Understanding this metaphor for how the mind works, makes it easier for direct-care counseling staff to move beyond the behavior-management level of intervention and instead help kids development their self-regulation abilities.   This episode revisits those three interventions from the perspective of the Aspect Compass Model and then goes on to present the labeling intervention.  Different variations on the Labeling intervention are used to increase clients' self-monitoring of their own behaviors, their own bodies, their own feelings, and their own developing social skills.  One variation on Labeling is also used in place of giving directions and setting limits.  Those interventions are intended to encourage compliance, where labeling encourages kids to chose cooperation.   

Episode 53 reviews the first four tools and techniques that make up the Hierarchy of Interventions (Distraction, Engaging, Verbal Redirection, Labeling) and presents the next two steps in the Hierarchy, Changing the Environment and Limit Setting.  A major emphasis is placed on using these techniques to not only manage behaviors, but also to help clients develop their abilities to self-regulate. Behavior Management is a necessary component of providing Care to troubled children and youth.  All kids sometimes exhibit behavior problems.  However, kids in residential treatment, perhaps especially because they're surrounded by other struggling peers, will sometimes use problem-behaviors.  Part of the Care of children is to maintain a safe environment, including efforts to keep kids safe from their own dysregulated behaviors and those of their peers.  But behavior management is not enough. In addition to providing Care, a residential treatment program must also provide a Treatment experience.  It's not enough to create an environment in which kids "behave" only to have problem-behaviors reappear after kids leave the program.  For lasting change to occur, kids need to improve their abilities to self-regulate their emotions, thoughts, and behaviors (including internal physiological "behaviors").  When used skillfully, the techniques that make up the Hierarchy of Intervention can be used in way that not only manages behaviors but also encourages the brain development necessary for improved self-regulation.  Changing the Environment is a very powerful way to help kids who have become overwhelmed and dysregulated to the point where they can no longer fully process language.  Changing various aspects of a kids surroundings is a generally reliable way to help them to calm down to the point where they can calm down enough to make thoughtful choices. Limit Setting, when used to clarify behavioral expectations, and especially when used to clarify values, is another way to help kids learn how to better regulate their own thoughts and behaviors.