Podcasts about residential treatment

Episode 54 concludes a four-episode arc, within the Unit Supervision Pathway, that presents the 10 techniques that make up the Hierarchy of Interventions.  This episode focuses on how to implement these interventions in a way that goes beyond surface behavior management to supporting the development of self-regulation in children and youth.   This episode particularly focuses on the Forced-Choice and related Weighted-Choice techniques.  These interventions leverage a program's consequence system to help child-clients make choices that determine whether or not they receive a consequence for any misbehaviors.  That, in turn, supports the development of self-regulation over their own impluses and emotional-reasoning.  These techniques are also a very effective way to help kids who struggle with taking responsibility for their own feelings, thoughts, and especially behaviors to mature.  They are also excellent techniques for ending pointless control-battles between a staff person and a client.   Centering Breaks are similar to Time Outs, however, they add structures to the time that move the intervention beyond simply removing a client from an over-stimulating or triggering situation.  These structures are individualized to the needs and abilities of individual kids, but are strategically intended to help each child or youth become emotionally, cognitively, behaviorally, and physiologically centered.   The Support Center structure and intervention is used by many multi-unit residential programs and schools to completely separate misbehaving kids from their peers.  Typically, separate counselors staff the Support Center, providing a change of face as well as a Change-of-Environment.  Ideally, Support Center counselors also Process the incidents that resulted in a child or youth being separated from the group.  A structured approach to Processing is presented in prior podcast episodes. Physical Interventions, including physical restraint, are techniques used in residential treatment programs to safely de-escalate or contain extreme behaviors.  Processing afterwards is key for moving these interventions beyond behavior management to supporting the development of self-regulation in kids.  

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.  

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.   

Having talked to Casie Fariello (Other Parents Like Me) on the podcast last week about her son's mental health struggle and their experience with his inpatient treatment, followed by a Substack post about getting insurance to pay for residential treatment—I realized I still had more to say on this topic.So, on today's episode, I explain that sending your teen away from home for treatment for their mental health and/or behavior should only be considered as a last resort, with the biggest consideration being their safety or the safety of others.According to the prevailing opinion in the child and adolescent mental health field, kids and teens should be kept at home and all other treatment options should be exhausted before considering residential treatment, wilderness, a therapeutic boarding school, etc. In this episode, I also argue that parents must take a hard look at their parenting practices and their mental health to insure they are not exacerbating their teen's mental health or behavior problems, before making this big decision.Today's Substack post takes the topic even further as I discuss how to prevent fear (often caused by the "troubled teen industry") from driving your decision to send your teen away from home for treatment. Show Notes for other resources and sourcesTranscriptFind our FREE Parenting Guides Here"I just wanted to let you know that I'm so thankful for your podcast! ...I'm so happy I discovered it!" Speaking of Teens Listener^If you feel the same way, please consider rating and reviewing my show! This helps people know the show is worth their time to listen. Tap here, to go to Apple podcasts, and scroll down until you see the STARS to tap on the last star, then tap on “Write a Review” and let me know what you love about the show. If you're listening in Spotify, you can also rate the show by going to the main episode page and tap the 3 dots to the right of the follow button, tap rate show and tap the 5th star!Thank you in advance for helping me help more parents!I drop new episodes every Tuesday and Friday so please tap Follow on the main episode page, so they'll be ready for you in your app.You can reach out to me with ideas for the show or guest suggestions here. Thanks so much for listening!Check out PARENT CAMP - a cohort-based, 10-week experience that includes a virtual course, in-depth exercises and tools, and weekly live meetings with Ann, where you will learn how to strengthen your relationship and decrease the conflict with your teens and tweens (while improving their behavior.)Connect with us on Facebook or Instagram Read Speaking of Teens weekly articles on Substack Join our Facebook Group for Free Support for Parents and others who care for Teens (and get easy access to all the parenting guides above!)See My Recommended Books For Both You And Your Teen

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 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 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. 

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, 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!   

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.   

Bryan Fields and Isaac Smoldon talk about the details of our new residential treatment program.

Despite living more solidly in the psychology domain, Collaborative Problem Solving (CPS) as a treatment for oppositional behaviors is increasingly moving into the mainstream. But does its attempts to change behavior patterns make it behavior analytic or something else? In this episode we look at a few of the earliest studies to evaluate the efficacy of CPS as well as some of the more recent publications on CPS as a treatment for challenging behavior and to discuss just what it is and whether you should be paying attention. But will we answer the key question: Is studying CPS an avenue of collaboration between behavior analysis and psychology or a watered-down version of older behavioral treatments? This episode is available for 1.0 LEARNING CEU. Articles discussed this episode: Greene, R.W., Ablon, J.S., & Goring, J.C. (2003). A transactional model of oppositional behavior: Underpinnings of the Collaborative Problem Solving approach. Journal of Psychosomatic Research, 55, 67-75. doi: 10.1016/S0022-3999(02)00585-8 Greene, R.W., Ablon. J.S., Goring, J.C., Raezer-Blakely, L., Markey, J., Monuteaux, M.C., Henin, A., Edwards, G., & Rabbit, S. (2004). Effectiveness of Collaborative Problem Solving in affectively dysregulated children with oppositional-defiant disorder: Initial findings. Journal of Consulting and Clinical Psychology, 72, 1157-1164. doi: 10.1037/0022-006X.72.6.1157 Pollastri, A.R., Wang, L., Eddy, C.J., & Ablon, J.S. (2023). An open trial of Collaborative Problem Solving in a naturalistic outpatient setting. Clinical Child Psychology and Psychiatry, 28, 512-524. doi: 10.1177/13591045221094387 Stoll, S.J., Hartman, J.D., Paxton, D., Wang, L., Ablon, J.S., Perry, B.D., & Pollastri, A.R. (2023). De-implemnting a point and level system in youth residential care without increased safety risk: A case study. Residential Treatment for Children and Youth. doi: 10.1080/0886571X.2023.2233408 If you're interested in ordering CEs for listening to this episode, click here to go to the store page. You'll need to enter your name, BCBA #, and the two episode secret code words to complete the purchase. Email us at abainsidetrack@gmail.com for further assistance.

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 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/.  

About a dozen years ago, Wasco County Sheriff Lane Magill became aware of a growing need for treatment services for residents experiencing mental health crises in his county. Faced with a lack of residential care services in the region, he struggled to find help for people experiencing homelessness or veterans who suffered from PTSD. The surge of fentanyl-related overdoses in the county since 2021 also highlighted the link between behavioral health and substance use disorders, and the lack of local treatment options.But that may now soon change. As first reported in the Columbia Gorge News, Magill expects to break ground this year on a new residential treatment facility in The Dalles. It would offer 16 beds to treat residents in Hood River, Wasco and Sherman Counties for substance use disorders, along with a walk-in center for people in mental health crisis. Sheriff Magill joins us to talk about the status of the $50 million project, and the regulatory roadblocks it faces. 

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/.    

As our resolution for the new year, we decided to record 300 podcast episodes. And wouldn't you know it: We're almost there! Kick off 2025 by learning about the, surprisingly, never-before discussed on the show matching law! Then we blast off into a more recent development by reviewing research on Collaborative Problem Solving before settling down for a wintry Grab Bag jamboree. And speaking of jamborees, we release our 300th episode on the always relevant topic, vaccines not causing autism. Want to see ABA Inside Track celebrate the 300th episode milestone in person? Join us on Thursday, January 9th, 2025 from 5-7pm EST at Regis College for a full-length live recording, food, our typical brand of shenanigans, and a free CE. Click here to RSVP. Articles for January 2025 Matching Law Reed, D.D. & Kaplan, B.A. (2011). The matching law: A tutorial for practitioners. Behavior Analysis in Practice, 4, 15-24. doi: 10.1007/BF03391780 Alferink, L.A., Critchfield, T.S., Hitt, J.L., & Higgins, W.J. (2009). Generality of the matching law as a descriptor of shot selection in basketball. Journal of Applied Behavior Analysis, 42, 595-608. doi: 10.1901/jaba.2009.42-595 Morris, S.L. & Vollmer, T.R. (2022). The matching law provides a quantitative description of social time allocation in children with autism. Journal of Applied Behavior Analysis, 55, 934-957. doi: 10.1002/jaba.934   Auld Bag Syne (Winter 2025 Grab Bag) Graham, S., Keenan, M., & Dillenburger, K. (2024). All for one and one for all: The good inclusion game. Behavioral Interventions. doi: 10.1002/bin.2048 Migan-Gandonou Horr, J. & Campos, C. (2024). Effects of a technology‐based self‐management intervention on social media use in a college student. Behavior Analysis in Practice. doi: 10.1007/s40617-024-00977-3 Schmidt, J., Krantz, J., King, H., Vetter, J., & Maruska, C. (2024). Using a brief experimental analysis for writing speed intervention identification. Behavioral Interventions, 39. doi: 10.1002/bin.2019   Collaborative Problem Solving Greene, R.W., Ablon, J.S., & Goring, J.C. (2003). A transactional model of oppositional behavior: Underpinnings of the Collaborative Problem Solving approach. Journal of Psychosomatic Research, 55, 67-75. doi: 10.1016/S0022-3999(02)00585-8 Greene, R.W., Ablon. J.S., Goring, J.C., Raezer-Blakely, L., Markey, J., Monuteaux, M.C., Henin, A., Edwards, G., & Rabbit, S. (2004). Effectiveness of Collaborative Problem Solving in affectively dysregulated children with oppositional-defiant disorder: Initial findings. Journal of Consulting and Clinical Psychology, 72, 1157-1164. doi: 10.1037/0022-006X.72.6.1157 Pollastri, A.R., Wang, L., Eddy, C.J., & Ablon, J.S. (2023). An open trial of Collaborative Problem Solving in a naturalistic outpatient setting. Clinical Child Psychology and Psychiatry, 28, 512-524. doi: 10.1177/13591045221094387 Stoll, S.J., Hartman, J.D., Paxton, D., Wang, L., Ablon, J.S., Perry, B.D., & Pollastri, A.R. (2023). De-implemnting a point and level system in youth residential care without increased safety risk: A case study. Residential Treatment for Children and Youth. doi: 10.1080/0886571X.2023.2233408   Vaccines Do Not Cause Autism Ahearn, W.H. (2010). What every behavior analyst should know about the “MMR causes autism” hypothesis. Behavior Analysis in Practice, 3, 46-52. doi: 10.1007/BF03391757 Deer, B. (2011). How the case against the MMR vaccine was fixed. The BMJ, 342:c5347. doi: 10.1136/bmj.c5347 Taylor, L.E., Swerdfeger, A.L., & Eslick, G.D. (2014). Vaccines are not associated with autism: An evidence-based meta-analysis of case-control and cohort studies. Vaccine, 32, 3623-2629. doi: 10.1016/j.vaccine.2014.04.085 Alvik-Harju, C. (2024). Finding more constructive ways forward in the debate over vaccines with increased disability cultural competence. Med Humanit, 49, 9-16. doi: 10.1136/medhum-2021-012342

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 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.  

Why does God allow his people to suffer? What purpose is there is pain? We have Part Two of my conversation with Norm Wielsch, where we talk about these very important topics. What is one of the things that God hates?(It's not what you think.) We talk about another book he has in the works about the question of suffering. You will be encouraged and lifted up listening to Norm's experiences of loss and recovery. Connect with Norm and purchase his books on his website: Healing A Broken Heart: A Christ-Centered healing of Trauma God's Purpose in Pain: Why Does God Allow Suffering https://www.christ-centeredhealing.com/ Bio: Norm Wielsch was a law enforcement officer for over 25 years. Sixteen of those as an undercover narcotic agent. He has experienced many traumatic incidents during his career. In 1998 he was diagnosed with an incurable neuro-muscular disease that caused the loss of feeling, mobility, and strength in his hands and feet. After over 30 surgeries he became addicted to opioids. He was diagnosed with PTSD. Then his daughter was diagnosed with a serious illness with a poor prognosis. Due to his poor coping mechanisms that are against God's moral standards, Norm made a series of poor decisions that landed him in federal prison with a 14 year sentence. It was during this most intense trial of his life, with the reality that he was going to go to prison for a long time, that he answered God's calling. Norm had been an agnostic all of his life, but he knew that God was calling him to minister to those people who were suffering from trauma, especially first responders.  ​ While in prison, he obtained a Master's Degree in Theology & Counseling, a Doctorate in Christian Counseling, and a California Drug and Alcohol Counseling Certificate. He is currently working at a Men's Residential Treatment facility as a Registered Alcohol and drug Counselor and Pastoral   Care Chaplain. While in prison, Norm counseled many inmates with a variety of issues, preached God's word in the chapel, taught Christian classes, and led bible studies. ​ Norm often speaks to those who are suffering from traumatic experiences  including churches and addiction ministries. ​ Norm has a Master's Degree in Law Enforcement Management. He achieved the rank of commander prior to his arrest and has over ten commendations for outstanding service. Norm Wielsch is an expert in law enforcement tactics including: narcotic, enforcement, addictions and influence, criminal investigations, traffic collisions, pursuit driving, high risk search warrant service, report writing, PTSD, and the police culture. Link Tree Website: https://dswministries.org Email: diana@dswministries.org Social media links: Facebook: https://www.facebook.com/DSW-Ministries-230135337033879 Twitter: https://twitter.com/DswMinistries YouTube: https://www.youtube.com/channel/UCxgIpWVQCmjqog0PMK4khDw/playlists Instagram: https://www.instagram.com/dswministries/ https://dswministries.org/subscribe-to-podcast/ Available on Apple Podcasts, Spotify, iHeart Radio, Google Podcasts, Pandora, Stitcher, Listen Notes Keep in touch with me! Email subscribe to get my handpicked list of the best resources for abuse survivors! https://thoughtful-composer-4268.ck.page #abuse #trauma Mentoring https://youtu.be/WWgkERpkIoY An easy way to help my ministry: https://dswministries.org/product/buy-me-a-cup-of-tea/ A donation link: https://dswministries.org/donate/ Affiliate links: Can't travel to The Holy Land right now? The next best thing is Walking The Bible Lands! Get a free video sample of the Bible lands here! https://www.walkingthebiblelands.com/a/18410/hN8u6LQP Get one free month of Blubrry podcast hosting with the promotional code: FAITHFUL http://create.blubrry.com/resources/podcast-media-hosting/?code=FAITHFUL Get quality podcast guests and interviews from PodMatch! Get paid to be a host!

In episode 457 I chat with Jon Hershfield, MFT. Jon is the director of Sheppard Pratt's The Center for OCD and Anxiety.  In this episode we discuss what is a residential treatment center, who can benefit from residential treatment, what a day in the life in residential looks like, the duration of a residential stay, therapy at residential centers, art therapy, yoga, mindfulness, having a team around you, the use of family therapy, and much more. Hope it helps.   Show notes: https://theocdstories.com/episode/jon-457 The podcast is made possible by NOCD. NOCD offers effective, convenient therapy available in the US and outside the US. To find out more about NOCD, their therapy plans and if they currently take your insurance head over to https://go.treatmyocd.com/theocdstories Join many other listeners getting our weekly emails. Never miss a podcast episode or update: https://theocdstories.com/newsletter   Thanks to all our patrons for supporting our work. To sign up to our Patreon and to check out the benefits you'll receive as a Patron, visit: https://www.patreon.com/theocdstoriespodcast 

We have Norm Wielsch from Episode 35 back on the show this week, promoting his new book: Healing A Broken Heart: Christ Centered Healing of Trauma. Be sure to go back to listen to his story if you haven't already. He talks candidly about having PTSD as a police officer. He then was diagnosed with an incurable, debilitating neuromuscular disease, having over 25 surgeries in 10 years. He was abusing the opioids to relieve the negative emotions of PTSD. On top of that, his daughter was diagnosed with liver tumors. This placed him in a downward spiral that led him to make some very poor decisions that led to a 14 year prison sentence. Find out how he is doing today with his health, his family, and his new career in counseling. Hear how he is now helping others to heal who are struggling with abuse, trauma, PTSD, and addictions. We had an enjoyable and encouraging conversation filled with hope! Don't miss it. Connect with Norm and buy his new book on his website: https://www.christ-centeredhealing.com/ Norm Wielsch was a law enforcement officer for over 25 years. Sixteen of those as an undercover narcotic agent. He has experienced many traumatic incidents during his career. In 1998 he was diagnosed with an incurable neuro-muscular disease that caused the loss of feeling, mobility, and strength in his hands and feet. After over 30 surgeries he became addicted to opioids. He was diagnosed with PTSD. Then his daughter was diagnosed with a serious illness with a poor prognosis. Due to his poor coping mechanisms that are against God's moral standards, Norm made a series of poor decisions that landed him in federal prison with a 14 year sentence. It was during this most intense trial of his life, with the reality that he was going to go to prison for a long time, that he answered God's calling. Norm had been an agnostic all of his life, but he knew that God was calling him to minister to those people who were suffering from trauma, especially first responders.  ​ While in prison, he obtained a Master's Degree in Theology & Counseling, a Doctorate in Christian Counseling, and a California Drug and Alcohol Counseling Certificate. He is currently working at a Men's Residential Treatment facility as a Registered Alcohol and drug Counselor and Pastoral   Care Chaplain. While in prison, Norm counseled many inmates with a variety of issues, preached God's word in the chapel, taught Christian classes, and led bible studies. ​ Norm often speaks to those who are suffering from traumatic experiences  including churches and addiction ministries. ​ Norm has a Master's Degree in Law Enforcement Management. He achieved the rank of commander prior to his arrest and has over ten commendations for outstanding service. Norm Wielsch is an expert in law enforcement tactics including: narcotic, enforcement, addictions and influence, criminal investigations, traffic collisions, pursuit driving, high risk search warrant service, report writing, PTSD, and the police culture. Link Tree Website: https://dswministries.org Email: diana@dswministries.org Social media links: Facebook: https://www.facebook.com/DSW-Ministries-230135337033879 Twitter: https://twitter.com/DswMinistries YouTube: https://www.youtube.com/channel/UCxgIpWVQCmjqog0PMK4khDw/playlists Instagram: https://www.instagram.com/dswministries/ https://dswministries.org/subscribe-to-podcast/ Available on Apple Podcasts, Spotify, iHeart Radio, Google Podcasts, Pandora, Stitcher, Listen Notes Keep in touch with me! Email subscribe to get my handpicked list of the best resources for abuse survivors! https://thoughtful-composer-4268.ck.page #abuse #trauma Mentoring https://youtu.be/WWgkERpkIoY An easy way to help my ministry: https://dswministries.org/product/buy-me-a-cup-of-tea/ A donation link: https://dswministries.org/donate/ Affiliate links: Can't travel to The Holy Land right now?

Austin sits down with Chateau's own Ben & Danny to give the listeners a deep perspective on what Residential Treatment level of care really means clinically, non-clinically and the culture of this level of care. Further discussion delves into the differences in the various levels of treatment care that the listener can use to help determine his/her needs.

ABOUT THE EPISODE:As a mom of four boys, I confess to knowing very little about raising girls. But my guests today have an intimate understanding of the specific emotional needs and experiences of adolescent girls, young women, and gender diverse individuals grounded in decades of therapeutic work.Dr. Marcy Russo and Sara Osbourne advocate for a whole-person approach to residential treatment for many of the most common mental and behavioral health issues -- anxiety, depression, trauma, eating disorders -- and the substance use disorders that sometimes result.In this episode we'll discuss the perfect storm of issues, from Covid to social media, that has left so many young women feeling they cannot navigate social expectations or develop healthy, supportive relationships. We also talk about the use of relational and somatic therapeutic tools to help girls find authenticity and self-understanding for long term wellness and recovery. EPISODE RESOURCES:Wellspring websiteAngelus House websiteThis podcast is part of a nonprofit called Hopestream CommunityLearn about The Stream, our private online community for momsLearn about The Woods, our private online community for dadsFind us on Instagram: @hopestreamcommunityDownload a free e-book, Worried Sick: A Compassionate Guide For Parents When Your Teen or Young Adult Child Misuses Drugs and AlcoholHopestream Community is a registered 501(c)3 nonprofit organization and an Amazon Associate. We may make a small commission if you purchase from our links.

In today's episode I continue my conversation with Colin MacDonald, co-founder of Not Therapy - a high-touch coaching program for young people. Colin told his story as a former "troubled teen" in episode 168. And today he outlines the "4 Pillars of Transition" for teens and young adults moving from residential treatment, wilderness programs and other therapeutic facilities back to "the real world".This is a must-listen episode if you have a teenager or young adult currently in treatment or recently discharged. Show Notes and TranscriptFind our FREE Parenting Guides Here"I just wanted to let you know that I'm so thankful for your podcast! ...I'm so happy I discovered it!" Speaking of Teens Listener^If you feel the same way, please consider rating and reviewing my show! This helps people know the show is worth their time to listen. Tap here, to go to Apple podcasts, and scroll down until you see the STARS to tap on the last star, then tap on “Write a Review” and let me know what you love about the show. If you're listening in Spotify, you can also rate the show by going to the main episode page and tap the 3 dots to the right of the follow button, tap rate show and tap the 5th star!Thank you in advance for helping me help more parents!I drop new episodes every Tuesday and Friday so please tap Follow on the main episode page, so they'll be ready for you in your app.You can reach out to me with ideas for the show or guest suggestions here. Thanks so much for listening!Check out PARENT CAMP - a cohort-based, 10-week experience that includes a virtual course, in-depth exercises and tools, and weekly live meetings with Ann, where you will learn how to strengthen your relationship and decrease the conflict with your teens and tweens (while improving their behavior.) Join our Facebook Group for Free Support for Parents and others who care for Teens (and get immediate access to all the parenting guides above!)See My Recommended Books For Both You And Your TeenConnect with us on Facebook or Instagram Get the FREE GUIDE, "Emotional Awareness Strategies"

Send us a Text Message.Rehab is often associated with people who have the most urgent and complex addictions and mental health crises. What if we better educate our service members on what was available, what TriCare covers, and how to spot a reputable provider? My next guest and I will explore this subject in depth and discuss how military members can significantly benefit from these organizations' targeted services. We will also shatter the stigma, myths, and stereotypes of those who seek this care and what this treatment can do long-term for your life growth, health, and happiness. Bill Reynolds is a U.S. Navy-trained physician assistant who served on active duty for 30 years and retired as a Lieutenant Commander in 2012. He has been a PA for over 20 years and has extensive experience in family medicine and psychiatry. Bill guides Sierra Tucson's acclaimed “Red, White & Blue” program for military veterans, police officers, and other first responders.Bill was awarded numerous commendation medals for superior performance while in the Navy and had the honor of caring for patients on submarines, in combat, and as the medical officer of a US Navy SEAL team.Having worked extensively with service members suffering from post-traumatic stress and addiction, Bill brings unique experience to Sierra Tucson as he cares for our military and first responder clients. He is a strong proponent of integrative medicine and understands the importance of treating the “whole person.”Sierra Tucson is #1 in Newsweek's list of Best Addiction Treatment Centers in Arizona for 2023. More on Bill and Sierra Tucson Book TribeBook Body Keeps A ScoreVisit my website: https://thehello.llc/THERESACARPENTERRead my writings on my blog: https://www.theresatapestries.com/Listen to other episodes on my podcast: https://storiesofservice.buzzsprout.comWatch episodes of my podcast:https://www.youtube.com/c/TheresaCarpenter76

A recent Senate investigation found that children in residential treatment facilities are sometimes subjected to abuse and neglect. We hear from people who lived in these facilities when they were younger, and Ali Rogin speaks with Sixto Cancel, founder and CEO of Think of Us, a nonprofit aimed at improving conditions for youth in the child welfare system, to learn more. PBS News is supported by - https://www.pbs.org/newshour/about/funders

A recent Senate investigation found that children in residential treatment facilities are sometimes subjected to abuse and neglect. We hear from people who lived in these facilities when they were younger, and Ali Rogin speaks with Sixto Cancel, founder and CEO of Think of Us, a nonprofit aimed at improving conditions for youth in the child welfare system, to learn more. PBS News is supported by - https://www.pbs.org/newshour/about/funders

We often discuss the NeuroAffective Relational Model (NARM) as it relates to the adult journey of healing from complex trauma, but what about younger clients? On this episode of Transforming Trauma, host Emily Ruth is joined by Kami Black, LCSW, founder of ROOTs Transitions, a program that supports adolescent females ages 15 to 18 and their families by blending elements of outdoor therapy and residential treatment in Park City, Utah. The pair explore ROOTs' commitment to utilizing NARM as both a therapeutic modality and a rubric for staff engagement. They also discuss the program's assessment, treatment, and reintegration phases, plus the value of embracing and navigating dysregulation within the safety of the on-site therapeutic environment. About Kami Black: As a young adult, Kami Black, LCSW, knew that she wanted to be a therapist and help give back to a community that once served her and address the trauma impacting others. After completing her schooling, she began working with adolescents and their families, as well as signing up for any trauma training that she could find. This included EMDR, Somatic Experiencing, Brainspotting, and many others. About five years ago, Kami came across NARM at a conference. She was intrigued by the language, and specifically the way it articulated complex trauma healing through a deeply interpersonal process. She trained in NARM and hoped that one day this healing modality would be at the foundation of a program she was envisioning. ROOTs Transition emerged from her vision, and has been open for almost three years now. And, NARM is now the foundation of their clinical approach and how they train their therapists, guides and staff. The principles of NARM also inspire and challenges them each day to stay curious and provide agency to those around them. Learn More: ROOTs Transition To read the full show notes and discover more resources, visit https://complextraumatrainingcenter.com/transformingtrauma *** The Complex Trauma Training Center: https://complextraumatrainingcenter.com View upcoming trainings: https://complextraumatrainingcenter.com/schedule/ The Complex Trauma Training Center (CTTC) is a professional organization providing clinical training, education, consultation, and mentorship for psychotherapists and mental health professionals working with individuals and communities impacted by Adverse Childhood Experiences (ACEs) and Complex Trauma (C-PTSD). CTTC provides NARM® Therapist and NARM® Master Therapist Training programs, as well as ongoing monthly groups in support of those learning NARM. CTTC offers a depth-oriented professional community for those seeking a supportive network of therapists focused on three levels of shared human experience: personal, interpersonal & transpersonal.  The Transforming Trauma podcast embodies the spirit of CTTC – best described by its three keywords: depth, connection, and heart - and offers guidance to those interested in effective, transformational trauma-informed care. We want to connect with you! Facebook @complextraumatrainingcenter YouTube Instagram @complextraumatrainingcenter

On this week's episode we go deep on one headline: a recent Senate Finance Committee hearing in which Chairman Ron Wyden called the residential care business an inherently flawed model that intentionally puts children in unsafe situations. The hearing followed the release of a scathing report on the committee's findings from a multi-year investigation into four of the biggest providers in that space.In this episode, we break down nine different clips from the nearly two hour hearing that speak to some of the major themes and topics covered.Reading RoomSenate Investigation Slams Residential Treatment Centers for Children as ‘Warehouses of Neglect'https://bit.ly/3zsMAHqWarehouses of Neglect: How Taxpayers Are Funding Systemic Abuse in Youth Residential Treatment Facilitieshttps://bit.ly/4bsUY6KThe Forgotten Children of Texashttps://bit.ly/3ouvOh2New Study Suggests Ending Group Care for Foster Youthhttps://bit.ly/3rsVqMUImprint Coverage Tagged “Congregate Care”https://imprintnews.org/tag/congregate-care

ABOUT THE EPISODE:When Heather discovered that some significant changes were happening in her daughter's residential program, she began to worry the family was not receiving what they were promised. After an unproductive discussion with the program director, Heather made the difficult choice of bringing her daughter home early. Now what?When we spoke for this coaching episode, Heather's daughter had been home for just one week after spending seven months in residential treatment. There are new boundaries to determine - from big issues like driving and employment to simple matters like cleaning up messes in the house.In this session, Heather and I discuss how to assist her daughter in avoiding a return to THC use, while also preventing her own relapse into old, unhealthy patterns of communication.EPISODE RESOURCES:Partnership to End AddictionThis podcast is part of a nonprofit called Hopestream CommunityLearn about The Stream, our private online community for momsLearn about The Woods, our private online community for dadsFind us on Instagram: @hopestreamcommunityDownload a free e-book, Worried Sick: A Compassionate Guide For Parents When Your Teen or Young Adult Child Misuses Drugs and AlcoholHopestream Community is a registered 501(c)3 nonprofit organization and an Amazon Associate. We may make a small commission if you purchase from our links.

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. 

FEATURED GUESTS: Jasmine Parker is a Registered Art Therapist and holds a dual master's degree in both Mental Health Counseling and Art Therapy. Her clinical experience covers a wide range of settings to include: Residential Treatment, Public Schools, Community Agencies, Psychiatric Hospitals, Medical Hospitals, Juvenile Correctional Centers, and private practice. Jasmine's vision is to empower young people by providing them with a safe space to express themselves creatively and openly, free from judgment; giving them the opportunity to explore their inner workings and learn how to successfully navigate life's daily challenges. Jasmine is the owner of Listen to Your Art Therapy & Empowerment Services LLC, a company focused on the needs of the clients. Her practice is an art based, group focused and caters to teens and young adults Jasmine's life goal is to help teens and young adults build resiliency and hope.LISTEN & LEARN:- What goes into operating a mobile art therapy practice. - What Jasmine learned since taking her practice on the road. - Community collaboration as part of a practice business model.  RESOURCES MENTIONED ON THE SHOW: Connect with Jasmine at www.ltyart.com Check out Jasmines Art Therapy Notebook https://www.ltyart.com/category/all-products Instagram: https://www.instagram.com/ltyart_tes https://www.instagram.com/Miniatr_dolls Facebook: https://www.facebook.com/LTYArt/ --- Support this podcast: https://podcasters.spotify.com/pod/show/reina-lombardi5/support

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  

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.

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.

Improvements in quality of life and reduced healthcare costs are just some of the benefits uncovered in a Monash University study of Australia's only residential treatment program for people struggling with eating disorders. Wandi Nerida, based on Queensland's Sunshine Coast, provides a unique model of holistic, person-centred, inpatient care. As the rate of eating disorders continues to rise, so does the need for improved treatment approaches. “We're trying to step away from that more clinical hospital feel, where everything's super sterile,” says Dr Carly Roukos, Want Nerida's Clinical Lead. “As much as possible, we try to have it feel less like a hospital and much more like a home.” In this episode of Let's Talk, Dr. Roukos shares how the pioneering model of care at Wandi Nerida was first developed, and what life's like for participants who receive treatment there. Dr Roukos has been with the centre from its inception in 2020 and has played an important role in developing the successful clinical program. “The transition from treatment to home can be really difficult,” she says. “So, we provide opportunities to practice real-life things in real-life settings to help with that transition.” This piece is key post discharge from hospital: How do we maintain our health and recovery in regular life? Dr Roukos addresses this issue and more. Find out more about Wandi Nerida Enquire about placement at Wandi Nerida Meet the team at Wandi NeridaSee omnystudio.com/listener for privacy information.

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.”).  

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.          

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.      

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.

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.

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 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.

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 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 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. 

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.

In this revealing special episode, we dive into the announcement that WinGate Wilderness Therapy in Utah is closing in September. WinGate has joined three other outdoor behavioral healthcare programs (SUWS of the Carolinas, Aspiro, Outback) to shutter its doors in recent months. We trace WinGate's origins, its rapid rise under Shayne and Sherry Gallagher and Family Help and Wellness, and ponder why these wilderness therapy programs, once hailed as life-changers, now face such existential challenges. Beyond the heartfelt narratives, we also explore the broader shifts in the industry, from public perceptions to the financial challenges that many residential wilderness therapy programs face today. By contrasting historical trends, such as the closure of Tent Therapy programs in the early 1900s, the post-Great Recession closures, and the current mental health crisis, we attempt to paint a comprehensive picture of where wilderness therapy stands today and where it may be going. Tune in for a broader understanding of the evolving field of mental health treatment in the outdoors. Listen to the Nov. 2018 interview with WinGate Co-Founder Shayne Gallagher on Stories from the Field.  Family Help and Wellness Website

In this episode, I sit down with Devora Shabtai LCSW and we delve into the world of residential treatment programs. Devora sheds light on what these programs entail and she dispels common misconceptions. We explore the goals and dynamics of these programs, offering valuable insights for individuals and families seeking effective rehabilitation solutions. We discuss the core objectives of residential treatment, emphasizing the importance of understanding its role in the recovery journey. Moreover, Devora shares crucial factors to consider when dealing with residential treatment programs, ensuring that listeners are equipped with the knowledge needed to make informed decisions. Whether you're seeking help or supporting a loved one, this episode provides a comprehensive overview of the landscape, helping you navigate the path to healing with clarity and confidence. Devora can be reached at dshabtai@onwardliving.org Check out our sponsor OKclarity.com OKclarity.com is THE place for any Jew - no matter how frum or religious you are - to find an excellent therapist, psychiatrist, coach, or nutritionist. And it's completely free for you to use!OKCLARITY.com's professionals are vetted and have extensive experience working with the Jewish community. Yes, you can even find me there! If you're in the market for a therapist, coach, nutritionist, psychiatrist, or the like - you want to check them out. If you don't find what you're looking for, they have a concierge service where you complete a short form and they will personally match you.Important side note! If you are a wellness professional, I highly recommend joining their directory. Their team is amazing and I've received referrals immediately! OKclarity also has an amazing WhatsApp status with over 8 thousand obsessed followers. Their WhatsApp is a free way to improve your mental health and they post great humor so you'll laugh too. If you have WhatsApp, shoot them a message at 917-426-1495. My personal OKclarity website:https://okclarity.com/directory/raizel-schusterman/. Find an OKclarity verified professional: https://okclarity.comBecome an OKclarity verified professional:https://okclarity.com/for-professionals/. Join OKclarity on WhatsApp status or groups:https://api.whatsapp.com/send?phone=19174261495&text=Hey!%20I'd%20like%20to%20join%20OKclarity%20on%20WhatsApp.%20(APPR) Raizel Schusterman can be reached at apositivecoach.com or email Raizel@jewishpeabody.com --- Support this podcast: https://podcasters.spotify.com/pod/show/apositivepodcast/support