The Happiness Project

The Happiness Project

I attended a YWCA Women in Leadership Luncheon on Wed, (I am a past winner). The speaker was

Gretchen Rubin, the author of The Happiness Project  or, Why I Spent a Year Trying to Sing in the Morning, Clean My Closets, Fight Right, Read Aristotle, and Generally Have More Fun (Harper; 1 edition, December, 2009). She was kind enough to give each of us a copy of her new book, Happier at Home: Kiss More, Jump More, Abandon a Project, Read Samuel Johnson, and My Other Experiments in the Practice of Everyday Life ( Harmony;1 edition, September, 2012).

I have been reading it and like it quite a bit. Of course, I was reminded of something I emphasize strongly in my teaching these days: what if our actual job is to help these kids to be happy?

But aren’t we supposed to be making them behave better? Ms, Rubin speaks to that in her discussion of whether it is selfish to pay attention to one’s own happiness:

“I sided with the ancient philosophers and modern scientists who argue that working to be happier is a worthy goal. According to Aristotle, “Happiness is the meaning and purpose of life, the whole aim and end of human existence.” Epicurious wrote: “We must exercise ourselves in the things that bring us happiness, since, if that be present, we have everything, and, if that be absent, all are actions are directed towards obtaining it.” Contemporary research shows that happy people are more altruistic, more productive, more helpful, more likeable, more creative, more resilient, more interested in others, friendlier and healthier. Happy people make better friends, colleagues and citizens. …

I knew it was certainly easier for me to be good when I was happy. I was more patient, more forgiving, more energetic, more lighthearted, and more generous. “(the Happiness Project, Getting Started)

So I guess happiness is a worthwhile goal for our kids as well.

Ms. Rubin has created Eight Splendid Truths about Happiness.  Here are some I find particul;arily relevant to our work:

Second Splendid Truth
One of the best ways to make yourself happy is to make other people happy;

Hence the importance of providing ways for our kids to give to others…

Fifth Splendid Truth
I can build a happy life only on the foundation of my own nature.

Do we try to help our kids be their best selves, or to be someone they are not? What if Leslie is withdrawn and loves to read and is writing a novel- do we insist that participating in group therapy is the only way she can heal?

Sixth Splendid Truth
The only person I can change is myself.

Do we try to impose change on our kids, or do we create an environment in which they feel safe enough to change?

Ms. Rubin has also created her own list of the Secrets of Adulthood. Yes, she loves lists. Here’s some we might consider if or how we teach to our kids: (My comments in parentheses)

• Outer order contributes to inner calm. (Important that we realize how outer order represents inner lack of calm, and  actions can change feelings.)
• The opposite of a great truth is also true. (DBT dialectic)
• You manage what you measure. (Tracking change)
• By doing a little bit each day, you can get a lot accomplished.
• People don’t notice your mistakes and flaws as much as you think.
• Try not to let yourself get too hungry.
• It’s okay to ask for help.
• You can choose what you do; you can’t choose what you LIKE to do.
• Happiness doesn’t always make you feel happy.
• What you do EVERY DAY matters more than what you do ONCE IN A WHILE.
• You don’t have to be good at everything.
• Soap and water removes most stains.
• It’s important to be nice to EVERYONE.
• You know as much as most people.
• Eat better, eat less, exercise more.
• Houseplants and photo albums are a lot of trouble.
• If you’re not failing, you’re not trying hard enough.

Interesting, any thoughts? Has anyone else read these books? If so, any ideas about connecting them with our work or ourselves as treaters?

I have already written about what we might mean by a happier child in a treatment program, I’ll have to go back and relate with this. Stand by for further reflection.

On another topic, I am thinking of the skill of being able to do non-mood related behavior. That is, the ability to do something even when you don’t feel like it, in the service of a greater goal. All of us do this well and less well at different times. How do we learn to do this? How can we teach our kids? Please share any ideas you have.

 

 

What's Happened and What's Happening

I thought I would let you know what we have been doing and what is coming next. This may also help explain why I have skipped some weeks writing in my blog.

I have been doing quite a bit of training in California. In an agency outside of Los Angeles we trained RC Basic, the Restorative Approach, and Train-the-Trainer. We also did a Train-the-Trainer and a Recertification in Santa Rosa.

Steve has been extremely busy working on a research project we are doing in the Yukon Territory in Canada. We are so lucky to have the continuing support of Courtney Baker from Tulane University.

While Steve was in the Yukon he made presentations to several government leaders, hopefully leading to a wider adaptation of RC.

I presented a webinar for NEARI press on the Restorative Approach, the topic of my book which they publish. In fact, we have become webinar pros. We have done several webinars for our trainers, on topics such as shame, supervision and neuro-feed back (coming soon).

Of course we continue to offer RC Basic, Train-the-trainers and Consultation Groups in CT. I am very proud of the Consult Groups, we gather great minds and discuss important topics. Our latest event was about using trauma informed supervision as the back bone of maintaining trauma informed care in agencies. This has resulted in engagements to train agency supervisors in this practice. I also presented this material at the CT NASW Annual Conference with an able partner, Rebecca Desautels LCSW. Let me know if you would like to know more about this.

Steve Brown did a training for the Berkshire School Counselors Organization. Both Steve and I presented at the MASOC conference this year. I did a pre-conference workshop on the Restorative Approach, and Steve presented a very popular workshop on Vicarious Traumatization.

I did an Introduction to Trauma speech for the students and alumni of the St. Joseph’s college MSW program, and spoke to a UConn School of Social Work class on Vulnerable Populations about children in the child welfare system.

I was proud and delighted to become a true Adjunct Faculty member at the UConn School of Social Work this year. I taught a class called Clinical Conditions of Children and Adolescents, and I loved it! I hope to do more,

I’m probably leaving some things out.

So what is happening next? Tuesday we have a recertification for a group of our CT trainers, and we have two more of these scheduled. I am excited to offer our trainers new materials. Next week is the aforementioned webinar on neuro feedback.

I’m doing a Train-the-Trainer for people who want to be trainers of foster parents in early June. I am lucky enough to train with Kay Saakvitne, PhD. There is still time to register for this one, if you have been through the RC basic.

Then in July Steve will be teaching a regular Train the Trainer, and you can also still register for that. The difference is that the first one is for people who want to train foster parents, the second for people who want to train foster parents.

While he is doing that I will be presenting two workshops in Mississippi at the Lookin’ to th Future conference at Natchez, Mississippi. I will also be doing an agency consult on that trip.

Then jumping ahead to a conference I will be doing a major event in October in North Dakota.  I will do an all-day Professional Conference for PATH ND, Inc.  a family and professional agency. Then the next day the 2013 ND Foster and Adoptive Family Conference begins. I will do a keynote and two workshops. They have promised me a microphone so I don’t end up with laryngitis as I did at the Vermont foster care conference.

I am looking forward to both of these events!

I think we may have other things already scheduled but I can’t remember any right now. I do know I am taking a few days off this week to recover my sanity.

 

 

 

Question from a New Therapist

I recently received the following inquiry (posted with permission).

Hi Patricia,

I was just reading your blog on trauma-informed treatment planning for children. I am a fairly new social worker who works part-time in the community with children who have varying degrees of trauma. I am currently working with an 8 yo female who has had multiple traumas (substance abuse, physical, emotional and possibly sexual abuse, removal from home, placement in a crime-plagued inner city neighborhood) I am at a loss as where to even start, problems are so overwhelming…hoping you could share your goals and objectives. I found the info in your blog very helpful and it has assisted me in beginning to prioritize but would appreciate any help you cold give me.

Thanks!

Linda

 

My answer was:

 

Hi Linda,

First of all, do you have any help? Like Supervision from your agency?

Have you taken any training or trauma?

In working with your client, my first thought would be to her current situation. Is her current foster placement safe? Have the foster parents received any training on trauma, or could they? It is important that they understand that current symptoms she may display are not because of them, but because of her history. And that she will not trust them at first and will take a long time to form a relationship with them.

Then the next priority would be any unsafe behaviors she is displaying. Explore what they are and what they do for her- what problem is she trying to solve? How do her behaviors help her? How you work with her in therapy depends on what kind of kid she is. Can she talk about herself? Would it be better to use art or other mediums? If she is not able to be verbal, use rhythmic interactions- like taking a walk, rocking, pushing a big ball back and forth between you. Over time this helps her body become calmer and more regulated.

When/if she is ready try teaching her some regulating techniques, even as simple as taking a deep breath. Have you ever heard of TF-CBT? They have a free training at http://tfcbt.musc.edu/ I DO NOT recommend you do a trauma narrative until she is really safe and solid, which may not be within your time with her. But this training includes some good symptom management techniques.

Don't get drawn into the idea that what you are supposed to do as a therapist is to get her to tell you what happened to her. That is a much later step, one she may not be ready for for years, if ever. Your job is to help her become more regulated and safe.

Most importantly your job is to help her change her basic template about people. You do that through forming a relationship with her. Through your being trustworthy and not hurting her, she learns that some people are good. This may be the most important thing to do. But this, too, may not be easy as she will try to push you away.

There are many resources for you to learn in this area. One book that is a good starting point is Building the Bonds of Attachment by Daniel Hughes. Here are some others:

Allen, Jon. (2001). Traumatic Relationships and Serious Mental Disorders. New York: Wiley and Sons.

Blaustein, M. and Kinniburgh, K (2010) Treating Traumatic Stress in Children and Adolescents: How to Foster Resilience through Attachment, Self-Regulation, and Competency The Guilford Press

Diffenbaugh, Vanessa The Language of Flowers: A Novel Ballantine Books; (2012)

Hughes, Daniel. (1998). Building the bonds of attachment: Awakening love in deeply troubled children. Jason Aronson

Perry, Bruce and Szalavitz, Maia. The Boy Who Was Raised as a Dog: And Other Stories from a Child Psychiatrist's Notebook Child Psychiatrist's Notebook--What Traumatized Children Can Teach Us About Loss, Love, and Healing (2007) Basic Books

Saakvitne, Karen et al.(2000) Risking connection: A training curriculum for working with survivors of childhood abuse. Lutherville, MD: Sidran Press.

Saakvitne, Karen, et. al. (1996) Transforming the pain: A workbook on vicarious traumatization. New York: W.S. Norton

Saxe, Glenn; Ellis, B. Heidi; and Kaplow, Julie B. Collaborative Treatment of Traumatized Children and Teens: The Trauma Systems Therapy Approach (2006) The Guilford Press

 There is a lot of good free information in my blog. I have written recently on changing the template on 11/11 and 11/18. On 8/14 I wrote about changing the brain.

And of course there is my book, Trauma-Informed Treatment, The Restorative Approach available at www.neari.org

 Good luck, Linda, and let me know if I can be of further help.

 Anything else you would have added? Click on "comment" and let me know!

 

A Small Thought About Band-aids

Jason came up to me in the main hall and started talking about a client in our day school, Marvin. Marvin had been diagnosed with autism. It was clear that Jason was very committed to Marvin and wanted what was best for him.  Together they had developed many tools that helped Marvin stay calm as he moved throughout his day. They included such items as a fidget ball which Marvin kept in his pocket and a weighted vest which Marvin could wear when agitated. Marvin reported feeling calmer when he wore the vest.

But Jason was very uneasy about Marvin’s use of these items. He was concerned about what would happen when Marvin returned to public school. When he used these items the other kids would tease him, he would not have any friends, and he would be miserable. Jason was thinking of taking away the items now so that Marvin could learn to do without them.

Later as I helped my husband to apply a Band-Aid to his cut thumb, I reflected on the idea of a band aid. When we apply a bandage to a cut, we do not worry about the person’s reliance on a bandage. Even if it is a big cut and a big bandage. Or a plaster cast. We do not assume they will need this bandage for life and other people will make fun of them. We realize that the body has a powerful innate healing capacity. All we need to do is provide an environment in which the injured part will not receive further jury and thus will heal. We know that as soon as the cut is mended, the broken bone re-connected the person will reject the band aid and the cast on their own.

When you think of it, it is pretty miraculous that skin knits back together; that bones reconnect and are even stronger than previously; that internal organs return to healthy functioning. I have read that a lot of medicine is providing a safe, supportive environment in which the body can heal itself.

So maybe that is a large part of what we do in treatment. We try to avoid hurting our clients further, and we offer safety and support that promotes healing.

Of course in medicine we cannot cure everything. The person may have a scar. Some need prosthetics. Again, we don’t worry about people’s reactions in the future. If the patient needs the aide, medical personnel will teach him how to use it most effectively.

So Jason doesn’t have to worry about taking the supportive tools away from Marvin. When he doesn’t need them, he will drop them himself. The urge to be grown up and normal will prevail. And it he continues to need some help when he goes to school, work with him on how to use it discretely.  

And he may get teased. Most kids do at some point. But maybe we will have taught him tricks not to over react. And the memory of Jason, who cared about him, will give him the strength and hope to keep moving forward.

The Tragedy of Inadequate Resources

All over the country the child welfare system at every level is reinventing itself to provide trauma informed care. At State agencies, at non-profit treatment providers, at the foster care level, in schools, in outpatient therapy, good caring people are working hard to understand behavior through a trauma lens and to offer treatment that is more relationship-based and collaborative, less punitive and inflexible. Much training is being offered, including by us, on viewing symptoms as adaptations; understanding that the child is doing the best they can; and offering youth safe and caring relationships in which to heal. The same principles are being applied to parents, and there is increased awareness of how their early trauma experiences interfere with their parenting. Utilizing the information from the ACEs study we have learned the societal cost of early childhood adverse experiences, and thus the importance of early and skillful intervention.

Yet I am increasingly aware of a central tragedy at the heart of our attempts to reform. For our children who have been damaged at an early age through a combination of neglect, abuse, trauma and attachment disruptions, the best treatment skills in the world are useless if the children have to keep moving around.

Recently I was doing a training in another state at a residential facility and I was asked to consult on a girl they were struggling with. Tabitha is thirteen years old and her placement at this facility is her 29^th. She has been kicked out of day care, foster homes, treatment facilities, and schools. Currently the facility that she is in is considering kicking her out because she keeps attacking the other youth and seriously hurting them. With the resources they have, they are unable to keep the other kids safe while Tabitha is there.

We have done this to Tabitha, we in the child welfare service delivery system. Sure, the damage started when her bio family, overwhelmed with their own trauma, poverty and despair, abused her. But she was removed from them at the age of two. Since then, we have been unable to create a home with enough support and safety that Tabitha could have time to heal. By moving her around we have eventually taught her that people are expendable, that relationships cause pain, and that it is important to be tough so that no one can hurt you.

We know that Tabitha will increasingly cost the taxpayers money, in addition to the considerable amount we have spent on her already. Whether that money be incarceration, drug treatment, medical care for stress-related illness, placement of her children-to-be, etc. etc. it will be spent. And at the same time we will not be reaping the benefit to society that Tabitha could have provided if she had been given time and consistency in one safe place. Furthermore, we lose whatever talents and contributions Tabitha could have added to the world.

Yet all of this money is from different pots authorized by different people counted in different systems. So there is no way to look at this situation and say: spend money now and save it later. It is not that we are choosing not to spend enough money on Tabitha throughout her lifetime. It is that our inability to spend enough money early enough results in our wasting ever increasing amounts of money on short term ineffectual attempts at change.

Tabitha needs love to heal.

She cannot heal if she keeps moving from caretaker to caretaker.

She cannot heal if she keeps getting her worst opinions of herself confirmed by being kicked out of places.

She cannot heal in six week bursts of treatment.

She needs containment and safety to get her through the worst part of learning to manage her feelings, calm her biology, rebuild her brain, develop connections, learn skills to manage feelings, and discover some worth in herself. She needs resources to keep her and others safe until she learns to do it herself.

In order to help Tabitha heal, the adults around her need sufficient resources so that they do not become injured and exhausted. Only if they are well cared for will they be able to see beneath Tabitha’s seeming uncaring aggression to the scared child within. In addition, the adults around Tabitha need training in order to understand why she is acting the ways she does; to understand it is not about them personally; and to give them a road map for healing. This will help them have the stamina to stay engaged with her. And the adults have to understand that it is safety, connection and pleasure that will help Tabitha, not restrictions and punishments.

In the mean time, the agency where Tabitha is currently placed is doing their best. They have been given an additional five hours a week of staffing for her. They are trying to make safety plans. And they are validating her experiences and helping her understand her feelings and learn skills to manage them. Hopefully, they will make some progress.

Or, because of inadequately funding, limited options, and exhausted treaters Tabitha will succeed in once again seriously hurting one of her peers. And the facility will have no choice but to ask the state to remove her. And Tabitha will leave for her 30^th placement, where ever that might be, and the next bunch of people who seem kind but really will not stick by her.

And we will continue to support her ever increasing needs.

 

 

Current Activities

I’d like to update you on some of my activities and those of the Traumatic Stress Institute.

This past week I was honored to attend two activities that emerged from the Newtown tragedy. My boss Dr. Steve Girelli was one of the local experts chosen to be part of a panel at an event focusing on Gun Violence. The event was held at the campus of WestConn University in Danbury and the keynote speaker was Vice President Joe Biden. Many local politicians also participated including Senator Richard Blumenthal, Senator Chris Murphy and Representative Elizabeth Esty. Attending with Vice President Biden was U.S. Secretary of Education Arne Duncan. Newtown First Selectman E. Patricia Llodra was also present. The first panel focused on gun control, and some of the participants were Hartford Mayor Pedro Segarra; Lynn and Chris McDonnell, parents of Newtown victim Grace McDonnell, a first-grader; and Dale Hourigan, a state police captain and Newtown first-responder, Capt. Dale Hourigan of the Connecticut State Police and Dom Basile, an advocate for gun owners and safe storage. The second panel focused on mental health and school safety. In addition to Dr. Girelli there was Kathryn Seifert an author and psychologist and University of Connecticut professor George Sugai. It was very interesting and moving.

The following day I attended a conference sponsored by Connecticut NASW and the CT Schools of Social Work entitled: Social Workers Respond to Newtown. This involved a panel of speakers including Kenneth J. Doka, PhD is a Professor at The College of New Rochelle and Senior Consultant at The Hospice Foundation of America.  He provided an overview of “Coping with Public Tragedy” including a discussion of grief, the tasks and styles of grief, and what happens after the tragedy. Kathi Legare, LCSW founder of the Family Affirmation Center for Treatment in Vernon spoke on “Tools and Interventions for Working with Traumatized Children”, Joshua Miller, PhD, LICSW a Professor and Associate Dean at Smith College School for Social Work speaking on “The Use of Groups to Foster Resiliency in the Wake of a Tragic Disaster” and my friend  S. Megan Berthold, PhD, LCSW an Assistant Professor at the University of Connecticut School of Social Work and has over 20 years of experience as a clinician with survivors of trauma, war, and torture in different parts of the world who discussed “Attending to Our Own Vicarious Trauma: How to take care of ourselves as we treat the trauma of those in the community”. I was delighted to hear Risking Connection acknowledged by several speakers.

While we are on the subject of NASW, this coming Friday I will be presenting a day-long training for the new Clinical Solutions series. My topic is “Using the New Brain Science to Create More Effective Treatment.” There may be space left, check it out at http://www.naswct.org/. And I will also be presenting at the 28th Annual NASW/CT Statewide Conference April 19, 2013
Coco Key, Waterbury, CT. "Weaving Threads of Resilience and Advocacy: The Power of Social Work" Gary Bailey, MSW, ACSW, from Simmons College is scheduled to be the Keynote Speaker. I’ll be speaking with a co-worker, Rebecca Desautels, LCSW,  on Sustaining Trauma Informed Care through Supervision. That’s always a great conference, and you get to see a lot of old friends.

My co-worker Steve Brown took off today for a trip to the Yukon Territory in Canada. We are doing an exciting research project there, and Steve is also meeting with the leaders of various Yukon departments as they would like to expand the use of Risking Connection there.

I am heading out early tomorrow to Los Angeles California to do a two-day Restorative Approach training at Maryvale in Rosemead, California. This is my first time doing a two day RA which is based on my book, and I am very excited about it.

On Thursday, April 11, 2013 both Steve and I will present at the MASOC conference in Worchester, which is a premiere conference about treating adolescents with problem sexual behaviors. I’m doing a pre-conference half-day on the Restorative Approach Thursday and Steve is presenting on VT during the conference. Why not come- find out about it at http://www.masoc.net/conference-information.html.

Then later in April I will be presenting at the Professional Day March 21- 23, 2013
of the True Colors’ 20th Anniversary Conference: Celebrating our Heroes of the Past, Present & Future. It is held at the University of Connecticut, Storrs. I’m very honored to be part of this event.

We have quite a few more agency trainings set up. For our Associate Trainers we have a wonderful series of in person consult groups and webinars this year. The first one is on March 5^th on the subject of Brené Brown on Vulnerability and Shame: What Are Millions of Viewers So Excited About? I think this will lead to an important discussion.

In addition to all this, I am teaching a course at the UConn School of Social Work- a regular credit course. I really love doing it.

We are also continuing with our project of training people to train foster parents in Risking Connection. We held a training for our Associate Trainers who wanted to learn the new Foster Parent Curriculum. That was very successful, and there was a lot of enthusiasm about the material. Out next step will be to hold a training for people who are not yet RC trainers, but who would like to be specifically trained to teach foster parents. It will be required that participants have attended a Risking Connection basic training. This will be in New Britain probably in late May. Let us know if you are interested by emailing Marci at marcim@klingberg.org.

This seems like a lot, doesn’t it? And that’s not everything. But it is fun! Please attend one of these events, and come up and introduce yourself to me. I’d love to meet you!

Brain Based Social Work

Those who know me or who have been following this blog know that I am interested in the works of Bruce Perry and the neurosequential development of the brain. I believe that if we take his work seriously it could lead to a reveoution in the helping programs. To over-simplify, I believe that our most important task is to teach the child through experience that people cen be associated with pleasure. Then we also have to support brain development, offering that youth as many experiences as possible to promote his brain catching up to where it should be. This has all sort of ramifications.

So what do we actually do? I am giving a seminar for CT NASW: Using the New Brain Science to Create More Effective Treatment
Friday, March 1, 2013 - 9:00AM to 4:30 PM
(http://www.naswct.org/ to register, hope to see you there), and in my preparation I decided to make a list of brain based interventions. This list is not complete by any means but it might be enough to start you thinking,

 

Brain Based Social Work

1.      With children and Youth

a.      Evaluation of brain capabilities

b.      Evaluation of verbal abilities

c.       Individualize approach to treatment

d.      Concentrate on positive interactions

e.      Use rhythm

                                                              i.      Walking

                                                            ii.      Rocking

                                                          iii.      Hand games

                                                           iv.      Throwing ball back and forth

                                                             v.      Use OT materials like large ball, mats  

f.        Emphasize narrative

                                                              i.      Journals back and forth

g.      Art

h.      Rythmic non verbal interaction when beginning to escalate

i.        Music and dance

j.        Sensory interventions

k.       Cooperative games

l.        Specifically inquire about safety

m.    Create opportunities for effective action

2.      With Families

a.      Playing together in session

b.      Project Joy

c.       Psycho-education

d.      Teach narrative, reading, etc.

e.      Sharing of skills

f.        Own trauma historie

3.      With adult clients

a.      Opportunities for motion

                                                              i.      Rocking chair

                                                            ii.      walks

b.      Sensory interventions

c.       Activity groups

d.      Cooking

e.      Parenting

4.  Specifically inquire about safety

g.      Create opportunities for effective action

h.      Create own narrative

i.        Not just trauma

j.        Teaching skill

k.       Effect of trauma on parenting

4.      As a supervisor

1.      Prioritize supervision

2.      Teach awareness and use of own feelings

3.      Celebrate success

4.      Hiring and promotions

5.      Awareness of VT

6.      Self and other care

7.      Notice and reward uses of brain-based thinking

8.      Acknowledge and troubleshoot obstacles

9.      Specific action on resistance

10.  Cultivate mindfulness

5.      As an administrator

1.      Enthusiastically support trauma informed care

2.      Clear vision of whyyou are making this change

3.      Measure results and share

4.      Resist  off over-using people

5.      Provide time to talk and think

6.      Promote inclusion of families

7.      Emphasize supervision and provide time for it

8.      Celebrate success

9.      Pay attention

10.  Acknowledge VT

 

So, what do you think? Do you have more examples? Click on#comment# and share them.

 

 

 

 

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