Book review: Building the bonds of Atachment by Daniel Hughes

Hi everyone,

I just read a very informative and heartfelt book on raising children with reactive attachment disorder or PTSD. It’s written by a well known child psychologist, Daniel Hughes. He has worked for many years with deeply traumatized children and their foster or adoptive families. He believes in a strong partnership between the therapist and parents, and specific therapeutic and parenting techniques that will create over much time and with many obstacles a secure attachment in a child who never had one.

To make his points, he tells the story of Katie. It follows Katie and those around her from birth to age eight. Katie’s mother Sally was very young when she had her. She never had approval from her own mother and temporarily having a baby brought that for her. However because she herself wasn’t raised in a loving home, she didn’t have the slightest idea on how to nurture a newborn. She would sometimes pick up Katie and hold her and sometimes leave her to cry. There was no routine for meals, or play, or even changing her diaper. More often than not Katie was just left to cry and cry. When Sally’s abusive husband Mike was around, things were worse. He often would grab Katie roughly or shake her or have Sally “get that kid to shut up.” So her mother’s coming to her, rather than bring comfort brought emotional distress as Katie could sense her mothers fear and frustration.

Katie stayed with her parents until she was 18 months. By that time she had her arm broken when Sally flung her on the bed, and Mike’s brother saw Mike shaking Katie. By that time now being able to walk, and having more of a sense of what was going on around her she would often “make her parents mad” by spilling things etc.

It seemed that any attention was better than none and the only way to really get her parents attention was to upset them. But then would come the terror of their physical and emotional abuse and neglect.

When the brother saw how mike had treated Katie he did call social services and Katie was taken into care. Her first foster home was with a woman named ruth and her children. Ruth saw Katie as “strong willed” and needing lots of supervision, very hyperactive but that was all in the beginning. Then it seemed her behaviors would get worse if Ruth wasn’t constantly around or she was left alone for too long.

Throughout Katie’s four foster homes she had the same therapist. This was a play therapist who worked well with children who did not have a trauma background. She would use play therapy techniques and would not have any of the foster mothers in the room with she and Katie. There didn’t seem to be the same behaviors displayed at therapy as were at home which made it imposible for the therapist to really work on the behavior.

Katie was moved from Ruth’s to Karen’s to Susan’s foster home. Each foster parent basically had the same approach that of using behavior modification. Praising any positive behaviors with rewards and ignoring the negative. This again will work with many children who understand cause and effect and are motivated by praise. But Katie didn’t even have the capacity to form a relationship with someone that wasn’t based on manipulation and feeling such self-hatred that deep down she knew no one really wanted her.

So these behavior programs backfired. Katie would work to earn the rewards only when she really wanted something. And then go back to acting however she wanted. She would steal, lie, go into rages, pee on things, and generally make things hell for the family. In a couple of families her behavior caused tention between the parents and siblings began to really resent Katie.

In Karen’s foster home Karen got so frustrated trying to do right by Katie, and Katie seeming to do things “just to get her back,” that she turned to spanking hitting and scratching Katie on occasion. Obveously she was moved from that home.

Susan was the last foster mother Katie had before going into attachment specific treatment. She was truly caring, and truly committed to doing anything possible for Katie. They tried all the behavior methods. She tried to be with Katie as much as possible do fun things etc. But Katie again kept showing such manipulation and unpredictable emotions that Susan never knew what was really going on. In spite of so much upheaval Susan was determined to keep Katie. And did for much longer than any of the other foster parents. But the last straw was when she was helping Susan cook for a family party and put her own fecies in hamburger. (wisdom around having a child handle raw meat aside!)

This was Susan’s breaking point. But she didn’t take it lightly. She felt like she had really let Katie down. Katie’s caseworker was very discouraged himself as he’d followed Katie’s progress or lack there of. He talked with his supervisor and she realized Katie’s case was much too complex for mainstream foster care. She recommended a therapeutic foster home. The caseworker, Susan and the play therapist were skeptical and a bit defensive. They knew something was wrong but why wasn’t their type of care good enough? The supervisor explained how parents in therapeutic homes are trained in specific ways of parenting specific to children with attachment disorder and trauma histories. It is extremely specialized as is therapy.

The caseworker knew there was no other alternative and was curious about this approach. This is how Alison and Jackie came into Katie’s life. Alison was an extremely caring and competent therapist in the field of trauma. Upon meeting Katie she did not fall for Katie’s manipulations or back down when she went into a rage. She set the expectations (that Susan and the caseworker would be in the room, when Katie could play with toys and when she couldn’t etc) and Katie followed though with much anger. This is where Alison diagnosed Katie with post traumatic stress disorder and attachment disorder.

Alison recommended Jackie and her family as a good therapeutic parent for Katie. As with Alison, Jackie was extremely skilled at giving Katie boundaries but also empathy right from the start. Not five minutes after walking through Jackie’s door, Katie had a tantrum about getting crackers for snack instead of cookies. Jackie emediately was firm with her about this, and held her in a safe restraining position when she became so angry that she was trying to hurt Jackie. The social worker thought this was a bit much over nothing but Jackie assured him that this needed to be done. A little shocked he decided to leave them to it.

The next day at therapy Alison established how therapy would work. Jackie would be in every therapy session sitting next to and touching/holding Katie. Alison would first always be playful and silly with Katie to get her to relax and connect in a non threatening way. This included games like this little piggy, counting Katie’s freckles, and drawing a circle on Katie’s face with her fingers. And generally seeking eye contact, playful tone of voice ETC. She also facilitated these playful interactions between Katie and Jackie which were the basis of a nonthreatening way of being in relationship.

Firmly but still in a caring way Alison would then steer the conversation to more difficult topics. Like what it was like to be in Jackie’s home, her strong emotions etc. During this time Alison would coach Katie to say certain things like how mad she was at Jackie, or how she felt bad and like no one wanted her. Or whatever feelings associated with what was happening. Sometimes Katie would start by expressing some emotion and Alison would pick up on the intensity and match it. When Katie resisted in speaking her feelings Alison would speak them for her which would often elicit an emotional response. Katie was able to let her anger out in the office with Jackie safely holding her.

When they discussed Katie’s behaviors Jackie and Alison would always express genuine empathy for what was behind the behaviors. Like “you were really mad that I didn’t let you go swimming and it was really hard for you to do this or that chore.” Instead of punishing her for her response or tieing it into some reward that had nothing to do with what had happened.

It wasn’t long before Jackie realized that allowing Katie to participate in activities unsupervised and with unscheduled time as most seven year olds would do was not working for her. So with Alison’s guidance Jackie provided a firm but very nurturing therapeutic home environment. Anytime she was not at school she was extremely close to Jackie. She would sit right by her when they doing chores or just sitting. Katie often hated this and had frequent rages where Jackie would hold her, make eye contact and say over and over again that she cared about Katie and knew how hard these feelings and rules were for her. Also Jackie and Alison realized that it was hard for Katie to handle too many fun activities. Anything like playing outside going somewhere like to the zoo ETC would stir up too many feelings for Katie. She would deep down feel like she didn’t deserve the fun, that something bad was gonna happen after something good and in general it would cause her to get emotionally off track.

So Jackie would keep such activities to just what Katie could handle. For example for her seventh birthday rather than having a “big party” they just had a normal day where Katie got to choose what kind of cake they had, and got a small present. One thing that was a solid part of all this was “Mom time.” This was time right before bed where Jackie would do relaxing things together with Katie no matter what else happened that day. They would sing songs together, sometimes eat candy, cuddle, play with dolls ETC. At times Jackie would give Katie a bottle to try and give her the experience she did not have as an infant with that key mother/ child interaction. She would only do this when Katie asked for it, and when she knew it wasn’t a manipulation.

It seemed that for mom time Katie would put aside the fighting for just that time and often be able to take in what was being given.

This was an intense struggle for Jackie and her family. Katie demanded constant attention during this time. I think what kept Jackie from being burned out was the support of her husband and teenage children, as well as her relationship with Alison. Alison would always see Jackie before the therapy session to see how she was doing emotionally and talk about what they’d cover in therapy that day. If Jackie didn’t have that unconditional support from Alison I doubt she would be able to do this work.

After a disasterous thanksgiving dinner, where Katie manipulated the whole of Jackie’s family and then spilled hot gravy in her sister’s lap, that was the hardest moment for Jackie. She could not hold back her anger, and she told her husband to look after Katie for that night. She knew she needed a break and could not come back into an empathetic place that day.

She was self- reflective enough to realize that her trigger was about her relationship with her mother, and wanting her mother to aproove of how much she was doing with Katie and how well she was doing. She always felt like her mother liked her sister more and never expressed affection to her that she could take in. Alison gave Jackie time to process these feelings and Jackie was able to even have her mother in for a session where they were able to clear the air. This made a difference to how Jackie worked with Katie.

The process was often one step forward five steps back. But very slowly the steps forward stuck. Katie was slowly accepting love, saying how “hard it was to work on love,” and feeling bad when she did something to upset Jackie. It became no longer about manipulation but about a genuine interest in Jackie’s reactions. She was able to eventually connect the consequences with her behaviors. She went through a time of physically hitting herself/ head banging in order to try and numb her feelings and not hurt Jackie. Alison and Jackie encouraged her to express all her feelings and that feelings wouldn’t hurt them. She had to let them out because keeping them in hurt Katie.

Katie made a huge amount of headway in realizing that she was not bad, that her parents were wrong for what they had done. This took a very long time as it was at the root of Katie’s behaviors and no self-worth. This was done by Jackie affirming the power of their relationship a million times a day, providing consequences not punishments and playful empathy and curiosity. This was reinforced in therapy by very careful interventions from Alison where Katie could speak her feelings to her birth parents through looking at pictures, or role play. In this way she was able to resolve the deep rooted shame caused by abuse and neglect and separate Jackie as a loving mom.

Around this time talk turned to adoption. Most children in therapeutic homes are there for six months to a year and then move on, this was true of Jackie’s last foster placement. Alison and the caseworker argued that though Katie’s attachment to Jackie was new, the full attachment just recently occurring, that it would survive the separation. That Katie would turn to Jackie for comfort and Jackie would still have an active role in her life. A strong intuitive feeling in Jackie drove her to second guess this plan. She truly felt that Katie had become part of her heart and the heart of the family. She couldn’t imagine what Katie’s life would be like if Jackie wasn’t in it, no matter how gentle the parting.

It was Jackie’s husband who brought up the idea of adoption. He knew his wife was thinking along these lines but hadn’t wanted to say anything. They together came to this decision. Alison and the caseworker made it clear that Jackie needed to be clear she wasn’t adopting Katie out of fear for Katie’s life in a new home or guilt that she couldn’t be a forever mom to her. But the family was clear this wasn’t the case.

Things were rocky for Katie at just being told of adoption. All the caseworker could say when Katie demanded to stay with Jackie’s family was that they would find the best family for her and he hoped it would be Jackie’s. Katie did throw a tantrum and hit Jackie. But then felt totally ashamed and like she must be a “bad kid.” The repair in this instance happened very quickly and Katie wasn’t set back by it. Jackie sharing tears with Katie and saying she was scared too of what could happen made Katie feel like they were in this together.

Jackie did not want there to be a long build up for Katie around this. And she thought they broke the record for the fastest foster to adoption process. The total joy that the family experienced when they got the news was completely heartfelt.

This child made it against all odds. She overcame abuse since birth, and four failed foster placements. She fought first against Jackie as the enemy, and then the fight became against Sally and Mike and realizing that they were wrong and that she was good. That she deserved a good mom. This would not have happened if not for a trained trauma and attachment therapist. And a commited therapeutic family. From reading several blogs on this subject I know that such stories sadly are few and far between. The reality is that just finding a therapist who even remotely understands attachment and trauma, doesn’t get manipulated by the child or blame the parents is a huge obstacle. Another big one is that parents when choosing to foster or adopt go through a honeymoon period where the child acts perfect for weeks and months. Then suddenly major behaviors emerge and the family is stranded. Getting services especially after a finalized adoption is almost impossible. The whole service system can’t wrap their minds around this condition, so blame parents, just don’t bother to help and basically turn their backs. And with all healthcare, the ones that don’t have the money for private therapy treatment centers ETC get almost nothing.

The majority of parents that I read about end up stripped of everything good in their lives. They’ve poured their hearts into proper treatment, proper parenting, support groups and anything else. By the time children with attachment disorder are teens their brains are going through such changes that the internal experiences of how they understand relationships are harder to shift. They become extremely abusive to the family and it hits harder because at this time they’re not children that can more easily be redirected. It just seems to get worse as they get older. And the family though still loving the child, feel incredibly bitter at the system that had no clue as to how to keep these behaviors from getting worse and often family members get PTSD as a result.

This book I feel shows the ideal circumstances for a child with these issues. In many cases there are a lot more failed foster placement and even dissolved adoptions. Many therapists that do more harm than good and erratic treatment. I wish that every story could turn out like Katies. Where obviously there will always be more work to do because of her start in life. But by the end she won the birthright of any human being: to have a deep sense that they’re special, loved and good people no matter what. It was a hard won battle for Katie, Jackie and her family and Alison. I hope this book gives readers an in depth understanding of trauma and attachment disorder in children and what works and what doesn’t for real healing to take place.

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Book Review: A Stolen Childhood by Casey Watson

So I have another Casey Watson book to review today.

A Stolen Childhood tells the story of Casey’s work in a behavioral management unit. This is where she works before deciding to become a foster carer. I personally enjoy her foster care memoirs better. Though I believe that memoirs about the ups and downs of working in such settings, such as the stuff written by Torey Hayden and Shane Dunphy (in the girl who couldn’t smile) is very important. I just feel that I resonate with her fostering memoirs more.

All that to say that I personally wasn’t moved by this book and found it hard to keep reading. I was moved by the story but the book was just not very engaging to me.

It tells the story of a 12 year old girl named Keara. Casey meets Keara during an incredibly chaotic situation at an assembly, where Keara has gotten into a physical confrontation with a male classmate. Casey takes Keara for the day to help calm her down and sees something in her. She sees Keara as incredibly articulate and without the anger that she previously displayed, as naturally a good natured child. However she notices a troubling anxiety about Keara. She pulls her hair out when anxious. She is also incredibly tired often drifting off to sleep in the middle of talking/ doing work.

These may seem like small issues compared to others displayed by the kids in the unit but Casey has an intuitive sense that Keara needs individual attention. So she goes to the unit full time. Keara mixes well with the other kids, even when as luck would have it, the boy that she fought with at the assembly ends up in the group. She good naturedly hangs out with over affectionate Kloe, and tolerates the behavior of the boy classmates appropriately.

Casey still sees Keara as somewhat of a mystery then. Talking to her it seems she has some family troubles. Keara’s mom is bitterly opposed to her father’s re-entry in Keara’s life, but Keara couldn’t be happier. Her mother often works long hours at a care home, and Keara is left home alone. She seems not to mind but it’s clear how much she enjoys the time spent with her Dad.

This seems a pretty common issue for children with divorced/ separated parents who do not have any kind of healthy relationship around co-parenting. When Casey goes to visit Keara’s mom’s house she finds it intimidating in the fact that it’s full of expensive items. It seems like a child doesn’t live there at all. Her mom wants nothing more than to bad mouth her ex which doesn’t get Casey anywhere.

When it becomes apparent that Keara is missing school after weekends with her dad, she visits her dad in the hopes of setting up appropriate boundaries for his having house rules for Keara. She finds her Dad to be shy, very loving towards Keara. He doesn’t have a job and has a messy house but other than that there isn’t much to worry about.

Until her father drops the shocking realization that Keara’s mother is envolved in sex work. Casey is stunned and wants to fix things right away. However to her frustration all she can do is pass on the information to Gary the child protection officer, and let the system do it’s thing. It’s a theme throughout the book that Casey is emotionally drained, not so much from her work with the children specifically, but by not being able to be apart of anything to do with social services involvement. At the time having little understanding of the system. It also deeply saddens her when a child leaves the school through social services and she gets no updates or contact. It’s pretty clear she’s on her way to wanting to work more personally with children, and understand more about the social service system but isn’t quite sure how.

Keara then is taken temporarily into foster care. While her mom is investigated. Her mom one day calls the school in a drunken rage hinting that Keara’s life just got a lot worse living with her father full time. Casey and staff pass it off as pure animosity and being very drunk. However just as the school year is winding down Keara and Casey are driving to an end of the year school trip and Keara reveals that her father has sexually abused her. Though tragically she doesn’t know it as such.

Casey is then flooded with even more emotions, guilt for not knowing, anger that this was happening and no one else knew, and helplessness around the process again of social services envolvement in which Casey really has no part. She has to watch as a screaming inconsolable Keara is taken away and never seen again.

I guess what did strike me was the raw account of Casey’s own feelings around the process of social services at the time, how little she knew about the system and how much she wished she knew more. For whatever reason as I said though I was moved by the story, it just didn’t resonate as much as Casey’s other books have.

Would love your thoughts.

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wanting to create a peer lead supportive housing community

Hi everyone,

So this idea has been bouncing around in my mind in different forms for awhile. I know I’ve posted about it. And many might be tired of hearing about it. Because it’s just an extremely rough seed of an idea and many might say it has no substance at all and could never work. It doesn’t help that I haven’t been able to articulate it well.

However this week I think I found the framework I’m looking for.

As people dealing with mental health challenges we struggle with a lot of things. Finding a job or staying in school or some kind of volunteer work/ activity, having social relationships, and living in an environment that’s workable and supports healing.

I have very close friends and we help each other day by day on an online support group. I so wish that we could all be together in person to exchange our strengths and talents in the service of helping one another. A huge problem I see is a lot of isolation. My friends for the most part live alone in their own apartments. Not all but some. I notice that they often have no way of getting to any social events, have trouble maintaining relationships (a huge issue in that is others not being able to deal with having a friend with a mental illness or disability,) and sadly often basic needs are not fulfilled. For some their disabilities makes getting/ preparing food, keeping a clean house, hygene ETC difficult. As well as things like managing money and access to medication. I feel so helpless and frustrated to see them struggling along. I’m especially frustrated when they’re supposedly getting “support services” that are less than supportive. The staff coming in are insensitive, won’t change what they’re doing when it’s brought up they’re doing things that are not working, just don’t show up ETC. This leaves the person even more emotionally lost because they were depending on at least a minimum amount of help which is unreliable.

Not everyone is on their own obviously. And some do just fine. Some live with family or have family members or friends come in and it does work out really well. It’s wonderful to hear about even one solid supportive person in someone’s life as it’s so hard to come by. But even for these friends I still often pick up on a deep loneliness and wish for more ongoing support from those that are in the same situation as if the whole group of us could come together that would make a world of difference.

Then there’s residential with all its ups and downs. Nine times out of ten staff there are controlling approaching things as if they know better than the residents that live their talking down to them ETC. Even at the best of places there are rules that are designed for safety but because they’re not individualized. This includes things like when you have to be in, if someone is on restriction or not (meaning that they can only go out with staff) having to eat what’s served here only getting $30 a month, no pets, no meds in your room, no sharp objects ETC. .

Many people would absolutely not be able to deal with these rules. I’ve been here three years and have taken the rules and annoyances in stride in exchange for the good support I do get here, the best friend I’ve made and just plain how much better I’ve been doing. And knowing that I need to hang in here until I find something else better, and that any sudden move would destabilize me.

That said I’m starting to find the atmosphere very frustrating. Particularly people who lack any kind of self-awareness manners ETC and having to just put up with it. Residents that yell and scream and staff say it’s ok because that’s “their baseline” and other things.

Clearly all of these ways of doing things aren’t cutting it. I have to say I’m at a disadvantage here as I’m proposing a model I don’t have much experience with. Which would be a peer lead supportive housing program. Along the same lines as how clubhouses or peer respite centers work. That these organizations do have staf involvement however the staff subscribe to the idea that we as mental health consumers know what our needs are and can best run things with guidance rather than being told what to do. Unfortunately I haven’t as I said ever been a part of either program as a client. I wish I had. In MA they have a lot of such resources. In Chicago due to everything under the sun being cut they don’t have hardly anything. When I was in MA however I did hear great things about club houses, and online sites look very promising. Similarly I’ve heard good things about peer respite programs. Though I’m sure everything has its ups and downs.

But the idea of us making decisions around what kind of living environment would be most healing would solve many problems. Certainly the first being the isolation and lack of true understanding of the struggle. Having professionals in that understand and totally resonate with this way of thinking would be a must as well as providing for safety concerns. It would have to probably be part of a community mental health program but again one that’s extremely creative and doesn’t box people into catagories.

I see the main component of it being an apartment building where people could choose to have single or double rooms. And where they could then work out with their roommates and help of the general community healthy guidelines for living. How things like chores, preparing meals ETC would be done ( whether strictly done in each apartment with assistance from peers and staff or as a community in common areas) would have to be determined on the basis of the members needs and abilities. But a huge part of it would be the support of doing activities together, r informal support groups, hobby groups going out to restaurants and other fun things. I

Again I don’t know if this is just some crazy idea. And obviously I don’t know how it would be funded or if there’s anything remotely like it in the world. But at least it’s better than no new idea at all. I welcome any thoughts or additions. Especially from those that work at/ have been to club houses or peer respite centers or any other peer driven programs.

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teaching staff here the importance of direct communication

So had a totally exhausting experience last night. That was made exhausting by the way it was handled by staff here.

Where I live staff have a certain way of doing things when it comes to addressing issues with residents. All staff or PRCS can potentially interact with all residents just fine. They run different groups can check in with other residents, residents can go to whoever they need to in a crisis. Each resident does have a main PRC that they work with. Who sees them at least once a week does their plan and generally knows them best. Though this varies from resident to resident some refuse to see their PRC at all, others don’t like theirs. Though you have the right to switch if things aren’t working out.

But anyway for whatever reason their rule generally is that if a PRC that’s not someone’s specific one sees an issue that they’re concerned about they tell the resident’s PRC rather than going to the resident directly. This apparently makes it easier for the resident to hear the information from their own PRC than from one that they don’t have as good of a relationship with.

However for those like me that are self-aware enough and emotionally clued in, it really comes down to feeling like the person originally concerned is talking behind your back about you and leaving it to your PRC to relay the message.

So over the weekend a PRC that isn’t either my or my friend’s was talking to my friend who was having a hard time. I was doing something else with another friend who was there and in the middle of something. I hadn’t realized at the time how much my friend needed support and was in a serious conversation with the PRC she was talking to. Who she did have a pretty solid relationship with. I was impatiently trying to get her to get back to what we were doing and snapped at her to help me. To the PRC this seemed insensitive and rude which it was.

I realized that and apologized to both of them. Sounds simple right? Well their way of handling it went like this:

This happened on a Saturday night. The person concerned waited until yesterday to tell both of our PRCS. She told them individually I guess so they could then talk to each of us about it. Keep in mind neither PRC had actually witnessed this. This was now secondhand communication.

My friend’s PRC talked to her first before mine told me and my friend was confused herself. She hadn’t really been concerned about the incident that night and couldn’t really articulate in a way I could fully understand what was even said.

Similarly when I went to my PRC and found out she knew (again I had known nothing about this) she couldn’t even really give me a solid explanation of what the concern was. I pretty much demanded to talk to the actual witness. She came in I listened to what she had to say understood it and that was it. My PRC and she were really worried I would lash out at her but obviously I didn’t. I wanted to prove to them that this kind of indirect almost high school behavior communication was the cause of the problem. In the future I told the person to please come directly to me. Something that seemed a novel concept for these people.

They really feel it’s best for staff that don’t have a relationship with a resident to just leave it to the resident’s PRC. However I just think that’s really unhealthy. The fact they model this and are afraid to approach you personally is like ok? You’re supposed to be teaching social skills? I get that so many residents are not insightful enough to maybe handle this. That just listening to their own PRC is a huge issue and anything sets them off. But I know I can’t be the only one upset by this, or who could use this type of healthy communication. Just really weird. I came out feeling very proud of myself but was shocked at how emotionally exhausting they made this situation. Especially as they’re professionals.

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I missed DBT this morning feel bad

Hi everyone,

So I unfortunately missed DBT group this morning. I have hypoglycima I don’t know if that’s the right spelling. It’s not officially diagnosed. I heard to do that you’d have to test my blood sugar endlessly and who wants that!

But since I was a kid I would get extremely hot weak and dizzy when I was hungry and it could happen even if I thought I’d eaten enough.

Unfortunately I’m very low on snacks. And I lost my bank card this week. I had to cancel it and will get a new one tomorrow. So I probably waited too long to eat anything. I did have my last snack a honey bun. I ate it but still felt weak and very tired. I lay down and slept and did not go to group.

I feel bad for the group leader as this is a brand new group. I’ve co-lead groups before where members have came and went not attending every week and it’s extremely difficult and frustrating. She knows there will be ups and downs but yeah. And things are just starting out. I guess today there were only two other people besides Jess.

I hope that I won’t have to skip again for awhile.

In other news I do like the info on the handout that I guess they didn’t completely go over but will share below.

General Handout 4

Skills Training Assumptions

An assumption is a belief that cannot be proved,

but we agree to abide by it anyway.

1. People are doing the best they can.

All people at any given point in time are doing the best they can.

2. People want to improve.

The common characteristic of all people is that they want to improve their lives and be happy.

3. People need to do better, try harder, and be more motivated to change.*

The fact that people are doing the best they can, and want to do even better, does not mean

that these things are enough to solve the problem.

4. People may not have caused all of our own problems, but they have to solve them


People have to change their own behavioral responses and alter their environment for their life

to change.

5. New behavior has to be learned in all relevant contexts.

New behavioral skills have to be practiced in the situations where the skills are needed, not just

in the situation where the skills are first learned.

6. All behaviors (actions, thoughts, emotions) are caused.

There is always a cause or set of causes for our actions, thoughts, and emotions, even if we do

not know what the causes are.

7. Figuring out and changing the causes of behavior work better than judging and blaming.

Judging and blaming are easier, but if we want to create change in the world, we have to

change the chains of events that cause unwanted behaviors and events.


I agree with all of this and look forward to diving in to this work as the weeks go by.

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made an awesome new friend

Hey everyone,

So today’s major highlight. I am pretty sure I posted info about Nai the blind interpreter and my efferts to find Nai. They saw the comment on my video and e-mailed me. We had an awesome skype conversation. I’m more than totally motivated about learning sign language as a blind person. She is extremely encouraging bout everything!

We also have other things in our life in common. Which is really refreshing. I have a feeling we’ll build a solid supportive friendship and I’m thrilled. I love when I can make those connections from unexpected sources like youtube!

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Book review: Hush Little Baby by Shane Dunphy

I just finished reading another Shane Dunphy memoir that so clearly captures the ups and downs and shere diversity of what one would come across in child protection.

Shane sums it up well in the end of the book when he says the stories are themed around the responsibilities we have to each other in our families and the dynamics between parents and children. These five stories do reflect this and show the inner strength of all envolved. And most striking, the ability of the children in some cases to continue a healthy as possible relationship with their parents despite mistreatment.

In the first story Shane is involved in a case with a traveler family. The traveler community has it’s own culture, music and ways of being. They are nomadic, live in what would be considered broken down trailers have no running water/ electricity. Often are told they are dirty uneducated ETC. They have amistrustfull relationship with the “settled community” who actually ended up envading their territory in the first place.

Shane uses this knowledge of their culture, and his past experience with knowing some travelers, to gain the trust of Tilly a severely battered wife. On the first meeting Shane is trying to talk to the children. The youngest boy Johny and he are playing a game. He wanted to continue playing. But his father in an unexpected rage beat Johny literally before anyone could do anything. Tilly and the other children were stunned as was Shane. This brutality was a devastating common occurrence in the family. Social service and the polece were called in to remove everyone from the home. They arrested Tilly’s husband, Shane carried several children out of the house. Tilly broken and alone did finally agree to go to a women’s shelter.

Throughout the book Shane tirelessly builds a relationship with her in spite of her not wanting anything to do with him. They get a new modern motor home. The only bad thing is that it’s parked near a river. There is a thin railing separating the river from the land. Tilly and the children are very happy with their new home and have warmed up to Shane. Shane is amazed at Johny’s recovery though extremely slow and there is great evidence of brain damage. Still the family welcome him with such caring and help in any way they can. Things seem a success for this family until tragedy strikes.

Shane’s second case is really a favor asked by a former colleague. Her brother Clive is a teen who has been locked in an adult psychiatric unit for years. He used to be fun loving, loved nature and bird watching. Now is completely psychotic and extremely violent. Shane is sent in to try to piece together what is going on. At first Clive greets him with complete paranoia and violence. The unknown of Clive’s sudden rage is always hanging over their interactions. But Shane perseveres . And slowly does build a relationship. Clive often talks of monsters attacking him and demons. The medications don’t seem to be helping and Shane is convinced it’s trauma based. When he finds out the truth it reveals shocking ritual abuse by the people who were supposed to care for him.

In the next case Shane is asked to go to a residential home to help Katie an out of control 13 year old girl. For the past ten months she’s been terrorizing the staff with her rages lasting hours. She will not cooperate or engage in any kind of therapy. The staff are at their wits end with her. In the beginning Shane doesn’t do much better in getting behind her thick walls. His first big intervention is to allow Katie to physically release all of her anger While Shane insures her safety both with matts on the floor and his knowledge of restraining and handling a person in that state. There are also cameras on in the room. Incredibly The staff are ok with this though skeptical and it seems the first time he’s done something like this. But the physical pain and emotional exhaustion of these sessions pays off. Each day the time it takes Katie to calm down decreases. The process takes three days and by the end of it the two have forged a much closer bond, Katie knowing for the first time that someone will face her anger without retreating.

It is then that she is able to open up. Through sandplay she is able to disclose horrific physical and sexual abuse. This is by no means the end to the harm that came to her. She had more emotional demons to face with Shane by her side. She came through much stronger for it. Even reconnecting with the one person in her life she felt cared. Her life was forever changed by having Shane a part of it.

The next case involves a brother and sister adopted by their foster parents Gutrude and Percy. This case is given to Shane called an “open and shut” case by his colleague. It ends up being the most challenging case in the book. Gurtrude is a very emotionally intimidating woman. She wants everything done her way. She is obsessed about how Patrick is so difficult to raise that his behavior is so out of line that she can’t handle it. She states other social workers leaving the case with things unchanged as a testimony to how no one can handle Patrick. Bethany on the other hand, his younger sister can do no wrong in Gurtrude’s eyes.

This is a heartbreaking situation for Shane to walk into. With an extremely emotionally manipulative woman who quite successfully alienated Patrick from the whole family. Her husband is so passive and afraid of her he’s unable to speak up for his son or protect him from this emotional abuse. His poor five year old sister is innocently caught in the crossfire, set as the favorite but not sure why.

Shane starts out with some family sessions. Trying to get everyone talking and on the same page. This fails miserably as Gurtrude does everything in her power to resist the sessions. It turns out that the behaviors that she thinks are so terrible are really only teen issues quite normal. Throwing a sweatshirt at his mom instead of handing it to her. Not cleaning up after himself, going to the arkaid when his mom said no ETC. Really nothing to call in social services for.

As things escalate with Gurtrude demanding that Patrick get removed Shane becomes personally envolved in finding this troubled yet intelligent boy the support he needs. Patrick is extremely loving and perceptive. He chose once in care to seek out his birth mother. When he found out she was a drug addict and very mentally unstable he vowed to continue contact. With her as well as gurtrude, for all she hurt him. His love for them, saying you can’t choose your family, propelled him to be a part of their lives. But in a healthy way where he wouldn’t allow himself to be abused anymore.

The last story is the conclusion to a story in a previous book. Twins Larry and Francey were locked up starved and beaten almost to death when put in residential. Shane first came on the scene because their behavior was like that of wild animals. He was able to get through to them. Their father Maliki is extremely developmentally disabled. He is like a huge at times violent five year old. Their mother Vera is emotionally abusive to the point where she used her husband in order to get away free from what she did to the children. She claimed that Maliki abused her and the kids and made her do what she did.

Shane continues on with this case building a relationship with Maliki in order to uncover the truth. Even when Vera fooled every social worker on the case with the exception of Shane’s supervisor, Shane persisted. He knew that she had every chance of getting her kids returned to her as she was such a good manipulator. And had zero remorse for anything that happened. He cleverly puts her in a position where she’s so stressed she slips majorly and admits her wrongdoing. Meanwhile through careful questioning Maliki breaks down and admits what she made him do. Due to his intellectual disability he honestly didn’t know at the time what he was doing was wrong. Somehow the kids were able to slowly build trust with their father. But more importantly Shane saved these kids from likely being killed.

These five cases weave and intertwine throughout the book. They show the wide spectrum of families that a childcare worker will meet, the controversial issues faced, and the out of the box interventions that often are the only thing to unlock past traumas and get to the healing that all deserve. Again I would highly recommend this book for any classes dealing with social work, ethics, counseling psychology ETC.

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facebook group I highly recommend on mental illness support

Hi everyone,

Unfortunately my mental illness caring and sharing FB group is still extremely quiet and not taking off. Am frustrated and wondering if I should leave it up or not. One problem is half the group is people who already really know each other and are in other groups. But there are a bunch of other members who just don’t post that often so yeah. Don’t get why my one group took off so well and no others have. But I’m so happy that blind mental health is and will always be awesome.

Anyway I have found an FB group I’m really happy with on mental illness support finally. Called the mental illness fight all types

This group is extremely well moderated. Been around a year or so, huge membership like thousands of people. But surprising it’s not overcrowded. The same group of people seem to post a lot and that really helps make it seem like a community. They have a bunch of admins obviously who really know what they’re doing. No weird pictures of SH, or spam or anything. Haven’t seen any big drama or conflict. Are very disability and DID friendly. I just started posting yesterday so don’t know all the ins and outs but am very impressed.

So would totally recommend this group. May work with the admins there to help this group as running my own doesn’t seem to be working. Would love others to join!

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Well today wasn’t that good a day.

DBT was good I guess. Still really like the people. Learned more about a couple of them and was sad to hear the trauma and intense pain they go through daily. But good to validate what they’re going through and support them more as we learn more about them. I’m glad the therapist did allow them to talk about their situations some.

My goals (without the thing in front of me) are to work on accepting reassurances when I’m anxious/ staying in the present, not canceling plans/ doing things I know will help with depression, and not banging the walls/ kicking the walls table ETC when I’m irritated. (have fun with that!)

I did get in a disagreement with the therapist that still irritates me. I think part of it has been seeing a few of my good friends really struggling and not getting the help they need.

We were talking about problem solving. I said how in the past I wasn’t good at solving emotional problems because I never was able to really feel and express emotions. With Jonathan I’ve learned about processing feelings while solving the problem, or before or however it ends up LOL! And we solve the problem together.

So she’s like it’s good you have support in your life but what’s the main goal? Answer to what sounds like a trick question. To solve the problems on my own.

Which I suppose can be true for some things and I get it’s important to be able to know what you’re doing because people aren’t always gonna be around and whatever.

But looking at myself and others in the group, I think having severe mental illness makes daily life difficult. Things that wouldn’t make someone else bat an eye can seem overwhelming to someone who deals with mood swings across the board, flashbacks impulsive behavior ETC. For these people just going to someone reaching out and saying I need help is huge! For them to step back from what’s for many like drowning in their own emotions, to want to let someone in is just so amazing. To then be told you need to go through this whole experience, like flashbacks, depression ETC without anyone just work it out in your head I feel is saying in a way that you’re not welcome to reach out that you must do everything on your own/ alone.

I guess like I said I might not be so sensitive on this subject if I hadn’t seen a few friends just not getting the help they need from professionals. To be told they’re doing fine even if due to their mental illness/ disability getting food meds ETC is erratic, or just getting no answers and professionals being totally unconcerned when someone is clearly struggling makes me want to wring someone’s neck.

And the therapist was like yeah yeah ok. Like whatever just agreeing to shut me up I think. She then said that it’s ok to go to someone for big problems but not little problems. I said that that’s subjective and no one outside of the person can judge what’s a little problem from a big one. I swear half these therapists and certainly the ones who come up with these therapies don’t have mental illness. If they did I think they wouldn’t say things like this. Don’t get me wrong this person is generally compassionate. I haven’t connected with her in depth. And like I said she made a good move earlier in the group by letting people speak and has good intentions just ugh. And I’m the kind of person where that interaction makes me clearly not want to open up to her in the future. I’m not gonna go through the emotional turmoil of getting myself to open up if I know I’m gonna be told something like that. It hurts way more than it helps and it is not worth it. No wonder I want to bang the walls! LOL just kidding but ya know.

Oh and then couldn’t see Jonathan because they had some emergency. And Jess is having trouble with her school stuff and it’s up in the air whether this situation can be fixed to allow her to go to school. I’m really hoping it can as this means so much to her. But am very anxious if it can’t.

So not the best day actually.

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hate hate fire alarms

So we had a lovely wake up call this morning at two in the morning! The fire alarm.

We thought it was someone smoking in their room/ bathroom for sure or someone pulled it. They’ve gotten way stricter with the smoking in your room/ bathroom/ stairs/ anywhere but the right places so we were eager for some annoying can’t follow the rules person to get kicked out!

Sigh. Sadly not true. We heard it was the first floor washing machine. That over heats and has smoke coming out of it or somehow catches fire not like explodes into flame but enough to set off the alarms. This has happened one other time. Wish they would fix it!

Well I got an ativan after the alarm. Think I was supposed to wait til later because I take 1 mg at night so shouldn’t technically take .5 til I think like the morning. But hey that’s cool lol. Did sleep good after that and had a good morning nap.

Robbie and I ended up having to change our visiting plans for today which now I’m kind of glad about as there’s no way I would have gotten to FP. Well I’d be half asleep and then slept on his bed for awhile LOL!

So yeah not the best start to the day but hey that’s ok.

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