CAP Conference The Importance of Approaching FASD with a Relational and Strengths Approach

1. CAP ConferenceThe Importance of Approaching FASD with a Relational and Strengths Approach

2. Introduction and Brief Story

3. Referral To You�

4. Preferred Outcomes for Youth with FASD Develop an understanding of who they are and equate that with seeing themselves as a valuable human being. Grows into an adult who feels comfortable with interdependence or �successful dependence� (Ory). Has understanding, respectful support people in their lives that they use as needed to assist with areas of difficulty or confusion. Is successfully utilizing areas of strength to feel competent, and make positive contributions to themselves, their families, and their communities. Are valued members of society.

5. Introduction to RBSA and FASD Why use a relational approach with youth with FASD? Why use a strength-based approach with youth with FASD?

6. The importance of a relational focus� Difficulties following birth�attachment�caring�comfort�consistency�etc�. Difficulties or challenges with attaching � sensory-issues�physical and neurodevelopmental sensitivities� Early childhood � emotional and social challenges and difficulties with self regulation and peer interaction Many children have been violated in relationships that have been confusing, hurtful and unsafe � seriously compromising and confusing their experiences and understanding of �healthy� and �safe � relationships Childhood � difficulties with peer attachments � relationships with younger children or older cohort. Adolescence � challenges with peer relationships .

7. The importance of a relational focus� Many children live with a great deal of stigma and discrimination making relationships with self and others more challenging Many children with FASD experience neurodevelopmental challenges � can result in difficulties and misunderstandings that may undermine safe and comfortable relationships with others Many children with FASD struggle with peer relationships due to a lack of intrapersonal and interpersonal relational skills for coping, adapting, communicating and interacting

8. Relationships and FASD Youth with FASD greatly value relationships with friends, family, educators and other caregivers who really understand them. Youth with FASD frequently need to rely heavily on others for support, cueing, processing, remembering, and interpreting their environments. For successful outcomes it is critical that these support people form relationships with youth with FASD that are safe, predictable, and respectful.

9. Relationships and FASD Youth with FASD may have a history of being excluded or ostracized by peers who do not understand the differences resulting from having FASD. A strong desire for friends may leave a youth with FASD vulnerable to being exploited or coerced into negative or risky behaviours. Learning to differentiate between positive versus negative friends, and to develop social skills to maintain healthy friendships may be helpful for youth with FASD.

10. Relationships and FASD Many youth with FASD have difficulty with appropriate social communication and behaviours. Youth with FASD may be friendly and outgoing and make friends easily but have difficulty maintaining positive friendships. Youth with FASD may be more successful making friends with individuals younger or older than themselves rather than with same age peers.

11. The Need for a Relational Stance� We need to go �over the top� when it comes to developing safe, trusting and comfortable attachments with children and youth with FASD We need to keep in mind the need for a secure, safe and significant relationship that fosters a sense of confidence, competence and well being

12. Trusted, effective relationships with youth with FASD must be: Accepting of differences Non-judgmental Unconditional Honest Caring

13. FASD Lens: Belief in the dignity and worth of youth as valuable human beings. Media reports often pathologize individuals with FASD. Well meaning others often pathologize families living with FASD. Despite differences in their brains, youth with FASD are valuable members of our society with strengths to contribute. Youth with FASD need an environment that supports these differences and allows youth with FASD to experience themselves as valuable human beings.

14. FASD Lens: Belief in the respect and recognition of all Youth as unique. Youth with FASD are born unique individual human beings. How FASD manifests in each youth with FASD is unique to that specific individual. Life events through childhood and youth have further shaped each youth with FASD into a unique individual.

15. FASD Lens: Belief in the necessity of a �secure base�. Having basic needs met, and a sense of safety and security are critical for all youth. Long-term prospective research (Streissguth et al. 1997, 2004) indicates protective factors for individual with FASD include: �living in a safe and stable environment,� �living in a good quality home for most of life,� and �never having been exposed to violence.�

16. FASD Lens: Belief that reality is socially constructed. Youth construct their own understanding of situations through the lens of how their brain works, perceives, processes, leading to potentially very different understandings of caregivers. Caregivers and community members may negatively construct youth with FASD as �bad, lazy, oppositional, violent . . .� or more positively as neurodevelopmentally differences or having a brain that experiences the world differently. Ideally, having FASD would mean �differences� that can be valued as part of human diversity, versus differences that are feared and negatively labeled.

17. FASD Lens: Belief that all youth are resilient, have strengths and the capacity to grow. Youth with FASD learn, grow and mature. However, they may do so at a different rate than other youth. Youth with FASD often learn what we are actually teaching versus what we think we are teaching. Many youth with FASD have incredible resilience and demonstrate amazing �survival skills� or the ability to persevere against amazing obstacles. Youth with FASD always have areas of strength that can be utilized to develop plans at home and school, and later to develop plans for living as adults or engaging in productive work activities.

18. FASD Lens: Belief that all youth want what is good for them and have a desire to change. Youth with FASD have plans, goals, and desires. Spending time with a youth, really listening to them, and working to understand what they are saying helps to understand the underlying needs and goals a youth has. Youth with FASD may have difficulty following through with stated goals, and need additional support to be successful; or they may change goals frequently and require caregivers and others to be flexible.

19. FASD Lens: Belief in the significance of promoting Empowerment and Self-determination. Youth with FASD may have grown up not understanding their own strengths and limitations, and may have been punished over and over because of their brain�s inability to comply with society demands. Recognizing and validating a youth�s own perceptions and knowledge of their experiences mitigates some of their negative experiences. When caregivers can assist youth to understand the choices open to them, they can make their own choices and self-determine a life plan and direction that has meaning for them.

20. FASD Lens: Belief in the importance of Purpose and Goal-directedness. Youth with FASD may view the world in concrete ways. Having clearly stated goals, with concrete steps or tasks to lead to those goals can help youth with the often difficult task of follow through. Make goals, and the steps to achieve them, more visual and concrete helps youth to follow through and successfully reach goals. Experiences of success help to mitigate feelings of incompetence and low self-esteem that occur when youth with FASD have faced repeated �failures� to comply with unrealistic expectations.

21. Got Strengths? The Desperate Search for the �Not-So-Obvious� �Common Sense�?

22. Despite caring and nurturing intentions, children with FASD exist in a system that is focussed on deficits, dysfunction, risk, disability, problems, pathology, disorder which also takes an individual focus on treatment and �dealing with� the individual Unfortunately the system is often risk, not strengths focussed It can be difficult to see the strengths of children who have so many emotional, cognitive, social and behavioural challenges

23. Barriers to youth Strengths.

24. Potential Barriers to the youth and the youth�s story.

25. Getting to know the youth and the youth�s story.

26. Many Programs and Helpers emphasize importance of a Strengths Focus. BUT� Youth are often described with, by or in context of the FASD diagnosis � and/or with combination of multiple diagnoses. Sometimes all issues of challenge or struggle are viewed or interpreted solely through the FASD lens. Youth are described as and/or represented by what their limitations are (can�t, won�t, will never) Files are often set up as leading with negatives, problems, deficits, pathology, dysfunction, disabilities, etc. over strengths. Strengths section of file is considerably smaller, if existent at all.

27. Many Programs and Helpers emphasize importance of Strengths Focus. BUT� Mandatory and compulsory file/assessment �strengths� sections often sparsely represented. When focus on strengths � often two or three key strengths identified. Sometimes general list of strengths presented and drawn on for youth. Some �strengths-focussed� programs place youth in environments which may seriously undermine strengths development or interfere with demonstration of strengths capacities. Many youth are not invited or present at their own planning/case meetings. Many youth do not have goals (that are important to them, or that they se value in) in the case plan.

28. What can we do? Make Relationship Focus a Priority Utilize a Relational and Strengths Based Approach (see supplemental HO) Understand the importance of safety (consistent, predictable, anticipated) and significance in relationships Know your youth � predicting and preventing crisis situations. Understand that relationships are critical for shaping and developing the capacities of individuals with FASD

29. What can we do? Make Strengths Focus a Priority Understand potential for �negative� focus of rigid FASD lens Be cautious � Realistic (ongoing) and accurate assessment of limitations Consider the reality we may be perpetuating � At Risk vs. At Potential Suspend assumptions about what you think youth is capable of Provide opportunities for youth to teach you about areas of strength and potential Involve the youth as much as and to the extent possible in planning Ensure that the youth has goals (in the plan) that are important to them Endorse a consistent search for strengths � then build on and mobilize

30. In the most concrete and practical terms� Ask these questions: How come the youth is not at this meeting? What goals are important to the youth? What goals does the youth see the value in? What do you like about this youth? What is this youth good at? What does this youth do well? What does this youth like? What is it about that? Who does this youth like? What is it about them? Where are the strengths�in this file, assessment, report?

31. Strengths and Loose Change�

32. Questions or Comments�

33. THANK YOU!