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THERAPEUTIC ENVIRONMENTS

THERAPEUTIC ENVIRONMENTS. MANAGING BEHAVIOR IN FOSTER & KINSHIP CARE Kim Hantz & Scott Hanauer Community Youth Services 711 State Avenue NE Olympia, WA 98506 www.communityyouthservices.org. TRAUMA CHECKLIST Physical Abuse Emotional Neglect Drug/Alcohol Abuse in Family

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THERAPEUTIC ENVIRONMENTS

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  1. THERAPEUTIC ENVIRONMENTS MANAGING BEHAVIOR IN FOSTER & KINSHIP CARE Kim Hantz & Scott Hanauer Community Youth Services 711 State Avenue NE Olympia, WA 98506 www.communityyouthservices.org

  2. TRAUMA CHECKLIST • Physical Abuse • Emotional Neglect • Drug/Alcohol Abuse in Family • Untreated Mental Illness in Family • Prenatal Exposure to Drugs/Alcohol • Domestic Violence • Sexual Abuse

  3. Frontal Lobe & Neo-Cortex Problem Solving Judgment Inhibition of Behavior Planning & Anticipation Self-Monitoring Attention and Concentration Mental Flexibility Expressive Language Executive Functioning Brain Stem Arousal Response to Stress & Danger Alarm Panic Fear Body Functions Heart Rate Spheres of the Brain

  4. HYPERAROUSAL Over Stimulated Aggressive Running Away Exaggerated Responses Grandiosity Flights of Ideas & Thoughts Impulsive HYPOAROUSAL Irritable Bored Disinterest “I Don’t Care, Why Try” Sleep Disruption Emotional Outbursts Hopelessness Self Regulation – Brain Stem

  5. COMMON DIAGNOSES Post Traumatic Stress Disorder Oppositional-Defiant Disorder Attention-Deficit/Hyperactivity Disorder Conduct Disorder Depression/Dysthymic Disorder Bi-Polar Disorder Alcohol Related Neurological Disorders COMMON CRITERIA (SYMPTOMS) Exposure to Trauma Irritability Difficulty Concentrating Fails to Pay Close Attention Loses Temper Annoyed Angry Gives up Easily Anxiety Sleep Problems Poor Judgment Difficulty Learning Aggressive Destructive DIAGNOSTICS & FOSTER CARE

  6. Developmental Scale 0 ------------------------------------------------------------------------18 By the time children are 18 they should be able to make 100% of the decisions about their life on their own. What is your child’s chronological age? What is your child’s developmental age?

  7. COMPONENTS OF A PROACTIVE THERAPEUTIC ENVIRONMENT High NurtureHigh Structure Pro-Social Relationships Accountability Your Enrichment Activities Routines Your Child’s Enrichment Activities Parental Permission Bedtimes Earning Privileges Meals Limits Physical Nurturing School & Foster Family

  8. Collaborating with Schools: Strategies for Foster Parents & Foster Care Staff • Proactive support in the school is preferred over reactive support. • Support the school’s understanding of how trauma affects children. • Understand the IEP process. • Advocate for services in school that are components of the IEP. • Children with IEP’s should not be unofficially suspended & make that clear to the school administration. • Understand “manifestation of disability”. • Be patient & sensitive and remember that schools have an unfunded mandate to meet every child’s needs with very few resources. • Be in the school especially when the child is doing well as opposed to only being at school to deal with problems. • Communicate regularly with the school. • Utilize school notes, email, phone calls to track daily/weekly progress. • Intervene early when problems become apparent. • Avoid being the “executioner”. • Foster parents/staff should not be the disciplinarians for problems at school. • Avoid remedial or punitive “homework”. “

  9. What Works In Foster Care? Structure/Predictability/Routines/Consistency Mirror Imaging Reading Cues, Empathy, Self Regulation Neuro-Imbedding Process of teaching executive functioning to foster youth High Nurture/High Structure

  10. PARENTING SKILLS Stay Calm Intervene Early with Escalating Behavior Follow Through – “Act, Don’t Talk” Offer Choices Avoid Rigid Rules Understand & Utilize Discipline Plans

  11. “Consequences” • Develops positive self esteem in everyone Consequences are a critical components for everyone • Teaches problem solving. • Teaches “cause & effect” • Teaches judgment A person’s ability to anticipate the outcome of their decisions & behavior • Teaches reciprocity • Frequency v. Intensity

  12. Be less tolerant Know the antecedents of escalating behavior Act, Don’t Talk Saying “sorry” doesn’t work “Making it Right” Jobs, timeout, money, etc. Beginning, Middle, End Dispassionate Implementation Be the “judge” giving community service Talking, moralizing, lectures Taking things away Trying to “jolt” behavior changes Anger & frustration only lets the child have control No sense of how to “make it right” ACTIVE CONSEQUENCESPASSIVE CONSEQUENCES

  13. PLANNED DISCIPLINED EXPECTION REWARD CONSEQUENCE EXPECTION REWARD CONSEQUENCE EXPECTATION REWARD CONSEQUENCE EXPECTATION REWARD CONSEQUENCE EXPECTATION REWARD CONSEQUENCE

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