Creating a “Healing Home” for foster youth with mental ......Children thrive in safe, caring,...

Creating a “Healing Home” for foster youth with mental

health challenges

David Reed, MSW, LCSW, CSAYC

Children thrive in safe, caring, supportive families and communities

TRAINING OBJECTIVES

• Improve foster parent knowledge of behaviors associated with childhood mental health, and ensure that foster parents are equipped to effectively care for children with mental health concerns.

• Improve the care that youth with mental health concerns receive.


OBJECTIVES CONTINUED

3

• Ensure that caregivers understand the importance of environment, self-awareness, role-modeling, and compliance/participation with service plans.

• Improve placement stability—reduce overall number of foster placements. Why?


SOME FACTS

• On any given day 500,000 youth are in some form of foster care across the country.

• 50-60% of these children have “moderate to severe” mental health problems.* (some research suggest that it’s closer to 80%). This is compared to 18-22% of the general population.

*Health Services for Children in Foster Care. Institute for Research on Woman and Families. December 1998 (2nd printing.)


FACTS Continued

• Former foster youth are found to suffer from post-traumatic stress disorder (PTSD) at 2 times the level of U.S. war veterans. +

• Although 63% of the children who enter foster care remain in the system for less than two years, on average, they experience three placements. (Vulin-Reynolds, et al., 2008)

+ Improving Family Foster Care: Findings from the Northwest Foster Care Alumni Study. Casey Family Programs, 2005.


Still more facts…

• “Externalizing disorders—such as disruptive behaviors, delinquency, hyperactivity and aggression—are more common in foster children than internalizing disorders—such as anxiety, fear, low self-esteem, sadness and depression.” * Why is this important to note?

*Evidenced-based practices in mental health services for foster youth. California Institute for Mental Health. 2002


So…

• According to evidenced-based research, what works for these “externalizing disorders”? What actually helps these kids get better and heal?

???


Medicine ???


A good therapist


A whole lot of love?


Well, no, not exactly…

• The research doesn’t really support any of those interventions, and certainly not in isolation.

• So, what does work?????


YOU!

• your safe and loving home, consistent care, and time!


And that’s why we’re here today!

• We want to help make sure your homes are healthy and safe and are well-equipped to deal with the long-term challenges of parenting foster youth.

• If these kids are to heal, there isn’t any other way, and it isn’t going to be easy.

• Helping these kids to heal is a marathon, not a sprint, and there aren’t any shortcuts. If you’re smart though, you’ll “run the tangents”…huh?


Running the tangents…

• Parenting these kids is hard. Period. And it’s going to continue to be hard. But, if you are INTENTIONAL about doing things the right way (well thought-out and consistent rules, consequences, and rewards; patience; and a concerted effort to understand what your child is going through emotionally), you will see improvements much more quickly. Engage in “Discipline Don’ts”, and you’re making the “course” longer.


So…

• We’ve established that LOTS of these kids present with externalizing disorders that are really “treatment resistant”, and take a long time to heal. How can we help make the “healing” happen as quickly as possible? What can you do? Any ideas?


Continued…• Research strongly indicates that

externalizing disorders are “created”, more than they are “born”, and the things that research has shown are likely to create these disorders are:

• Inconsistent/unsafe (abusive)/overly harsh/absent or lax parenting, and…

• Multiple moves (i.e., placements) and housing instability.

Sound like anyone you might know??


So…

• If those things cause (or at the very least heavily contribute to) these disorders, what do you think would help correct them?


Yep!

• The opposite of those things! Foster parents obviously don’t have the power to change what’s already been done, but they can change what they do from the moment the child comes into their home.


Foster parents need to display/have/use/support…

• Active parental interest• Parental monitoring• Close family relationships• Pro-social parental values• Parent self-control• Appropriate sanctions for poor behaviors• Respectful parents• Supportive family relationships• Intact family relationships


There’s more…

• Stable care with stable caregiver• Positive relationship with adult• Positive peer relationship• Positive sibling relationship• Modeling of pro-social behaviors• Modeling of pro-social values and attitudes• Involvement in positive activities• Concerted effort to limit media influences• Carefully follow recommendations from

treatment providers


What else?

• Our kids need to feel safe and wanted (believe me, they don’t feel this way coming into your home). How can we communicate to them that they are these things???


Let’s start with “safe”

• What are your ideas on how to make a child feel safe?

• Do your ideas change any when I say, “foster child”?

• What does the research say about this?


Structure and routine, structure and routine, structure and routine and…

• And not a “willy nilly” structure and routine. It needs to be intentional, stated, and followed.

• Oh, and time too!


What do these three things ----structure, routine, and time ---

communicate to a child?• That things are predictable,• that things are stable, and• that YOU are predictable and stable! For

many of these kids, you can’t even imagine how different that makes you from anyone else with whom they’ve ever spent significant time!


Now hear this too…

• You don’t have to be fanatical about your schedule, and it really is okay to have fun too (in fact, it’s strongly encouraged!), but be organized, plan out your day-to-day activities (including fun ones!), and pay special attention to the importance of routine, especially around activities like meals, bedtimes, homework, hygiene activities, etc.


It’s true!

• Did you know that research shows what people remember most from their childhoods are family meals and trips? Yep. What an opportunity these things are to create happy memories for our children, huh?


Now, onto “wanted”

• Hmmmm? How do we (you, actually!) convince a foster child they’re wanted by you--a complete stranger who looks suspiciously like the last six (or eight, or ten, or fifteen) other grown-ups who said they wanted this child only to send them packing?

• That…is….tough!


Any ideas?


Actually, before you answer that, let me make it clear what you’re up

against…Kids, just because they’re kids, do two things that are really gonna work against ya! They:

1. Overgeneralize, and

2. Internalize.


Say what?

• Overgeneralize. Adults can be bitten by a dog (say, a German Shepherd), and not think that another dog (even another German Shepherd), is going to bite them just because the other one did. Kids have a really hard time with this. “If one person didn’t want me, no one’s gonna.” That’s just how they think…


It gets worse…

• Internalize. Adults, who are bitten by a dog, think, “What the heck is wrong with that dog??? Darn thing just bit me!” Kids think, “I made that dog bite me.” Can you see how this will impact a child who has been abused or rejected? They’ll think, “There’s something wrong with me that makes people hurt me/not want me/forget about me. It…is…my…fault.”


Oh, but it gets worse still!

• Because they think you’re going to reject them, they’re probably not even going to try to convince you not to. In their mind, “What’s the point? It’s not gonna work anyway. If I actually try to make them like me (they won’t), it’ll just hurt even more when I leave.”


So NOW what are your ideas?

• You’ve got a kid who thinks EVERYONE is going to hurt them, and they think THEY are the reason for it. How are you going to convince them you’re different???


Yeah, what you do matters…

• But so does what you DON’T do! Refer to the list of “Discipline Don’ts” with your handouts. Know that list well, and make every effort not to do those things! If you do, you’re making your “course” longer!


In general,

• Watch out for highly emotional responses to the child’s behavior…why?? There are TWO really good reasons (one about them, and one about you)…

• Honestly know yourself (your feelings, your “buttons”, your limitations, your needs), and take care of yourself! Use respite (plan it out), have outlets, communicate honestly with your social worker.


Actions speak…

• Follow through! Do what you say you are going to do! This goes for good things (like going to the movies) and bad things (like early bedtimes)…

• Actively and intentionally involve yourself in your child’s therapy/medication management/school/treatment team meetings. Follow closely the recommendations of treatment providers.


Hear ye, hear ye!• Watch what you say! Especially about things like

birth families, problems you’ve had with the child, DCS, placement decisions, etc. Watch what you say in public about the child as well (“This is my foster child”, etc.)

• NEVER say things like, “Get it together or you’re out of here!”, “If you don’t want to be here, you don’t have to be!”, “If it weren’t for me, you be…”, etc., etc., etc. Please remember whose job it is to “do the picking” and whose job it is to “be picked”, and please be mature! Watch out for anger (remember how it effects IQ)!


If you fail to plan…

• Create (and yes, follow!) behavior plans that make sense. Enlist the help of your social worker/therapist/psychiatrist in creating these. Be specific…If you aim at nothing…

• Work on eliminating the behaviors that make you the most crazy! These are the things that jeopardize the placement!


No one said it would be easy,

and I promise you, it won’t be, but…


Don’t give up!


Conclusion

• Any questions?

THANK YOU!

Creating a “Healing Home” for foster youth with mental ......Children thrive in safe, caring,...

Documents

Transcript of Creating a “Healing Home” for foster youth with mental ......Children thrive in safe, caring,...