THERAPEUTIC ENVIRONMENTS

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
E M O T I O N A L R E A C T I O N S TO T R A
U M A

• FEAR OF PHYSICAL HARM
• EXCESSIVE WORRY ANXIETY
• FEAR OF ABANDONMENT
• ANIMAL ABUSE
• CRUELTY TO OTHERS
• DESTRUCTIVE
• DRUG/ALCOHOL ABUSE
• UNSURE OF THE FUTURE
• UNSURE OF WHAT IS TRUE
• LOW FRUSTRATION TOLERANCE

• VICTIMS BECOME ABUSERS
• SCHOOL PROBLEMS
• ACADEMIC BEHAVIORAL
• EXCESSIVELY GUILTY
• INABILITY TO ACCEPT NURTURING
• SELF HURTFUL
• POOR JUDGMENT
• IMPULSIVE
• SLEEP DISRUPTION
• DEPRESSION
• NEUROLOGICAL DISSIMLITUDE

4
(No Transcript)
5
Spheres of the Brain

• 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

6
Self Regulation Brain Stem

• HYPERAROUSAL
• Over Stimulated
• Aggressive
• Running Away
• Exaggerated Responses
• Grandiosity
• Flights of Ideas Thoughts
• Impulsive

• HYPOAROUSAL
• Irritable
• Bored
• Disinterest
• I Dont Care, Why Try
• Sleep Disruption
• Emotional Outbursts
• Hopelessness

7
DIAGNOSTICS FOSTER CARE

• 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

8
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 childs chronological age?
• What is your childs developmental age?

9
COMPONENTS OF A PROACTIVE THERAPEUTIC ENVIRONMENT

• High Nurture High Structure
• Pro-Social Relationships Accountability
• Your Enrichment Activities Routines
• Your Childs Enrichment Activities
  Parental Permission
• Bedtimes Earning Privileges
• Meals Limits
• Physical Nurturing

School Foster Family
10
Collaborating with Schools Strategies for
Foster Parents Foster Care Staff

• Proactive support in the school is preferred over
  reactive support.
• Support the schools understanding of how trauma
  affects children.
• Understand the IEP process.
• Advocate for services in school that are
  components of the IEP.
• Children with IEPs 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 childs
  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.

11
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

12
PARENTING SKILLS

• Stay Calm
• Intervene Early with Escalating Behavior
• Follow Through Act, Dont Talk
• Offer Choices
• Avoid Rigid Rules
• Understand Utilize Discipline Plans

13
Consequences

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

14
ACTIVE CONSEQUENCES PASSIVE CONSEQUENCES

• Be less tolerant
• Know the antecedents of escalating behavior
• Act, Dont Talk
• Saying sorry doesnt 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

15
PLANNED DISCIPLINED

• EXPECTION REWARD CONSEQUENCE
• EXPECTION REWARD CONSEQUENCE
• EXPECTATION REWARD CONSEQUENCE
• EXPECTATION REWARD CONSEQUENCE
• EXPECTATION REWARD CONSEQUENCE