Becoming Centered

This podcast builds off of the concept that, overall, our brains understand the totality of our life experiences as a story.  It's crucial for our mental health, and overall sense of becoming centered, to see ourselves as the hero of our own life-story.  This is the situation for children and youth in residential treatment.  Upon entering residential treatment, kids often feel at a low point, viewing their challenges as insurmountable. They need to become part of a classic story-line in which our young central character faces personal tragedy, separates from parents, finds mentors and friends, and undergoes growth to become the hero.  The key quality for the hero needs is courage. Actions in the face of dangerous situations can show bravery, with or without the significant presence of fear.  Courage, on the other hand, always involves facing fear.  There cannot be courage without fear.  A way to gain power over one's personal fears is to be able to talk about fear in a more generalized fashion.  This episode introduces the concept of the "Eight Fears of All Human Beings," placing them within the Meta-Compass Model used in other episodes of this podcast. These fears include the fear of the cold, being alone, the woods, the dark, animals, water, rot, and being judged. The discussion delves into each fear, its metaphorical meaning, and how addressing these fears both requires courage and nurtures courage. These fears can also be understood in the context of the developmental stages of life, cognitive processes, and behavioral responses. The goal is to empower clients in residential treatment to recognize their fears, recognize that they can face those fears with courage, and thus become more resilient.  By framing these fears as universal conditions, the counselor aims to create a non-judgmental space for kids to discuss their experiences and demonstrate courage in the face of adversity.

Welcome to the first episode of Becoming Centered.  This episode begins the Residential Counselor Orientation series, designed for the new Residential Counselor.  It introduces a way to understand your role, your relationship with clients and other counselors, and introduces some basic tools for becoming a skilled Residential Counselor.  Episode 1 focuses on a specific understanding of the role of a Residential Counselor.  For related resources check out the Bear Clan, llc website at www.BearClanllc.com.     There's different types of residential treatment programs for serving school-age children.  The length of treatment and the setting can greatly vary.   The extent to which residential treatment is a therapeutic and transformational experience will greatly depend on the quality of the relationships formed between residential staff and the clients. Staying in a professional role can be challenging for a variety of reasons.  However, that's the ideal for which to strive. "Counseling" can be thought of as helping people improve their ability to become centered. It's helpful to understand the brain and personal psychology in terms of four domains of functioning: Emotions Cognitions Behaviors Executive Skills Possible areas on which to focus during your orientation period include: ·       Assist clients with becoming emotionally centered by presenting yourself in a calm and organized fashion.  It's okay if that feels like you're just acting; give yourself time to grow into this complex role. ·       Assist clients with becoming cognitively centered by learning the daily schedule and helping clients be organized and prepared for the tasks associated with the different parts of the schedule. ·         Assist clients with becoming behaviorally centered by attending to their basic physical needs for hydration, food, rest, sleep, exercise, etc.  Also take care to attend to your own basic needs so that you're able to function at a high level despite the difficult hours of your work day.  Help clients learn to co-regulate their nervous system with yours by playing with them and having fun with them. ·         Assist clients with their developing executive skills by supporting their self-regulation of their own emotions, cognitions, and behaviors.  Asking clients what comes next in the schedule and what preparation is needed, is a simple way to get them to think ahead and practice their executive skills.

Professional boundaries includes: 1.         the schedule of when you'll have contact with the kids, 2.         limits on physical touch, 3.         limits on personal disclosure, and 4.         the general tone of the professional relationship.   1.  Your contact with clients is during scheduled hours.         Be polite but minimize any accidental contact with clients outside of work.          Don't talk about your clients in public. 2.  Limits on physical touch.          Providing Physical Assistance:  If your clients require physical assistance with hygiene, always be business-like and clinical.          Affectionate Touch:  Kids thrive on affectionate touch but because of the treatment issues common in residential programs your organization likely has guidelines to avoid types of affectionate touch that are too intimate.          Sexualized Touch:  Sexualized behaviors toward clients is clearly a boundary violation.  You may have to set limits on sexualized clients trying to relate to you in a sexualized or harassing fashion.          Directive Touch:  If your clients require physical assistance with hygiene, always be business-like and clinical.  Only use directive touch in a manner consistent with your organization's trainings, policies, procedures, and practices. 3.  Limits on personal disclosure.          Your relationships with the kids are based on the time you spend together, not on your personal history, your life outside of work, or the type of information you might exchange with peers in order to develop a relationship.          Kids will test to see if you have professional personal disclosure boundaries, so have in mind some respectful ways to not answer questions about your life outside of work.          Don't disclose personal issues that overlap with issues that the kids bring into treatment, such as drug use, unless your program directly trains and supports you in how to use that sort of disclosure in a therapeutic way. 4.  The general tone of the professional relationship.          Dress like a professional.  Speak like a professional.  Carry yourself in a confident fashion.          Don't promise to keep any secrets.  You're part of a treatment team and may be professionally obligated to share any information you learn from a client.          Allow yourself to develop genuine caring feelings for the kids, but maintain a level of clinical distance to create an important professional emotional boundary.

Therapeutic relationships help your clients become centered in four domains of psychological functioning.  This can be visualized using The Domain Compass: ·       In the East, there's the domain of emotions, consisting of feeling and moods. ·       In the South, there's the domain of cognitions, consisting of thoughts and beliefs. ·       In the West, there's the domain of behaviors, consisting of both all external actions and the internal actions of the physical body. ·       In the North, there's the domain of executive skills and self-regulation.  1.  Three relationship qualities to strive for within the domain of emotions. ·         Focus on increasing clients' awareness of their own emotions. o   The Check-In technique helps clients express their feelings and moods in words or in various kinds of rating scales. ·         Help sooth emotions that become too powerful or chaotic. o   The Low and Slow approach helps to cool down an overheating nervous system. o   The Organized Activities approach helps to structure a chaotic nervous system. ·         Build up clients' fragile and/or low self-esteem. o   Praise works through high frequency repetition to help kids see their own strengths and worth. o   Attention helps kids feel their own worth.  Often times, older kids in residential treatment still need the intense level of attention that people appear to intuitively give to pre-schoolers. 2.  Two relationship qualities that help kids within the domain of cognitions. ·         Increase external structures to reduce cognitive chaos. ·         Break sequences down into smaller chunks. 3.  Three relationship qualities that help kids become behaviorally and physiologically centered. ·         Attend to kids' basic physiological needs (water, food, sleep, exercise, rest). ·         Become an active and skilled listener. ·         Co-regulate with kids through joining them in play. 4.  One key relationship quality that helps kids in the domain of executive skills. ·         Help each kid make and keep friends. 

High level team work is an absolutely essential aspect of being an effective Residential Counselor.  There's a classic way to think about the formation of effective teams.  It breaks team development into 5 over-lapping phases:  Forming, Storming, Norming, Performing, Adjourning. (1)  Forming refers to all the dynamics that happen between team-mates when you're relatively new to working with one another.  ·         The key to moving through the forming phase is constant communication among team members.  Let your partners know where you are, what you're doing, and which kids, or zone, you're covering. (2)  In the Storming Phase, little conflicts among your team-mates have appeared.  ·         The key to moving through the storming phase is feedback.  Make giving you feedback as easy as possible.  Make it clear to your teammates that you want to know how to excel at being an effective teammate.  At least at first, focus on getting feedback on how you're doing as a member of team, rather than your work directly with the kids.     (3)  In the Norming Phase routine tasks, including transitioning through all the different parts of the daily schedule, are generally going smoothly.  ·         The key to supporting this normative level of teamwork is appreciation.  Don't take for granted when parts of the shift go well.  That only happened because of you and your team-mates.  Be generous in expressing your appreciation for your fellow staff do. T  (4)  The Performing Phase of team development.  Now, it's not just the routine parts of the shift that are going well, but the team skillful adapts and overcomes various challenges.  ·         Find ways to recognize and celebrate when your team performs at a high level. 5  (5)  The Adjourning Phase in residential treatment is most relevant in the context of how each shift is ended.  That's when you're most likely able to speak with one another.  That's when you can ask for feedback, express appreciation, and celebrate the team's successes.  However, there's also a really important team function that should be prioritized – and that's debriefing; specifically what's known as "Critical Incident Stress Debriefing". ·         Residential treatment work frequently exposes staff to extreme situations that can have trauma-like effects.  Checking-in with fellow staff at the end of the shift and sometimes telling the story of what happened, in a calm fashion, can blunt the neurological effects on your brain of intense experiences with clients. Residential work is highly stressful and the skilled Residential Counselors attend to their own self-care.  You can't effectively take care of others if you're not also taking care of yourself.

This episode reviews The Domain Compass, which is a way to visualize four domains of psychological functioning. In the East, there's the domain of emotions, consisting of feelings and moods.  In the South, there's the domain of cognitions, consisting of thoughts and beliefs. In the West, there's the domain of behaviors.  That's includes both external behaviors and all the internal workings of your physical body and nervous system. In the North, there's the domain of executive skills.  That's where self-control is found. Another helpful way to visualize personal psychology is captured by The Aspect Compass. The Artist expresses emotions to communicate to others and experiences the world, largely in terms of emotions. The Scout is in charge of exploring the world, trying to make sense of it, and reporting its findings to the rest of your brain.  The Warrior includes the parts of your brain that control your muscles and entire physical body. The Chief gets feedback from the other aspects of your personal psychology and provides regulation through executive skills. Labeling is a key technique for giving each kid's inner Chief the feedback it needs to do its job of self-regulation of emotions, cognitions, and behaviors.  It begins with increasing each kid's awareness of their own behaviors. Labeling is simply stating, with no attached judgment or direction, what a kid is doing, that specific moment.  Attentive adults instinctively do this with very young kids; however, even older youth in residential treatment tend to have developmentally delayed executive skills. Labeling develops kid's inner Chief through repetition.  Eventually, the clients will replace your voice with an internal voice (their inner Chief's) that helps them monitor their own behaviors.  As that ability strengthens, their inner Chief will also become more skilled at monitoring, at maintaining awareness of, their own emotions and thoughts as well. 

This episode uses The Aspect Compass to frame the role of a Residential Counselor as serving as The Chief function with the clients to set limits, to help regulate, the kids' emotions, cognitions, and behaviors. When residential staff don't set enough limits, you'll see a phenomenon called contagion.  This comes from firefighting and describes how a fire will spread from one tree to another.  It's also used to describe how a disease will spread from one organism to another. The Artist responds to emotional appeals, highly dependent on your relationship with each kid.  This can work quickly to regulate kids, but has the downside of "do it for me" and so doesn't necessarily lead to inner growth in self-control.  The Scout responds to questions.  This can lead to more thoughtful behaviors but is dependent on the kid being cognitively organized enough to think before acting (or speaking).    The Warrior responds to commands.  This can work quickly, and may be crucial in a behavior crisis.  However, cooperation is preferable to compliance.  The goal is always for the clients to become more independent and to learn more self-control, rather than just obeying.  Check-In's help each kid's inner Artist learn how to use words, or a rating scale, to express emotions, rather than acting out.  Likewise, being a skilled listener, asking for clarification, getting kids to use different ways to express themselves, develops their inner Artist's abilities to communicate. The Low & Slow approach and Organized Activity help each kid's inner Scout become organized enough to think before acting.  Every time they "practice" becoming more cognitively organized, it becomes easier to do (on a neurological level).  Implementing program structures in a consistent and predictable fashion allows kids to make the connection between their own choices, their own  behaviors, and positive and negative consequences that are enforced by staff.  This trains their inner Scout in understanding a key way in which the world works, rather than believing that things just happen to them. Playing with the kids allows them to co-regulate their neurology with your own.  This helps emotionally soothe them and cognitively organizes them.  When you do have to blatantly be directive, two excellent related strategies are the Forced-Choice and Weighted-Choice techniques. The Forced-Choice Technique is when a counselor presents the client with two choices, and won't engage in any unrelated discussion. The Weighted-Choice Technique is when the counselor presents one of the choices as being more attractive.  Nevertheless, the client still gets to choose and may decide on the larger consequence.  That's unfortunate, so don't make the weighted choice too disproportionate to the situation, but either way you're still developing the client's executive skills, forcing them to exercise their inner Chief.

Physical Restraints are a complex and controversial subject that might be triggering for some people.  There are scholarly articles on this subject and many national organizations have expressed opinions on the use of physical restraint.  My perspective is primarily driven by my professional experiences participating in physical restraints, mechanical restraints, chemical restraints, and seclusion; and reviewing and reporting on thousands of these sorts of incidents. Ethical concerns around the use of  physical restraints, per Scheurmann in the Journal of Disability Policy Studies 27(2), include: 1.  Potential for death or injury. 2.  Failure to use the least intrusive intervention. 3.  Inappropriate restrictions on liberty and removal of access to education. 4.  Repeated use of a potentially dangerous and ineffective intervention. 5.  Disproportionate use with certain critical groups. 6.  Insufficient professional training, supervision, and monitoring. I would add that some kids who get restrained probably would not become that aggressive if they weren't living in programs where extreme behaviors are commonplace. Physical intimidation and force are contrary to treatment. However, if residential treatment programs simply don't accept, or simply discharge, clients with aggressive behaviors the alternatives for these kids are even more problematic.  Children and youth end up back at home where their parents, siblings, and the community are terrorized by their violent behaviors and their own safety is at greater risk. The police and public schools end up having to address these behaviors, and they are less specifically trained than residential staff in how to help these kids. Psychiatric hospitalizations are used, but the result is, all too often, the use of medications that have unwanted side effects such as flattening emotions and physical discomforts.  Medication has to be continually monitored and changed as kids grow.  Often times, these kids will cycle in and out of short-term psychiatric hospitalizations with no sense of the child having actually changed and learned new levels of self-control. Juvenile incarceration will be the path that some of these kids face.  These setting seem to struggle even more than residential treatment programs with becoming abusive toward the kids.  It's even harder to provide these kids with effective treatment that will change the trajectory of their lives for the positive. In my opinion, the ethical concerns around the use of physical restraints are best addressed in a treatment program setting.   

Physical Restraints are, in my opinion, the best option for safely dealing with violent behaviors among children and youth in residential treatment. Self-injurious behaviors need to be stopped before they lead to permanent, or at least significant, damage.  Assaultive behaviors need to be stopped before they lead to harm. Runaway behavior is a more nuanced judgement call.  Sometimes staff can continue to monitor a runaway child or youth.  However, allowing a troubled kid to be on their own in a wilderness, urban, or other environment can place them in serious danger. Property damage can sometimes be monitored without physically intervening.  However, in my experience, when kids are allowed to rage they tend to escalate to the point where they are creating a real safety risk to themselves and others.  There are also practical limits to how much damage a facility can financially endure.  There are alternatives to physical restraint, including mechanical restraint, chemical restraint, and seclusion.  However, each typically are preceded by a physical restraint. In addition, mechanical restraints tend to be very frightening for the child or youth, require a separate type of training for the staff, require constant monitoring, and the transition into the mechanical restraint frequently requires more directed force than a physical restraint.  They also lack any tactile feedback for staff to help determine when the level of restrictiveness on the restraint can be lessened.  Chemical restraints require specifically trained personnel, and most residential treatment programs are not licensed to use them.  Seclusion tends to result in either the client raging in the seclusion room to the point where a physical restraint may have to be re-established to prevent self-harm, or the client calming down which implies that they don't really need seclusion.  In my experience seclusion can be an effective tool to ending a violent situation; however, in most cases I have not seen it provide enough advantages to outweigh the added risks and the dehumanizing treatment of the client.  Some physical restraint systems train staff in the use of pain compliance holds.  These can greatly shorten a physical restraint and may be a legitimate tool for programs that can't bring enough staff into a restraint situation (such as wilderness therapy programs that are in isolated setting rather than operating as part of a multi-unit campus).  However, inflicting pain on children is morally repugnant and it may be that programs that can't, when needed, devote four or five staff to a physical restraint simply can't serve some clients.  Performing physical restraints subjects staff to "small t" trauma.  There are things staff can do to minimize the effects of that trauma on their nervous system, which will make the staff person more resilient to this stress. 

Physical Restraints tend to be in response to intense, often times violent, situations and will have some degree of traumatizing effect on both the staff and the client. The neurochemical changes in the brain that are caused by traumatic incidents don't automatically reset.  Instead, memories of the incident are stored in your brain with the emotional content that the incident evoked.  Parts of your body, your muscles and nervous system, also store the stress caused by the incident, long after the incident has ended. It can be very tempting to turn to coercion, essentially intimidation and force, to try and change the extreme behaviors that many children in residential treatment exhibit.  That's because we instinctively understand that human beings will change their behaviors most quickly in order to avoid pain and unwanted consequences. However, behavioral change motivated by a coercive environment tends to not be internalized or generalized by clients.  That means that upon leaving a residential treatment program, the old behaviors reappear. Instead of using coercion, even though it "works" more quickly, an effective treatment program encourages the growth of executive skills in children and youth and fosters cooperation from clients rather obedience. As a staff person your attitude toward the clients impacts their functioning.  The Pygmalion Effect (aka the Rosenthal Effect) refers to the observation that people will change their demonstrated abilities based on the expectations of other people.  Kids will perform down to any low expectations you have for them.  Likewise, the Stanford Prisoner Experiment demonstrated that if you think of yourself as a tough authority figure, such as a guard, and you think about your clients as something akin to prisoners, then sadistic tendencies will be more likely to emerge in you. It helps to keep in mind that people are not their behaviors.  The children and youth in your care are complex human beings with emotions, cognitions, behaviors, executive skills, relationships with others and tasks for which they've taken responsibility.  All behavior happens for a reason.  You may not know what that reason is, but give the kids in your care credit for even their most unpleasant behaviors being an attempt to get their needs met. Anticipation and training are two qualities that will protect you from some of the traumatizing effects of restraint situations.  Try to anticipate the various emotional reactions you might have to a restraint – including you might go frosty and not feel a lot during the actual process.  Alternatively, you might feel elated at a restraint that goes well, or you might feel devastated by a restraint that doesn't go well.  Try to balance your feelings afterwards. Your program should have a formal training program in the actual physical techniques used in physical restraint.  However, you may benefit from extra coaching and practice.  You might have to seek that out. Once a restraint has been fully established, pay attention to your body and breathing.  Relax any muscle groups that aren't necessary to maintain the hold.  Pay particularly attention to your grip, which may be much harder than is needed.  Pay attention to your breathing.  Perhaps do some simple breathing exercises such as focusing on exhaling first and then relaxing and letting the inhalations happen automatically.  Check-in with the other members of your team.  Someone simply asking if everyone is okay, needs to shift, needs to sub out, produces neurochemicals that counter the stress hormones that are flooding everyone's bodies.  Talking to the client, while the restraint is going on, can be very agitating for some clients, especially kids who struggle with processing words.  In other cases, simple soothing statements appear to be helpful.  In some cases, staff conversing among themselves has seemed to help a kid calm down.  There's no universal formula for this. Don't forget about the other kids.  If other children in the program have been impacted by the restraint situtation, checking-in with them, and reassuring them around safety helps minimize the trauma effects they might be experiencing just from what they've seen or heard.

This podcast episode is part four of a series addressing the use of physical restraints and interventions in response to extreme client behaviors, particularly in residential treatment settings. The previous episodes discussed the uncomfortable nature of these interventions and the necessity of their use for the safety of both staff and clients. The focus of this final episode is on post-restraint procedures to protect staff from the traumatic effects of such incidents. After a physical hold, staff are advised to relax their muscles, engage in deep breathing, and attend to basic needs like drinking water. These self-care measures help counter the lingering stress chemicals in their system. Debriefing is emphasized as a crucial step, occurring ideally before the shift ends. It involves clinically recounting the incident to overwrite traumatic memories with a calm recounting. Debriefing should be facilitated by a colleague or supervisor to be most effective. Processing, which delves into emotions and thoughts before and after each behavior in the restraint sequence, can follow debriefing. This helps clients understand their actions and take responsibility for them.  It helps staff to further overwrite traumatic memories of an incident with the memory of calmly talking about their emotional reactions and thoughts. The podcast suggests various techniques for clients and staff, like relaxation, meditation, and mindfulness, to regain self-control and reduce trauma effects. These techniques are only truly effective when they are practiced in advance. Furthermore, supporting and appreciating colleagues is highlighted for staff well-being. Expressing gratitude and providing opportunities for relaxation also reduces the damaging impact of stress. The episode also touches on administrative reviews of incidents, which are stressful for staff. Anticipating emotional reactions, maintaining honesty, and adhering to strong values like respect, love, honesty, bravery, humility, wisdom, and integrity are recommended for resilience in such situations. This episode emphasizes the importance of self-care, debriefing, and processing as essential tools for staff to cope with the emotional toll of physical restraints and protect themselves from trauma.

This podcast discusses the importance of coregulation in residential treatment settings for children who are emotionally, cognitively, and behaviorally disorganized. Coregulation refers to the process where an adult's nervous system synchronizes with a child's, helping the child learn self-control and emotional regulation. Coregulation starts from infancy when a baby's nervous system is linked with the mother's. Over time, babies learn to independently regulate their bodily functions, but they still rely on coregulation for emotional stability, and for learning how to organize thoughts, and regulate behaviors. Human Beings use coregulation before they learn self-regulation. Self-regulation involves controlling the electrical and chemical activity within one's brain. It includes skills like reaction inhibition (thinking before acting) and stress tolerance (tolerating stressful situations). Residential staff play a crucial role in teaching executive skills like reaction inhibition and stress tolerance to children in their care. They achieve this by actively engaging with the children, whether through play, games, daily chores, and all the other scheduled activities. Some executive skills directly regulate behaviors, such as self-awareness and metacognition (thinking about one's own thoughts), while other executive skills organize thinking, such as planning and prioritizing. These skills are also developed through coregulation and practice. Various activities, such as playing games, watching movies, and relaxation exercises, are all opportunities for coregulation. Staff should actively participate in these activities with the children, creating shared experiences that foster emotional and neurological coregulation. Coregulation, coaching, and cheerleading by residential staff help children develop self-control, emotional stability, and cognitive executive skills. The goal is to gradually transition children from dependence on coregulation to independent self-regulation, ultimately preparing them to leave residential treatment with improved emotional and cognitive abilities.

This podcast delves into the fundamental structures of residential treatment programs and the concept of structural interventions. While theoretically residential treatment could customize programs for each individual, practicality dictates the need for a standardized framework designed to meet the overall needs of a group of kids.  The concept of program structures includes physical aspects like room configurations and the flow of rooms, as well as how clients are allowed to move throughout a program.  Other major structures are elements such as the daily schedule, analogous to a class schedule in school.  Additionally, program structures include rules, expectations, and traditions that govern clients' interactions and behaviors.    Structural interventions are adjustments made within these structures to positively influence resident behavior. These can range from changing room arrangements to introducing rules or   Personal cleanliness, really basic hygiene routines are also critical, and different levels of structure may be necessary for different children and treatment populations. The concept of "key staff" is introduced, wherein a specific staff member is assigned to work closely with individual residents, addressing their unique needs and fostering a supportive relationship. This structure facilitates oversight tasks, communication with parents, and helps nurture a sense of care and stability. The podcast concludes by emphasizing that the effectiveness of structures and structural interventions relies on their enforcement. The next episode is set to delve into the art of setting limits in a therapeutic manner.

This podcast episode explores the crucial role of structure and firm, yet respectful, limit-setting in residential care for troubled children. Structures and external boundaries are essential for creating order in a group environment, especially when dealing with children facing various challenges such as trauma, ADHD, developmental delays, and mental health issues. A core value in a treatment setting is that respect should not be something earned but freely given, as it is a gift that helps build trust and facilitates change in child-clients. The podcast stresses the need for residential staff to be firm but not harsh when setting limits. A lower-pitched tone of voice, neutral body language, and presenting clients with a choice can convey firmness without intimidation. The goal is to create an environment where children feel safe and can learn and grow. This can be difficult in part because children may try to recreate familiar, disrespectful environments, making it essential for staff to remain emotionally, cognitively, and behaviorally centered. Many children have grown up with too much inconsistency and unpredictability.  In order for clients to truly feel safe, and to learn how to take responsibility for their own actions and choices, it's essential that staff set consistent and predictable limits.  Various techniques, such as planned persistence and labeling, can be effective for setting limits, and can be used to reinforce directives without getting caught up in a control-battle argument.  Some limits, though, are always going to be difficult or tricky when working with a residential treatment population.  These include sexualized behaviors and swearing.  However, consistency and predictability, along with strategic use of warnings and proportional consequences can be used to effectively shape these sorts of behaviors. In conclusion, the podcast underscores that maintaining firm yet respectful boundaries and structures is essential in residential care for troubled children. By doing so, staff can create a safe environment that fosters learning and self-regulation, ultimately helping children overcome their challenges and develop internal controls over their behavior and language.

This podcast episode discusses the use of timeouts as a common and effective technique in residential treatment programs working with children and adolescents. Timeouts are employed to manage disruptive behaviors and prevent the spread of problematic behaviors and emotions within a group, similar to containing a fire's spread. The episode emphasizes the importance of setting limits in a firm but non-harsh manner to encourage cooperation and internalization. While timeouts can be used as a purely behavioral intervention, their effectiveness can be enhanced by targeting cognitive development. Warnings and timeouts can be combined, encouraging self-awareness and self-control while providing specific advice for calming down. Time Outs can also be effectively used without warning.  These Automatic Time Outs are based on written rules that are regularly reviewed with the group. Processing timeouts with children is discussed, focusing on helping them take responsibility for their actions, consider the impact on others, and engage in relationship repair or restitution when necessary. The episode also highlights the benefits of group explanations, where clients review their timeouts with the group, fostering accountability and constructive feedback. The concept of "chaining" or "linking" is introduced as a technique to help children map out the sequence of events leading to a timeout, identify thoughts and feelings associated with each step, and recognize choice points where alternative actions could have been taken. Different approaches to determining timeout duration are explored, emphasizing the goal of reintegrating the child when they are calm and the group is ready. Techniques for aiding children in calming down, including organizing tasks and physiological centering exercises, are mentioned. Lastly, the concept of "resets" is introduced, which are self-timeouts that allow children to regain control and rejoin the group, promoting self-control and self-determination. Overall, timeouts are seen as a versatile tool that can serve both as a behavioral management technique and as a means of teaching children to become centered and self-regulated.

This episode explores various techniques for helping children process their feelings and develop emotional regulation skills. The episode begins with a recap of previous discussions on physiological coregulation and processing aimed at helping kids become cognitively centered. The focus then shifts to processing feelings, which can be more difficult, because emotions are challenging for children to articulate. Check-in's are a basic tool for helping kids express their emotions. These check-in's involve asking children about their current emotional state. It often times is a good practice to focus on basic needs like hunger, thirst, and fatigue as potential sources of emotional distress.  Helping children monitor these needs is also developing their executive skill of self-monitoring.   The episode also introduces two valuable tools: the Emotional Intensity Thermometer and the Feelings Map. The Emotional Intensity Thermometer is used to assess and rate the strength of different emotions, allowing children to better understand and express their feelings. The Feelings Map helps children identify and separate complex, simultaneous emotions, providing a visual aid for discussing their feelings. Empathic Listening is presented as a powerful technique for counselors to connect with children on an emotional level. The importance of mirroring body language and tone, asking clarifying questions, and avoiding problem-solving during empathic listening sessions is emphasized. Some cautions include anticipating the potential for disclosures of abuse or trauma during empathic listening and the importance of communicating such disclosures to the child's therapist.  There is also a risk that Empathic Listening will lead a child to assume that you agree with all of their framing, including negative views of other people.  Ways to address that possibility are addressed. The episode concludes with guidance on transitioning from Empathic Listening back to structured activities and routines, highlighting the role of the counselor in providing emotional support and fostering a sense of belonging in children. Throughout the episode, there's a focus on the development of executive skills, self-monitoring, and stress tolerance as crucial components of helping children process their feelings and achieve emotional centeredness.

This podcast presents a powerful perspective for helping your child-clients become centered.  It's based on understanding your kids' needs through The Aspect Compass, a model representing four aspects of the psyche: The Artist (emotions), The Scout (cognitions), The Warrior (behaviors), and The Chief (executive skills). Each aspect has unique needs that, when addressed, can help children become centered and balanced: For the inner Artist:         Getting sufficient attention.         Experiencing a full range of feelings.         Achieving emotional stability.         Expressing feelings.         Facing fears.         Grieving. Attention and validation are essential for children's emotional well-being. Offering appropriate outlets for expressing emotions through words or art is encouraged. Support in facing fears and containing grief, while directing processing of grief to a therapist, are all important ways residentials staff support The Artist feeling centered.  For the inner Scout:          Developing awareness.          Observing skills.          Acquiring knowledge.          Navigating effectively.          Reporting skills. Engaging in activities that focus on sensory perception and cognitive exploration helps children become cognitively centered.  Physically exploring and navigating an environment will help kids experience behaving like a scout.  Encouraging accurate reporting will develop their abilities to be an effective scout, and will help their inner Scout feel centered.  For the inner Warrior:          Having a mission and plan.          Feeling a sense of agency, achievement, and accomplishment.          Sense that one's behaviors are meaningful.          Meeting basic physical and psychological safety needs.          Maintaining physical health.          Relaxation. Helping children establish goals, fostering a sense of agency, and recognizing their achievements are essential for their behavioral well-being. Ensuring physical safety, health, and relaxation are also key components of centering the inner Warrior.  Structured time for relaxing is an important part of helping the inner Warrior feel centered. For the inner Chief:          Enhancing self-awareness.          Maintaining integrity.          Cultivating wisdom.          Fostering a state of appreciation.          Building a sense of tribe/community.          Encouraging service to others. The Chief plays a crucial role in coordinating the other aspects and needs self-awareness, integrity, and wisdom. Developing a sense of appreciation, belonging to a community, and engaging in service to others are vital for the Chief to feel centered. This podcast emphasizes that understanding and addressing these needs can help residential staff design therapeutic programs and create environments that promote positive learning and growth for child clients, ultimately helping them become emotionally, cognitively, behaviorally, and physiologically centered while fostering a sense of community and belonging.

This podcast episode discusses the challenging issue of dealing with suicidal ideation among child-clients in residential treatment. The podcast offers insights into different scenarios where staff may encounter suicidal ideation in child-clients and explains the unique challenges residential staff face, such as having to be the front-line mental health professionals, despite formal training. The episode introduces the Columbia Protocol, a set of questions used to assess suicidal ideation, and discusses the importance of empathetic listening and creating a safe space for clients to express their thoughts and emotions. The speaker emphasizes that the goal is not to uncover why clients have suicidal thoughts but to understand when, how often, in what situations, and what triggers these thoughts. Additionally, the podcast highlights the importance of assessing risk and rescue factors associated with suicidal plans and gestures. The episode also touches on the role of different aspects of a client's psyche, such as the Artist, Scout, Warrior, and Chief, in processing suicidal ideation and emphasizes the importance of strengthening the client's stress tolerance and sense of belonging. In conclusion, the podcast offers valuable insights and guidance for residential staff on how to approach and respond to suicidal ideation among child-clients, emphasizing empathy, assessment, and creating a supportive environment. It also encourages seeking professional help when needed through resources like the National Suicide and Crisis Lifeline (988).

This podcast episode is the second part of a series that addresses how to intervene when dealing with suicidal ideation in children and youth. It emphasizes the importance of training for counselors and aims to make discussing this sensitive subject more approachable. An important focus is for counselors is to help clients understand suicidal ideation as a symptom rather than delving into the "why" behind it, which is a task for therapists. The episode emphasizes the need to distance clients from these thoughts and work on developing their executive skills, especially stress tolerance. The counselor's role involves empathetic listening, establishing a sense of belonging, and helping the client tolerate their negative feelings and thoughts without using harmful behaviors.  If suicidal ideation includes gestures, attempts, or plans, the counselor should assess the situation in terms of risk and rescue factors and consult with an on-call clinician. After a check-in around suicidal ideation, there are important communications and documentation to the rest of the team.  There may also be structural interventions put in place such as Scheduled Check-Ins, Increased Structure, Staff Shadowing, Re-entry Plans, and various restrictions that can be documented on a Safety Watch form.  That documentation helps everyone on the immediate team, and involved in follow up the next day, to work as a team to help keep the client feeling and acting safe. Another powerful intervention is the creation of a Safety Contract, which serves as a formal agreement between the at-risk client and staff to ensure safety and offers personalized support. The episode also underscores the partnership between therapy and counseling, with therapy addressing the "why" and counseling addressing the "how" of maladaptive behaviors. Lastly, the podcast reminds listeners of the National Suicide and Crisis Lifeline (988) as a resource for those needing guidance and emotional support outside of their work lives.

This podcast episode discusses the importance of management and delegation within residential treatment programs for children and youth. It highlights the different levels of management within such organizations, including Executive Management responsible for overall leadership, Senior Management overseeing major aspects of the agency's operations, Middle Managers handling specific service units, and Frontline Managers leading shifts. It emphasizes that effective management is essential to provide quality care to the clients. The episode explores various roles within residential programs, such as coordinators responsible for specific tasks like organizing activities or managing facility supplies. It also delves into the role of Key Staff, who work directly with clients, helping with activities of daily living, treatment programming, and more. Delegation is a central theme in the podcast, and it stresses the importance of role clarity, administrative infrastructure, and a strong process for successful delegation and for program development. A five-step model for a delegation process is explained, involving (1) task explanation, including clarification of deliverables, (2) checking the person's understanding of the delegated task or project, (3) reviewing what resources the person can use to achieve the task or project, (4) collaboratively establish a deadline and understanding around asking for an extension if needed, and (5) feedback afterwards on how the project or task delegation went.  The episode underscores the need for management to empower staff by clearly defining roles and responsibilities and creating a shared vision for the organization. It also touches on different sources of influences beyond the Authority-Influence that comes from having any particular position within the organization.  Additional sources of influence, and power to achieve one's responsibilities, include Relationship-Influence, Power Broker-Influence, Charismatic-Influence, Expert-Influence, and Fame-Influence.  Ultimately, this podcast provides insights into the challenges and best practices of managing residential treatment programs, with an emphasis on effective delegation as a key tool for success. It encourages a collaborative and organized approach to improve the quality of care and empower staff at all levels of management.