Attachment

Transitions, Change and Loss

chaos and change

This time last year I’d not long arrived in Kansas and it’s been a long time since my last blog, I just want you all to know that this blog site is far from finished as there are many more reflections, topics and visits I want to share with you all.  Obviously I’m home now and have been on Australian soil for some time.  The title of this blog which was already next in line for publication is also true and reflective of why it’s been so long between posts… transitions, change and loss, but more about that later on…

Visiting Mount Saint Vincent Home I spent time reflecting on the impact of change, loss and transition.  On my first day with them, the Clinical Director Kirk Ward, advised me that they were facing all sorts of changes, transitions and loss.  It was coming up to the end of the school year and children were graduating out of the school, out of the program or going off on summer break for the day treatment clients, there had been some staff turnover resulting in a lot of retraining of new staff and to top it off the County had started to refer a slightly different demographic of child.

As a result of all of this, staff and clients were struggling.  Emotions were running higher, people more reactive and that week staff and I often reflected on the struggle they faced given old strategies were not working as successfully as they had been.  When we are faced with challenges as such it’s not surprising that we think it’s time to try something new or change things up.  We can find ourselves feeling stressed and anxious about the seemingly little impact we are making.  We know from my prior blogs and the work of Dr Perry and Dr Siegel that the more stressed we become the more reactive we become.  The more reactive we become the less we are able to really think creatively and reflectively about a situation.  This is a universal human phenomenon, not only does it happen to our troubled and traumatised clients, but it happens for every one of us.

When we are stressed and reactive, the danger in changing it up or trying something new is further increasing the uncertainty, predictability and routine and in turn further exacerbating stress levels and reactivity of all involved.  I’m not saying that we should always soldier on and hold firm to our way of operating, not in the least as it could very well be the way we are doing things is problematic or part of the issue.  What I am saying though is that we need to take space, calm ourselves so to really be able to think more reflectively and creatively about what we are doing, and how we move forward in making a difference in the lives of others.

My time with Mount Saint Vincent home highlighted again the absolute importance of staff being emotionally regulated and emotionally safe within themselves.  The ability to take time as a staffing group, reflect and seek supervision and manage ourselves is paramount in the treatment, care and healing of trauma. I was impressed with the clinical, residential and educational team at Mount Saint Vincent and their ability to support children and young people at times of emotional and behavioural escalation.  Staff would come away from these situations and interactions concerned and worried for the wellbeing of the children, the success of their interventions, in turn requiring regulation and support from each other and their management.   However when engaged and interacting with the young people in their program and the emotional and behavioural distress these kids demonstrated, the Mount Saint Vincent staff were focussed, centred, and on the whole all about co regulating these kids.  I witnessed clever use of movement, music, and sensory input to keep young people regulated and/or regulate them.

The challenges facing Mount Saint Vincent during my visit could easily have derailed them, left them focussing on new and different strategies. I’m not saying as a program emotions weren’t running high and the staffing group were certainly concerned, but I watched them rally together and co regulate each other so as to not to let the transitions, chaos and loss their program was experiencing result in organisational reactivity, but instead continue in the provision of safe, predictable and thoughtful care to their clients.

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Mount Saint Vincent Home

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Mount Saint Vincent Home

In stunning Denver Colorado, surrounded by snow capped mountain ranges, I spent the week of 2nd to 6th June 2014, at Mount Saint Vincent Home. This was my second visit to Mount Saint Vincent in as many years and approaching the gateway on my first day, for the first time in weeks, I felt a sense of familiarity and connection.

Mount Saint Vincent Home is located  just a short bus ride from downtown Denver and is situated on a 16 acre property, offering a running track, football field, multiple playgrounds and a swimming pool.  Founded by the Sisters of Charity Leavenworth Kansas in 1883, Mount Saint Vincent had it’s origins as an orphanage.  With social change and the move away from orphanage based care to out of home foster care and residential treatment, Mount Saint Vincent moved with the times and now prides itself on being a treatment center for children ages 3 – 13 years.

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Mount Saint Vincent specializes in treatment of children who have suffered abuse, neglect, trauma and/or mental illness, offering services with a child-focused but family centered approach acknowledging the importance of the family in a child’s healing and recovery.  Referrals to Mount Saint Vincent Home come largely from the County Human Services Department of Child Protection, School districts and other mental health services.

 Mount Saint Vincent offers a variety of services to clients including:

  • A 36 bed residential treatment program consisting of 3 cottages each housing 12 children
  • Individualised day treatment programs for up to 55 children
  • In home treatment and follow up services
  • K – 8 School program that affords children developmentally matched education rather than chronological determined education.
  • An early learning child care program

All of the services offered by Mount Saint Vincent operate under their treatment philosophy that focuses on the regulation of a child rather than compliance; that care is developmentally appropriate and matched and that they afford a child an environment of safety that allows children to ‘try on’ and develop positive relationships.

Mount Saint Vincent has some very innovative service elements including:

  • Creative Arts Therapy team who provide music therapy, dance/movement therapy and art therapy;
  • An animal assisted therapy program onsite using dogs and guinea pigs and offsite using horses
  • An onsite volunteer tactile therapy program offering clothed massage, yoga, meditation/mindfulness, bach flower remedies and reiki for example.
  • Individual Therapy
  • EMDR
  • Swimming
  • Bike Riding
  • Gym
  • Group Therapy Programs including Lego Group and Psychodrama
  • Sensory tool boxes for each child and program
  • The school program has a dedicated mental health clinician to support the inclusion of developmentally matched regulatory activities for the students so to assist in maintaining a state of regulation, coupled with an intervention team able to take students in the moment and provide co-regulation for children to assist them back into classroom learning activities.msv swimming pool

Like everywhere else I had visited up to this point, the staff at Mount Saint Vincent Home are dedicated, passionate and committed to making a difference in the lives of children.  I watched and listened to staff talk openly about their love of the work, the challenges it brings and most importantly the changes they feel privileged to be part of in the journey of these children.  Like all services operating with the public health system there were clearly challenges that the programs were having to manage and deal with, but that aside the Mount Saint Vincent team not unlike Sandhill, Cal Farley’s, Sumner Mental Health and Alexander Youth Network were thoughtful, authentic and so very respectful in their work with children and families.

In 2013 Mount Saint Vincent Home’s Creative Arts Therapy team published an awesome resource called, “Doodles, Dances and Ditties: A Somatosensory Handbook”.  This book is a collection of creative, sensory and movement based activities you can use to regulate children.   You can get it on their website http://www.msvhome.org or via amazon – where I see it now comes in a Kindle version.

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Alexander Youth Network

 

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In the last week of May I journeyed to beautiful Charlotte in North Carolina to spend the week with my colleagues at Alexander Youth Network (AYN).  AYN’s main campus or headquarters, and the home of it’s Psychiatric Residential Treatment Facility (PRTF) and one of their Day Treatment Programs, is located on a picturesque 60 acre property with buildings nestled in a woodland area with open grounds and recreation areas for their clients.  This campus also houses facilities including a gym, indoor swimming pool and cafeteria.

AYN is a non profit community based organisation receiving funding from fees for services (medicaid, insurance and the like) as well as contributions from individuals, corporations, foundations and government agencies.  AYN serves children ages 5 to 18, who are referred from hospitals, physicians, parents, schools and from state and county organisations such as department of social services and juvenile justice.  AYN serve over 7000 children each year.

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Surrounding woodlands

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Woodland Trail

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Deep in the woodland trail

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Alexander Youth Network Grounds

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Onsite Playgrounds

AYN provide an array of mental health treatment for serious emotional and behavioural difficulities including: diagnostic and outpatient services, community based programs, multisytemic day therapy, therapeutic foster care and an onsite, 36 bed psychiatric residential treatment facility.  The idea being that children, young people and families accessing their services can move from service to service with established working relationships of trust within the one organisation.  Added to this is the strong grounding the staff have in child development, trauma, attachment and neurodevelopment as a core component of their orientation and ongoing training.

AYN array diagrams 2012

It was a contrast to go from services that have decisively removed themselves from the medicaid system or appear to have more flexibility than is given from the public health system and as a result appear better funded and able to provide longer term intervention for their clients.  At AYN the financial resourcing struggle of service delivery was evident in comparison to the private services I had visited.  While the AYN staff were at times a bit despondent about this, I was nonetheless impressed at what they were offering and able to offer.  There is something about not having resources at your fingertips that can contribute to a creative resourcefulness and the team at AYN do this well.  In fact when it comes to neurodevelopmentally informed and respectful interventions AYN have lots to offer:

  • Individual therapy including EMDR, play therapy, sand tray and an awesome play room furnished largely by donation and financial grants
  • Art Therapy including pottery and their very own kiln
  • A ropes course for adventure therapy
  • A Labyrinth
  • Occupational Therapy with a motor and sensory furnished room including a swing and tunnels.
  • Physical Therapy
  • Reiki
  • Swimming
  • Vegetable and flower bed gardens and gardening program
  • Woodland walking trails
  • Playgrounds
  • Gym
  • Developmentally matched classrooms that afford children regular (every 10 – 15 mins) brain breaks and recreation
  • Classrooms that are highly sensory and provide calming, alerting and regulating activities including rocking chairs, bean bags, chill out areas and such
  • Bike program whereby each PRTF child has their own bike.

 

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Art Therapy room including Kiln

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Play Therapy Room

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Play Therapy equipment

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Play Therapy Room – role play and dress ups

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Play Therapy puppets

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Play Therapy sand tray and figures

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Occupational Therapy room

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Developmentally matched classrooms

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Chill out area in classroom

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Of more concern to me than their financial resourcing issues, were the systemic restrictions being placed on AYN in relation to the length of service delivery they are able to offer their clients.  The public health system funding children coming into the PRTF, those clients with the most serious of emotional and behavioural disturbances, are placing pressure on the service to treat and “repair” these children in 3 months.  The years of clinical practice, much of the theory out there, and my more recent acquisition of neurodevelopment and trauma expertise have taught me that it takes more than 3 months to form a trusting relationship with some of these kids.

 And we know that it is only in the context of such trusting relationships that these children can being to heal.

So with that knowledge I take my hat off to my colleagues at AYN and their ability to work within a public health system that places considerable restraint on their ability to really heal these kids.  The staff I met talked openly of the 30 day review process they have to undertake to retain or regain funding for ongoing work and the associated challenges. Despite this, the passion and commitment for their work and the children and families they serve sees them rise daily to these challenges and provide meaningful connections and healing opportunities for North Carolina’s more vulnerable citizens.

 

Cal Farley’s Boys Ranch: A Shirttail to Hang Onto!

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I had the absolute privilege of spending the week of 19th – 23rd of May in Amarillo Texas on Ranch at Cal Farley’s residential treatment centre.  It is hard to know where to start when describing Cal Farley’s and my experience there. One blog is not going to even remotely capture the breadth of what the service offers.  First and foremost I have to acknowledge the absolute generosity of the Cal Farley’s team from their Chief Operating Officer, Clinicians, Training team, House Parents and well basically everyone on the property. My visit was catered for most generously and my schedule was very busy – largely because there was just SO much to see and in the spirit of my Fellowship,  I didn’t want to miss a thing.

Cal Farley’s is a one of a kind service, of this I’m pretty confident.  It is one of America’s largest privately-funded child and family service providers specializing in both residential and community-based services at no cost to the families of children in their care.

Yes you read me right, NO COST!

The founder of the Ranch, Cal Farley was quite a visionary for his time and in 1961, he established the Cal Farley’s Boys Ranch Foundation. Contributions from the Ranch’s friends and supporters provide approximately 30 – 40% of the funds required to meet total annual operating expenditures. Through the foresight of Cal Farley and his Board of Directors, the remaining funds required to operate are available through the Cal Farley’s Boys Ranch Foundation.

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Cal Farley Statue

Cal Farley’s operates like a small town – in fact it’s almost big enough to be a small town.  It hosts a chapel, fire station, it’s own bank and post office services, has it’s own independent school district, complete with administration, including their own superintendent, elementary, middle, and high school.  An activity centre, gym, pool, football field, indoor horse riding arena, rodeo stadium, athletics field, stores and the communal dining hall.  Many of the staff live on site at the Ranch, which in addition to the staff homes, hosts 28 residential homes each of which caters up to 12 children and young people.  At capacity Cal Farley’s can have up to 260 children and young people at a time.  Residential homes are staffed by 2 sets of house parents, the lead house parents and relief house parents. The residential homes as you can see from the photos are all designed similarly and provide a very homely feel.

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Example of Cal Farley BR home

 

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Kitchen/Dining

 

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Living Room

 

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Bedroom

Neurodevelopmentally informed interventions/activities included (and I will probably leave some out):

  • Individual Therapy
  • Neurofeedback
  • Play Therapy
  • Art Therapy
  • AAT – largely equine based including colt and filly training and Rhythmic Riding
  • EMDR
  • Adventure Therapies – Ropes Courses, Kayaking, Trail Rides, Challenge course
  • Rocket Club
  • Computer Lab
  • Woodwork Studio
  • Robot and other electronics programs
  • Rodeo skills
  • Drumming
  • Archery
  • Gardening/Agriculture
  • Agriculture workshop – where they built a trailer for example so that they could transport their livestock to agricultural shows.
  • Mentoring of younger children by older children
  • Capacity for vocational training and part time employment

All of this is embedded in a community where relationships serve as the key to success.  As I wandered around Cal Farley’s I had to remind myself that this was a service for children and young people who had mental health, emotional and behavioural problems, because often what I saw and experienced seemed just like any ordinary community.  The importance of relationships whereby the kids were positively supported, contained and nurtured by multiple adults in their daily experiences was evident in the way the children and young people conducted themselves in the community. I’m not saying that there were no challenges, as there were, but on the whole the adults in this community do a wonderful job of creating a relationally rich environment filled with amazing activities, “interventions” and opportunities.

If you work in the child and welfare sector and you ever find yourself in Amarillo Texas – look Cal Farley’s up and see if you can visit – it’s nothing short of impressive and it’s folk are just downright good people who are absolutely and only in this for the best outcomes for kids.

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Kayaking Adventure Therapy Session

 

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Practicing capsizing and rescue and the experience thereof.

 

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Robot built in rocket/robotics/electronics/ computing lab

 

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Pre therapy jigsaw pieces – goals and wishes

 

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Therapy Closure Jigsaw Pieces – outcomes

The Impact of Fear: My Firsthand Experience.

It has been a while since my last entry and I apologise for that.  The last 3 weeks have been so very busy and I became a little unwell (nothing too serious – just allergies) so that’s put me a little behind on the documentation of reflections. I can’t help but wonder however if some of the delay in getting another story out, was because I’m a stickler for chronology and really wanted to talk about & reflect on an experience I had in Albuquerque, the night before heading to Cal Farley’s in Texas.  The difficulty being that I was auditory witness to what sounded like a horrible domestic violence incident in my hotel that left me nothing short of scared if I’m to be honest.  I think it’s taken me time to process and think about that experience and how to reflect upon and turn it into something I have learnt from, but can also help others to learn from.images-3

In all the training and staffings I have done as part of my NMT certification with the ChildTrauma Academy I have a pretty good understanding of Dr Perry’s notion of the arousal continuum and the impact of increasing levels of stress and fear on the way in which our brain operates.  I even use examples of my own stressful situations to illustrate the arousal continuum when I teach and train.

Arousal continuum, Chelle what are you talking about? In short, there is a universal human phenomenon whereby activation of the stress response system or the experience of stress or threat, moves us along a continuum of arousal from calm to alert to alarm to fearful to terrified.  Now as Dr Perry often says, in today’s world it’s quite rare to achieve a state of calm and for most of us we operate on a day to day basis in the mental state of alert.  At each different state of arousal and because all of our functioning is brain mediated, there is a different part of the brain that is most active.

So when we are in a state of calm or alert this is when we have access to our cortex – the thinking and problem solving part of our brain.  We can recall information, manipulate thoughts and come up with solutions.  Moving up the arousal continuum to a state of alarm, fear and then terror sequentially reduces the access we have to our cortex.  Essentially the more stressed or afraid we become the less access we have to our thinking brain and our ability to problem solve and think clearly. Dan Seigel describes this here in his hand brain model https://www.youtube.com/watch?v=DD-lfP1FBFk when he talks about rising emotions leading us to flip our lids.

Unfortunately on the evening of the 17th of May, I was staying in Albuquerque, where after tucking up in bed, excited about the week ahead of me I could hear very clearly the screams and pleas for help from a woman.  Coupling these terrifying screams were loud bangs, the sounds of things being thrown around, threatening yelling from a male voice and then the sound of skin hitting skin.  It was clear that somewhere very close to me a woman was being assaulted and needed assistance.

Now if I were in my own country and feeling less isolated I may have had a different response, but what happened that night was that I became overwhelmed with fear.  Here I was a woman, alone, in another country and not having immediate access to the things that make me feel safe – my husband or my family.  I could feel my heart racing and I found myself almost paralysed with fear.  I couldn’t move, didn’t want to move.  Initially I thought about the notion of calling 911, but the fear of being heard or drawing attention to myself was so great and the possible threat to my own safety took hold.  Instead I found myself lying completely still, like a mouse not making a sound and jumping on Facebook messenger to connect with my safe base – my husband. Essentially in that moment I “flipped my lid”.

Not only did I have the first hand experience of the arousal continuum where I found myself unable to do anything but focus on what I needed to do for my own safety.  I couldn’t think, sort out solutions or even contemplate what I might need or be able to do to assist this poor woman being assaulted.  My cortex, the thinking part of my brain was shut down and the survival parts of my brain in full force – keeping me safe.  I didn’t sleep a wink that night, not even after the three hour ordeal settled, I was hypervigilantly on guard for additional threat.

The next morning, when I had resumed a baseline level of alert arousal and my cortex accessible again, I was struck by my experience of shame.  I didn’t let this consume me – reminding myself of neurobiology and the response I had as being natural, but nonetheless for a short period of time, with emerging access to my cortex, I felt bad for not having acted to protect that woman.  For those concerned, someone who wasn’t as scared was able to seek help for the woman and her abusive partner was arrested and taken away.

In the time that has passed since then however, I have spent a lot of time thinking about being a child in another room of the house, while those you love are being hurt and/or hurting each other.  I am a grown adult, I’ve had a really solid upbringing and I have relative security in my attachment and relationships, I had no personal connection to those individuals being violent and yet I still found myself terrified and immobilised by fear.  Imagine being a child, vulnerable, alone, scared and unable to do anything to help your loved one from being hurt.

I’ve heard all too often from parents, “the kids don’t know or see it”, “they are in another room”, “our fighting (aka domestic violence) doesn’t have an impact on them”.  I have always challenged these notions and beliefs of parents, knowing that this is nothing short of a fallacy.  Of course kids know and hear.  What concerns me more now though as I reflect on my experience in Albuquerque, is that when you can hear domestic violence and not see it, it might be just as, if not more scary than actually witnessing it.  When it is not in front of you and you “flip your lid”, your imagination about what is happening or what might happen can take hold, exacerbating your fear.

What’s more, if you have grown up in an environment of such violence and aggression between those you love, you are more likely to have an overactive stress response and hence be more alert to the cues of aggression and violence and more reactive to them.  The witnessing, be that visual or just auditory, will only serve to reinforce and exacerbate that overreactive stress response and possible resultant shame for not being able to help due to fear.

My experience has left me further adamant of the fact that hearing and not seeing domestic violence is absolutely in NO way less frightening or  damaging to children, than being visual witness to it!!

An Excuse for New Boots!

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The Sandhill Trail Ride with Acacia Riding Adventures: San Lorenzo Canyon New Mexico.

I’m always looking for a reason to add to my collection of cowboy boots. Now there’s more to this story and while this blog is really about neurodevelopmentally informed interventions and I’ll get there in this one, just let me set the scene a little.

There I was in Denver – a little over a week of being in the States and well I hadn’t really packed for a cold snap.  In fact, despite what seemed to be seamless organisation in relation to my packing – I really didn’t consider or even think about researching the spring weather conditions for places like Denver, Banff and Calgary.  So after a 102/38 degree day in Wichita, I head to Denver – where it was a crisp 63/17 degrees and my footwear is pretty much a pair of canvas Toms and two pair of open toe summer sandals!  This coupled with a Facebook post from a dear colleague in Calgary showing their spring snowfall (looks like our winter on the ski slopes) resulted in a rapid move up the arousal continuum to a state of mild stress activation.  “Will it be like that when I get there in June ?” “I’ve only canvas and open toed shoes, hello frostbite…”  and then as I engaged some self regulation, calmed and regained access to my thinking brain, came the problem solving “…Hello Boots!” On that very same day I get an email from Cal Farley’s to let me know that I’d be doing a trail ride – on a horse.  It is meant to be and now the deal is sealed, new boots for me!

I haven’t ridden for over 23 years, so the idea of getting back on a horse caused me some apprehension, however in the last two weeks I’ve now had opportunity to do two trail rides, firstly with Sandhill in one of the most picturesque canyons, secondly at Cal Farley’s around the treatment centre campus.  I’d love to be able to tell you that it’s just like riding a bike and one of my observers suggested to me that it looked just like that – on the back of that animal although – that’s not how it felt.

The mere idea of getting back up on horseback was in and of itself anxiety provoking for me.  I’m not a lover of heights, and well I’ve put on a bit of weight since I was a kid riding and being a lover of animals was quite concerned about my horse having to bear my weight.  On both rides what was fantastic was the reassurance from experienced horse handlers that both of my horses were more than capable of carrying me and doing so safely.  The other thing that I loved about both Dacodah and David was their ability to scaffold a feeling of competence and in turn begin the process of co-regulation of my anxiety.  I couldn’t help but think about what this experience would be like for a child or young person so used to negative human interaction, to have both an animal and its handler working together in the most natural of ways and leaving you feeling nothing but important and what’s more, even with skill.

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Cal Farley’s Trail Ride

Once on the back of the horse, there was no going back on either occasion.  In fact on the first ride there may not have been any going forward either had the horse not clearly communicated to me that I was anxious and she was not enjoying that experience.  My horse kept looking at me and snorting almost with derision.  Initially this did nothing to quell my anxiety and left me thinking all sort of negative self talk about my weight and the horse’s experience of it.  Not unlike the float tank, it was interesting to notice the thought processes that emerged about myself and the importance of sorting that stuff out or at the very least challenging it, for the success of the experience.

Dacodah and David on both occasions reminded me that the horse, being a prey animal, have an overactive stress response system – not unlike the abused and traumatised kids we work with and that they are finely attuned to threat.  Sensing my anxiety both the horses had started to become a bit “on edge” really just feeding off my own anxiety.  So in order to calm them, I had to calm myself.  The horse like the frightened and traumatised child, at the heart of it, really wants a calm, regulated, nice, nurturing, rewarding rider who can take control and be respectful of them.  The more I was able to manage my anxiety and relax into the animal while at the same time retain a sense of confident control the more attuned the horse and I became, the more responsive they were to me and the more confident and skilled I felt.

I can only imagine living a life where you feel out of control all the time and then having an experience like this where you have capacity to control the success of your interaction.  Yeah sure we could argue that our kids have capacity to control the success of their interactions with us all the time, but the immediate feedback from the animal that is without judgement, mixed messages and completely non verbal is so very powerful.  If you don’t get yourself sorted and regulated then your horse is going to do what it needs to take care of itself. There’s not going to be responsivity, let alone the chance of working together.   I watched young people who got this and were able to, in the moment, do what they needed to do to have a successful and pleasant ride with their horse.  I also watched other young people struggle to manage themselves, then end up more dysregulated when their horse wouldn’t do what they wanted, making the horse even more non compliant and not interested in the process.  I could absolutely see the benefit for in the moment reflection and wondering about the experience with the kids and the power of experiential learning when observations and interactions could be reflected on and internalised.  Aside from the physical sensory experience of riding there is definitely something in this equine based work!!

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Not so new anymore

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San Lorenzo Canyon

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On the trail

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A Self Portrait on horseback

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Canyon Pictures

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More of the Canyon

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Pictures do not capture the beauty of this place

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Just like in the movies

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Views from a top San Lorenzo Canyon

 

 

 

 

Sandhill Child Development Center: Authenticity in Relationships

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Del Rio House

I spent the week of May 12 -16 with the staff and residents at Sandhill Child Development Center in Los Lunas New Mexico.  “Sandhill Child Development Center is a residential program for children ages 5 to 13 at admission, who are experiencing significant difficulties functioning in their current home, school or community due to an inability to regulate their emotional states. By repairing a child’s trust in care and adult guidance, Sandhill gives the child the tools necessary to proceed with a healthy and bright future. Sandhill Child Development Center emphasizes a relationally-based clinical approach that is grounded in the Neurosequential Model of Therapeutics (NMT) developed by Bruce Perry, M.D., Ph.D. and The ChildTrauma Academy.” www.sandhillcenter.org  Sandhill takes children from all over the United States.

As one of the ChildTrauma Academy’s initial partner certification sites there was no question about visiting Sandhill.  Having been at the implementation of neurodevelopmentally informed interventions in their residential treatment for some time now, I wanted to see for myself where they were up to and what discoveries they had made.

Sandhill have two homes located on two different sites a short drive from each other in Los Lunas, New Mexico.  The home pictured above and it’s surrounding property align the Rio Grande River and both homes look out onto majestic mountain ranges.  Spending time with Sandhill you can’t help but feel relaxed and like you’ve known these people all your life.  The Zimmerman Family who run the service, exemplify nothing short of authenticity in relationships and with that as their template their recruitment of staff seems to follow suit.  It is clear from Management to Direct Child Care staff that relationships are the core of the healing approach at Sandhill.  Wrap that up with all the staff having a thorough grounding in neurodevelopment theory and you have a program applying all sorts of playful, rhythmic, sensory and somatic interventions with the children staying there.

Interventions include:

  • Individual weekly therapy for the child
  • Family therapy – both face to face during visits and via Skype sessions
  • Parent training sessions
  • Modelling sessions/co-parenting on site
  • EMDR
  • Animal Assisted Interventions – Horses, cats, dogs, chickens and peacocks.  Including day to day care of animals, as well as play and working with the animals therapeutically.
  • Nutrition – provision of a “brain friendly” diet which strives to use many organic and whole foods.
  • Exercise and recreation – including sports, team building, martial arts and other exercise based activities.
  • Service Learning via voluntary interaction in the community – litter/trash clean up on roads & volunteering at the local animal shelter.
  • Neurofeedback
  • Floating
  • Wilderness Adventure Therapy.
  • Daily education program through Del Rio Academy whereby the students are closely monitored from skilled and attuned education staff and given “brain breaks” when needed to help re regulate.  This involves taking the children out of the classroom in small groups and having them engage in exercise such as running laps, bilateral stimulation exercises, walking and talking and much more.
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Romero House

All of this provided on site or as part of the one program!

Sandhill has capacity for up to 30 children and adolescents at any given time and their average length of stay is around 18 months.  While the lists of interventions is broad, it is by no means all of what they do and one of the lovely observations I made was in fact the individual consideration given to each child’s sensory or regulatory need in the moment and matching all sorts of movement, sensory, mindful, relaxation and/or exercise based regulatory activity to them.

As I left Sandhill I reflected to their staff, that you know a program is doing a good job when the clients come up and tell you about themselves, why they are there and what they have learnt and how thankful they are for the experience at Sandhill.  Even more so when this happens in a house full of preadolescent and adolescent boys!

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Del Rio Swimming Pool

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Del Rio Academy onsite at Del Rio Property

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The Bath House: Home to the Float Tank and Neurofeedback

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Sports Court @ Romero (note trampolines in background)

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Romero Sports Court

 

 

 

 

Animal Assisted Therapy: Assisted is NO accident!

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Pella: Aurora Police Dept.

I took a lot from the Transforming Trauma: Methods for Animal Assisted Interventions, but like any conference, it’s the message you don’t expect to bring home that stays with you and is most powerful.  My prior blog provided an overview of the conference and some of the key take home messages I had and each of those messages are so very important, thoughtful and thought provoking.  I attended this hoping to learn more about AAT and Child Trauma and oh boy I most certainly did learn.  You know what though, I learnt something so very important for the success of AAT that I hadn’t previously considered and I’m so glad I heard this before venturing into AAT in my own work.

Aubrey Fine stated that first and foremost “animals require very skills therapists alongside them”.  The animal is “not a magic bullet on their own” and that in order to do the work properly, professionally and most ethically the human therapist – must be so very well skilled in their field and able to be attuned to picking up the nuances in the human animal interaction.

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Daniel & I

The other take home message for me, was the importance of the welfare of the animal.  This was repeated over and over again during the conference.  As trauma therapists, we all get tired, overwhelmed by the stories we hear and the work that we do.  We seek out supervision, health and wellbeing time and take self care.  It is unfair of us to think that our dog, horse, bird or guinea pig can go back to back in session all day without thought being given to their wellbeing.  As Aubrey Fine said “this work is very demanding on the animals”.  Rise VanFleet said something that will always guide me as I move forward in my exploration of clinical AAT; “the animal must enjoy the majority of interactions and not just tolerate it”.

As I see it, as an animal assisted therapist you need to be a skilled clinician, respect your animal colleagues and be able to manage the multiple relationships that come to exist in the room: you and the client, the client and the animal, you and the animal and the triad relationship.  I suspect a lot of people are drawn to the idea of an animal in the room with them and think it’s easy and just about having the animal there, but you know what? I’ve learnt that this is a very special and demanding style of working that requires unique skill and clinical maturity to really get the best out of the work.

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Transforming Trauma: Methods for Animal Assisted Interventions

Almost a month ago now I had the privilege to attend the Denver University Institute for Human Animal Connection, Transforming Trauma: Methods for Animal Assisted Interventions Conference.  This was a jam packed two days exploring clinical and research approaches to advancing the use of animal assisted interventions in the treatment of trauma.  While there were many fantastic presentations given over the conference, four clinical based presentations really stood out to me: Aubrey Fine reflecting on his many years of using animals in the treatment of child maltreatment, Molly DePrekel who blew me away as she pulled the links between neuroscience, Pat Ogden’s Sensorimotor Psychotherapy work and Animal Assisted Therapy (AAT) together in the treatment of trauma, Rise VanFleet who presented her dynamic work in animal assisted play therapy and Tim & Bettina Jobe presenting on their Trauma Focussed Equine Assisted Psychotherapy model.

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Dr Molly DePrekel

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Dr Aubrey Fine

Each presenter captured and spoke about the human animal connection that allows direct experiential feedback for the child/client.  Treated as a colleague in the therapeutic process the animal (be it horse, dog, lizard or even bird) and the client form a relationship and it is in the context of this relationship that patterns of attachment and relating can be observed.  The animal therapist provides immediate interactional feedback to the client that can then with the assistance of the human therapist can be reflected upon, wondered about and when appropriate redirected with skills development.

So many key messages came from the conference for me and have really led me to the realisation that I need to learn so much more about this work before I bring the new labrador I’m hoping to buy into the therapy room.

Here’s a couple of key messages I took from the conference:

  • In the human-animal interaction look for the reaction of the animal to the client’s presentation, notice it and provide feedback.
  • Notice both human and animal body language and reflect on and wonder about that.
  • Notice your own reactions as a therapist as you watch the interaction.
  • Use the feedback from the relational interactions to adjust behaviour.
  • The importance of wrapping traditional skills development around these observations to change client’s relational and coping styles – for example – relaxation skills, mindfulness, EMDR, self soothing, play therapy etc.
  • Remember that 40% of change in therapeutic treatment has little to do with the technique you are using  – it’s about the relationships and the animal in the room can be a form of social lubricant and initial relational engagement.
  • The importance of rhythm and relationships and the ability to achieve both in equine based mounted interventions using Rhythmic Riding TM and Relationship Logic TM
  • Use the relationship we have as therapists with our therapy animal as a model for healthy relationships for our clients.
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Tim & Bettina Jobe

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Rise VanFleet

 

Want to know more??

Check out:

Rise VanFleet’s Playful Pooch Program (2014)  www.risevanfleet.com

Molly DePrekel:  www.mwtraumacenter.com

Aubrey Fine and his many publications: www.aubreyhfine.com

Tim & Bettina Jobe and their Trauma Focussed Equine Assisted Psychotherapy TM: www.naturallifemanship.com