Child Maltreatment

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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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