33--55--7 model7 model - ocwtp
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33--55--7 Model7 Model: A Practice Approach for
Permanency Work with Children & Youth
Darla L Henry PhD MSWDarla L. Henry, PhD, MSWFamily Design Resources, Inc.
November 2007
CORE WORKCORE WORKCORE WORKCORE WORKLOSSLOSS
Repeated, profound, traumatic SAFETYSAFETY
Grieving for a youth is search for emotional safetyATTACHMENTS/RELATIONSHIPS
Who will help grieve the pain of losses?RESILIENCE
Ability to cope with /adapt to risk factors
GUIDE for WORKERS & FAMILIESFRAMES WORK of:
RECONCILING LOSSESREBUILDING RELATIONSHIPS through PAST & CURRENT ATTACHMENTSBELONGING to FAMILY by ACHIEVING SAFETY; CLAIMING by FAMILY encourages PERMANENCY
PROVIDES a COMMON LANGUAGE for professionals and families
ESTABLISHES BEST PRACTICE
BEST PRACTICE BEST PRACTICE PROCESSPROCESS
Ensures youth have opportunity to reconcileEnsures youth have opportunity to reconcile losses:
- with consistency in practice- in a safe, stable environment- to ask questions- feel positively about prospective familiesfeel positively about prospective families
Helps youth establish a more secure foundation f id tit f ti b i i &for identity formation by recognizing & maintaining their biological, cultural and placement history
BEST PRACTICEBEST PRACTICEPROCESSPROCESSPROCESSPROCESS
Work with youth requires specialized skills: y q pgrief/loss, attachment/relationship building, understanding of self, encouraging collaboration engaging youthcollaboration, engaging youth
Engaging youth requires: g g g y qpatience, understanding developmental stages, sensitivity to and knowledge of youth’s traumayouth s trauma
PRACTICEPRACTICEPRACTICEPRACTICECOMPLETION OF 3 TASKS
ANSWERING 5 CONCEPTUALANSWERING 5 CONCEPTUAL QUESTIONS
USE OF 7 CRITICAL SKILL ELEMENTS
3 TASKS of WORK with YOUTH
CLARIFICATION:reasons for being in care;reasons for being in care; life events
INTEGRATION:acceptance of family memberships; family membership and loyalty
ACTUALIZATIONACTUALIZATION:visualize permanent relationships,family membership; belonging to a familyfamily membership; belonging to a family
5 QuestionsQuestions5 QuestionsQuestionsh ddWho Am I?………………………………IdentityIdentity
What Happened To Me?………………….LossLoss
Where Am I Going?…………….…AttachmentAttachment
How Will I Get There?…………..RelationshipsRelationships
When Will I Know I belong?... Safety/ClaimingSafety/Claiming
killkill ll7 7 skillskill ElementsElementsENGAGE youth in the process…
LISTEN t th th’ dLISTEN to the youth s words…
When you speak, TELL THE TRUTH…
VALIDATE the youth and their story…
Create a SAFE SPACE for the youth…y
It’s Never too late to GO BACK IN TIME…
PAIN IS PART OF THE PROCESS ! !PAIN IS PART OF THE PROCESS ! !
ActivityActivityActivityActivity1 What has your personal grief taught 1. What has your personal grief taught
you about what helps people heal?
2. What have grieving people taught you?you?
3 Wh t l 3. What are your own personal strengths and challenges as a caregiver?caregiver?
GIVES YOUTH VOICE
To encourage the voicing of feelings and emotions is healing processg pExploring what subjects are important and interesting to themand interesting to themFreedom and encouragement to express emotions with their voice helpsexpress emotions with their voice helps to recognize their power
HONOR’S YOUTH’S PAST
Have lost parts of history—identityFills holes of “lost self”Fills holes of lost selfProvides more complete picture of self
Acknowledges all events in lifeHonors heritage/culture/familyEncourages building of attachmentsEncourages building of attachments
ANSWERS THE QUESTIONS
Rarely have good understanding of life eventsMisinformation/incomplete information/no informationinformation/no informationProvides clear truthful information; opens activities to improve self esteemopens activities to improve self esteemIncreases capacity to reconcile previous
l ti hi d f l ti hirelationships and form new relationships
CREATES CONNECTIONS
Have lost many relationships in livesModel identifies people who were part of theirModel identifies people who were part of their past—re-establish connectionsBuilds web of supportive connectionsBuilds web of supportive connectionsSurfaces issues that have stood in way of building relationshipsbuilding relationshipsBuilds relationships through cycling of attachment processp
LOOKS TO FUTUREPast relationships are woven into currentPast relationships are woven into current relationshipsMeaning is given to lost relationships so g g pyouth can move onTrust develops in safe/secure environment; b i i f j t b l ibeginning of journey to belonging Reunification, adoption, kinship, legal custodianshipcustodianship
is completed; future is “visible”
THE LOSS EXPERIENCETHE LOSS EXPERIENCE
E tEvents PRIMARY TRAUMA
Abuse: physical, sexual, emotionalNeglectAbandonment: sudden/episodicViolent environment
SECONDARY TRAUMAPlacement (LOSS)Re-placement (more LOSS) Stigmatization (official LOSS)
Post traumatic stress disorder (PTSD)Post traumatic stress disorder (PTSD)Oppositional defiant disorder (ODD)C d di dConduct disorderADD/ADHDReactive attachment disorder (RAD)
ANGER/RAGE BEHAVIORSANGER/RAGE BEHAVIORSANGER/RAGE BEHAVIORSANGER/RAGE BEHAVIORS
Oppositional and hypersensitivePhysical symptoms/emotional outburstsy y pDestructive/aggressive, tantrumsLying and stealingLying and stealingWithdrawal, sulking, poutingGrouchy nothing satisfiesGrouchy, nothing satisfiesNon-complianceE ti / l i di t bEating/sleeping disturbances
CLARIFICATIONCLARIFICATION• Practice issues
-------------------------- Wh H d– IDENTITY
• Developmental:h th tl
B
rific
atio
n What Happened to Me?
where youth currently sees self C
lar
h– LOSS• Primary (abuse/neglect)• Secondary (placements)
CWho am I?Who am I?
y ( )
READINESS
DISENFRANCHISED GRIEFGRIEF
The grief that is experienced when a loss is incurred that is
not or cannot be openly acknowledged, publicly
mourned, or socially supported
Circumstances ofCircumstances of Disenfranchised Grief
1. Relationships are not recognized
2. Loss is not recognized
3. Griever is not recognized
4 Loss is somehow stigmatized4. Loss is somehow stigmatized
GRIEF JOURNEYGRIEF JOURNEYrequires:
CONTEMPLATION and TURNING INWARDTURNING INWARD
DEPRESSION, ANXIETY, and LOSS of CONTROLCONTROL
SEARCH for MEANING:to REGAIN PURPOSEto REDISCOVER LOVEA REASON to GET OUT of BED in the MORNING
Working with YouthElicit and listen to history of relationships and lossV lid t l i t f l ti hi tValidate loss, importance of relationships to them Support and encourage their right to grieveSupport and encourage their right to grieveEducate, normalize feelings, find others who have same issuesCreate rituals to work through lossUse photos as talking points to solicit p g pmemories
ACTIVITIES/EXERCISES
• GRIEVING LOSSES
• LIFE BOOKS • LIFE MAPS
• PAINFUL RESPONSES TO TRAUMA/LOSS
LIFE MAPS• ECO-MAPS• LOSS LINETRAUMA/LOSS
• INTENSIFYING OF FEELINGS
• LOSS LINE• From Recipes for
Success:OF FEELINGS AND BEHAVIORS (PROTEST TO RAGE)
Success:
The Life Map of a Youth
Boyfriend kept
Lived With Mom andHer family05-22-00-6-15-00
Moved with Mom to live
Boyfriend kept Threatening to
kill my momSummer 2000
Billy Born
05-22-00
Mom to live with her boyfriend
6-15-00
Moved with my DadTo live with his parents
And his girlfriend9-00
Dad came home –moved back in with him –
girlfriend left12-03
Dad went to jail –stayed with girlfriend
and dad’s parents02-03
Dad and girlfriendGot their own Apartment –
took me with them06-02
Met my mom again…01-05
INTEGRATIONINTEGRATION• Practice Issues Where Am I• Practice Issues
--------------------------– IDENTITY
Where Am I Going?
IDENTITY• Who am I? Who was
I? What roles did I play? R
ATIO
N What Happened to Me?p ay
– LOSS• How did I get here?
What happened?
INTE
GR
hWhat happened?– ATTACHMENT
• Who was important to me; who did I relate
CWho am I?Who am I?
me; who did I relate to; how was I viewed? READINESS
Attachment CycleAttachment CyclePhysical orPhysical or
psychological need
SECURITYTRUST
Behavior Behavior TRUSTATTACHMENT
lessens or stops
e av oResponse
Satisfaction
p
of Need
Adaptive/Modified Att h tAttachment
(Dee Paddock)
SECURITYTRUST
ATTACHMENT
MOM
DAD
MOM
SIBLING
MOM
YOUTHDAD
NEW YOUTH
YOUTHDAD
ACTIVITIES/EXERCISES
• MULTIPLE FAMILY FAMILY MEMBERSHIPS
• NO NEED TO
• LIFE BOOK (CON’T)• COLLAGESNO NEED TO
CHOOSE ONE FAMILY
• SAND JAR• From Recipes for
• EXPLORE LOYALTY TO BIOLOGICAL
pSuccess:
BIOLOGICAL FAMILY
ACTUALIZATION When will I
• Practice issues IH ill I
Know I Belong?
• Practice issues--------------------------IDENTITY; LOSS; N
How will Iget There?
IDENTITY; LOSS; ATTACHMENT;
RELATIONSHIPS; SAFETY LI
LZAT
ION
Where am I Going?
SAFETY
CLAIMING/BELONGING AC
TUA
L
What Happened to Me?
WELL-BEING & PERMANENCY
CWho am I?
Who am I?PERMANENCY
READINESS
Th F ’ l HThe Four O’Clock Hourh lPhysical or
PsychologicalNeed
Relaxation St t f a aOf
Tension
State of High Arousal
SECURITYTRUST
ATTACHMENT
3pCtcYpi Ctm&u Y
A WWk
Building the RelationshipBuilding the RelationshipBuilding the RelationshipBuilding the RelationshipR
E
L
AA
T
I
O
N
SS
H
I
p
LOVE IS ESSENTIAL, LOVE IS ESSENTIAL, BUT NOT WHERE BUT NOT WHERE BUT NOT WHERE BUT NOT WHERE
YOU BEGINYOU BEGINYOU BEGINYOU BEGIN••BASIC PHYSICAL BASIC PHYSICAL
NEEDSNEEDS
••SAFETY AND SAFETY AND SECURITYSECURITYSECURITYSECURITY
LOVE AND LOVE AND ••LOVE AND LOVE AND BELONGINGBELONGING
ACTIVITIES/EXERCISES
• RECONCILIATION OF LOSSES
• LIFE BOOKBEADS
• ACCEPTANCE OF
• BEADS• STORIES
F R i f RELATIONSHIPS WHO WILL
E
• From Recipes for Success:
PROVIDE PERMANENCY
Engaging/Joining withEngaging/Joining with Youth
Be TruthfulBe Attentive/Listen
Validate the youth’s feelingsby acknowledging them
Be PatientSupport the youth throughout
b h i l lbehavioral response cluesSurroundings: safe, quietTi i t i t tTime: convenient; consistent
Explore ConnectionsExplore Connections with Youth
Review records to determine past relationships
Explore who is relevant and important to the youth
Help the youth see him/herself as a member ofHelp the youth see him/herself as a member of more than one family
Gi hi /h i i t i l l tGive him/her permission to remain loyal to more than one family
Help youth develop skills around making connections and keeping connected
PreparationPreparation
“Grown-ups never understand h f h l d
panything for themselves, and it is tiresome for children to be always and f r r plai i g thi g t th ”forever explaining things to them.”
Antoine de Saint-Exupery
PreparationPreparation
“Each has his own past shut in a a pahim like the leaves of a book known to him by his heart ”known to him by his heart.
Virginia Woolf
PreparationPreparation
“All of our lives we rework the All of our lives, we rework the things from our childhood, like feeling good about ourselves,
i f li managing our angry feelings, being able to say good-bye to people we love”people we love
Mr. Fred Rogers
PreparationPreparation
“As different as we are from one another as As different as we are from one another, as unique as each one of us is, we are much more the same than we are different. Being a a a d gConnected to others is one of the most important things in life”p g
Fred Rogers
PreparationPreparation
“Be patient towards all that is Be patient towards all that is unsolved in your heart, and learn to love the questions a qthemselves”
Maria Rilke Rainer
PRACTICE ISSUESPRACTICE ISSUESINDIVIDUAL and/or GROUPINDIVIDUAL and/or GROUPTIME of DAY/ DAY of the WeeK
CONVENIENT; CONSISTENT;
PLACE: FOSTER HOME/OFFICE/SCHOOLSAFE SPACE; PRIVACY; NO DISTRACTIONS
SIBLINGSSIBLINGS:CONSIDER FAMILY GROUPS IN A NEUTRAL SETTING
THEY SHARE HISTORY/EXPERIENCESTHEY CAN CLARIFY FACTSFAMILY CONNECTIONS ARE MAINTAINED
SEPARATE WORK CAN BE CONSIDERED BUT SHOULDSEPARATE WORK CAN BE CONSIDERED, BUT SHOULD NOT BE A BARRIER BASED ON: AGE AND DEVELOPMENTAL LEVELS; DIFFERENT ADOPTERS/PERMANENCY PLANS
IMPLEMENTATIONIMPLEMENTATION WHO WILL RECEIVE SERVICES?WHO WILL RECEIVE SERVICES?
HOW WILL CONTINUITY BE ASSURED?HOW WILL CONTINUITY BE ASSURED?TIME FRAMEYOUTH’S PACE
WORKER ROLESWHO WILL DO THE WORK?WHO WILL SUPPORT THE WORK?WHO WILL SUPPORT THE WORK?
RESOURCE PARENT/THERAPIST ROLES
FUNDING RESOURCES
FAMILY DESIGN FAMILY DESIGN RESOURCES INCRESOURCES INCRESOURCES INC.RESOURCES INC.