As I’ve mentioned, and I’m sure as many people can relate to, the thing that has been so gut-wrenchingly awful to me about the Haiti earthquake is the stories and scenes of the families searching for their loved ones. To put myself in their place for just one second, looking around the ruins of the place that was once my home, hoping to find some clue about the fate of my husband, parents, sisters, son…I can hardly imagine it.
Family. That’s the thread that I’m going to take from the situation in Haiti and extend all the way here to an experience I had today. I’ve referenced my line of work before, but I think more details become relevant here to set up the story I’d like to tell.
One model of treatment we use is called Multisystemic Therapy, or MST. This evidence-based model of treatment focuses on engaging the systems involved with a child – family, school, community – to adapt their approach to the child in order to reach the goals they have for that child. A lot of the work that needs to be done with families is changing their perception of what is driving the behavior they would like to see changed.
To give a quick example, we work with a lot of kids who hate school and are chronically truant. To spend hours and hours with a child trying to convince them that they want to go to school is an exercise in futility – it doesn’t matter if they want to go, other people who have power in their lives have decided they have to go. Therefore, it is the goal of the systems involved in their lives (court, family, school) and those are the parties that need to take on the burden of changing in order to get what they want.
One of the main things we try to avoid is having a child placed out of the home, in a hospital, residential, or disciplinary setting. None of those alternatives will make sustainable changes in a child’s life, and none address the major drivers of behavior – namely the family interactional patterns that contribute to the problem. A child that is sent away, even if he or she is able to learn new anger management/coping/behavioral strategies, will be returned to a home where those strategies will not have been learned and nothing will have changed. That will be more a more powerful force than anything a professional can ever hope to instill in a child, and their behaviors will revert.
Our goal instead is to empower caregivers to help a child manage their anger/cope with their feelings/manage their behavior. Most treatment modalities reinforce the idea that if a child experiences a trauma, they need to talk to a professional counselor, process the trauma verbally, et cetera. However, the outcomes with that strategy are not so great.
Think about it for a second: Something terrible happens to you. Who is the person, or who are the people, who you want to talk to first? Who do you want to give you support, try to understand what you are going through – love you – during that time? Your family, and your friends. Not a paid professional. Imagine you are a kid: Who are the people who are supposed to love you and keep you safe? Those are the people we seek to empower in those situations to respond to their child’s experience with warmth and openness and unconditional love.
We’ve really gotten away from that as a culture. The language of emotions, the conversations of our hearts, are not comfortable for most of us. We feel ill-equipped to respond the “right” way, to say the “right” things. I don’t know where we all got that idea, that you need special knowledge to care properly. You don’t. You just need empathy, and the person going through the rough time needs to feel properly attached to you. If a person can have those things, there is a much lower chance that they will develop residual effects from their experience, such as posttraumatic stress disorder.
So I’m in the business of reminding people to trust their instincts, listen to their hearts, respond with warmth to their children. The fabulous thing about today is that it worked.
There is a young girl who is in a lot of pain. Not so long ago, she had something pretty awful happen to her. In the immediate weeks after it happened, some bad choices have been made. Her mom has shut down all conversations about the incident, out of a misguided attempt to help her daughter move past it. Her stepfather has responded with a lot of anger, stemming from the guilt he feels about not protecting her. Her school suggested she be moved to another school, for a “fresh start,” so she was transplanted to a new school, which may as well be Mars when you are 14 and needing your friends and familiar surroundings.
This girl started begging for someone to help her, in the way that 14-year-old girls know how to beg for help. She started making superficial cuts in her arms, she started making herself faint, she started claiming to feel “unsafe” and wanting to be brought to the hospital to get the attention and safety that no one else in her life was giving her. She went through three revolving-door rounds at the local behavioral inpatient facility before they called us in.
So now we need to change the way that everyone in this girl’s life responds to her. Not an easy task. It’s meant her clinician spending hours at the school, hours with her parents, hours in the ER convincing the doctors that she needs to be sent home with her family, not sent away. Today, success.
The success came from this girl’s mother finally being able to say to her daughter “I want you home, you belong at home with me and your dad.We will help you with this.” All of a sudden, she didn’t need the hospital anymore, she didn’t need to cut herself again today, and she didn’t need to pretend to faint. She needed – and got – her mom. Fabulous.
So, Fabulous Thing #15: Families, together.