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)

GRIEF AND LOSS CYCLEGRIEF AND LOSS CYCLE

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:

Life Map

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

Show and TellShow and TellShow and TellShow and Tell

Attachment CycleAttachment CyclePhysical orPhysical or

psychological need

SECURITYTRUST

Behavior Behavior TRUSTATTACHMENT

lessens or stops

e av oResponse

Satisfaction

p

of Need

Building A RelationshipBuilding A RelationshipContinuityStabilityyMutualityyReciprocityR p y

Adaptive/Modified Att h tAttachment

(Dee Paddock)

SECURITYTRUST

ATTACHMENT

MOM

DAD

MOM

SIBLING

MOM

YOUTHDAD

NEW YOUTH

YOUTHDAD

TRAUMATIZED YOUTHTRAUMATIZED YOUTH NEED:

STRUCTURE

CONSISTENCY

PREDICTABILITY

CONTROLCONTROL

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

COLLAGE

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

Gi Y th Gives Youth a V !Voice!

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

Honors Youth’s Honors Youth s Past!

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

Answers The Answers The Q ti !Questions!

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

Creates Creates C t !Connections!

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

hLooks to the Future!

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.

1-717-231-6424dhenry@familydesign.org