2. What are the qualifications of the line staff who work directly with the teens?
There should be someone of at least a master's level working with the kids most of the time; staff should have been subjected to criminal background checks, and the more educated the line staff, the better. Any kind of group should be led by a therapist of at least master's level -- less than that (especially no degree required, trained only by the program itself) is a red flag.
She's right about the Master's level therapist working with the kids. However, she's making a mistake that is all to common when she calls for better educated staff. Keep in mind here that the Harvard study regarding prisoners and inmates was conducted by college students. This implies that a better educated staff member is just as susceptible to falling into step with an abusive system than a half-witted drooling idiot fresh out of a methadone clinic.
What I would ask, and like the guest says this by no means promises a good program either, is what training do all staff have to undergo upon arrival.
I'd want to see the following:
1) Standard red cross/cpr training
- This is a given as everyone at a facility should be able to know how to cope with emergency medical situations.
2) De-escalation training.
- I'm of the opinion that de-escalation training should be a stand alone training that focuses on the practical aspects of de-escalating an angry person through active listening.
Lemme explain what that means..
Active listening is merely confirming to the pissed off person that you are listening by repeating, worded slightly differently, what they are saying.
Angry dude: I gonna #@$#@$#@$# mess that dude up!
staff: I can see you are pretty pissed off and you want to mess that dude up!
That's a big of a generalization, but more or less it just confirms that you are respecting the person's space and listening to what they have to say.
De-escalation takes into account that angry people need more space. They most often need someone to listen to them to let them rant. These aren't bad things to give an angry person are they? The problem I found with new staff members, and myself is included in this one as well as I've screwed this one up more than once, is that once someone gets angry and combative they skip directly past de-escalation and active listening to dropping them on their heads.
So, I'd want to know how much de-escalation emphasized, how often they are retrained in it, and how much role playing do they do in training. If they are only required to do one role playing scenario before moving onto the physical portion of restraints then you are better off tying your child up and leaving them in the garage.
De-escalation takes a shitload of confidence and needs a shitload of practice in live role-plays. They should be spending most of two days working through active scenarios. My last training, in 2007 for a developmentally disabled home I worked at for six months, gave us one live role play and most of a day listening to the trainer blather on about the theory of anger and blah blah blah.
3) Restraint training
- Like it or not some form of restraint training is going to occur. I don't see this as an automatic redflag though. You do want to know what systems they are using.
- Restraints calling for the staff member to place any part of their body directly on the client's chest should be avoided. This is how clients get suffocated.
- Restraints lasting more than 15 minutes should be avoided. Let them up.. if they keep getting violent then reapply as needed.
The staff should be well trained enough in de-escalation to be able to avoid having to restrain someone at all. However, shit does happen and you do want to know if they are well trained in these matters.
Are they using pressure point holds?
Chemical restraints?
Mechanical restraints?
These are red flags.
Are they required to debrief the restraints after? This means the staff and clients are quietly questioned by program administrators to ensure that there was an actual need for the restraint. Feel free to ask how many restraints they have a month. More than 3 would be a huge red flag. If they've killed someone or injured them in a restraint that would be a huge effing red flag.
Absolutely what must be established is what they feel is a serious threat to the health of the client or others.
- Is walking away from their group a serious threat?
... Uh.. no.. not immediately.. Maybe walking towards a cliff saying, "I'm gonna jump" is a huge ass threat. But if the cliff is far enough away you have still ask what the staff member did to attempt to de-escalate the person prior to going into a restraint.
- Is making a verbal threat to a staff member or other client a matter of restraint?
.... Uh.. no.. If they are just ranting that's kind of expected. Let them rant and listen to them and chances are they'll wind down on their own and apologize.
- Is breaking something of value a matter for restraint?
..... Uh.. no... depends.. are they using their forehead? If not.. go with the you break it, you buy it policy. If they aren't physically harming themselves or another.. leave them alone.
Protip: Saying in a loud voice, "OH you just bought that!" is only going to promise a restraint.
In essence what you really want to know is if the staff have the verbal training to avoid restraints. Things do break down at times, and if so are they well trained enough to perform restraints safely.
4) Mediation training..
Put a bunch of teenage boys together and at some point you are going to have to play the role of mediator. Nothing wrong with helping young men and women to compromise with each other to help them resolve disputes. Part of the problem is the confrontational aspects of programs put the kids in charge of handling these meditations.
- Do the staff have the training to successfully direct and lead a group meeting. These group meetings should not for the purpose of blowing people's doors off. Confrontation can be done politely, it can be done respectfully, and it can be helpful. However, in order for it to be any of those things the staff has to be the one directing the flow of traffic to get to those desired results.
Keep in mind these aren't therapy sessions. These are merely discussions between people to help them resolve situations and personality conflicts through compromise. If you have to go get the therapist every time you have a problem that group isn't going anywhere at all.
5) Boundaries training...
Maybe it is just me, but staff who can't keep their personal lives at home have no business working with children. The clients don't need to know about their meth addictions, gambling problems, or what not. What happens is the staff start trying to identify with the clients. That isn't their role.. Their role is to ensure a safe environment to the best of their abilities.
You simply don't do this by going on about your own personal lives. I mean yeah its ok to talk your dog, or what you like to do, and maybe what movies you like to watch.
Also this training includes what sort of conversations are appropriate, what sort of touch is allowed, and that sort of thing. I don't mean touching the kid's pee pee either. I do mean is it ok to hug a kid? That's a tough one given the age range of the children but in general I'd say keep your hands off the kids.
These are what I would look for, but again they don't promise a good program. Major programs like Eckerds, Three Springs, and Aspens to some extent have been asking their line staff to have a bachelor's degree for sometime. Yet, this in no real way has helped to minimize abuse or to create a higher quality of staff.
More education isn't the answer, but better education at doing their jobs safely does go along way.
