Treatment Abuse, Behavior Modification, Thought Reform > CALO - Change Academy at Lake of the Ozarks

CALO email... thanks bob.

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Che Gookin:
Wow Nicole... talk about glossing over shit..

So PCS does what now? OHHH pressure point holds based upon a report from a survivor I talked to and a staff member. Will be posting more about this soon.

Regroup? Well we know from your own coaching manual this means taking the kid away from the group and making them work till they behave.

therapeutic touch? Are these people idiots? The absolute last thing you want to do with an angry person is get near them and touch them. Sounds to me like they are setting these kids up to get restrained.




ps.. thanks Bob.. you da man.




--- Quote ---From: "Fuglsang, Nicole" <[email protected]>
To: Bob Peterson
Cc: "Fuglsang, Nicole" <[email protected]>
Sent: Monday, May 18, 2009 8:44:30 AM
Subject: RE: CALO - Change Academy Lake of the Ozarks

Bob,

I was pleased to see your request fro information in regard to CALO. I will answer each of your question is detail below. First I wanted to give you a brief overview our general philosophy as they go hand-in-hand with our procedures. At CALO, we work a small window of student issues focusing specifically on issues of emotional regulation, attachment and trauma. At CALO relationships are the primary change agent. All treatment is connected to and motivated by relationships. Relationships with family, CALO staff, and CALO peers are what drive change. Since family relationships are primary, we do not accept students into our program; we accept families into our program. We want and encourage our families to be highly active in the CALO program and the change process. The parents are an integral part of the treatment team and we require their intimate involvement. The treatment team consists of the family, the student, the CALO Leadership Team, the Treating Therapist, Academic Staff, Recreation Staff and our Residential Coaches.

 

Answers to your questions:
(1) Would staff physically restrain my son when necessary?


The staff members at CALO utilize various types of physical touch to demonstrate acceptance, to encourage trust, and help students to return to a state of voluntary cooperation. One of the potential concerns parents may have about the open environment at CALO is the occasional noise and periodic disruptions in the milieu. Traditional behavioral programs respond to dysregulation and disrespect by insisting on compliance through quick consequences and punishments that may include immediate group confrontation, immediate isolation of a client from all contact. Because CALO’s philosophy is more about relationships and boundary coaching when interpersonal difficulties arise, there will be times where students are rude, “hyper”, and otherwise disrespectful. We deal with this but we deal with it in ways that preserve relationships. At times, this will require therapeutic holds. I will walk you through some of the types of interventions that occur before a hold. At CALO, we utilize the following tools/interventions: Therapeutic touch, Closeness vs. consequence, Time-in vs. Time-out, Regroup, P.L.A.C.E. (Playfulness, Love, Acceptance, Curiosity, and Empathy), Connection-Break-Repair, Rhythm Control (through our daily schedule), Transferable Attachment, Cycles/Patterns, Modeling and peer accountability.

 

Therapeutic Touch- As part of Dyadic Developmental Psycho Therapy, touch is an important variable in the change process.  The staff at CALO may utilize various types of physical touch to demonstrate acceptance, to encourage trust, and to help students to return to a state of voluntary cooperation. Therapeutic touch is initiated by CALO staff during critical and non-critical incidents to encourage trust, and is a physical representation of an emotional connection. Therapeutic touch is often initiated by the placement of a staff member’s hand on a student’s “safe zone” during a conversation. This “safe zone” consists of the portion of the student’s body from one elbow, across their back, and down to the other elbow. The “safe zone” region is limited to those areas on the body that are least likely to elicit a sexual response, transmit a sexual message or be intrusive or traumatizing to the student in any way. The staff members at CALO utilize therapeutic touch during processing and coaching moments, in addition to times when staff make requests for cooperation, mandates for compliance, and statements of immanent consequences. Therapeutic touch is also a productive form of non-verbal communication while processing with a student following a critical incident. Philosophically, we believe that students need appropriate touch in their lives. They may reject this touch initially but almost always become accustomed to, and usually desire, this form of connection.  CALO is eager to assist parents in initiating or restoring therapeutic touch with their son/daughter as this foundation of caring important as a child transitions into life following treatment.

 

Closeness- When a student is dysregulated and/or not responding to coaching, many times the student needs an intervention in order to allow the student to have their needs met.  Closeness provides such an intervention and is best defined as a student needing staff assistance to regulate emotions and/or remain safe. When a student is struggling emotionally, instead of having him/her go to “time-out” CALO allows for the student to have a “time-in” through Closeness.  Basically, staff is assigned to be close to that student and be available to process and connect with the student during difficult and emotionally dysregulated times. Therefore, dysregulated students who need Closeness but are not creating or feeding into chaos get such Closeness from the staff assigned to them. Closeness can be necessary at anytime throughout the day or night as needed to keep students safe; both physically and emotionally. There is no predetermined length of time for closeness as it may be as little as ten minutes or could last for days, weeks, or even months (unless otherwise directed by a therapist, supervisor, or member of the extended leadership team (ELT)).  Closeness leverages the power of relationships by creating physical and emotional intimacy. The goal is for dysregulated students to recognize that connecting to a safe and stable adult is a healing, soothing, and positive experience.  Essentially, Closeness is aimed to further the attachment and healing process.

 

Regroup- CALO desires students to be a part of the milieu and believes that students get the best treatment when they are engaging with staff and peers.  However, when students are not responding to coaching, or are creating or feeding into chaos, they may benefit from another mechanism to regain control; they may be appropriate for Regroup.  Students who cause property damage (e.g. punched a hole in a wall, torn clothing, broke a chair) may also participate in regroup to help them return to a safe and emotionally regulated state of mind..  Regroup provides an alternative to regular milieu function, and often provides opportunities for students to work on simple physical tasks while learning to regulate themselves.

 

Peer Accountability- Within the milieu, as the student community evolves, staff take a more supportive role and students assume more responsibility in managing their peer group. The ultimate goal is for the students to be able to effectively communicate and hold each other accountable with minimal staff involvement. Students who are working on Trust of Self will frequently help regulate the community and hold peers accountable in a group setting. Generally, these groups are called “peer accountability groups.” Almost any staff or student can call for a peer accountability group. If someone sees the community or an individual acting in a way that is harmful to the community, they call a group and highlight the problem. During these groups staff are always present. Our residential coaches attempt to “lead from behind” by asking questions at opportune times, pointing out inconsistencies and asking for feedback, or challenging poor belief systems.


(a) What reasons could my son be restrained for?
CALO staff may physically hold students only when absolutely necessary to prevent students from harming themselves, to prevent students from harming others, and to prevent students from creating a chaotic and potentially dangerous environment.  These therapeutic holds occur as a last resort.  Staff must exhaust de-escalation methods prior to initiating a physical holds unless an immediate response to an out of control behavior requires immediate action.


(b) What restraint methods are used (mechanical restraints, basket holds, chemical restraints, pressure point holds etc.)?

We do not use pressure point, chemical, mechanical or basket holds. The only physical holds authorized at CALO are those ascribed to PCS (Positive Control Systems).  CALO staff members including therapists, residential coaches, recreational therapists and others receive formal training, and are certified in the use of PCS therapeutic holds within 90 days of employment. The use of non-physical, verbal and non-verbal de-escalation techniques is always the preferred method of managing negative, aggressive, chaotic or potentially dangerous behaviors.  Within 90 days of employment, the leaders of CALO train staff to be competent to participate in PCS certified therapeutic escorts and holds.  This training focuses on communication techniques proven to minimize circumstances that give rise to physical interventions.  Student to staff ratios are normally at 3:1 but never exceeding 4:1 so that non-physical interventions may have precedence over physical interventions.

 

Positive Control Systems

When CALO first opened, it utilized de-escalation training provided by the CALM system.  It became evident that the CALM system did not provide the staff with the best verbal and physical training available to de-escalate potentially dangerous situations quickly and safely.  After researching a number of de-escalation training systems including the Mandt system and CPI, CALO decided to pursue training in the PCS system because it encourages the greatest degree of safety for both students and staff by adhering to the following principles:

1)      None of the PCS holds or takedowns restrict breathing.

2)      Once students return to a place of voluntary cooperation, communication begins immediately to offer aid and support, and to ensure students are breathing.

3)      PCS never prescribes the use of pressure applied to the head neck or torso.

4)      The focus of PCS is voluntary cooperation which requires two-way communication and naturally results in de-escalation.

5)      Mechanical restraints are never used.

6)      Chemical Restraints are never used.

7)      Isolation and/or seclusion rooms are never used.

 

I hope this  helps. Please feel free to conact me with a dditoinal questions.

 

Sincerely,

 

Nicole

 

Nicole Fuglsang, M.A., L.P.C., Admissions Director

 

 

http://www.caloteens.com

Cell (573) 746-1884

Toll Free Direct (866) 459-1362

130 CALO Lane

Lake Ozark, MO 65049
--- End quote ---

Nicole Fuglang lies her ass off... and more.

Anonymous:

--- Quote from: "Che Gookin" ---Nicole Fuglang lies her ass off... and more.
--- End quote ---

Beyond a doubt!


--- Quote from: "Darling Nikki" ---The “safe zone” region is limited to those areas on the body that are least likely to elicit a sexual response, transmit a sexual message or be intrusive or traumatizing to the student in any way.
--- End quote ---

When I was a teenager, there was no part of my body that didn't become an erogenous zone with the slightest stimulus.

CALO's website lists admissions criteria:


--- Quote from: "CALO's Deceptive Marketing" ---
We accept students, ages 13 to 17, with the following diagnosis:


    * Attachment Issues: adoption issues, identity issues, reactive attachment disorder, personality disorders (borderline, histrionic, narcissistic traits)
    * Trauma Issues: abandonment, victims of abuse and/or neglect, bereavement, post traumatic stress disorder
    * Emotion Regulation Issues: depression, dysthymia, bipolar, anxiety, personality disorders (borderline, histrionic, narcissistic traits)

Symptomatic behaviors include: poor impulse control, poor social skills, promiscuity, severe control issues, self-destructive behaviors, academic decline, family conflict, identity issues, low self-esteem, low motivation, manipulation, oppositional behaviors.

We do not accept students with the following:

    * Parents that are unwilling to actively participate in the CALO program
    * Psychosis
    * A primary diagnosis of substance abuse
    * A confirmed diagnosis of anti-social or conduct disorder
    * Students who are actively homicidal or suicidal
    * Students that are pregnant

--- End quote ---


OK...We see what they will and will not treat, but do you see a problem with the treatable/non-treatable conditions?  CALO will accept bipolar patients, but not patients with psychosis or a primary diagnosis of substance abuse.  Unless a bipolar patient is stabilized, s/he is likely to be in full substance abuse mode, suffering from psychosis and possibly suicidal.   If the patient is stable, why are they being institutionalized?


--- Quote from: "CALO's Deceptive Marketing" ---* Trauma Issues: abandonment, victims of abuse and/or neglect, bereavement, post traumatic stress disorder
--- End quote ---

Could Mr. Peterson call CALO about placing a child suffering from abandonment, abuse, neglect and PTSD?  When Nikki says "Oh, yeah,"  a bomb could be dropped like "I'm glad you can help my child.  S/he was in a program in Utah that is a  bit of hell on earth run by Salt Lake City assholes in jackboots where they physically abused her, causing the PTSD and such.  We're suing the Magic Underwear off those Mormon freaks, so damned hard their polygamist/pervert ancestors will be reaching for their wallets.  Your program is abuse-free, then?  Young lady?"  


--- Quote from: "Darling Nikki" ---6) Chemical Restraints are never used.
--- End quote ---

Huh.  They don't accept diagnosed schizophrenics at CALO and the bipolar patients would have to be stable...so why are certain meds on tap at CALO:


--- Quote from: "CALO Coach's Handbook, pg. 14" ---Storing and Administering Controlled Medications
Controlled medications include, but are not limited to the following:
o Clonidine- (Clonidine is used to treat Tardive, not a neuroleptic)
o Strattera - (Non-stimulant for treating ADHD)
o Adderal, Ritalin, Dexadrine, (amphetamines, not neuroleptics/antipsychotics)
o Zoloft., Paxil, Wellbutrin, Focalin Prozac, Fluoxetine (Antidepressants)
o Metadate (ADHD Medication)
o Lithium (Mood stabilizing drug)
o Concerta (ADHD Med, narcolepsy med, other off label uses)
o Zyprexa  (atypical antipsychotic, can cause tardive)
o Muscle Relaxors (That's too vague, but muscle relaxers don't cause Tardive)
o Depakote (Epilepsy treatment, treatment of manic/bipolar, not a cause of Tardive)
o Narcotics (narcotics don't cause tardive, but "Narcotics" is too damn vague a description)
o Trileptal (anticonvulsant/mood stabilizing treatment, not a cause of Tardive)
o Risperdal (atypical antipsychotic)
--- End quote ---

Along with this warning in the Coach's Handbook:


--- Quote from: "CALO Coach's Handbook, pg. 14" ---Administering staff is to be aware of symptoms indicative of tardive
dyskinesia, a neurological syndrome caused by the long-term use of
neuroleptic drugs. Neuroleptic drugs are generally prescribed for
psychiatric disorders, as well as for some gastrointestinal and
neurological disorders. Tardive dyskinesia is characterized by repetitive,
involuntary purposeless movements. Features of the disorder may
include grimacing, tongue protrusion, lip smacking, puckering and
pursing, and rapid eye blinking. Rapid movements of the arms,legs, and
trunk may also occur. Involuntary movements of the fingers may appear
as though the patient is playing an invisible guitar or piano.
--- End quote ---

"Long-term" neuroleptic use can cause Tardive dyskinesia or one of it's variants.  Long-term use to the point of dyskinesia indicates an unstable condition, which would make the patient untreatable at CALO.  Why such concern over Tardive?

Massive doses over a relatively short period of time can cause Tardive, too.  It's interesting to note the Coach's Handbook doesn't mention dyskinesia can be permanent,  even after ceasing treatment with neuroleptics.  

There's the Clonidine in the med cabinet, too.  It is generally used to treat high blood pressure, but Clonidine has some interesting off-label uses.  It can be used to ease opiate withdrawal, and to treat symptoms of Tardive dyskinesia associated with neuroleptics.  Clonidine is an ?2 adrenergic agonist.  It's highly suspicious to have Clonidine present with neuroleptics like Risperdal and Zyprexa.  Patients' medical records from RTC's might show no diagnosis of Tardive, yet symptoms of Tardive are noted elsewhere in the records, perhaps in the nursing records.  Program survivors chemically restrained with antipsychotics who have their medical records should check for any changes in medication 2-4 weeks before their discharge date.  Look to see if an agonist like Clonidine or Naltrexone was added to your regimen.  If you see that an agonist was introduced, you were being "cleaned up" for discharge.

INVESTIGATORS:  IF KIDS ARE REPORTING THE USE OF ANTIPSYCHOTICS AS RESTRAINTS AND YOU CANNOT FIND ANY RECORD OF THEIR USAGE IN THE RESTRAINT LOGS, YOU ARE LOOKING IN THE WRONG PLACE.  ASK TO SEE THE MEDICAL/MEDICATION RECORDS OF PATIENTS WHO WERE RESTRAINED.  FIND THE MEDICAL DOCUMENTATION WITH THE SAME DATE AS THE RESTRAINT.

THE PROGRAMS ARE HIDING CHEMICAL RESTRAINTS IN THE MEDICAL RECORDS AS "MEDICATION".   TRUSTING PROGRAMS TO BE ETHICAL IS A MISTAKE THAT WILL COMPROMISE ANY INVESTIGATION.

Father Muldoon:
The following would be a partial list of the type of teenager CALO would specialize in treating:

A teenage adoptee struggling to connect with parents and caregivers
A teen who has been physically, emotionally, or sexually abused and is now acting out behaviorally
A teen who has survived a trauma and cannot maintain emotional control
A foreign-adopted teen who is not fitting in at home or at school and is draining emotional resources from his/her adopted family
A teen with anger control issues and a history of abuse or neglect
An untrustworthy and sexually promiscuous teenager who does not enjoy deeper connection with family or caregivers

Anonymous:

--- Quote from: "Father Muldoon" ---The following would be a partial list of the type of teenager CALO would specialize in treating:

A teenage adoptee struggling to connect with parents and caregivers
A teen who has been physically, emotionally, or sexually abused and is now acting out behaviorally
A teen who has survived a trauma and cannot maintain emotional control
A foreign-adopted teen who is not fitting in at home or at school and is draining emotional resources from his/her adopted family
A teen with anger control issues and a history of abuse or neglect
An untrustworthy and sexually promiscuous teenager who does not enjoy deeper connection with family or caregivers
--- End quote ---



Wow.  I fail to see a need for residential treatment for the types of problems listed.  It seems possible that a child suffering from abuse and neglect might find being shipped away from home to an RTC would be further traumatized.  

I see nothing on this partial list of problems CALO claims to treat that would require a  medicine cabinet containing antipsychotics, either.  How did CALO get JCAHO accreditation?  Is there a hospital connected with them?

Anonymous:
How did they get certification? Here is their quality report link on the Joint Commission site. Have complaints been filed with them yet? I have been told that a report on file with them is an important part of the overall grievance procedure.

http://www.qualitycheck.org/qualityrepo ... oid=459885

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