Fornits
Treatment Abuse, Behavior Modification, Thought Reform => Facility Question and Answers => CALO - Change Academy at Lake of the Ozarks => Topic started by: Che Gookin on May 16, 2009, 10:33:35 AM
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A birdie came to me and sat on my shoulder...
It whispered into my ear..
Che.. Che.. you sexy thing.. I saw your sig... I work and I repeat, "I work at CALO and they have done me wrong."
Well not a direct quote, but none the less...
The little birdie asked me, "What can I do to help?"
I replied, "Send me your documents."
The little birdie has delivered:
First five pages...
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Next 5 pages..
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next 5 pages of epic lollerskates...
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Change Academy Lake of the Ozark
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I'm sure it is, but do these dogs get to enjoy hour long pressure point holds like the kids do?
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More of the good stuff...
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More and more and more...
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And the good times keep rolling.
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Hey, phone numbers!
Jennifer Woodard I minute (808) 927-1938
Tyler Farr I minute (816) 365-4035
Steve Peer 5 minutes (513) 964-6053 or (602) 620-3808
Nathan Asbell 15 minutes (208) 757-8949
Carl Vigil 20 minutes (573> 3A2-1821or (719) 534-3328 or (719) 534-3354
Landon Kirk}7 minutes 302-7317 or 746-1715
Ken Huey 35 minutes 346-7797 or 746-6331
Matt Fuglsang2T minutes 348-3204 or 746-0565
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almost finished..
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The end for the staff manual..
Not sure why pages are missing, but I'll ask my contact to provide them if they can.
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CALO Suicide Plan
CALO Staff Coaching Tips
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There are people who don't believe the extreme, sadistic abuse reported by survivors could occur in an RTC.
They think:
"Some state agency has to oversee programs for teens. I thought a place had to be licensed to work with kids. right?"
Ya think? No state or Federal agency claims full responsibility for overseeing private RTC's. Programs call themselves "academies" and "schools" to avoid potential run-ins with the Dep't. of Mental Health and license issues.
"The parents would know if their kids were being abused from phone conversations or letters"
Some parents do know about the abuse and want the debasing and torture kicked up a notch, or wish they could join in. Most are clueless because there is no unmonitored communication with their kids and the program's "professional" team tell them the kid is playing the parents as suckers, they're weak if they cave to his narcissistic manipulation and withdraw him, and premature withdrawal limits your child's future to two possibilities: death or jail, either result reached in some horrible, sick way with the selfish intent of bringing shame upon the family's good name in the community. No one wants to be the parents of a Columbine Kid.
"No one could even treat a dog like these kids say they were treated"
That's true. Dogs are free from coercive treatment/physical abuse at CALO and any kid would gladly take a dog's place.
If the dogs try to relieve themselves indoors, they should be led outside right away and not yelled at, spanked or hit.
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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.
That's not forthcoming with the facts about the effects of Tardive and it's variants, which can be permanent:
"Other closely related neurological disorders have been recognized as variants of tardive dyskinesia. Tardive dystonia is similar to standard dystonia but permanent."
"...Tardive dyskinesia may persist after withdrawal of the drug for months, years, or even permanently"
What neuroleptic/antipsychotic meds are being used at CALO?
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)
Risperidal and Zyprexa are the only two atypical/neuroleptics CALO claims, but this list "is not limited to" what is shown.
Remember:
Tardive dyskinesia most commonly occurs in patients with psychiatric conditions who are treated with antipsychotic medications for many years. One study reported that within the first four years of using antipsychotic medications, 18.5 percent of young adults develop symptoms.
The use of antipsychotics on children as chemical restraints must stop, the risk is too great.
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They tell the staff : Fake it till you make it ?!?
Thats hilarious!
What a great approach...
It only shows, who works at CALO - really educated professionals, right.. :jawdrop:
From their web :
Closeness is communicated by students wearing a green shirt/sweatshirt. The shirt/sweatshirt helps all recognize the need for the students to be kept safe and assisted in regulating their emotions, affect and behavior.
That is all the parents learn about green shirts...not a word about the reality of it.
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These people are really into Attachment Therapy (red flags are a-flyin'). Specifically, the work of:
Daniel A. Hughes—
- Clinical psychologist in Waterville, Maine.
- Specializes in child abuse and neglect, attachment, foster care, and adoption.
- Cites, employs, and uses some of the frameworks of Milton Erickson, Connell Watkins, Nancy Thomas, Deborah Hage, Allan Schore, Stanley Greenspan, Ann Jernberg and other therapists and clinicians.
- Utilizes a "psychodynamic perspective in interpreting for a child and his parent how past experiences of abuse and neglect are affecting his current affective, perceptual, and cognitive experiences and his related behaviors."
- Works with treatment centers such as the Attachment Center in Evergreen, Colorado and with Villa Santa Maria in Albuquerque.
- Recognizes that traditional interventions of play therapy, parent education, and cognitive behavioral techniques are not sufficient to effect significant progress with the poorly attached child.
Villa Santa Maria has other TTI connections ... and wasn't there a kid who was killed a few years ago in Colorado, actually literally squashed to death by her therapists?
I would hunker a guess that a fair chunk of the clients at CALO are adoptees who "don't demonstrate enough affection" towards their adoptive parents.
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Ursus, From My little birdie:
Whomever it was that posted about the kids being a bunch of adopted kids, hit it right on the head.
Over half are adopted from the orphanages in Eastern Europe.
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Ursus, From My little birdie:
Whomever it was that posted about the kids being a bunch of adopted kids, hit it right on the head.
Over half are adopted from the orphanages in Eastern Europe.
Given the punch the U.S. market has been hit with, I guess the industry is looking for other territory to feed off of! :D
...'Course that punch came well after CALO was already established. I guess CALO must think they are in the right place at the right time, huh?
Propaganda about Attachment Therapy and its accompanying "Disorder" (which, btw, is completely bogus) is aimed at a niche market of adoptive parents. Probably all those baby boomers who didn't already have kids of their own, for some reason or other...
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Well remember the adopt a starving kid from Romania craze way back when? Most parents ended up with some well adjusted kids, but keep in mind a lot of them survived some hellish conditions in state run orphanages. One of the Whitmore parents told me all about it a while back. She adopted a great kid from Romania and Whitmore did a number on the poor kid. Thank god the parent her kid out in time. Last I heard the young lady was doing just fine despite the BS diagnosis and Whitmore.
I'd bet most of the kids adopted out of these Eastern Euro orphanages are doing just fine today, but like the rest of the world their specific population probably has problems just like any other kids. Leave it to the Teen Gitmo association to find away to spin it to their profit margin's advantage.
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Okay... The three posts following this one will contain the entirety of the CALO Coach's Handbook, transcribed for posterity as well as for those unable to handle the sheer enormity of the download. Page numbers refer to the original document (not the IMG download number, posted by Che earlier on this thread).
There are two holes, namely pages 27+28, and 39 (original page numbers). I'll edit those in if/when the material becomes available.
Breakdown / Particulars:
CALO Coach's Handbook, pp 1-15 (http://http://www.fornits.com/phpbb/viewtopic.php?f=9&t=27533&p=332051#p332049) (#1/3)
Communication, Medication
[/list]
CALO Coach's Handbook, pp 16-29 (http://http://www.fornits.com/phpbb/viewtopic.php?f=9&t=27533&p=332048#p332050) (#2/3)
Canine Therapy, Green Shirts, Stewardships, Run Plans
[/list]
CALO Coach's Handbook, pp 30-46 (http://http://www.fornits.com/phpbb/viewtopic.php?f=9&t=27533&p=332048#p332051) (#3/3)
Attachment & Trauma, How to be a Great Coach
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CALO Coach's Handbook
TABLE OF CONTENTS
COMMUNICATION.................2
MEDICATION ADMINISTRATION.................7
CANINE THERAPY.................16
GREEN SHIRT REGULATIONS.................2I
STEWARDSHIPS.................25
RUN PLAN PROCEDURES.................27
RUN TEAM ASSIGNMENTS.................29
ATTACHMENT AND TRAUMA.................30
COMMUNICATION
As coaches at CALO, our chief responsibility is to create safety. This allows opportunities for students to practice having relationships in a nonthreatening environment. Communication is essential in creating a safe environment. Communication is encouraged through Emails, telephone calls, and personal communication both verbal and written.
Emails
All staff members have email addresses and important communications are posted daily. Important communications concerning staff scheduling and pay role should be sent via Email. To communicate concerns concerning the students coaches should Email "allstaff". An email must be sent if any of the following concerns arise:
- A student becomes a safety concern.
- A student harms themselves or others.
- A student appears to be a run threat or a run risk.
- A student is placed in a therapeutic hold.
- A student is unusually quiet.
- A student is unusually anxious.
- A student is thought to be involved in inappropriate sexual behavior.
- An incident report is required.
Phone Communication
If immediate information is required for the safety of the coaches and students, call the appropriate Therapist or Administrator. However, please limit phone calls to emergencies and immediate safety issues.
- A therapist should be called if:
- A student harms self or others.
- A student runs or threatens to run.
- A therapeutic hold is used.
- The coaches believe a student is involved in inappropriate sexual behavior.
- There is a Medical Emergency.
- A student makes suicidal thoughts, threats or attempts.
- An administrator should be called if,
- There are insuffcient ratios on shift.
- There is a Medical Emergency
- A coach is unable to perform theirjob.
- The facility becomes unsafe for students or coaches.
- Coach Cell Phones- Nextel cell phones are available for the residential coaches to facilitate communication. Each phone is equipped with a "Direct Connect" feature that allows the phones to be used as a walkie-talkie. Each group of coaches is required to carry a phone with them at all times. This includes off-campus and aquatic activities. Nextel phones:
- Are to remain in staff possession at all times.
- Must be charged each night by the night shift.
- Should take the place of personal cell phones while coaches are on shift.
- Will be utilized in the event of a run.
- CALO Phones As we provide World Class treatment to students, families and education consultants, it is critical that we provide World Class communication as well. As coaches we must ensure all phones calls are answered. Phone calls will be answered by administration from 9:00 AM to 5:00 PM. Coaches must answer all other phone calls, and messages must be sent via email to the appropriate persons.
- Student Phone Calls
As part of treatment, students are to have regular communication with their primary care givers. As a coach we must utilize the Q-15 to ensure these communications are taking place appropriately and on time. After each communication a coach must document in the phone log the details of the conversation, and the emotional state of the student during the communication. When assisting a student make a phone call:
- A coach must dial the phone number and personally ask for the appropriate person.
- When the phone is answered a coach must prepare both parties for the phone conversation explaining time frames.
- A coach must explain that if the conversation is not appropriate, or if the student proves unable to emotionally regulate, the coach will hang up the phone and end the conversation.
- A coach must document in the phone log what the student talked about, and the student's emotional state during the conversation.
- A coach must be present at all times during a phone conversation.
Personal Communication
It is critical that personal communication occur throughout the day. This information is passed on both verbally and in written format.
Verbal
As each shift lead prepares to begin a shift they need to converse with the previous shift lead and gather any specific information concerning the students. This information needs to be passed on to the coaches via the Q-15. Throughout the shift:
- The coaches must communicate student progress, misbehavior, or illnesses.
- The coaches must communicate activities planned, and any changes in the schedule.
- The coaches must communicate any new medications.
- The coaches must communicate green shirt progress.
- The coaches must communicate specific problems or concerns.
- The coaches must communicate their location.
- The coach cell phones must be worn at all times.
Written communication
Each shift should end with the completion of the appropriate paperwork. This paperwork is critically important in communicating important information to therapists and subsequent coaches. Ultimately it is the shift lead's responsibility to ensure that all written communication is completed before he or she leaves.
- Shift Reports
- Must include student's name, staff name, date, and shift.
- Need to be a detailed description of student's mood, behavior, affect, and activities throughout the day.
- Are not travel logs of the day's activities; it is more important to describe how the activities were done rather than what the activities were.
- Will be read by therapist and coaches.
- Need to be done every shift on every student.
- Incident Reports
- Must be completed before the coach leaves shift.
- Must be specific and objective.
- Must be sent out in an "allstaff" email.
- Must list the steps taken in accordance with PCS training.
- Lead Notes
At the end of each shift the lead should send out a brief "allstaff" email listing each student and any important information concerning that student. In this email:
- Green shirts should be listed.
[li]New medication information should be passed along. - Specific concerns should be communicated.
- Appointments should be listed.
[/li][/list]
Medications Administration
A medication is defined as, "Any substance, other than food or devices, that may be used on or administered to persons as an aid in the diagnosis, treatment, or prevention of disease or other abnormal condition." This includes any product designated by the FDA as a medication or drug, including vaccines, diagnostic and contrast agents, respiratory therapy treatments, sample medications, prescription medications, or over-the-counter medications. For the purposes of accreditation, herbal remedies, vitamins, nutriceuticals, and health supplements are considered over-the-counter medications."
Prescribed Medications Procedures
CALO procures, administers, and stores prescribed drugs, and monitors their effects on students. The following procedures ensure that these functions are carried out in a manner that ensures the safety of our students.
Student Specific Information
Information relating to a student's medication management is located in his/her Application for Admission, Psychosocial Assessment a copy of which is kept in the Infirmary/Dispensary Medical Binder with the student's Medication Sick Call Record. This information includes:
1.) The student's age.
2.) The student's gender.
3.) A list of current medications.
4.) Any past medications.
5.) A drug and alcohol use/abuse history (if applicable).
6.) Any medical diagnoses and concerns.
7.) The results of relevant blood and laboratory screens.
8.) All known allergies and sensitivities. This information is reviewed with all staff working directly with the student at the day of enrollment during the
Initial Student Treatment Team Meeting.[/list]
Medications Training
- All residential staff receives training from the CALO Nurse.
- Content of training includes:
- Types and nature of psychotropic medications typically used by students enrolled in CALO.
- Side effects of typical medications and how to monitor.
- Adverse effects of missing a dose or taking too much, and how to monitor.
- Storing medications under proper conditions of sanitation, temperature, light, moisture, ventilation, segregation, safety and security.
- How to administer.
- What to do in the event of a serious adverse drug reaction.
- How to handle controlled medications.
Receiving and Managing Prescribed Medications
- Student medications can be accepted at enrollment/admission/intake only if:
1.) The medications are provided by the parents/guardians directly.
2.) The medications are contained in their original prescription bottle/containers.
- When medications are received (initially or after procurement), they are double counted, verified, and recorded on the Medications Count Log Form for each student. This means staff must count and verify the amount of medication received.
- All medications are counted and verified twice a week, and recorded on each student's Medications Count Log Form. Counts are checked with administration record (Medications and Sick Call Record) to verify accuracy of count and administration history. If there is a discrepancy, an Incident Report must be filed.
- Medications are stored in the Infirmary/Dispensary Medications Closet in the Administration building at aII times. (See procedure for Storage of Prescribed Medications below).
- Prescription changes, either in dosage or schedule, are recorded on the Medications and Sick Call Record Form only after receipt of a new prescription from the prescribing physician. Care should be taken to clearly document dosage and schedule on this form so that confusion is avoided.
Procuring Prescribed Medications
- Student should enroll in CALO with enough medication for at least the first 30 days of the program. This will alleviate the need for CALO to procure prescription medications immediately upon enrollment.
- If a student's prescription medication is lost or destroyed, or the student did not enroll with the amount needed to complete the program, the following procedures apply:
- The residential staff immediately informs the Nurse of the problem.
- The Nurse contacts the parent(s)/guardian(s) of the student.
- The staff nurse obtains the medications from a pharmacy, and delivers the medication to the Infirmary.
- The Nurse documents the medication receipt.
- The Nurse verifies the prescription.
- The Nurse inventories and records receipt of the medication on the Medications and Sick Call Record Form.
- Medications ordered by an independently licensed physician for a student at CALO while enrolled:
- Physician signed,legible, and complete medication orders (including usage directions, generic authorization, and refill status) are transported to an independent pharmacy for dispensing within one business day of receipt.
- A copy of the original prescription is placed in the student chart/fiIe.
- Instructors make necessary changes/additions to the Medication Sick Call Record for the student indicated.
- Illegible prescriptions are given directly to the Nurse who then contacts the prescribing physician's office directly and clarifies the order.
- Medications required for urgent or emergent conditions after hours should be obtained through the Emergency Room pharmary at Lake Regional Hospital in accordance with standard emergency procedures.
Administering Prescribed Medications
- One staff person monitors the students and insures only the student being called to received medications is near the staff person administering the medications. The other staff person is to administer medications to one student at a time.
- The staff person administering the medications will:
Medication and Sick Call Record Form from the team's Medication Log Binder.
2.) Identify from the Medications and Sick Call Record Form which medications to pull from the medications closet, and the correct dosage of each.
3.) PuIl the student's medications from the medical closet.
4.) Verify the medication is not expired or damaged.
5.) Call a single student forward to receive his/her medications.
6.) Verify the right student is receiving the medications (with two identifies).
7.) Verify the correct medication time and dosage (as indication on the Medications and Sick Call Record Form) with the label and the student.
8.) Observe the student taking the medication to ensure he/she swallows it and does not "cheek" or hide the medications for later abuse. Inspect the student's mouth after swallowing the medication. Steps include:
9.) Staff hands the medication(s) to the student. Never put the meds on the table and let the student grab them, as the student may knock the medication on the floor.
10.) Student should then place all the medication(s) in his/her mouth. If they are unable to swallow all medications at one time, student should have staff retain the extra, until ready repeat these steps.
11.) Once the meds are placed in the student's mouth, he/she should hold the hand the medication was given in to prove the medication is in the student's mouth.
12.) The student should take several swallows of water to decrease the risk of "cheeking" the medication. The student may not take any medication without water unless it is chewable or dissolvable.
13.) Staff then has the student place the forefingers on each hand inside his/her cheeks to expose all gum area. He/she then lifts their tongue up and then places it down while looking up, so staff may inspect the roof of the student's mouth.
14.) The student then takes their fingers out of their mouth, and coughs.
15.) If during any of these steps the student acts like they are putting a medication in his/her pocket, staff requests that student to pull out their pockets.
16.) Record administration on Medications and Sick Call Record Form. Staff and student initial the form. Staff records the time the medication was administered next to the initials. The student must use their correct initials, not signs or symbols. If the student refuses the medication or to initial properly and Incident Report must be filed.
17.) Inform the staff nurse if a dose is missed or of any other mistakes/abnormalities.
18.) If a student refuses to take a prescribed medication, staff annotates the student's refusal on the Medications and Sick Call Record Form and immediately sends and Incident Report to the leadership team, and the student's therapist. The Clinical Director will discuss the refusal with the student's therapist for courses of action to pursue. Refusal to take prescribed medication is grounds for psychiatric hospitalization.
19.) Return the student's medications to the medication storage closet.
20.) Return the student's Medication and Sick Call Record to the Medical Binder.
21.) Repeat these steps for each student.
[/li][/list]
Monitoring Effects of Prescribed Medications
- Staff monitors student for medication effectiveness. Report ineffectiveness to the Therapist, Clinical Director, and the nurse.
- If an adverse drug reaction occurs (in accordance with the medications training descriptions of adverse reactions), administering staff is to take all necessary steps to insure student safety. If the reaction presents an imminent danger to the student (sever allergic reaction, loss of consciousness, etc.), then standard emergency medical procedures are to be initiated. If the reaction does not present an imminent danger to the student, closely and accurately document the reaction in the Medications and Sick Call Record Form and inform the leadership team.
- 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.
Serious Adverse Drug Reactions
- Descriptions of the typical medications used at CALO with common signs and symptoms of serious adverse drug events and toxicity is maintained by the nurse in the medication closet. This is used for reference in the case of a serious drug reaction.
- Staff immediately notifies the leadership team and nurse. If the effects have resulted in a medical emergency, transport to Lake Regional Hospital immediately.
- Emergency facilitator notifies the student's parent(s)/guardian(s).
- Staff fills out an Incident Report. If the effects have resulted in a medical emergency, the Clinical Director reports the incident to the Missouri Department of Human Resources, Child Care Division.
Storing Prescription Medications
- When students are on campus, prescription medications are kept locked in the medications closet of the administrative building at CALO, unless medications require cold storage. If cold storage is required, medications are clearly marked and stored in a locked container in the infirmary refrigerator.
- When students are off campus, medications are maintained by the residential coaches in the Medication Lock Box (a box designated for the storage of medications). The box is kept locked and away from the students in the cab of the CALO vehicles at all times.
- Appropriate paperwork and documentation must be completed.
- When storing medications in the medication lock boxes or in the locked Medications Closet, staff ensures medications are stored at the correct temperature, free from contamination or spoilage.
- Staff inspects the medications closet twice a week during medication counts to ensure there are no expired medications, condensation, or mold, and verify the medications are clearly labeled.
Storing and Administering Controlled Medications
- Controlled medications include, but are not limited to the following:
- Clonidine
- Strattera
- Adderal, Ritalin, Dexadrine, Focalin
- Zoloft, Paxil, Wellbutrin, Prozac, Fluoxetine
- Metadate
- Lithium
- Concerta
- Zyprexa
- Muscle Relaxors
- Depakote
- Narcotics
- Trileptal
- Risperdal
- These medications require special handling. The following procedures will be used:
- Inventory medications upon receipt and twice a week there after to insure proper dosing, etc. If any discrepancies are found and Incident Report should be filed.
- Double lock. Store medications in a locked container inside a locked area. Medications are kept locked inside the locked medications closet or inside the locked support vehicle. No student should be allowed in the medications closet for any reoson. No student should be allowed to transport medications in the lock box.
- Use two means to identify the student who is taking the medication(s). This can be staff recognition confirmed by another reliable source. A student room number is not an appropriate identifier. Examples: Staff recognition, date of birth, etc.
Over-The-Counter Medications
Over-the-counter medications include: pain medication, anti-bacterial lotions or creams, antiseptics, cough drops, cough medicine, foot powder, etc. Over-the-counter medications are found in the first aid kits and additional supplies are found in the infirmary/dispensary. Over-the-counter medications must be controlled and administered according to the following procedures:
- Emergency medications are always kept locked in the medications closet, or under constant surveillance by staff.
- Medications are administered strictly in accordance with the instructions on their containers, and only when there is a verifiable need.
- All cough and cold medications should be verified appropriate by the nurse.
- Appropriate paperwork and documentation must be completed.
When a student indicates to a staff member that he/she is in physical pain, the staff member does a preliminary assessment to determine reliability and extent of the student's complaint. If the staff member deems the pain legitimate, the staff member reports the pain on the Medications and Sick Call Record and takes additional appropriate action based on the staff member's pain management training. This action consists of administering over-the-counter pain medication if the pain is minor, or coordinating for the staff nurse to make an assessment of the pain. Staff records the administration of the over-the-counter medications on the Medications and Sick Call Record Form. The same procedures should be followed as if the staff were administering prescription medications.
CALO staff can provide the students with a variety of over-the-counter medications for minor pain and illnesses. Residential staff is trained in identifying the illness, pain management and administering the medications. The staff nurse is responsible for medication replacement and checking expiration dates.
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Canine Therapy
Philosophy Behind Canines
Our Dog training program comes in part from the book called: THE LOVED DOG. The author was an abused child, and the basis for the book is to teach dogs to behave appropriately with love and kindness while gaining their respect as the owner/trainer. While at CALO all students will have the opportunity to spend time with the canines and learn to invest in their physical and emotional needs. While this interaction would be beneficial for all adolescents, it is particularly productive for the specific students we work with at CALO. The canine therapy program offered at CALO provides a safe opportunity for students to practice appropriate attachments with very safe and very forgiving creatures. Some students will have the chance to adopt a canine that will eventually go home with the student encouraging a long-term relationship. The instinctive ability for the canines to love and forgive immediately provides a unique opportunity for the students to practice attaching with a non-threatening friend.
Canine Care
Proper behavior with the dogs is essential for the learning process of the students. Throughout all canine time students must be demonstrating love. Coaches have an important opportunity and responsibility to demonstrate appropriate interaction with the canines. Coaches, please be prepared to get wet and dirty while coaching the students with the dogs. The students will follow your example. Please remember that the canines are the property of CALO and/or a student, and everyone is responsible for the health, and safe care of each dog.
Daily Checklist
Posted above the dog kennels is a checklist of daily interactions that must take place to ensure the safety and productivity of our canines. It is the coach's responsibility to ensure that the students perform all of the daily tasks in a loving and respectful manner. The following is a detailed description of each interaction.
7:00 AM
- Dogs should be let out at 7:00 each morning to poop before anyone pets or interacts with the dog.
- While the dogs are pooping, the kennels should be washed clean of any urine or excrement.
- When the dogs return from pooping they should be given positive reinforcement via petting or doggy treats.
- After positive reinforcement, up to two cups of food and clean water should be given to each dog.
- After their breakfast the dogs will poop again! Allow them time to poop a second time before returning them to their kennels.
8:30
- Let each dog out on a leash and escort them to an appropriate place for them to poop.
- When each dog has done its business, escort the dogs indoors to the great room and spend quiet time with the dogs indoors practicing leash training reinforcing positive interactions with doggy treats.
- Return the dogs to their kennels.
10:30
- Let each dog out on a leash and escort them to an appropriate place for them to poop.
- When each dog has done its business, escort the dogs indoors to the great room and spend quiet time with the dogs indoors practicing leash training reinforcing positive interactions with doggy treats.
- Return the dogs to their kennels.
12:30
- Let each dog out on a leash and escort them to an appropriate place for them to poop.
- On Monday, Wednesday, and Friday the dogs need to be bathed in the far corner of the lowest parking level near the hose. Shampoo must be applied and rinsed appropriately.
- On Tuesday, Thursday, and Saturday the kennels must be washed out. If they don't appear dirty, wash them anyway to keep the dogs from getting sick.
- Kennel dogs and make sure they have clean water.
2:00
- Let each dog out on a leash and escort them to an appropriate place for them to poop.
- When each dog has done its business, students are free to have interactive free time with their dogs.
- Kennel dogs and make sure they have clean water.
4:00
- Let each dog out on a leash and escort them to an appropriate place for them to poop.
- Provide each dog with up to two cups of dog food and clean water. Allow them time to eat at their own pace.
- While still on the leash take dogs out to an appropriate place to poop. They need to poop at this time!
- After dogs have done their business, escort them indoors where they will spend the remainder of the after noon.
7:00
- Leash dogs and escort them outside to their appropriate place to poop,
- When each dog has done its business, provide the dogs with plenty of clean water and return them to their kennel where they will spend the remainder of the night.
10:30
- One night staff carrying a charged flashlight and radio will let each dog out on a leash individually allowing one final poop before they are returned to their kennels until morning.
General Canine Guidelines
Canines and Green Shirts
Please show kindness and respect to dogs at all times. Call the dogs by name and encourage students to do so. Watch students closely during canine time and redirect when they are inappropriate. If students continue to act out with dogs, they should be asked to sit out for a while and someone else should take over. NEVER let a student hit, kick or mistreat the animals. Unsafe behavior should be communicated to other staff through the appropriate use of a Green Shirt. Although some students will use the green shirt to avoid time with dogs, all students should be encouraged to do canine time if they are in a good place. Any student in a Green Shirt must have their dog on a Ieash at all times. This is to ensure that an unsafe student is not required to chase their dog if it runs away.
Training Time with Canines
During training time doggy treats should be used as an incentive for the dogs to learn. Limit treats for training to no more than 4 per student per day. (This is not a meal, just an incentive to learn.) Each treat can be broken into small pieces; a dog may also lick the treat for the same result during training.
Indoor Time with Canines
Indoor time is extremely important for the canines. Begin by bringing the dogs indoors each day for small periods of time. If the dogs try to relieve themselves indoors, they should be led outside right away and not yelled at, spanked or hit. As they continue to show good behavior, their time indoors will increase. When they are 6 months or so, they should be able to spend lots of time indoors walking about without staff or students. Many toys should be available for the dogs during this time since the students will be in school, doing chores, and busy with other activities. Dogs should never be brushed, washed or groomed indoors.
Kennel Time with Canines
The longest a dog should ever be Ieft in a kennel during the day is 2 hours. The longest a dog should ever be left in a kennel during the night is 9 hours. Water should be fresh each day and changed often when temperatures are above 85 degrees. The dogs should be bathed and brushed two or three times per week.
Free Time with Canines
During free time and training time dogs should be encouraged to exercise while interacting with the students. Fetching, running, walking and playing with the students are encouraged during each outing. The dogs will enjoy swimming in the lake when temps and humidity are high.
Canine Health
Staff and students will attend regular vet appointments. Dogs will be spayed and/or neutered when vet advises. Health issues, changes in behavior & appearance should be communicated with the coach supervising canine therapy via email. If there is a medication for any of the dogs, wrap the pill in a piece of cheese and follow the instructions on the bottle. If you cannot participate with the dogs due to allergies, or some other legitimate reason, please let Landon Kirk know so that we can adjust your time with the dogs accordingly.
Canine Therapy
Students will participate once a week in an hour-long canine therapy session where they will be coached and taught how to train their dog. Throughout the following week students should reinforce and practice what was learned during their canine therapy.
Green Shirt Regulations
Safety And The Green Shirt
The one rule at CALO is that each student must regulate his or her own emotional, physical, mental, sexual and psychological safety at all times. If a student is unable to do this on their own, it is the coaches responsibility to help give that student the additional support and coaching they need. Students must be guided towards good safe choices while they experiment with their relationships with the coaches. If a student makes an unsafe decision, or is unable to regulate his or her own emotional, physical, mental, sexual or psychological safety, that student is placed in a green shirt indicating to themselves and others that they are not currently in a safe place, and/or they are not making safe decisions.
Not A Punishment
The purpose of the green shirt is not to "punish" the student for behaving badly; it is to keep them safe. Consequences occur naturally when students who make unsafe decisions need stay close to the coaches. Coaches must be willing to provide the students with "time in" for additional coaching rather than "time out" for bad behavior. When a student is in a green shirt, a coach will be assigned to that student for the entirety of that shift. The student is to remain in a coach's "back pocket" for the entire shift indicating their willingness to make safe decisions. This means the coach must be able to see and hear a student in a green shirt at all times. It is best to have the student within arms length of their assigned coach at all times. The coach's responsibility is then to provide the unsafe student with the support and coaching they need in order to make safe decisions. Coaches must pass on pertinent information to subsequent staff concerning the progress of the student.
A Time To Process
Placing a student in a green shirt provides coaches with excellent opportunities to process with the student. Being placed in a green shirt also allows students time to reflect, process, and come to an understanding of the events resulted in the student's unsafe behavior. Once the student has deescalated, the assigned coach is to continually process with them. This does not mean pester, put down, condemn, criticize or make sarcastic comments to the student. We are here to help them regulate their emotions and keep them deescalated, and process with them in an attempt to increase their awareness and safety.
The Team Approach
When a coach thinks it is necessary to put a student in a green shirt they need to discuss it with other coaches or therapists if possible. This "team approach" is to ensure that we do not place a student in a green shirt as a punishment. When a student makes a mistake but is self-regulating well, and is able to process, it may not be necessary for them to be in a green shirt. Their willingness to process is the key. However, if it is necessary to put a student in a green shirt, an "all staff" email must be sent out as soon as possible. The coach who placed the student in a green shirt needs to send this email. However, the shift lead is ultimately responsible to make sure an "all staff" email is sent out with an incident report whenever a student is placed in a green shirt. Subsequent coaches who read their emails before shift will then be able to effectively process with that student.
Chaotic Environments
Refusing to follow staff instructions creates a chaotic environment and is unsafe. Students should be given every opportunity to make good choices, and coaches should encourage cooperation in their approach with the students. However, if a student refused to follow a coach's instruction, it is unpredictable and unsafe. Coaches must follow the steps outlined in PCS before placing a student in a green shirt for failure to follow instructions. These steps are as follows:
1- Request for compliance
2- Mandate for compliance
3- Statement of imminent consequences
4- Verbal enforcement of consequences
Suicide Watch And Green Shirts
Suicidal thoughts and actions should immediately result in the appropriate use of a green shirt. When a student jests at the idea of suicide, it is unsafe. If a student makes attempts to self-harm, it is unsafe. That student should be put in a green shirt and remain with a coach for the remainder of the day. An incident report should be sent out in an "all staff" email informing the rest of the staff of the situation. With the prescription of a therapist, certain situations like suicidal thoughts and actions justify the necessity of having a student sleep in the commons area under the close supervision of the night staff.
Sexual Deviancy
Sexual deviancy is unsafe. If one student alone is involved in sexually deviant behaviors, a therapist should be involved in the decision to place that student in a green shirt. If two students are involved in sexually deviant behavior together, they must be separated immediately and placed in green shirts to keep them apart from each other, and close to the coaches until a therapist decides they are in a safe enough places to be taken out of the green shirts.
Green Shirt Expectations
A student in a green shirt must ask permission before doing anything. A student in a green shirt is expected to participate in school, therapy, and recreational therapy groups. During this time they must raise their hand to speak to staff members only. They are not allowed to speak to other students, especially students of the opposite gender. Students in a green shirt should have no interaction with the other students unless prescribed by a therapist. During canine time a student must keep their dog on a leash at all times. Under no circumstances are students in green shirts to leave the campus without the approval of their therapist or the Clinical Director.
Getting Out Of A Green Shirt
The only persons who can take a student out of a green shirt are their therapist or the Clinical Director. Therapists will be continually asking coaches for updates concerning the student's emotional physical, mental, sexual and psychological safety. It is critical in the therapeutic process that students have opportunities to repair with any necessary parties before they are removed from their green shirt. Length of time in a green shirt is dependant on how long it takes the student to demonstrate they are consistently in a safe place.
Stewardships
The responsibilities of the students shall be called "stewardships." The term "stewardships" denotes that the team as a whole depends on the labor of the team collectively in order to function in daily activities.
Daily Personal Stewardships
Each student is responsible for the cleanliness of his or her own room and living area. Stewardships shall not be considered complete until passed off by the coach assigned to the student, or the shift lead. Students are to never be in possession of chemicals (i.e. Windex, Formula 409, or any other cleaner). The staff assigned to the students in that room must spray the chemicals on the mirrors, window, and floors of the bathroom. If at any time the room becomes dirty or disorderly, the student may be asked to tend to that stewardship again. It should be an expectation of the students to maintain their stewardships in order to continue to participate in the other activities of the day. Daily personal stewardships include:
- Beds made.
- Floors in bedroom vacuumed.
- Dirty clothes in the hamper.
- Clean clothes hung in the closet or in the drawers.
- The air conditioner turned off.
- Surfaces in the room dusted and organized
- Counters cleaned and organized.
- Floors in the bathroom mopped.
- Mirrors cleaned.
Daily Group Stewardships
Throughout the day students will participate together to accomplish group stewardships. Opposite genders should never mix during this time. If at any time a student refuses to care for a stewardship, a natural or logical consequence should accompany this refusal to participate and the students should not be allowed to proceed with the daily activities. Daily Group Stewardships include:
- Washing the dishes in the kitchen.
- Sweeping the dining room floor.
- Cleaning the serving line.
- Removal of trash.
- Organization and cleaning of the great room.
- Organization of schoolrooms.
Weekly Stewardships
Once a week on Saturday morning, students will work on their weekly stewardships. Participation in these stewardships is required for weekend activities such as the YMCA, pizza, and movies. Deep Clean Stewardships include:
- Dusting the great room.
- Polishing kitchen stainless steel.
- Polishing the serving line stainless steel.
- Deep cleaning of the kitchen as directed by the kitchen manager.
- Vacuuming the great room.
- Cleaning the bathtubs.
[Pages 27, 28 are missing]
Current Run Team Assignments (August 7, 2007)
Jennifer Woodard 1 minute (808) 927-1938
Tyler Farr 1 minute (816) 365-4035
Steve Peer 5 minutes (573) 964-6053 or (602) 620-3808
Nathan Asbell 15 minutes (208) 757-8949
Carl Vigil 20 minutes (573) 302-1821 or (719) 534-3328 or (719) 534-3354
Landon Kirk 27 minutes 302-7317 or 746-1715
Ken Huey 35 minutes 346-7797 or 746-6331
Matt Fuglsang 27 minutes 348-3204 or 746-0565
Jennifer's assignment = corner of Goldenrod and Bittersweet. This will close off the area to escape the fastest.
Caleb's assignment = corner of Anemone road and Bittersweet. This may prevent students walking to the Horny Toad and Shady Gator's
Tyler's assignment = Outside towards the back of the building before the new driveway.
Steve's assignment = Outside towards the front of the building after the new driveway.
Nathan's assignment = Outside towards the back near the water treatment plant.
Carl's assignment = Outside towards the front after the water treatment plant.
Landon's assignment = adjacent neighborhood patrol (the neighborhood north of CALO)
Ken's assignment = adjacent neighborhood patrol (the neighborhood south of CALO)
Matt's assignment = help where needed in the woods or roving in motorized patrol.
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Attachment ant Trauma
"It is critical for children to form healthy attachments to their parents if they are to proceed through the developmental tasks of life and have a working model for future successes and relationships."
What is the mission of CALO? CALO provides world class residential services for troubled adolescents. We facilitate lifelong attachment and healing between families and their children.
How is the mission accomplished? CALO provides a safe and secure base for families to explore, experiment, and develop healthy relationship and life skills. CALO believes intimate relationships are the best part of life and are critical for children to have a successful life.
CALO Guiding Concepts
- Children get what they need, not what they earn
- Nurturance is a right
- Fairness is getting what you need
- Change agent is relationships
- Permission to feel
- AII interactions are therapeutic opportunities
- Alliance not compliance
NON-CALO: Level System/Behavioral Modification
CALO: Nurturing, support, relationships[/list][/list]
NON-CALO: Confrontation
CALO: Joining--attunement[/list][/list]
NON-CALO: Attachment behavior avoided
CALO: Attachment behavior embraced[/list][/list]
NON-CALO: Structure
CALO: Rhythm[/list][/list]
NON-CALO: Time-outs
CALO: Time-in[/list][/list]
TERMS/DEFINITIONS
Students: The title we use for the adolescents in our program. Typical students will be between the ages of 13-16 upon admission and 14-18 at discharge.
Residential Coach: The front line, direct care staff. Residential coaches play a significant part of the change process in adolescents. Students spend most of their time in the structure of the program so all residential coaches, under the direction of the student's therapist and administrative team, need to know how to implement, model and coach students towards change.
Parent(s): Parents can visit CALO as often as clinically appropriate to visit their student. In facilitating attachment, having the parents involved in treatment and participating in the milieu is critical. Students don't earn time with parents and can request more contact with parents than weekly therapy if clinically appropriate. CALO requires all staff to introduce themselves to parents and to be of any assistance that the parents need. CALO especially wants parents to meet every worker over the phone. Students will tell parents "tales" and "stories" so the parents need to know each worker so there is some trust in clarification.
Bonding: Emotional events that evoke attachment behaviors; each bonding moment strengthens the connection/loyalty/bond to the attachment figure. Females talking about relationships, males golfing together, a son playing catch with his father, and a mother nursing her child are examples of bonding activities.
Attachment: An enduring and reciprocal process by which an emotional relationship develops with a specific person. Healthy relationships bring safety, comfort, trust, soothing and pleasure. Loss or threat of loss to the person evokes intense fear and distress. Having a relationship with a parent does not insure that the child is "attached" to her. Attachment refers to the unique relationship between child and parent through which the child is able to proceed with the major qualities of his own psychological development.
Attunement: "The intersubjective sharing of affect" (Stern, 1985). There are (or should be for healthy attachment) thousands of attunement experiences in the first two years of the mother-child attachment. Attunement between staff and student is being on the same emotional level and understanding without having to verbalize these emotions.
Affect: The non-verbal outward expression of inward feelings. "Affect is not just facial expressions but the whole non-verbal meaning in the person."
Affect Regulation: One's ability to appropriately bring mood and affect into harmony.
Milieu: Or the "environment" of the therapeutic model. The Milieu is usually the most significant part of the change process. Students spend almost all of their time in the milieu. Residential coaches are not just to create a bond with students but help adolescents regulate emotions for the rest of their life. Coaches should help sooth students, regulate, control rhythms, process, and hold students accountable with love in the daily interactions in the milieu.
Rhythms: As opposed to "structure" alone, living life in consistent rhythms helps students manage their moods and affect long-term. Students are more vulnerable to change and trusting of staff when adults caring for them are controlling the rhythms of the milieu. "S/he who controls the rhythms controls the house." Coaches should talk to the students about almost everything that is going on in their personal lives and on campus -- visits, activities, sessions, etc. Every change in the students schedule and structure alters the rhythm of the program. The more consistent the rhythms, the more vulnerable and trusting the students are of the staff caring for them.
Core Beliefs: Early experiences with caregivers shape a child's core beliefs about self, others, and life in general. Experiences of the baby and young child are encoded in the brain. Emotional experiences of nurturance and protection are encoded in the brain's limbic area) the emotional center. Over time, repeated encoded experiences become internal working models core beliefs about self, self in relation to others, and the world in general. These core beliefs become the lens through which children (and later adults) view themselves and others, especially authority and attachment figures. Core beliefs serve to interpret the present and anticipate the future.
ATTACHMENT THEORISTS
John Bowlby—Pioneer of attachment therapy. Developed attachment theory out of his work with abused children in England. Much of our understanding of attachment and trauma treatment stems from his initial work. Many other professionals have taken the reigns since then and have expanded upon his work.
CALO follows and implements the framework that Bowlby set forth as well as several attachment experts. Specifically, CALO follows the work of Daniel Hughes as he has extensive experience in residential treatment of attachment.
Daniel A. Hughes—
- Clinical psychologist in Waterville, Maine.
- Specializes in child abuse and neglect, attachment, foster care, and adoption.
- Cites, employs, and uses some of the frameworks of Milton Erickson, Connell Watkins, Nancy Thomas, Deborah Hage, Allan Schore, Stanley Greenspan, Ann Jernberg and other therapists and clinicians.
- Utilizes a "psychodynamic perspective in interpreting for a child and his parent how past experiences of abuse and neglect are affecting his current affective, perceptual, and cognitive experiences and his related behaviors."
- Works with treatment centers such as the Attachment Center in Evergreen, Colorado and with Villa Santa Maria in Albuquerque.
- Recognizes that traditional interventions of play therapy, parent education, and cognitive behavioral techniques are not sufficient to effect significant progress with the poorly attached child.
ATTACHMENT THEORY
Bowlby has stated that the most basic need humans have is to reach out and connect with someone. We have this need from our development in the womb. Children want to know -- "do I matter to you," "do you notice me," "can I depend on you?" Bowlby -- "unfortunately a mother [parent] can be physically present but emotionally absent."
BASICS:
- Infants are predisposed to be attached to caregivers.
- Infants seek proximity to parents in times of distress (survival, biological function)
- The child will organize own behavior and thinking in order to maintain those attachment relationships, which are key to psychological and physical survival.
- The child will often maintain such relationships at great cost to his/her own functioning.
- The distortions in feeling and thinking that stem from early disturbances in attachment occur most often in response to the parents' inability to meet the child's needs for comfort, security and emotional reassurance.
- In children, attachment to primary caregivers influences the child's physical, neurological, cognitive, and psychological development. It becomes the basis for development of basic trust or mistrust, and shapes how the child will relate to the world, learn, and form relationships throughout life.
- "All children, at the core of their beings, need to be attached to someone who considers them to be very special and who is committed to providing for their on-going care."
- "Children who lose their birth parents, especially those who have experienced the trauma of abuse and neglect, desperately need such a relationship if they are to heal and grow."
- "If children in treatment are not experiencing an attachment to a parent, whether because of lack of ability or opportunity, the therapist is greatly limited in her efforts to assist the child in beginning to heal and in wanting to work to become 'special' to self and others."
- "Stopping the abuse is not enough. The results of the abuse often live on within the child and render him unable to take advantage of the new opportunities presented to him."
- "To have a chance for a good life, he must be able to form a secure attachment with his new parents and develop healthy attachment pattems that facilitate his affective, behavioral and cognitive development." (S. Greenspan, 1988, 1989)
- Stern (1985) states that the infant's "first order of business" is to form the core sense of self and others.
- "The nature of the attachment to the mother influences all later socioemotional transactions." A "working model" for future relationships develops because of this parent-child relationship. (Schore, 1994).
- When the abuse is at the hands of his caregiver, a child is most likely to experience maladaptive attachment.
- Trauma impedes development of trust and subsequent development of self and ability to relate and attach to others.
- Schore (1994) stresses that the affect regulation and attunement experiences between the mother-child are the core of the child creating his origin of self.
- Kaplan (1995) states the parent-child attunement breaks down "whenever there is a consistent and prolonged loss of empathy."
- The child who has infrequent attunement experiences perceives himself as being flawed and often feels empty, hopeless, and helpless.
- "Children who are subject to profound neglect have few of the experiences of physical comforting and affection that are central to attunement and which are necessary for secure attachment."
- A critical or sensitive period for attachment is early in the child's life. The older the child, the higher the chances the student will be resistant to attachment.
- "Our hypothesis is that access to childhood pain becomes a powerful deterrent against repetition in parenting." -- Frailberg
- "Attachment is an addictive process -- the more you do it the more you like it."
- The symptoms of emotional loss are almost parallel to drug withdrawal.
HEALTHY ATTACHMENT
Healthy attachment occurs when the infant experiences a primary caregiver as consistently providing emotional essentials such as touch, movement, eye contact and smiles, in addition to the basic necessities such as food, shelter, and clothing. If this process is disrupted, the child may not develop the secure base necessary to support future healthy development.
* "The child discovers that he can develop himself as a worthwhile and competent individual without sacrificing the basic attachment with his parents."
* "Within a healthy attachment, discipline is a fact of life. The child may grumble, but he accepts the fact that one parental role is to teach...has basic trust that this teaching (though at times annoying) is ultimately given in his best interests."
The core beliefs of children who have experienced secure attachments in the early years are as follows:
Secure Attachment Core Beliefs:
Self: "I am good, wanted, worthwhile, competent, and lovable."
"My influence is felt as part of a family system."
"My needs will be constantly met by my parents because they love me."
Caregivers: "My parents are appropriately responsive to my needs, sensitive, dependable, caring, trustworthy."
"The world is safe and/or my parents will keep it safe."
Life: "My world feels safe; life is worth living."
"I know I will have repair when negative experiences occur."[/list]
CAUSES OF POOR ATTACHMENT
Factors which may impair healthy attachment include but are not limited to:
1.) Multiple caregivers
2.) Invasive or painful medical procedures
3.) Inconsistent or inadequate care at home or in day care (care must include holding, talking, nurturing, as well as meeting basic physical needs)
4.) Sudden or traumatic separation from caregivers
5.) Frequent moves and/or placements
6.) Hospitalization at critical developmental periods
7.) Neglect (of physical or emotional needs)
8.) Sexual, emotional, or physical abuse
9.) Chronic depression of primary caretaker
10.) Illness or pain which cannot be alleviated by caretaker
11.) Prenatal alcohol or drug exposure
12.) Neurological problem in child which interferes with perception of or ability to receive nurturing (i.e. babies exposed to crack cocaine in uterus).
Children adopted at birth can still have significant attachment issues -- we don't know all of the reasons why yet but it is believed some of the reasons are:
1.) Pre-natal-Drugs? Activity? Did not know about pregnancy?
2.) Birth trauma
3.) Ingrained desire to be with birth mother-smells, voice of birth mother in womb, activity of birth mother, did birth mother listen to music and adoptive mother didn't?
4.) Do adoptive parents have their own attachment issues? Are they guarding against bonding because afraid of losing child or view child as not of their "own?"
SIGNS AND SYMPTOMS
What Does Attachment Look Like?
Diagnosis relies heavily on events that happened, not the behaviors that are manifest. ODD, CD, ADHD, RAD can look a lot a like so it is the history that is really important.
On the outside, children with attachment disturbance often project an image of self-sufficiency and charm while masking inner feelings of insecurity and self hate. Infantile fear, hurt and anger are expressed in disturbing behaviors that serve to keep caregivers at a distance and perpetuate the child's belief that s/he is unlovable.
- "Perceive caregivers as violent, cruel, rejecting, and unpredictable. Safety is increased through avoidance, silence, denial of one's own...
[Page 39 is missing.]
- No signs of longing or distress when one caregiver leaves and another arrives.
Behaviors Associated with Problematic Attachment
Unable to engage in satisfying reciprocal relationship:
1. Superficially engaging, charming (not genuine)
2. Lack of eye contact
3. Indiscriminately affectionate with strangers
4. Lack of ability to give and receive affection on parents' terms (not cuddly)
5. Inappropriately demanding and clingy
6. Persistent nonsense questions and incessant chatter
7. Poor peer relationships
8. Low self esteem
9. Extreme control problems - may attempt to control overtly, or in sneaky ways
10. Poor cause and effect thinking:
11. Difficulty learning from mistakes
12. Learning problems - disabilities, delays
13. Poor impulse control
14. Other poor conscience developmental issues
C. Emotional development disturbed: child shows traits of young child in "oral stage"
1. Abnormal speech patterns
2. Abnormal eating patterns
D. Infantile fear and rage.
1. Chronic "crazy" lying
2. Stealing
3. Destructive to self, others, property
4. Cruel to animals
5. Preoccupied with fire, blood, and gore
E. "Negative attachment cycle" in family
1. Child engages in negative behaviors which can't be ignored
2. Parent reacts with strong emotion, creating intense but unsatisfying connection
3. Both parent and child distance and connection is severed
*** Clients with attachment disorders may also be sexually inappropriate due to poor boundaries and insight. At times, sexual inappropriateness may even be violent in attempts to connect with someone else. ***
Compromised Attachment:
Self: "I am bad, unwanted, worthless, helpless, and unlovable."
Caregivers: "Parents are unresponsive to my needs, insensitive, hurtful, and untrustworthy."
Life: "My world feels unsafe; life is painful and burdensome."[/list]
- Students with poor attachment are "Likely to experience deep shame, intense rage, pervasive anxiety, and extreme isolation and despair."
- "They are also likely to manifest a variety of destructive and selfdestructive symptoms whose functions are to attempt to make life bearable when it is lived outside the basic reality of interpersonal relatedness."
- "These children often make their new parents' love, support, guidance, and directions ineffective and permeated with stress, conflict, and disillusionment."
- They work very hard to control all situations, especially the feelings and behaviors of their caregivers.
- They relish power struggles and have a compulsion to win them.
- They feel empowered by repeatedly saying, "No."
- They cause emotional and, at times, physical pain to others.
- They strongly maintain a negative self-concept.
- They have a very limited ability to regulate their affect.
- They avoid reciprocal fun, engagement, and laugher.
- Avoid needing anyone or asking for help and favors.
- Avoid being praised and recognized as worthwhile.
- Avoid being loved and feeling special to someone.
- Enveloped by shame at the origin of the self.
PROGNOSIS OF UNTREATED ATTACHMENT AND TRAUMA
"The unsolved mystery is why, under conditions of extremity, in early childhood, some children who later become parents keep pain alive...we hope to explore these problems in the further study." - Frailberg
Children who never form secure attachments to adoptive parents often later seek out their primary abusive caregiver, searching for a connection to a parent, generally with no chance of either healing or developing a new pattern. They then wander the world, experiencing and causing pain and despair.
Adults with untreated attachment have high rates of conduct disorder and anti-social disorder. Issues that further interfere with one's ability to be successful in life.
COACHING
What Is My Job As A Coach? To mentor, engage, supervise and be an example of integrity to young adults at CALO. Effective coaching jump in the "mud" with students and climb out together. Coaches who utilize metaphors, clear boundaries, and who develop healthy relationships with the students at CALO are the most effective and facilitating change.
What Is The Most Important? The most important role you have, before doing anything else is to keep the students safe -- physically first, then emotionally, psychologically, sexually, etc. Everything else you do for good in the student's lives should come after being vigilant about student safety. Before you do anything, ask yourself, "Am I doing everything to keep this (these) student(s) safe? For example: "Are all of their seatbelts fastened before I pull out of this parking lot?" "Do I have all of the students I am in charge of in my line of sight right now?" "Am I being especially watchful of (student) who is having a difficult day?" "Are students figuring out my patterns of bed checks during the night?"
HOW TO BE A GREAT COACH
- If the student does not respond to cues say, "we are behind you and we will give you a chance to do better later."
- Apply good cognition to wrong or negative behaviors-- "You hugged that stranger. You must love her very much." "You are chattering again, you are worried that you don't exist." "You are bossing me around again. You want to control me."
- At no time should children be punished for failure to comply with coaching. The coach simply says, "We will try again later."
- Don't attempt to coach a child who is out of control: The anger curve for many of the students is quick to peak, so it is imperative that all contact in which confrontation is a possibility is approached with coaching as opposed to questioning.
- The students need constant feedback on want is positive and negative. Make your feedback as objective as possible-- "You seem very hyper right now. Most people don't like being around someone who is out of control." Instead of, "You are driving me crazy. Will you please calm down?"
- Be on the rhythm of the student. Instead of asking why the student does things, point out to them why they do it: "You are hiding behind me because a stranger has just come into the room and you are a little scared." "You are sitting real close to me because you need to feel close to someone right now." "You told the truth because you feel bad about what you did." "You came and gave me a hug because you are hurting and need me to help you feel better."
- Scolding, questioning, punishing produces shame and evokes defense mechanisms as opposed to internalizations of moral lesson.
- Coach the student as if they know nothing about the game. Don't assume they have skills expected of their age group. Tell the player what to do and how to do it -- the more you leave open for interpretation, the more confused and frustrated the student may get. If a player does not follow the rules he/she is benched -- not because they are a bad player but because they are not being a good teammate.
- Healthy coaches do not expect to be loved and do not attempt to get his/her emotional needs meet from players.
- Emotional signals are the music of a person's behavior. Remember not about stopping the bad but raising the good -- don't get caught up playing whack-a-mole.
- Consequences and coaching point out the relationship between what children do, how they feel, and how their behavior affects others.
- Coaching helps students shift out of shame ["I am a flawed person"] and into guilt ["I did something wrong"] by activating a higher level response system -- the social engagement circuitry.
- Tricks of the trade: Don't ask the students lots of questions. Questioning is likely to be perceived by the student as accusatory and will push the child into defense mode. Instead, "Why did you break that toy" becomes a coaching moment from the staff: "this is where you say to me: Shellie, I broke my toy because I was mad." "Where were you?" becomes..."this is where you say to me: Jordan, I was hanging out in the bathroom because I didn't want to do my school work." "Didn't I tell you to do your chores?" becomes..."Kelly, I heard you tell me to do my chores but I chose not to do them."
- Coaches show students how to do something by being hands on and not just shouting from the sidelines.
CONSEQUENCES & DISCIPLINE
- Staff and parents should avoid power struggles.
- Focus on choices the students can make to improve their lives instead of coercion or force from the authority figure.
- In correcting many types of behavior, it is best to provide the adolescent with at least two choices, one that encourages a healthy way of living and regulating self and another choice that leads to a logical consequence if the student continues to make bad choices. For example, if a student is escalating in the cafeteria, staff would offer the student two choices, "[Student], I can see you are having a difficult time right now. I am so sorry you are struggling. Because of where we are you have two choices, 1) you can regulate those emotions so we can talk about this later with your therapist and continue to remain here as a team in the cafeteria or 2)we can leave right now and go back to [place] to cool down. Which would you prefer?...How can I help you re-engage in an appropriate way?" If the student persists in negative or escalating behavior and/or does not respond to the options, staff must be okay with and respond consistently to the second option provided to the student. Otherwise trust and effectiveness is lost. Do not Iet the student manipulate after a staff has allowed the student sufficient time to make a decision by suddenly agreeing to option #1 when realizing staff are following through with option #2. With empathy state, "I see you now realize a better option. I am happy you are able to think clearly but unfortunately your behaviors and patterns do not feel safe to me so we need to follow through with option #2. I really hope next time you will remember this experience and make the right choice sooner." During all of the interactions the staff or parent is calm and is not condescending. The approach is to help the student make better choices that lead to a successful life.
- Consequences should be connected to the behavior and not arbitrary decisions by the authority figure. If the student is slow waking up on time he should wake up earlier and not have a consequence of less talking.
- Choices and consequences are not commands or punishments!
- Not all student mistakes should have consequences. Only those that are pattern in nature, interfere with the functioning of self or others, or pose a threat to the safety and welfare of self or others.
- Remember, with many students, closeness is the real issue -- because you practice supportive control -- I want you to meet expectations and not allow life to punish you. Cognitively help them regulate after and during struggles.
- Remember, students can tell where your heart is at even if your words and behavior are appropriate.
- Discipline, regulate with, stay in control -- always, always, always follow with nurturing love.
# # #
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Ursus! That's some CRAZY shit, my bear. I could call a kick in the balls a "therapeutic touch" and it would be alright? Well, well. In that case, who wants a "hug"?
Dios Mio, I can see a therapeutic touch going awry and wandering into forbidden areas, resulting in a sexual abuse scandal that causes CALO to close it's doors forever in shame and bankruptcy.
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Jesus, those dogs are entirely over-pooped!
and exactly how is doggie doo doo duty therapeutic for attachment issues?
Im curious to see how they can spin that one in their favor.
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Ah... you're most welcome. But the real kudos should go to the unnamed original provider of the docs, and to Che, for orchestrating and facilitating their release.
I'll have you know though, that any typos and format inconsistencies you find are 99.9999% likely to be in the original. I copied this with brutal fidelity. I particularly liked this little number:
Attachment ant Trauma
The only thing I fiddled with was a table of "NON-CALO vs. CALO," which was so messed up in the original that the format had to be changed a bit, just to make any sense of it.
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Tribute to Nicole Fuglsang Admissions Director at CALO
(http://http://www.dancewithshadows.com/society/images/greg-chappell-middle-finger.jpg)(http://http://www.dancewithshadows.com/society/images/greg-chappell-middle-finger.jpg)(http://http://www.dancewithshadows.com/society/images/greg-chappell-middle-finger.jpg)(http://http://www.dancewithshadows.com/society/images/greg-chappell-middle-finger.jpg)
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Serual Deviancy
Sexual deviancy is unsafe. If one student alone is involved in sexually deviant
behaviors, a therapist should be involved in the decision to place that student
in a green shirt. If two students are involved in sexually deviant behavior
together, they rnust be separated irnrnediately and placed in green shirts to
keep thern apart frorn each other, and close to the coaches until a therapist
decides they are in a safe enough places to be taken out of the green shirts.
Suicide Watch And Green Shirts
Suicidal thoughts and actions should irnrnediately result in the appropriate
use of a green shirt. When a student jests at the idea of suicide, it is unsafe. If
a student rnakes atternpts to self-harrn, it is unsafe. That student should be
put in a green shirt and rernain with a coach for the rernainder of the day. An
incident report should be sent out in an "all staff' ernail inforrning the rest of
the staffof the situation. With the prescription of a therapist, certain
situations like suicidal thoughts and actions justi$ the necessity of having a
student sleep in the corrrrnons area under the close supervision ofthe night
staff.
What exactly qualifies as "sexual deviance" at CALO? I am not aware of any "shaming children you hold captive" therapy for things like (i'm assuming) masterbation that is recognized by any accredited body. And putting suicidal kids into the same catagory as "sexual deviants" so as to affirm they are equally "deviant" and shameful? Nice touch, child torturers at CALO.
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So the actual manual says to use "therapeutic touch" with kids who aren't allowed to say no.
What could possibly go wrong?
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Kind of scares me to be honest as it is so wide open to interpretation.
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Kind of scares me to be honest as it is so wide open to interpretation.
'Wide open' is right... :bs: :sue: ::puke::
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So the actual manual says to use "therapeutic touch" with kids who aren't allowed to say no.
What could possibly go wrong?
And what about the difficulties created for a kid who psychologically internalizes that they cannot reject unwanted touch?
Do you know how pimps "turn out" kids they target for prostitution? Basically, they forcibly rape them, over and over. After internalizing that they cannot resist unwanted touch and this form of masochistic human bonding they voluntarily submit their bodies to consensual rape in the form of prostitution. For the same reason, women sexually abused as children often end up in careers of sex work.
This "forced touching" therapy is in this same spectrum of physical violation deliberately practiced to induce learned helplessness and self destructive physical submission and masochistic relations in its victim.
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I hadn't quite thought of it like that, but I do thank you for bring that up. Another way to look at is by reading up on grooming techniques used by child molesters. This touching seems somewhat similar to that sort of thing.
I do know that the idea of touching an angry child is going to instigate a great number of these painful wristlocks. They shouldn't be getting anywhere near these kids when they are angry. However, CALOs methodology calls for "Time In" rather than "Time out".
Which in my, rather informed opinion as evidenced by a few years of personal experience and training, is instigating restraints.
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bump
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Current Run Team Assignments (August 7r20A7)
Jennifer Woodard I minute (808) 927-1938
Tyler Farr I minute (816) 365-4035
Steve Peer 5 minutes (513) 964-6053 or (602) 620-3808
Nathan Asbell 15 minutes (208) 757-8949
Carl Vigil 20 minutes (573> 3A2-1821or (719) 534-3328 or (719) 534-3354
Landon Kirk}7 minutes 302-7317 or 746-1715
Ken Huey 35 minutes 346-7797 or 746-6331
Matt Fuglsang2T minutes 348-3204 or 746-0565
Jennifer's assignment: comer of Goldeffod and Bittersweet. This will close off the area
.to escape the fastest.
Caleb's assignment: cornero f Anemoner oad and Bittersweet.T his may prevent
students walking to the Homy Toad and Shady Gator's
Tyler's assignment: Outside towards the back of the building before the new driveway.
Steve's assignment: Outside towards the front of the building after the new driveway.
Nathan'sa ssignmen:t Outsidet owardst he back neart he watert reatmentp lant.
Carl's assignment: Outsidet owardst he front after the water treatmentp lant.
Landon's assignment: adjacentn eighborhoodp atrol (the neighborhoodn orth of CALO)
Ken's assignment: adjacentn eighborhoodp atrol (the neighborhoods outho f CALO)
Matt's assignment: help where needed in the woods or roving in motorized patrol.
Anyone else have problems finding the ‘how to deal with "run aways"’ chapter?
Above, Jennifer's 'assignment' seems to be, closing "off the area to escape the fastest."
This is printed in what would be the ‘how to deal with "run aways”’ chapter, but I cant find the two preceeding pages.
Am I correct in assuming that it is the "students" at CALO who Jennifer needs to prevent from escaping?
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Am I correct in assuming that it is the "students" at CALO who Jennifer needs to prevent from escaping?
Yes. The students are the "runaways." The CALO staff that run away are called "fired."
By the way, the entire Coaches Handbook (save for the missing 3 pages) is copied out starting HERE (http://http://www.fornits.com/phpbb/viewtopic.php?f=9&t=27533&p=332022#p332048). All those funny typos that come from an imperfect read from the PDF have been corrected.
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:bump:
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[email protected] > Ken Huey's e-mail address
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:bump:
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We have a (supposed, appears non-troll) parent reading this, so I'm going to punt this back to the top.