Serving children: Local health officials, CBR YouthConnect share resources

1. May 2009 by admin.

La Junta, Colo. -
Otero County Health Department recently teamed up with CBR YouthConnect to provide rehabilitation clinics for children with special needs.
Kevin Harsh, director of nursing with the Otero County Health Department, said the health department provides rehab clinics for children from a nine-county area.
A team of doctors and special needs specialists are available at the clinic to visit with children and families on anything from physical therapy and medical examinations to wheelchair improvements and brace inspections.
Because of the high number of clients and cramped clinic conditions at their previous location, the department began searching for a new facility.
Martin Maser, CEO of CBR YouthConnect, offered one of the vacant buildings on the campus located north of La Junta.
“This is an interagency collaboration to improve health care access to children with special needs,” Harsh said.
Maser agreed.
“CBR YouthConnect and the Otero County Health Department are in the business of serving children,” Maser said. “This was a perfect fit. We are reaching back to the communities that have supported us. We wanted to extend our services and community resources to the Arkansas Valley and the community we serve here.”
Kirk Snyder, chief operating officer at CBR, has been the lead executive for the collaboration and spearheaded what needed to happen on the campus to help provide services to children with special needs.
Harsh said with families struggling in today’s economy, this clinic offers an affordable alternative to people in rural areas.
“The recession is particularly hard on everyone,” Harsh said. “It would cost a lot of money to visit this type of team. People would have to travel to Denver. We are very fortunate to have them here.”
Also contributing to the clinic is the Board of Cooperative Educational Services.

http://www.lajuntatribunedemocrat.com/archive/x360587469/Serving-children-Local-health-officials-CBR-YouthConnect-share-resources

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CBR’s own Kristy Hartless helps to mark the last LJ Tiger Relays

28. April 2009 by admin.

La Junta, Colo. -
For Kristi Hartless, her presence at the final running of the storied Tiger Relays on La Junta’s history laden cinder track meant more than that of paying forward the gratitude garnered from relays past.
For Hartless, the final running on the cinders meant keeping a promise made long ago to a man she admires still today; a mentor to not only the sport, but to her everyday life.
A once discus and shot-put hurler at La Junta High School, Hartless claimed third in the disc and sixth in the shot put in 1992, her junior year in high school. During her senior tenure, Hartless suffered a horseback riding injury which ended her season and has since made her paralyzed and wheelchair bound.
She recalled the incident from the pit Friday.
“I was coming back to win it all, she said of returning to school her senior year under the supervision of former track and field coach Bob Murphy. “I got hurt during Christmas break and Murphy found a way for me to help out with the meet.”
Fourteen years later and since a field judge at the discus pit, Hartless recalled a promise made then to her former coach.
“He told me, ‘never let them take this away from you,’” she said. “And I haven’t. I hope I never do.”
Following Friday’s final round, Hartless took one final spin around the discus pit she once threw from as a high school competitor now from her wheelchair before rolling on to the storied infield where she picked pieces of the grass she says she plans to keep for herself and Murphy.
Hartless too took part in a commemorative 800 meter run / walk around Tiger Field intended for runners of relays past.
Amongst the runners were the familiar faces of La Junta’s Dave Bomar and Lorie Moreno-Roch, and along the infield the memorable faces of former La Junta High School athletic director Tano Paolucci, longtime volunteer Ron Davis, and former participants Jerry Church and Larry Fisher.
“It never was the track that made this a special meet”, said Vera Tate, wife of the late John Tate, son of founder Paul Tate, when referring to the forty-plus years of service dedicated by Paolucci, Davis, and countless others. “It’s the people that make the event possible that make this meet what it has become.”
Vera Tate, now a resident of Pueblo, says the relays will always hold a special place in her heart. “Before John I didn’t know much about track”, she admitted. “But because of him track will always be in my blood.”
In sharing the passion once displayed by her father and grandfather, Sue Tate, daughter of John Tate, too expressed undying passion for the sport, particularly on Tiger Field, saying, “I love the cinders. It’s a great place to compete and a place that I’ll never forget.”
In the sixty years that the Tiger Relays have taken place, Sue has, under her own count, missed only six meets dating back to 1949, the year that her grandfather started the relays. She was three years old then.
“It’s a sad time to see the events on this track come to an end”, said Sue. “But it is also a very happy time. The kids deserve better and the new track will give that to them.”
Construction on the new Tiger Field began April 1 and will be the new sight of the Tiger Relays beginning next season.
The new field will feature an artificial turf and nine lane all-weather track currently being constructed behind the existing La Junta High School. The current Tiger Field will soon be demolished to make room for the new Arkansas Valley Community Center, a $4.3 million project slated to break ground shortly after.
“It doesn’t matter where we hold this meet”, said long-time volunteer Ron Davis during this year’s relays. “There are people and coaches that will continue to support the relays as long as they are around, and for that reason, the Tiger Relays will never die.”

http://www.lajuntatribunedemocrat.com/homepage/x50633943/Lasting-memories-Friday-marked-the-last-LJ-Tiger-Relays?popular=true

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Youth at CBR Celebrate Earth Day

24. April 2009 by admin.

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Brandon H - Opinions may change over a period of time.

20. April 2009 by admin.

Opinions may change over a period of time. In fact, most will change depending on the person and their point of view. Early in my life, this would have never occurred to me because I was very set in my ways. As opinions change, so do people. When I was a kid I believed in solving problems though hostility. I would lash out at every opportunity. I was often violent with peers for any little reason. I have learned a lot since then and now I think that the world works best when problems are solved with reason. I am learning all kinds of ways to control my anger. I have learned to use verbal skills to express my anger rather that lashing out at someone. I have changed my opinion, to put it simply; reason is the best way to solve problems and almost all problems can be solved if you just try to think your way out.

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Double the caring — Cronins’ service to youth

6. March 2009 by admin.

Mike and Peg Cronin were recognized at the CBRYC Christmas banquet as each marked their 35th Anniversary at CBRYC! While the number of years is important, it is the thousands of young lives that Mike and Peg have influenced during their careers that are truly important. In 35 years, their caring for the welfare of youth has never wavered. When boys who have been at CBRYC call to “check in” with staff, Mike and Peggy are on the list of people the boys hope to visit with and share what they are doing now. Mike joined CBR in 1973 as a mental health counselor/teacher. Peg joined CBRYC a few months later and they both committed to being houseparents. At that time, being a house-parent meant you were “parents” to 11or 12 boys, on a 24-hour basis. When Mike and Peg began their family, they moved into other positions at CBR. Today, Mike is a program director, and he relates directly with the boys in a number of situations. Mike would be the person listening to a boy share about how great a time he had at an event (perhaps a prom, basketball or football game). Mike would also be the person tying the ends together when something is amiss. Mike has a great ability to connect readily with the boys. Mike’s “high-5’s” are legendary with the boys. “It has been a privilege to work with the boys at CBRYC through the years, and a privilege to work with all youth,” stated Peggy. Peg’s easy smile and approachable style says to the boys (without a word exchanged) that she will be a person who cares about them. Peggy is Activities Director in the Education Dept. In that capacity, she develops class schedules, maintains the master schedule for all student class assignments, participates in the Individual Education Plan (IEP) meetings, and plans special events. Working with youth at CBRYC is rewarding and challenging. Mike commented, “What other job could you do each day and have the potential to impact a youngster’s future, with a pat on the back, a positive word, or by teaching a life-long skill.” You might think that when this couple went home, they happily retired to peaceful quarters. Not so for Mike and Peg. Both are active leaders in the community, continuing to share their caring with community youth. Mike is a past president of Task Resources for Youth, (TRY) an organization that works diligently to make a difference for youth. He is a coordinator for the annual Toy Bowl, which involves many hours of volunteer service. (See related story.) Peggy also shares her time and talent as coach for the girls’ high school track team. This is also an effort of caring that requires many hours to see the results of her coaching efforts. When this busy couple slows down to catch their breath, they check in with daughters Tiffany and Tonja and grandchildren Trenten, Jayven, and the newest addition, Payton. This is a special couple for whom their reward is the difference they make in young lives.

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Enriched Environments in Child/Adolescent

18. February 2009 by admin.

Martin Masar MSW/LCSW

There is an increasing amount of literature discussing characteristics of environments that encourage and promote change. These environments can support the acquisition of positive learning, appropriate behavior and healthy emotions. This presentation examines the elements of an enriched environment, as it relates to child and adolescent mental health care settings. The more these settings promote the characteristics of an enriched environment, the greater opportunity for individual growth. Healthy environments stimulate memory and learning that can lead to greater awareness, insight and subsequently more functional and adaptive behavior. An extensive literature review, individual surveys with former adolescents of a mental health care facility, and individual interviews with adults not from care settings were conducted within this study. The individual surveys and interviews supported the essential elements of an enriched environment. The more we understand what constitutes an enriched environment within any setting and certainly mental health care settings, the better we become at influencing healthy change for the children in our care.

“Hello John, it is great to here from you!” This would not be the first or last call either myself or the other facility staff would receive from a former resident of our psychiatric care facility. Early on it occurred to us; we should try and ask several questions of our former adolescent population. These questions we felt would help us do a better job with our current residents by learning from those who have gone through and lived in our residential care system; and who to learn better from than those who lived in and experienced it in person. As outside observers and supervisors there is a clear and definitive difference between being in an environment and living in an environment, 24 hours a day. Within these environments, we know there are both formal and informal decision making systems, problem-solving systems and a pecking order of influence and power, to name a few. Independent of the amount of supervision by mental health staff, this undercurrent system exists in every residential care system. No environment is free from the covert power of this undercurrent system; and it has existed for hundreds of years.

So, what can professional and care givers in mental health systems do to positively influence the environment of those entrusted to us?

As a mental health care facility, we have preformed outcome studies for many years. This data dates back to 1987, and involves surveys with over 500 individual youth. Our surveys then and now, focused on those youth who, successfully or unsuccessfully, had left our system of care. While we also surveyed current residents over the past 20 years, we painstakingly contacted former youth. Blending the survey results allowed us to evaluate what our current and former customers thought of our services and care. This was not always a pleasant task. At times, it placed before us some very difficult and challenging learning’s and decisions. Day to day, we prided ourselves in delivering and insuring quality care, in a safe and healthy environment. Yet, we listened to those who live and lived in that same environment as the evaluators of its effectiveness. Some times surprisingly and at other times knowingly, we swallowed our pride to look at ourselves and our system. Thereafter, we instrumented changes in response to our most learned evaluators.

After gathering, analyzing, and assessing the data from our outcome studies, we then began an exhaustive literature search of elements and characteristics of healthy or growth producing environments, called “enriched environments” within the neuroscience literature. (Diamond, 1999) Not unexpectedly, 20 years ago, little published information was available regarding enriched environments. However, in the past 3 – 10 years, an increasingly qualitative mass of literature has been published. While the bulk of the literature has evaluated and reviewed environments using laboratory experiments, much can be learned from the literature and outcomes of the scientific studies. I would not suggest that the human lives entrusted to our care should be equated to laboratory experiments; rather, that if similar conditions were present in human care settings, again enriched environments, we might be promoting conditions that influence healthy change. Finally, as the youth survey data was analyzed, we separated in the data those elements that our residents reported were most effective environmentally and combined them with the health and growth characteristic from our literature search.

As a final piece to this study, informal interviews were conducted with older adults, not from our care system. In these interviews, we sought to determine if there was a relationship or similarity between the results of the youth interviews, the literature review and the adult’s personal experiences of learning environments. The adult surveys were composed of individuals in the average age range of 58+ years old. There was no scientific determination of the adult age group, rather, and most simply, it was the most readily available adult population willing to be interviewed.

The youth surveys have changed in content in the past 20 years. What we felt was important 20 years ago, has changed with time. Our first task was to discern within the data, commonalities and similar concepts in the questions asked. We were also able to rely on the data from the past 10 years where the questions asked remained relatively similar. The survey’s themselves, at least from the past 10 years, were conducted using a neutral assistant. We felt an individual with no experience or emotional connectedness to our system of care would provide for us the most objective data. In addition, the neutral assistant sought second source verification when available. This way we had two sources answering the same questions about the youth. The youth surveys are completed annually, and usually take 6 to 8 weeks to complete. As mentioned earlier, we survey both current residents and past residents. The survey data represented over 500 individual interviews. The average length of stay within our facility was 14.5 months. As a facility that treats youth from across the nation the youth surveyed represented 8 different States and over 70 cities/towns from across the nation. Approximately 35% represented rural areas and the remaining 65% were from communities of 90,000+ population. The average age was 22, with the upper end age group at 28 and the lower end group at 12. The average time away from the facility or after being discharge from our care was 34.5 months. Among all the survey questions ask about our service systems, the following were identified for this study:
• What did you like best about our facility?
• What did you not like about our facility?
• What do you think helped you the most? Why?
• What do you feel helped you in your treatment unit?
• What was the worst thing(s) about your treatment unit?

In the survey results we analyzed for common themes and problems. A summary of the survey results indicated the following:

• What did you like best about our facility?
Survey results: The answers here varied from individual to individual. Some liked their therapist the best; others liked their teacher or child care staff. Some talked about a particular class or activity they enjoyed. Despite the individualized answers, we began to see that interactive, relationship driven activities were meaningful to our youth, and were the most remembered.

• What did you not like about our facility?
Survey results: The answers here took on a significant similarity. The most disliked aspect of our program was the restrictive techniques we unfortunately needed to utilize in the event of a situation of dangerousness. The youth were clear in their understanding between appropriate limit setting and the more intensive restrictive techniques. When asked if experiencing the restrictive techniques was helpful later on in their lives, the answer was essentially the same, as one young man put it, “I hated it then and I hate it now.” Other variables reported to be disliked included not feeling safe, not feeling cared for, and negative peer influence (usually reported as covert).

• What do you think helped you the most? Why?
Survey results: Here we were looking for something we were doing the youth felt positively impacted them. This answer has not changed in 20 years of survey results – relationships. Simple and direct, as one youth recently told me during a phone interview – what was the most helpful, he answered, “You!” When I asked why he felt our relationships meant so much, he answered, “It was you I carried in my memory all these years, it helped me when I needed it most – you were always there.”

Now within that “You” is much more than just a good friend. It is a complex understanding by trained professionals about the varied and interactive, developmental, emotional, maturation, motivational, cognitive and a host of other mental health variables influencing and affecting the youth.

• What do you feel helped you in your treatment unit?
Survey results: Here we were looking for environmental aspects the survey’s reported to promote lasting, healthy and permanent change in the individual. Relationships with the care staff were of course mentioned, in addition, survey results also indicated a feeling of being safe, a lot of interaction with the staff, interactive games played with staff, challenges to learn and do better, “generally” good food, rest/sleep, praise and positive feedback, choices and role models.

• What was the worst thing(s) about your treatment unit?
Survey results: The consensus answers here were not about the physical structure of the living unit, such as the material of the walls, or the indoor - outdoor carpet, or the amount and number of flowers outside or the color of paint, or even the amount of floor space. The consensus answer reflected times when the youth felt alone, fearful, isolated and uncared for. When despite constant supervision and everything that was fancy, ultramodern and brand new within the living units, the youth still felt alone.

As the data from youth surveys was being analyzed, we turned our attention to the literature search for enriched environments. A wealth of information has been published which studied or commented on the characteristics of healthy or growth promoting environments. Marian Diamond (1999, 2006), Marilee Sprenger (1999), Daniel Amen (2006), Louis Cozolino (2002), and Daniel Siegel (1999) to name a few authors have published on healthy or growth promoting environments, referenced as enriched environments. Louis Cosolino (2002) characterizes an enriched environment as one that promotes “a level of stimulation and complexity that enhances learning and growth.” Marilee Sprenger (1999) draws a number of conclusions about enriched environments. She comments that they include “social interactions, care, challenge and play.” We know the brain, or the way a person thinks, changes to reflect the influences’ of our environments. These influences or elements can have a significant positive or negative affect on the individual. I am reminded in a web based article by Ashish Ranpura (1997) who notes that while much is known about the influences of an enriched environment “under laboratory conditions”, correlation does not mean causation. Yet he notes, we know that “children who are exposed to [enriched environments] and varied education early in life develop a great capacity for learning throughout life. Furthermore real learning, not just rote exercise, can have a dramatic influence on the physical structure of the brain.”

The advanced research of Marian Diamond and Janet Hopson (1998) and studies from Josh Trachtenberg, Brain Chen, and Karel Svoboda (2002) has lead to a new awareness of environmental characteristics that promote healthy brain development and growth. The research exposed laboratory animals to different elements within their environments. This shifted from the lack of social interaction, lack of care, poor nutrition, no challenge or stimulation and lack of physical exercise; to environments with plenty of social interaction, appropriate care/touch, a healthy diet, intellectual challenges and physical exercise. They used a variety of techniques to monitor brain development and growth, including a photon laser scanning microscope. Svoboda (2002) summarized the results of their research on the affects or influences of an enriched environment indicating “a pronounced increase in the rate of birth and death of the synapses. [The research concluded] that there’s a pronounced rewiring of synaptic circuitry, with the formation of new synapses [within enriched environments].” These studies confirmed the significant and rapid “neural growth” taking place within enriched environments. (Wylie and Simon, 2005) The growth and development of new brain connections, synapses and dendrites, are associated with learning and memory. (Cozolino, 2002, Sprenger, 1999, Howard, 2002) Whether a classroom, home, therapists office or institution caring for children; the acquisition of new learning and memory are essential to both intellectual growth and behavior change.

Examining the characteristics of an enriched environment involved comparing the identified similar environmental characteristics from the various studies. These elements or characteristics included challenging educational and experiential opportunities that encouraged learning of new skills and expanding knowledge. Education, practicing skills and interactive engagement in mental activities also correlate with healthy growth and development. (Beaulieu, 2006) Compiling the most common themes from the research based literature; we developed the following list of elements that appear to influence health and growth in enriched environments:
• Nutrition = eating well balanced meals
• Repetition = reminders and exercises that lead to memory retention
• Interaction = verbal, social and engaging interactions/conversations with others
• Challenging = not overly stressful, but stimulating, and limit setting
• Care = human touch, emotion
• Learning = games, dialogue, motivation, and participation.
• Restful = a good nights sleep is invaluable to body regeneration.
• Exercise = physical activity
• Praise and Positive feedback = this is essential for corrective learning
• Safety = a sense of feeling safe or the absence of threat to self
• Choices = opportunities to choose from
• Role Modeling = demonstration of healthy behaviors and emotions
• Laughter = though not as clearly defined within the research, laughter promotes powerful interpersonal awareness, a healthy release of body chemicals and engages others in interactive dialogue.

We then turned our attention to literature where the enriched environments characteristics were not present. Obviously, the absence of the enriched environment elements promoted less learning and did at times stop all learning. The literature is fairly well documented in regards to environments that were unhealthy and non-growth promoting. Imagine poor nutrition, the continued presence of fear, overwhelming daily stress, and limited to poor interactions with others. We can clearly see why such environments would not be health promoting. Finally, as our literature search unfolded and volumes of data were analyzed, an interesting phenomenon emerged. Enriched environments should never be assumed to be rich or wealthy environments. Fancy, new age, modern and highly stylized architecture does not promote an enriched environment. None of the identified elements of an enriched environment are about modern conveniences or new-age design; rather they identify at the very least, interactive elements that a potential learning environment can assimilate, replicate and demonstrate.

As we began to merge the results of the above two studies, similarities surfaced We learned from our studies with our youth the characteristics, elements and seemingly most profound memories, which the youth identified as most influential in their life’s journey. We found these elements were similar to the elements identified within the literature.

We learned that an environment can also have a significant deleterious affect on the youth. To conclude the enriched environment alone is responsible for all change would be erroneous and misleading. For example, in the phone call I received, noted above, the young man described his relationship with me as a profound influence in his life. Cosolino (2002) describes it as “empathic attunement”, a “process involved in attachment and bonding.” More than just a good friend or companion, the process of empathic attunement involves the complex understanding of human psychology. In combination within an enriched environment, it is a therapeutic engagement process designed to elicit an emotional response, cognitive awareness, physiological sensation and behavioral correction. Cosolino also points out; the therapist’s office can become an enriched environment, promoting healthy elements in a therapeutic exchange. Therefore, while an enriched environment becomes a catalyst for growth; the care giver, therapist, parent, or teachers are the necessary change agents who assimilate the growth opportunity and potential into cognitive awareness. Learning and memory are the effects of cognitive awareness.

In the final stages of this study, we conducted informal interviews with various adults. We sought to determine from their perspective and life long memories, what environmental factors they felt influenced their lives in a healthy and productive manner. Not surprisingly, they all reference an emotional connection – empathic attunement – with a significant other, in a seemingly enriched environment. These persons ranged from parents, grandparents, teachers, therapists, and friends. The environments where these individuals reported their most profound learning took place were most often described as safe, caring, and interactive. One elderly lady explained it best, “Oh that would have been my grandfather’s home. He was such a kind and gentle man. I remember sitting around the kitchen table, in that old house with brightly colored wallpaper and those old linoleum floors – you know, that kind of house where the screened door slammed each time we went out to play. Grand dad would sit back and tell us kids all about his life and the things he learned along the way. I think we would sit for the longest time and listen to him. Our imaginations would run wild as he wove stories of learning and life – I remember it still to this day.” For this lady, she retained the valuable messages her Grandparent gave her, within characteristically what might be called an enriched environment.

This study has been in development for several years, and while it is a far cry from pure scientific research and methodology, it nonetheless has given us great insight. Examining 20 years of youth survey data and the literature search results, we have been able to make some definite conclusions. We have thought about a host of other measures we might perform and include in our future data analysis. We might redefine the questions and seek greater specifics. We might identify a control group and perform the same analysis and we might give more attention to the actual physical characteristics of an enriched environment. Yet in the end, the study was extremely helpful. The more we understand what constitutes an enriched environment within any setting and certainly mental health care settings, the better we become at influencing healthy change for the children in our care. We know today that enriched environments are essential if we are to help children along in their individual life’s journey; and who better to ask about a healthy learning and growth producing environment than the children themselves.

In summary, I have once again, identified those enriched environment characteristics that serve a positive function in promoting healthy change. They include:
• Personal instruction by parents or care givers
• Supportive and caring human interaction
• A personal feeling of safety
• Love, nurturance and acceptance
• Not feeling along - attention
• Cleanliness or healthy
• Balance nutrition
• Exercise
• Laughter – positive emotion
• Positive Role Modeling
• Educational Opportunities
• Challenges/reasonable obstacles/problem-solving and choice
• Limits
• Opportunities in the form of creativity and imagination

An enriched environment cannot be brought – it is created. An enriched environment is often felt – long before it is seen.

References

Amen, D. (2006). Making a good brain great. Arizona conference presentation.

Beaulieu, D. (2006). Impact techniques: Applying our knowledge of human memory systems to psychotherapy. www.americanpsychotherapy.com; winter annals.

Cozolino, L.J. (2002). The neuroscience of psychotherapy. New York: W.W. Norton Company.

Diamond, M.C. (2006). Response of the brain to enrichment. Web based article. http://www.newhorizons.org/neuro/diamond.

Diamond, M.C. (2006). What are the determinants of children’s academic successes and difficulties? Web based article. http://www.newhorizons.org/neuro/diamond.

Diamond, M.C., Hopson, J. (2006). Characteristics of an enriched environment. Web based article. http://www.newhorizons.org/lifelong/childhood/diamond.

Diamond, M., Hopson, J. (1999). Magic trees of the mind. New York. The Penguin Group.

Howard, P.J. (2000). The owner’s manual for the brain. 2nd. ed. Marietta, GA. Bard Press.

Ranpura, A. (2007). Weightlifting for the mind: Enriched environments and cortical plasticity. Web based article. http://www.brainconnection.com/topics.

Siegel, D.J. (1999) The developing mind. New York: The Guilford Press.

Sprenger, M (1999). Learning and memory: The brain in action. Alexandria, VA. Association for Supervision and Curriculum Development.

Trachtenberg, J., Chen, B., Svoboda, K. (2002). A new window to view how experiences rewire the brain. Web based article. http://www.newhorizons.org/neuro/hhmi.htm.

Wylie, M.S., Simon, R. (2005). How the neuroscience revolution can change your practice. Psychotherapy Networker. www.psychotherapynetworker.org.

All rights reserved. Republication or redistribution of content is expressly prohibited without prior written consent of the author.
YCI© 2007

Posted in Treatment, Clinical | 1 Comment »

Patrick E - Important Goal

11. February 2009 by admin.

One important goal I would like to achieve in the next few years is to obtain a college degree in business and automotive technology. I would also hope to get these degrees from a community college close to my home in Philadelphia. I will explain my steps to reach my goal.
My whole plan starts with studying and passing my GED, since I have not completed the proper number of credits for a high school diploma. Without a GED, I will not be able to go to college. I will be the first person in my family to get a GED or a High School diploma.
After I obtain my GED, I will apply for acceptance to many different Technology colleges in Pennsylvania. I also plan to apply to a few community colleges as a backup plan, in case I can’t get into a technology college. I plan to do a few semesters at a junior college and then reapply to the other colleges.
After I get accepted, I will apply for grants, scholarships, and loans. I will also probably have to get a part time job at night and on weekends. I understand that College isn’t cheap. My family does not have a lot of money, so I know that I will have to pay for most of college on my own. I think that it is better if I pay my own way through college, because I will be more motivated to do well.
Completing my GED and graduating from college with degrees in business and automotive technology are the most important goals for me. These goals will help me shape my future. I will be able to get a good job or open my own business.

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My Goal by James Mc

28. January 2009 by admin.

James Mc
One important goal I would like to achieve in the next few years is to earn my diploma. I think I could do it because I am a smart young man that tries hard on everything. I also have a lot of people supporting me, especially my mother. She has always told that I can accomplish anything that I set my mind to, as long as I put my heart into it. I have two brothers that both died before they could finish school. They also wanted me to finish my education. I plan on working as hard as I can to complete this goal not only for myself, but also for my mother and my brothers.
I don’t really have the necessary credits to graduate, so I’m in a GED class. I have a long way to go to finish my GED, but I am working hard and everyone tells me that I have a good head on my shoulders. After I complete my GED I plan to enroll in a community college near my home in California. This would make my family very happy.
Aside from wanting to please my family, I have come to realize how important an education is to leading a successful life. In today’s world it is very difficult to get and keep a good paying job without a good education. Someday I want to have a family of my own. To do this, I will need a good education so I can get a good job to support them and even provide them with more than I had when I was growing up.
I can’t wait till I complete my GED and start a new life. I know it will not be easy. I know that I will need help and support from the education staff and my family. This short term goal will lead to accomplishing the long term goals I have set for my life. Most importantly I know that I have the will, and I can do it.

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The Seeds of Aggression

12. January 2009 by admin.

By
Martin Masar, MSW/LCSW

Violence in our world remains at epidemic proportions. This article discusses a methodology for aggression intervention, by considering the origin and purpose of aggression. An examination of aggression from this perspective can lead to more effective, healthier and permanent solutions in our mental health work. Examining the multiple functions of aggression and then designing an intervention, might lead the practitioner beyond just problem-solving, to development of an intervention designed to address why the aggression was used to problem-solve. If a clinical intervention is designed to resolve or alleviate a difficulty, then it is logical the intervention will address the cause or purpose of the difficulty. In this presentation we will examine the multiple functions of aggression and then discuss a format used to develop effective intervention strategies. Violence at epidemic levels globally, calls for understanding the seeds of aggression and interventions designed to address lasting and permanent change.

Michael, almost 17 years old, was a young man, who learned to survive by using his strength and aggression to his advantage. He demonstrated his use of aggression with acts of violence towards others. Over time his aggression increased. Michael was raised in a world of anger, defiance and hatred. During his childhood he was repeatedly beaten. He learned that “might makes right.” In Michael’s mind the world was a terrible place, where he had come to expect the worst.

As I began therapy sessions with Michael he would demonstrate his aggression through the use of strong words and threats. Late one afternoon he stormed into the office lobby demanding to speak with me. He was very angry and threatening to hurt others. I welcomed Michael to my office. For the longest time he sat there quietly. Eventually he began to talk and each time I suggested a different problem-solving method, he would react with verbal assaults. I let him talk and began to notice the intensity of his anger decreasing. When he paused, I asked what inside of him made him so angry. Lifting his pant legs above his knees, he turned around. On the back of each leg were many scars – the product of his childhood torture. Michael’s scars symbolized the origin of his aggression. In Michael’s mind his aggressive behavior was his way of insuring he would never be scarred again.

An examination of aggression only from its effect or outcome limits our interventions to the effects. We spend time problem-solving the current situation, rather than understanding why the aggression was used to problem-solve. Examining aggression from its origin and then purpose leads to a myriad of strategies aimed at the cause, not the effect. We begin by examining different perspective of aggression.

Aggression can be a difficult behavior to change. In many persons it was imprinted through early learning, was repetitively demonstrated, when utilized was successful; it gained immediate reward and experienced few if any punishments or disappointments. (Reilly & Shopshire, 2006)
Aggression can be exhibited as an overt behavior. It is initiated by a variety of emotions and translated through cognitive perceptions. It is an emotional, behavioral and cognitive phenomenon, requiring interventions that address all three spheres. (Reilly & Shopshire, 2006)

The pioneering research of Jean Gervais and Richard Tremblay (2005) examines aggression in young children. Their research concludes that aggressive acts in young children are more frequent than their older counterpart adolescents. This phenomenon, they suggests, relates to the young child’s immature brain development, possible genetic temperament and includes the lack of ability for social awareness and self control. Dr. Gervais suggests aggression has a biological, genetic or inherited aspect, independent of the child’s subsequent learning. As the child grows and learns, he/she begins to understand and learn both social and personal control due to the relationship between the caregiver and the child. John Ratey (2001) and Emil Coccaro (2004) also discuss genetic involvement of aggression. Dr. Ratey indicates that aggression “used to be blamed on the environment,” however; new research suggests a genetic component affecting temperament. To further the point, Dr. Coccaro states aggression “has a substantial genetic component. What you really have is predispositional issues.”

In early childhood, the language centers of the brain go through a process of rapid growth. (Pally, 2002) As these centers grow, they seek knowledge to help understand and make sense of their environments. Thereafter, the brain develops narratives or stories that are stored and called upon in future decision–making and problem-solving. Learning and memory are the basis of all behavior. (Pinel, 2006) We use these stored memories in our decision-making for the rest of our lives. (Siegel, 1999) As this process develops our memory systems categorize and assimilate the information. This helps us make emotional and cognitive connections between places, events and ourselves. These connections direct and guide our actions and behavior.

We can see how early life experiences that are negative, abusive or harmful would affect the way we perceive (emotions) and interpret (cognitions) an event or situation. This happens because we have learned and remembered a variety of different narratives throughout our early childhood. This could lead the person to choose potentially maladaptive or inappropriate behaviors, which makes sense to them due to the negative narratives gained in early childhood, but may be inappropriate for the actual event or situation.

The learning of aggressive behavior can occur in a variety of situations. These include observation, imitation, personal experience and rehearsal. (Goldstein, Glick & Gibbs, 1998) Aggression may also include a combination of both learning and biology or genetics. A young child exposed to various experiences begins to acquire a knowledge base for the future use of aggression. This combined with genetic effects, would influence early cognitive perceptions. The child’s experiences may also be reinforced by a variety of other sources, such as care givers, schools, communities, neighborhoods, and media. All of these elements play a role in the manifestation and learning of aggression.
If the demonstration of aggression is viewed as a product of learning, then in an obvious, but often over-looked area, aggression regulation in adolescent may be an absence of alternative knowledge or learning. (Goldstein, Glick & Gibbs, 1998) Given the prevalence of aggression in our lives today, the acceptance of aggression as an appropriate means to and end, and the popular though unfortunate role models that use aggression, very little attention is given to the development and learning of more appropriate, healthy alternatives.

The use of aggression can have a powerful emotional effect. When aggressive, the individual may experience a release of body chemicals, which produce a pleasure sensation. This sensation gives a feeling of well-being and when tied to the aggressive behavior, has a tremendous and powerful reinforcement affect. (LeDoux, 1996; Pliszka, 2003) Daniel Siegel (1999) takes this a step further indicating that past traumatic experiences and other disruptive events can produce “maladaptive emotional regulation.” Here, due to traumatic stress and/or abuse the brain lacks the ability to achieve emotional regulation, or to self regulate. In either situation above the inability to self-regulate or regain emotional control may be intensified if the traumatic experiences are engrained within deep memory. Steven Pliszka (2003) writes that early childhood abuse and other negative childhood experiences, can produce stress levels that can permanently alter the brain’s functioning and the individual’s ability to ever self-regulate. If we presume that aggression is pure learning, then we can deduce that new learning can effectively alter and reduce episodes of aggression. However, to understand that aggression can also be a permanent brain impairment, gives quite a different scenario.

Aggression can serve as a function and come into existence through the acquisition of learning and memory. As a function, aggression can serve a socially identified outcome. Coccaro (2004) calls this “socially-sanctioned aggression.” For example, the coach of a sports team instructs the player, “Get aggressive!” Here channeled aggression into the opponent of the opposite team is viewed as a positive end result of aggression. The same case is true during acts of war, where aggression is seen as an adaptive response to environmental circumstances. Another example is the parent protecting their child from pending harm. The onset emotion maybe fear, which drives the otherwise calm parent to an act of aggression. Here aggression maybe a process driven by such emotions as fear, self-protection, safety, or even a sports team victory.

There are different types of aggression. An aggressive act can be proactive, reactive, (Vitiello & Stoff, 1997) or instrumental and noninstrumental. Proactive aggression is considered well-planned, directive and without emotion. Reactive aggression is impulsive, hostile and with emotion. Instrumental aggression is directed, intentional and purposeful; and noninstrumental aggression is non-directed, random, impulsive and unintentional. Emil Coccaro (2004) breaks down aggression into socially-sanctioned, medical, premeditated and impulsive. Socially-sanctioned aggression is an individual who is responding aggressively because of the situation in which they are placed. For example, war or a sporting event. Medical aggression is exhibited in response to some type of medical or biological condition that otherwise takes over the better judgment of the individual. An example of this might be poisoning or a medical illness. Next, premeditated aggression is seen in individuals that actively plan an aggressive event. It is goal directed and might be considered sociopathic in diagnostic terms. Finally, impulsive aggression is generally in response to a personal stressor, which triggers an aggressive response. Intermittent Explosive Disorder is often tied to impulsive aggression.

As we break-down the types of aggression, in the following paragraph we will examine how information is processed and a behavioral response determined. Prior to an action or behavior, an individual’s brain processes information is mere seconds and then determines the appropriate course of action. This is based on a variety of stored memories or experiences. (Siegel, 1999)

There are various stages of information processing we all go through as part of our decision to act aggressively. First the event or situation must be received and understood by the brain. This includes information such as the tone of voice, facial expression, body language, physical proximity, intention, and others. Next, this information, which is now received and understood, must be interpreted. Is the information friendly, neutral, educational, or hostile? Our brain then selects a goal for our interaction and generates possible responses. We then choose among the possible responses and carry out our interaction or behavior. (Siegel, 1999; Applegate & Shapiro, 2005) If we view an event as educational, we might calmly sit and listen; however, if an event is determined to be hostile, we might choose to act in an aggressive manner. Imagine how difficult or distorted the above information processing may become, if the individual has experienced or learned maladaptive responses or if the individual is under the influence of mind altering drugs, or if the individual has perceptual or cognitive distortions.

Some myths about aggression:

• Aggression is inherited. Evidence from research studies are mixed on this myth. Authors studying genetics and neuroscience suggest a biological or genetic component to aggression and others suggest no biological connection, rather a learned environmental phenomenon. (Gervais, 2003; Ratey, 2001) Recognizing a balance of influence between genetics and environment might provide the most reasonable consideration.
• Anger [aggression] automatically leads to violent outcome. Channeled aggression, such as in a sporting game, does not necessarily lead to violence. Controlled aggression can be used to assert energy.
• You must be aggressive to get what you want. Aggression and assertiveness are frequently confused. Aggression is usually used to control or dominate, whereas assertiveness, can be used to express oneself and in controlled manner.
• Venting anger [aggression] is always desirable. Research studies indicate the expression of aggression through such things as hitting a pillow and screaming, only reinforces aggressive behavior.
(Reilly & Shopshire, 2002)

An intervention is considered a procedure or technique that is designed to interrupt, interfere with or modify an ongoing maladaptive process. (Reber, 1995) A maladaptive response limits the individual’s ability to develop alternative behaviors. Maladaptive can also be seen as a behavior that causes psychic stress or emotional discomfort. And, a maladaptive behavior can have situational, cultural, personal, and social conditions, where demonstration of a behavior in one environment is appropriate, while demonstration of that same behavior in another is inappropriate.

An examination of violence is not enough; and an examination of aggression as a maladaptive behavior it not enough. Developing problem–solving strategies aimed at the effects of the aggression is not enough. As we move forward we need to examine a methodology for aggression intervention, by considering its origin and purpose. Rather than discuss the hundreds of creative interventions for aggression, various concepts will be discussed to assist the practitioner in determining what constitutes an effective intervention for the individual’s aggression. Imagine, as discussed previously, a parent acting aggressively out of fear for the certain harm of her child. Would our interventions ask the parent to just walk away or take a time out?

When developing an intervention for a particular behavior i.e., aggression, the following considerations should be evaluated and assessed:

• What is the purpose of the intervention?
o Is it to increase an action or behavior?
o Is it to decrease an action or behavior?
 The choice above is dependent on the severity of the behavior. The learning of new strengths and demonstration of new behaviors, builds from a strength based model.
• Will the intervention target the individuals’ emotion, cognitions or behaviors?
 The choice is a determination of the therapist; however, each area is essential in the therapeutic process, if we are to address the seeds of aggression.
• Was the action of the individual culturally, socially, personally or even age appropriate?
 Consider the context in which the aggression was exhibited.
• Will the intervention address the individual’s perception of the event?
o The event itself?
o How the event was felt?
 (emotion)
o How the event was processed?
 (cognition)
o Or how the person chose to behaviorally respond to the event?
 (behavior)
• Was the aggressive action considered proactive, reactive, instrumental, noninstrumental, socially-sanctioned, medical, premeditated or impulsive?
• Will the intervention seek to address social skills or awareness?
o Was there a lack of social understanding or misinterpretation?
• Will the intervention address relationships skills?
• Will the individual’s insight be addressed?
 (cognition)
• Does the individual find the release of aggression as pleasurable or uncomfortable?
o The more an individual finds aggression as pleasurable – the more difficult change becomes.
• Will the intervention seek to improve empathy?
o (Empathy helps the individual see the other person’s point of view)?
• Was the aggressive act driven by cognitive distortions?
o Consider A – B – C – D:
 What was the activating situation or event?
 What does the person believe as true about the event?
 What were the cognitions regarding the event and consequences?
 What is the most reasonable decision?
• Is the aggressive person viewed as “bad”?
o This reflects the therapist’s perceptions. If the aggressive person is viewed as “bad” we may tend to design punitive or disciplinary interventions. However, if the actions of the individual are viewed as a conditioned or learned response, we may choose an intervention that reflects the acquisition of new skills and/or behaviors?
• Was the aggressive act driven by an absence of knowledge?
o The individual just did not know what else to do.
• Will the intervention consider the age of the individual?
o Their maturation level?
o Their cognitive level?
• Will the intervention seek to reward new behaviors? If so, how?
• Will the identified intervention motivate the individual?
o Motivation is a powerful element in change.
• Did the aggressive act have a functional on dysfunctional purpose?
o Consider the types of aggression listed earlier.
• What theoretical orientation will the therapist use within the intervention?
o Cognitive Behavioral Therapy?
o Person Centered Therapy?
o Dialectic Behavioral Therapy?
o Others
• Does the intervention consider possible brain damage, a medical condition, drug induced aggression, or other brain altering conditions?
o Consider a complete medical and neurological evaluation.
• Was the aggressive event a reaction to fear, safety, guilt, shame, embarrassment, humiliation, etc?
o What emotion(s) were at the cause of the aggression?
• Was the aggressive event a reaction to jealousy, revenge, limit setting, selfishness, anger, defiance, etc?
o Same
• Will the intervention involve education, role play, unconscious emotions, deep memory, and coping strategies?
o Role-play has been found to be extremely helpful in the learning of new behaviors. (Beaulieu, 2006) Cognitive and behavioral rehearsals are just as important as physical exercise. Would you participate in a sporting event without practice?
• If the intervention serves to stop or extinguish a behavior, what new skills will be taught in place?
• Interventions should include recognition of affect, cognition, sensation and behavior.
o This bridges information across the various domains of the brain. This process of “neural integration” enables the person to integrate information across the various sections of their brain and builds self-awareness. This improves the ability for self-regulation, which leads to conscious awareness and more effective adaptive behavior. (Fonagy, Gergely, Jurist, & Target, 2002)

An examination of aggression through consideration of the above interventions, also seeks to assess if patterns exist. In the analysis of information consider replicated patterns, similar events or triggers, times and place, or any other events that appear to coincide with the aggression. This may help determine how aggression is used in a particular context or situation and may give rise to further exploration of the individual’s origin of aggression. And finally, to assess and gather the information needed calls for access to the individual’s history, school records, in-person interviews, testing and any other information that might be helpful. The more we know about an individual, the better we become at developing interventions to assist them.

Understanding and intervening with aggression at its origin and purpose can lead to more effective, healthier and permanent interventions in our mental health work. Examining the multiple functions of aggression and then designing an intervention, can lead the practitioner beyond just problem-solving, to development of an intervention designed to address why the aggression was used to problem-solve.

In this article we examined the multiple functions of aggression and discussed a format to develop effective intervention strategies. Understanding the seeds of aggression calls for the development of interventions designed to address the origins of aggression, which can lead to lasting and permanent change.

Remembering Michael:

As Michael left my office that day, I walked him to the lobby door and watched him return to his unit. The sun, in all its brilliance, gave away the scarring on his legs. I imagined how hard it must be for Michael to be teased about his legs. For a moment I was lost in a dream, trying to understand how a very young child could ever protect themselves against such vicious abuse. I wondered if anyone ever heard his screams.

In the months that followed Michael slowly improved. At first, there were very few days when he was not aggressive, but ever so slowly he began to show improvement. Michael and I developed his intervention plan. While it was built on exhibiting and rewarding positive behavior, it also called for him to write a brief paragraph when he misbehaved. In this paragraph, Michael was to describe the negative incident, how he responded and what he could have done differently.

Admittedly, Michael spent a lot of time writing his paragraphs. One day, while reviewing another set of paragraphs, Michael wrote the following (the grammar and spelling are Michael’s): I got in staffs face. I did no hit him this time. I feel bad tonite. I dont know why I feel this way. I no I let you down again. I run from my problems and I hit people. I am sorey for what I did. All I want is you give me a chance. (M. Masar, case file, 2005)

Reading Michael’s paragraph I just filled with emotion. Michael was connecting. For the first time in his life he was reaching out and trying to understand his aggressive behavior. He was connecting his behavior to both himself and others; and he was searching for answers. After several moments of quiet excitement, I went to Michael’s unit. Finding him in his room, I asked if he would like to visit. He cautiously agreed and moved the bedding around so I would have a place to sit. After a minute or two of cordial talk, I read the paragraph above to Michael. I believe he could see my eyes light up, hands shake and voice break ever so slightly. After I finished reading the paragraph, I put it aside and waited for Michael to speak. In a gentle voice he said, “So maybe I done better?” Looking earnestly at Michael I told him, “You done GREAT!” And maybe it was his smile or maybe it was his eyes, but in that moment, I believe that hurt child deep within Michael, sitting crossed legged in front of me – stopped screaming.

************************************************************************

References

Applegate, J.S., Shapiro, J.R. (2005). Neurobiology for clinical social work. New York: W.W. Norton & Company.

Beaulieu, D. (2006). Impact techniques: Applying our knowledge of human memory systems to psychotherapy. www.americanpsychotherapy.com; winter annals.

Coccaro, E. (2004). Understanding aggressive behavior through neuroscience. http://www.bioethics.gov/transcripts/sep04/session2.html.

Fonagy, P., Gergely, G., Jurist, E.L. Target, M. (2002). Affect regulation, metalization and the development of the self. New York: Other Press.

Gervais, J., Tremblay, R.E. (2005). Origins of Human Aggression. National Film Board of Canada. www.nfb.ca. Canada.

Goldstein, A.P., Glick, B., Gibbs, J.C. (1998). Aggression replacement training. Champaign, Illinois: Research Press.

LeDoux, J.E. (1996). The emotional brain: The mysterious underpinning of emotional life. New York: Simon & Schuster.

Pally, R. (2000). The mind-brain relationship. London: Karnac books.

Pinel, J.P.J. (2006). Biopsychology (6th ed.). Boston, Massachusetts: Pearson, A&B.

Pliszka, S.R. (2003). Neuroscience for the mental health clinician. New York: The Guilford Press.

Ratey,J.J. (2001). A user’s guide to the brain: Perception, attention, and the four theaters of the brain. New York: Vintage Books.

Reber, A.S. (1995). Dictionary of psychology. New York: Penguin Books.

Reilly,P.M., Shopshire,M.S. (2006). Anger management for substance abuse and mental health clients: A cognitive behavioral therapy manual. DHHS Pub. (SMA) 06-4213, Rockville, MD.

Siegel, D.J. (1999). The developing mind. New York: The Guilford Press.

Vitiello, B., Stoff, D.M. (1997). Subtypes of aggression and their relevance to child psychiatry. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 307-315.
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YCI© 2007

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Weathering the Challenges of Change

29. December 2008 by admin.

We have now experienced the early chill of winter and passed through the Thanksgiving holiday. The weeks ahead will usher in the Christmas season and welcome the New Year. As with all things, the changing of seasons is a constant in our lives. As we enter 2009, many of the changes will not be as festive. Our national economy has dramatically changed with further deficits on the horizon. The state agencies that support our children’s needs are struggling and are likely to pass on increasingly stringent cost-saving measures. Within the larger provider community, we face major changes in the rules, processes and requirements that affect the treatment available to troubled children and their families. Those of us who serve children and families will look at these changes in the context of all that it takes in this day and age to help a single child. In quiet desperate moments many of us will ask—why? Our children’s needs did not diminish, go away or somehow fix themselves. In fact, according to any number of reports, our nation’s children are struggling with increasingly severe and complex problems—from trouble with learning and behavior to abuse, neglect, hurt and abandonment. The challenges facing those who provide treatment, education and care to our nation’s children have accelerated. Not only do we face increased costs for essentials such as food, housing, transportation and insurance, we will be confronted with increased regulations and ever more stringent requirements. Challenges and change can be both professional and personal. After many years of direct service to children and families I will move to a new office and begin a different journey at CBR YouthConnect (see sidebar). Aaron and his family were the last of my therapy cases. My promise to Aaron and his mother was that I would personally continue to provide their therapy until he was discharged and reunited with his family. As the end of Aaron’s treatment drew near, he greeted me as I walked across campus late one evening. After a few routine questions, Aaron blurted out, “When do you give up?” His query caught me off guard and I paused for a moment. And then, as simple as his question had been, the answer was as well—“never.”
Despite the problems that plague our state and national governments, we must for the sake of our children, never ever give up. As we get ready for the uncertainties of the New Year, I wish you unwaveringly belief in our children and families and the commitment it takes to see another child successfully return home.
—Martin Masar, CBR YouthConnect Executive Director of Campus Operations

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