Girls, Grime, and Relationships

Girls, Grime, and Relationships TAPG best practice conference 2007

Eilean Mackenzie LCPC Clinical Director New Horizons for Young Women. Nhywcd@earthlink.net • Deb Hibbard Program Director New Horizons for Young Women. Nhywpd@earthlink.net TAPG best practice conference 2007

NHYW History • : Started 6/ 2001, Jackie RMA graduate vision to have a program that meets the needs of girls. • “Connection Philosophy is my concept that everything we do in life, positive or negative, connects or disconnects us with something else. An example of this is technology. The more connected we become through technology the more disconnected we become with our family. As a society we have replaced family dinners with electronic jewelry!” Jacqueline Danforth – Founder and Executive Director New Horizons For Young Women TAPG best practice conference 2007

Girls, Grime, & Relationship Workshop Our goal is to provide a review of literature that is specific to girl’s developmental issues and discuss how that plays out at NHYW. To provide participants with an opportunity to share experiences and talk about what they have found that works. Lastly, to present what we believe makes for best practice in working with teenage girls. TAPG best practice conference 2007

Program Description • Program Department Young Women Ages 13-18 6-9 Week Year-Round Program located in Maine Clinical Therapy integrated with Emotional Growth work Nature/Outdoor 5 day Expeditions, 3 day Base Camp Model • Clinical Therapy Department Bio-Psycho-Social Model: using cognitive behavioral, relational and family systems interventions Therapy is driven by an individualized treatment plan o Individual Clinical Therapy (2) times per week/Group Clinical Therapy Weekly Clinical Family Support Psychological/Psychiatric Assessments Offered o Comprehensive discharge summary with progress on goals, accomplishments and recommendations • Field / Logistics Department Physically challenging, experienced focused, year-round expeditions Seasonal Physical Activity Averages: Summer Canoeing/Backpacking & Winter Camping/Snowshoeing: 8 miles/day TAPG best practice conference 2007

Program Description • Medical / Nutrition Department On Site, Fully Equipped Infirmary staffed by state licensed medical personnel Weekly Wellness Check-Ups Medical and Medication Education Monitored Nutrition consisting of whole grains, protein, fruits and vegetables • Admissions Department Enrollment Application Accessible on Website Educational Loans Offered, Maine scholarship fund • Supportive Services Therapists involved in family aftercare planning Parent Representative available for support • Human Resources Department Therapists Mental Health licensed in the State of Maine (Min. Masters) Annual training and/or certification in various disciplines: Medical, Risk Management, De-escalation/Intervention Techniques, Client Rights, Confidentiality, Cultural Diversity, Workplace Conduct, and Seasonally Specific Outdoor Activities TAPG best practice conference 2007

NHYW Mission • INDIVIDUAL: To support young women in better understanding themselves and what motivates their choices, relationships and behaviors. • FAMILY: To establish healthy connections between young women and their families. • SOCIO-CULTURAL: To empower young women in navigating society and culture. • APPROACH: To challenge young women with empathy, respect, truth and support on their journey of personal growth. TAPG best practice conference 2007

NHYW Values New Horizons For Young Women provides the opportunity to reflect on past decisions and future choices. If participants choose to fully engage in the program they will learn the value of personal challenges, relationships and empowerment. We will encourage girls to embrace opportunities designed to enhance their personal strengths. New Horizons empowers young women to confidently meet the complex challenges in today’s society. TAPG best practice conference 2007

Licensing • State of Maine DMH licensed as an outpatient mental health clinic for children and 18 year olds. • State of Maine DHS licensed as an outdoor youth camp. • CARF Commission on Accreditation of Rehabilitation Facilities, 3 year accreditation. • MOFGA (Maine Organic Farmers and Gardeners Association) Certified Gardens. TAPG best practice conference 2007

YOQ Data 2006 • Table 1: • This table details the admission and discharge totals for students completing the program in 2006. A drop of 18 points is considered clinically significant, and our students had a drop of 24 points. Total number of students seen in 2006 =46, completed forms =42. TAPG best practice conference 2007

Table 2:This table details baseline admissions YOQ-SR 2.0 scores compared to baseline scores of students in residential, outpatient, partial hospital, and community settings. TAPG best practice conference 2007

Table 3: • This table is a comparison of 2005 and 2006 NHYW admission and discharge scores with Keith Russell's admission and discharge totals from research conducted in 2002. TAPG best practice conference 2007

Teenage Developmental Issues • Important to look at teenage developmental issues for both boys and girls. The study ‘Raising teens: A synthesis of Research and a Foundation for Action’ published by Harvard School of Public Health and edited by Rae Simpson 2001 outlines the 10 Tasks of Adolescence. This study pulled together much of the current research on adolescent development and put it into a format that is helpful for both parents and professionals alike. • Adjust to Sexually Maturing Bodies and Feelings • Develop and Apply Abstract Thinking Skills • Develop and Apply a More Complex Level Of Perspective Taking • Develop and Apply new Coping Skills in Areas such as Decision Making, Problem Solving, and Conflict Resolution • Identify Meaningful Moral Standards, Values and Belief Systems • Understand and Express more complex Emotional Experiences • Form Friendships that are Mutually Close and Supportive • Establish Key Aspects of Identity • Meet the Demands of Increasingly Mature Roles and Responsibilities • Renegotiate Relationships with Adults in Parenting Roles Young women attending our program readily address these developmental tasks and the combination of both outdoor, wilderness experiences and therapeutic interventions provides a framework to explore these issues. TAPG best practice conference 2007

Young Women are different than Young men • While research continues to confirm that there are similarities between genders, there are also issues unique to the process of development in teenage girls. I want to present a brief overview of literature that has spoken to these differences and why they are important. • Jean Baker Miller: ‘Toward A New Psychology of Women’ (1976) In this groundbreaking book Dr Miller maintained that women’s desire to connect with others and their emotional accessibility were strengths, not weaknesses as they were traditionally regarded. She created a framework for looking at girls and women’s development within the context of relationships. TAPG best practice conference 2007

Carol Gilligan: ‘In a Different Voice: Psychological Theory of Women’s Development’ (1982) Gilligan asserted that women have differing moral and psychological tendencies than men. According to Gilligan, men think in terms of rules and justice and women are more inclined to think in terms of caring and relationships. She asks that Western society begin to value both equally. She outlines three stages of moral development progressing from selfish, to social or conventional morality, and finally to post conventional or principled morality. The developmental challenge for women is to learn to attend to both their own interests and to the interests of others. TAPG best practice conference 2007

Lyn Mikel Brown & Carol Gilligan, ‘Meeting at the Crossroads: Women’s Psychology and Girl’s Development’ (1992) Based on a 5 year study of girls going through middle to high school Brown & Gilligan listen to the stories of girls as they negotiate their way through adolescence. “ We witness the struggle girls undergo as they enter adolescence only to find that what they think and feel can no longer be said directly. We see them at a cultural impasse, and listen as they make the painful, necessary adjustments, outspokenness giving way to circumspection, self-knowledge to uncertainty, authority to compliance. These changes mark the edge of adolescence as a watershed in women’s psychological development, a time of wrenching disjunctions between body and psyche, voice and desire, self and relationship.” For a brief period in early adolescence, usually about age 12 , girls appear to understand the centrality of relationships in their lives; at the same time they are able to verbalize the frustrations they feel when faced with the conflict between maintaining themselves and their relationships with others. Their research “suggests that adolescence is a time of disconnection, sometimes dissociation or repression of women’s lives, so that women often do not remember – tend to forget or to cover over- what as girls they have experienced and known”. TAPG best practice conference 2007

Mary Pipher, ‘Reviving Ophelia: Saving the Selves of Adolescent Girls’ (1994) Pipher argues that we live in a look obsessed, media-saturated, ‘girl poisoning’ culture. A culture that encourages girls to stifle their creative and natural impulses. Prior to age 12 girls are often assertive, energetic and resilient, then with the transition to adolescence they become more deferential, self-critical and depressed. She names her book after the story of Ophelia in Shakespeare’s Hamlet. As a girl Ophelia is happy and free, but with adolescence loses herself. When she falls in love with Hamlet she lives only for his approval. Ophelia is torn by her efforts to please both Hamlet and her father. When Hamlet spurns her for being an obedient daughter, she goes mad with grief and drowns herself in a stream of flowers. “Most girls chose to be socially accepted and split into two selves, one that is authentic and one that is culturally scripted. In public they become who they are supposed to be.” TAPG best practice conference 2007

Sarah Shandler, ‘Ophelia Speaks: Adolescent Girls Write about Their Search for Self’ (1999) Inspired by reading ‘Reviving Ophelia’ Sarah Shandler provides a forum for adolescent girls to tell the honest stories of their lives. Ophelia Speaks is a compilation of short essays and poetry on themes of body image, sexuality, friendship, self-identity, family relationships. Shandler notes in her editorial that many of the girls who wrote about dark problems were on the surface ‘perfect girls’; smart, pretty and popular. She maintains that adolescent girls are caught in the crossfire between ‘ where we have been told we should be and where we really are’. This is the first book we have students read at NHYW. Their assignment is to read the book, write about several stories they identify with and then run a group talking about why they chose the specific stories and how they relate to your life. TAPG best practice conference 2007

Rachel Simmons, ‘Odd Girl Out: The Hidden Culture of Aggression in Girls’ (2002) Building on the work of Gilligan and Brown Rachel Simmons used their ‘Listening Guide’ to interview adolescent girls (10 –14 years old) and explore the topic of bullying between girls. She notes that ‘the importance of relationships and connection in girls’ lives, along with the fear of solitude, leads many of them to hold on to destructive friendships even at the expense of their emotional safety’. She explores the dual role of both bully and being bullied and how girls are often both. She sees that particularly for white middle class girls the expression of anger and aggression is frowned upon. In attempts to be a ‘good girl’ girls avoid openly expressing anger and instead it goes underground and is expressed through indirect acts of ‘relational aggression’. TAPG best practice conference 2007

Lyn Mikel Brown, Ed.D ‘Girlfighting: Betrayal and Rejection Among Girls’ ( 2003) Brown looks at girl fighting and “relational aggression” within the today’s social context as a reaction to girls feeling powerless. Girls are discouraged from expressing strong feelings and are pressured to fulfill unrealistic expectations, to be popular, and struggle to find their way in a society that still reinforces gender stereotypes and places greater value on boys. Under such pressure, in their frustration and anger, girls (often unconsciously) find it less risky to take out their fears and anxieties on other girls instead of challenging the ways boys treat them, the way the media represents them, or the way the culture at large supports sexist practices. ‘The answer to reducing girl fighting and girl bullying is less about tightening control over girls than about appreciating girls’ need to have control in their own lives, to feel important, to be visible, to be taken seriously, to have an effect.’ We need to work to replace old stories of girls and women as deceitful, backstabbing, nasty and mean with alternative realities of strong girls and women, girls as allies, and collation-building. TAPG best practice conference 2007

Lisa Machoian, ‘The Disappearing Girl: Learning the Language of Teen Depression’ (2005) Machoian argues that teenage girls begin to ‘disappear’ when they feel disconnected from friends or family, and when the pressures of society to fit in or be a certain way become overwhelming. “At age 12 years girls are no more likely than boys to be depressed; by 18 years they are twice as likely to suffer from depression.” “Genes make some kids vulnerable to the stresses of adolescence. It is particularly difficult when girls are intelligent; high intelligence increases girl’s risks for depression, but not for boys because brainy girls are rejected more.” “The more girls are concerned about relationships and pleasing people, the more prone she is to over think- to ruminate and worry. These over thinkers are most likely to become depressed.” TAPG best practice conference 2007

Issues we see at NHYW • On entry “I hate girls” • Importance of peers and being in peer group • Acceptance by peers more important than self & own needs • Who am I, different personality with each subgroup • Emotional reactivity/ regulation - do they like me etc • Difficulty identify feelings • Depression, lack of acceptance & feeling different • Anxiety fueled by peer group issues & acceptance • Self harming behaviors cutting, often triggered by conflict, feeling out of control • Anger management: stuffing or exploding • Binge purging, feeling out of control in group, life • Body image issues, comparisons & jealousy • Sexual behavior, the power of sexuality • Substance use often for peer acceptance, managing social situations or managing feelings. • Family conflict; lack of relationship with dad, conflict with mom • Academic difficulties, as struggle academically look for peer acceptance with lower functioning peers TAPG best practice conference 2007

Have participants break into small groups (approx 6 people per group). • Ask each group to do a group drawing or creative presentation that represents the issues they see teenage girls struggling with in their work. TAPG best practice conference 2007

Research specific to Wilderness Programming and Girls • Whittington Anja, ‘Challenging Girls Construction of Femininity in the Outdoors’ Journal of Experiential Education (2006) Qualitative study of teenage girls who participated in a 23 day wilderness canoe expedition. Found that girls challenged conventional notions of femininity in diverse ways: • Perseverance, strength & determination • Challenging assumptions about girls abilities • Feelings of accomplishment and pride • Questioning ideal images of beauty • Increased ability to speak out and leadership skills • Building significant relationships with other girls “They were able to place themselves in two domains – being in the wilderness and being a girl”. The experience allowed them to challenge the assumption that the wilderness is a masculine sphere. TAPG best practice conference 2007

Caulkins, White & Russell, ‘The Role of Physical Exercise in Wilderness Therapy for troubled Adolescent Women’ Journal of Experiential Education (2006) Study explored the impact of backpacking in the therapeutic process for teenage girls & revealed 8 central impacts: • Reflection; removed from every day experiences & have time to reflect on themselves • Perceived Competence; increased physical strength • Accomplishment; feeling good about what they have done • Self-Efficacy; increased faith in their ability to influence their personal thoughts & behaviors • Awareness of surroundings, self & others. With this an ability to take more responsibility for one’s behavior • Timelessness; distraction free TAPG best practice conference 2007

Recommendations for Successful Programming with Young Women: Regardless of gender the importance of good programming: -State licensing standards, CARF/ JACO, AEE, NATSAP, NATWC - Standardized staff training, supervision, and continuing education. - Networking with other programs, sharing information. • Wilderness & outdoors has traditionally been viewed as a male environment. We know that empowerment & self –efficacy is important so how do we allow girls to be girls & feel comfortable in the woods: just because you carry a pink back-pack does it make it any easier? • Using gender specific gear, • Being aware of our language how it can be exclusive • Brains vs. brawn • Do we need to get to the top or is it about the journey? • Balancing soft and hard skills • What is a soft program? • Being a girl, getting dirty, being playful, feeling strong challenges stereotypes of women & girls as passive & helpless. TAPG best practice conference 2007

Staff as role models • All female staff vs. co-ed staff groups. 1. How girls respond & react to all female staff teams: anxiety, excitement, different conversations. 2. In co-ed staff teams it is important that all team members are aware of their roles, how they share power, decision making and resolve conflict. • Sharing of hard and soft skills • Male staff to be aware of sexual issues, boundaries, appropriate touch TAPG best practice conference 2007

Not just about the individual journey but about the group – supporting one another, acknowledging when we need help. When one girl hurting it impacts them all. Honoring the role of caring and nurturing while balancing needs for self. • Learning about co-operation and collaboration • Being aware of in and out groups, sub cultures and covert communication • Teaching respectful & direct communication/ assertiveness training/ role plays • Focus on friends & what are healthy friendships • Leadership skills, decision making & organizational skills • Honoring different roles and skills within the group • Importance of relationships with staff, collaboration • Learning about differences; girls often surprised about the friends they make which are girls they wouldn’t usually talk to • Finding their voice TAPG best practice conference 2007

Feelings, feelings, feelings…..drama is the base line • Regardless of different diagnosis (borderline personality disorder, bipolar, mood disorders) much of what we do is helping girls understand their feelings, label them and manage them. Emotional discharge for the sake of emotional expression is not enough and at times harmful. First girls need emotional regulation skills and then how to contain feelings. • Teaching skills, learning about and identifying feelings • Mindfulness awareness of and letting go of feelings vs. them controlling you • Meditation skills; guided meditations, walking meditation, relaxation skills, yoga • Learning assertive communication • Conflict resolution TAPG best practice conference 2007

Food issues: • Food as a source of strength, learning to eat 3 meals a day & healthy food. • Wilderness cooking provides opportunities for building competency, pride, skills. • Food as an issue of control, mindfulness • Binging: eating for comfort, developing mindfulness and awareness of being full • Purging – awareness of talking about emotionally charged issues during meals, 20 minute bathroom rule, feelings check ins, journaling • Parent reunion, cooking a meal allows them to demonstrate skills & give back. Welcoming parents into their hearth TAPG best practice conference 2007

Hygiene & body image: • Learning self care skills • Discussions about female bodies (hair, smells) what is normal • Challenging conventional notions of beauty • Pride in strength, stamina • Using your body as a way to feel grounded TAPG best practice conference 2007

Trauma: • Being aware of when a student is triggered/ dissociating and how her story is effecting others in the group • Staff using grounding and containment vs. pushing • Staff helping students with emotional regulation; meditation, yoga, breathing exercises • Boundaries and appropriate disclosures, not always appropriate to tell everything to everyone • Physical boundaries, touch TAPG best practice conference 2007

Incorporating the cultural context: • Media images of girls, music, fashion, all appropriate conversations • Societal double standards: “good girls”, “bad girls” • Class & race differences • Religious differences • Looking at family culture TAPG best practice conference 2007

Use of ceremonies and female rights of passage: • Solos balance personal development and awareness with the group sharing in the experience • Ceremonies help establish group norms, mark progress, provide a context and support for change. Traditional female rights of passage frequently center around puberty and the power of a woman’s sexuality and ability to give life. They often involve a girl entering into the world of women sharing stories, learning about healing, relationships and support. Girls today discover the power of their sexuality but may not have the support of other women to figure out how they can use it and respect their own bodies. • Solo experiences are brought back and shared within the context of the group • Group members giving words of advice and support before a student leaves for solo • Challenge with encouragement, and modification of solos for younger girls TAPG best practice conference 2007

Girls, Grime, and Relationships