What Youth Care Professionals Should Know About Developmental Psychology

1. What Youth Care Professionals Should Know About Developmental Psychology Charlie Appelstein, M.S.W. charlieap@comcast.net www.charliea.com

2. Attachment Disorder Mastery Object Permanency 13-17 years old = Second Phase of Separation-Individuation In other words: “I’m moving on. I’m separating from my parents. I’m thinking about: - Who I am? - Where do I fit in? - Where I’m going? - Changes in my body? - What I’ll be? - Sexuality?

3. Helping Inflexible/Explosive Children & Youth • Characteristics of Such Kids: • Display deficits in frustration tolerance • Generally do not respond well to consequences and rewards • (i.e. traditional motivational approaches) • Symptoms are thought to emanate more from neurological as • opposed to psychological factors • Prone to stubborn, inflexible, explosive outbursts • Often display genuine remorse after an episode • How to Help: • Create user-friendly environments to clear the smoke (take the air out of the • balloon) • Determine which behaviors need to be addressed and how best to respond. Categorize behaviors and responses into one of three baskets: • A = Non-negotiable B = Compromise & Negotiation C = Ignore • As kids meltdown and approach vapor lock, immediately distract, empathize, • and offer aid. Help them to downshift into a calmer state (i.e. make the cognitive • shift). • A = Non-negotiable, often a • safety concern.Consequences could be issued. • B = Room for compromise & negotiation • C = Ignore A B C Most of this material is from The Explosive Child by Ross Greene, Ph.D.

4. What Educators & Youth Care Professionals Should Know • About Developmental Psychology • Key Developmental Considerations: • The first three years, including the pre-natal period, are the most important in a human’s life. • During the first three years, parents create a holding environmentfor their child, which is • defined as a total environmental provision in which kids are able to grow physically, • psychologically, and socially. • A school or child care setting is in essence a holding environment where the elements of the • first three years are replicated. They include: • Unconditional Love • Nurturing • Appropriate physical affection • Safety and security • Consistency • Considerable attention • Meeting food and clothing needs • Intellectual stimulation • _________________ (add your own) • The first three years can be termed the foundation years. Similar to a house, all kids need a • strong foundation. In other words, enough bricks to become independent and happy. According • to theorists, toddlers need to separate and individuate (separation-individuation) and develop a • goodsense of self by the age of three in order to be independent and happy. If a child • successfully navigates the first three years, she achieves object constancy. In other words, the • child has a sense of security with respect to human relationships. Whether loved ones are • present or not, she knows she has meaningful ties to these people (i.e. objects) and • can function effectively. • At-risk children and youth who chronically misbehave often have issues with object constancy. • Their relationships with loved ones have often been tenuous. Some kids enter public school • with weakened foundations. In other words, they have not received enough • bricks and therefore do not possess a good sense of self. Some of these children were • born missing bricks. In other words, they were born with neurological problems, such as • autism, Asperger’s Syndrome, sensory-integration issues, learning disabilities, etc. • Due to these “wiring” problems, life is increasing more frustrating for these children. • Great effort should be devoted to understanding the neurological condition of every child, and • how to best meet his or her needs.

5. Educators and youth care professionals should view themselves as fillers vs. talkers, who • deal with deficits vs. conflicts. Filling vs. talking refers to the importance of “filling in the • missing bricks” or framed in another way: Actions over words. Examples of “filling” • are listed below: • Coming in on time with a positive attitude • Being consistent • Providing plentiful activities • Making each child feel special • Helping with hygiene – with a smile on your face! • Maintaining a neat and organized setting • Using humor liberally (but avoiding sarcasm) • Being proactive • Doing necessary paperwork on a timely basis • Setting appropriate limits • Staying calm when kids misbehave • Providing safety and security • Maintaining an upbeat demeanor • ___________________ (add your own) • Deficits vs. conflict implies that the conflicts troubled kids frequently experience are • generally symptoms of a deeper problem, namely: an incomplete sense of self, due to basic • needs not having been met earlier in life, and/or neurobiological factors. • Think about a house build on a weak foundation. Beams are more likely to crack and • windows to pop out due to the immense pressure being applied to the weakened foundation. • The beam and window problems are conflicts the house owner experiences. Yet, if the owner • replaces a beam, there is no guarantee that it won’t crack again unless more bricks are placed in • the foundation. Educators and youth care professionals need to form appropriate expectations • for the kids in their care, as well as themselves. Being a successful educator or youth care • professional means responding vs. reacting at all times (i.e. using the Golden Rule). Every time • we “respond” a brick goes in. • When a teacher hasa positive, meaningful interaction (such as a great talk) with a • challenging child, she should reflect upon the interaction and think: • “Hey, that was a great intervention. I just put another brick in this kid’s foundation; a brick that \will be in place forever.” • The teacher should not get upset if ten minutes later the talk didn’t seem to have an effect. At this • point the teacher should stay calm and respond vs. react. If she does, yet another brick will be added • to that kid’s foundation. A bricklayer feels immense satisfaction and pride when he/she views a • completed house that he/she has painstakingly created the foundation for. • The world of responding to at-risk children and their families is no different. It might take years • before the fruits of our hard labor come to fruition.

6. Seeing is Believing = Unconditional support If you visit the home of family that has a toddler or two what do you see everywhere? Toys. Did the children need to earn them? No. They were offered unconditionally. This act of unconditional love and kindness strengthens bonds, facilitates object constancy (my parents are always there for me), and enhances self-image (“I’m someone of value!”) vs. Believing is Seeing = Standard behavior management (If I do well, I am rewarded. If I don’t, I am not) Seeing is believing produces Optimism – which feeds possibility, and motivates coping and adaptive behavior, even in the face of difficult odds Strength-Based Practice: Principles Seeing is Believing “Butch, you D’a man! We’re excited that you’re here!” NOT: Believing is Seeing! “We’ll treat you nicely once you put that slingshot down, lose some weight, and get rid of that ridiculous hat!” Seeing is believing examples: Have lunch with a troubling student; Do something fun with a group that is struggling; bring in a special snack; give the group extra recreation time even if they haven’t earned it. “You don’t always have to behave great for me to treat you great. I love working with you guys and I care about you –regardless of your behavior. Of course, I like good choices and fine acting – but I’m behind you either way.” Perform Deliberate Acts of Kindness

7. Working with Families Key Principles, Terms and Concepts “The more the relationship between families and the school is a Real partnership, the more student achievement increases. When Schools engage families in ways that are linked to improving learning, Students make greater gains. When families are engaged in positive ways, rather than labeled as problems, schools can be transformed from places where only certain students prosper to one where all children do well.” Excerpt from Into, p.1, Beyond the Bake Sale School personnel and parents form Interlocking Partnerships Teachers s view parents as Collaborators Family work is Cultural rather than Compartmental* * All school personnel can reach out and make a difference with a family • The Continuum of Parental Involvement • Engagement • - Focus on the strengths and passions of each family member • Understand & appreciate resistance (i.e. cautiousness) • Take an active interest in who they are. • Assist with socio-economic support. • Participation • - Invite parents into their children’s schools. Create parent • centers for collaborative learning and support • Empowerment • - Actively seek their advice when there are important issues/questions regarding their children • 4. Graduation

8. Working with Families 1. How family friendly is your school or program? _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ ______________________________________________________________ ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 2. What steps could you take to better embrace and assist the families you service? ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

9. Paranoid personality disorder . The individual affected with this disorder believes in general that people will exploit, harm, or deceive him or her, even if there is no evidence to support this belief. Schizoid personality disorder . The individual with this disorder seems to lack desire for intimacy or belonging in a social group, and often chooses being alone to being with others. This individual also tends not to show a full range of emotions. Schizotypal personality disorder . With this disorder, the affected person is uncomfortable with (and may be unable to sustain) close relationships, and also has odd behaviors and thoughts that would typically be viewed by others as eccentric, erratic, and bizarre. Antisocial personality disorder . Individuals with this disorder have no regard for the rights of others. Other, recent names associated with this personality type are psychopath and sociopath. Unable to base their actions on anything except their own immediate desires, persons with this disorder demonstrate a pattern of impulsive, irresponsible, thoughtless, and sometimes criminal behavior. They are often intelligent, articulate individuals with an ability to charm and manipulate others; at their most dangerous, they can become violent criminals who are particularly dangerous to society because of their ability to gain the trust of others combined with their lack of conscience or remorse. Borderline personality disorder . People with this disorder are unstable in their relationships, decisions, moods, and self-perceptions. These individuals are often impulsive and insecure. Histrionic personality disorder . The behavior of individuals of this personality type is characterized by persistent attention-seeking, exaggerated emotional displays (such as tantrums), and overreaction to trivial problems and events. Narcissistic personality disorder . This disorder consists primarily of an inflated sense of self-importance coupled with a lack of empathy for others. Individuals with this disorder display an exaggerated sense of their own importance and abilities and tend to fantasize about them. Such persons also have a sense of entitlement, expecting (and taking for granted) special treatment and concessions from others. Paradoxically, individuals with narcissistic personality disorder are generally very insecure and suffer from low self-esteem. Avoidant personality disorder . This disorder has characteristics that resemble those of social phobia , including hypersensitivity to possible rejection and the resulting social withdrawal in spite of a strong need for love and acceptance. Individuals with this disorder are inhibited and feel inadequate in social situations. Dependent personality disorder . Persons with dependent personality disorder are extremely passive and tend to subordinate their own needs to those of others. Due to their lack of self-confidence, they avoid asserting themselves and allow others to take responsibility for their lives. Obsessive-compulsive personality disorder . This disorder is characterized by a preoccupation with orderliness, perfectionism, and control. Read more: Personality disorders - DSM, functioning, therapy, withdrawal, people, traits, Definition, Descriptionhttp://www.minddisorders.com/Ob-Ps/Personality-disorders.html#ixzz1NVz8V7wV Personality Disorders Personality disorders constitute a separate diagnostic category (Axis II) in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders ( DSM). Unlike the major mental disorders (Axis I), which are characterized by periods of illness and remission, personality disorders are generally ongoing. Often, they first appear in childhood or adolescence and persist throughout a person's lifetime. Aside from their persistence, the other major characteristic of personality disorders is inflexibility. Persons affected by these disorders have rigid personality traits and coping styles, are unable to adapt to changing situations, and experience impaired social and/or occupational functioning. A further difference between personality disorders and the major clinical syndromes listed in Axis I of DSM-IV-TR ( DSM , fourth edition, text revised) is that people with personality disorders may not perceive that there is anything wrong with their behavior and are not motivated to change it. Although the DSM-IV-TR lists specific descriptions of 10 personality disorders, these conditions are often difficult to diagnose. Some characteristics of the various disorders overlap. In other cases, the complexity of human behavior makes it difficult to pinpoint a clear dividing line between pathology and normality in the assessment of personality. In still other cases, persons may have more than one personality disorder, complicating the diagnosis. The 10 personality disorders listed in DSM-IV-TR include: Paranoid personality disorder . The individual affected with this disorder believes in general that people will exploit, harm, or deceive him or her, even if there is no evidence to support this belief. Schizoid personality disorder . The individual with this disorder seems to lack desire for intimacy or belonging in a social group, and often chooses being alone to being with others. This individual also tends not to show a full range of emotions. Schizotypal personality disorder . With this disorder, the affected person is uncomfortable with (and may be unable to sustain) close relationships, and also has odd behaviors and thoughts that would typically be viewed by others as eccentric, erratic, and bizarre. Antisocial personality disorder . Individuals with this disorder have no regard for the rights of others. Other, recent names associated with this personality type are psychopath and sociopath. Unable to base their actions on anything except their own immediate desires, persons with this disorder demonstrate a pattern of impulsive, irresponsible, thoughtless, and sometimes criminal behavior. They are often intelligent, articulate individuals with an ability to charm and manipulate others; at their most dangerous, they can become violent criminals who are particularly dangerous to society because of their ability to gain the trust of others combined with their lack of conscience or remorse. Borderline personality disorder . People with this disorder are unstable in their relationships, decisions, moods, and self-perceptions. These individuals are often impulsive and insecure and tend to “split” individuals against each other. Histrionic personality disorder . The behavior of individuals of this personality type is characterized by persistent attention-seeking, exaggerated emotional displays (such as tantrums), and overreaction to trivial problems and events.

10. Narcissistic personality disorder . This disorder consists primarily of an inflated sense of self-importance coupled with a lack of empathy for others. Individuals with this disorder display an exaggerated sense of their own importance and abilities and tend to fantasize about them. Such persons also have a sense of entitlement, expecting (and taking for granted) special treatment and concessions from others. Paradoxically, individuals with narcissistic personality disorder are generally very insecure and suffer from low self-esteem. Avoidant personality disorder . This disorder has characteristics that resemble those of social phobia, including hypersensitivity to possible rejection and the resulting social withdrawal in spite of a strong need for love and acceptance. Individuals with this disorder are inhibited and feel inadequate in social situations. Dependent personality disorder . Persons with dependent personality disorder are extremely passive and tend to subordinate their own needs to those of others. Due to their lack of self-confidence, they avoid asserting themselves and allow others to take responsibility for their lives. Obsessive-compulsive personality disorder . This disorder is characterized by a preoccupation with orderliness, perfectionism, and control.

11. Splitting Individuals whose developmental needs get skewed, primarily during the terrible two’s period, tend to do a lot of splitting. In other words, they try to get the adults in their lives at odds with one another. Splitting is a normal developmental occurrence that rears its head during the terrible twos, when a child is beginning to separate and individuate and doesn’t want to be told what to do. When the emerging two year old hears “No” for the first time, it causes stress, prompting the child to split: “When mom’s being good to me, that must be the good mom. When she’s saying ‘No,’ that’s the bad mom.” If parents remain balanced (i.e. set reasonable limits but stay warm and loving) during the “splitting” (terrible two) period, the child emerges with a good sense of self and understands that mom (and dad) can be both good or bad, but is one cohesive person, and I am too. Children and youth who tend to seriously split the important adults in their lives, often do so because it brings them back to the developmental stage they still need to master. If the adult caregivers refrain from splitting and stay balanced in their approach to such youth, treatment progresses. Splitting is a stress reaction. When one feels stress, in the haste to relieve it, polarization occurs: Whatever is causing the stress is bad, and the individual is good (i.e. a split occurs) The stress of working in an under-supported youth care setting or school coupled with the developmental need for some at-risk children and youth to provoke disharmony among the staff members, often results in programs/schools having a great deal of inter-personal and departmental splitting. Therefore, it is essential for professionals to avoid splitting at all costs: Splitting stops a youth – and a program – from moving forward. Youth: My mother said you guys are too punitive. Teacher: I like your mother. I’ll give her a call to make sure we’re on the same page. Tip: Whenever you feel yourself being drawn into a “split” think: “I’m not as good as I think and they’re not as bad. Stress and a number of other factors is causing me to polarize (i.e. See things in black-and-white terms) Stop it. Find the middle ground. Communicate more. Don’t be played like a puppet. Stay professional. No Spltting Zone Every social service program and school in America should hang the following symbol throughout its setting:

12. Splitting Exercise • Does your school or agency suffer from problematic staff splitting? • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________ • 2. If yes, what steps could you take to become more cohesive as a team (i.e. reduce the splitting) • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________

13. P (cognitive modules). Dialectical Behavior Therapy Dialectical behavior therapy (DBT) is a system of therapy developed by Marsha Linehan, a psychology researcher at the University of Washington to treat persons with borderline personality disorder (BPD). DBT combines standard cognitive-behavioral techniques for emotion regulation and reality-testing with concepts of distress tolerance, acceptance, and mindful awareness largely Derived from Buddhist meditative practice. DBT may be the first therapy that has been experimentally demonstrated to be generally effective in treating BPD. Research indicates that DBT is also effective in treating patients who present varied symptoms and behaviors associated with spectrum mood disorders, including self-injury. Recent work suggests its effectiveness with sexual abuse survivors and chemical dependency. Linehan observed "burn-out" in therapists after coping with non-motivated patients who repudiated co-operation in successful treatment. Her first core insight was to recognize that the chronically suicidal patients she studied had been raised in profoundly invalidating environments and therefore required a climate of unconditional acceptance in which to develop a successful therapeutic alliance. Her second insight involved the need for a commensurate commitment from patients, who needed to be willing to accept their dire level of emotional dysfunction. DBT strives to have the patient view the therapist as an ally rather than an adversary, in the treatment of psychological issues. Accordingly, in DBT the therapist aims to accept and validate the client’s feelings at any given time while nonetheless informing the client that some feelings and behaviors are maladaptive, and showing them better alternatives. Linehan and others combined a commitment to the core conditions of acceptance and change through the Hegelian principle of dialectical progress (in which thesis + antithesis → synthesis) and assembled an array of skills for emotional self-regulation drawn from Western psychological traditions (e.g., cognitive behavioral therapy and an interpersonal variant, “assertive training”) and Eastern meditative traditions (e.g., Buddhist mindfulness meditation). Arguably her most significant contribution was to alter the adversarial nature of the therapist/client relationship in favour of an alliance based on intersubjective tough love. From Wikipedia, the free encyclopedia

14. Exploring Personal Boundaries How would you respond if a youth asked you any one of these questions? Do you have a boy/girlfriend? Do you have sex? Are you gay? Are you straight? Do you drink or do drugs? Did you do either when you were my age? Where do you live…with whom? Where? Have you ever been abused? Been in therapy? Do you gamble? Buy lottery tickets? Where did you grow up? Any brothers or sisters? Are you my friend? Do you love me?

15. Exploring Personal Boundaries • Important factors to consider when deciding when to self-disclose personal information: • 1. Why is the student asking the question? • 2. Whose need will be met by answering honestly? • 3. Do I want the answer shared with others? • 4. How strong is our relationship? • 5. How will the child/youth understand and experience the answer? (i.e. What is his/her frame of reference? For example if a worker is asked whether he/she drinks • and answers: • “I have an occasional beer on the weekends.” • How do we know that this child wasn’t abused by someone who called him/herself an “occasional” drinker? If so, trust between the two will be impugned. Suggestions: Inform all students during the orientation period that the staff members have been asked not to share delicate personal information. If a student asks a delicate personal question, respond: “Thanks for asking. But remember when we started, you were told that we have been asked not to answer very personal questions. And do you remember why? Are you curious about what normal drinking habits are among adults? I’d be happy to talk about that.

16. Duo Therapy: Psychotherapeutic work with two unrelated children. Purpose: To promote each child’s progression in her/her development through identification with the healthy functions of the other child and the therapist, while curbing, undermining, or working through the child’s less desirable personality traits. It involves helping children appropriately use and help one another. Distinctive Features: The opportunity for a peer relationship The regulation of distance The enhanced likelihood of problems surfacing in the therapy Interpersonal skills building Sharing of common problems Familial transferences Progresses Through Stages: Pre-affiliation > Power and Control > Intimacy > Differentiation > Separation/Termination (Garland, Jones, and Kolodny) Criteria for Selection: Complimentary strengths and weaknesses A hunger to relate A possibility for a mutuality of interaction Role of the Therapist/Counselor: Helping children to help one another through stimulation of the group process Support (direct/vicarious reinforcement) Confrontation Limit setting Clarification Selective interpretations

17. Facilitating Friendships • Please rate your school or program with respect to how you are helping the kids in • your care to make and sustain friendships? • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________ • 2. What steps could you take to help kids better learn and practice friendship building skills? ______ • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________ • _________________________________________________________________