April 28, 2010 02:04 by Ken
A few weeks ago one of our current residential coaches got an email from a former coach--Kyle is his name. The current coach asked Kyle about his new job at a different residential treatment facilty. Kyle's response gives interesting insight into working in a level-based, behavior modification residential program. I won't name the new residential program where Kyle works but that facility operates much differently than CALO. I am copying and pasting Kyle's email here, unedited except for names. I (Ken Huey) am glad I work at CALO and can pay more attention to relationships than behavior. Here you go, Kyle writes:
I have been going back in forth on what to email you in regards to the differences with CALO and where I am currently employed. I have thought long and hard as to what to write about. I am going to try to be as objective as possible. With that in mind I will start on a positive note.
Today during our weekly team meeting I was informed that we would no longer have to wear forearm pads. Yes, forearm pads. Forearm pads that might have been worn by a mid 90's defensive lineman. Due to the low volume of bites that were taking place in the adolescent units it was determined that they would no longer be required. I faced the potential write up and elected to seldom wear my forearm pads with the camouflage of long sleeves. The feeling of padding up before going onto the floor felt as if we were preparing for war. I am temporarily distracted from this email by the bruise on my bicep made from the chompers of a 13 year old and am glad that I did not report it to my PM due to fears that we would soon be required to wear shark proof suits. Yes, we do have restraints, however, they are not always effective. If a student becomes assaultive (which happens often) I have to dodge, block, and take punches and kicks until two other staff members can assist in a restraint. The TCI manual suggests a bear hug at this point, however, I have learned that this opens up more vulnerable areas to attack such as head butts or a knee to the groin. Our go to restraint these days is one which the client is face up. This usually results in being spat in the face from anywhere from fifteen to forty five minutes. One incident involved me being barricaded in the seclusion room with a pissed off client as he kicked and punched me (mostly in the legs) successfully striking me in the groin at one point. My fellow co-workers were not able to enter the room nor would they lock the door allowing me to generate some space from the client. I couldn't help but chuckle to myself while my left knee was being abused because there was nothing I could do. Fortunately there were no real injuries.
The model is all skills based. We have kids with different primary diagnosis but most have similar trauma and backgrounds. However, our approach is to constantly address behaviors. It feels very robotic and the kids seldom get to talk about what is going on or how they are feeling. It is encouraged to talk things out but rarely has opportunity to take place. There is this yucky staff v. students feeling. The students have "point cards" where they earn negative points for negative behaviors or positive points for positive behaviors. a certain amount of points are required for the student to participate in privilege activities such as going outside or playing a game with peers. as a staff I might say: " Hey so and so... I can see that you are mad about what's his face throwing food but you have earned a corrective (negative points) for voice tone. Its important to use good voice tone because then people are more likely to be receptive to what you are saying. Your practice is going to be to tell me the skill components for appropriate voice tone." and they will either accept their consequences of more points will be deducted.
Our students spend a lot of time in there rooms and if a client is "off task" students who are going what they should be doing get sent to there rooms while staff attempt to de-escalate the off task student (usually with no success) for about an average of 30 minutes. We don't really have any natural consequences, its based mostly on points.
I like this analogy. Think of the average client as a house. One traumatic event = a crack in the foundation. another one is a hole in the roof. ok and there is some siding falling off here and there and a crack in the window. At (facility name redacted) we are merely applying some caulk here, covering some things with paint here, and putting it back on the market. At CALO the treatment team helps the student to properly repair the foundation, fixing the roof, putting things back in place so it can be successful.
Despite the frustrations I do have positive experiences and small successes with the kids. The bottom line is these kids need help and not many places are able to take them. Whether it be due to finances (we are non profit) proximity, or behaviors. Many of our kids will be returning to broken homes, gang culture, or group homes. One of our clients (from charlotte) informed me that everyone in her house carries a handgun at all times. She doesn't feel safe at home.
I work with a great group of people who are dedicated to helping kids who need help (though slightly miss guided). Unfortunately it has evolved into a culture where it is acceptable for staff to take a beating in the process.
To the CALO staff: be very grateful that you have a leadership team dedicated to, not only top notch treatment for clients, but the well being of the invaluable staff working with the students day in and day out. I think about my past experiences with CALO and realize that CALO is not always rainbows and butterflies either, but you should feel great to know that you are helping to rebuild. Keep up the good work and in the mean time I will be a painting robot trying to make a difference.
Thanks again for letting me stop by last week and I look forward to seeing you all again whenever I happen to be back through the area. It was great to see so many of you but there are many more I wish I had seen.