Tuesday, April 9, 2019

The Work Book

After working with a particular child for a short while I found myself re-creating the same exercises in session that I've done with many kids in the past. I thought, I should just make this child a book that we put all these worksheets in. But then something better popped into my head: the work we were doing could help a lot of kids.
Below I pasted in the introduction to my book, and I cite The Kempe Center for much of the framework. I don't understand why this content has not become standardized to all mental health training. It can be used in so many situation with so many clients. It was designed to treat sexually abusive youth, initially. But it is truly universal. It should be viral. Teachers should know these skills as well. So please consider using this with your client caseload - each child should have a book of their own to document their progress and ability to self-regulate and plan for their own safety. You can find it on Amazon.com and search "Preventing and Treating Abusive Behaviors: A Workbook for Children and Teens. 
This workbook is a mixture of various exercises and treatment concepts that I use in my work with children and adolescents in therapy. It is based on the principles of Perpetration Prevention developed by the Kempe Center, in Denver, Colorado. I was trained by Gail Ryan, MA to teach others how to address sexual behaviors in children and teens including problem behaviors and abusive behaviors. Over time it became clear that these concepts can be applied to a number of situations where children’s behaviors become abusive. The concept is simplified as “Abuse is Abuse” meaning if someone is doing harm to another person, an animal, to property, or themselves, it is still abusive behavior and needs to stop. We do this by teaching children the goals of Communication, Empathy and Accountability. We also do not want to diminish the needs of the child engaging in problem behaviors. Therefore, we use many of the exercises to explore identity, assets versus risks, what their high-risk cycle looks like leading up to their abusive behaviors. Children still need to learn pro-social behavior and make friends in typical environments despite having experienced or exposed to violence, trauma, and loss. The table on the following page outlines the types of abuse we wish to stop and ultimately prevent.
A cautionary note to parents: This book is ideally used within a therapeutic relationship. If your child is engaging in problematic behaviors, especially sexually abusive behaviors, please seek professional help. This book can be used in conjunction with a multi-disciplinary treatment team for the management of sexually abusive behaviors. A professional will have the background to utilize these concepts to their fullest benefit.
The High-Risk Cycle exercise introduces the concept of a Trigger – something seen more and more often in the media. However, it is more than a place, or subject in our case. We want children and teens to identify the emotion associated with the triggering topic or event. Some examples are:
Not feeling liked, valued; feeling policed; feeling left out or rejected; feeling unsafe; afraid; feeling unheard or misunderstood; being mistaken, falsely accused or assumed guilty, feeling jealous, feeling uncomfortable with compliments or comments on appearance.
When a parent or caregiver is aware of situations that are potential triggers for their child, they can mitigate the child’s risks by observing and addressing the issues directly and as quickly as possible. Remember that if your child had a trauma, it is not a predictor of future behavior. Having plenty of normal activities and interactions can balance out their development. That is what the scale activity is meant to achieve. Children and Teens often feel that they will not be able to change their destinies, even if they have experienced consequences of their behaviors. It is critical that they believe in themselves.
In the exercise about their body, children and teens can learn to identify where they hold onto their anxieties and other emotions. Some hold tension in their throats, or trapezoid muscles, others may get stomach aches. This tuning in helps children and teens connect back to their physical selves and create the mind-body connection that is important in mindfulness practice, and not relying on dissociation to cope with difficult feelings.
Of course, there is more that can help your child engage in self-discovery and healing.
I hope you find this workbook useful for your kids and your clients! I believe it has been needed for a long while!

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