By MICHAEL HOLTZ

Special to The Olathe News

Response from Brandon Mock, Phoenix Director,  MS, ATR-BC, LPC, LMFT

http://kidstlc.org/kidstlc-story/meet-the-kidstlc-team/

Question:

I have a 12 yr old daughter who has a lot of anger issues with me. She is very disrespectful, and she spends a lot of time at the neighbors house, rather than being at home with me. I have had her in therapy several times, but it doesn’t seem to help. I really think she needs a “wake up call” as to what life is really all about, and what is going to be expected of her. She plays with children much younger than herself, and is very self absorbed with always having a good time, and never wanting to take any responsibilities, or as stated above, being respectful. I think she needs to have a tour of your facility, and if she can’t “get it together here”, then maybe she needs to stay at your facility until she can. Is there any way that we can make this work?

Our Thoughts:

Thank you for caring enough about your daughter to reach out to KidsTLC

Managing disrespect can be very difficult for a parent, especially when your own child is showing anger and disrespect toward you. Parenting from a place of love and compassion quickly becomes parenting from a place of control… and fear. Parents oftentimes fear that kids who only focus on having fun and ignore responsibilities will grow up to be irresponsible adolescents and eventually irresponsible adults with no regard for consequences. I think your idea of giving your child a “wake up call” by touring KidsTLC is a natural response if you believe your child cannot fully respect and appreciate the life they live right now. Here’s what you will find if you tour KidsTLC:

-       Staff members and children running and laughing during a kickball or ultimate football activity centered on sportsmanship.

-       Teachers and staff smiling with students in the classroom as they try a new recipe for fudge in learning how to measure and follow sequential steps.

-       An enthusiastic group of staff and kids wearing brightly colored hats and singing and dancing as part of a volunteer activity put on by Starlight Theater.

-       You might see “Bill,” a weekly volunteer bring a mountain of games to play with the kids.

-       A group may be returning from New Horizon’s Ranch after an afternoon of Equine Therapy.

-       You might see “James Brown” who is a brown-spotted Dalmatian who visits the kids every Tuesday morning so the kids can read to him or simply spend time giving him hugs.

-       There’s a possibility you won’t see children from our Bridge Unit because they’re attending a Royals or Sporting Kansas City event in order to practice social skills in a community setting.

If you ask any child on the KidsTLC campus about his/her mission statement, they will quickly and proudly reply, “To learn and practice self control, self respect, and respect for others.” This mission statement is what we encourage our kids (and ourselves) to strive for and work on each day. The KidsTLC staff believes that this mission statement is more easily achieved if the learning environment is upbeat, fun, consistent, structured, and safe. KidsTLC believes that problems with disrespect, lying, arguing, hostility, and defiance are stress responses to feeling unsafe and afraid. These behaviors are not acceptable at KidsTLC but how we address these behaviors has little to do with consequences related to loss of privileges and more to do with repairing “breaks” in relationships and collaborating on problem-solving/conflict resolution. Engaging in a wide variety of activities and experiences is how our residents learn how to relate to each other, get along with supportive adults, and learn about themselves and their potential. Involving families in kids’ treatment is a critical component to our treatment approach because addressing the breaks in family relationships is vital to emotional health.

I would invite you to visit and tour our facility at any time. KidsTLC is more than willing to assist you in finding resources to help with you and your daughter’s relational challenges.

A few weeks ago I took a trip to downtown Kansas City with our Street Outreach Service (SOS) Team when I saw a young guy taking a shower outside of a building using a garden hose. Surrounded by graffiti and concrete that young man used whatever resource he had to have some sort of normality.

He is just one story within thousands and thousands of other homeless kid’s stories. The reality is that more than 4,000 kids will be homeless tonight in the KC Metro area.

For most of us, and for many of you reading this, we hear that homeless number and assume that most or all of those kids are from the downtown area. While a lot of them are, the numbers for homeless kids surrounding the city is growing.

In our “nicer” neighborhoods and counties there are a staggering numbers of kids without a home.

Even for me, seeing those numbers in my home town is hard a hard pill to swallow.

So now what?

I saw the kid showering outside and I have seen the homeless rate grow, but what I do?What is the plan to decrease this number? How is MY community helping those kids who just want to sleep in a normal bed, or take a regular shower.

One thing that our SOS Team is doing to help tackle this giant task is to first raise awareness.

For the second year in a row KidsTLC held a Homeless Night to raise awareness April 27.

The goal is simple; reach out to the community and explain the problem.

Then leave them with an action plan so that everyone can be part of the solution.

Ten churches participated in our 2^nd Annual Homeless Night.

Church members, kids from the community and KidsTLC staff met in several locations to camp out in card board boxes. All participants were presented with the harsh facts of the growing homeless rate and what they could do to help.

The location I was at gave up food and even their electronics to for 30 hours. That meant no cell phones. They wanted to live the full experience. A few of the people I talked with there could not believe that there were kids their age or younger sleeping in the same arrangements.

At first it was fun to grab a box, a blanket or sleeping bag and prepare for the night.

When the weather turned cold and the sky glistened with rain, the fun wore off very quickly. Reality set in and some looked for relief. When you are homeless, relief is hard to find.

Our SOS team works hard everyday to provide some relief to the growing number of kids without a home, but we can not reach them all.

What can you do to help? We are always in need of supplies and donations.

Blankets, clothes, food, shoes, sleeping bags, hygiene products, etc. are in high demand.  You can reach our SOS team at 913-324-3619 or check their web page. http://kidstlc.org/what-we-do/kids-in-the-community/street-outreach-services/

Our SOS team helped hundreds of kids already and with everyone’s help we can help decrease these numbers and provide real showers for all kids.

OLATHE, Kan. — A group of Olathe teens traded their warm beds for cardboard boxes on Friday night. They’re raising awareness about homelessness in the metro.

The teens from First Presbyterian Church of Olathe went to extremes.

“We slept under a tarp,” said Stephen McCoy. “You can see the sleeping bags, pillows and things like that.”

They were tired and hungry on Saturday morning because for 30 hours, the teens didn’t eat. They also gave up electronics. They wanted to feel what it’s like to be homeless.

“I feel bad for them because I have a home and don’t feel their pain everyday,” said participant Robyn Freund.

Friday night’s storm meant there was only a layer of plastic covered cardboard or a thin tarp between the teens and the elements.

There are almost 4,000 homeless children in the metro. They don’t sleep in tents are cardboard boxes.

“They are counting kids that are couch surfing or going to relatives. Not all of them are on the streets but they are homeless…so that’s where the numbers come from,” said Jeremy Brenneman with Kids TLC.

The numbers show there are an estimated 600 homeless kids just in Olathe.

“We  have some kids in the youth group here who either have been homeless or are doing some couch surfing now,” said Peter Perme with First Pres. Church of Olathe.  “It strikes close to our hearts here at Olathe Presbyterian.”

George Thompson, MD, KidsTLC Medical Director:   http://kidstlc.org/kidstlc-story/meet-the-kidstlc-team/

First of all, this is an important and often agonizing question. “When should parents place their child in a residential facility, given that the goal is to help the child to form a secure attachment to them?” Parents often ask us: “Should I send my child away when what I want is to be closer to him?” ”Will she ever understand that I sent her to treatment because I love her?”

Here is how we look at these questions at KidsTLC.

Dr. Dan Hughes, creator of dyadic developmental psychotherapy, says that two fundamental emotional/relational capacities for children are:

1. The ability to identify, regulate and communicate emotions, and

2. The ability to accept care and support from care givers

When working with youth with attachment issues, we at KidsTLC place development of the child’s emotional and relational capacities at the core of treatment. And when a child’s deficits in these areas make it dangerous for her to stay at home, we feel that the child needs care in a Psychiatric Residential Treatment Facility or PRTF.

Eighty to ninety percent of the youth we see at the KidsTLC PRTF have a history of childhood trauma, abuse or neglect, as well as disrupted attachments. Many are now being raised by foster parents, adoptive parents, or grandparents and other relatives. Most would meet criteria for complex PTSD or developmental trauma disorder, which are research diagnoses and not in the DSM IV (see van der Kolk, 2005). These kids usually get diagnosed with a mood disorder such as Mood Disorder NOS or Bipolar Disorder, along with disruptive behavior disorders, such as ADHD and Oppositional Defiant Disorder. Sometimes they have an anxiety disorder like PTSD, Social Anxiety Disorder or Anxiety Disorder NOS. Sometimes they meet criteria for Reactive Attachment Disorder.

Regardless of diagnosis, these youth are admitted to PRTF’s because their emotional instability leads to emotional explosions (or implosions) in which they yell and curse, throw and break things, hit and kick people, and cut and burn themselves. They are reckless with their lives – driving drunk, having indiscriminate sex, taking drugs. These youth have developed mistrust of adults – i.e. they feel that they can only trust themselves. So they are resistant to and defiant of adults in authority. They cannot accept care and support from adults who have good intentions – parents, foster parents, therapists and case managers. Their dangerous behaviors and resistance to help makes them difficult to treat.

When these kids are admitted to TLC, we target these fundamental emotional and relational capacities. We see that as the youth learns to identify emotions, she gains more control over them, more ability to regulate them. As she is able to regulate them better, they are less scary, and this makes them easier to communicate to others. Parents learn to accept and empathize with these feelings. Identifying, regulating and communicating emotions gives the child a new sense of competence and makes her inner world more understandable to those around her. 

At the same time we are helping the child to learn about emotions, we work with her to accept care from the adults involved in her life – both those from her life at home, like parents and foster parents, as well as those from her life in the residential program, like her therapist and her primary staff person.

More and more we are using a dyadic developmental psychotherapy approach, which works both with the child and the parent together, to create increased attachment security. Sessions focus on helping the child know what to do with a good adult who has care to offer them. Even when the parent is not around, we continue to work on the goals of identifying, regulating and communicating emotions and increasing the ability to accept care and support from care givers. Learning these skills with residential clinicians and staff prepares the child to transfer the skills to the primary parent-child relationship.

In addition to the work inside the therapy, we also work with routines within the family that have been problematic. For example, a recent patient of ours was an 11-year-old girl adopted from overseas. She had experienced trauma, attachment disorganization and disruptive behaviors. Bedtime was especially problematic for her, and her outbursts each evening made it impossible for her to remain in her home. Her primary staff, Rachel, worked out a routine of reading her stories at bedtime, moving progressively toward the door with each story. She would read the first story next to the bed, then inside the door of the room, then from outside the door. Over several nights, the girl adjusted to this routine and was able to go to sleep with much less anxiety. Then we invited the parents into the facility to be the one reading the story. And finally the girl’s primary staff person and her therapist, the Phoenix Program Director Brandon Mock, went to the family home at bedtime during her first overnight pass, and assisted with the routine there. Soon she felt secure enough to fall asleep at home with her family.

So in general, we work with the parents and child in therapy together to address the emotional and relationship goals, and work with the family to create routines that both parents and child can succeed in carrying out. We can work with the family at our facility, in their home or by Skype.

Finally, we use these two treatment objectives to determine readiness for discharge. When a child is able to identify emotions, experience some ability to regulate them and is able to communicate them to their parents and therapist, these are signs that they can succeed in outpatient treatment. Their emotions no longer destabilize them to the point of significant disruption or harm to self and others. Likewise when the child is able to accept care and support from the parents and therapist, they will be able to avail themselves of support that their outpatient clinicians provide. Upsetting situations can be handled through support from others.

Families feel that the cost of spending time apart is worth it, because the child learns to accept the love and care that her parents have to offer. She can return home and work together with them to share in the challenges and joys of life.

Here is a story from the mother of the 11 year-old girl with problems at bedtime:

Hi Team,

 We just wanted to check in and let you know Camille (not her real name) is doing really well.  She had a great first week home and is settling into a new routine.  Our homeschooling went well also.  She liked the one-on-one attention and even got the chance to help cook lunch with mom.

She took her first bubble bath (thanks to Ms. Rachel and her favorite book with the poem Bath Time).  She was just so cute giggling at the sight of all those bubbles she was about to step into.  (I think I dumped half the bottle into the tub)  Then she laughed because they tickled her skin:)

Last night she Skyped with a friend in Chicago, who was adopted after Camille from the same orphanage.   Camille told her about TLC and said she had to get some help with dealing with her feelings.  The friend said “oh that’s sad”. And Camille told her “no its not sad……it’s good because now I will be home forever.”  It’s good to see her feel more in control of her emotions. 

Residential treatment can become the separation to end all separations.

References:

Daniel A. Hughes, Building the Bonds of Attachment: Awakening Love in Deeply Troubled Children. Jason Aronson, Inc., 2nd edition, 2006.

Bessel van der Kolk, et al, Developmental Trauma Disorder, Psychiatric Annals, 35:5, May 2005, pp. 401-408). )

That’s what makes Chaplain James Amos, or “Jamos” as the kids call him, such an important part of the program.

“My role here is to help encourage and inspire hope in the lives of our kids, the kids parents and our front line staff,” Jamos said.

Hope is what Jamos offered to Ashleigh during a dark and desperate time in her life.

Ashleigh suffered a  trauma during her freshman year of high school that sent her spiraling downward into self-mutilating behavior in which she cut herself with a razorblades or knives.  She suffered such severe depression she tried more than once to take her own life.

“I didn’t want to live anymore,” Ashleigh remembers.  “I told my parents that over and over.”

After several stays in psychiatric facilities, Ashleigh’s parents decided to try KidsTLC.

Jamos was there to offer spiritual guidance and a supportive role to compliment the intense therapies offered by the experienced KidsTLC clinical team.

“If we are going to treat the whole person- body and mind, we also have to treat the spirit, because the spirit is where the wound often lies,” said Jamos.

While Ashleigh worked with her therapists, she grew to trust Jamos as a spiritual friend.

Trauma and sadness are nothing new for Jamos.   He hears the horrific stories of kids who have been abused almost daily.

“A young man shared with me that his mom would chase him around the house with a butcher knife threatening to kill him,” Jamos explains.

“A number of our young ladies have been subjected to horrible sexual abuse that they have encountered at the hands of their biological family, but also with foster or step families,” he said.

“There have been days when I have gone back to my office and just wept.”

But he doesn’t cry for too long.  There is too much to do.

Jamos conducts bible studies for kids in the KidsTLC Phoenix Program for residential psychiatric treatment who want it, organizes group activities, and helps kids of all denominations and religious beliefs worship in their own traditions.

Jamos also offers ways in which kids who have been abused or traumatized can help heal, by reaching out to others in need.

He organized a supply drive with the children of KidsTLC and personally delivered the hygiene items and toys to people who were devastated by the May, 2011 tornado.

“A lot of these kids come in hopeless because what they have experienced in life.  So we try to build into them that you can face the terrible today, because of the possibility or hope of better tomorrows,” he said.

Jamos and the staff also makes sure kids at KidsTLC fun being kids with the annual slop fest, a messy tournament that leaves kids and staff a mess.

For Ashleigh, Jamos was one more source of strength in her journey of healing.

She had two stays at KidsTLC.  Dealing with loss and trauma was a slow and painful, but worth it.

“He gave me an insane amount of support,” Ashleigh said of Jamos.

“He never gave up.”

Ashleigh’s parents met with Jamos as part of her treatment.

“It became very apparent that Jamos was a focal point in her road to recovery,” said Ashleigh’s dad Greg.    “Jamos is part of the family, KidsTLC is part of the family.”

Ashleigh has come a long way since her depression.

Today she is a confident young woman with bright eyes, and an easy going smile.  She works two jobs and is preparing to graduate from high school.

Ashleigh gives back for the help she has been given by sharing her story with kids who are currently in treatment, and with others in the community.

Ashleigh tells them to stick with their program and face what they need to as she eventually did.

“Learn all the different skills they teach you,” she said.

“Facing the pain was hard work and I didn’t want to do it at first.   But now I am so glad I did.  I have a great life.”

Not all of the kids Jamos works with in the Chaplaincy program have done as well as Ashleigh, but he never gives up hope.  And he never gives up on love.

“ I want them to know that regardless of their circumstances or regardless of what they have been through in life, is that they have innate value, they are people of worth.”

By: Dr. Roy Rotz

 The littlest thing seems to set off a volcanic reaction totally out of proportion to the request. “Could you please put away your toys?” or “I need you to stop pestering the dog.” Simple instructions that produce a stream of profanity that would make a hardened sailor blush, or even worse a violent, rage-filled outburst that makes everyone run for cover. The object of these appeals is a 9-year old boy, Billy (not his real name) who is living with his fourth set of foster parents. He has been hospitalized three times in the past two years and has spent a total of six months in two separate psychiatric residential treatment facilities. Foster parents #2 accepted him and his older brother and younger sister for care. The other two children seemed to accept the requirements of the home and settled in for the long haul. In fact, this set of foster parents was so pleased with the behaviors of the older brother and younger sister that they initiated the process to adopt all three. They assumed that eventually the middle child would calm down and act like his two siblings. When the impulsive and aggressive behaviors did not stop, but got progressively worse, the foster parents called the police. They restrained him and took him to the nearest emergency room for a psychiatric evaluation. The results got him admitted for the first time to an acute psychiatric hospital. He was there five days and when it was time to discharge, the foster parents refused to take him back for fear of their safety and that of his brother and sister. That was one of the first stop on the merry-go-round that still spins.

Billy was born to a teenage truant who had gotten pregnant by a man she met while on the run.   They lived together for a while, but he couldn’t keep a job and the pressure of trying to keep Billy, his toddler brother and their mother fed was too much, so the erstwhile father left. Billy’s mom soon took up with a different man, got pregnant with Billy’s younger half-sister and hoped for the best. The new “dad” however, fought a losing battle with alcohol. When he was drunk, which was most of the time, he got mean and would go into towering rages chasing the mother around the house with any weapon he could find. The three small children learned to hide in closets or under tables until the rage subsided and they could emerge to help their battered mother clean up and brace for the next round.

Children like Billy don’t have to be beaten within an inch of their lives to suffer from the effects of severe trauma. Being a witness to violence or living in a constantly violent and unstable environment is enough. Having to endure the rejection of an immature and mostly incompetent parent inflicts deep and long-lasting emotional wounds. Those scars can last a lifetime. The chronic, impulsive behaviors exhibited by Billy are often mislabeled as “anti-social” or “defiant” or “oppositional” or “bad”. The exposure to traumatic events in combination with the highly negative labeling can leave a youngster with a severe case of toxic shame that triggers a reaction against even those with noble intentions, like foster parents or professionals in the child welfare system. One noted child psychiatrist, Dr. George Thompson of KidsTLC in Olathe, Kansas, recently stated in a treatment meeting, “The difference between guilt and shame is remarkable. Guilt is the inherent sense, ‘I feel like I have made a mistake.’ ‘Shame is the unshakable feeling, “I AM a mistake!’”

The result is a child who is hyper-aroused, full of mistrust and highly prone to recreating the trauma that has been so damaging. However, it must be understood that the behaviors are not intentional, but are automatic and adaptive. Billy does not consciously think, “I’m going to scream profanities or try to hit someone with a lamp.” He just reacts instantaneously and intensely to anything that is even mildly upsetting. Experts in complex trauma agree that it has a notably adverse impact on brain development, which can take a lifetime to overcome.

Effective treatment includes the use of restorative therapy models that understand the impact on the brain. It seeks to first help the child find a calm and stable emotional place where the “fight, flight or freeze” mechanism in the primitive brain can be brought under some control and thinking before reacting has a chance to occur. Clinical staff is trained to remain calm and stable in order to provide the kind of emotionally regulated temperature that begins to enable a less intensive reaction. Even though some very provoking and aggressive words or behaviors may be demonstrated by the hyper-aroused child, the treatment team has been trained to not personalize or get defensive. Instead, they choose to see the behavior as an adaptive attempt to accomplish a purpose—recreate the trauma, so that the child has some sense of what to do. Staff is able to remain productively engaged with the child until over time he learns that the calm and stable adults in his life can be trusted. Successful treatment may take many months or even years to complete. The scars will most likely remain, but the person can function reasonably well in spite of them.

NOTE: “Billy” is a fictitious character who is a composite of the type of child treated at KidsTLC, a Psychiatric Residential Treatment Facility (PRTF) in Olathe, Kansas.

“It’s great.  It’s an awesome service,” Kansas City resident Katherine Torbett said.

Call For Action’s annual Shred-it event was a big success.  Long lines of cars made their way through six Commerce Bank locations to drop off old material to be turned into recyclable materials in a matter of minutes.

This year, more than 190,000 lbs. of paper were shredded. That’s 30,000 more than last year.

Some people like Sharon Goldstein of Prairie Village plan for months to come to the event.

“I have one of those shredders at home,” Goldstein said. “It would take me three months to shred all this myself.”

Shred-it is an annual event that continues to grow. Staff and volunteers from Commerce Bank, the Better Business Bureau, Kids TLC and Shred-it hauled bag after bag from car after car all morning long.

“We’ve had a steady flow of traffic,” Dave Foster of Shred-It said. “Cars are lined up as far as I can see.”