– Alvin Weaver
Regional Administrator of Residential Services
There are certain times during the day that are particularly important in the development of an adolescent. Certain routines must be established before the adolescent feels comfortable and secure enough to take the risk of changing behaviors that are a part of his patterned way of life. Once a secure routine is developed a more abstract level of interaction can be established with a higher expectation of results.
The following is an outline for understanding intervention:
There are many types of interventions with adolescents and the following three categories are to be used to help develop a common sense of understanding and terminology that will allow the staff to collectively agree on needed areas and types of interventions.
The three categories are Routines, Anchor Points, and Outside Limits. The amount of flexibility used depends upon the defined categories. Operating a program using a humanistic model can be difficult if the staff does not operate within a similar value system. Since person-to-person involvement is valued as being the most productive type of intervention, subjectivity becomes a primary concern. These three categories define, within broad parameters, an understanding for intervention. An ongoing discussion needs to occur, so staff is aware of what the difference between a routine and an anchor point is, when certain behavior becomes an outside limit, and what type of intervention needs to occur.
If a child is to function as a productive human being, he must participate in certain routine activities each day. He must get up, get washed and dressed, eat, go to school, or engage in some type of social exchange, go to bed, etc. Since routines are life-essential activities, they are not negotiable. But staff should take care to handle them in a manner that helps the adolescent participate in them with a minimum of conflict and upset. Wake up, mealtimes, and bedtimes should never become areas in which staff struggle with an adolescent. Confrontations can come later in the day, at the time chosen by the staff, around activities that are not so essential.
During routine activities, all energy and effort should be concentrated on accomplishing the task at hand. It is helpful if the staff are consistent in their handling of routines so the child can predict what is going to happen and anticipate what is expected of him.
- The wake-up procedure is one of the most important interventions in the day. The night counselor should be aware of the attached outline of how to wake up an adolescent. The most important part of the attached outline is the phase that states the waking up of a resident is a time of mobilization, not confrontation.
- Personal appearance. Children should wash themselves, brush their teeth, comb their hair, and perform all the other usual activities of personal hygiene and grooming. The staff should see that they are adequately and properly clothed. Some children will be able to assume greater responsibility for their personal hygiene than others. Staff should know which children need direction/parenting to achieve the required standard of cleanliness and good appearance consistent with a good self-image, and which children can be expected to assume some responsibility for this, though they might need help at certain times. The child sees himself through the eyes of the adult who cares for him this is communicated by the adult in all the care functions related to the child’s physical well-being and appearance. The adult must be concerned to communicate love and pride in the child’s being, with enough strength, to overcome the child’s poor image of himself and his general despair at his worth.
- Mealtimes should be approached with special tactfulness. They are the most emotionally laden periods of contact between caring persons and the child throughout the day. A child should not be forced to eat, but the caring adult should be prepared to spend a great deal of time coaxing and urging him to eat. In nature, it is normal for a child to eat if hungry. Refusal to eat is always an indication of a serious breakdown in the relationship between the child and the caring adult. Emotionally disturbed children frequently test the adult’s concern for them by creating issues around eating. The process of eating has psychological implications that when we eat, we take something from outside ourselves into ourselves and make it part of us. A child will not take food -happily into himself without protest- that is contaminated by anger distrust, disdain, and rejection. What is not so obvious is that the emotionally disturbed child who feels undeserving and worthless may have to reject food given in love as being something he does not deserve. We are lucky if this happens because we can then join the battle to convince the child of his worth, his usefulness, his lovability, in an area that contains our most powerful aids and opportunities for communicating with care for the investment in the child. So, we fuss and extend ourselves in all the creative ways we can think of. We surround the child with tiny tidbits and morsels: delicious, appealing, tinged with love, appreciation, and a tactful, nonverbal communication of our belief in the child’s worth.
- At bedtime, the child goes from engagement in the context of daily life activities to the isolation of sleep, and the wonder and terror coming to him through dreams and nightmares. Bedtime should be a process during which the staff gradually and gently get the child disengaged from activities in the house, into his room, then into his bed, and finally snuggled down into the comfort and security of sleep. It is important that the staffs’ contact with the child, as bedtime approaches, should not be of a nature that will create anxiety or a feeling of rejection. The focus should be on humanizing experiences that help allay his fears of being undefended while asleep, in an often, unpredictable world. With children who are particularly anxious about bedtime, it is a good idea to have a countdown. Staff should start at whatever time the child begins to exhibit bedtime anxiety. At intervals, the staff should remind the child of some pleasant happening associated with bedtime: the story that will be read, a special bedtime snack, the amount of time remaining before getting into night clothes, taking a shower, or lights out. Sleep is a natural consequence of a series of benevolent retrogressive experiences that gradually detach the child from the reality of the abject world around him in a humanly reassuring way. Since the state of sleep is a state of almost total withdrawal, the staff person can encourage sleepiness in a child by doing everything within their power to ensure the child feels safe withdrawing, and as a practical measure by gradually reducing the amount of stimulation the child is receiving from the world around him through his sensory modalities. The first task is to reduce the amount of communication the child is receiving from the world around him through his eyes and by dimming the lights in the bedroom area. Noise in other parts of the house should be kept to a minimum. In talking to the child in the bedroom the staff member should progress from talking in a normal tone of voice to talking in a soft voice, a whisper, and then silence. The light should be gradually dimmed until the room is dark. Once these routines are firmly established, confrontation of more abstract behavioral problems can begin.