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eJOURNAL OF THE INTERNATIONAL CHILD AND YOUTH CARE NETWORK (CYC-Net) – ISSN 1605-7406

ISSUE 122 APRIL 2009 •  CONTENTS •  HOME PAGE

PRACTICE

I can’t hold it in forever: Connecting with a youth in pain

Mark Freado

Much troubled behavior results as youth “import” problems that originate in the family or community, thus displacing conflicts on neutral parties. Such outside stressors can overwhelm a youth and contaminate relationships with well-meaning persons. LSCI is designed to deal with such situations through a “red flag intervention.” This article shows how the helping adult can calm turbulent relations, listen carefully to what really is bothering the student, and work with the youth to resolve the problem and restore harmony. In contrast, the simplistic application of consequences often fails to either identify or solve the problem, thus escalating stress and stirring turbulent emotions.

It was obvious from a glance into the room that Brandon was very upset about something. A few minutes later the commotion in the classroom spilled out to the hall. There was the loud voice; part growling, part yelling. Then there was the sound of furniture banging. Brandon came out of the classroom with a very aggressive posture. Soon several staff members formed a semicircle around Brandon, who was threatening harm to anyone who came near him. From some distance away, I asked his teacher, Miss Nancy, if it would be all right if I tried to talk with Brandon. She readily agreed and there was no objection from the others.

I waited a few minutes and let the other adults in the area recede before I approached and asked Brandon if there was anything I could do to help him relax. He quietly but firmly suggested that I could leave him alone. I told him I would stand back and check back with him shortly. He was not quite ready as he paced around in a small area of the hall talking, mostly to himself, about how someone was going to “get f ----d up.” Stage One, The De-escalation Stage, of the Life Space Crisis Intervention (LSCI) had begun. After just a couple minutes, I told him that it was clear that he was very upset about something and I hoped he would be able to talk with me or someone rather than letting things get more out of control. I told him, as I often say to young people in this first stage of involvement in their crisis, “I can see you’re very angry, but I have no idea what you’re so angry about. I’d really like to understand what is going on with you.” Then it was important for me to be quiet so he could consider his choices. Letting silence happen is an important skill that many adults find difficult to embrace without training and support. Giving him some space and time was made easier since all the other students had now settled in their classrooms and the adults had gone back to their primary tasks. Two of them stayed within range but out of sight of Brandon in case things escalated again.

The setting was a small, private, non-profit agency in California providing residential services in group homes in the community. The organization also provided educational and mental health services in another setting that was part of the program. The program served 20 adolescents considered very troubled and at risk in the rating system used by the state. My involvement in the program was as a trainer and consultant, and I had been there several times over a period of a few months. A principal part of the training was Life Space Crisis Intervention (LSCI). As a consultant I spent time in the program settings observing, teaching, and building relationships. During my previous visits, I had established a good rapport with Brandon and believed he would talk with me once he was able to compose himself.

Brandon is thirteen years old, tall, overweight, and of mixed racial background. He has no direct knowledge of his father and, until placement, lived with his mother and younger sister. He is considerably larger than the other young men in his group, giving him a menacing appearance when he is angry. He has been aggressive with peers and adults prior to and during the earlier parts of his placement in this program. In recent months, however, he has been working with the program, gaining new trust, more responsibility, and additional privileges. His nature seemed to me to be much gentler than his reputation would have one believe. We talked about that on other occasions, and he acknowledged that he gets really mad sometimes and uses his size and strength to be threatening.

After approximately 3-5 minutes (those intervals always seem longer than they are), I approached Brandon again to let him know I appreciated his taking some quiet time and hoped it helped him settle enough to talk with me. He did not say anything, which I interpreted as evidence he was more settled. I walked to the doorway of a room adjacent to the classroom and asked him to come in and sit down with me if he was ready. He walked in slowly and sat across from me at a small table. After thanking him for trusting me to talk with him about this problem, I asked him if it would be all right with him if two program staff members, Heather and Ron, sat in the room while we talked. I explained that the way I was going to talk with him was what I was teaching staff to do and, if he let them sit in and listen, he would be giving them a great learning opportunity. Together we could help the staff get better at what they do. He said it would be all right with him if it was only him and me that talked. We all agreed and were able to proceed.

Stage Two of the LSCI intervention, The Timeline, provides opportunity to build trust with a young person through effective listening. One of the goals of this stage is to assist the young person in telling his or her story. In The Seven Habits of Highly Effective People, Steven Covey writes that we should seek first to understand, then to be understood (1989), and so it is with Stage Two of the LSCI process. Our task at this point is to listen to the story from the youth’s point of view, to understand their perceptions and thoughts, and assess their experience for patterns of behavior that get them in and keep them in trouble.

Interviewer: “Brandon, things were really tense as soon as you came to school. Did something happen earlier this morning that caused you to be so upset?”

Brandon: “I don’t want people on my back all the time. People just need to leave me alone.”

Interviewer: “Someone was bothering you this morning?”

Brandon: “Miss Heather came in to get us up like every morning and kept yelling at me to get up so I could get breakfast and get to school on time.”

Interviewer: “She yelled at you like that in a loud and angry sounding voice?”

Brandon: “No, but she kept saying ‘get up, Brandon, get up, Brandon’.” He said that with a sneering voice.

Interviewer: “Brandon, I have to ask, did she say it like that with that tone?”

Brandon just smiled slightly and looked at Miss Heather, who was in the room with us.

Interviewer: “So she said it in her normal voice but she said it a few times?”

Brandon nodded affirmatively.

Interviewer: “Do you think she really just wanted you to get up on time for breakfast and school or do you think she was trying to get you angry?”

Brandon: “She was just being nice but I didn’t want to get up so I yelled at her and said some really bad things.”

Interviewer: “What did Miss Heather do then?”

Brandon: “She just said I should make a good choice and she would be in the kitchen waiting for me.”

Interviewer: “So she gave you some space. Did you get up then?”

Brandon: “Yea, but all I got for breakfast was an apple and some toast to eat in the van.”

Interviewer: “So you were late but she made sure you had something to eat anyway?”

Brandon nodded affirmatively and looked sideways in Heather’s direction.

Interviewer: “Were you upset about something before Miss Heather came in to wake you?”

Brandon: “I was mad the whole weekend.”

Interviewer: “The whole weekend? Was there something going on in the house that you were having a hard time with?”

Brandon put his head down. I could see tears dripping from his eyes.

Interviewer: “Brandon, it looks like something happened that really has you upset. It could be lots of things, maybe with the other boys or the staff. Whatever it is really seems like it’s important to you. Please give me some idea about what happened if you are okay talking about it with me.”

Brandon continued to sit in silence with his head down.

Interviewer: “We don’t have to talk about it if you don’t want to. I can see it is something important to you.”

Brandon: “It’s my mother again.”

Interviewer: “Again? I don’t know what you mean when you say that.”

Brandon: “She was supposed to bring my sister and come to visit me on Friday but she didn’t come.”

Interviewer: “I’m really sorry to hear that, Brandon. I can see that really was upsetting to you.
Anyone would probably be upset in a situation like that. What happened that she didn’t come to visit?”

Brandon: “I don’t know.”

Interviewer: “You don’t know? You weren’t able to talk with her?”

Brandon: “No, she didn’t call and she doesn’t have a phone.”

Interviewer: “You still don’t know what happened, through the whole weekend?”

Brandon shook his head no.

Interviewer: “No wonder you’re upset. You said again. This has happened before?”

Brandon: “She hasn’t come for visits before but she called. This time she didn’t call so I’m mad but I’m also scared something happened.”

Interviewer: “If she doesn’t have a phone, how do you usually talk with her?”

Brandon: “My aunt lives down the street and she has a phone.”

Interviewer: “Did you call your aunt’s house?”

Brandon: “Yeah, but nobody answered the phone.”

Interviewer: “Did the staff working this weekend try to help you find out what happened?”

Brandon: “They let me keep calling and they let me call my therapist and she said she will try to find out, too, but she never told me anything. I told her she better find out something or she’ll be sorry.”

Interviewer: “Three days must seem like a really long time when things like this happen.”

Brandon: “It’s really long. It was her birthday. I got dressed up and had a present for her. I made a cross from wood and painted it for her.”

Interviewer: “Oh, Brandon. No wonder you’re so upset. Did you have problems with other people over the weekend?”

Brandon: “I didn’t really do anything. I yelled at the other guys and the staff but it was no big deal.”

Interviewer: “You held all those upset feelings in pretty much all weekend but this morning they just came flying out. What happened this morning that made it harder to control?”

Brandon: “I can’t hold it in forever, you know! First Miss Heather was on my back in the house then Miss Nancy started on me as soon as I came in to school. My mother didn’t come to visit me and these women are on my back.”

Interviewer: “If I understand this right, you weren’t very pleasant with anyone since this happened Friday but you were a little harder on the women you talked with than the other guys or male staff. Is that right?”

Brandon nodded.

Interviewer: “This kind of thing gets in your way a lot, doesn’t it?”

Brandon nodded again.

In Stage Three, The Central Issue Stage, of LSCI we decide what kind of intervention to use, based on what is the most important issue for the young person and the pattern of self-defeating behavior we discern from listening to their story. In this case, we used a Red Flag Tap-In Reclaiming Intervention. When his mother didn’t show up for this visit, Brandon’s long-held painful feelings about his family were stirred up again. He took out his anger in increasing doses with the people in the house, his therapist, Miss Heather, and then Miss Nancy.

I asked Brandon if it would be all right if we went to work on making sure his mother is all right and finding out what happened last Friday. He said that would be good.

I then asked him if he would change anything if he could do any of this over again. Initially, he said he didn’t know what he could do. During Stage Four, The Insight Stage of LSCI, we try to help the young person gain some situational insight. In The Troubled and Troubling Child, Nicholas Hobbs writes, “Self-control can be taught and children and adolescents helped to manage their behavior without the development of psychodynamic insight; and symptoms can and should be controlled by direct address, not necessarily by an uncovering therapy” (1984, p. 261). Situational insight is one way we teach self-control using LSCI. We try to help the young person recognize that in many of these crisis situations, they have some responsibility for how things turn out. But it is also important that we help them realize they also have some control and power to make things turn out differently.

Many adults talk with young people in trouble about being responsible. Helping them understand that they can also have control about choices and behaviors and power to change outcomes can be a powerful experience. It is most useful if we lead the young person to insight rather than give it to them, as is typical for helping adults who might say, “All you have to do....” Leading them to insight works through effective questioning.

Brandon: “If I could change things, do you think I would be here?”

Interviewer: “I understand that you’d like things to be different with your family, that it is a really big thing in your life. That may be something that’s too big for you to change and I know that could be really frustrating. Is there anything else that happened in this that you could make be different?”

Brandon: “I tore up papers in the classroom, do you mean that?”

Interviewer: “That’s something you might have some control over, do you think? What could you have done differently?”

Brandon: “I could have just told Miss Nancy to give me some space because I was upset about my mom.”

Interviewer: “That’s a good example. Anything else?”

Brandon: “I said some really bad things to Miss Heather this morning.”

Interviewer: “That’s another good example. What could you have done differently about that?”

Brandon: “I could have just got up.” Then, looking at Heather, he said, “Miss Heather, I’m really sorry I said those things to you. You were just trying to help me, but I was so mad about what happened with my mom, I just didn’t care about anything.”

Heather: “Thank you for apologizing, Brandon. I think I understand how badly you felt about what happened with your mom and now I know you’re still worried. Maybe I can help find out if she’s all right and what happened.”

Brandon: “Okay”

Interviewer: “Do you have any ideas how we can help you so things don’t get worse for you when you get so angry about things?”

Stage Five of the LSCI process, The New Skills Stage, is another opportunity for us to teach practical skills or support skills the young person already has. In this case, I was assessing Brandon’s ability to see alternative behavior choices. If he has ideas that will be positive alternatives, we can help him through practice and on-going support with reminders of his plan to keep events from getting out of control. If the idea of what to do comes from the young person and if he has some of the skills already, there is a much greater likelihood that we will be successful in helping him because he is personally invested in the solution.

Brandon: “I could let people know when I’m mad, but they probably already know that. Staff can remind me that I don’t want to make things worse. But when I’m like that, I just don’t care.”

Interviewer: “Not long after things like this happen, though, you do care, Brandon. Now you’re able to see how some of your choices made a situation that was already really hard for you even worse. Can we say or do something that will help you remember that you will care again soon?”

Brandon: “Maybe they can just say that and then give me some space.”

Interviewer: “Let’s make that our plan, then. We’ll ask the staff to remind you to think ahead about how you’ll feel if you handle things better rather than just act on the bad feelings and then give you some space. Then maybe you can talk things out. Are there people here you can talk with like you just did with me?”

Brandon: “I would if they listened like you did!”

Interviewer: “That’s what we’re working on, Brandon, and you just became the best teacher for Heather and Ron since you let them sit here with us. Good work! (Brandon smiles broadly) What needs to happen now so we can move on, besides finding out about your mom?”

Brandon: “I need to apologize to Miss Nancy and my group and fix the things I messed up. I’ll probably lose privileges or something.”

Interviewer: “Let’s start with that apology and getting things back to normal. This program is working on letting the learning and making things right be the consequence rather than adding punishment on top of other problems. Let’s get back with Miss Nancy and check in with the group to see where we go from here. We’ll let you know what’s going on about finding your mom, so you don’t worry that anyone forgot that important thing.”

The sixth and final stage of the LSCI process, The Transfer of Learning Stage, is the time to move on from the problem or crisis and get back to some balance and regular functioning. In this case, we checked with his teacher, Nancy, to be sure she was ready to accept Brandon’s apology and assess the readiness of the group to have him back. We found that we could proceed and help Brandon get closure with his teacher and his peers.

Brandon’s mother is developmentally handicapped and diabetic. She experienced some medical problems that required a brief hospitalization earlier on Friday. The aunt who usually provided the communication link between Brandon and his mother was out of town. His sister stayed with a neighbor for the weekend. Brandon was able to talk with his mother later that day to know she was all right and wish her a happy birthday. A visit was set up for the following weekend.

What we learn from incidents that happen with young people like Brandon is that superficial behavioral approaches to dealing with problems are not enough and they may even make things worse. Brandon did make poor choices and acted in disrespectful and irresponsible ways and that needs to be addressed. Programs that react to such behavior with rewards or punishment fail to address the baggage, painful thoughts, and feelings that troubled young people carry around with them. It is reasonable that there should be accountability for the actions of troubled youth. When that accountability includes trusting relationships with significant adults, as well as understanding and restorative responses, more learning will occur resulting in meaningful growth and change.

References

Covey S. (1989). The 7 habits of highly effective people. New York. Free Press.

Hobbs, N. (1984). The troubled and troubling child. Cleveland, OH. AREA.

Long, N., Wood, M. and Fecser, F. (2001). Life Space Crisis Intervention. Austin, TX. PRO-ED.

 


This feature: Freado, M. (2007). I can’t hold it in forever: Connecting with a youth in pain. Reclaiming Children and Youth, 15, 4. pp. 229-233.