 From coercive to strength-based intervention:
Responding
to the needs of children in pain
Larry K. Brendtro, Ph.D.
Executive Summary
For two centuries, there have been
attempts to eliminate coercive discipline practices in education and
treatment. Now, a new positive psychology of youth development has
identified the strengths and supports which lead to resilient
outcomes. But if children’s needs are not met, they can show a range
of emotional and behavioral problems.
Recent clinical and brain studies
indicate that troubled children and youth are reacting to
distressing life circumstances with "pain-based behavior." Those who
deal with such behavior often lack the necessary skills to prevent
and manage crisis situations. Instead, pain-based behavior is met
with coercive interventions. Among the most controversial behavior
management practices are restraint and seclusion. Debates about
these methods reflect three different viewpoints: humanistic values,
research findings, and practice reality. Effective interventions
should be consistent with all three perspectives.
An Inventory of Behavioral
Interventions with troubled children and youth is presented. This
shows a polarization between coercive and strength-based
philosophies. In spite of research on the ineffectiveness of
coercion, such practices persist and are believed by many to be
essential for maintaining order and discipline. The antidote to
coercion is training in strength-based restorative methods. Such
training must provide the specific positive skills necessary to
transform adversarial relationships and climates. Since treatment
philosophies cascade down from leadership levels through staff to
the youth being served, training should orient all stakeholders to
strength-based approaches. The key components of such a training
curriculum are presented.
Children and youth in conflict need
positive guidance and support from concerned and competent individuals.
This requires the creation of respectful relationships and group
climates. Among the most crucial skills are strategies to prevent and
de-escalate conflict. Yet research suggests that up to 90% of youth
professionals do not consider themselves adequately prepared to handle
serious crisis situations (Dawson, 2003). Those who feel threatened by
difficult behavior either react with hostility or retreat from
relationships. In particular, when children become defiant or physically
aggressive, conflict cycles can easily escalate into volatile
confrontations.
At the core of all emotional and
behavioral problems are unmet needs (Sternberg, 1999). Yet it is often
difficult to recognize or respond to these needs because disruptive
behavior seems to call for "extreme interventions." To maintain safety,
order, and discipline, a variety of coercive interventions are widely
employed in settings serving troubled youth. This article examines the
routine use of coercive methods with particular attention to physical
restraint and seclusion. Specific strength-based alternatives are
proposed to meet the needs of our most challenging youth.
Historical perspectives
Concerns about punitive treatment of troubled persons are not new.
Attempts to eliminate such practices were hallmarks of the mental health
movement of the mid-nineteenth century (Bockhoven, 1956). Under the
banner of "moral treatment," idealistic young physicians rejected
authoritarian models and founded the first mental hospitals. Treating
patients as partners, doctors worked on the front lines to create
positive living and learning communities. They saw their primary mission
as forging a close interpersonal alliance that would eliminate the need
for depersonalized and punitive methods. Similar progressive
philosophies marked the Wandervogel youth movement in early
twentieth century Europe. Wayward youth were seen as having positive
potentials, and restorative relationships replaced punishment. A
prominent leader of this movement was Karl Wilker, who transformed
Germany’s most oppressive youth institution. In 1920 he wrote:
What we want to achieve in our work
with young people is to find and strengthen the positive and healthy
elements, no matter how deeply they are hidden. We enthusiastically
believe in the existence of those elements even in the seemingly
worst of our adolescents. (p. 69)
Strength-building reformers apparently
were successful in eliminating coercive methods. Moral treatment
virtually ended restraint and locked isolation in mental hospitals. It
created a climate of hope where most patients were able to heal and
return to the community (Menninger, 1959). Similar progress was
documented in programs for troubled youth world-wide as punitive models
gave way to systems of self-governance (Liepmann, 1928). However, such
reforms were short-lived, only to be followed by the return to
repressive climates. Three factors sabotaged progressive ideas:
Traditionally authoritarian cultures
resisted alternative methods.
There was limited research on
positive youth development.
There were no programs to train
professionals in positive methods.
A noted historian of mental health
chronicled how the positive spirit of the "moral treatment" movement had
vanished by the mid-twentieth century (Bockhoven, 1956). Pessimism
replaced optimism, and the prevailing opinion was that troubled persons
could not be trusted but needed to be kept under strict control. Staff
maintained a high pitch of alertness to spot any sign of impending
violence. This mindset was like vigilance against an attacking enemy and
sparked distrust between helpers and clients. Similar adversarial
climates are common in many current programs for youth.
Controversies about coercion
Although coercive methods are widely used, they continue to be
controversial. A debate has been raging since the Hartford Courant
in Connecticut published a 1998 exposé documenting 150 restraint-related
deaths of both children and adults in care-giving agencies (Mullen,
2000). This prompted professional organizations to re-examine practices
of restraint and seclusion. For example, the American Academy of Child
and Adolescent Psychiatry (AACAP, 2002) published a special journal
issue on management of aggressive behavior focusing on the topic of
restraint. In 2003, the Child Welfare League of America and the
Substance Abuse and Mental Health Services Administration sponsored a
conference on eliminating physical restraint and seclusion in treatment
programs for children and youth. Many other policy and practice
statements have been developed from accrediting and licensing bodies,
and organizations that conduct training in this field. However, the
enduring challenge is how to change entrenched coercive practices of
behavior management.
Restraint and seclusion usually occur
outside of the view of the public, who ordinarily have little knowledge
or investment in such issues. For example, some years ago, a study at
the University of Illinois documented a century of maltreatment of
children at the Chicago State Hospital (Saettler, 1967). Every several
years there was some exposé of abusive practices. After a brief public
outcry, staff would return to the underground use of sundry coercive
methods.
Punitive climates seem to be
self-sustaining. When specific coercive methods of discipline are
outlawed, other forms of coercion are substituted. Thus, when spanking
was banned in schools, educators switched to suspension. Similarly, many
residential facilities traded physical punishment for physical
restraint. One might predict that if treatment programs were prohibited
from using restraint or seclusion, lacking other alternatives,
problematic youth would simply be turned over to law enforcement or
correctional systems where coercion and confinement are routine.
At times the public has seemed to support
coercive treatment of problem youth. In the nineties, schools adopted
zero-tolerance policies to exclude disruptive students. Youth in the
juvenile justice system were sent to boot camps, ostensibly to learn
discipline and respect. But absolute obedience can deteriorate into
verbal and physical abuse, group harassment, disorientation, deprivation
of basic physical needs, and forced exertion to the point of injury
(CBS, 2001). In fact, these same extreme interventions were concocted
three centuries ago by the Prussian Army and used widely with
delinquents until the advent of democracy (Konopka, 1971). These methods
continue to be used in some corrections facilities and private
"treatment" centers which have been described as "gulags" (Parks, 2002).
Such abuse led to this lawsuit in a federal court:
The family of a teenage boy was suing
state authorities for physical abuse in a correctional boot camp.
The boy took the stand, readily admitting he had been a
"troublemaker" who defied drill instructors. He recounted in vivid
detail many incidents of being strapped face down on what was called
the "surf board." He was forced to stay in this position for hours
until he was lying in his urine-soaked clothes. The staff laughed at
him as he cried and pleaded to be released. He had to eat oatmeal
spooned onto the surfboard, and he acquired a serious infection from
consuming this polluted food. Next, the "colonel" in charge of the
boot camp took the stand. He responded to most queries by reading
excerpts from a "policy manual." He dismissed the youth’s
allegations, contending that restraints were used only to manage
disruptive youth and keep them from hurting themselves or others.
Finally, in instructions to the jury, the federal judge noted that
it was not illegal for correctional authorities to administer pain
for purposes of discipline. The "jury of peers" sided with the boot
camp administration.
In contrast to this extreme example,
restraint and seclusion are typically described in the professional
literature as therapeutic or protective rather than punitive. It has
been suggested that sensitive handling of restraint can teach limits,
help children feel safe, and stop any payoff for aggression (Bath,
1994). But, countering these benign rationales for restraint is a
troubling reality. As psychologist Nicholas Long (1995) notes, those
locked in conflict cycles may not be responding in the best interests of
the child, but rather reacting out of their own anger, fear,
helplessness, or frustration.
Intrusive interventions can have negative
effects with particular children. Coercion motivates rebellion in
oppositional youth rather than teaching autonomy and responsible
self-control (Rotherem-Borus & Duan, 2003). Children with histories of
abuse at the hands of adults often construe discipline as hostility
(Dodge & Somberg, 1987). Children from certain cultural backgrounds
experience obedience training of discipline as threats to their cultural
safety (Fulcher, 2001). Coercive discipline with children of color
exacerbates "historic distrust" related to racism. It also contributes
to the disproportionate representation of minority groups in
disciplinary sanctions (Newkirk & Rutstein, 2000; Cunningham, 2003).
Physical restraint by peers was once a
staple of early peer group treatment programs, but later manuals warn
against peer abuse of power (Vorrath & Brendtro, 1974, 1985). While many
state and professional regulatory bodies specifically have prohibited
using youth to discipline peers (e.g., American Correctional
Association, 1994), the practice persists. According to the Omaha
World Herald, a Nebraska juvenile facility used peer physical
restraint an average of 3.7 times per day (Tysver, 2002). The youth
called these takedowns "slammings." One citizen observed: "Wait until
the first accidental death occurs, and the taxpayers of Nebraska will be
ripe for a huge lawsuit."
Among the treatment theories which have
been invoked to justify restraint or seclusion are behavior
modification, attachment theory, and psychodynamic catharsis (Day,
2002). Provocative therapy programs use restraint to "burst the client’s
narcissistic smugness" (Rich, 1997, p. 5). Proponents of "holding
therapy" provoke rage and in an attempt to bond to children with
attachment disorders. In one variation, a child is forcibly wrapped in
blankets for "rebirthing." The scientific evidence to support such
so-called treatment is underwhelming.
Some children seem to seek restraint to
gain intimate contact with adults. Decades ago, Albert Trieschman
described how a child being held during a temper tantrum finally is all
cried out, gives up fighting the adult, and may submit and cuddle in the
adult’s arms (Trieschman, Whittaker, & Brendtro, 1969). Although
restraint can end with a positive tone, this is not sufficient rationale
to instigate holds for treatment effect. Even if data were to show that
provocative restraint modifies behavior, this seems to be the ethical
equivalent of strapping kids to restraint boards until they become
subservient to authority.
Ultimately, any tidy philosophy
justifying restraint should be tested against the perspectives of
children and youth who have been at the receiving end of such
interventions. As one youth in a treatment setting told Raychaba:
The last thing a person needs coming
out of their home is to be faced with a violent situation. That’s
why I don’t agree with this restraining thing, it’s violent. (1992,
p. ix)
Pain-based behavior
Traditional research on troubled youth focuses on observable problem
behavior that bothers others, but largely ignores the perspective of the
"inside kid" (Brendtro & Shahbazian, 2004). In his book Pain, Lots of
Pain, Brian Raychaba (1993) shines a light into the little known
inner world of troubled young persons. He interviewed Canadian youth who
had been removed from their families and sent to alternative settings.
Raychaba himself came from such a background, so most quickly opened up
to him. They recounted the powerlessness of being at the mercy of
traumatic life events. The most enduring theme was that they believed
their pain was seldom understood, even by trained professionals (Raychaba,
1993).
Recent research, including brain studies
of emotional distress, has led to a new understanding of what is
commonly called "disruptive" or "disturbed" behavior. These terms
describe how the observer frames the behavior, but mask what is actually
happening with the troubled youth. Emotional and behavioral problems of
youth should be called "pain-based behavior" contends James Anglin
(2003) of the University of Victoria.
Anglin extensively studied the cultures
of ten residential treatment programs. He concluded that every young
person without exception was experiencing deep and pervasive
emotional pain (Anglin, 2003, p. 111). Similar findings have been
reported in a variety of studies of troubled students and of residents
in juvenile justice settings (Brendtro & Shahbazian, 2004). But few who
worked with such children were trained to recognize or address the pain
concealed beneath self-defeating or acting-out behavior. Instead, the
typical intervention was a sharp verbal reprimand or threat of
consequences. Anglin concluded that many who deal with troubled behavior
lack the training to respond to the pain and needs of the youth.
Describing troubled emotions as "pain" is
more than a metaphor of physical pain. The phrase "hurt feelings" is
literally true. Researchers at UCLA found that physical and social pain
operate in similar ways in the human brain (Eisenberger, Lieberman, &
Williams, 2003). Psychologists used brain scans to study the reactions
of individuals excluded by peers from a computer simulated game. Even
this contrived social rejection aroused precisely the same pain centers
of the brain that are activated by physical pain.
Troubled behavior of children and youth
is closely related to brain states of emotional distress (Bradley,
2000). Many stressors can disrupt well-being:
Physical stressors
produce physiological distress. Examples are abuse, as well as
neglect of basic needs for food, sleep, shelter, and safety.
Emotional stressors
produce psychological distress as experienced in feelings of fear,
anger, shame, guilt, and worthlessness.
Social stressors
frustrate normal growth needs by interfering with the development of
attachment, achievement, autonomy, and altruism.
Children in conflict experience internal
or external distress that triggers pain-based emotions and behavior.
Ironically, coercive behavior management intensifies this distress. In
fact, the word punishment comes from the Latin word poèna,
which means pain. No responsible parent would punish a small
child for crying out in pain, but would try to address the unmet needs.
No medical professional would try to administer more pain to a patient
in pain. But coercive behavior management practices involve fighting
pain with pain.
Blending values, research, and practice
Philosophers of science propose that a problem is best understood
when examined from multiple perspectives (Wilson, 1998). But debates
about behavior management often embody narrow viewpoints and
assumptions. Effective treatment interventions should reflect democratic
values, research evidence, and practice realities. But these can
be in conflict. For example:
Democratic values suggest restraint
interferes with rights of freedom.
Research evidence shows physical and
psychological risks of restraint.
Current practice uses restraint to
ensure safety, compliance, and order.
Only by wrestling with the tensions in
these views can we create more valid and defensible policy and practice.
We begin this process by sampling concepts expressed from these three
diverse viewpoints.
Values
Children should be treated consistent with principles of democratic
society, as individuals of dignity and worth. Discipline should respect
the child’s potential for positive development and preclude acts of
superiority and dehumanization (Seita, Mitchell, & Tobin, 1995). To
ensure the rights of children, the principles of least restrictive
interventions and best interests of the child should apply
(Freud, Goldstein, & Solnit, 1996).
Common law treated children as property
and deprived them of many protections afforded adults. This status has
been dramatically changed under the United Nations Convention on the
Rights of the Child (Castelle, 1990). Children are guaranteed specific
rights to be treated in ways that meet their needs. Children cannot be
subjected to abuse, and specific protections apply to children removed
from their families. Although the United States is the world’s only
democracy that has not ratified the U.N. treaty on the rights of the
child, these standards have the status of international law.
Under ordinary circumstances it is a
felony to strike, hold, or confine a person without consent. But adults
also have a legal duty to protect children which might involve forcible
physical contact, depending on the age, maturity, and status of the
child. Physical intervention to protect property is sometimes seen as a
legal response to a breach of the peace and at other times is precluded
by policies or rules.
Youth-serving organizations bear the
moral responsibility for insuring safety and serving the best interests
of young persons in their care. Values of respect for children must be
intentionally taught. This requires training in the ethics of practice,
rather than just in techniques for behavior control. Formal policies are
not sufficient to protect children. Unless an organization is
transparent and all persons have a voice, there is a high risk of
maltreatment in covert negative subcultures of youth and staff
(Schubert, 2002).
The fact that a coercive method "works"
cannot legitimatize its use. If the end justified the means, each
individual would become a law unto oneself. In his treatise, On
Liberty, John Stuart Mill (1859) wrote, "The sole end for which
mankind are warranted, individually or collectively, in interfering with
the liberty of any of their number is self-protection." With the added
qualification that adults are also responsible for protecting children
from their own self-destructive acts, this can serve as a core value in
work with youth.
Research
A new positive psychology is emerging which views children as having
self-righting potentials and innate strengths for resilient outcomes (Laursen,
2003; Benard, 2004). Problems are seen as resulting from obstruction of
basic physical, social, and growth needs. Maslow (1970) described
"deficit needs" for physiological well-being and "growth needs" for
achieving one’s potential. For children to thrive, basic physical needs
must be met as well as needs for attachment, achievement, autonomy, and
altruism. This is the "resilience code" for positive youth development (Brendtro
& Larson, 2004). When growth needs are met, children develop strengths (Wolin,
2003). If these needs are frustrated, children display a host of
problems (Mitchell, 2003).
Problems present potential learning
opportunities. The successful resolution of difficult life challenges
provides a foundation for the development of positive strengths and
resilience (Sternberg, 2003). If conflict cannot be positively resolved,
cycles of acting out and self-defeating behavior are perpetuated. Those
in direct contact with youth in crisis, including peers, can use
problems as occasions to help an individual gain insight and develop
effective coping behavior (Toch & Adams, 2002).
Studies of the biology of violence show
that coercive treatment produces powerful stress reactions (Niehoff,
1999). Specific triggers include a) restraint, b) prolonged isolation,
c) forced subordination, and d) angry conflict. The immediate brain
effects of stress can endure for many hours, keeping the individual
hyper-reactive to provocation. Episodes of extreme or chronic stress are
chemically burned into long-term memory causing persons to develop
reactive patterns of defensiveness or aggression.
The human brain is endowed with a "Tit
for Tat" program that motivates us to respond in kind to either
friendliness or hostility (Rapaport, 1960). Angry aggression involves
reciprocal hostility (Zillman, 1993). Both parties in an angry conflict
experience hostile thinking, feelings, and behavior. They fuel each
other’s feelings in a series of hostile exchanges which can escalate
into crisis or violence (Long, 1995). This conflict cycle is shown in an
accompanying diagram.
Those in emotionally volatile conflicts
are not being governed by their problem-solving brain. In any
challenging situation, the amygdala in the emotional brain
gathers cues to detect possible threat and then activates emotions that
motivate fight or flight (Aggleton, 2000). Children with histories of
abuse are particularly hypervigilant for danger and react with fear or
aggression to subtle cues of possible hostile intent. Most fears are
learned, but some are preprogrammed in the brain, such as fear of
forcible restraint.
In crisis situations, however benign the
adult’s intention, the critical issue is how the encounter is perceived,
for this is the psychological reality of the child. Threat need not be
physical; the perception of rancor or disrespect triggers extreme
emotional reactions at being violated (Beck, 1999). This pattern of
private logic provides justification and reinforcement for
counter-aggression. One youth in care described his emotional reaction
to restraint:
If you put your hands on me I’m
breaking your neck, you know what I mean? A few people grabbed me
and tried to put me in my room and I just smashed them…. I’ve been
grabbed all my life. You know what I mean? It just turns me right
off when someone touches me. (Raychaba, 1992, p. 94)
Environments that insure physical and
emotional well-being prevent aggression and foster learning and
resilient coping with stress (Bluestein, 2001). If an individual’s sense
of psychological or physical safety is violated, this produces
opposition, aggression, and hopelessness (Hyman & Snook, 2001). Since a
key developmental task of young persons is to gain autonomy (Benson,
1997), coercive behavior management frustrates this need and leads to
reciprocal coercive interactions (Reid, Patterson, & Snyder, 2002).
Coercive behavior control poses serious
physical and psychological risks. Adults who model punitive management
are imitated by youth who then scapegoat and mistreat their peers (Lewin,
Lippit, & White, 1939). Physical encounters with a distressed youth can
trigger physical aggression, placing both parties at risk for injury.
Studies show that prone restraints can cause death, often by positional
asphyxia (Journal of Safe Management, 2000).
Children do not function well in settings
that lack safety, order, and well-being. Thus, ignoring aggression or
allowing youth to act out angry feelings for "catharsis" is not helpful.
Intervening with minor behavior may prevent major problems, said
Goldstein (1999), who advised to "catch it low." Persons also need to be
secure from attacks to their self-esteem. Ridicule or emotional
harassment may have more lasting negative effects than physical
aggression (Garbarino & deLara, 2002).
Isolation can be as destructive as direct
physical restraint. Locked isolation of children produces a surge of
aggressive and self-destructive thoughts and impairs therapeutic
relationships (Miller, 1986). Documented trauma from extensive use of
seclusion includes a host of symptoms of mental illness: sleep
disturbance, anxiety, panic, rage, paranoia, hallucinations,
hopelessness, self-mutilation, suicidal ideation, and a sense of
impending doom (Haney, 2003).
When self-defeating and disruptive
behavior continues in spite of management attempts, the purpose or
function of the behavior can be assessed. This provides the basis for
designing positive behavior supports and interventions (Gable, Quinn,
Rutherford, Howell, & Hoffman, 2002). Since young persons are the best
experts on their goals and needs, they should be involved in assessment
and planning (Artz, Nicholson, Halsatt, & Larke, 2001; Seita & Brendtro,
2002).
Practice
Einstein once observed that common sense is the collection of prejudices
acquired by age 18. This applies to folk theories of human behavior as
well (Hunt, 1987). When dealing with young persons in pain, untrained
helpers who revert to intuitive common sense reactions often deal out
more pain. With greater experience and training, effective helpers can
respond in ways that meet the needs of the young person. The cumulative
effect of these moment-by-moment daily encounters shapes the outcome of
treatment (Anglin, 2003).
The quality of services to children is
largely determined by the qualifications of those who spend most contact
time with them. In Western Europe and increasingly in Canada, child and
youth care roles are filled by highly trained professionals who
are skilled in developing positive relationships with reluctant youth (Garfat,
1995). In the United States, most direct service workers lack prior
training and must learn on the job. Limited in-service training is often
dominated by procedural and liability issues leaving no means for staff
to acquire necessary skills. Thus, many workers do the best they can
using intuitive methods.
Coercive approaches tend towards excess.
In behavioral terms, exercising control over others may be a
reinforcer for persons in power, even if this is not an effective
reducer for the youth’s behavior. Certain personality types are more
likely to embrace punitive practices. For example, adults who are most
frequently injured in work with troubled youth are likely to be males
who are high on aggression and low on empathy (Center & Calloway, 1999).
While physical encounters are unpleasant, sometimes a youth or adult can
actually get some positive reward from this aggression (Jones & Timbers,
2002). Practitioners have identified various reinforcers that can
provide a positive payoff to physical encounters such as restraint.
These are shown in Table 1.
Table 1
Potential Payoffs from Physical Encounters
| Reinforcers for Youth |
Reinforcers for Adult |
| sense of power/control |
sense of power/control |
| excitement/emotional high |
excitement/emotional
high |
| peer/adult attention |
peer/spouse recognition |
| reduce anxiety/restore calm |
reduce anxiety/restore
calm
|
| physical/sexual stimulation |
physical/sexual
stimulation |
| reputation for "toughness" |
reputation as an
"intimidator" |
| opportunity for aggression |
opportunity for retribution |
Many potential payoffs from physical
encounters are similar for both youth and staff. This could explain why
it is so difficult to break cycles of restraint even if these encounters
are unpleasant and fail to modify a youth’s behavior.
Practitioners in residential programs
where peers assist with restraint were polled for their viewpoints on
this issue. Not surprisingly, most staff believed both that peer
restraint was acceptable and, in fact, had certain advantages. They
suggested that when peers help in restraint, one is never
"understaffed." The immediate availability of support of peers can
prevent injury to youth or staff. Programs using peer restraint do not
have to hire physically powerful workers but can operate with less
costly staffing and crisis back-up. Peer-assisted restraint can also
reduce the potential for absconding. However, most recognized that
restraint by adults is the "politically correct" norm and is widely
viewed as less abusive than using peers.
Workers develop personal styles for
coping with difficult behavior. Some learn to secure voluntary
compliance rather than reverting to so-called tough techniques. For
example, "verbal judo" procedures are used by police and other contact
professionals to deflect angry aggression and secure cooperation
(Thompson & Jenkins, 1994). However, in the absence of formal training
to deal with challenging behavior, most adopt a management style
consistent with that employed by others in the informal organizational
culture. This can include underground methods that contravene formal
treatment and discipline policies (Brendtro & Shahbazian, 2004).
Not surprisingly, practitioners focus
mainly on practical matters. To have broad application, treatment
theories must be translated into training programs using principles of
universal design. Jargon-free concepts can be understood by
professionals, parents, and young persons alike. Training also should
apply across a broad range of settings and cultural backgrounds. Content
should be relevant to real-life practice situations and be effective
with a wide range of problems presented by challenging children and
youth.
An inventory of interventions
In spite of research and rhetoric about positive methods of discipline,
coercion thrives. It may be codified in formal rules such as suspension
and expulsion policies. Often coercion goes "underground" as those in
power dish out punishments according to their own folk psychology of
justice. Perhaps the most widespread coercion is found in moment by
moment human interactions that convey emotional negativity or rancor.
Since coercion often operates in the
shadows, such practices need to be brought into the open. Table 2
provides an "Inventory of Behavioral Interventions" which compares
coercive and strength-based methods of discipline. These coercive
methods are in common use in various settings for challenging youth.
Tactics range from mild restrictions to outright abuse. This does not
imply that all use of force is destructive. However, coercive discipline
often sparks conflict and impedes positive growth.
Table 2 identifies three categories of
intrusive interventions, namely physical, emotional, and
social coercion. These are contrasted with physical, emotional
and social support. Specific examples are discussed in the
following section.
Table 2
An Inventory of Behavioral Interventions
|
Coercion |
Strength-Building |
Physical Distress
- Physical Punishment
- Physical Deprivation
- Physical Restraint
|
Physical Support
-
Physical Protection
-
Physical Nurturance
-
Physical Freedom
|
| Emotional Distress
|
Emotional Support
|
Social Distress
- Restrict Relationships
- Restrict Interests
- Restrict Decisions
- Restrict Kindness
|
Social Support
-
Restore Belonging
-
Restore Mastery
-
Restore
Independence
-
Restore Generosity
|
© 2004 Circle of Courage www.reclaiming.com
I. Physical Coercion or Physical Support
Physical coercion produces physiological distress. Interventions involve
physical punishment, deprivation, and restraint. Physical support seeks
to foster physical protection, nurturance, and freedom.
a. Physical Punishment versus Physical
Protection
Children develop best in environments where they are free from the fear
of physical distress or harm. However, many coercive methods are
intended to cause bodily pain. In addition to physical or sexual abuse,
"corporal punishment" inflicts pain through spanking, hitting, slamming,
slapping, hair pulling, pressure points, and other painful treatment.
Punishment by proxy uses peers to administer pain or forces a youth to
cause pain to self by exercise drills, painful posture, or eating
noxious substances (Hyman and Snook, 1999). Tools for inflicting bodily
pain include paddles, straps, clubs, and stun guns, and the use of
painful chemicals like mace. Physical punishment was the main
enforcement tool in dominator cultures but is now considered abuse in
many democracies, even in the home.
Physical attacks by peers or authority
figures have been widely documented in schools and residential settings
with climates of violence and victimization. School psychologists found
that 60 percent of "worst school experiences" reported by students
involved peers and 40 percent involved adults. These experiences were
not limited to verbal put-downs but also include physically intimidating
behavior (Hyman & Snook, 2001). At least half of middle school students
experience physical harassment or attack by peers. Corporal punishment
in schools is permitted in 23 states with three-quarters of a million
incidents documented annually, although many more go unreported. In
addition to the popular paddle, punishment is applied with hands, fists,
straps, hoses, and bats.
Children and adolescents rely on adults
for protection and are very threatened when caregivers become physically
abusive or threaten bodily or sexual boundaries. A student recalled,
"One of the teachers – he threw a kid up against the wall and that was
scary." Another said, "Surly aides who have nasty rumors spreading about
them make me feel unsafe" (cited in Garbarino & deLara, 2002, p. 77).
b. Physical Deprivation versus Physical
Nurturance
For optimal development, humans need to be free from want and to feel
secure that their basic physical needs will be met. They also need safe
and predictable physical environments that contribute to a sense of
health and well-being. Some coercive interventions seek to frustrate
these basic needs.
Children become highly distressed by
discipline which disrupts physiological well being. Examples include
withholding food, sleep, exercise, elimination, hygiene, medical care,
clothing, and shelter. In correctional settings, "shock incarceration"
is designed to disrupt physiological and psychological balance by
interfering with basic physical and security needs.
Physical surroundings can contribute to a
sense of well-being or can be highly distressing. Many facilities are
cold, barren, graffiti covered, and equipped with meager physical
resources. Problems of noise, crowding, temperature, lighting,
sanitation, and air quality are common. Surroundings lack normalcy,
beauty, and harmony with nature. Some settings are purposely designed to
be austere and uncomfortable to avoid "rewarding" youth for problem
behavior or to instill "pains of imprisonment." Bruno Bettelheim (1974)
once compared such conditions to those he encountered as a prisoner in a
concentration camp, and he tried to create surroundings for children
that would be a "home for the heart." An environment of beauty is a
silent teacher conveying to youth that they are of value. Surroundings
of ugliness send equally powerful messages.
Somehow interventions which would
otherwise qualify as neglect or abuse have long been seen as acceptable
for use with delinquents. A widely quoted early model of behavior
modification was conducted at the National Training School in
Washington, DC. The basic motivation system relied heavily on a "token
economy" which began by depriving youth of basic needs. Boys who entered
this experimental project were placed on "welfare" status in bleak
surroundings. They were then forced to earn such basics as decent meals,
privacy, and a place for possessions. As might be expected, most youth
jumped through whatever hoops were required to earn these "privileges."
The day the project closed, the students rioted and destroyed the
facilities.
Children connect to adults who meet their
needs and resist persons who obstruct their needs. Thus, deprivation
damages social bonds. Further, adults have legal obligations to provide
for children, and neglecting this responsibility is evidence of
maltreatment.
c. Physical Restraint versus Physical
Freedom
Humans desire to maintain control over their bodies and be free from
unwanted physical restraint or confinement. Thus, restraint or
seclusion, whether intended as punishment or not, is likely to be
experienced as such. Restraint includes physical holds applied by adults
or peers. Restraint tools include cuffs, shackles, straps, jackets, or
chairs. Chemical restraints employ drugs or injections. Seclusion
imposes severe physical isolation and stimulus deprivation, while locked
settings limit physical freedom. In various forms, physical restraint is
widely used to manage troubled children and youth.
Studies of discipline in residential
settings show that physical confrontations are sometimes instigated by
staff who goad youth until they lose control (Raychaba, 1993). When
their authority is challenged, adults take a combative stance and
provoke confrontation. One girl recalled a family session where the
therapist put his chair in front of the door to block her exit and
commanded, "Talk! Tell your mother what happened." She said she "freaked
out" and was dragged off to seclusion.
I had never hit anybody, never hurt
anybody. ...they were forcing me into this room and weren’t going to
let me out until I told people what I was thinking. I felt like my
world was collapsing. I didn’t feel safe anymore. There was no place
to hide, being locked in this room. (Raychaba, 1993, p. 88)
It is difficult to distinguish physical
restraint for bona fide safety needs from that provoked by mishandling
of behavioral incidents. Even though formal reports are kept, these may
not reflect actual details of how behavior escalated. There is a massive
disparity in the frequency of restraint and seclusion in various
settings serving similar populations. Once expectations are established
that restraint or seclusion will be used, there seems to be an erosion
of boundaries: Youth are primed to get into physical encounters and
adults feel their behavioral control is dependent upon these extreme
interventions. Restraint and seclusion are not limited to dangerous
behavior but are widely used as sanctions for noncompliance and defiance
(Barnett, dos Reis, & Riddle, 2002).
Even professionals specifically trained
for work with troubled children often believe restraint and seclusion
are necessary evils (Wood, 1988). If troubled youngsters do not respond
to normal discipline, staff revert to highly aversive means, such as
verbal confrontation and threats. If this does not work, restraint,
seclusion, and exclusion often follow. While staff recognizes that
coercion does not promote educational growth, they may still believe
such methods are needed to maintain order and authority.
II. Emotional coercion or emotional
support
Emotional coercion produces psychological distress and interferes with
the normal development of emotional resilience (Viscott, 1996). This
includes behavior management tactics involving blame, threat, and
rejection. Emotional support builds empathy, trust, and respect.
a. Blame versus Empathy
Youth need the support of adults and peers who look beneath their
negative behaviors and treat them with positive regard (Benard, 2004).
But fault-finding and judgmental reactions obscure strengths and
exaggerate flaws. Fault-finding assumes the worst about a person. It is
conveyed in overt blame and criticism as well as more subtle nonverbal
signals, such as tone of voice and signs of irritation, annoyance, and
condemnation. Some in authority believe harsh confrontation is tough
love while empathy is weak and ineffectual. But belittling criticism
creates a sense of inadequacy that interferes with the ability to
creatively solve problems.
Adults greatly overuse preaching and
scolding. Reprimands are the most frequent interventions used by
elementary and junior high teachers who deliver one reprimand every two
minutes. Some youth just tune out such nattering, while chronically
disruptive students become more defiant under a barrage of parental and
teacher criticism. Research shows that positive teacher support
decreases inappropriate student behavior, but such is rare in many
programs for troubled students (Shores & Wehby, 1999).
Blame is an innate style of emotional
logic which primes humans to identify and attack a perceived enemy.
Blame is often confused with responsibility which involves owning one’s
behavior and being accountable to others. Blame blocks empathy and
esteem and prevents one from understanding or showing concern for
another. Blame and empathy are incompatible brain states. In blame, one
is driven by personal negative emotions. In empathy, the emotional brain
tunes in to the affective state of another person (Amini, Lannon, &
Lewis, 2001). Only those who experience empathy are able to get accurate
information about the needs of a troubled youth.
b. Threat versus trust
Only those who pass the "trust test" with
young persons are able to engage them in a positive alliance. An
alliance is a positive connection in which parties work cooperatively
towards mutually agreed goals (Kozart, 2002). But threat and
intimidation create fear and lead to avoidance or adversarial contests.
Examples include verbal threats, shouting, swearing, invading space, and
menacing looks and gestures. Peers also use bullying and group
intimidation.
Threat is sometimes used to establish
authority. The display of power enforced by angry emotion presumably
warns kids to be wary of this adult. Rachel, a youth who lived on the
streets of Sydney, Australia, described her reaction to adults who
approached her in a domineering manner:
They don’t listen. They tell you to
shut up. They flaunt their authority. When people try to ram things
down my throat, I want to rebel. I’ll do the complete opposite of
what they want. Staff can’t be the dominator. When I can share with
staff, there is an aura of respect.
Angry, hostile confrontation is even
purported to be a "treatment" method where a therapist or group tries to
break down defenses and exercise control. After the sudden death of his
father, fourteen-year-old Allan displayed troubled behavior in school.
He describes being ripped from his family and shipped to a residential
program where peers were used to punish problem behavior.
I hated this place and they hated me.
During the general meeting, the other kids were required to
"confront" the person who had problems. They would surround you and
yell, scream, and swear. If this didn’t work, the group would
restrain you on the floor…. I hated being restrained and kept
fighting them. When restraint wouldn’t work, the next punishment was
to place the kid in "The Ring." Staff put boxing gear on me. The
other kids would surround me, joining arms. Three bigger, tougher
boys took turns fighting me to teach me a lesson.
(Brendtro & Shahbazian, 2004, pp.190-191)
Outside the mainstream of therapy are some who propose
highly confrontational and intrusive methods. A book on family treatment
advises parents of troubled youth to prepare for "atom bomb
interventions" including taking clothes away, forcing youth to dress as
nerds, selling their possessions, and confining them to the bathroom for
as many hours as they have run away (Sells, 1998). In some group
programs, youth are placed on a "hot seat" and their defenses are broken
down to force disclosure to peers or adults. Intrusive discipline
demands subjugation to dictatorial power.
While children need guidance and limits on behavior,
recent research documents the destructive effect of intrusive
discipline that dictates thoughts and feelings (Barber, 2002). Any
disagreement is stifled by demands of absolute loyalty and obedience to
those in power. Intrusive discipline often is accompanied with the
threat of love withdrawal as if the youth were property owned by
another. Intrusive discipline is emotional abuse and has been shown to
produce serious emotional problems, including both acting out and
internalizing behaviors. In contrast, developing resilience requires a
sense of personal power and self-efficacy so one can exercise inner
control and distance oneself from destructive influences.
While youth need to develop self-discipline, the
obedience model requires subjugation to an all-powerful authority.
Demands for absolute obedience easily deteriorate into abuse (CBS,
2001). Children need trusting relationships with adults and peers who
can provide emotional support.
c. Rejection versus respect
Children who are treated with love and respect come to believe
they are persons of value. But those who feel unwanted and rejected
neither respect themselves nor show respect to others. The most caustic
methods of discipline are hostile, demeaning acts that convey dislike
and rejection. Such treatment triggers the emotion of shame and feelings
of worthlessness. Some rejected persons turn their shame against others
in hate and hostility. Specific behaviors that convey rancor and
rejection include ridicule, name-calling, scapegoating, shunning, and
various verbal and nonverbal signals of indifference, contempt, and
exclusion.
Under the guise of "helping" persons sometimes
patronize with subtle messages that a young person is inferior. More
direct rejection is seen in acts of bigotry and hate which demean
individuals because of their family, friends, religion, race, culture,
class, gender, age, sexual orientation, disability, or appearance.
Prejudicial behavior operated on a continuum of speaking ill of others,
discriminating, segregating, attacking, and destroying (Allport, 1954).
In any setting for youth, adults have legal and moral
obligations to prevent climates of rejection, but such harassment is
common. In many schools, popular students like male athletes use their
strength to ostracize or demean peers they label as "weird." Homosexual
youth are five times as likely as others to miss school because of fear
of such hostility (Garbarino & deLara, 2002) and harassing interactions
are common among both girls and boys. Those most at risk for peer
hostility include children with disabilities, minority populations, and
non-assertive, weaker, or socially different children.
Admittedly, kids who present problems can evoke great
frustration for those who live and work with them. Many adults want to
avoid or get rid of such young persons. A high school teacher in a
training on youth at risk said, "My job is to teach the 70% who are good
kids; it’s not worth wasting time on the others." A principal in another
school bragged that his job was to "amputate" troublesome students.
Many who "demand respect" forget that in its most
basic meaning, respect requires treating others the way we wish to be
treated, which of course is the Golden Rule. Actions that disrespect
youth fuel disrespect and defiance.
III. Social coercion or social support
Children have universal growth needs for attachment, achievement,
autonomy, and altruism (Benard, 2004). Social coercion frustrates these
normal developmental needs. This involves restricting relationships,
interests, decisions, and kindness (Vanderven, 2000). Social support
restores normal developmental growth by providing opportunities for
belonging, mastery, independence, and generosity (Brendtro, Brokenleg, &
Van Bockern, 2002).
a. Restrict relationships versus restore belonging
Needs for attachment are met by supportive
relationships in the family, peer group, school, and community. Since
children have strong motivations for social contact, restricting
socialization is a high-octane means of behavior control. This entails
withholding contact with friends and peers, even if they are a positive
influence. In settings where youth are separated from families, it is a
common practice to treat the right to family contact as if it were a
privilege dependent on acceptable behavior.
Other coercive management methods that block social
relations include lengthy time out, rules against physical contact, and
the silent treatment. Youth also may be deprived of normal bonds by
being placed in settings where they are forced to be in contact with
disliked or feared persons. Ironically many programs that segregated
troubled youth are impoverished of social support. A child can go
through an entire day without any positive social interactions with
another person (Knitzer, Steinberg, & Fleisch, 1990).
b. Restrict interests versus restore mastery
Children are motivated toward challenging activities that develop
creativity and problem-solving skills. Curiosity is among the most
widespread of human emotions, so depriving youth of normal interests and
activities can be a harsh punishment. Examples are withholding
participation in desired recreation or learning activities, such as
athletics, trips, cultural ceremonies, religious involvement, school
activities, and even school attendance. Management by "overcorrection"
seeks to modify behavior by tedious repetition of an action. This is
reminiscent of long-used punishments requiring meaningless, unpleasant
work.
Restricting involvement in activities can wield
short-term punitive power, but interferes with long-term learning. Redl
(1957) contended that young persons needed a rich menu of activities
even if their behavior does not suggest they "deserve" this. Withholding
participation in activities because a youth is not able to handle such
stimulation is a natural consequence. Likewise, there is research
rationale for sequencing activities so less desirable tasks must be
performed before enjoyable activities (this Premack Principle is
sometimes called "Grandma’s rule"). Children are better able to manage
logical or natural consequences than discipline contrived to purposely
cause pain.
There is little disagreement that one can motivate
behavior with token economies that deprive youth of desired activities
or resources. But these "response cost" interventions are much more
likely to engender counter-resistance than strictly positive
reinforcement. We have seen many examples of children in pain who keep
digging themselves into an impossible hole of losing so many points they
lose hope about ever participating in positive experiences. Some years
ago in Texas, a law was passed making participation in sports dependent
upon grades. In spite of public popularity, research by Mike Baizerman
at the University of Minnesota showed that being removed from the
basketball team actually served not to increase scholarly activity but
gang involvement.
c. Restrict decisions versus restore independence
Young persons need opportunities to make decisions and the power to
exercise self-control (Wasmund & Tate, 1995). The desire for autonomy is
frustrated by rigid rules and adult-imposed routines. Large,
depersonalized organizations such as schools are often totally organized
around long lists of prescribed rules and penalties. "But they have to
learn to follow rules in life" is the common rationale of those in
power. That might make sense if the rules imposed matched those in the
real world. Many rules simply interfere with the youth’s desire for
autonomy without teaching any core values. Recurrent examples are
contests about style of dress or grooming. Even when a rule is sensible
it may be carried out in foolish ways that fail to respect the young
person’s need to learn from failure. One wealthy school district
proposed fining any student who was late for class one hundred dollars.
Presumably this rule won’t apply to teachers.
When punishments don’t stop rule breaking, more are
administered. If doctors worked this way, they would double dosages of
medications that create ill effects. Research on effective alternative
schools (Gold & Mann, 1984; Gold, 1995) challenged the myth that "clear
rules and consequences" are effective with disruptive students.
Successful schools modify rules to respond to the needs of non-adjusting
students. This does not mean that permissiveness is desirable since
children need structure and order. Effective mentors are those who can
hold youth accountable as well as respond to their needs (Gold & Osgood,
1992).
In an overreaction to fears of school violence, levels
of security exceeded supervision needs and undercut the capacity of
youth for self-governance. Pervasive monitoring and surveillance limits
privacy. Arbitrary reward and punishment systems impose order without
youth input. Rules not embraced by the governed will be flouted. A
saying common among early youth work pioneers was that building walls
only makes wall-climbing a sport.
d. Restrict kindness versus restore generosity
Positive values develop in a climate of mutual
concern where persons treat others with a spirit of generosity. Being
treated as a person of value and being able to show concern for others
gives life, purpose, and meaning. But without the opportunity to give
and receive kindness, young persons remain self-centered and fail to
develop empathy. When kindness and love are absent, caring for others is
not fashionable. Students harass one another in hostile peer cultures.
Adult-youth encounters are adversarial and aloof.
While love was a central concept in early educational
philosophy, close bonds between adults and youth are frowned on in
depersonalized schools and institutions. Yet, resilience research shows
that "simple sustained kindness – a touch on the shoulder, a smile, a
greeting – have powerful corrective impact" (Higgins, 1994, p. 324-325).
To avoid "pampering" youth, some environments create a
tone where kindness is simply not allowed. When adult-youth contacts are
severely limited to formal social roles, any strong bonds between a
youth and adult are likely to be seen as suspect. Conversations of child
and youth care workers on an international website decry regulations
forbidding expression of warmth between caregivers and children. One
setting requires staff to ask permission to give a "high five" handshake
to a youth!
A group of German professionals visiting a young
woman’s correctional facility in the U.S. were startled at the rule that
neither staff nor inmates were allowed any physical contact. "We think
hugging is therapy," said the puzzled visitors. In fact, behavioral
research showed that in positive settings, youth and adults frequently
interact in proximity of less than three feet of distance (Solnick, et
al., 1981).
Nick Long (1997) concludes that the most powerful
therapeutic method is kindness. The root of the word "kindness" is "kin"
and refers to treating others as if they were related (Roddick, 2003).
Generosity may require giving and forgiving even when our natural
reaction to difficult behavior would be to strike back in anger. The
most dangerous persons are those deprived of kindness and love. Those
who are unable to receive and reciprocate kindness live self-centered
and purposeless lives.
In sum, a wide variety of coercive strategies are used
with problem behavior, although there is little likelihood one can
remedy pain-based behavior by applying negative consequences.
Administering negative consequences or frustrating basic needs and
desires might provide short-term coercive control but does nothing to
build controls from within.
Beyond pessimistic mindsets
For a century, debates about problem behavior have swirled around
punishment versus rehabilitation. Punishment uses coercion to control
deviance while rehabilitation typically focused on deficit and disorder.
Thus, punishment and rehabilitation are not really opposites since both
involve pessimistic, fault-finding mindsets (Brendtro, Ness, & Mitchell,
2001).
As we have seen, coercive interventions frustrate
physical, emotional, and growth needs. Strength-building methods are
grounded in respectful values and the science of positive youth
development. Many of these practices were part of the "natural" process
of rearing responsible children practiced for centuries in cultures that
respected children.
Coercive and strength-building strategies each seek to
produce positive behavior but are opposite in their thrust. Coercion
restricts the very opportunities that strength-based methods seek to
encourage. To be specific:
Physical Coercion
produces physiological distress.
Physical Support
fosters physiological well-being.
Emotional Coercion
produces psychological distress.
Emotional Support fosters psychological
well-being.
Social Coercion
frustrates normal growth needs.
Social Support fosters positive growth and
development.
There is little disagreement that children need both
love and limits to thrive. However, coercion relies on punishment and
adult-dominated controls to instill obedience. Strength-based approaches
use encouragement and guidance to enable youth to follow pathways to
responsibility.
Pioneering child psychiatrist Richard Jenkins
cautioned that we may not always have available enough positive methods
and relationships to deal with highly challenging children without some
use of coercion (Jenkins & Brown, 1988). But unless positives
predominate, management efforts are likely to be futile (Patterson,
Reid, & Eddy, 2002). Research at Girls and Boys Town supports a ratio of
support to criticism in discipline of 9 to 1. This maintains social
bonds and a climate of respect even in moments of correction.
While no coercion-free environment is possible, there
is a profound polarization between punitive and empowering philosophies.
Persons entrenched in coercive approaches may initially believe
strength-building methods are foolish and impractical. Those embracing
strength-building come to regard coercive methods as emotionally
reactive and ineffectual.
Recommendations
The intent of this paper is not to prescribe arbitrary policies that
apply to all settings and types of youth. Instead, we have explored the
challenges of developing interventions that incorporate values,
research, and practice wisdom. The following principles were generated
in discussions with colleagues in the Alliance for Children for
Families. They are presented in order to stimulate dialogue that can
inform policy and practice:
Principle 1: Coercive tactics are educational and
treatment failures.
Democratic values, science, and best practices all point towards
managing behavior with the least intrusive methods. There is a growing
consensus that physical restraint or seclusion should not be used for
discipline, punishment, or for demonstrating authority. The only
legitimate rationale for restraint may be to provide protection or
safety in emergency situations. Whether restraint is used to prevent a
young person from absconding or damaging property depends on the
setting, the youth, and the harm that would result otherwise.
Any restraint and seclusion beyond the minimum time
necessary to secure safety mutates these methods into punishment. Staff
must be trained to recognize when an intervention itself is triggering
continuing volatile behavior, at which point other means to de-escalate
must be used (Joint Commission Resources, 2000). To further limit the
use of highly intrusive interventions, these tests are proposed
(Barnett, dos Reis, & Riddle, 2002):
a) Imminent danger of physical harm exists.
This requires that a person has the motive, means, ability, and
opportunity to hurt self or others. A youth standing across the room
shouting threats does not pose imminent danger. A child preparing to
run in front of traffic does.
b) All less intrusive options are exhausted.
This presumes that preventive and restorative strategies have
been made available. Those who are not trained in these positive
methods will default to coercion.
What is the proper role of young persons in behavior
management? Youth are empowered to help but have no right to harass,
punish, or use coercive methods with peers. Adults knowingly accept some
level of risk when working with troubled youth, but young persons bear
no responsibility for putting themselves at risk. Since restraint is a
physical risk, involving youth in restraint appears to violate current
professional and legal standards, even though some youth could arguably
handle this responsibility better than many adults. This does not
preclude young persons from acting in "Good Samaritan" roles if they can
do so safely in cases of emergency, as by shielding a peer from
abuse or separating peers in volatile interactions.
B. F. Skinner, the founder of modern behaviorism,
concluded that punishment was not an educational method. Expressing a
similar view, Charles Curie (2003) of the Substance Abuse and Mental
Health Services Administration contends that restraint and seclusion are
not therapeutic interventions but evidence of therapeutic failure.
Principle 2: Any restraint is scrutinized as a
critical sentinel event.
Most organizations already require formal reporting of physical
restraints and seclusions. Unfortunately, this has not proven sufficient
to lead to extinction of this method. If we are to walk our talk and
make physical restraint a "last resort" intervention, we need more
intensive procedures to study these problems. This involves two
complementary types of sophisticated processes: organizational
sentinel event analysis and individual
critical event analysis.
a. Organizational sentinel event analysis.
This technology, which was developed in the field of behavioral health
care, puts the system rather than the patient on the couch
(JCAHO, 1999). Serious or chronic adverse events in a program (e.g.,
escape or suicide attempts) are studied in order to identify the root
cause of the problem. Most sentinel events have layers of causes and
one begins by asking why this event happened. From the initial
explanation (e.g., "We don’t have enough staff on duty"), one keeps
asking why questions until answers are exhausted and the root
cause is identified. For example, a common root cause behind restraints
is the lack of staff competence to deal with youth of color who present
verbal defiance. A sentinel event analysis probes beneath superficial
"blame the kid" explanations to identify core systemic problems and
develop proactive solutions.
b. Individual critical event analysis.
Crisis situations provide unique opportunities for
learning and growth. A comprehensive study of critical incidents of
acting-out behavior was recently published by the American Psychological
Association (Toch & Adams, 2002). These researchers recommended using
residents and front-line staff as the primary agents to help troubled
youth understand and change their destructive behavior. Peer and adult
mentors can be trained to assist a youth to reflect on "here and now"
problem incidents, discover how this behavior affects self and others,
and replace "recidivism cycles" with responsible behavior. Creating a
positive alliance between youth and staff requires transforming
destructive group climates. The researchers described the Positive
Peer Culture as an example of such a model (Vorrath & Brendtro,
1985; Quigley, 2003).
The Life Space Crisis Intervention Institute has
developed programs to train professionals to talk to youth in crisis and
help them alter self-defeating behavior (Long, Wood, & Fecser, 2001).
This intensive life space therapy enhances established crisis management
programs such as those provided by the Crisis Prevention Institute (CPI)
and the Therapeutic Crisis Intervention (TCI) models. It provides staff
the critical skills for using crisis situations as learning
opportunities (Dawson, 2003).
Starr Commonwealth and Reclaiming Youth International
developed the Cultivating Respectful Environments curriculum to
build caring climates in educational and treatment settings (Berkey,
Keyes, & Longhurst, 2001; Brendtro, Ness, & Mitchell, 2001). This
involves training adult and youth mentors to foster responsible,
resilient behavior (Brendtro & du Toit, 2004). With serious and chronic
problems, a Developmental Audit® is used to assess the private
logic behind self-defeating behavior (Brendtro & Shahbazian, 2004). Even
with the most serious challenges, the focus is on strengths and
solutions. As Jamie Chambers articulates this positive psychology:
"Glance at problems, gaze at strengths."
Principle 3: Replacing coercion requires training in
restorative methods.
The core competency of restorative intervention is to create
growth-enhancing environments that minimize risks for physical or
psychological harm to either children or adults. Safety cannot be
guaranteed if there is bullying by either peers or staff. Program
leadership must embrace and instill an ethos where no hurting behavior
or misuse of power is tolerated. If youth persist in adversarial
relationships with adults, this is ample evidence that they do not see
adults as acting in their best interests (Anglin, 2003).
Ultimately, youth outnumber adults. As bullying
research has shown, achieving a safe environment requires enlisting
young persons as partners in this process (Olweus, 1993). Even
antisocial youth report that they desire caring and non-violent
environments (Gibbs, 2003). There are now available research-validated
strategies for changing negative peer cultures in schools and youth
serving organizations (Gibbs, Potter, & Goldstein, 1995; Wasmund & Tate,
1995; Lantieri & Patti, 1996; Brendtro, Ness, & Mitchell, 2001).
The Inventory of Behavioral Interventions discussed
above provides the scaffolding for constructing comprehensive training
initiatives which replace coercive with strength-based approaches.
Providing physical support is the antidote to physical coercion.
Emotional support trumps emotional coercion. Finally, social support
addresses the growth needs that underlie resilient behavior. Staff and
youth are trained to replace coercive climates with respectful
environments where there will be no disposable kids.
Principle 4: Enduring change requires system-wide
commitment.
An intensive study of ten residential settings for troubled youth
identified the practical theories shaping the actions of those involved
in the programs (Anglin, 2003). Research showed that the beliefs
articulated at the highest levels of leadership "cascade down" through
the organization. In programs where the core theme was controlling
youth, this adversarial ethos was found at all levels, from policy and
leadership through supervisors to direct contact staff and among the
residents. When the guiding theory was "the best interests of youth,"
this theme also could be tracked through the organization to the young
people in care who acted as partners in their own healing. Similar
research by the University of Michigan studied over 40 groups of
troubled youth. Data showed that the morale and belief systems of staff
teams were reflected in the behavior of the youth. This is a top-down
process where staff problems produced youth problems, not the reverse
(Gold & Osgood, 1992).
Since organizations differ, there are no prepackaged
solutions. The first step in planning is conducting an organizational
audit. Successful programs embody these essential ingredients:
- A strength-based mindset among staff and youth.
- Forming trusting connections with youth in
conflict.
- Responding to needs rather than reacting to
pain-based behavior.
- Enlisting youth in solving problems and restoring
damaged bonds.
- Creating respect among young persons, adults,
leaders, and families.
To the maximum extent, attempts to change systems
should involve all stakeholders. At the governance level, coercive
policies are supplanted by restorative policies. At the executive level,
servant leadership styles of management foster a restorative
environment. Those at the supervisory level seek to build strengths in
direct-care professionals. Persons having most direct contact with youth
are the most potent agents for change and need practical methods for
building positive relationships and group climates. Ultimately, when a
community is enlisted in building reclaiming environments, the
restorative cascade is complete.
Conclusion
Climates of respect do not spring up spontaneously. Building
positive adult and youth cultures requires a new genre of training in
strength-building interventions. The antidote to coercive tactics such
as restraint and seclusion are providing both adults and youth with a
new generation of hands-on skills to replace rancor with respect. All
stakeholders need to be involved in developing safe, restorative
environments for children and youth in pain.
Copyright 2004 by No Disposable Kids, Inc. Presented with Charles
Curie, SAMSHA, at Children & Youth: Their Needs, Our Commitment,
a conference of the Alliance for Children and Families, January 15,
2004, Naples Beach, Florida.
Larry Brendtro, PhD, is founder of Reclaiming Youth International and
dean of the Reclaiming Youth Research Council, Starr Commonwealth,
Albion, Michigan. He has worked as a youth care worker, special
educator, psychologist, and agency executive. He has held appointments
on the faculties of the University of Illinois, The Ohio State
University, and Augustana College. He has co-authored ten books on the
treatment of troubled youth and is co-editor with Dr. Nicholas Long of
the journal Reclaiming Children and Youth. He serves on the U.S.
Coordinating Council on Juvenile Justice and Delinquency Prevention, and
has been on the board of the Alliance for Children and Families. For
further information, see www.reclaiming.com
or call 1-800-647-5244.
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