Ready to Start, Ready to Learn, Ready to Help

Fifteen years ago my husband and I went through the training to become foster parents through our state.  This summer my husband and I finished up the training (and are 90% done with the licensing requirements!) to foster through a private agency for a slightly different demographic than we have fostered in the past- I'm sure I'll write more about that experience sometime in the future. 

Last year the following article was published in the December 2019/January 2020 issue of Foster Roster, a magazine sent out to foster parents in my region.  The article was written by the man who was our trainer over a decade ago and as I read it a lot of memories came flooding back- specifically surrounding the word "nervouscited" which is a great way to describe how I was feeling back then and how my husband and I are feeling now as we embark on a slightly different fostering path.

I'm sharing this article now for anyone who may need to hear any part of its message- wether you're just starting out on your journey to become a foster parent or are a veteran or have been considering the possibilities of fostering, or you have found your way here for whatever reason.

Ya’ Know, I’ve Been Thinking… By: Brian Young, Education, Utah Foster Care 

 Every month when I walk into a classroom for Class 1, at one of our region’s DCFS buildings, I look around the room at a group of new faces…. that have absolutely no idea what’s about to happen to them. You all remember that night, right? You were so “nervouscited” to finally start your foster care journey, which I understand, that you didn’t even notice that some of your spouses, if you had one there, were glaring at me with a “I can think of 100 places I'd rather be” face, which I also understand. 

A few months ago, I had a couple looking at me with a different face. It was more like a, “I think I remember you,” face and they asked, “Wasn’t it you that was teaching 15 or 16 years ago when we went through this the first time?” I nodded my head, smiled and thought, “I've been doing this for 20 years and feel, really old.” 

It’s made me think about a lot of things; how much child welfare has changed in our great state over the past 2 decades, how much more we know about how to better help kids and families who find themselves dealing with a situation and system they’d rather not be in, how frustrating and sad it is that sometimes it doesn’t work out the way we wanted or hoped, and how frustrating and sad it is, in a different way, that sometimes it does.

I think what’s been coming to my mind the most is all of you. With a little quick figuring and guesstimating, in the last 20 years, I've met over 3,000 families, roughly 6,000 people who had one thing in common - they had decided that sharing their lives with traumatized children and their families was something they wanted to do, without really even knowing what that meant. But there you were, ready to start, ready to learn, and ready to help. 

I say it every month in class, “People who don’t understand fostering really can’t help you understand and deal with the challenges of fostering.” But I also realize that people who don’t understand fostering, can’t fully appreciate those who do it either. 

You’re an odd bunch, you know that, right? You come to this to help, usually not realizing that “helping” means bringing these kiddos into your homes, lives and families, with all the “stuff ” that comes with them. You give them your heart, your time, your patience, your money, and sometimes whatever was left of your sanity, with the idea that if all goes well, you’ll be able to then watch them walk back, with a piece of your heart, to the family they came to you from. That’s if you have a “normal” case, whatever that means anymore. Add to that the extra stress of a case where it’s a constant battle with a bio-parent, a challenge to work with agencies who are sometimes having to work under a different set of rules than you, and sometimes they, would like, situations beyond your control that make you want to question the one thing you can control, whether you keep doing this or not. And you do. 

Now don’t go getting all misty-eyed on me, we’ll always have more work to do to stay focused. I know when I sit in meetings with DCFS and hear that foster parents are frustrated with, or not participating in efforts towards determining if reunification will work, or deciding way before a judge does that adoption really is the best plan for a child they’re caring for, or want a child moved, because the very behaviors that made sense while we talked about them in class, are now somehow unacceptable in actual real-life practice, we’ll always have more work to do. 

With all that said, what it comes down to, for me, is that I've had 20 years to work with some amazingly odd people. Thank you for trying, even when it seemed like a waste of time. Thank you for hoping, even when it seemed hopeless. Thank you for not saying out loud, in that moment of borderline rational thought, what you were thinking in that family team meeting, knowing you would have regretted it when you calmed down a bit. Thank you for helping those children you brought into your lives know it was ok to trust a parent again. Thank you for stretching your parameters a little, deciding that 9-year-old boy you said yes to really is kinda close to your initial request for girls only, from birth to 3. And the fact he’s a package deal with a 6-year-old sister, when you requested one child only, really is kinda like one, kinda. 

See? I told you, you are odd. 

Thanks and not just from me not that long ago I sat in a meeting with Melonie Brown, our Regional Director, who looked at me and said, “We love our foster parents! It’s crazy what we ask them to do. To take these kids in and love them like their own, give so much of themselves to help them, and then give them back. It’s just crazy, but we love them for doing it!” 

That obviously doesn’t mean there won’t be disagreements, challenges and frustrations, but know your efforts, even though it might seem so, aren’t going unnoticed. Even if you’re not hearing it, I am. 

One last time, thank you. I appreciate the opportunity to be a small part of your journey through the craziness. Even those of you who were staring at me that first night of class with something other than a look of excited anticipation on your face. Thanks for still being here.

Things Can't Be Awesome All of The Time

        Sometimes inspiration can be found in the most surprising of places. Tonight I let my kids stay up way past their bedtime and watch too much TV.  I was trying to finish up one of my final papers of the semester and decided to stay in the same room with them and type while they were watching The Lego Movie 2 on Netflix.  I hadn't seen it before and wasn't paying much attention except to make an occasional glance towards the screen.  I stopped typing mid-sentence towards the end of the movie when I was so unexpectedly touched by the lyrics to one of the songs (to the tune of "Everything is Awesome" from the first movie) that I literally made my 12 year old rewind the movie and pause it while I got all of the words written down on my computer.

Everything is definitely not awesome in the world right now.  We are in the middle of a global pandemic which has drastically changed the economy and people's mental health- not to even mention the obvious fatalities and physical consequences of the widespread virus. 

On a personal level I'm making the transition to unexpectedly homeschooling my kids while trying to finish up my graduate degree which won't even have an official graduation ceremony because numerous plans have been cancelled, put on hold, or turned upside down.  

In addition to the world dealing with collective grief and loss surrounding this latest strain of the coronavirus, I had the heartbreaking experience of recently saying goodbye to my child and adolescent clients from my internship who have already experienced so much grief and loss in their short lives.  I felt guilty for their sakes but relieved that I can have more time to focus on the needs of my children who must be my first priority right now.

I keep vacillating between worrying about my own concerns and then feeling guilty that I'm not in more of a position to help others who are in crisis- specifically those who don't have the luxury of staying home from work because work means putting food on the table for their families or those who are staying home when home is not necessarily a safe place to be.  When it was announced that schools would be closed I immediately thought of the kids who count on school as their safe place (or at least a place to be fed when they may not otherwise be.)  "Child abuse rates are going to be on the rise" I told my husband.  Same with domestic violence.  What must it be like to have to be told to stay safe at home when home is more like a prison for some people?

Last week I finished up a course of immunosuppressant medication to treat an autoimmune flare-up because apparently when I don't admit that I might be experiencing some stress my body is sure to tell me.  I worry about people with underlying medical conditions and those who are more vulnerable, including my elderly parents and my in-laws in their locked down Assisted Living Center. I feel like my own immediate family and the members under my own roof are the only ones that I really have any semblance of partial control over.  In addition to the anxiety and uncertainty surrounding COVID-19, members of my household and residents of my state have also been dealing with the aftershocks from a recent earthquake (which isn't a usual occurrence since this isn't California!)  

All I can do is focus on what things I have control over and which blessings I can be grateful for.  Some days I do better than others.  It's just a fact that some days are going to be easier than others and I need to cut myself some slack on the days when I don't have the emotional or physical energy or motivation to get out of my pajamas, make three home-cooked meals for my family, find a way to be physically active, and organize every single cupboard or nook and cranny in my house while making sure that my kids complete their schoolwork in addition to keeping up with my own school assignments.

Some days you just have to let go of unrealistic expectations and come up with ways to go from "awesome" to "not bad" as these inspiring and reassuring lyrics from The Lego Movie 2 reminded me tonight:

2019 Hiatus & Update

You might be in your final year of graduate school if. . .

You have only written four blog posts IN ONE YEAR!

Yep, I’m still here.  I’ve just taken a brief hiatus as I focus on balancing my graduate studies with my family life and working part-time.  I’ve been made painfully aware that it’s impossible to be “perfect” in all areas of one’s life- something’s got to give and be put on the back burner.  And this blog has definitely been put on the back burner over the past couple of years.

The good news is that I am starting to see the proverbial “Light at the End of the Tunnel” as this Spring I will be finishing up my graduate studies and required hours of supervised internship experience to receive my Masters in Social Work.   Eventually, after 4,000 MORE supervised hours and passing the licensing exam I will be an LCSW (Licensed Clinical Social Worker).

          I am currently working in my second internship placement and I am quite satisfied with both the population I serve and the work I am involved with.  I felt a loss last year, as well as a bit of guilt, when we came to the decision to close our foster care license after 12 years of fostering.  Then in 2019 I was presented with a job opportunity (at my current internship) which seemed to fill that particular “void” of helping children in the foster care system without necessarily being a foster parent.  

        At my current practicum placement I not only get to work with children and adolescents in the foster care system, but with their caseworkers, their foster parents, their biological parents (in some cases), as well as a few Guardians ad Liteums and judges on occasion.  More specifically, I have been trained to conduct mental health assessments and provide in-home therapy to these children and their families.  To learn more about the type of modality I’ve been trained in and use, which is both trauma-informed and attachment-based refer to this post.  Other modalities I draw from in my work with clients are Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) Parent-Child Interaction Therapy (PCIT), and Trust-Based Relational Intervention (TBRI).

          Although I can’t and won’t give details about my experiences for obvious reasons, I’d like to provide some general observations (not necessarily in any particular order) of things I’ve learned over the past year in my therapeutic role to children and families impacted by being placed in state custody.  I feel like I could honestly write an individual post for each one of these observations, but for the sake of space and time these summaries will do for now:

-      Caseworkers have a tough job- witnessing a lot of emotional pain and having high caseloads.  It's challenging to work with clients who are court-ordered and don't believe they need any services.   It’s not surprising that child welfare workers have a heavy turnover rate.

-    I appreciate relatives who are able to step up and open their homes to becoming Kinship Placements- especially grandmas, who forfeit their role as grandparent to that of “parent” to their grandchildren in what could be their years of retirement.  In some cases, these grandmas are the bedrock and/or savior of their family

-      Parentification isn’t just about taking care of younger sibling’s physical needs: (getting them dressed or to school on time, and making sure they have enough to eat), but there’s an emotional aspect a well where the child feels responsible for their parent’s emotional needs.

-   Regarding parentification and patterns I’ve seen, many children from early to middle childhood (grade school) continue to worry about and feel false responsibility for their parents who are or have been absent from their lives due to substance abuse struggles and/or mental illness, and readily excuse and overlook any dysfunction on the part of their parents.  However, by the time these same children reach adolescence or young adulthood they are more prone to be filled with resentment for caring for younger siblings for so long and/or they become tired of having the roles reversed after constantly worrying about or covering for their parents for so long.

-      Attachment is everything.  Children can become hurt, broken, and damaged in relationships (especially in family relationships) but healing can take place with the proper interventions and resources, including supportive relationships.

-     So many disorders can be preventable because of early traumas and one’s family life.  One semester when I had a class delving into the DSM, I would find myself immediately jumping ahead to the section of “Risk Factors” for disorders to find just how many disorders are influenced or precipitated by neglect and abuse, including Oppositional Defiant Disorder, Conduct Disorder, Borderline Personality Disorder, Reactive Attachment Disorder (which is probably the most obvious) but trauma and stressor-related disorders and Depressive and Anxiety Disorders.  

-   
 I believe it’s more important to treat a person than a diagnosis.  And although diagnoses are helpful in formulating a Treatment Plan or understanding which symptoms to focus on (and are necessary for Medicaid reimbursement), a person is much more than their diagnosis.

-   I wish Developmental Trauma were an officially recognized DSM-V Disorder because although it has similarities with other traumas the attachment and trust component require such specialized care and a unique approach.

-      It is essential to understand that someone’s developmental age may be vastly different than their chronological age.  It was very insightful to me to read a very comprehensive neuropsychological evaluation of one of my clients from a developmental psychologist who measured different aspects of one’s IQ.  I realized that I needed to approach this client in a different way based on his developmental age.

-      Symptoms of ADHD and Trauma can look a lot alike.  Sometimes it’s hard to unravel the two- especially if both exist.

         (I got this graphic off of Pinterest- don't know where exact credit should go)

-      Just like “It takes a village to raise a child” , it takes a team to work together for children in foster care.  I’ve been able to attend Child and Family Team Meetings in a new role this past year- as a therapist versus a foster parent- but my observations are the same:  There are so many facets of support to a youth in state custody: physical health, mental health, schooling, other opportunities- that the more professionals and caregivers can step forward and come together in behalf of a child, the more hope and resources there are for the child.  

    I was touched to be able to attend one CFTM where not only the teacher and after-school coordinator of a client were present, but the principal of the school as well.  In a different meeting, a Transition to Adult Living Coordinator was there to help the youth who was preparing to age out of the system.  In other meetings nurses are ready to make sure all appointments or physical concerns are followed through with.  I even discovered that my state has a specific nurse assigned to oversee any youth who are prescribed psychotropic medications.

-      School is children’s work- where they spend most of their day.  Because of that, I’m grateful for trauma-informed classrooms and sensitive teachers.

-      Because I’m a social worker, I try to get the “big picture” of what’s going on in a client’s life: not just their mental health, but their physical health, their social environment, their school, etc.  Having said that, I would like to learn to incorporate more physically-based interventions (besides just deep breathing and meditation- maybe somatic experiencing or sensorimotor techniques) with my clients who have sleep problems- particularly insomnia, or who have a lot of muscle tension as a result of past traumas or whatever reasons.  I feel so frustrated for children and adolescents who can’t relax because muscle aches and insomnia seem like “old person problems”.  Many of these kids have tried melatonin which may help them get to sleep but they cannot sustain restful sleep.  And then they're expected to go to work (school) the next day and perform like nothing is wrong!

-      I use various assessment measures when conducting Mental Health Assessments with clients for the first time, but I recently started using the ACEs- not necessarily because it will give me a diagnosis, but because it helps me to gather a more complete social history of the client.  After one session this year, I was both amazed and saddened that I came across one client who had an ACES score of 9 (out of 10). He had experienced all but one of the adverse childhood experiences.  As I was driving home from work that night and the enormity of what my client had been through sunk in with me I wanted to cry.

    On a more hopeful note, here are some protective factors to help mitigate a high ACES score:

Using Attachment, Regulation, and Competency Modality with Foster Children

This is a summary/review of an assignment I did last semester.

Background:  This year I am doing my internship with an agency that contracts with DCFS to provide Mental Health Assessments and Individual and Family Therapy to children and adolescents who are currently in the foster care system or who have been adopted (in many instances) from foster care. 

Employees at my work are required to read the book Treating Traumatic Stress in Children and Adolescents: How to Foster Resilience and through Attachment, Self-Regulation, and Competency written by two clinicians, Margaret Blaustein and Kristine Kinniburgh.  Blaustein and Kinniburgh are a clinical psychologist and a clinical social worker who both specialize in treating complex childhood trauma and/or in incorporating trauma-informed practices into a range of settings.  These two women were influenced by the work of Dr. Bessell Van der Kolk, among other clinicians, who work with clients impacted by trauma and they have developed a specific treatment framework called the ARC Modality which is used to treat developmental trauma and accompanying problems in youth.   

Before I explain the ARC Modality, I will summarize what Treating Traumatic Stress in Children and Adolescents teaches about developmental trauma and how that fits into my internship:  The population that I work with would never have come into state custody in the first place if they hadn’t suffered from abuse, neglect, or abandonment.  Although the symptoms and diagnoses of my clients vary, all of these children are suffering in some degree from the affects of developmental trauma which can be defined as chronic trauma caused by a child’s caregivers early in life which greatly affects, among other areas, their ability to form safe and healthy attachments with others.  There are many other traumas such as a car accident, natural disaster, or sexual assault which can result in the victim developing acute stress disorder, adjustment disorder, or PTSD.  The difference between a traumatic event such as a car accident or fire, for example, versus parental neglect and child abuse is that they are not usually caused by an individual’s caretaker who has the responsibility to care for them so the child’s ability to trust and form safe and healthy attachments is greatly impacted, sometimes resulting in attachment disorders such as Reactive Attachment Disorder or Disinhibited Social Engagement Disorder.  Many children suffering from early trauma at the hands of their caregivers also have trouble regulating their emotions since so much of their energy and brain is stuck in “fight, flight, or freeze” mode or they are triggered easily.

ARC stands for Attachment,Regulation, and Competency which are the three different domains of their treatment.  When I develop treatment plans and therapy goals with my clients at work I am required to use the ARC Modality.  

 Attachment refers to being able to connect with people in a safe way which is hard for a lot of kids if they never had the opportunity for their parents or first families to meet their needs and model what a healthy, nurturing parent-child securely attached relationship looks like for them.  Regulation simply refers to not only being able to identify emotions in oneself and others but being able to express those emotions in healthy ways (not kicking or hitting other people when you’re angry, etc).  or, on the other extreme, not ignoring or dissociating from unpleasant emotions and sensations.  Competency refers to being able to function executively and follow through with basic tasks of everyday living. 

The majority of my sessions with clients focus on the simple goal of affect identification and regulation- or simply put, being aware of one’s emotions and keeping them in check.  This book not only gives an overview of attachment theory and developmental trauma, but also contains some assessment questions and suggested interventions for treating each of the domains in the ARC Modality- Attachment, Regulation, and Competency.  It’s been especially helpful to get ideas for interventions for attachment because I’ve recently started doing family therapy with a few clients either between parent and child or siblings together and attachment is almost always primarily what we work on in those sessions.  In addition, some of the attachment interventions are ones I can use to increase attunement with my own children in my own home.

If you currently work with or have an interest in working with clients or families who have suffered attachment injuries or developmental trauma I recommend reading the book Treating Traumatic Stress in Children and Adolescents.

The Child Protection Plan

Earlier this year my husband and I had the humbling and sobering experience of meeting with an attorney to draw up the papers for our personal Family Trust.  As part of the process, we had to come up with “nominations” of family members we trusted enough to become guardians to our children in the case that we both died or became incapacitated while our children were still minors. 

Part of the paperwork we had to fill out in our Trust included a document called a “Child Protection Plan” in which we also had to provide information for any possible future guardians of our children.  The name alone of the document, “Child Protection Plan”, sounded like some sort of form a child welfare worker would fill out, but rather than being filled out by a social worker, it was filled out by two parents concerned for the welfare of their children’s futures.  Some of the questions on the document we had to answer were:

“What values do you want instilled into your children?”

“What special holidays or observances would you like them to participate in?

“How would you like your children to be disciplined?”   (I had a whole list of books & theories for this question when, perhaps, the words “lovingly” and “just” would suffice.)

“What community or extracurricular activities would you like your children to be involved in?”

“What people do you want to be a part of your child’s life?”

It was a bit overwhelming to answer these questions because it really hit home what an enormous responsibility and commitment parenting is.  My husband and I found ourselves exploring topics such as “How are we doing raising our children?” and “What kind of legacy do we want to leave for our children after we’re gone?” 

It was also very depressing to think about not being able to be there for our kids when they need us the most.  I automatically equated the way I was feeling to how an expectant parent or birth parent might feel when choosing to make an adoption plan for their child and trying to decide what kind of a family or person to entrust with the sacred responsibility of raising their child.  What an incredible sense of loss and a huge relinquishment of control!  I saw the following quote last year and it helped me to get a glimpse of what it might be like to be a birth parent:

I also thought of what it would be like to be a parent whose children are taken into state custody: Who would I want my child placed with?  Do I even have a say in the matter?  Or, I imagined what it would be like to be an unwed mother in the “olden days” of unethical and unregulated adoption practices who had their child taken from them against their will (I’m knocking on wood that most of those horror stories were in the past and don’t currently exist).  In either case, I would be in a state of utmost panic for the sake of my child:  Would my child’s new caregivers be able to give them the care they need?  If they have children, will they treat my child as well as they treat their own children?

Whether you are a birth parent/first parent reading this who grieves for the child you brought into this world but whom you aren’t raising, or perhaps you had your children taken away from you and placed in foster care or have had to, by necessity, have family members step in and raise your children, and may be shouldering burdens of resentment, guilt, or grief . . .  I think there are some feelings any parent can relate to- namely, It’s tough- [whether you had a say in where your child ended up or if it was against your will and personal choice]- not to be able to raise your children the way you want- or perhaps, by whom you want.  It takes an extreme amount of trust that there are other people out there who have enough love in their hearts and room in their homes (and resources- because raising children isn’t cheap!) to commit to raising a child.

It is also a helpful reminder to those of us raising children who weren't ours to begin with to be mindful of their first families.