Tuesday, August 10, 2010

August Prompt

Has your involvement this summer in community-based work impacted your motivation to engage further in community issues, research or service?

Most definitely. This project has opened up a world of new possibilities for me. In particular, it has made me realize that instead of pursuing an MSW in Social Work, I would rather obtain a PhD in Clinical Psychology. I never thought that I truly love research; however, I have found that when you find your true interest (trauma and kids), the research becomes enjoyable...fun. In addition, I have really loved creating a coping skills treatment program and measuring its results. I am hoping to continue testing this program, with more formal measures, in the fall. With a PhD, I will have the capability to create treatment programs targeted for minority youth (a section of our population which to this day the mental health field does not adequately serve). We need empirically supported methods for African Americans, Latinos, Asians, etc. To say that a program tested on Caucasians will apply to all other ethnic groups is simply not acceptable. Furthermore, we also need to be looking at socio-economic status. As in many instance, far to often, low-income, minority groups find themselves left behind in the dust (their voices forgotten). The future must work to stop this trend. There is initial work out there, but we need more people to help in this challenge. I hope to be one of these forerunners, working and collaborating within the field to create new empirically-supported treatment programs to help minority youth.

What assistance will be most helpful to you in the fall semester in wrapping up your Bryan fellowship?

The support and guidance that I have received from everyone in regards to this project has been remarkable. I could not have asked for a better network of support. I really cannot think of anything else that I will need, other than the same level of encouragement and care that I have received these last 3 months.

Please share recommendations you would have for future Bryan Fellows knowing what you know now.

My biggest recommendation would be to make sure that you establish a relationship and form of communication with your mentors. I met face-to-face with my community and faculty mentor every week and would email/call about 2 to 3 times a week. Whenever a challenge arose, I knew that I would have support and backup to overcome the issue at hand.

Also, make sure that you pick a topic you find highly interesting. This project will take up a lot of your time and energy. Find something you are passionate about...and it will be worth every minute of it :) I loved every minute of this project. It's a great feeling to love what you do while also making a difference in this world.

Last Two Group Sessions

The eight week group program of Forgotten Voices officially ended last Monday. It really is hard to believe how fast this summer flew by...

The second to last session focused upon the topic of anger. The children were divided into two different groups, based upon age. Within the groups, we worked on skills related to anger (identifying, expressing, coping, and problem solving). The children learned new words to express their feelings (rage, envy, jealousy, irritation, etc). We used anger thermometers to represent our current anger levels. The Turtle Technique from Trauma Focused Cognitive Behavioral Therapy was used to help children learn how to better solve problems. The 5 step process entails - STOP - GO IN YOUR SHELL LIKE A TURTLE - RELAX - THINK - DO SOMETHING. The children really liked this method, and we practiced the technique with role plays. Finally, we worked on some ways to cope with our anger (breathing, mindfulness, yoga, using the 5 senses, and other distraction methods). All of the children really seemed to enjoy this session, and most cited it as their favorite session in the post-group evaluations.

The last session was centered around the topic of choices. The take home message was that we all have choices in life. Some choices are good. Some choices are bad. Ultimately, it is up to the individual to decide how he or she wants to act. The children divided up into two groups and created a skit with puppets centering around a problem. Using the Turtle Technique, both groups worked out the problem and choose an effective and healthy solution. After this activity, the children played a review game as a means of summarizing all of the programs themes. Candy was awarded for participation. Lastly, we had an award ceremony, as each child was given a certificate for the successful completion of Forgotten Voices. A party followed with treats from Loco-Pops, balloons, confetti, and noise makers. The session marked a great ending to a wonderful group experience.

Having finished all of the post-group interviews, the results are phenomenal. Our assessment and evaluation tools show remarkable success. Upon comparison with the Pre-Group Strength and Difficulties Questionnaire, all children either stayed stable within the normal range for targeted issues, or made improvements (moving from an abnormal/borderline score to a normal score) on the Post-Group Strengths and Difficulties Questionnaire. Also, all parents indicated on the Post-Group Strengths and Difficulties Questionnaire that they have seem improvements in their children since the beginning of the group. In addition, on the individual evaluations, all of the children stated that they liked the group and expressed interest in joining another program in the future.

Amazing results. Great project. Future plans...most definitely. We will be back at this transitional housing facility for another group starting the beginning of October. We will continue to assess results, tweaking the program with each run, and working to ensure the success for these remarkable children.

Monday, July 19, 2010

Safety Planning

I want to take the time to say a special thanks to the Chapel Hill Police Department, in particular Officer Geercken, for coming out and speaking to the Forgotten Voice's Children's Group. Many of these children have only come into contact with police officers under rather troubling circumstances (a parent being arrested, a fight being broken up, etc.). The majority of the children expressed initial hesitation about having a police officer visit the group; however, they all displayed a high level of respect during the presentation. Officer Geercken did a wonderful job of interacting with the children and helping to break down the barrier of mistrust. I truly believe that all of the children walked away with a different, more positive, feeling toward law enforcement.


Last week, by far, marked the most challenging group session that I have ever led for child witnesses of domestic violence. The subject topic was abuse. This topic is always a hard one to address, due to both the serious nature and high level of pain associated with the matter. A large majority of the children with which I have had the pleasure of working with over the past six weeks come from extremely troubling backgrounds, having seen/experienced far more pain than any person should ever have to undergo throughout his/her lifetime. Amazingly, which I think says a lot about the success of the group, the children were ready and eager to talk. They wanted their experiences validated. They wanted someone to listen. My co-facilitator and I were able to do this job. We can validate emotions. We can listen. We can give support. However, sadly, a limitation does arise. Without a professional license, I cannot help these children to relive/reprocess this events, something they desperately crave. It makes me sad for the present; yet, motivated for the future, as I definitely now know I want/need to pursue higher education/training in order to effectively help this population.

Currently, I am working on referrals for these kids. The Center for Child and Family Health in Durham has wonderful resources. They use empirically supported treatment plans and accept many forms of insurance, in addition to Medicaide (the plan that the majority of my clients have). Everyone who I have spoken to at this agency is upbeat and positive. They work individually with children to ensure a successful treatment plan. Hope remains in the future. It simply is hard, when you encounter so much pain (physical abuse, neglect, sexual abuse, domestic violence, verbal assault, etc) in a child, and there is no way for you to erase that feeling of violation and sadness away. That memory of pain will always remain with the child. The question becomes, how does the mental health field help a child to reprocess this event in order to move successfully forward in the future. Is it possible to live happily ever after?

Monday, July 12, 2010

Group Updates

As we enter July, Forgotten Voices marks its half way point. The past group sessions have been incredible. Session 2 focused on self esteem. This is highly important given that self esteem is a major resiliency factor for children who experience domestic violence. The session helped the children to realize how they are all unique individuals and concluded with the creation of an "I Am Special" poster, in which every child made their hand-print and wrote an adjective underneath to describe themselves. This poster has been, and will continue to be, hung up at every group session. Session 3 centered on emotions and feelings. The children were challenged to explore different emotions and talk about how these made them feel. Instead of saying, "I feel good," the children were encouraged to expand and use different words such as happy, enthusiastic, delighted, etc. The example of a "rainbow of feelings" helped the children to understand that we all go through different feelings, ranging from red (anger) to blue (sad) with a multitude in-between. The take home message was that all of our feelings are valid. Session 4 dealt with families. We talked about the similarities and differences in families. At the end of the session, each child was received "A Special Member Of My Family Award." This session emphasized that although families can be different, that is okay.

Given the half-way mark of the program, we held a special parenting session last week. This was a chance for parents to check in, voice concerns, learn more about their child's progress, and participate in a parental psycho-education component on the impact of trauma on children and parenting skills. The meeting was a huge success. It was projected to only last one hour, instead due to large parent involvement/participation, it nearly lasted two! These mothers have been such a pleasure to work with. Through their dedication, concern, and support of the program it is obvious how much they truly care for their children and are actively working to ensure their successful futures. I feel honored to be working in their presence.

The first half of Forgotten Voices has been a true success. For the second half, we will begin to wind down the group and begin focusing on developing a training program for future group facilitators. I feel confident that the second half of Forgotten Voices will continue to thrive and prosper :)

Tuesday, June 15, 2010

June Reflection

I am extremely happy with the initial start and success of Forgotten Voices. Starting in May, I researched extensively for 3 weeks. I delved further into the study of domestic violence, especially its effects pertaining to children. Of particular note, I completed a Child and Domestic Violence Training Series through the Center for Child and Family Health. Lastly, I investigated the newest, empirical treatment methods: Trauma Focused Cognitive Behavioral Therapy (Cohen, Mannarino, & Deblinger, 2006), Group Treatment for Children Who Witness Woman Abuse (Loosley, Bentley, Lehman, Marshall, Rabenstein, & Sudermann, 1997), Structured Psychotherapy for Adolescents Responding to Chronic Stress (DeRosa, Habib, Pelcovitz, Rathus, Sonnenklar, Ford, et al., 2006), and Alternatives for Families: A Cognitive Behavioral Therapy (Kolko, 2002). Components of these methods have been incorporated into our new coping skills program: Forgotten Voices.

To be honest, the biggest challenge for me has been to not overstep my boundaries. I am NOT a trained clinician. And this is NOT a therapy group. Forgotten Voices is a coping skills group, that untrained clinician can facilitate to children experiencing times of transition and change (ex. domestic violence, transitional housing, etc). Thankfully, I have a wonderful support group through Ardith Burkes (Community Mentor), Bob Pleasants (Faculty Mentor), and Nicole Heilbron (UNC Clinical Psychology), who have all helped me to understand my limits. This collaboration has resulted in the creation of a new program (Forgotten Voices), which utilizes empirically supported treatment program components, for untrained clinicians to administer. This work has definitely further fueled my desire to become a therapist, further reinforcing that this line of work is my life calling.

Having completed the pre-group interviews with both moms and children and Session 1, my biggest surprise has been the overwhelming amount of support and participation, we have received from both the mothers and the children. I have facilitated 4 coping skills groups in the past. This group, by far, possesses the most engaged mothers. To be fair, we have changed components of the program, strongly emphasizing communication between facilitators and mothers. However, even with this new focus, I have been pleasantly surprised by the overwhelming interest these mothers have taken. I truly hope that the enthusiasm continues throughout the program's development.

In general, the scope of the program has changed slightly. Initially, I had thought that from the very beginning I would be advertising at schools and local agencies in order to recruit children. However, the Family Violence Prevention Center and I decided that instead it would first be better to focus on creating a sustainable and well-researched program. Second, we would test it at a familiar location which we have worked with in the past. Last, we will conduct more recruiting, especially with DSS (Department of Social Services), at the end of the summer, once we have the results from the success of our group (pre and post evaluation measures are being conducted) and a solid program created and finalized.

Overall, Forgotten Voices has been a success. I am extremely happy with the progress made thus far. I look forward to seeing how the rest of the summer progresses, ready to tackle new challenges and embrace pleasant surprises.

Session 1: Introduction to Group

This week, we completed our first successful group session. This first session serves as a basic overview of the program, enabling the children to understand the goals and expectations of group. All of the children seemed very excited to be there, fully participating throughout the session. They all directly expressed that they believed that the group was a good idea, that they felt there was a need to have this group, and that they wanted to participate in the group.

The main goal of our first group was to teach the children that "Violence is Never Okay." We talked about how we live in an extremely violent world, creating a collage from newspaper images to illustrate this point, and that "No person deserves to live in a world like this." We ended by talking about respect for others and self-respect. The children all gave examples about how they would show respect either to others or their selves this week. Candy was awarded for participation.

All of the children expressed desire to come back next week. We are off to a successful start! Hopefully, things will only continue to get better.