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.

Challenges

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?

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 :)

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.

Pre-Group Interviews

The group is finally beginning. All of the hard work and research as culminated into a wonderful final project, ready to be served to the general public! Yesterday, we began our pre-group interview for the children's coping skills group, which will officially begin next week at a transitional housing facility for women and children in Chapel Hill. Given that Orange County does not have a shelter for battered women and their children, a fact that desperately needs to be changed, many of the women in this facility come from domestic violence settings.

The pre-group interviews went wonderful, better than I ever could have expected and/or hoped for. Stephanie and I began by conducting a brief introduction with the mothers. We explained the overview of the program, highlighting new changes to the curriculum. We also emphasized our commitment to working one-on-one with the mothers. We strongly believe that a lack of communication/relationship between facilitators and mothers was a major fault of the last group which we led here in the spring of 2010. Thus, Forgotten Voices emphasizes open dialogue, respect, and trust among facilitators, mothers, and children. We are all working for the same goal: present and future success and happiness for these children. In order to accomplish this objective, it is vital to all work together.

After the introduction, Stephanie and I interviewed each mom along with her child. After this interview, moms completed a brief child history form and the Strengths and Difficulties Questionnaire. This last assessment tool will be compared with a followup version at the end of the group. The results will be used to help evaluate the success and effectiveness of the group.

Currently, we are working with 4 families, with a total of 7 children. Two to three more families are projected to move into the facility this week. If any of the new families include children between the ages of 4 to 11, they will also be included in the group. Stephanie and I will conduct their pre-group interviews at a designated time this weekend, prior to the first group session next week.

Beginnings...

I am nearing the end of my third week of the Fellowship. The majority of this time has been devoted to research; for that reason, I have not posted until this point...as I did not feel it would be quite that interesting for others to read. On the other hand, I was fascinated by the work, loving every minute, and probably talking this topic to death among family and friends. 40 plus hours of research and 5 online trainings from the Center for Child and Family Health: Child and Domestic Violence Series has culminated into the restructuring and creation of a new children's program for the Family Violence Prevention Center of Orange County.

Forgotten Voices is based upon the Wilder Foundation’s Children Domestic Abuse Program (1985). Although never empirically tested, this coping skills program has received large client satisfaction ratings over the past 20 years. The North Carolina Coalition Against Domestic Violence recommends the use of this program for non-trained clinicians. In striving to create the best coping skills program possible, additional empirical sources have been incorporated. While Forgotten Voices is NOT a therapy group, it does contain psycho-education and coping skills components from 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). All additions from these various psychotherapeutic methods are either psycho-education or general coping skill activities, both of which can be administered by non-licensed clinicians. The decision to incorporate these materials was due to the large amount of empirical support that the programs have received, which we believe will serve to ensure more success outcomes for participants.

This program has been structured to instill coping skills in children, as a way to increase resiliency factors and support children exposed to violence. It is important to note that not all children exposed to domestic violence suffer from negative consequences. A child may demonstrate resiliency, thereby buffering the negative consequences of domestic violence. Research indicates that the best predictor for a child’s healthy recovery from intimate partner violence is having an emotionally responsive and caregiving parent. Other factors include: child’s positive self esteem, child’s beliefs that his/her actions can change the outcome of his/her situation, average to above average cognitive, language, and coping abilities, external attribution of blame for violence, family cohesion, extra-familial support, and mother’s warmth/emotional ability (Center for Child and Family Health, 2009). Through various psycho-education measures, parental involvement, and workshops pertaining to self esteem and emotion regulation, the group hopes to instill and foster various resiliency factors in these children, thereby working to buffer the negative effects of their home environment.

Today, I received official word that we have a placement site. We will be working at a transitional housing facility for women and children in Chapel Hill. I am very excited about this placement, given that we just completed a group there in the spring of this year. Many of the initial barriers have already been confronted with this population of women and children, laying the base for a good, working relationship. I think this will also be a wonderful opportunity for this community to partake in, given that we have drastically changed our old program by incorporating empirically supported methods and encouraging parent participation.

Pre-interviews with both the mother and the child are scheduled to happen within the next two weeks. During this time, mothers will complete the Strengths and Difficulties Questionaire, a 25 questions assessment of a child's emotional difficulties, conduct displays, hyperactivity levels, social skills, and prosocial behaviors. A post followup of the Strengths and Difficulties Questionaire will be conducted at the end of the group, along with an exit interview. This will allow us to measure the group's overall success and each child's individual improvement. The group is projected to start Monday, June 14th and will run until Monday, August 2nd. Each session will be one hour in length. Topics will include: introduction to group, self esteem, emotions, families, abuse, safety, anger, and choices. Half-way through there will be a information and parenting skills session for mothers. My co-facilitator will be Stephanie Jones (UNC Greensboro Social Work Graduate Student 2012). Stephanie helped me to lead the group at this transitional home in the spring. She has great experience working with children who display conduct and hyperactivity tendencies. I am really looking forward to the upcoming weeks!