From the TFC Director:
Greetings to all of you who serve our TFC and HOPE program children and youth so wonderfully.
I would like to take this opportunity to introduce myself to you. My name is Jason Collender. I am the Treatment Foster Care (TFC) Director here at Catholic Charities Center for Family Services (CFS). I have met or spoken to some of you in my sort tenure with CFS. Many of you I have yet to meet and I look forward to doing so. I am very pleased to be part of the CFS team and appreciate the opportunity to serve my team, our agency partners, you as families, and the children in our care. I began my work in TFC in late January. I may be new to Treatment Foster Care and CFS but I am not new to Catholic Charities. My most recent position with Catholic Charities was also in the Child and Family Services Division (CFSD). I served as Program Director for the Sojourner Unit of the residential services program in Timonium, Maryland. Sojourner was the intensive treatment unit located at our Dulaney Valley site of St. Vincent’s Villa. Many of you may remember the Residential Treatment Center (RTC) program as Villa Maria. I led the Sojourner Unit team for just under nine years until its recent closure as part of the St. Vincent’s Villa consolidation process. I have additional professional experience as a therapist in employee assistance programs, schools and private practice. I started my career as a direct care worker at Villa Maria. I have also worked as a carpenter and as a very part-time musician.
Many of you may be aware of changes in the way children are served in the state of Maryland. In my earlier years with Catholic Charities, children would be admitted to the RTC program and live there for long periods of time, sometimes years. Over the past decade, there has been a movement in the state to have fewer children admitted into group or congregate care. Those who needed residential treatment would stay shorter periods of time. As a result, there has been a strong focus on working with children within their family homes or in therapeutic foster care families in efforts to keep children in need in the community. Trends indicate that, as months and years progress, Maryland is showing an increasing need for foster families. Not only are more families needed as resources for placement, foster families are in a position to serve more challenging children than in the past. I am sure many of you have stories of what those behavioral challenges really look like in the community. Our foster families have grown and continue to grow in parenting wisdom as they navigate the ever-challenging journey of helping our children to thrive and learn in life. As you have learned what is best for children and what works, the same is true about the provider community. That includes our agency as well.
As a society we have evolved quite a bit in our understanding of what mental illness is and how we can best respond to bring relief and healing to those who suffer with it. There have been many schools of thought about what causes these problems and what works best. In looking at helping children and youth, there has been a very prominent approach in working to bring about change in their mental health conditions, most frequently gauged by observing their behavior. Families, schools, treatment providers and foster parents often use what we shall call “behavioral approaches”. These include using a lot of structure and consistency to build discipline, consequences to discourage negative behavior, encouragement, rewards and incentives to motivate positive behavior. Many times, these approaches work and work for a good number of our children in care. It seems to best equate this with what many of us have experienced in our own growing up process. This of course, is also assuming that there is a sense of trust and safety in the adult-child relationship. You all know too well that getting children to accept your teaching first requires children to have a reason to believe and accept what you are trying to teach them. This is established in the building of a relationship with the child. Nurturance, safety, trust and consistency are all part of growing the adult-child relationship in a healthy way.
What we have known and continue to discover is that the children most often presenting with serious mental health issues and problem behavior have a history of bad experiences. These experiences may vary but are not the kind we can just describe as hard times or disappointments. These experiences have been frightening and hurtful in a way that overpowers a young person’s ability to “just get over it.” These experiences that happen early on can have a lasting impact on children throughout their lives and into adulthood if not carefully addressed. These experiences are trauma. For many, when they think of trauma they think of bad memories of physical or sexual abuse. While these are traumatic, trauma can include so much more. The fact alone that a child cannot live in the home of a parent indicates the trauma of separation, whether the new family home is the best thing for the child or not. Children with the most loving and well-intended of adult caregivers experience trauma when the severity of their mental illness and behavior makes it necessary to leave a home urgently and enter a psychiatric hospital. Think about leaving your own home as a child to temporarily live in a place that can be quite frightening. Sometimes trauma has a cause and a fault. At other times its occurrence is just a matter of difficult circumstances or events. This is absolutely true about us as well. Bad things happen and cause us all, as humans, wear and tear.
It is very important to understand what happens to people who are traumatized. Trauma does not just cause bad memories. Trauma activates the body and brain into a protective state. Fight, flight or freeze has often been heard to describe what happens to any living thing that detects a threat. When any of our brains and bodies detect a threat or a lack of safety, they immediately devote all of the body’s energy and resources to the act of protection. This can help explain how smart people cannot necessarily think their way out of a dangerous situation. Have you ever wondered how several intelligent people who witness the same serious event, from the same location, at the same time, can have such vastly different reports on what has actually occurred? When a person detects a threat or experiences trauma, the frontal planning, reasoning and critical thinking part of the brain decreases in its ability to function. The survival and emotional part of the brain takes over and becomes the body’s pilot. Many of our children who have been abused, neglected or otherwise harmed have needed to run away, become aggressive or completely shut down from their bodies in response to trauma. These experiences are traumatic in that they have been overwhelming to the child. The child lacks any coping strategy to deal with their profound harm. When in the moment coping is compromised, the survival response is activated and cannot shut down completely. When you use a computer, think about any time you have opened any program and attempted to shut it down when you no longer needed it. We’ve all seen the message “program is not responding” when this occurs. This is very similar to what happens to traumatized children when they have been harmed to the degree the survival program was opened. Traumatized people cannot just shut this down with their own will. Very common in our TFC children is the phenomenon of them walking around in daily life with their survival program always up and running.
So what happens to anyone walking around in life with this open program? Anything the body detects as looking like, smelling like, feeling like or sounding like a threat or hurt from the past may instantly activate the program all over again. This is called triggering. As care-giving adults, we have often seen children quickly become upset and out of control with no obvious or expected cause. We may have even told a child that he or she was overreacting to something that happened or something we said. The children may not even be aware of what happened to upset them, and most often cannot respond to any explanation, reason or limit on their behavior the adult is offering. Remember, once activated to this state, the brain does not reason or decide as well as when things are calm. Adults are often left scratching their heads as to why and how a child fell into a full-blown behavioral outburst over having to wait for what he or she wanted. Triggering something from the past that was hurtful or harmful may be the reason. How many of your foster children have had major outbursts about food? I will cover the issue of food in a future article.
As you read what I have written, you may be wondering if you were ever fully aware of what hurts have come to the children in your care before they came to your home. You may be painfully aware of how poorly the children have been treated and may think about what it means if the children in your care have not only had a traumatic event, but many, repeated traumatic experiences (abandonment, neglect, loss and abuse). First, despite the best efforts of record keeping in our children’s files, there are many events that may have happened in the lives of these children which occurred outside the knowledge of a caring adult or professional. Traumatized children, like adults, often do not want to talk about these experiences so they do not necessarily report them all. There is a common misconception that this tendency is about hiding hurts or avoiding embarrassment in acknowledging trauma happened. While some of that can be partially true, there is more to it. What we do know is that thinking about or talking about trauma actually brings about significant body discomfort and overwhelming emotions. This is explains why many of our children will not “process” trauma in therapy. It literally still hurts to bring it up, even years later in a safe place away from trauma.
Second, children who have been repeatedly traumatized are even more of a challenge in daily family life. These children may have been hurt so often and deeply that they see the world as a dangerous place where they are not safe, particularly around an adult who can turn on them and overpower them. They don’t trust easily, because they do not feel safe. When you talk to them about the rules of the house or what the activity of the day will be, he or she may be nodding his or her head but simultaneously scanning the area for escape routes or objects to use for protection. These children engage in daily decision-making that appears oppositional or resistant to proven, safe and trustworthy authority. These children also may often appear self-defeating. These are the children who act out and continue to respond in ways that get them into trouble despite your twenty conversations about the same thing, over and over again. These are the children who show discomfort in dealing with consequences but continue to engage in the behavior that brings more consequences. It is easy to get stuck in this cycle with these children. I once talked to a child in the RTC about getting serious consequences for unsafe behavior. The child responded by telling me there was nothing I could do to her that was any worse than anything that has already been done to her. The child had an extensive trauma history and was one hundred percent correct.
I want you all to know that you will all be hearing more about trauma and how to deal with its presence in the lives of foster children residing in your homes. You will hear about it in future training sessions, meetings about the children in your care, from your TFC social workers, your foster child’s mental health providers, and certainly from me. Maryland is taking very positive steps toward developing a trauma-informed system of care. This includes particular attention to developing trauma knowledge in our treatment foster care providers. My commitment to you is to make me and my team available to help prepare you for the complexity of caring for traumatized children and youth.
You have heard the challenges from me and now I will share the positives and potential for rewards. Traumatized children are being served more and more by therapists who have developed competency in addressing trauma in treatment. Many are using evidence-based therapy practices that can bring relief to our children. There is no better holding environment that promotes healing from trauma than a loving, well-trained and patient family. Once children have more effectively dealt with the impact of their traumatic experiences, they make rapid progress. This is highly evident in improved behavior and relationship reciprocity. There is a part of every hurt child that has within him or her strong desire for safety, healing, love and growth. You are all so important in making that happen. I look forward to sharing more knowledge and having more conversations about helping our children. This is an exciting time in our program. Thank you for taking time out of your busy schedules to read my thoughts.
All the Best,
Jason R. Collender, LCSW-C
Treatment Foster Care