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					                                                                69 Eastern Avenue, P.O. Box 1306
                                                                     Haliburton, Ontario, K0M 1S0
                                                    Telephone: (705) 457-5345 ● (705) 286-2191
                                                                             Fax: (705) 457-3492
                                                                              www.pointintime.ca
                                                                      Email: info@pointintime.ca



June 26, 2008



Hi Julie,

Here is an update on the Anger Solutions™ I have completed so far. I believe you are
aware that I do not run groups per se, but use the program in my work with at risk youth
and their families. As the Differential Response Worker for Haliburton County 80% of
my referrals, come from CAS. The remaining 20% come from Youth Justice (kids on
probation) and in-agency referrals.

Generally, the youth and their families who are referred to me are experiencing
significant conflict; their relationships have deteriorated with huge issues around
appropriate communication between all family members.

 Additionally about 80% of the parents I work with have mental health issues, such as
depression and/or anxiety, and have received little or no support/counseling in the past.
Many of the parents have experienced some form of abuse as children, including sexual,
verbal, and/or physical abuse. About 50% of parents I work with have struggled with
some form of substance abuse in their past, and a small percent continue to struggle with
it.

Other factors that influence the quality of their mental well-being would be most live
below the poverty level; they are in poorly paying jobs, on social assistance, or disability.
My clients live in rural areas where transportation is often an issue, (some do not even
own a vehicle) which further limits their access to already limited resources.

50% of my teen clients are substance abusers with a concurrent disorder such as, ADHD,
ADD, depression, anxiety, PDD and ODD. For the other 50%, substance abuse is not an
issue however; most of them have been diagnosed with one of the above-mentioned
disorders. 80% of my clients are in blended families. 1/3 of the clients referred are
female. I generally work with youth 12 to 17 as well as with their parents/grandparents,
whoever the primary caregiver is, and siblings.

Ideally, I try to deliver the program to the entire family as the conflict within the home
and with other family members has had a significant negative impact on the dynamics of
the family. I normally work with clients in their own homes as transportation is often an
issue, which sometimes presents additional hindrances’ such as younger siblings being a
distraction, a cluttered or unkempt home environment and more opportunity for
distraction, i.e. TV, phone, friends.

It has been a challenge to get through the entire program in a timely fashion, or once the
program has started to have the family follow through on finishing it. The reason for the
above-mentioned challenges is with this clientele the presenting issues often keep them in
crisis mode; therefore, there is regular disruption from the program in order to deal with
the crisis at hand. It is easy to be caught up in constantly putting out fires without getting
to how the fires are being started! They find it very difficult to implement what they are
learning because by the time they are referred to me they are very overwhelmed (both
parent and teens) and have very little faith that positive change is possible. As well
generally, there is underlying mental health or previous abuse issues with the parents that
undermine their ability to provide a stable consistent environment at home.

The first family who participated in the Anger Solutions™ program was a grandmother
and her granddaughter; they completed the entire program, but it took months to
complete. The granddaughter struggled with participating; she was 15yrs. old at the time.
This youth has been diagnosed with extreme ADHD as well as having ODD. The
grandmother found the program to be very beneficial in helping her become more aware
as to how she reacted to her granddaughter’s behaviour. She came to understand how her
responses to her granddaughter’s oppositional behaviour were key in maintaining control
of a situation that would have often escalated into explosive confrontations. The
grandmother has expressed to me on numerous occasions that the Anger Solutions™
program has had a significant positive impact on her ability to cope and manage herself
during stressful and challenging times. The granddaughter has told me that even though
she didn’t always actively participate she did learn something, and has used some of the
strategies to avoid conflict in certain situations.

The second family that I began the program with was a blended family; the members that
participated in the family were two brothers 12 & 15, their mom as well as her partner’s
daughter who was 17. This family had a history of reactive explosive behaviours towards
one another. The youngest son had been diagnosed ODD. In the past, this family had
been victims of domestic violence and abuse. We started the program, but because of an
ongoing need for crisis management, there were many interruptions in the flow of the
program. We completed up to Module #5 Assertive Body Language. I discontinued
delivering a structured form of the program when it became apparent that it was a
challenge for the participants to stay focused during our session. I did integrate the
principles and lessons of the program during normal discussions and visits. This family
did indicate by their actions that they had picked up on the concepts of the program. It
was observed that they did become more aware of how their aggressive behaviour
influenced their family relationships and over time, they did make adjustments as to how
they would respond to each other. This family did indicate a decrease of conflict in the
home and improved relationships with each other.

I have nearly completed the program with two other families. One family is a blended
family of five children and two parents. Historically there has been considerable unrest
and fighting amongst the children and between the children and parents. There are
significant mental health issues with the mother and most of the children, i.e. depression,
mood instability, anxiety, ADHD. This family has been a challenge in that it was
difficult to effectively accommodate the variety of learning styles for all family members
in respect to their ages and their developmental and emotional challenges. It appeared in
delivering this program to the family they found it difficult to grasp some of the concepts,
i.e. differentiating between assertiveness and aggressiveness even after 3 sessions of
explanation and role-playing. I had them write out the definition of assertiveness and
hang it up in their living room and kitchen so they could recite it every night together for
homework.

 As with some of my families, it seems difficult for them to maintain consistency in
implementing new concepts into their everyday lives. They are so caught up in the
conflict and difficulties they are currently experiencing it’s hard for them to change the
way they look at the situation and see their own potential, even when presented with
positive practical strategies for positive change. Even still, although I may not see any
drastic improvements during my time when I’m delivering the program, this particular
family has indicated that there has been a decline in the amount of conflict within the
home; the mother has reported some overall improvement in family relationships. Mom
has indicated that she is making more of a conscious effort not to react to everything that
happens in an aggressive manner.

The other family, with whom I have nearly completed the program with, includes a boy
of 11years, his mother and her brother who has temporary care of his nephew. The boy is
ADHD and had been displaying very aggressive behaviour at home and in school. The
mother’s ability to effectively parent her son was in question, so the uncle was to have
the boy in his care while we supported the mother in doing the Anger Solutions™
program together with the uncle. As it turned out the mother was not committed or
prepared to explore how her behaviour impacted on the relationship she had with her son,
therefore her relationship with her son further disintegrated and we eventually continued
the program with out the mother’s participation. The uncle has reported that he has found
the program to be helpful in looking at how his actions and responses to his high needs
nephew will play a significant role in positively supporting him and setting up a model
for behaviour for his nephew to follow. The uncle has indicated that there has been an
improvement in his nephew’s behaviour at home; there has been less confrontation, less
oppositional behaviour, and more compliance to house rules. Fewer episodes of
aggressive behaviour have been reported by the school in which my client attends.

I started the program with a family whose 15-year-old son was living with another family
member with the goal to rebuild family relations between him and his parents. A break-
down in communication and inconsistent parenting were identified as the key issues.
Substance abuse was a major issue with this boy along with a diagnosis of ADHD. Mom
suffered from anxiety as well as depression. The mom and stepdad were motivated
participants however the teen was not. Present during our meetings were two younger
siblings under the age of 6 years. The Anger Solutions™ program was started, however
due to ongoing family crisis which included the youth getting into trouble with the law,
we discontinued sessions after Module #4 as it was determined that the youth was not
interested or motivated to make positive changes to improve his relationship with his
family or for his own benefit. With the material we did cover, the parents did indicate
they found it to be helpful in identifying how their communication style was contributing
to the difficulties they were encountering with their son.

I did attempt to start the program with another family who initially identified their 14-
year-old daughter as the source of their conflicts. Upon assessing the situation, it was
apparent that dad had extreme anger issues, (dad had been abused as a child, and is on
disability and in chronic pain) and mom suffers from anxiety and depression. Mom was
extremely passive and the father was extremely aggressive. The father decided after the
second module that he would no longer participate; as he believed, he was not in need of
any help. Mom and daughter have since agreed to continue with the program on their
own.

I will be starting the program with a family of three next month 2 parents and their 14-
year-old daughter. The dad in this family suffers from depression and has had some
significant trauma in his past. His family has identified him as an angry person who has a
hard time controlling his temper. The daughter has been defiant and oppositional but has
not been diagnosed with a behavioural disorder.

I feel that the Anger Solutions™ program is a great tool when working with youth and
their families. When I meet these families and find out their history it is common that
there are usually larger underlying issues with one or both parents that also need to be
addressed in order to have somewhat of a solid foundation in which to build up from
which has been one of my biggest challenges in doing family work. I am working with
teens who also have either some trauma in their past, a behavioural disorder, or both,
which also presents another set of challenges when it comes to working with the family
as a whole. Some of these families only agree to my service because CAS has instructed
them to.

It can be an upstream paddle trying to get my clients to see their own potential for
positive change and well-being when they tend to only allow themselves to focus on what
isn’t going right. I do start the program by reading a poem to them called “Nail in the
Fence” which is about how our words can cause as much damage to one another as
physical wounds. I also have my clients near the beginning of the program write out a
list of all the positive aspects they see in each other and ask them to hang it somewhere
visible and try to focus on what may be going right instead of always focusing on what is
going wrong. I ask them to add to their positive lists as they can. I am finding when I
come to the forgiveness module it’s not always an appropriate subject that I can fully
explore within the family unit. Sometimes the individuals who may have cause my
clients pain or anger could also be in the room, or it is so personal they do not want to
share or talk about it amongst other family members. Instead, I have to generalize the
benefits of forgiveness as an important process to move forward. I have used the
workbooks but usually just make copies of some of the exercises to do in our meetings or
as homework, I try to stay away from writing too much as I am finding either due to the
age of some of my clients, or challenges in literacy, writing can be obstacle to client
participation. I have my Anger Solutions™ participants fill out the intake survey, most
of which will acknowledge the negative behaviours and feelings associated with their
anger or frustration and say they hope to achieve some improvement by participating in
the program.

As you may remember when I first did the workshop for the Anger Solutions™ program,
I had just started this job, which I had to hit the ground running with. I have been
incredibly busy since then therefore; I have not had much opportunity to put in the
necessary time to critique the program to further fit the needs of my clients. From my
experiences so far working with this clientele I have discovered, they generally need
more time then one session to fully absorb the information being presented, therefore it is
taking me much longer to complete the program, as well as the fact that these families are
often in a state of crisis.

Julie, I hope that this report provides you with all the information that you were seeking,
feel free to give me a call or e-mail me if you require clarification or would like
additional information.

Sincerely,

Kim Ross
Youth Outreach Worker
Point in Time, Centre for Children Youth and Parents

				
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