Meet the New Nursing Management Team

         Pomegranate announced an updated nursing management infrastructure recently. Under Pomegranate’s new Director of Nursing, Melveena D. Edwards, PhD, RN, BSN, MA (with significant psychiatric nursing experience),  three nursing supervisors were named: All have demonstrated psychiatric nursing proficiency and supervisory experience.  The new structure includes a supervising nurse manager, Thomas Engram, RN, whose focus is management and support for nursing and care staff in both the acute hospital and residential treatment setting across all five wings. Pomegranate employs over 200.  

          Edwards explained the new nursing model, ‘Nursing C.A.R.E.S’, which stands for: compassion, accountability, respect, excellence and service. The inspiration behind the model is Watson’s ‘Ten Carative Factors’.  “The DON will assume a more educational focus to promote excellence, innovation and change management encompassing evidence-based practice.  There are now rounding nurse huddles, a greater reliance on strategy, data collection and statistics as well as documentation. When a resident/patient is admitted, he/she is assigned a therapist and a CPST (psychiatric case manager) and now, his/her own nurse.  In addition, nursing is assuming a more prominent leadership role as part of the enhanced corporate-wide emphasis on trauma-informed care,” said Angela Nickell, MS, CEO.

           At the October 2015 All Staff meetings, nursing supervisors presented an updated and more thorough trauma-informed care module which will be expanded upon in small group sessions with participation of Pomegranate’s compliance/quality improvement manager, Kia Brown, LPN.  Nurse Engram, the presenter, shared statistics that ‘90% of public mental health clients were exposed to trauma and most to multiple experiences of trauma.’  He explained that the effects of trauma predispose a client to maladaptive coping mechanisms such as the body’s natural alarm system not functioning as it should -which can result in a diminished capacity to trust others and affect an individual’s sense of safety.  A maladaptive response might include the survival mode of fight, flight or freeze with rational thought less possible. A client might experience hyperarousal or shutdown mode.

             According to Nickell, “along with the nursing infrastructure update, an intake social worker is joining the acute admissions team due to Pomegranate’s growth and quality enhancement initiative.  The exam room is being renovated and updated with an enhanced focus on patient and family care upon admission, with a streamlined entry process in the works.  Nurse Tiffany Folmar RN was named residential UR/admissions manager as Valerie Nutter transitions to the business development & marketing team as customer relations manager.  This will continue to contribute to our positive, safe and therapeutic environment in building professionalism, enhanced therapeutic communication, rapport, and patient advocacy as Pomegranate continues to look toward the future.”

What is a psychiatric assessment about? What to consider.

What is a psychiatric assessment about? When does a child need one and what are the implications for diagnosis and treatment?  At the Cincinnati Children’s Pediatric Mental Health Conference held in early October, Sergio V. Delgado, MD, Professor of Psychiatry, Child Psychiatry Medical Director and Outpatient Services at CCHMC presented a highly accessible general session covering psychiatric symptoms, parental concerns, learning issues and diagnostic dilemmas. An integrated assessment is important because it includes developmental milestones in addition to what are considered psychiatric and learning issues. A pediatrician is often the first to be consulted and will know when to refer to a psychiatrist.

When a problem presents, there might be psychiatric symptoms which include ”irritability, disruptive behavior in school, (suspensions), trouble paying attention in class, mood swings, depression, suicide attempts, self-harm, cutting and/or substance abuse.”  Delgado named several DSM (diagnostic manual) psychiatric diagnoses.  Then there is the ‘mom report’. This report can include  ‘outbursts’, ‘rapid mood swings’, ‘anger towards others’, ‘history of ‘getting depressed’’ coupled with a history, and/or record of prior treatments.  Parents may become frustrated with therapy, medication, school, and even their own parenting approaches. Signs and symptoms as described by patient, parents- including frequency, variations or intensity, may be 40-60% inaccurate, so a multi-faceted approach is important.

Delgado discussed early years, and  subjectivity of others. Is the child secure, anxious, dismissive or disorganized? What is development of cognition, and different learning styles like?  He stated that 10-40% of the population  have learning weaknesses; 6-7% of population has a formal learning disability; schools often help about 2-3% (based on funding), and 15-20% of the population may have some symptoms of dyslexia.  In addition, early life experiences of trauma, environment, intellectual disability, learning disability or brain injury may affect outcomes.

An appropriate visual called ‘Our Expectations’ shows a professorial man behind a desk addressing a bird, monkey, penguin, elephant, fish, otter, and a dog. He says, ‘for a fair selection everybody has to take the same exam: please climb that tree.’  If 80% have a language-based learning disability, and 20% a non-verbal learning disability, this could explain some of the contributing factors to difficulty with learning and behavior.  An integrated assessment includes verbal, visual, fluid reasoning, working memory and processing speed. There are contributing effects of cognitive weakness which can include everything from sensory responsiveness to social skills, understanding moral rules, reciprocity, fine motor skills, and impaired insight.  As a result, a child or teen might be oppositional, manipulative, truant, disrespectful, and awkward, isolates him or herself, or engages in impulsivity. It is not an equal playing field for differently abled kids.

Delgado presented representative examples as approached from different professionals-occupational, and speech-language. He cautioned that, ‘our expectations need to match with the child’s abilities.’  This might require an IEP (individual educational plan) for the home- and not just the school.  He suggested a visual token system to accumulate successes and not lose what is gained.  There are also hardwired personality traits. Some children will be more dependent (clingy); others demanding, or self-destructive. Some will reject help altogether. His recommendation is to be humble in the face of a comprehensive assessment and be prepared to offer a large amount of external support.  His final slide: ‘it’s okay to be different’ summed up a message of acceptance and hope.

(Photo credit: Image shows Air Force Capt. Kristine Andrews, a pediatrician from Montgomery, Ala. during a Continuing Promise 2011 community service medical project at the Polideportivo medical site in the Caribbean.  U.S. Air Force photo is by Staff Sgt. Courtney Richardson.  This Image was released by the United States Navy with the ID 110715-F-NJ219-161. Source Wikimedia Commons.)

Teen moms and perinatal depression

Pomegranate was a sponsor/exhibitor at the Mental Health America Franklin County Fall Conference on Maternal Mental Health and Perinatal Depression. Speaker Birdie Gunyon Meyer, RN, MA, CLC  was the primary presenter.  PSI, Postpartum Support International focuses on perinatal mood disorders.  The organization was founded in 1987 by Jane Honikman, MS and is a global network ‘dedicated to increase awareness of mental health related to childbearing. This is the only worldwide organization representing support groups that play a significant role in prevention and treatment of maternal mental illness.’  It is essentially about ‘mothering the mother’ according to the speaker/s.  View an educational DVD called ‘Healthy Mom, Happy Family’ at  http://postpartum.net/Resources.aspx or call 1-800-944-4773 for more information.

Depression is the number one medical complication related to child-bearing and up to 23% of pregnant women experience moderate to severe symptoms of depression and/or anxiety. PMAD stands for Perinatal Mood (depression and bipolar), Anxiety (GAD, panic, OCD, PTSD), Disorders.  There are many myths and facts associated with pregnancy along with unrealistic expectations, and both psychological and physiological changes. In recent years we’ve heard from public figures like Brooke Shields and through her book, ‘Down Came the Rain.’  Pregnant teens may experience barriers to utilizing support, Gunyon-Meyer explained.  Research by Clemmens, Paskewicz and Matern shows teens may be in denial, or not get adequate pre-natal care; feel isolated, abandoned and rejected by partners and peers and of course feel scared.  Postpartum, a woman often experiences feelings of loss.  This might be from loss of: freedom, old identity, sense of control, body image, career/potential, or self-esteem; all magnified in a teen mom.

According to Gunyon-Meyer, ‘Some 750,000 Teenage women age 15-19 become pregnant in the US each year; 11% of all births are to teens and almost half experience depressive symptoms in early postpartum period. Prevalence of depressive symptoms at 3 months was 36.7%.’  Significantly, ‘Almost 90% of those who reported depressive symptoms at 4 years postpartum had experienced these symptoms at 12 months postpartum.’   There are many effects of PMADs on a teen mother which include stressed relationships and disruption of school and work plans. For as much as some shows/the media glamorize motherhood and ‘her baby bump’, this is a side to motherhood which is un-appreciated, and not understood.

There is a role conflict between responsibilities to one’s child and one’s self as well as fear of an unknown future. Additionally, ‘there is stigma. Studies of inner city teens include crying, feeling of being punished, sadness, guilt, self-criticism, feeling like a failure, anxiousness, panic, tired . . . ‘ according to a study by Shanok and Miller, cited by Gunyon-Meyer.   Support from parents and learning new skill sets through multi-disciplinary treatment is helpful.  The thorough presentation covered treatment approaches to help process feelings of loss, alienation and rejection as well as medical and pharmacological interventions.  The pharmacological section stressed there are the risks of NOT treating and the benefit of treatment- to both mother and fetus.  Evidence-based therapeutic approaches include cognitive behavioral therapy, dialectical behavioral therapy, interpersonal psychotherapy, peer support, psycho-educational group therapy and mother-infant therapy and education.  It’s important to bond with baby; and good to know that help is available.

Resources:

Hope . . . Joy (and a Few Little Thoughts) for Pregnant Teens by Rachel Brinoni, 2008

Teen Pregnancy: Teenage Pregnancy Support: Advice for Parents and Teens 2014 by Phebe Pearson

Pregnancy: The Essential Teen Pregnancy Guide: All-In-One Advice for Anxious Teens 2015 by Susan Hart

[article by P.A. Rodemann; photo credit by GEOGOZZ posted April 2015 to Wikimedia Commons under Creative Commons Attribution]

What does employee orientation cover?

“Pomegranate Health Systems reviews all its policies on an ongoing basis. One of the policies relates to training and is evaluated against Ohio Mental Health and Addiction Services standards. The policy covers not only orientation but in-service, and mandatory training and certification-specific training,” explained Pat Griffey, HR Director. Working with an under age 18 population and in mental health in a hospital setting does have additional requirements than other types of employment environments.

“For instance, after their mandatory orientation, employees attend All-Staff meetings every month which cover a range of related topics. Recent examples have included suicide intervention, boundaries, trauma informed care, anger management, and managing stress. The August workshops (all 3 shifts) covered LGBTQQIA terminology and understanding. There are also additional departmental in-service trainings for nursing, the therapy team-which can now offer CE coursework, dietary, youth leaders and direct care staff,”   she explained.

The September All Staff meeting was more of a ‘town hall’ format. Angela Nickell, CEO and Pat Griffey HR addressed all three shifts and provided updated employee handbooks. January 2016, the company is mandating a uniform dress code for youth leaders, senior youth leaders and shift supervisors with polo shirts. The company has an order form with a range of shirts, vests and jackets available –with logo.

Here are the training modules required for direct care employees at new employee orientation. This is by no means the complete list of training which also includes mission, goals, core values, leadership, benefits, tour, facilities, housekeeping, dietary, maintenance, boundaries, communication, marketing, psychotropic meds, infection control and nursing, trauma informed care, behavior management, crisis intervention, CPR, first aid and training in medical software.

Here’s the summary:

• CPR/First Aid
• Standard/Universal Precautions and OSHA
• Fire Safety and Other Disaster Procedures
• Infection Control
• Communicable Disease Prevention
• Cultural Diversity
• HIPAA
• Abuse and Neglect
• Client Rights
• Client and Staff Confidentiality
• Crisis Communication
• Location of First Aid Kits
• Non-Physical Intervention/De-Escalation Techniques
• Obtaining Medical and Psychiatric Assistance
• Minor Aversive Behavioral Interventions
• Major Aversive Behavioral Interventions
• Behavior Management Plan Intervention
• Assistance with Self-Administration of Medication
• Incident Report Documentation
• Major Unusual Incidents (MUI)
• Confidentiality and Boundaries
• Obtaining Medical/Psychiatric Assistance
• Identification and Assessment of Contraindications

In addition to the above, there are employment requirements prior to a new hire coming on board to provide patient care, treatment or services. These include a BCI background report, negative drug screen test, negative PPD test or current CRX. Licensure verification is required and no findings on the Ohio Department of Developmental Disabilities, Nurse Aid Registry, Office of Inspector General and Sex Offender Registry databases.

A confidentiality information statement must also be signed. ‘We take our obligations seriously and work hard to ensure the team is equipped to care for the adolescents in our facility,’ added Griffey. “The symphony of scheduling both activities and facility for 90 teens and staff is incredible and it’s accomplished one wing or unit at a time in a continuous overlapping pattern throughout the building. You can really appreciate the dedication of the entire team 24-7 in serving the mental and behavioral healthcare needs of Ohio’s teens.”

Link to HR Video:

http://youtu.be/C7fg5-Mt-og

Can teens recover? Do Pomegranate teens make it? YES!

Within the past two weeks we’ve rejoiced with three client success stories. It goes without saying that working with behaviorally challenged teens sometimes presents the team with opportunities to exercise patience and use every skill they’ve been taught. And then, there are the success stories, the kind that make faces beam with pride and eyes mist. [The teen and her mother interviewed here completed a media release and wanted to share their experience with others.]

For 16 year old Isabelle and her mother, Samantha, ‘Pomegranate is a little diamond in the rough. We hadn’t heard much- if anything- about it.” Isabelle explained that ‘It’s sometimes about being an example for other people. It’s important to share good things about my healing journey, and to give them hope.’ Both women agree that, “recovery is a lifetime process,” and they could not be more pleased with this outcome. Isabelle was treated in Pomegranate’s acute hospital. In appreciation, she created abstract artwork for Valerie in admissions, Tiffany-CPST, and her therapist, Brandi. The transparent overlays of colorful shapes are reminiscent of stained glass windows. The two returned on a steamy July day to express their thanks.

Client A.R. wrote us on Facebook. [Because of the HIPAA privacy act and under 18 population, we do not feature an open forum.] A.R.’s learning opened a new world to him. He says, “My name is —- and I was one of your recent patients. I want to thank you for your treatment and services. It has changed my life so much (that) words can’t explain how happy (I am) and set on my future. I love life, and your facility is the best thing that has ever happened to me. I am at a positive stage in my life and have goals for the future. I thought to myself when I got out of Pomegranate that I wanted to help people with their life problems such as: stress, anxiety, depression, PTSD, suicidal thoughts, and cutting problems. I am only 17 but I have (begun) my first goal and dream in life. I have written a biography of my life and it includes information of how I have used my coping skills, and how to view the better part of life. I include information about setting goals, finding natural remedies for treating stress, anxiety, depression, and PTSD- the main, most common source of all of those symptoms.”

AR want to share the proceeds from his book “as a way of saying thank you for the wonderful treatment and help that Pomegranate Health Systems provides to the youth who need the help and treatment your company has to offer. I was really impressed with how life-changing your system is. Thank you . . . “

Another resident who came to Pomegranate through the Department of Youth Services celebrated her high school graduation, and plans to go on to college and career. https://twitter.com/OhioDYS/status/617709815171805184

At  Columbus State for the mental health resource fair last  year, a transition age young adult visited our table.  We asked if he’d heard of Pomegranate and he said he’d lived here- it helped change his life significantly for the better.  For many, it comes down to learning new skills and making the right choices. Without that interval of intensive daily therapeutic intervention, outcomes may not have been as positive. We congratulate all our teens and wish them the very best wherever they are in their journey.

Positive Parenting

Everything that happens in life is within a context.  No one grows up in a bubble.  Interactions shape how we’re socialized, how we develop given the genetics, family unit and socio-economic/demographic environment we’re delivered into.  The Positive Parenting workshop at OCPOA Ohio Chief Probation Officer Association Conference covered the importance of building relationships and collaboration to affect change in an adolescent’s life- especially with regard to substance abuse, behavioral issues, and making the right changes.  Presented by Home Remedy, LLC, Emily Coen, MT-BC, LPCC-S, Burton Griess, PC and Mary Kay Bulmer, LSW, LCDCIII  made the point that, “Every individual has a story, every family has a history. We cannot expect to help or support families if we do not know what makes that family unique.”  Often, the negative behavior which is causing a problem is the target for change; not pointing a finger at the child-or parent.  The therapist asks, ‘why?’

Because any change has to occur within the context or family system, each person will have a different understanding of what the biggest concern is and a different view of family strengths, struggles, values and what works or doesn’t work.  The therapist role is establishing respect and listening.  Griess presented four parenting styles from Diana Baumrind research: authoritative, authoritarian, permissive and uninvolved.   This has proved helpful in understanding  a family system. Here are some examples:    For Tony, Pop set the rules. He was old world, old school and rigid. You knew where you stood; no negotiation.  Tony became deceitful to get around it.  This ‘my way or the highway’ style is authoritarian.  By contrast, Jackie’s dad held a high profile sales job and was gone much of the time.  Her mom was busy with her own career and Jackie often nuked her own dinner which was left in the fridge-or not.  Mom would flatly say, ‘that’s interesting’ while checking text messages when Jackie tried to tell her about the day at school or added, ‘whatever’ when asked permission to go out with an older guy. This is ‘uninvolved parenting’.

Authoritative parenting might be represented by Bob whose son Jamal knew what was expected of him and strived to live up to Dad’s standards.  His parents often came to his games, or school events, and even hosted cook-outs that his friends found inviting.  They were engaged in his life and he looked up to them.  Rachelle’s folks crossed the line in allowing her to hold overnight get-togethers, giving her more responsibility than she could safely handle (including beer), and friended her pals on Facebook, Snapchat and Instagram. This is known as permissive parenting.  In understanding a teen’s context, one looks at not only the home, but school, community, peers and the maturity/personal characteristics of a child.  A behavior plan which holds folks to accountability includes identifying the behaviors, expectation and consequences- both positive and negative.

In decreasing risk factors and enhancing a pro-social environment, it’s important to model  high nurturing, enlightenment and positive influence in the home environment. Coen and Griess stressed that socializing should be encouraged in the home, and parents should have names and contact information of peers and families.  Because the peer environment is so important; identify ‘red light’, ‘yellow light’ and ‘green light’ friends, they advise. Positive parenting should include meaningful interventions- which can include short consequences-such as removing a cell phone, and setting measurable goals.  Clear expectations and matter of fact explanations are more effective than responding in an emotionally charged way.  Negative behaviors are often used to manipulate parents if a child develops maladaptive personality traits over time.  In hitting the ‘reset button’ through counseling and new insight, self-control, peace,  respect , and hope return.

Foster care teens vulnerable to trafficking

Some 18,000 to 20,000 missing children incidents are reported every year. Of homeless, runaway or ‘throwaway youth’, a third are lured into prostitution or offered money for sex within 48 hours of leaving home.  Of the 500,000 children in the U.S. in some form of foster care, vulnerability is especially high, according to Brent Currence of the Ohio Missing Persons Unit of the State Attorney General Mike DeWine’s Office, Bureau of Criminal Investigation at last week’s Ohio Chief Probation Officer’s Conference.

Essentially, human trafficking amounts to slavery, whether its labor trafficking, compelled service, or sex trafficking.  Labor trafficking might happen from debt bondage. Compelled service could be in childcare, domestic  or janitorial work, agriculture, garment work, street peddling, construction trades or manufacturing, or in the restaurant trades.  People might be recruited by newspaper ads for modeling jobs or other fake employment agencies with offers too good to be true.  Acquaintances or family might recruit the victim and then there are abduction stories as naïve folks are lured through front businesses, he explained.

His presentation explored risk factors which  include neglect or abuse at home, a troubled home life, mental disability, or not having a positive adult role model.  For those trafficked into labor, many have experienced high unemployment,  discrimination, an environment of crime, lived in poverty, or come from a country with political conflict, corruption, or where labor trafficking is commonly practiced.  Frequent moves, high density living environment, restricted movement/communication or requiring an interpreter to be the intermediary might be indicators of trafficking activity. Not having access to one’s identity papers-driver’s license, social security card/number, birth certificate, cell phone, bank account, or personal possessions could be a red flag. Did you ever wonder about a Central American roofing crew who arrived in the same van, worked in blistering heat with two short 15 minute breaks, didn’t speak English, and were controlled by a tough crew boss?  Perhaps the kitchen crew in an Asian or Mexican restaurant made you wonder, or the unlikely couple in a convention hotel- a young girl with an older man.

Teen runaways are vulnerable.  Naïve teens often fall for false advertising, modeling, acting or dancing opportunities or ads on social media where they share photos or other personal information.  A pimp might attempt to gain the child’s trust and pretend he cares and will look after them.  Often a pimp- or his female recruiter will lavish the victim with treats like shopping trips, visits to salons or out to eat or drink.  The victim is systematically isolated from people they know until they are forced to rely on the pimp. The teen is gradually lured into sex, or groomed to become an eventual escort  through psychological –and sometimes physical control.  Often, they’re controlled through violence and later, through drugs-upon which they become dependent.  Sometimes  photos or private information is used as threat or blackmail.  The internet has opened a new world of potential cyber-victimization.  A teen could be tracked via their cell phone GPS.

You might notice a victim by their canned responses, the hovering presence of a person who seems to control them, or by the child exhibiting hesitant or fearful behavior.  They might have tattoos (branding), new uncharacteristic clothing, be evasive, or fail to make eye contact.  They might have bruises and are frequently absent or out of contact.  Often, victims are brainwashed or manipulated; told false promises or lied to that this is a good way to improve their life, or ‘its only a time or two’.  Though they might feel shame, they compensate by becoming boisterous or develop an attitude.

Currence shared several stories. Two young teen girls were chatted up at a Dairy Queen not far from home by a man.  His female accomplice was in the front seat of a van.  It began to rain and they were led to believe it was the father/parents of a friend.  They got in the car when he offered a ride; but the child safety locks clicked.  They were abducted and raped, forced into trafficking.  Sexual trafficking might involve 8 to 10 contacts a day.  Currence’  presentation stated that:  * 1/3 of women entered prostitution before age 15 (hardly consenting) and 62% before their 18^th birthday; *96% of prostitutes who entered prostitution as juveniles were runaways;  *72% of these juveniles suffer from sexual and physical abuse;  *Develop a dissociative personality regarding normal intimacy and boundaries.  Further, 82% of these women are physically assaulted; 83% of these women have been raped-27% by multiple assailants; 35% have sustained broken bones and 47% sustain traumatic brain injuries. Hardly, the ‘Pretty Woman’ movie.  Nor is going to a party where the teen is drugged and gang raped.

He said, it’s difficult gaining a victim’s trust even for professionals.  Safety and medical care are important to them, and re-assurance. Often, victims have very basic needs –such as a safe place to go, housing, clothing, food, treatment, legal help, connection with benefits and job training or further education. Substance abuse is likely to be an issue, and learning how to take care of themselves and plan for a future.

The audience saw photos of trafficked girls, before and after.  These were images of school age kids in one frame, and sorry ‘lights out’ trafficked women, some clearly addicts, others looking utterly beaten into submission, defeated  by a hard life.  Slavery is illegal, whatever type, Currence asserted.

Resources:

What would you do?  Watch this video what happens when a 16 year old girl meets up with a guy she met online. He turns out to be a predator.  http://higherperspectives.com/wwyd/

Gracehaven was founded in 2008 to address the huge need for rehabilitation for victims of domestic minor sex trafficking or, as it is also known, commercial sexual exploitation of children.    http://gracehaven.me/

Watch Jennifer’s story.   Jennifer’s journey into the darkness of human trafficking started, like many of the women she worked alongside on the streets of downtown Columbus, with a chaotic and abusive childhood, a history of violent and destructive relationships and a downwards spiral into street prostitution and drug addiction. http://www.theguardian.com/global-development/2014/nov/16/sp-the-tattooed-trafficking-survivors-reclaiming-their-past

http://www.polarisproject.org/what-we-do/national-human-trafficking-hotline/the-nhtrc/overview

http://www.traffickingresourcecenter.org/

http://www.missingkids.com/home

http://www.centralohiorescueandrestore.org/

Ohio Bureau of Criminal Investigation hotline 855-224-6446

[photo credit: Anita Patterson Peppers Dreamstime.com  206107.  Article author: Patricia Rodemann]

Teens take art to new level

Art therapist Darci, ATR works with Pomegranate’s teens in the acute hospital to explore memories, moods and dreams as part of the therapeutic process.  CPST Ruthie brings her art background to encourage teens on Pomegranate’s five residential campuses to express themselves through art-which can include painting, drawing, knitting and assorted arts & crafts.  A guest on tour recently was exceptionally impressed at the emerging art in residential day rooms, corridors and meeting rooms. Afternoon light streamed in and the murals glowed- while teens alternately finished up their day in the classroom, went to the gym, watched a movie for group discussion, or were scheduled for a short quiet period. The entire facility continues to evolve and improve aesthetically with unique and interesting murals and art creations.  In addition to the Madison County 4H contribution to the cafeteria, Pomegranate’s own teens designed their day rooms, mixing their own colors and diligently painting their hearts out across all 5 wings.

“The residential art program gives teens the opportunity to learn to make decisions and control the process, to learn from their mistakes. They can still have a success even with a ‘mistake’-and teens learn to focus on the process, not merely on the outcome.  Art touches all the intelligences; you can teach almost anything through art.  As creators, each child has a different goal; and it is cool for them to discover and share their perspective.  I have them acknowledge what skill they learned, and how to practice it.  It is more than just making art, however. I ask, ‘What do  I need to do to move them along the healing process?’  They’re craving this SO MUCH,” explained Ruthie.  A client said to her, ‘I wouldn’t ever be painting. I wouldn’t ever be knitting if it wasn’t for you.  Its helped me realize  I can create something meaningful. Thank-you! Thank-you!’

Currently, in process:

• The Celso unit mural is an ornate elephant, blowing colorful bubbles through his trunk.
• The Kennedy unit mural has a woman lying in the grass with emerging flowers.
• The Sathappan unit mural features super-heroes.
• The Meena unit mural features random designs.
• The Kaufman unit mural has well-known icons-like Mario or Popeye.

Teens have now painted inspirational sayings in the gym, and plans are in the works for additional corridor enhancement. You can see all the individual paint cups representing the inspiration which contributed to a beautiful outcome. Beauty is more than skin or surface deep! It changes attitudes and inspires hope.

See previous posts:

http://pomegranatecares.com/2011/06/30/unlocking-feelings-through-art-as-a-therapeutic-tool

Young Minds and Violence in the Home

When Pam met the new neighbors, their adorable school age children, 5 and 8 smiled sweetly, but were very withdrawn . Her puppy bounded up to them, wagging its tail, but they pulled back, fearful, and clung to mom.  The puppy seemed intent, and surprised- as all the other neighborhood children actively pet and played ball or tug of war with it. Pam thought it odd she’d never seen the children out playing in the yard or with other kids. She ran into the neighbor at the grocery two years later who was chatting with a friend, and overheard that the son was in psychiatric care, on medication; the daughter seeing a therapist. There had been two emergency vehicles to the home, a few months apart. The father was taken away. At one point, she’d heard angry shouting and loud crashes, working in the garden. Not long after, the mother and children moved to their own apartment. The mother and children stayed together and took advantage of care and counseling opportunities. Today, the children are in college and thriving, and mom -a fiancé.

At the Voices for Children conference, there were two presentations focused on prioritizing safety for children who are exposed to domestic violence. The first, “Walking the Walk; Talking the Talk’ and the second, ‘Safe and Together: How Ohio is Helping Children Heal from Exposure to Domestic Violence.’  The IPV Collaborative reports  that “According to the Ohio Family Violence Prevention Project, more than 48,000 children (ages 0-17) in Ohio live in homes where an adult reports intimate partner violence. More than 4,300 take shelter in a local domestic violence shelter.”  Jenny Hartmann, MSSA, LSW, Collaborative Coordinator reported on the impact of DV on children.  By age four, 1/4^th of children have witnessed one violent event according to SAMHSA data. As insidious as not seeing or hearing it, is ‘knowing it’.  And most cases don’t come to the attention of authorities. Hartmann led the audience through an exercise to identify how children experience DV. Every child processes the experience differently; some have more resilience factors than others.

The National Center on Domestic Violence, Trauma & Mental Health reports that as infants and toddlers, children may exhibit fearfulness, separation anxiety, sleep disturbance, become irritable or aggressive, or startle easily.  School age children might engage in play that is a re-enactment of the experience or event; feel vengeful, exhibit physical symptoms- like stomach aches, be withdrawn or avoid reminders, feel guilt, and/or show difficulty concentrating in school. In adolescents emotions and behaviors can emerge such as detachment, shame, self-consciousness, acting out, making plans or having fantasies of revenge, or exhibiting coping behaviors –which can include self-harm.   The Voices for Children audience watched a video, ‘First impressions’ on exposure to domestic violence. Here’s the YouTube link: https://www.youtube.com/watch?v=brVOYtNMmKk

The Ohio Intimate Partner Violence Collaborative identified Safe and Together™ as a model to help increase safety and well-being of children exposed to DV- by David Mandel & Associates.  This model stresses keeping a family together -children with the non-offending parent, and holding perpetrators accountable for their behavior-which includes coercive control. It identifies contributing factors such as socioeconomic conditions, mental health issues, cultural heritage and conditioning, or substance abuse.

It’s important to help children and teens find ways to express their feelings whether through art, journaling, writing stories, poems or play/recreation. Actor Tom Hanks is bullied in the movie Forest Gump, and channels his terror, anger and sense of helplessness into running. Recently, the Center for Family Safety and Healing and the NFL have each launched ads to bring awareness of DV to public attention; that it is not acceptable to batter partners or children, no matter who you are, or what you’ve experienced.

Resources:

Video- First Impressions different version:   https://www.youtube.com/watch?v=gkSW3__pbI0

Video on Trauma:  https://www.youtube.com/watch?v=jYyEEMlMMb0

Social and Emotional Development in Early Childhood: https://www.youtube.com/watch?v=vkJwFRAwDNE

Safe and Together™ model  www.endingviolence.com

The National Center on Domestic Violence, Trauma & Mental Health www.nationalcenterdvtraumamh.org  (See Children Exposed to Domestic Violence: A Curriculum for DV Advocates, Patricia Van Horn, JD, PhD)

(photo credit: Dreamstime 523811)

Pomegranate to offer Alcohol and Drug Workshops by Maryhaven

This Spring, Maryhaven began offering AOD group programming at Pomegranate Health Systems. Maryhaven is a well-known treatment provider for alcohol and drug addiction in Central Ohio, accepting voluntary admissions, medical and court-referred clients. Maryhaven has operated in Central Ohio for over five decades and in that time, served over 175,000 people.

Angela Reynolds is Maryhaven’s site program counselor. Reynolds has a LCDC II (licensed chemical dependency counselor designation) and a SWA. She has experience with adult inpatient counseling, detoxification counseling, adult and adolescent outpatient counseling, and now is taking on the role of working with adolescents who are dealing with addiction issues.

What happens in an AOD group counseling?

• Psychoeducational groups, which teach about the different types of substance abuse.
• Skills development groups, which practice the skills necessary to break free of addictions.
• Cognitive–behavioral groups, which challenge patterns of thinking and action that lead to addiction.
• Support groups, where peers can challenge each other’s excuses and support and encourage constructive change.
• Process group psychotherapy which enable clients to rethink the rational and irrational choices and decisions that they have made which lead them to the substance use.

Her first order of business is to provide AOD individual and group counseling. Part of her mission is education (for instance, psycho-education on drugs and the effects on their young bodies, coping skills and relapse prevention).

“Based on experience it is highly likely that most of the residents at Pomegranate have had some sort of familiarity with drug or alcohol use or abuse in their home environment or have a peer group that uses. This is evidence-based treatment to help the clients work towards a realization of how the affects of addiction are directly related to criminal behavior and how to work on changing thought processes that directly relate with behavior,” she explained.

“Clients will learn about thinking errors, coping skills to deal with the world they live in, relapse prevention and how to maintain sobriety in their life. Behavior change and thinking pattern change can help the clients at Pomegranate, to not look at themselves as broken. It can give them a new insight like a light shining in their corner that says “I can be a contributing member in society”, said Reynolds. “As the program grows we are certain that it will benefit all clients at Pomegranate who have AOD concerns.”

For context, the state population age 12-20 numbered 1,466,000. In looking at underage drinking facts from the Report to Congress on the Prevention and Reduction of Underage Drinking,  27% or 406,000 used alcohol in the past month and 29% engaged in binge alcohol use.  Alcohol use starts with 5% in the age 12-14 cohort, moves to 22.5%  (110,000) in the age 15-17 group, and 51.5%  (274,000) in the 18-20 group. Illicit drug use ages 12-17 stands at 8.8% of the population per SAMHSA Center for Behavioral Health Statistics & Quality NSDUH 2013.

The recent PCSAO 2015-2016 Factbook cites the impact of the opiate epidemic effect on child welfare. For instance, “Child welfare cases involving parents abusing heroin, cocaine, or both rose from about 15 percent to more than 25 percent of the statewide caseload between 2009 and 2013.  Seventy percent of children age 1 or younger placed in Ohio’s foster system are children of parents with substance use disorders involving opiates and cocaine.”  Clearly, drug abuse is a serious and growing concern not to mention the societal cost.  Teen parents and parents of addicted teens alike are affected.

[photo credit: Wavebreakmediamicro/Dreamweaver #39195983 Therapist talking with . . . taking notes]