Tuesday, May 17, 2011
As a therapist, I am always looking for new ideas on how to build a relationship with a client and help them to discover for themselves what they need to do to change. Back when I started I had all kinds of time to think up new creative methods. I was working mainly with children at the time and the movie Pirates of the Caribbean: The Curse of the Black Pearl had been released. I was amazed at how attractive the idea of being a pirate was to children. In fact, one little boy would use toy swords in our play therapy center and try to re-enact (with me) the scene where Captain Jack Sparrow and Will Turner dual in the blacksmith shop. He knew the scene word for word and even tried to do the footwork. It was fun, all except for the bruises I would get on my hands and fingers. When I say dual, I mean that I would stand there and try to not let the kid hit me.
This activity brought to mind the possibility to create a level-based play-therapy treatment program for kids who were struggling with behaviors. I began to research information on pirates and piracy (i.e. hierarchy on a ship; how money was divvied out; responsibilities of each individual on a ship; the pirates’ code, etc.). I found the information intriguing. So, I spent a few weeks writing up a treatment protocol for individual and group therapy based on the ideas of pirate hierarchy. I was only able to use some of the principles (due to funding) with some of the kids. They loved it, and I had fun with it! I wish I would have had more resources to do it at the time. It was specifically tailored for boys, rather than girls, but could have been adapted.
Below is some of the information and ideas I compiled. It was just a fun “idea” and anyone is free to read it. I think I had been in the industry only for about a year when I started thinking it up. If anyone takes any ideas from it, just remember where you got it from. If you use it, modify it, and turn it into something big, I will only require a 10% payment of everything you make. Just kidding.
The title of the program was “Becoming A Man.”
This program will serve teenage and latency age populations, both boys and girls. The concern is that many of the positive characteristics and traits from older generations are not being learned by today’s generations. The reasons are not important, nor are they an emphasis in this approach.
This program will involve an individual, group, and family therapeutic approach. The group therapy approach will be primary and the individual and family secondary. The goal of the treatment program is to provide a naturalistic therapeutic environment and activities that foster positive trait and characteristic growth, therapeutic healing, relationship building, and life skills training. It will be an 8 to 12 week program that is open/closed. Open, in that it will constantly be cycling through the objectives and activities so that anybody can join during any point of the process. Thus it is a continuous group without beginning or end. Closed in that once a person joins the group they and their parents or caregivers must sign a contract to complete the regime once it has begun. If a client misses a session then the group will hold a council to agree if the client should be allowed to come back into the group. The point of this is to teach the child the importance of loyalty to a group and integrity–fulfilling their word. It is recognized that there are valid reasons for missing a set appointment. It will still continue with a group council as this will foster growth for the group who will serve as merciful judges of the situation. The group must learn to work together and be compassionate in all situations.
The program will have three tiers or levels that a client can graduate from. The first is attaining and incorporating positive traits and characteristics. These include morality, responsibility, respect, integrity, loyalty, courage, spirituality, team work, and trust (this is not the final list). The objective is to provide activities and experiential interventions that foster growth and dvelopment of these traits and characteristics. Some of the desired activities will include ropes course, natural group dynamics, games (outdoor–capture the flag), wildernes survival skills training, campfire groups, drum circles, and various character tests that will be provided at random without notice. The tests will be done in a manner that appears natural and ordinary. One example will be to leave a large bill (money) out in the open where the kids meet for their group. They will be unsupervised at this point (as if the therapist had stepped out of the room). The test is to see what the group will do about the money being left out in the open. The therapist will not ask about the money upon return and act as if all is normal until the group starts. Then, the therapist will confront the group about the money, unless it is not brought up by the clients. This will test their integrity and honesty. Another example will be derived from the Parable of the Talents from the New Testament where they will be entrusted with an object and instructed to “make it grow.”
Other activities will be trust walks (preferably in a natural setting where there are trees and obstacles to challenge the clients. The clients will also be required to maintain an active exercise regimen which they will keep track of and be required to reach specific goals. Thus, they have many responsibilities to carry out. The main desire, also, is to provide an outdoor setting that has been purchased for the clinic that has natural resources, places to build a ropes course, and the capability of including possible farm animals such as sheep, etc. The purpose is to include animal care as a way to increase responsibility for others.
The therapeutic healing aspect will be incorporated as a part of the group process. Naturally, many clients will have specific traumas and difficulties that they have not yet been able to overcome. Sand-tray work, EMD/R, and other non-traditional trauma resoution therapies will be provided on an individual basis. Those treatment goals will be individual to meet each client’s special needs. Many of these clients will have witnessed difficult things to comprehend and thus will need a compassionate and empathetic therapist to guide them through this process. The individual appointments will be made on a client-to-client basis. The main goals of the individual therapy will be to decrease symptoms related to trauma and provide individual life skills training to maintain personal mental and emotional health. Thus, the program will maintain the general purpose of the Trauma Awareness and Treatment Center.
BECOMING A MAN–A PROGRAM FOR BOYS AND YOUNG MEN
The purpose of this approach is to help young boys (ages 7-18) develop a strong foundation of attributes, traits, and characteristics that will help them survive as a strong person in society. The ideas were thought up after working with young boys and men who had been abused by a father figure, been through a divorce, or have never had a male role model. Most of these boys in this clinic have behavioral problems, lack of insight, past traumas, and other mental health problems. The hope is to help them become motivated through positive and negative consequences/reinforcements, achieving goals all while having a fun time in a positive therapeutic environment and a growth promoting home. The program ideas are not only based on helping motivate the child, but also to help the child’s primary caretaker become an integral part of the process.
1. Choose a male role model or more than one. Do research on them to describe what makes them a man and worthy of being emulated. 1 pg minimum. You may have the help of a parent or someone else that you choose.
2. Choose a few specific personal values and characteristics that define a man. (These attributes will be added to an already existing list to accentuate the personal values of the client). These attributes will be what constitute the treatment objectives–an increase in their ability to use and portray these values while decreasing negative symptoms and behaviors. The goal of the treatment is to create a foundation upon which the clients can build their own character.
3. The reward/consequence system will be progressive leading towards the final goal and objectives as stated in 2. The rewards will become greater with the client’s therapeutic progress and responsibilities. Therefore, the increase in rewards must have a positive correlation to the increase of positive behaviors and responsibilities as outlined by the treatment objectives.
The child will maintain a journal or “crew log” of his assignments, daily observations, and positive and negative consequences. Each week he will be given two assignments from the treatment objectives and will receive small consequences for his actions, be they positive or negative. There must be a certain percentage of his ability to complete the assignments for him to progress to the next level. Each new level will involve new responsibilities on top of the prior responsibilities. Therefore, with each rank he attains, we will receive a greater reward plus greater responsibilities. The rewards will be defined in the description of each level.
4. The child’s parent(s) or caretaker(s) MUST be highly involved and follow through with the reward/consequence system. It requires consistency and love. It may also be necessary to involve other systems that are influential to the child. I.e. teachers, schools, clubs, other therapeutic centers.
5. The negative consequences must be awarded at the moment of the negative behavior, but in a positive manner that will give motivation for continued change and growth. I.e. “Reproving betimes with sharpness...and then showing forth afterwards an increase of love toward him when thou has reproved, lest he esteem thee to be his enemy; that he may know that thy faithfulness is stronger than the chords of death. Let thy bowels also be full of charity towards all men...” Doctrine and Covenants 121: 43-45. Thus the caretaker’s job is to provide a safe loving environment that fosters healing and change. If this is not provided the progress WILL FAIL. A parent will need to follow a love and logic approach to the consequence and reward system. They must not reward the child with anger or demeaning words as this will cancel out any other reward or consequence. The parent must display patience and good faith in their child despite their behaviors. However, the parent will provide the appropriate consequence for negative behaviors. The consequence would be best if it were related to the negative behavior. Most importantly as well, the child needs to have positive reinforcements that outweigh the negative. The rewards and consequences must be documented by a simple tally mark every day, as well as the completion of specific treatment assignments and the display of objective completions.
6. The actual treatment interventions will be pragmatic to fit each child’s unique neds. It will involve, however, modeling, psychoeducation, trauma resolution (all methods), parent training, experiential therapy, personal journaling, etc.
7. Each level will have a meaning with value to the client. They will be ranked and must be something personal and of intrinsic value to give the client a sense of pride, honor, and growth. (Boys Scouts program). The program is to serve as a right of passage of growth into manhood. The pirate ship and crew system will be used currently as a description of levels. Also, Black Bart Roberts democratic-like system will be implemented, although modified to fit the program.
8. The program will involve outcome measures. The BASC or Achenbach will be administered before and after to measure symptoms/behavior progress. There will also be brief symptom/behavior measures filled out weekly by the primary caretaker (use Joe’s children’s group measure).
Attributes and Characteristics of a Man
What Makes a Man a Man?
1. Is respectful of others despite their age;
2. Does not take advantage of others or hurt others purposely;
3. Gives respect to other men, women, girls, and children despite their race, ethnic group, or religion;
4. Is honest;
5. Will emote (talk about what he feels and thinks in an assertive manner) effectively and not act aggressively;
6. Is responsible for the charges/jobs that have been given to him and for his own actions;
7. Kind and loving and knows how to discipline in a positive manner.
8. Works hard;
9. Can accept criticism (and knows that he is always growing and developing, therefore he can acknowledge his strengths and weaknesses);
10. Can provide for, and protect his family in an effective manner.
One example of a man that can be emulated is the 16th US President, Abraham Lincoln. Information on his life and character can be found from multiple sources. Not only was he the President, but he was a man who suffered from severe depression, but found the inner strength and motivation to maintain a strong quality of life. He overcame many downfalls and unsuccess.
The following is a beautiful poem written by Walt Whitman after President Lincoln’s assassination. It describes Lincoln as a Captain of a ship that had “weather’d every rack,” yet was victorious in its purpose and ended in his death.
Walt Whitman (1819–1892). Leaves of Grass. 1900.
193. O Captain! My Captain!
O CAPTAIN! my Captain! our fearful trip is done;
The ship has weather’d every rack, the prize we sought is won;
The port is near, the bells I hear, the people all exulting,
While follow eyes the steady keel, the vessel grim and daring:
But O heart! heart! heart! 5
O the bleeding drops of red,
Where on the deck my Captain lies,
Fallen cold and dead.
O Captain! my Captain! rise up and hear the bells;
Rise up—for you the flag is flung—for you the bugle trills; 10
For you bouquets and ribbon’d wreaths—for you the shores a-crowding;
For you they call, the swaying mass, their eager faces turning;
Here Captain! dear father!
This arm beneath your head;
It is some dream that on the deck, 15
You’ve fallen cold and dead.
My Captain does not answer, his lips are pale and still;
My father does not feel my arm, he has no pulse nor will;
The ship is anchor’d safe and sound, its voyage closed and done;
From fearful trip, the victor ship, comes in with object won; 20
Exult, O shores, and ring, O bells!
But I, with mournful tread,
Walk the deck my Captain lies,
Fallen cold and dead.
The level system of this program will be derived from the Pirate Code, mainly due to the semi-democratic nature of how their ships were run. Although their goal was to pilage and plunder, they had to maintain a “tight ship” in order to attain their ultimate design. The following is a brief explanation of their semi-democratic nature and a Pirate Code by Black Bar Roberts. The point of using this as a level system is to provide a fun nature to the process. Afterall, what child is not enthralled with the prospect of being like Captain Jack Sparrow from “Pirates of the Caribbean?”
The Pirate Code: Democracy among Thieves
Though no universal code of conduct was acknowledged by all, many pirate captains established a set of rules with which each crew member was expected to comply while on board.
Many of these social contracts were remarkably democratic for their time and place in the world. As pirates, sailors had an unprecedented level of control of their destiny. In an assault to the traditional command structure at sea, pirate captains allowed the crew to vote in a new captain if a dispute warranted it. Good leaders gathered the support of their men, and many well-known pirates achieved their stature not by force, but by majority vote!
Another revolutionary concept was the pirate welfare system. Crew members injured in battle were given compensation for their injuries on a sliding scale of severity. A leg, for example, would have been worth more than an eye.
The eleven-article contract below was used by Black Bart Roberts. It must have been effective, for he was one of the most successful pirates of all time—capturing more than 400 ships over the 30-month span of his career.
The Pirate Code of Black Bart Roberts
1. Every man shall have an equal vote in affairs of moment. He shall have an equal title to the fresh provisions...
2. Every man shall be called fairly in turn by the list on board of prizes. But if they defraud the company to the value of even one dollar, they shall be marooned. If any man rob another he shall have his nose and ears slit, and be put ashore where he shall be sure to encounter hardships.
3. None shall game for money either with dice or cards.
4. The lights and candles shall be put out at eight at night, and if any of the crew desire to drink after that hour they shall sit upon the open deck without lights.
5. Each man shall keep his piece, cutlass and pistols at all times clean and ready for action.
6. No boy or woman to be allowed amongst them. If any man shall be found seducing any of the latter sex and carrying her to sea in disguise he shall suffer death.
7. He that shall desert the ship or his quarters in time of battle shall be punished by death or marooning.
8. None shall strike another on board the ship, but every man's quarrel shall be ended on shore by sword or pistol...
9. No man shall talk of breaking up their way of living till each has a share of 1,000. Every man who shall become a cripple or lose a limb in the service shall have 800 pieces of eight from the common stock and for lesser hurts proportionately.
10. The captain and quartermaster shall each receive two shares of a prize, the master gunner and boatswain, one and one half shares, all other officers one and one quarter, and private gentlemen of fortune one share each.
11. The musicians shall have rest on the Sabbath Day...
Level 1: Powder Monkey–scrub brush and crew log. This term was first used in the British Navy for the very young men who made up most gun crews in the 17th century. In contrast to a pirate officer who was elected, these men were forced to perform what was some of the most dangerous work on the ship. They were harshly treated and rarely paid, and if they avoided being mortally wounded in their service, desertion was probably as attractive as having very little hope of being promoted.
Level 2: Gunner–pistol. A gunner would be the leader of any separate group manning artillery. His special skill would be in aiming, but he would oversee the four to six men required to take the gun through the steps of loading aiming, firing, resetting, and swabbing for the next load. He would also work to ensure the gun crew’s safety in avoiding dangerous overheating or excessive recoiling of the weapon. A master gunner would help to coordinate the timing and accuracy of the individual crews especially when a broadside was ordered.
Level 3: Boatswain–bag of gold. This position may be compared to the modern chief petty officer. A boatswain’s whistle. A ship of any size would require the boatswain to oversee several junior officers who would share his responsibility for the crew’s morale and work efficiency as well as the maintenance and repair of the hull, rigging, lines, sails, and anchors.
Level 4: Quartermaster/First Mate. Some pirate ship crews had this position as the captain’s right-hand man and the one who would assume his role if he were killed in battle or could no longer perform his duties. This was often considered the job of a lieutenant in a regular navy, and most pirate crews chose a quartermaster instead of a First Mate. A large portion of the captain’s traditional role and power into the hands of an elected quartermaster who became second-in-command and almost a co-captain through his representing the best interests of the crew. As a foreman, he was in charge of maintaining order, distributing rations and supplies delegating work, and guarding and dividing plunder. In fighting, the quartermaster decided what ships were worth it and often led any boarding party, ultimately deciding what loot to keep. When discipline or punishment was necessary, only he could give it, but even then it was with the agreement of the captain or the vote of the crew. He was more or less second in command.
Level 5 and Final Level–THE MAN OF MEN!: Captain. He was elected as a sort of president of the shaky ship democracy, someone already respected for their leadership and navigation skills who would be level-headed and decisive in the heat of battle. He had to be cut from a different mold, because previous experience had taught most that life at sea was harsh enough without an inexperienced or cruel leader making it worse. It was during engagements that this man would be expected to rise above and help bring victory, but in most other occasions on ship, he was more or less another voting member, delegating most of the everyday tasks to the quartermaster or other junior officer. In these times, he was to be an even-tempered father who maintained the barest level of discipline necessary to hold the family venture together. This father could be voted out and even thrown off if he became passive or wavering, went against the majority vote, became too brutal, or simply no longer performed his duties to the liking of the pirate ship crew.
Finally, the following is one idea of how the consequence system can be tallied on a weekly basis. The desire is for the caretaker and the child to work together in maintaining a tally of the consequences and objectives that are completed during the week. The actual scoring system will be kept by the therapist. It is highly important for the caretaker to be objective during the weekly tallying.
I had an interesting conversation with a friend and colleague over the weekend. We were traveling from Utah to Denver for a class and while sitting comfortably in our Southwest Airlines seats (this is not a sales pitch for them) we discussed our thoughts and feelings on Star Trek. I know, I know it sounds hokey. I will get to my point why being a Trekky can have many positive aspects to it. I will get to those in a minute, but first I will explain my point-of-view on how Star Trek can have a positive influence on people.
I was raised on Star Trek. I remember watching Star Trek: The Motion Picture with my dad as a young boy and finding the idea of trekking through space at warp speed, meeting new people and civilizations to be intriguing, exciting, and educational. Besides, what little boy wouldn’t like to have the capacity to sore through the sky and space in a spaceship—especially the Starship Enterprise?
My space fascination continued into adolescence and then adulthood as Star Trek gave way to The Next Generation. I loved this series and still watch the re-runs. You can imagine my excitement when the new Star Trek movie came out in 2009, with a whole new set of actors and ideas. Oh, how the boyhood space-aged fantasies were re-awakened! I recall that year perusing the internet for information on the movie, when one day I came across a website (that I cannot recall) that talked about the ideas of Star Trek—i.e. seeking out new life and civilizations; boldly going where no one had gone before; living the Prime Directive; bettering oneself just for the sake of betterment. While reviewing it, I came across an excerpt from the comment section. It was a man who said he was a police officer in Los Angeles (or one of the large cities in California). He said that coming home at night and watching Star Trek: The Next Generation renewed his sense of hope in people and society. He described how his job at times could dishearten his ideas on who people were, and that the ideas of Star Trek rejuvenated him. I could relate to that to an extent with the sense of therapeutic burnout always looming over my head. I’ve found that I look for things that rebuild my sense of hope, just as this man.
Now, coming back to the present, my friend/colleague and I revisited the idea of Star Trek. I expressed, somewhat embarrassingly that I found the ideas attractive; though I know they were not attainable any time soon (possibly even farfetched). I was pleased when he expressed the same sentiment. But, now as I sit writing, I wonder if it is NOT impossible. I know that is a double-negative and I placed it there on purpose. Society is not ready for a place like the United Federation of Planets where there is no concept of money, poverty, or inequality, etc. Where people can learn and better themselves how, where, and in whatever manner they wish. BUT, what are we doing in our own homes or with ourselves to make our own little relative world peaceful in such a manner? I watch many people in the helping profession trying to change the world, but I would ask, what are you doing with yourself? Are you living what you preach? Are you teaching your children and those around you how to live the way you feel the world should be? Are you meeting resistance with your own resistance when you feel that peaceful resolution should be the road? I know that in my own little Universe (i.e. home) that when I am trying to focus my attention on bettering my children or even my wife, my efforts can become self-serving and be met with resistance and unhappiness. But, if I am focusing on my own actions and on how my moods, behaviors, and examples are being seen by my children…and I am trying to better myself for the sake of betterment…my children follow suit, my home is peaceful, and my Universe is no longer in upheaval. A lot can be learned from watching an episode or two of Star Trek. Try it out!
Sunday, May 15, 2011
This is a brief review of a podcast from the American Counselors Association (ACA). The ACA provides podcasts wherein they interview key professionals and specialists. This particular podcast was aired on February 8, 2009 with speaker Dr. Howard Kirschenbaum regarding the esteemed Carl Rogers. Carl Rogers was the developer of person-centered therapy which is now one of the front-running therapeutic philosophical approaches worldwide. Below you will find a few notes I took and a brief summary (some verbatim) of the podcast, as well as the URL where one can listen to the podcast. I recommend it!
HT007 -- CARL ROGERS, the Person-Centered Approach
Sunday, February 08, 2009 7:42 PM
Speaker Dr. Howard Kirschenbaum is the author of The Life and Work of Carl Rogers . He is Professor Emeritus and former chair of Counseling and Human Development at the Warner Graduate School of Education at the University of Rochester, in New York. Dr. Kirschenbaum is the author of more than 20 books on education, counseling, and history.
Dr. Kirschenbaum first talks about some of the personal issues that Carl Rogers had. Carl Rogers struggled with alcohol dependency for the last few decades of his life. It is one of several areas that show him as a more dynamic and “human” individual.
Kirschenbaum stated, regarding Rogers that “Person centered approach is a context of counseling and psychotherapy is an approach by which the relationship between the counselor and client is paramount. Rogers described the relationship as consisting of 3 necessary and sufficient conditions…core conditions. The therapist’s congruence or realness, empathy for the client (sensitive understanding of the world as the client experiences it), and an unconditional positive regard for the client (appreciation and respect as a person of individual worth and autonomy). If those conditions were offered by the therapists…and the client could perceive the conditions to a minimum degree, then a relationship would be developed that would enable the client to change in positive ways. The client-centered approach changed over the years, but the core is the three conditions.”
The counselor serves as a helpful and supportive person to enable the client to do their own work. The client is their own expert. Before Rogers, the therapist was the expert on the client. Rogers’ approach was “revolutionary.” Each person can arrive at their own answer.
Rogers never said that human beings were inherently good. He said that they are basically trustworthy when provided with the positive conditions for growth and self-actualization. Negative conditions bring about a warped individual. They will do what they must to meet their needs, even if done in a warped manner. Rogers was optimistic that if nurturing conditions were provided, a client would grow.
Person-centered approach is less of a theory and more of a philosophical means of being a therapist (in the U.S.). In other countries, it is the leading means of therapy. It is taught as a distinct approach and is empirically supported.
To learn more, listen to the full podcast.