Therapy, part II

Since my last post on therapy, Dusty has now had one therapy session. Next week, she will have been in our home 8 mos and she had her first appointment yesterday. How's that for efficiency?

The good news: The people I have talked to that are familiar with this therapist say she is great (that was maybe 2 people). In my intake meeting with her she requested that Dusty not be present b/c we would be discussing many things she should not hear. This seems like duh common sense, but she is the first therapist I've ever worked with that seems to get that. In other intakes, the therpaist is asking me to talk about the child's history, their trauma, their bio parents' issues, their current behavioral issues - all while the child plays in the room next to us and pretends not to be listening or aware of anything we are saying. But they hear it ALL! And a therapist should know that. So, she earns points for that one from me.

Another good thing is she seems to understand trauma and how kids will play out their trauma as a way of processing it and coping with it.

Now for the not-so-good news:

In the intake, I asked if I would be present during the sessions. She said "no". I asked if we would talk after the sessions to discuss what is happening in them and things I should be working on with her at home. She said she was not able to discuss specifics with me about what goes on in the sessions, but could tell me if she had a particularly emotional session or if she had a hard time etc.

I have a problem with this. A BIG problem with this. But, I also know this is standard and my raising an issue only makes me seem weird.

Let me walk you through how yesterday went. Imagine this is your child.

We arrive at the counseling center (a place that Dusty has never been to before), we go into the "lobby" (I use that term loosely, the lobby is a very small room (think large closet)with a few charis, a table w/some coloring books and crayons), there is no one in the lobby, there is no receptionist or anyone to check in with or let know you have arrived. There is a sign on the door that says to wait there and someone will come get you. The therapist (who Dusty has never met before) opens the door, stands in the doorway and says "are you ready?" Dusty walks back into a room with her. I stay in the "lobby". About 30min later, she opens the door and Dusty comes out. The therapist says "She did good. See you next week".

Now, remember I said, pretend this is your child. Would you be ok with this? I know that I would never have done this to my bio kids. NEVER!

If I felt my child needed therapy it would be because they had probably suffered some trauma. As their mom, I'd want the help of a therapist the help me help my kids to process it. I would want to be there to assure my child that this person is safe and that I trust them. I would want to be there so that when my child did begin to process their trauma and experience big emotions as a result, I would be there as their mom to comfort them, support them, love them. I would want to be in the room at all times because there is absolutely NO reason for this therapist to develop a private relationship with my child. The therapist is simply a tool our family is using to cope with difficulties.

Now, let's consider foster children:

1. They have tons of confusion about who is safe and can be trusted.
2. They often will go off with anyone and have difficulty discriminating roles of people (particularly understanding the role of primary caretaker).
3. Therapists come and go like (I can't think of a funny cliche here for things that come and go - so enter your own), so working on getting a child to trust a specific therapist only to leave them and get a new therapist - bad idea!
4. Therapists only see this child 1 x per week - the goal should be to empower the family with the skills to work through the issues the other 6 days of the week.

Let's not take this issue of stranger danger too lightly here.

With all of our placements (and respite kids), we have had issues with an inability to distinguish between people they know well and trust and any random person that approaches them and calls them cute. Every. One. Of. Them. It's not a small problem, it's a pervasive problem.

In a child that is well adjusted and has a secure attachment, there will be some hesitation to being approached by strangers or even people they have met before, but are only casual acquaintances of their parents. There is a clear distinction between who you go to when you are sad and need comfort, when you scraped your knee, when you need to go to the bathroom. It's not normal for kids to just ask the nearest adult to help them with these things. But kids in foster care do. Not only do they do that, but they will intentionally seek out adults other than their parents. When my children were young and a stranger talked to them, they may avert their eyes, lower their head, move closer to me, take a step back from the stranger (all things that signal "I don't know you, I am being cautious of you"). I LOVE when my kids do that. Love it! I know some people have real issues with shyness in their children and work hard to help them to get over it. And I get that too. And if we are talking about kids that have grown up in healthy homes and have secure attachments with their primary caregivers, then that's ok. But for kids in foster care, we should rejoice over "shyness". It's good. It's progress.

Now, if I had taken one of my kids to see a therapist, pulled up to a strange building, sat in a strange room, asked them to walk through a door with a stranger while I stay back in the other room, we would have had some serious protesting (probably screaming and crying as though they were being abducted). In fact, just the therapist approaching and talking to them would have elicited something like this:

Had Dusty behaved as though she were uncomfortable going off with this strange lady, I'm sure she would have had me sit in on the session until she was more comfortable. But the fact that she willingly went should be a red flag to the therapist. And we should not exploit this child's disorder/issue (whatever you want to call it) by asking them to do something, that if not for their issues, they would not do. Essentially, therapists working with the most vulnerable children (those in CPS custody) are exploiting their unhealthy attachments and further encouraging unhealthy behavior. Wonderful!

Let's Play Dumb, Part III

As promised here, today I'll post about what I can happily call "what used to be our daily shoe fiasco". That's right, it's no longer a daily issue and I can actually say it's becoming a rare occurrence. It's always so much nicer to blog about an issue after we have successfully come out on the other side of it :) Yay for progress!

Apparently, doing weird things with your shoes is a thing for kids with attachment issues. Remember when Jenny walked out of her shoe in the middle of the street and we all had to watch as it was run over repeatedly?

Or when Shirley lost her shoe in the corn maze or the numerous times she just couldn't keep them on her feet while in the stroller or the time she tried over and over to lose a shoe at Disneyland?

Well, Dusty has shoe retardedness as well. When she first came, she tried the walk-out-of-my-shoe routine, but soon decided that was not fun enough and adopted the put-my-shoes-on-the-wrong-feet-everytime-I-put-them-on routine instead.

Here she is walking down the street with one shoe on:

And that's exactly how we deal with that issue. If you want to walk around with one shoe on, it only makes you more uncomfortable, so knock yourself out.

Dusty has been with us over 7 mos now and just very recently, she stopped putting her shoes on the wrong feet. So, for more than 6mos, she put her shoes on the wrong feet every time she put them on with very few exceptions (and in our house this is several times a day b/c we take our shoes off at the door).

Now, how did we deal with it? At first, I would verbally remind her that her shoes were on wrong and to fix them. In the beginning, fixing them took her forever. She would take them off her feet, switch them around a few times and put them back on the wrong feet. Other times, she may take them off, look at them, look at me, appear very confused and just sit there. Once we determined this was a ploy to waste all of our time as we were on our way out the door, we started asking Dusty to get her shoes on immediately in the morning, before eating breakfast or anything else. That way, if she was going to waste time, she'd be wasting her own time, not ours. We also started sending her to her room to fix her shoes. That way, she couldn't sit and stare blankly at us as if she didn't know how to put her shoes on. The longer she took to fix her shoes, the longer she stayed in her room. This totally worked, in that, she immediately switched her shoes and was out of her room in seconds. It didn't immediately work, however, to get her to stop putting them on the wrong feet in the first place.

Over time, she started to have days where she put them on the right feet, every time, all day long. There were very few of those days, but they existed. Soon, the shoes became our barometer for measuring Dusty's internal state, how regulated she was that day. She may start the day out putting them on the wrong feet and typically that is how her whole day would go. Other times, she would start out great and something throughout the day would happen and I'd find myself saying in my head "she's going to put her shoes on the wrong feet". And I was right.

And now, she puts them on the right feet almost every time and almost every day. Progress. And to the extent that this tells me something about her internal regulation, emotional progress (even better!)

So, for those of you that wonder, what if you just said nothing or did nothing? Just let her wear her shoes on the wrong feet? Well, I had those same thoughts. And actually for close to a week long period, I actually did that. I just said nothing about her shoes, did nothing, let her wear them that way. However, I found that it still frustrated me that she did it and I wasn't as successful at just letting it go as I needed to be for this approach to work. Then I had a discussion with my husband and his take on it was this:

You told her to go put her shoes on. You gave her a direct instruction which you expect her to follow. And putting them on the wrong feet is her small way of being defiant. It's like saying "ok, I'll put them on, but not the way you want me to". In other words, "Eff you, lady. You aren't the boss of me". And the reality is, we see this behavior of challenging your authority at every turn with attachment disordered kids. And just as I have said before, it's crucial they learn you are in charge. Not because you want to be the big scary boss, but because you need to be in charge. They need you to be in charge to take care of them, meet their needs, keep them safe. And even small challenges to your authority need to be met with a (gentle) reminder that you are the boss, even of how they put their shoes on :)