- Does something here validate an experience you are having?
- Does something here point in a direction you would like to go?
- Does something here change how you think about what is possible?
There is a standard opener in most settings I find myself in these days, a variation of “things are so hard right now!” With the current convergence of social, political and physical upheaval, folks are tired. We search each other’s Zoom faces for connection, validation, engagement. We drop encouraging comments in the chat box or click an icon to indicate we love what we heard. Maybe someone asks the check-in question “what’s something good in your life right now?” and we search our memories for a meaningful answer. For some it is more time with a partner, for others a walk outside after work. Almost every casual conversation I have with coworkers and friends these days ends with an exchange of favorite podcasts and TV shows. We are desperate for a way to fill our free time and trying hard to come up with ways to help each other do that too. In these unprecedented circumstances of whatever week we are in, we are looking for something to help us feel good.
Recently Julie Kim brought a resource to our clinical supervisor team, an infographic from the Genesis Healing Institute that opened my eyes to another way to consider how we navigate this year. The concept is Transformative Healing, and the ideas presented on this graphic filled me with a new sense of hope and courage. At best, this offers a roadmap that helps guide us through the stages of reckoning and healing that this unprecedented time presents to us. At it is simplest, it is a beautiful collection of affirmations that capture so much of what many of us are feeling and exploring right now. I share the graphic with you here and invite you to consider:
It might be helpful to think of this as ‘less as a roadmap, more like a cycle,’ such as the stages of grief. We may go through these stages in and out of order each time we are presented with a new 2020 challenge. My hope is that you find this thought-provoking and that it offers you a new way to consider how you can survive (and thrive!?) during this unprecedented time.
Each week, our therapists and interns meet with a licensed clinical supervisor who oversees their training and development as well as treatment of clients in their schools. Generally speaking, both licensed and unlicensed therapists meet with their clinical supervisor for individual supervision at least one hour a week, and then in a group-setting with up to seven other therapists for a weekly two-hour group supervision. These units of supervision are non-negotiable, mandated structures put in place to support clinicians who are not yet licensed and are practicing under their supervisor’s license. We use a similar model for our licensed therapists in order to support their connectedness and growth.
Why so much clinical supervision?
So what goes on in there, anyway?
So much of what our school-based therapists do is not visible to others. Recently a colleague asked, “What do you do in [group] supervision, actually?” Great question!
In individual supervision, the clinician typically brings areas they are struggling with in their work or successes they’d like to share. They check in about required paperwork needs, professional development goals and the logistics of the work, and spend most of the time talking about their caseload, ethical issues and intervention plans. Supervisors are always listening for risk and safety issues for clients and making sure that the clinician is monitoring their clients’ safety in addition to their treatment goals. The relationship between supervisor and supervisee is attended to, discussed, and feedback is invited in both directions to enhance the quality of the relationship.
In a group supervision, up to eight therapists gather to learn from one another. With eight therapists and only two hours, we rarely have enough time to get to everyone’s clients, so the group prioritizes together how to use their time. The therapists identify themes in their work and talk through strategies for understanding their clients and responding to them. Every school year, each of our therapists spends between three and four hours across several groups to do a deep dive into their work with a chosen client. Their colleagues listen, ask questions and offer reflections to help move the therapist forward in their work. At times we read and discuss articles, watch videos or welcome a trainer into the group supervision to further develop clinical practice. Supervisors are always monitoring for safety concerns and making sure clients are always getting the best care. Experiential supervisions are some of my favorites -- that’s when we bring in interventions like play therapy techniques or art therapy activities and we try them out together.
Once our therapists achieve licensure (usually they’re required to have had at least 3000 hours of supervised experience before taking their exam), we continue using a similar supervision model to support their growth. In All-In!, our licensed therapists have the option of joining a “consultation group” instead of continuing in a supervision group. The consultation group is peer-led and gives licensed clinicians the chance to practice facilitating group supervision and supporting one another. For those who are interested in becoming clinical supervisors themselves, this consultation group is a chance to practice clinical leadership.
The goal of clinical supervision is to not only enhance and develop therapists’ clinical skills but also to further their professional development.
Thanks for reading!
Behavioral Strand Highlight
In All In, growth-mindset is part of our culture. In individual and group supervision, we are constantly discussing personal and professional growth opportunities as a result of this work.
As we wrapped up 2019, the Behavioral Strands Leadership Team hosted a Seneca Career Fair. The objective of the career fair was to provide the Behavioral Team, specifically our Student Support Assistants an opportunity to meet, actively engage with, and learn from their fellow Senecans about various career tracks held within Seneca Family of Agencies. On the panel of participants were an array of representatives for positions including, but not limited to:
As we enter into 2020, “Stay Interviews" have begun. We use this interview format to inquire about plans and professional development goals for next school year. The majority of our All-In Student Support Assistants are motivated to pursue higher learning opportunities, with the hope of staying with or returning to Seneca as a Teacher, Therapist, or Data Evaluator. Additionally, many of our Student Support Assistants have followed up with Career Fair representatives to further discuss their goals and plans for moving in that direction, which is AWESOME!!
So, be on the lookout for our amazing Behavioral Team. They have some aspiring teachers and therapists on the rise. Some are looking forward to starting grad school Fall 2020 and others are exploring potential Universities for Fall 2021. As Eric Thomas said, “When you find your why, you find a way to make it happen.”
Clinical Strand Highlight @ Education for Change
The EFC Clinical Strand has had a busy first half of the school year. For our new clinicians, it was a process of learning all the ins and outs of the Clinical Intervention Specialist role: integrating into a new school site, developing a caseload, creating relationships with clients, caregivers and school partners, finding time to do documentation and finding time for self-care. For clinicians who returned to their sites, they built on continuity with clients and school partners while also adapting to ever evolving school-wide needs, a reminder that each school year is unique. Through it all, our Clinical Team’s consistency and commitment to our clients, their families and capacity building with school partners has been outstanding. Their work embodies the foundation of Unconditional Education and is truly inspiring to witness.
As we all know, data is one of the most powerful tools to inform, engage, and create opportunities for growth and also helps us make connections that lead to insights and improvements. Thus, Increasing progress monitoring efforts has been a huge focal point this year for the Clinical Team, incorporating quantitative data with qualitative data to deepen the narrative of client experiences in connection with our #datatellsastory launch.
Whether connecting progress to a change in intervention or connecting a step back with a new stressor and then adjusting it, the ultimate goal is to track progress and share it meaningfully with clients and all stakeholders involved. The first months have been a learning process of navigating data collecting systems, finding ways to incorporate progress monitoring into already busy schedules, and writing meaningful goals that can be realistically tracked but with great momentum, the Clinical Strand has taken on this work head on and are looking forward to incorporating progress monitoring more seamlessly into future collaboration opportunities! Way to go team!
There is an age-old question clinicians hear all the time – “What do you DO with the kids in your office?” A clinician typically takes a gulp and wonders…what AM I doing? PLAYING?!?!?
Over the years, I have decidedly used play therapy as the primary model of working with kids in therapy. Play therapy is tricky to explain, since it can look a lot like simple play. A client and a therapist can be deep in the throes of a storyline that involves different races of dinosaurs battling each other to the death, spies who turn out to be counterspies (who turn out to be counterspies), and babies who require care but are also very annoying. Or a client can play Uno for several weeks, always changing the rules so that they win at the very end after a long, drawn out game. Or a client tells lie after lie, spills toys carelessly, and asks to open every drawer in the therapy office, saying they will never come back for therapy. Some of this looks like fun, boisterous play and some can be more coy and mischievous acts.
In play therapy, it doesn’t matter so much what the actions may be. We are playing. What makes it a therapeutic intervention is how the clinician responds to the client and how the space and time is held intentionally. I found a straightforward infograph that highlights what the difference is between play therapy and play. I use this often, in supervisions and as a reminder to myself.
The use of play therapy is based on the belief that the child is processing things through play. The idea is that play is never without important meaning, nor is any play by chance or without aim. Children use play to communicate, think through things, experience new situations, and inform their internal working models – the way they understand the world around them and their place in that world. The second important aspect of play therapy is the adult relationship. The experience of having an adult who has suspended judgement, is not moralizing or trying to formally teach, while remaining curious to allow the child to figure things out, control the story, or try different personas is a special interaction in therapy. If both pieces- free play and a holding adult relationship- are present, play therapy presents limitless ways for kids to experience disconfirming stances. “Disconfirming stances” are ways that we can support someone to have a new experience of themselves and the world, a chance to shift their internal working model if it’s become stuck or has resulted in unhealthy beliefs and behaviors. These disconfirming stances can be broad – like one client who witnessed severe violence in his family and arrived at the conclusion through play that love does not require you to destroy yourself to prove your love- or it can be very specific like the client who wanted to see different ways of playing games to make and keep friends.
Play therapy is a fantasy place, where adults don’t have to push an overt agenda, hold to a list of action steps, or make sure to check for understanding from the child. It takes a lot of intention to not take the invitation to focus on how to correct or change a child’s behavior especially with the emphasis on teaching more observable behaviors like classic coping skills. But the processing of the underlying needs of problematic behaviors is an important aspect of treatment that needs to be addressed for lasting health and strength. Play therapy offers a space where these underlying needs (questions about what happened to them, what their self-identity is, what the rules of relationships are) can be addressed to support shifts in internal working models that inform our behaviors over time. This is, in essence, the process of changing from within.
In our school partnerships we have an opportunity to use multi-tiered supports as well as multi-leveled clinical interventions to address entrenched problematic behaviors. In a world that values the effectiveness of CBT and skills based programs, please don’t forget to consider play therapy as an effective intervention that can give a new avenue for our students and clients to play with the prospect of change amidst limitless possibilities.
Most of us, at some point during our childhoods, have been asked the question: “What do you want to be when you grow up?” Most of the kids we work with have probably heard this question, too – probably more than once. And all of us just know implicitly that the expected answer to this question is career. Career role is a defining factor in establishing identity in our society. Even as adults, we ask similar questions. “What do you do?” is almost inevitable in the process of getting to know someone new. The answer, again, is implicitly understood to refer to your career.
Yet in today’s world, it’s increasingly unlikely that any individual will remain in the same career role throughout their life. This trend will likely continue as our young clients grow up and enter the workforce, and it has certainly been true of my own career journey that brought me to Seneca.
Throughout my adolescent and adult life, one aspect of my career journey has remained the same: I have always enjoyed working with children. When I was a child, this goal would have translated to a single, recognizable career identity, likely "A Teacher" or perhaps "A Nurse.” It was only as an adult that I discovered the many different avenues one can take to working with children – and since then I have tried on several of them.
My first job, for instance, was working for a children's play place (similar to the more recognizable icon of Chuck E. Cheese's.) I wasn’t a teacher, and I wasn’t a nurse, but I was working with kids. Yet even at the time I knew that this was a temporary role, a “stepping stone” so to speak. Looking back, I would say that my career journey really began with the two jobs I held in college, working in research labs – first studying language and cognition, and subsequently attachment. Instead of supervising children, I was studying them – a new role, with new responsibilities, and a much broader range of required skills.
Since then, I have been a special education aide, earned a Master’s in Fine Arts, taught classes on social justice & creative writing through an arts and education non-profit, set up side-gigs making art, transcribing audio, and substitute teaching, and most recently interned at my first MFT site placement with East Bay Agency for Children. Now here I am, working as a clinical intern with Seneca’s All-In program, and in May I will finish my master’s program and begin working towards licensure as a marriage and family therapist.
In some ways, I see MFT licensure as a “finish line,” establishing the career path that – at least as of now – I expect to follow long-term. Yet I still struggle sometimes with the questions “What do you do?” and “What do you want to be?” At twenty-nine years old, I have already “been” many things. Each of these roles has prompted me to strengthen new skills, tackle new problems, and take on new perspectives – contributing far more, in my opinion, to my sense of who I am than any particular job title. I try to keep this in mind when working with my clients, who also cannot be defined by any one role or aspect of their identities. And if anyone asks “What do you do?” Well, I listen, learn, try my best to be of service. “What do you want to be?” Empathetic, kind, and perhaps most importantly, flexible enough that, no matter what role I find myself in, I can continue to grow as an individual.
This week I’m highlighting one of our Education For Change partnership schools - Achieve Academy in Oakland’s Fruitvale district. Clinical Intervention Specialist Marianne Clark AMFT, who is also our featured staff in the blog this week, has engaged in an innovative practice at Achieve that expands her reach as a single Seneca clinician on her campus. Through building the capacity of others, Marianne and her collaborative Achieve team have been able to serve dozens of students through tier 2 Social Skills groups during the first cycle of service this year; truly an example of creatively bringing the mission of Unconditional Education to her campus.
The project began with an awareness of her limitations as a single provider at the school. Using our Social Emotional Screener tool, Marianne gathered emotional and behavioral data on every student at Achieve and was able to see trends and needs across grades, classrooms, and individual students. But how could Marianne find the time in her week to provide the myriad of group services the students there would most benefit from? Her answer: she couldn’t do it on her own. Marianne realized she needed more adults to provide groups and that she could share her expertise with them as a coach and mentor. She put together a presentation on the basics of running a group, and solicited interest from her school administration and staff community.
She then met with a group of interested EFC staff which included PE teachers, assistant principals, and other staff on site to provide them with a training on the basics of running a social skills group. Sitting down with each adult individually, Marianne was able to learn more about what types of issues, students and age groups they were most excited to work with. She was intentional around supporting them to feel more connected to the work by getting to know what their values were and what they were most interested in.
Next, Marianne revisited the data from her Social Emotional Screeners. She made sure to assign facilitators to grade levels and group topics that would resonate for them. Tailoring activities to the topics of the groups was another way that Marianne supported the adults with their new initiative. And they were off!!
Midway through the first group cycle, Marianne brought her team of adults together to provide problem-solving, consultation and connection. She also started getting input from the team on what they’d like to do for their next cycle in order to keep the momentum going on their new tier 2 initiative.
Primary and Secondary benefits:
In addition to providing social skills groups to 100 students in the first 6 weeks, other benefits of Marianne’s approach include:
Marianne is just getting going with the progress monitoring and outcomes measurements that we use for tier 2 groups. This will include gathering SDQ and collecting Social Emotional Screener data toward the end of the year to see if students involved in the tier 2 cycles showed improvement in any of their challenge areas. We’re also eager to hear how the facilitators feel after their first year of providing social skills groups with Marianne’s counsel. So far, this has been a big win for the students and school community of Achieve!
What about at your school? Is there an opportunity to build the capacity of others and leverage your own expertise to have a broader reach while building campus connections? Leave a comment below if you have thoughts or questions about how you might do this at your school.
“Incredible change happens in your life when you decide to take control of what you do have power over instead of craving control over what you don't.” ― Steve Maraboli
For those of you that don't know me, my name is Shar and my role in the All In Partnership program is as a Health Information Specialist. My job includes keeping track of all the different types of documentation our clinicians complete in order to meet best practice guidelines and requirements. Along with Claudia who is featured in our staff highlight, we support clinicians with monitoring the many changing requirements that come from governing bodies like the counties and state.
If I’m being honest, there are moments when I’d rather resist change with every fiber of my being than decide to be curious and open to the opportunity. What can nudge me into a better mindset is taking on the task of communicating that information along to others. Since I’m often relaying information and asking our amazing clinicians to handle yet another change in paperwork or procedures I want to understand for myself why this change happened and what it means in the long run for the incredible work they do.
On that note, I’d like to highlight the Pediatric Symptom Checklist (or PSC-35 for short) which rolled out throughout the state of California in 2018. The PSC-35 is a questionnaire that caregivers/parents complete and helps identify and assess changes in emotional and behavioral problems in children. As an agency and a program our clinicians strive to include caregiver voices in as many ways as possible and this new tool shows us the state also shares this value.
The PSC-35 shows us how the family is viewing the child and is a way of tracking their perspective over time. The fact that caregivers complete this evidence-based form on a regular cycle may also reinforce for them how important their voice is in our work. Despite the fact that I’m often asking our clinicians to take more on, when faced with a change in requirements it does me wonders to take a moment to pause and simply take a deep breath. Breathing a bit more thoughtfully stops me from jumping down the assumption rabbit hole of negativity. I quickly find myself motivated and inspired to understand and actually dive into it a bit deeper and find the value in how it highlights and adds to the amazing work our clinicians already do.
If you’d like to know more, please visit: https://www.massgeneral.org/psychiatry/services/psc_home.aspx
Several Clinical Intervention Specialists will begin using a computer based biofeedback program to support students making progress on social emotional goals. Biofeedback is a well-researched intervention to increase an individual’s awareness and control over emotional and physical states by monitoring and displaying automatic or involuntary bodily functions. The software our clinicians will be using is called HeartMath and is based on “heart rate variability.” Heart rate variability refers to the space between each heartbeat. When individuals are in a fight or flight state, the space between each heartbeat is very similar in length, which is described as low heart rate variability. Low heart rate variability is linked to the presence of anxiety disorders and increased risk of cardiovascular disorders. When individuals are in a relaxed state, the spaces between each heart beat appear to have more variability, or high heart rate variability (HRV).
The goal of the program is to train individuals to achieve higher states of HRV. By using a small and highly sensitive ear sensor, the program displays the heart rate (beats per minute) and HRV of an individual on the computer screen. With the visual cues from the computer and coaching from the clinician, individuals can practice “down regulating” their internal functions and experience more relaxed states of being, which the program refers to as “coherence.” The program offers several interfaces including visual games in which the higher HRV achieved, the faster the graphics appear or move across the screen. It also provides basic coaching and instruction on deep breathing techniques to increase HRV.
Here is a research article which speaks to the link between anxiety disorders and a low HRV: https://www.frontiersin.org/articles/10.3389/fpsyt.2014.00080/full
And a link to the HeartMath website for more information:
Blog Post Written by:
Rachel Murray, Clinical Supervisor
February is a richly themed month -- we celebrate Black History. We celebrate Love. This month we’re also celebrating the agency value of Courage, so I’ve been meditating on courage for the past two weeks wondering how I’d weave it into my blog post.
I’ll start with this quote from Nelson Mandela:
"I learned that courage was not the absence of fear, but the triumph over it. The brave man is not he who does not feel afraid, but he who conquers that fear."
Talking with Robin Detterman, Executive Director for All In, I mentioned the topic of Courage and my search for inspiration for this week’s post. Her response was immediate: “I think of Courage as the ability to return to Hope.” What followed was a rich discussion about how we want to create the conditions for the return to hope, so that our staff and students can greet their work and their lives with courage even in the most trying of times. We discussed how we can’t do this alone; that showing up for someone else is sometimes the most powerful way for them to access their courage and face adversity with a greater sense of self and connection.
Our job as directors, supervisors and leaders is in large part to bring hope to our teams when the going gets tough. We want to make sure staff know that we are here, see them and believe in them. It is, in essence, a parallel process to what our clinicians, teachers and student support assistants offer the students and schools they serve. Our staff holds hope and bears witness, so that students and families with challenges that threaten to take them down are able to access their internal motivation to persevere. Mandela calls this conquering or triumphing over fear. I like to think of courage as experiencing fear and pressing on, the courage to show up. And I know that we cannot do it without a sense of connection and purpose, without each other. Without love.
Valarie Kaur addresses the topic of love, bravery and justice in her inspiring Ted Talk ”3 lessons of revolutionary love in a time of rage“.
I also want to share a poem from Angel Gardner, Seattle's Youth Poet Laureate 2016/17, titled Black Courage. You can read her poem and a bit about her journey here: http://kuow.org/post/black-courage-young-poets-words-her-son
Blog Post Written by:
Emily Marsh, Director of Clinical Intervention
You may recall one of our discussions and activities during orientation this year was to think about the Seneca Model and how we might apply its principles to our work in partnership. We’re nearing the end of our first cycle of interventions in our schools. We are deep into the work, pulled in a lot of directions, sometimes scratching our heads about the next right thing to do, sometimes wondering, are we making a difference?
I think now is a good time to revisit your insights from that conversation, and the concepts we explored together. To freshen your memory: we looked at partnership in parallel to our work with clients and considered the Relational, Ecological and Behavioral streams of our clinical work. How, we pondered together, can we advocate for what we see as needed change in our schools, while maintaining an open, curious and engaged stance with our partners? How can we apply that same patience and openness we bring to our work with the students, who may not change as quickly as we wish, but whom we would never give up on? What helps us understand the process of systems-change, and how can we bring our spirit of respectful collaboration to the process every time?
I was enlivened by the insights so many of our All-In! teams brought to the discussion. The concepts of curiosity in the face of adversity, supporting change through reflection, compassion and positive reinforcement, finding alignment in values when we face challenges on the system level – these ideas, in their abstract form, flowed from the room and inspired me. I’ve heard from some of you that having this conversation with your site-based team could be extremely helpful now that you’re settled at your sites. Here are some suggestions and guiding questions you could bring to your next team meeting, as a check-in question at the start of COST, or even when you’re simply taking a few moments to connect with a partner.
And now, without further ado, here are some of the beautiful haiku our teams wrote as a reflection exercise during orientation. Thank you for taking the time to summarize deep learning in the 5-7-5 format. So simple and powerful!
Blog post written by:
Emily Marsh, Director of Clinical Intervention Services
All-In! Partnership Team