Therapeutic Foster Care in rural Western North Carolina

I hope that Creative Families will support, encourage, and refresh those of you who provide therapeutic services for children in desperate situations. I also hope to stir the desire of others to open their homes and hearts to children who have no where else to go.

Wednesday, April 4, 2012

The Stress of Childhood

                                     “I’m so busy.”   “I don’t have time.”  “I’m so stressed out.”
Unless you make intentional efforts to guard your time, these mantras seem to be the bane of our modern life existence.  We allow stress to follow us wherever we go and, by so doing, allow it to impact our health, our relationships, and our peace of mind. 
Mayo Clinic’s Effects of Stress on Health
Physical Effects
Emotional Effects
Behavioral Effects
Muscle tension
Stomach aches
High blood pressure
Decreased Productivity
Decreased motivation
Over or under eating
Anger outbursts
Substance Abuse
Social Isolation

Without a doubt stress impacts our lives, but do you realize how much stress impacts the lives of our children?   Children are in a crucible of developmental tension.  What seems trivial or like simple play is really a method of learning about the world around them and establishing their own sense of self.  At each developmental stage (Erickson, E.H., Childhood and Society, 1985), the child ultimately chooses between two world views and establishes how they will relate to adjusts to people and society. This is the normal work of a child and can be stressful in and of itself without the added stress imposed on them by adults:

What is normal stress for a child?
  • Seeing parents leave and come back (trust vs. mistrust)
  • Learning to share and not always getting what they want (initiative vs. guilt)
  • Trying something new until they succeed (autonomy vs. shame and doubt)
  •  Interacting with new environments (industry vs. inferiority)
  • Evaluating belief systems (identity vs. identity diffusion)
  • Forming friendships, experiencing loss, comparing and competing with peers
  • Standing up for themselves, people they love, and values they believe in

  These issues are tough and ones adults continue to perfect their grasp on throughout a lifetime. Children are accomplishing this huge stressful task of developing their own sense of self and view of the world.  In addition, they must manage the intense stress of divorce, poverty, nutritional depletion, domestic violence, substance abuse, abuse and neglect, internet predators, school shootings, racism, and more.  Children are onslaught with adult issues without the maturity necessary to process or cope in a healthy way.

All this to say, children are doing critical and difficult emotional work on a daily basis.  They need adults to help them manage this stress instead of adding to it.  As adults, it is our job to:

  1. Care for yourself (alone time, date nights, time with friends,  doing something you enjoy, explore your spirituality) 
  2. Take responsibility for the adult issues in your life (Don’t blame others, Don’t rely on your child as a confidante)
  3. Teach and demonstrate healthy coping mechanisms (positive ways of dealing with negative emotions)
  4.  Explain why things happen (link cause and effect and avoid your child seeing themselves as the cause)
  5.  Listen to your child without judgment or comment (don’t interrupt!)
  6. Establish routines that your child can depend on (meals, bed times, etc)
  7. Limit extracurricular  activities
  8. Prepare healthy meals and snacks
  9. Plan family activities
  10. Exercise

 “Appreciating each other is a true family value, one that will bail out much of the stress on the planet and help strengthen the universal bond all people have.” – Sara Paddison

Monday, March 26, 2012


Two weekends ago, I attended a Marriage Encounter with my husband.  The presenters, Dr. Tom and Beverly Rodgers, have been married for 34 years and co-directors of a private Christian counseling practice for 30 years (  At the event, the Rodgers taught what they describe as a "God inspired" technique for working through anger.

Anger  is a secondary emotion, the tip of the iceberg, the emotional method used to express another, primary emotion.  Ultimately, the root of this primary emotion is what needs to be addressed.  Once the root of this primary emotion is addressed then an individual can begin to alter their responses to emotional triggers.  

Most children, especially in foster care, are hurt at some point in their childhood.  This hurt often expresses itself in anger, both rational and irrational.  Children in foster care often struggle with outrageous anger and outbursts, usually evidenced in children much younger.  One 16 year old recently told me "I act like a two year old" when she gets mad.  Most recently, when the foster parent offered another egg with breakfast, the 16 year old threw the egg back at the foster parent, raised her voice, and ultimately ended  up kicking and screaming on the floor.  Afterward the child looks back and sees the ridiculousness of the moment, but in recalling the foster parent offering her the extra egg, she still gets angry.

I was able to teach this 16 year old the Rodgers' technique and use of the acronym GIFT, telling the youth that when she becomes angry to grab her thumb.  Grabbing her thumb is a "grounding technique" that allows her to be a little more rational in the heat of the moment.  Holding her thumb helps her to be more oriented to person, place, and time.  She becomes more aware of herself and her thumb is a reminder of what comes next.  At this point, the child has the chance to identify what happened that made her angry, "The Trigger".  Then she needs to try to verbalize what she really feels:
  • Guilty?
  • Inadequate/unworthy?
  • Fearful?
  • Trauma/ past hurt that this circumstance reminds you of?
These four feelings are primary emotions.  Acknowledging the real emotion diffuses the anger episode and allows the child to be honest with herself.  Being honest with herself and others allows her to begin to create real relationships.  These are relationships in which honesty, forgiveness, healing, and growth can occur.  Recognize and own the real emotion, then look at the root of when that emotion began.  We all experience hurts, some more traumatic than others.  When those hurts occur, we begin to believe a lie about ourselves.  This 16 year old, through neglect, came to believe "no one cares about me."  This refrain runs through her head, day in and day out.  When someone doesn't hear her say she does not want another egg and offers it to her anyway, she is transformed into that little neglected girl that no one paid attention to or stood up for.  And she responds the exact same way that little girl would, by kicking and screaming and throwing a fit for attention, to prove that somebody cared.

So the next time you get irrationally angry, stop and think. . .What am I really feeling?

Monday, March 19, 2012

Pow-Pow- Power Wheels

Robert is a 5 year old boy who arose early before his parents.  Deciding he wanted to go visit his grandmother three miles down the road, Robert climbed into his little power wheel jeep and started the three mile trip down the 4 lane road.  A woman saw him out her window and called the police.  When the police pulled the little man over, Robert refused to provide any information except for his first name.  "I'm not supposed to talk to strangers," he curtly told the officer.  Luckily, mom had since woken up and realizing her little boy was gone, called 911.  The family was alerted to Robert's whereabouts and the precocious 5 year old was safely returned home.  True story.

This anecdote strikes many chords: funny and scary all at the same time.  However, there is an additional piece to the story.  The child already had behavior issues that had been permitted to slide due to parental guilt and, according to the mother, already had a fear of police.  So, beyond a jaded awareness of "stranger danger", why might Robert's unyielding to the police be cause for concern?

Our social structure works on a basic communal understanding of healthy limits, right and wrong, rewards and consequences.  The premise of functioning adequately is acknowledging and working within this understanding.  We want to encourage the uniqueness in each person, celebrate freedoms, and inspire creativity.  At the same time, we want each individual to be respectful, conscientious, and safe.  Freedom and respect hang in a tense balance that frames our lives.

Children who enter into foster care often experience mistrust of authority which is then transferred to healthy authority.  Children have experienced abuse and neglect at the very hands of those entrusted with their care.  At a very early age, they have learned that those in authority are not just or safe in their responsibility.  Luckily, children are smart and adaptable; they alter their behavior to protect themselves and get their needs met.  Unfortunately, this independence lacks the maturity and insight of an adult perspective, potentially leading to dangerous circumstances.  A child may not disclose information appearing "secretive", he may engage in drug use appearing "delinquent", she may make overt sexual provocations appearing "loose".  Adults may interpret this immature or troublesome behavior as rebellion or punishable behavior, but really the behavior is a finely tuned way for the child to get what they need (control, security, acceptance, attention).  Since children have learned not to depend on others to get their needs met, children take it into their own hands.

For foster parents, remember that a child's ability to get their needs met is a strength.  The child is creative, adaptable, and resourceful.  Be warned, the child will not quickly trust you, nor will they quickly stop using the methods that have thus far worked for them.  Inter-dependence is hard to learn after you've established that you are the only one you can trust.  

  • The best thing you can do is be supportive and patient.  
  • Be an example of appropriate behavior and narrate what you do, how you do it, and why you do it. 
  • Ask open ended questions that help the child discover why he or she makes certain decisions.
  • Help a child paint a picture of what he or she wants in life
  • Demonstrate that you are on the child's team by advocating for what is in his or her best interest
  • Establish rewards and consequences that communicate that an adult is taking charge and watching out for the child
Don't stop believing in the possibility of change.  The longest and hardest part of change is coming to the realization and conviction that one needs the change.  Notice and affirm the small successes- being caught with the drugs, but choosing not to use them is a success.  It means you are doing something right!  Foster parents are deconstructing well built walls one stone at a time.

Monday, March 5, 2012

A Community Look at Foster Care

This past Saturday, the Waynesville Library, Appalachian Community Services, and Haywood Bound hosted an exciting opportunity to learn more about foster care in our area and the huge need for foster parents.  At last count, Haywood County DSS had custody of 98 children.  60% of those children are placed in local Haywood County homes.  However, 40% of those children are in homes outside of the county, away from family, friends, and community.  Over the last 6 months, in recognition of how important it is for children to stay a part of their community, DSS director Ira Dove has made a distinct effort to recruit foster families through collaboration of DSS and private foster care agencies.  This collaboration has come to be known as Haywood Bound.

As a part of the effort to recruit foster parents, Mr. Dove and several other community leaders came together for a panel event on foster care.  These community leaders included Dr. Steve Wall from Haywood Pediatrics, Tara Keilberg, director of Kids Advocacy Resource Effort (KARE), Scott MacGregor, a Family Life Educator and soon to be graduate of Western with a Masters in Clinical Mental Health with a focus on forgiveness, and Pablo and Maria Averza, therapeutic foster parents since 2006.  The panel was preceded by a dynamically honest dramatic interpretation by local actress Barbara Bates Smith of NC author Kaye Gibbon’s novel Ellen FosterEllen Foster tells the story of a little girl, Ellen, and her journey out of an abusive past and into a foster home that Ellen sees as her sanctuary, “somewhere friendly” and where “nothing new bad has happened to me since I got here.”

The panelists used Barabara’s performance as a backdrop to talk about the issues of foster care in Haywood County.  In 2010, 479 children in Western North Carolina were placed in legal custody of DSS.  8,826 children were in foster care statewide, with only 7, 684 licensed foster homes.   Children have been taken out of their homes for reasons of abuse and neglect and placed in relatives’ homes, therapeutic and family foster homes, group homes, etc.  Dr. Wall shared his experiences of how he has seen foster parents make a huge impact on children’s medical stability and ability to socially interact.  A foster parent needs nothing more than patience and an ability to establish healthy boundaries.  For the things a parent doesn’t know, there is a whole team involved to assist both the child and the foster parents.  Ms. Keilberg shared how KARE provides support for foster parents and birth parents through parenting classes and advocacy work.  Truly, though a family is doing the work with a child day in and day out, foster parents are not alone.  Parents are provided appropriate training, regular supervision, and access to services to help support the child.

Mr. MacGregor explained the researched benefits of forgiveness and helped to define what forgiveness is and what forgiveness is not.  Forgiveness is  not excusing the pain that was done, it is releasing the "right to revenge" and recognizing that every person is deserving of respect because they are created human.  Mr. MacGregor discussed how one can practice forgiveness, exercising by forgiving daily the little things (like someone cutting you off in traffic) so that you become strong enough to forgive the big things (like abuse or neglect).  Forgiveness has been medically demonstrated to improve the healing capacity of the body and mind.  Mr. and Mrs.  Averza echoed this sentiment, recognizing that it can be difficult to team together with struggling families.  However, the long time foster parents recognized the need for a child to have contact with their family and know that their parent is safe.  And, though attaching to a child and seeing that child leave again is difficult, the greater reward is modeling healthy relationships for that child and taking responsibility for and acting on a great need in the community.

The need for foster parents in Haywood County is an obtainable goal with the support of the community.  Haywood County needs 20 new foster parents in order to keep all of the children in their communities.  Look for Ellen Foster and Friends: A Look at Foster Care on your local Haywood County Television Channel.


Monday, February 13, 2012

"Boxing is the Love of My Life"

This summer something historic is happening.  For the first time women will compete in Olympic boxing.  Trying out for the team is Tyrieshia Douglas.  Tyrieshia grew up in foster care and is now in the running to be a world champion.  She and her four siblings grew up in separate foster homes after being removed from their own home due to parental drug abuse.  Tyrieshia first became interested in boxing after seeing her brother's box at the gym, amazed that they got to "beat up people for free."   When she asked to box, Tyrieshia was adamantly told "no" because she was a girl.  Eventually, at the recommendation of a juvenile court judge after she was arrested for fighting, Tyrieshia did start boxing and, at number 2 in the country for her weight division, has a chance to make history.

Tyrieshia's coach is like a father figure in her life; he has supported her in doing what everyone else thought was crazy and unfeminine.  Now at 23 years old, Tyrieshia is reunited with family, living with one of her brothers and on speaking terms with her mother.  Family never stops being family, but other mentors are priceless.  Without them, children may never get a chance to accomplish their dreams.  One foster family I've worked with did something similar for a little 11 year old girl.  They offered her every extracurricular activity in the book: gymnastics, ballet, cheer-leading.  The child's request?  Football.  The family, a two female home, were surprised but encouraging.  They decided that if football is what she wanted to do, then they would support her in that endeavor.  This tall, thin, blond, delightful girl became one of the best players on the team- nose guard, in fact.

"If you are strong enough to stand up against all the odds that you face, there is something within you that is special," says Christy Halbert, international women's boxing coach.  As parents, we often try to make our child fit within social boundaries.  This includes making them color in the lines, paint trees green instead of purple, girls cheer, boys play sports, sit down and stay still, don't talk, clean your plate without attention to how your body actually feels.  As tempting as it may be, do not slip into this trap.  See that something special in the child that is in your home, encourage them and help them to be "strong enough to stand up against all odds," you never know what they will become.  Our role as parents is to nurture the child's self-identity, build their confidence in who they are and their ability to make decisions, be creative, be self-aware and follow their dreams.  Anything less is bred from a spirit control.

Children who come into foster care are often so emotionally beat down that they have no positive opinion of themselves and no trust in their own thoughts or feelings.  They feel worthless.  One beautiful 14 year old girl I work with just recently stated, "nobody likes me, nobody cares."  She needs nurturers that will build self-worth into her.  She needs to see that people care and that people like her even if she doesn't believe it.  A foster parent has to teach a child how to pay attention to their feelings; often a foster parent must reteach the meaning of words and experiences- what is safe? what is love? what is satisfaction?

How does a parent walk a child from feeling totally worthless to feeling confident in themselves?  How do you do it for a 2 year old?  You squeal and rave over every little squiggle they make on a piece of paper.  You delight in the mud pie they serve you in the sandbox.  You react to them with the same amount of enjoyment/disappointment that they demonstrate.  This same principle applies whether you are 2 or 10 or 16 or 25.  We want people to respond with empathy, we want to know that we count for something.  We want to know that we matter.  The more a child believes in her own worth, the more she begins to respect herself.  The more she respects herself, the more she is able to respect other people. Self-worth and respect will help her to make safer decisions, to protect herself from inappropriate sexual behavior, to restrain herself when tempted to act out or not do anything.

"If you can get hit and hit a person back, you have to have heart. You might get hurt. That's heart to me"- Tyrieshia Douglas.  Kids get hurt all the time, they get hit in so many ways, but they stay in the fight.  Especially when they have a supportive team behind them.  That's heart.  The 11 year old nose guard went on to be adopted by a family member who will not let her play football.  She may not play football anymore, but she learned some valuable lessons that she will carry with her.  She learned her own strength.  She learned that people care.  She learned that she can accomplish what she sets her mind to do.  And she still visits her foster parents.

Monday, February 6, 2012

Just a Child

Sitting down with some very experienced foster parents for the first time, they told me "we do foster care differently from most people."  When I asked them to explain, they said "most therapeutic kids have to earn things to go in their rooms; we don't do that.  When a foster child walks in our doors the "foster" is dropped; they are just a child."

These parents are right.  Though a child may require therapeutic level boundaries and interventions, she still deserves a childhood.  The child still deserves fun comforters and music to listen to, stuffed animals on their bed and toys in their room, goofy socks and hair barrettes.  A child should not have to earn the right to be a child.  Though she may need to earn certain privileges, she should not have to earn a family's affection or a comfortable environment.  Children will meet the challenge of both the environment and the expectations of others.  The nicer and more respectful the environment, the more children will respond with care.

How do you create a comfortable and respectful environment?  Stay away from sterile.  Though therapeutic, you are a home not a hospital.  Many children, even older children, who have experienced abuse wet the bed at night.  So find a mattress cover that is not plastic or that doesn't crinkle when someone rolls over. Use colors to brighten or calm the environment.  Accent with rugs, curtains, pillows.  Provide dressers and shelves and closet storage that encourage organization.  Give the child a home tour when they first come, state the rules of the home and post them in visible place.  It may seem trite or insulting to state simple rules like knocking on doors before entering or dressing behind closed doors or talk about emotions instead of hitting.  But those rules, as simple as they seem, are not universal.  Stating and posting rules will let the child know the expectations up front and will teach communication and respect.

Create a special, safe place that a child wants to be.

Monday, January 23, 2012

Knight in Shining Pajamas?

My 3 year old has just been initiated into an age old guild of young boys, Knighthood.  He is a brave knight, the protector of his family, invisible sword in hand, conquering dragons and lions and tigers and whatever other threatening animals dwell in the darkness up the stairs at bed time. His fool proof "armor" are his safari pajamas.   Having developed a general trust in the world and the people in it, established confidence in his own independence and will, he as come to the point at which he must develop initiative versus guilt.  He must develop his sense of purpose, his knowing that he is in this world for a reason and that what he does matters. He must move forward in his life knowing that he can try new things and fail, explore the world both imaginary and real,  and that he will be loved and supported while he does so.

A child in this developmental stage of life needs to be affirmed that he is powerful and capable and that his explorations into the world around him are important.  A child also needs to be taught that his power is his to wield in the service of others.  He has the ability to change things as well as the ability to help others.  He has the right to his emotions, but also the responsibility to experience consequences.  This is the foundation of an emotionally intelligent and compassionate soul.

If, however, the struggle for initiative is thwarted, a child may easily experience guilt in his life.  He may feel that he is worthless, doing things wrong, or not doing enough.  A child experiencing this guilt may withdraw for fear of doing something wrong or overcompensate and try to take command of everything.  The foundation of the child continues to be damaged when at every turn he's not allowed to touch things or talk to people in public or he's laughed at for not being able to competently do a task or he's corrected at every turn or he is allowed to do anything he wants without parental intervention or  he is told that his made up story is a "lie" or he is punished for crying or getting angry.

Children come into foster care with many cracks in their developmental foundation.  As each developmental stage builds upon another, guilt builds upon shame and shame builds upon mistrust.  Foster parents have the job of going back to re-examine the foundations, no matter what the child's age, and filling in the cracks.  Therefore a 10 year old might need to be held and rocked like a 1 year old, an 8 year old might need to yell and tell you "no", and a 14 year old might need to play pretend.  They need help filling in those cracks, building back trust and autonomy and initiative.

We all have cracks, that is part of being human.  And there is no shame in being a parent who has not built a strong foundation for their child.  We act out of our own brokenness and we don't know any better than what we have been taught ourselves.  Thankfully we have friends, family, teachers, foster parents and more to help us build where we aren't able, but that never replaces the role of a parent in the heart of a child.

The Childhood Affirmations Program,, provides the following list of suggestions on concepts of how to encourage your 3-6 year old child.  Try your best to communicate that:

1) We enjoy having you explore who you are and finding out who other people are.
2) You can feel powerful and capable and still ask for help when you want it.
3) You can learn that behavior has consequences.
4) You can imagine things without being afraid they will come true.
5) We gladly give you our support and love.
6) All of your feelings are okay with us.

Build these affirmations in your child, no matter what the age.  Some of us adults still need them!