The Do It All Problem Solvers!
*Client names and other identifying information has been changed to protect confidentiality.
The Therapeutic Behavioral Services (TBS) specialists are do-it-all problem solvers, working tirelessly alongside various professional team members, parents, caregivers, and foster parents to help their clients "graduate."
In TBS language, to graduate means the client of the program has successfully met the goal to reduce the behaviors that were harmful to themselves and/or the people around them. William Lowery and Nikki Reyes are two of our Youth Homes' TBS specialists.
"We are a unique program because we work with everyone who touches the kiddo's life," William said. "We want to see what is positive and what is negative and how we can increase the positive. We assess the entire environment. For example, is this after-school basketball club a good fit for my client? A school therapist just doesn't have the same access that we TBS specialists have, but I can go to talk to the coach and see how the kids all interact together. We're kind of like detectives. We're trying to find the places and people who are on the same page as us."
William and Nikki both closed cases this year that exhibited the intense process of working hand-in-hand with the young person, and the rest of a sometimes large team, to overcome emotional and psychological challenges.
Nikki Reyes & Youth Homes TBS Client, Toby*
Before she met Toby, Nikki was aware of two potential barriers that could impact their work. Toby preferred working with males. A common request for clients is to work with someone as the same gender as themselves. Toby also didn't like service providers because working with them made him feel different from other kids. Fortunately for Nikki, she found a way for Toby and her to quickly form a bond.
"We connected by playing sports together," she said. "I think that's when I really started to see him blossom, so to speak. He liked the playground. Seeing him in his element was really nice because he's super soft and sweet."
However, "he's one of those kids who has his walls up to the max."
With Toby’s case, Nikki worked with an unusually large team consisting of other Youth Homes staff, providers at the client's school, and a foster parent. They were in almost constant contact, and the level of collaboration was greater than any other case she had worked on. Typically there are meetings once a month when everyone involved with a case provides updates on how they're doing with the client.
"I'm pleased with how the team worked collaboratively throughout the entire process," she said. "It's not all the time that you have so much contact with the entire team every month. With this case specifically, sometimes we'd have meetings twice a month, and the whole team is there. It was really helpful to have so much contact with everybody because it keeps us all on the same page. Hands down, this is the case with the most contact with the entire team."
According to Nikki, the complexity of this particular case and not COVID-19 was the reason for the emphasis on everyone working together. The pandemic has made working with the kids much more difficult, though.
After Nikki discovered the key to connecting with Toby required they be outside doing an activity together, COVID-19 hit and impacted their ability to meet in person. Toby refused to meet via Zoom for telehealth services, which created a new barrier.
They were able to get back on track when state health restrictions were relaxed to allow more in-person meetings. Toby has been close to his TBS goals for months, cutting his most common negative behavior in half, and has nearly eliminated all the other behaviors targeted to zero. If not for COVID-19, he probably would have been done a couple months ago, Nikki said.
For a TBS specialist like Nikki, there are often lessons they can take from working with one client to another case. Nikki was so pleased with how effectively the entire team worked together and communicated on a more frequent basis than usual. She plans to apply that approach to other cases.
William Lowery and Youth Homes TBS Client, Cory*
William is a veteran of TBS. During eight years at Youth Homes, he has been confronted by one emotionally draining case after another. Which is why success stories like this one, when the client was desperate for help but didn't know how to solve the behaviors, are so rewarding.
"I came in full speed ahead, and I really wanted to get this case off the ground because the behaviors had been so explosive and so unsafe," William said. "It was a matter of how can I help this family as quickly as possible? I believed that the kiddo had the potential to make all these changes possible. But he needed the support of a team. That was home life, mental health team, and the school team. I was really fortunate that the kiddo and I built an excellent rapport in a couple months. It was really easy for me to work on things with this kid."
Together, they established a literal toolbox for Cory to use whenever he felt like acting out. The tactic is based on "Zones of Regulation," which uses activities to help clients see how behaviors are linked to specific emotions and how to express them appropriately.
Over time William got creative with what was in the box. He worked with Cory on his communication skills so that he would tell a parent or teacher that he was feeling upset. They needed to break Cory's habit of resorting to sometimes violent outbursts or refusing to answer when someone asked him what was wrong.
William's persistent advocacy for his clients paid off in a significant way when he convinced Cory's school to do an assessment for an Individualized Education Plan (IEP). An IEP is used to discover what specialized instructions or extra services a student may need to succeed in school.
In William's opinion, the assessment discovered the source of the client's behaviors at school, where most of the incidents occurred. Cory was deeply frustrated because he lacked some specific skills and required specialized attention that his current school was unable to provide. William successfully advocated that his client be moved to a different school, more able to meet his needs.
"Once this kid moved to the new school, it was just like 'Hallelujah, Hallelujah'" William said. "The kiddo felt empowered because the material wasn't so difficult, and he was well supported."
Cory's behavior changed dramatically after that.
Another critical breakthrough occurred earlier this year. TBS can work closely with parents or caregivers to ensure they have the training and understanding to raise a kid who is struggling through a challenging behavior-change process.
"I didn't want to give up on the case, and I didn't want the family to give up...the light bulbs went on in their parents' heads because they saw all the things I was promoting … they started to see that if they moved in that direction and followed through with what William said, maybe change is possible. That's when the family really got on board to absorb all the teachings and strategies that I had been trying to bring to the table."
William instructed and coached the parents to use the Nurtured Heart Approach, which has three critical components:
Absolutely No: "I refuse to give my time, energy, and relationship to negative behavior. I will not accidentally foster failure, nor will I reward problems by responding to them in animated ways. I will save my time and energy for searching for success.
Absolutely Yes: "I will relentlessly and strategically pull the child into new patterns of success. I will constantly recognize the success and achievement that children are displaying no matter how small and present them with clear, undeniable evidence of their value and how great they are.
Absolutely Clear: "I will have clear and consistent consequences for children when a rule has been broken. 'Here are the rules, and here's what happens when you break a rule.'"
When Cory reached his goals for graduating from the TBS program, the feeling of satisfaction and gratitude between William Cory was powerful. Cory told William that he wants to be a TBS specialist one day and help kids the way that William had helped him. Cory also gave William a personalized gift that showed how transformational their work together had impacted him.
Cory was now a happy kiddo.
