A number of us have what is usually referred to by experts as troubled children. I have friends who are currently receiving a lot of deeply appreciated advice and assistance from a child-care specialist.
My friends went to a number of social service agencies, which recommended heavy medication. They were frustrated and depressed themselves, because their child had in effect assumed authority in the home. But they were convinced the answer was not drugs.Then they met Jeff Simpson, director of family-based treatment at the Utah Youth Village, 5790 Highland Drive, who agreed.
Although a political science major in college, Simpson has been a dedicated child-care worker for the past 14 years, having taught in residential treatment programs in Arizona and Montana and at the well-known Father Flanagan's Boys Town in Omaha, Neb., before coming to Lila Bjorkland's brainchild, the 26-year-old Utah Youth Village, just two years ago.
Simpson uses the village's home-based services program to keep the child in the home and give the parents back their authority. He goes into private homes and lovingly, patiently teaches children skills.
"We don't like to label kids. We don't call them sick. We say they are lacking self-esteem, independent-living and social skills that are hampering them from being successful. It may be something as simple as communicating with peers and adults, following instructions or appropriately disagreeing."
Initially, he does concentrated hands-on work with the child, then expands to the rest of the family, teaching them compatibility. Ideally, in 9-12 weeks the family develops enough independence to function on its own.
In difficult cases, like that of my friends, Simpson is there almost every day. "It is very intense in the beginning - a lot of hours. They need help right now, because they're in pain. You also need time to develop a relationship with them. For a family to take your suggestions, they have to have confidence in you from watching you work in their home."
So if Simpson gets a call from the family at 11:30 p.m. or 1:30 a.m. with a problem, he goes over there. "And I'm there until the crisis is over." Moreover, the family can continue to call him when the 12 weeks is over - all for the same one-time cost. By contrast, it usually takes six months to a year to achieve success if a child is taken out of the home.
"For anger, you teach the child cause and effect. It's all right to feel anger, but it's not all right to behave in inappropriate ways. There are negative consequences for engaging in an anger outburst."
He teaches the child skills she or he can use when angry. For example, "I'm feeling real angry right now - I need to go to my room and calm down." After awhile, the parents can help in recognizing when anger is escalating. "Why don't we talk about this later?"
This is called time out.
Simpson helps both parent and child visualize stop signs. "You take deep breaths, relaxing muscles. When a person gets angry, certain muscles tense up - the jaw, the shoulders, the face. When they escalate, you can give them the tools to de-escalate."
Simpson doesn't use the word punishment. "It has bad connotations. We use response cost. For example, when you're speeding and you get a ticket, that's a response cost. They take something away - money. We do the same thing - we take something away - maybe an hour of TV, phone privileges or an opportunity to go see a friend that day."
Simpson rejects the assertion that this might be called mind control. "You're helping them to learn to control their behavior - just as we all do. That's the beauty of it, because you can think anything you want to and have any feeling you want, but you cannot engage in inappropriate behavior in society, or it will place you in more restrictive environments."
Simpson says he never tells a child, "I know what you're thinking," or "I know how you feel." He deals strictly with the observable. Recently, he worked with a child who used to explode no matter what the consequence. "One time she got a butcher knife. Yesterday, she just stood there. Everyone knew she was upset. She took a couple of deep breaths, went into the laundry room and stayed there for about five minutes.
"We're not controlling the child's behavior. We're providing the incentive for the child to control his own behavior."
Simpson teaches the ABCs of behavior - "A" is antecedent, "B" is behavior, "C" is consequence. He uses an analogy of a child accompanying a parent to a grocery store. "The candy is located right at the kid's eye level at the check-out counter. The owners of the store know exactly what they're doing. They know the kid will say, `Mom, can I have this candy bar?' She might say no.
"The antecedent is Mom saying no. The behavior with a 2- or 3-year-old child typically is that the child will throw a temper tantrum. So the mom, who wants to avoid embarrassment, gives in. The child stands up, smiling. What's happened here? The consequence is he gets a candy bar. We teach that child that when he gets a no answer from Mom, he can just act up and get what he wants."
In Simpson's method, there is not only no candy bar but no Nintendo this afternoon. That is the "response cost." But Simpson hastens to say that this is not a "strict behavioral program." It is "humane, family-oriented, relationship-oriented, skill-oriented."
Although Simpson is enthusiastic about the success of the program, he worries that many families who need help cannot afford it. "We charge $3,200 a family." He has proposed a scholarship fund to be supported by affluent individuals or institutions, perhaps named after the contributor. "About $35,000 could help us serve 10 families. My goal is to serve 20 families a year. The program works. It preserves families."
Simpson suggests anyone who wants to contribute to the success of the program to donate to the Utah Youth Village preservation scholarship fund.