OCCASIONAL PAPER # 2 (January 2005)
MISTAKES COUNT: interpreting behavior
INTRODUCTION
Remember when your parents asked “what’s wrong” if you what did you have here before, it works better than this because not feeling well is internal not perceived as external weren’t feeling well? Or “what’s wrong with you” if you did something they did not approve? They needed an explanation before deciding how to react. Most parents realize that children communicate more by what they do than by what they say.
Youth offenses are messages. Youth who commit them are telling something about themselves, about their life situations, and about us. Their mistakes, misbehavior, missteps count. How much and why requires learning about their circumstances, situations and motives. Accurate clinical and environmental assessments are essential tools to understand and interpret their behavior before determining solutions likely to deal with them.
I. BEHAVIORAL MESSAGES
A host of reasons can affect social development and personal behavior. They can be the results of explicit, external pressures (what’s wrong) or subtle, internal ones (what’s wrong with you).
External pressures become visible through mistakes that some adults are quick to see as actions of “bad kids.” Often, however, these “bad kids” are trying to deliver serious messages about what they cannot control in their lives. Such pressures are frequently characterized by combinations of the following circumstances:
o Exhausted parents who, experiencing their own personal stressors, have no time or energy for their children, are afraid of parenting problematic kids, or are unsure of when, where or how to get help and who to get it from
o Youth frightened by a sense of loss, overwhelmed by helplessness and surrendering to dysfunctional home life or indifferent school life
o Social disillusionment that stems from a belief that no one cares about me or is willing to help me and that “I’m on my own.”
Internal pressures also lead to bad choices causing adults to ask “what’s wrong with you”. These are often evident in:
o Attraction to and use of illegal substances to escape from dreadful life situations, medicate against fear or psychic pain, or make impulsive decisions to enjoy life today because there’s little chance for a better tomorrow
o Acting up behavior usually intended to gain attention and get help can take many forms:
I. uncontrollable behavior or inadequate impulse control due to damaged neural capacities
II. increasing anger to express bad feelings because they do not know better ways to deal with their emotions
III. escalating hostility or sullenness when they think they are not being heard
o Self-conscious efforts to define and differentiate their individual identity and self worth in order to gain status and respect (“props”) often creating an “echo” effect with peers and siblings who imitate them to get respect, honor, or “one up” without remorse
o Focusing on short term risks and pleasures “now” because there’s no tomorrow.
Adolescents who experience abuse, neglect, or abandonment have learned to react cautiously and suspiciously to authority figures. In self-defense, they must decide quickly whether an adult in authority over them is going to be helpful, beneficial, loving, and protective or oppressive, dangerous and scheming to “keep me down.”
Parents are often confounded that our culture seems to disenfranchise them and undermine their natural authority. Certain laws, the media, the new digital world and ever-growing outside influences scare parents. They try to reassert themselves by becoming more authoritarian or permissive – stances that are almost always counterproductive, producing the opposite in their relationship with their adolescent than what they intend.
To be more effective, parents can learn ways to show their youngsters how to “buy in” to choices and decisions that will have better, longer benefits for them. This is an important baseline for adolescent-adult relationships. To the degree that parents learn to do this effectively, they can redefine and reclaim productive, positive relationships with their growing children.
Whenever parents fail to do this and their children continue to act up, society is forced to respond with alternative supervision. Historically, this has meant substituting surrogate parenting through various forms of “discipline and care” such as orphanages, military schools, foster care, residential care, special camps, training schools.
II. SITUATIONAL ANALYSIS
Ample evidence shows that none of these traditional surrogate methods has made a strong dent in preventing delinquency. This is why Wayne County decided to switch direction and adopt a new methodology of intervention. Instead of depending on a system that substitutes for or replaces parents, it created one designed to advise and support parents while also holding them accountable. It also expected that successful treatment outcomes would reduce juvenile involvement in criminal activity, provide timely interventions simultaneously appropriate and useful for the recipient, and improve community safety while being cost effective.
Wayne County’s juvenile justice care management system begins by accepting that mistakes count because they tell not only about the juveniles but also about their home lives. Instead of labeling youths based on behavior or offense, the new system starts by looking at the whole picture – assessing not only “what’s wrong with you” but also “what’s wrong.”
Behavior is a language that takes special tools to understand a person. Asking questions about the behavior is a tool. Listening to and assessing the answers are, too. They allow trained professionals to develop “keen ears.” Even though every juvenile has a different story, standardized questions surface the same issues. Common themes emerge.
This holistic approach looks at the external and internal circumstances of the juvenile and what he or she has done. Starting with a comprehensive series of assessments designed to provide this fuller picture, Juvenile Assessment Center (JAC) staff meet with the youth and parents to find out what’s going on in their lives, assess community support services to determine the environment’s capacity to provide education and job training, and test for mental health problems and any use of alcohol or drugs.
Because it is the single point of entry for eligibility and access to services, the Juvenile Assessment Center (JAC) carries out the following tasks:
- Establishes funding eligibility for services
- Does the intake for services funded by Wayne County
- Conducts psychological, social and psychiatric evaluations
- Screens for substance abuse and assesses related service needs
- Screens for eligibility and referral for community mental health services
- Acts as the County’s representative to the Circuit Court
- Authorizes and oversees movement of detention population
- Provides initial juvenile security classification and risk measurement
- Assigns cases to a service agency or Care Management Service (CMS)
- Monitors service delivery performance outcomes.
This methodology disputes a common social bias that a juvenile is “bad,” that behavior is an answer rather than a question. It challenges this bias for many reasons. First, because it excuses society from further responsibility for these youth and instead advances them into an adult system where costs to society will soar as it continues to “throw them away.” Second, it is self-defeating because it forces communities to spend more money on less promising results and to sacrifice realistic efforts to reclaim youth and families.
III. SYSTEMIC RESPONSES
The Juvenile Assessment Center/Care Management Services (JAC/CMS) approach is different. It starts by assuming behavior is a message that needs to be deciphered. It asks what is causing the behavior. It understands that the answer may be tough to find, but once discovered, it can help focus the juvenile and his or her family on making choices that will increase their responsibility as well as justify their accountability.
Clinical staff is trained to administer a proven assessment tool: the Child and Adolescent Functional Assessment Scale (CAFAS ®). Developed to assess impairment in day-to-day functioning in children or adolescents who have, or may be at risk for developing psychiatric, psychological, emotional, behavioral, mental health, or substance use problems, the CAFAS is also an outcome evaluation tool because it can be administered repeatedly over time.
CAFAS is useful in determining the intensity and type of services needed for a youth, in generating a service or treatment plan that matches the youth’s needs to appropriate interventions, and in evaluating the youth periodically while receiving services to determine whether interventions are being effective [Kay Hodges, Ph.D., Eastern Michigan Department of Psychology, Chapter for Handbook of Mental Health Screening and Assessment for Juvenile Justice, p. 1].
As it becomes clear through the course of these clinical tasks that a youth is acting out of “felt helplessness,” their environment is replaced with “felt help” in the form of structured programs that offer them ways to make better choices in their lives. The common goal of these choices is to bump up their sense of hope and optimism so that they start believing that “I can see a different path” and that “it’s worth behaving differently to pursue it.”
The role of clinical assessors and case managers is to help parents and youth discover and put together a positive plan for their future. This first step in caring, concerned intervention is to set the tone and level of future services. The youth and parents experience first hand what to expect from a system where people listen to them, take them seriously, and work with them to find better alternatives.
We know this works. A behaviorally-based review of their social histories demonstrates common patterns behind such “acting up” which suggest that these youth, rather than being “bad,” are reacting to dysfunctional living conditions. They are growing up trying to survive in a hurricane of confusion, hostility, and indifference toward them.
While there is undeniably a subset of kids suffering from a psychopathology expressed in gradually deteriorating behavior, who are becoming more extreme, anti-social, and uncontrolled, few kids are pathologically sick or without feelings. Most kids are reactive, although sometimes their mental health is affected by unsafe and unsupported living environments and/or biological conditions. In fact, among youths referred to mental health, those who recently engaged in delinquent behavior were found to be more impaired than youths without delinquent behavior. However, despite the high levels of impairment, the youths with histories of delinquency were able to make statistically and clinically meaningful treatment gains [Hodges, Ibid, p. 13].
The primary task of the Juvenile Assessment Center (JAC) is to determine what youths and families are reacting to. Extensive field practice, testing and interviews make clear how their limited resources and bad choices are often self-defeating as well as self-destructive. For example, testing positive for drugs or spending time in a juvenile facility can become a perverse “badge of honor” in the juvenile subculture. However, this bragging is often a rationalization that “I’m in the system with no way out.”
Bragging about what is shameful becomes a glib way to mask the reality that they are stuck in a bad direction. Indeed, too much in their lives reinforces this:
o Lifestyles reinforced by the media influence kids to establish a confused identity
o Peer choices start to replace parental influence (ironically, this is the time when parents must start asking more questions, getting friends’ phone numbers, and keeping up their personal energy to make sure that their youngsters do not get out of control or give up on themselves)
o Inadequate and difficult-to-get mental health services push these kids into a juvenile system unready for them.
Prior to the JAC/CMS approach, there was no good “front end” system for early intervention and prevention. The story of how youthful lives deteriorate was predictably common:
o An eight year-old is brought to a counselor and given medication
o The youth experiences improvement and stops taking the medication
o The youth then becomes more aggressive (for example: skipping school, smoking “pot”, fighting with family members)
o Counselors repeat the process but become helpless when youth/parent out of frustration refuse to cooperate further
o Behavior worsens to the point it becomes uncontrollable, socially unacceptable or both
o The youth ends up involved with the police and detained or placed in an impersonal, punitive system. If we are going to ‘win” over the court, perhaps we could describe it as a legal system that via due process determines eligibility for rehabilitation. Jurists will take this personally and we have a lot of new Judges right now that could be won over.
The JAC/CMS system starts over with this youth and the parents. Seeing their behavior as a message rather than a conclusion, it begins by acknowledging their immediate life-circumstances and examining their current life-issues in order to diagnose and recommend initial options. This diagnosis is passed along to specific Care Management Services (CMS) in the family’s neighborhood. The CMS assigns a personal Case Manager to the youth and family with a plan to make sure their basic needs are being met by appropriate authority. Every plan details consistent, structured service, intended to assure personal and community safety.
Measured, measurable care begins, based on this concrete plan. Because of the reliability of the Child and Adolescent Functional Assessment Scale (CAFAS), it is possible to determine service costs and monitor the validity and effectiveness of various methods of utilization delivered by local providers. The goal is to prepare the youth and family to achieve results that promise a more “hope-filled” tomorrow.
IV. VALID RESULTS
This new approach is trying to walk kids down from the high levels of chaos in their lives by starting with the presenting crisis to uncover exactly “what’s wrong?” This is the opening! Knowing that it is too overwhelming to deal with everything at once, the process concentrates first on stabilizing the immediate crisis as a way of showing the parents and youth how to seek and secure life-building structures that make better sense for their daily lives.
It is a demanding process even though it looks simple. It is important to move beyond viewing kids as bad (what’s wrong with them) and to begin seeing their behavior as a call for help (what’s wrong). It requires interpreting the behavior using culturally competent assessment and accurate, thoughtful planning. By starting with the here-and-now problem, the message is clear: “you can make better choices” that will improve your life today and tomorrow.