How to Advocate for Youth in Foster Care

0:10 - Hello, and welcome to the next webinar in our How To series from Strengthening the Heartland. My name's Amber Letcher. I'm one of the directors of this project and we're really excited that you could join us today to talk about a very important topic and one that's probably very important to most of you on this call today. So before I introduce our speaker for today, I just have a couple housekeeping items for you in case you are new or if you just need some reminders of the logistics for our webinars. Please feel free to type questions that you have into the Questions portal. You will not see those questions as you type them in, but they will come to us on our end.

0:55 And then we'll save those to the end of the presentation when I'll relay them to our guest speaker. Also, you will see handouts for the presentation today so that you can follow along. Those are in the Handout panel. And then lastly, you'll see a survey link. We love to get your feedback from the presentations we have. It helps us plan for upcoming events and a lot of the recommendations that you make become our next types of presentations, which was the case for our presentation today. So we're very excited. If you fill out that survey, you do have a chance to win a $25 gift card. So it's time very well spent. So please do that if you have a minute. With that, I'm gonna turn it over

1:42 to our guest speaker today. Stephanie Surdy, thank you so much and I'll turn it over to you. - Okay. Well, thank you so much for having me. I was so honored when I got the request to talk about this because it's a topic that I just really love and is close to my heart and I feel like I've got some good experience and stories about. So I'm gonna start with just a little about me. I've been working in the mental health field for 18 years in just various capacities. So I started my work in my undergraduate. I did in-home skills work. So I got to work in the home with families. From that, I went and got my master's degree and got a master's degree in marriage and family therapy

2:28 and worked in private practice for several years up until the birth of my youngest child, who's now three, when I transitioned into a role as a county case manager in Minnesota. So I work with the county as a children's mental health case manager here, so. In my work, in the past, I had a lot of (interference drowns out Stephanie). One of the first cases that I got when I did skills work and was working in the home was with a family who had done adoption. And it was one of those cases that, and I'll kinda talk about that a little bit later today, but it was just very fascinating to me and it caused a big shift in my perspective on adoption and what it really looks like, kind of behind closed doors. So that was really what started everything.

3:14 After that, I decided to get more education. I have a lot of experience doing play therapy, a lot of interest and work with children and adults with trauma. And so all of that stuff kinda goes hand-in-hand with kids who were in foster care. So that's kind of a little bit about me. I was able to do a training and I did put a link to the website for it, but it was a, oh my gosh, Permanency and Adoption Competency Certificate. Sorry, I had to think of that. It was a 72-hour training and I got so much out of that about adoption and foster care and it was just really geared at the experience of the kids. So I used a lot of that information

3:59 to shape this presentation. So I'm wondering, because we're not really sure who's all here, if you could just tell me, who's here today, what your role is and what your relationship is to the foster care system? And even if you don't have one, that's okay. And Amber's gonna read off a couple of different ones. It just kinda helps me tailor my presentation to make sure that I am covering everybody. - Yes, feel free to type those in to that Questions panel. Let's see who's here today. So we have a mental health crisis therapist, a foster parent, social workers,

4:46 let's see, business director, case managers, some individuals from CASA, graduate students. So middle school counselors. So it's like some 4H extension individuals, parent educators, really good group. - Awesome, yes, so diverse. I love it. And hopefully there'll be something for each of you to take away from this. So thanks so much for putting that in. So I wanted to start the presentation with just an invitation to be present. And I say this because we're very well versed in doing webinars now and I think one of my habits is I always have things going on in the background.

5:31 So I have a webinar going and I'm doing 10 other things. So I understand if you have other things to do, but I just want to invite you to take this time for yourself, take it as time to learn and be present. And with that, we're going to do a quick breathing exercise. So this is something that you can use and you can put in your toolkits for working with kids. It's the hand breathing exercise. Amber, can you see me okay or am I getting too much sun here? - There's a little bit of sun, but I can still see you. - There's a little bit of sun. Okay, we'll just go right over here. - That's better, yeah. - That's better. Okay. - It's perfect. - Sorry, sunny days. It's good, I love it, but. So the hand model, and so this is something like I said, that you can do with kids. There's a lot of talk about this when COVID came out,

6:17 it's good for you just to do too, and so hand model of breathing. So I'm gonna invite you to do this with me. So all you do is you take your pointer finger and when you go up your finger, you breathe in, and then when you go down your finger, you breathe out. And so we're just gonna do that. You can do it on your own, you could follow me, just to get us started, get us in the right mood, give our bodies regulated and calmed. So breathe in, hold, and out. And you go up and breathe in and out. Breathe in (Stephanie exhales loudly) and out. Two more times, big breath in,

7:05 out. Last one, big breath in, hold it, and out. I chose that one. My kids have done a lot of breathing. Their teachers do different things for different times of the year. So there's leaf breathing, pumpkin breathing, but the hand, it's something you always have that's accessible and it's a good visual. So one of the strategies that you can use to help kids regulate, and we'll talk more about that later. So I have some learning objectives for you. My biggest goal is this first one, practicing reframing negative behaviors into language that describes the expected stress reaction of a child in foster care. Really what I want that to be is I want you

7:52 to shift your lens on this, and we're gonna talk about that. I want you to shift your lens from thinking about things as a behavioral problem to a symptom of their experiences. We're gonna talk about three common behaviors, the hardest ones in my experience with kids in foster care, and then describe the critical need for mental health intervention. So last thing I promise with the chat, but I just wanted to know, to start off with, if you could type in the chat just a word, or a phrase, or just what comes to mind when you hear the phrase foster kid, foster child? And then Amber, if you'd be so kind to share those again. - Some responses coming in: "trauma,

8:41 hardship," more "trauma," have "loneliness, in need of love and empathy, need of help, support, in need of love, feeling lost," - Oh my gosh. - some more "love, challenging, identity, loss of identity." - I love that, I love that so many people thought of the trauma piece. So you're already ahead of the game. I love that. So thank you again for sharing. What I wanna talk about is a perspective and shifting a perspective, and it sounds like a lot of you already have a great perspective. So for you, maybe this is just gonna be a review, but for others, this might be something

9:28 that's a little bit new. And I just had an incidence of this that really reminded me of how important this is. I was talking with a family member the other day about something random with surgery and she had an appointment with her doctor. And her doctor is one of the foster care providers that I've worked with in the past and he and his wife have taken on some really, really challenging cases. They're a wonderful family, but the individual was saying how the doctor shared that he and his wife went on vacation and they ended up having to come back early. They have a foster child who's 13, they're adopting her, and that she was having a hard time. And the individual who was telling me the story said, "Doesn't she know how good she has it? Like, why would she act that way? She lives with a doctor.

10:14 They're just the nicest people. Like she just needs to learn to be grateful." And in the work that we do, for most of us, we're surrounded so much I think by people that are like minded that I forget sometimes that there's people who really do have that notion that you take these kids from a bad home, you put them in a new home and things should be better, or you just give them enough love and things should be better. And unfortunately, that's not the case. That's still needed, it's still necessary, but it's just not always enough. So one of the things that was shared was "challenging," definitely. So what I invite people to do is to shift their lens, instead of looking at the behaviors

11:04 and wondering about what happened to you. And for people who are Oprah fans or like Bruce Perry, she has a new book called "What Happened to You?" It's a great read, but it's all about looking at people's histories and questioning how they impacted them. So what we know about foster care is that the most common reasons that kids go into foster care is because of neglect, physical or sexual abuse, and then parent substance abuse. And so all of those things would be considered a form of trauma. And so when I operate, when I'm working with these families, I look at things from a trauma lens. And so I want to shift our perspective to that. When we look at these children and they come to us,

11:49 what was their life like before? And how did these behaviors serve you? So when kids come to us, and this is really true for anybody, we all have our, some people call it baggage, but children in foster care, especially come to us with what people refer to as an "invisible suitcase." That's what they bring with them about their beliefs about the world. And the reason why it's so important to know this about them is that their invisible suitcase is full of things that maybe aren't in other kids' suitcase. So in the illustration, you can see, it says these core beliefs: No one loves me. It's all my fault. Grownups lie. Grownups hurt me. I'm a bad kid. I'm stupid. I can't trust anyone.

12:36 And so these beliefs are what they bring with them into all situations and what they see the world through. So this was one of the more powerful things I think that I took from that PAC training that I did and it's something that I keep in mind for all of the kids that I work with is that, part of my job is to understand what they carry with them and what their beliefs are. Because once I know that, it really helps me understand how to relate to them, how to connect to them and how to help them. So since we have some foster parents, we have educators, we have people who are working at 4H, I mean, I think this applies to all of you, but one of the things that happens with a lot of these kids that come into the foster system

13:21 is that it's a sudden thing. They're in an unsafe position and they get shifted into a foster home. And unfortunately, there's not always a lot of time to give the family, the teachers, whoever, new information or to give them the information about them. And so sometimes that becomes the job of the people that surround them. There's been cases where they can barely give the foster parents their ages and their medical history. So sometimes these kids are coming in and there's very little background information. And so what's important is that we, as the people who work with them, try to get that information in whatever means we can. So whether it's asking the child protection worker questions that then they can ask family members, if it's reaching out to the teachers,

14:07 or people that were involved in this child's life prior to foster placement, and just asking things like: What are some things they like? What are some things you know that they really don't like? Any information that you get is going to help you connect with these kiddos and it'll help you inform interventions. So one thing I think of is some of the kids who are gonna be coming into these homes are gonna hate physical touch. They're gonna have an aversion to it, it's going to be a trigger. Even finding out like how they're they respond to that. Other kids, physical touch may be safe and they might actually need some of it, some of the deep pressure stuff to calm. So getting any of that information is gonna help with forming that connection and really getting to know the child coming into your care or into your classroom.

14:55 Also, anything that you can get to know about their past experiences. There's a very big difference between neglect and how kids who've been neglected present versus kids who have been physically abused. With neglect, there isn't typically a pattern to it, like there is with abuse. And so the kids can be a little bit more scattered and it's actually been proven to be more harmful because of the fact that there's no predictability to it. So I think a lot of times we think like, oh, physical or sexual abuse has gotta be the worst, but because there's some patterns and predictability to it and the kids can almost like gain a sense of control through that, like noticing the patterns and the predictability, a lot of times, they're less impacted as kids who've experienced neglect

15:42 just because there isn't that pattern. So it's just important to kinda know what experiences they had, maybe how old they were when it started, things of that nature. So the next thing, when these kiddos come to you, is your job and part of advocating for them and part of helping them is gonna be building attachment and connection. There's a phrase that one of my own children's teachers used and she said, "connection before correction." And I love that phrase and I think that's true for any kid. So before you go in and you want to start correcting behaviors, fixing things, doing all of that, it's so important to build that connection. And so I put a couple of simple ways

16:28 that you can start to build that, even with little to no information about these kiddos. One of the things that I love to do is and I try to do is, they're called noticing techniques. And so we're in a world where we use the phrase, "good job" all the time. I do it myself. I try to catch myself. It's great we want kids to feel like they're doing a great job. The problem is that it gives kids this external, not reward, but praise, instead of teaching them to look into themselves. And so noticing techniques are as simple as just saying to a child, let's say, they're coloring a picture and you can see that they're coloring within the lines, just saying, wow, you were able to do that whole thing staying in the lines

17:14 and you leave out any of the like evaluative phrases. So no good job, no I love it, nothing like that. And what that does is help them to be seen, but it also triggers this internal process of saying, oh, wow, I'm doing a good job, and they start to do that themselves. Also, kids who go into the system and kids who come from backgrounds like this don't always have a good sense of self. So even just noticing in them, helps them feel seen. So it might be, wow, you're wearing really bright colors today, or if they did their hair, you worked really hard on getting your hair to look like that. Just little things like that can make a big impact. Another thing is routines and predictability are gonna be really important, whether that be in the classroom, or in your home, in therapy.

18:01 And so that might look like having the same routine in the morning. So you eat breakfast, you get your shoes on, you go to the bus, and having like a welcome home routine. So you get off the bus, you have a fruit, like an apple for a snack, you read a story, and then you do homework. Just things that are predictable are going to help create a feeling or a sense of felt safety. One of the things with kids who are in foster care is we look at them and we say like, "You're safe, you're in a safe place," and there's a difference between actual safety and felt safety. And so what's important is to try to create experiences and try to do things to help them with the felt safety.

18:46 So routines, predictability is gonna help with that aspect of it. Boundaries are important to set right away. And when I say boundaries, some people think it's kinda like a bad word, but boundaries are just rules and guidelines for them so that they know what to expect. So it might be what the boundaries are with food or what the boundaries are, what do you expect with meals. What's acceptable as far as physical affection? Do you like hugs? Do you prefer that they ask first? Things of that nature, just so that they know kind of where they lie. They're likely going to push them, but if they know where they are, that process will go much quicker because they're gonna kinda know what the boundaries are and they're not gonna have to do as much testing. Lastly, follow through is going to be huge.

19:33 So if you say that you're going to do something, you need to work really hard to do it. So I encourage people who work with these kiddos, and I mean, really in general, don't make promises. Let's say that you have a trip planned to the zoo on Saturday and you tell them like that you're gonna go to the zoo. Give the caveat of, as long as the weather holds up, we're going to the zoo, so they know that there's this other piece that it could potentially fall through. If you're gonna be there at three o'clock to pick them up, be there at three o'clock to pick them up. Things like that mean a lot to them. And it might not seem like much, but that goes back to that predictability piece and consistency that's gonna be so huge.

20:20 So challenging behaviors. There's three that I picked out that I feel like are the most difficult for foster parents, society, everyone to kinda deal with: lying, stealing and raging. Those are three of the more common, difficult behaviors. And so again, when we are looking at kids who are displaying this kinda thing, I'm gonna ask that you use this new perspective. Take on the trauma lens and look at it from the standpoint of, what happened to you? And more importantly, how did this behavior serve you? When it comes to these behaviors, especially lying and stealing, I think one of the most difficult things for us

21:06 as a society, as just whatever our roles are, educators, foster parents, is that we personalize them. So when somebody lies to you, it's so hard not to feel like, oh, how could you? I thought I trusted you. Or stealing, you personalize it. How could they take something from me? That's mine. Like, don't they respect me? And when it comes to kids who have backgrounds, like these kids do, when they come from places of neglect, parents with substance abuse, unpredictable histories, these behaviors become more than just the behaviors. They're survival techniques for some of them. And so off the bat, I just encourage people not to personalize these behaviors

21:53 because 9 times out of 10, they really have nothing to do with you. These kids are living in an egocentric world because that's they've had to be in to protect themselves. I'm gonna tell a story that happened this week at work, just to kinda illustrate this, and then we'll get into more about each one of the behaviors, but a colleague of mine works with a teenager who's been adopted. He had a history of neglect, abuse, and I believe he was adopted when he was like six. So he had a pretty long stint of experiencing that pathogenic care in his early years. Has been in a stable home. The foster parents eventually adopted him. He has skills workers, he's got therapists.

22:39 He's got an IEP, so he has tons of resources. So this kiddo was at school in his special education room, and he has an IEP. People know that he has a history of stealing and that food is a big trigger for him and he is supposed to have a one-on-one para at all times. So kiddo's in his special education room. The special education teacher leaves for a little while. While the educator's gone, child goes through the cupboard and finds a cupcake that was given to this educator for his birthday. Child then eats the cupcake, which is to be expected given his history. Educator comes back, finds that his cupcake has been eaten and is furious. It becomes a big deal. He obviously contacts mom,

23:24 talks about potentially pressing charges against this child, and then for this, (audio interference) he doesn't talk to the child. And while we don't want to reinforce stealing, I felt like that was such a perfect example of personalizing a behavior. So this kiddo has food insecurity. He will probably always have food insecurity. He's afraid that there's never gonna be enough. And so if he has the opportunity to take food, he's gonna it because he still has a mindset, even after being cared for consistently for six, seven, eight years, that food could potentially go away, that he might not have another opportunity to have it. And so in that instance, he took the cupcake.

24:11 So this is one of those situations where I feel like it's so important to have this information. And so luckily he has a mom who gets it and he has my coworker who gets it and she's going to advocate for him, but there's some issues with how this educator who knows him, who's worked with him, who knows his IEP handled this situation. And I definitely think he was handling it from a personalization, he personalized that behavior. More logical consequence, I think, would be having the kiddo work at home to do some extra chores, to be able to pay for a replacement cupcake for the teacher that then would be given to him. And obviously it's okay for the teacher to be disappointed, but not talking to him for a couple of days, feels a little bit extreme. So it's still difficult for people

24:58 even who are in the education realm, special education realm. So I just think that illustrates that point. So for lying, lying is a common behavior. One thing that we tend to do as parents, as just individuals is if we're concerned that somebody is telling us a lie, we're gonna ask them about the thing that we think they're lying about to see that if they'll tell us the truth. So this might be, did you take that cupcake? when we already know the answer. And so, going back to that example, instead of saying, did you take that cupcake? Because what that does is provides them with an opportunity to lie, you give them the information and you say, I know that you took that cupcake, and now we need to figure out how we're going to

25:45 remedy this situation, like how we're gonna fix it. And the kid might say, no, no, no I didn't. And then you just, again, remind them, like, the cupcake was there. I know that you were the only one in the room. So let's try to figure out how we're gonna address this situation, and then provide a logical consequence. If you go into asking them repeatedly if they did something, why they did it and things like that, first of all, the child might not know why they did it, it's such an impulse. And second of all, it triggers things within us, which makes it hard for us to stay calm. So when somebody repeatedly lies to you, it's really hard to stay in that calm place. So don't ask if you know that they did something, just give them the information you have. Don't allow for more conversation about it. They will probably not admit to it.

26:31 And if they do, it'll be a couple of days later because being challenged on things like that is gonna put them kind of in their own trauma response. And so it might take a little bit of time before they can come back to it. Again, not about you, it's about them and their experiences. Oops. There we go, stealing. So I talked about this kiddo who I said had some food insecurities. Pretty common with a lot of these kiddos who are coming in, if there was a history of neglect or if parents have used substances, just because food, first of all, it may have been there but maybe there wasn't a parent who was able to make it for them. And so many of the kids who come from these backgrounds have some unhealthy relationships with food,

27:17 where they're just kind of not convinced that it's always gonna be there. And so it's important to know that because it's such a different framework from a typical developing child or a child who hasn't had that experience because they have no concerns about it, where even though you can tell these children over and over again, like there's food, there's food, we have food, do you see the food, the cupboards are full, it's still within them. So something that I recommend for at school, or at home, or even at like practices, if they're involved in sports or 4H, is that they know that there's food that's readily available. And obviously you're not gonna have cupcakes sitting out, but having a discussion at home, maybe about how fruit is always sitting out and you are welcome to have it, it is always yours.

28:03 Snacks are for special times, or treats, or snacks, or cakes, whatever, are for special times, but there's always food, and having it within sight is good. So part of that might be, like in a school setting, packing a snack so that they know that they always have a snack in their backpack. And if they steal food or they come home with extra candy, if they do things like that, again, confronting them from the standpoint of, I know that you didn't leave with this. So I just need to know who to return it to. If you find that they're eating or they're taking food from other kids, again, resort to those logical consequences and this is by far the hardest one for kids to break. No matter how long they're in a stable environment, the food thing, it lingers for a long time.

28:51 And I don't know specifically why that is. I just know in all of my work that I can have kids who've been in stable homes since the age of two and they still have food insecurity. It's just really ingrained in them, so it's tough. The rages and regulation. Again, this isn't every kid, but a lot of kiddos who have experience of early neglect or abuse have a difficult time with regulating their body, either they weren't taught how to regulate, because we teach our children how to regulate through co-regulation, or due to all of the trauma that they've experienced or all of the uncertainty, their systems aren't wired to just automatically regulate. So when kids rage,

29:40 it's typically not so much about like being told no or not getting their way. Typically, I like to label it as dysregulation. Their body is unable to regulate in some of those moments. And I think even just having that language about it helps. Words are important, and if we call things like tantrums or outbursts or things like that, there's a connotation with that that they have more control over it where I feel like dysregulation really speaks to the fact that they aren't able to get their body to a calm state. So when kids are having these rages or kinda having these behaviors or outbursts, whatever you wanna call them, a lot of times they're gonna require somebody to co-regulate with them. And that might look different for every kid,

30:26 which is why I say go back to the information that we have. So if we know that a kid likes deep pressure touches, that might be how we help regulate them. You might do some joint compressions where you take your two hands on your joint and push together, do it up here. Do deep pressure touches and just kinda do that on their shoulders and down their arms. If it's a kiddo who doesn't like to be touched and that isn't something that feels good to them, that's when you're gonna wanna go to like deep breathing. When we're calming and regulating kids, we don't wanna use a lot of words. When they're in this state, and we're gonna get to the hand model of the brain that'll explain that a little bit more, but their logical brains aren't working. They're very much in fight-flight-freeze.

31:14 And when they're in that reaction, our job is to help ground them, bring them back to the present so that then we can work on whatever it is that's going on, until they're out of that flight, fight or freeze response. Really, they're not able to take any of the things that we're saying inward. And so our job is to help them get to that point of calm. And then I would say even after that, give it a good 30 minutes before you start in with the, like, this is how we could do things. We wanna really make sure that they're at that calm stage, their body is regulated before we started with that again. And you keeping calm and you staying regulated is key. If you're not regulated, you can't regulate. And so for the foster parents who are listening to this, tag team.

32:00 If you have the ability to tag team your partner, if you can feel that you're getting frustrated, you can feel that you're losing some of your control, tag teaming is so important. Tag the other parent and to take over because some of these ran]ges can last a really long time and it's tough. In classrooms, I would say, if you can take the child or have somebody take the child out of the classroom, not necessarily into like a calm down room, but just even to get them into a hall or a place where there's maybe less commotion, that also helps a lot too, just to kinda reduce all of the things going on around them. So this is what I was talking about with the hand model of the brain. I was gonna show a video, but they don't work very well on here

32:46 and I didn't wanna go through the freezing. So you are going to get me teaching you this, but I did, in the resources, I included two different videos. One is a therapist doing it, and then the second video is my friend's daughter who did a very good job making a video about how to use the hand model of the brain. It's very cute. So they're good. She made it specifically for kids. So it's a good thing to share with kids. And I think some schools are starting to do this just for all of their kids, because this is something that happens to all of us. We all operate this way. So the hand model of the brain. So you use your hand. This area right here is to represent the brainstem, which is just our most primitive functioning. It's breathing. They call it the reptilian brain.

33:34 And so this area, that's what it does. It just basically is us making sure we're alive. And so you can use your thumb. Sorry, I'm getting sun again, but the thumb is your amygdala. And don't worry, I'm only gonna do one more brain term because sometimes it gets a little heavy, but your amygdala is important, especially for these kids. It's your fear center. So it's your big emotions. It's your fight-flight-freeze response. And with kids who have histories of trauma, abuse, neglect, their amygdala is gonna be much more active than your typical developing child. So then what kinda holds that all in together, this is your prefrontal cortex, and that is your rational brain. That's your executive functioning.

34:21 This is your regulation, your empathy, how you connect with people, it's all of your higher functioning, like I said, rationale, understanding. So this is your brain functioning in perfect harmony, but what happens to some of us and to these kids is that we say that they flip their lid. So their prefrontal cortex goes up and they're operating off of their brainstem and their amygdala, which is very primitive responses. And you can see when kids flip their lid, it's gonna look like those rages. They're gonna look disorganized. They might (pause), sorry, they might present with some regressive tendencies. So yelling, screaming, kinda kicking,

35:06 doing things like that because they're going into that more primitive state. So when their lids are flipped, our job is to work with them to do those strategies that we talked about, to button that back up so that they can start operating, using all of those other functioning, all of those other functions of their brains so that they can get back to reason, that they can get back to calming. And so to do that, you have to do those grounding techniques that we kinda talked about to help them with that. And so we have kids that we work with, who we teach this too. Like I said, some schools do. One of the little ones that I work with called it "mixed up monkeys" when she's like this. And in the video, they talk about like different animals. And so it just helps them start to identify with their feelings and give them a phrase.

35:51 So some kids will just like put a hand up like this and it gives them a way to say, like, I'm not okay right now and I'm gonna need some help, without having to say those words. So it's a good reminder and a good model to think of, when you see some of the behaviors coming out of the kids. Dan Siegel also refers to it as "upstairs and downstairs brain." And so when we're in our upstairs brain, we're doing really well. When our downstairs brain, we're starting to get angry, we're kinda acting out. So two different ways that you can think about it, but just good to know, and like I said, for us too, because we flip our lids. Some of the strategies that you can use for kids when they're having these rages, mindfulness strategies, so just being in the present.

36:38 Some of the things that you can do are using their senses. So three things you can hear, three things you can feel, three things you can see. Yoga, there is some awesome cosmic yoga for kids. I know that we had a program around here where teenagers were able to do yoga. The benefits are just unreal for these kids in learning how to regulate their bodies. So it's like I said, the cosmic kids yoga, it's free on YouTube, it's fun. So it's great for them connecting their mind to body. Deep breathing, even just the techniques that I showed you with the hand. So people will do birthday candles or blowing petals on a flower. Physical touch, again, if they're comfortable with it, it can be really helpful doing those deep pressure,

37:25 those joint compressions, things like that can help bring them back into their body, and also sensory experiences. So like I said, noticing things that they smell or even providing sensory experiences for them. For some kids in one of the models, they use lotion as like a calming strategy. And so even just saying, oh gosh, it seems like you've had a hard day. How about we do some lotion on your hands, or lotion on your arm, and that sensory process, even if these kids haven't had that experience, it brings us back to when we were little and our parents put lotion on us and it can be very calming, plus there's the smell that goes along with it too. And for those of you who like essential oils, (faintly speaking) great sensory experiences. Lavender is wonderful. So referrals.

38:12 One of the other, I would say common misconceptions with this population is that the child protection worker has kinda taken care of all of the referrals or that they're providing all of this. And so as a case manager, we have a really good relationship with our child protection team and they know that if they have a kid that they're putting in placement, that we're there to support them, getting them all the needs met. So child protection workers don't always do all of these referrals. And so there's a whole host of things that can be helpful, but I feel like one of the most important things, and this is probably for every child who's in foster care

38:57 is to get them into outpatient therapy, outpatient mental health therapy. When we think about kids going into foster care and we talk about trauma, depending on their age, it can be a really significant experience for them, whether it's good or bad, or like I said, if they're leaving a house that wasn't safe, but going into a safe space, it's a lot to process. And so getting them in for outpatient therapy to be evaluated just to connect with the provider and to have that service in place, I would say every child should have that who's been put into the foster system just to even process the experience of moving to a new home. The sooner that they process it, the better. The longer that you wait, the harder it is for them to process it. So that's gonna be huge.

39:43 Also, for foster parents, support. You have an incredibly hard job and having an outpatient therapy or outpatient therapist, even if it's for the child, gives you somebody that you can look to, for suggestions, for resources, and sometimes just to go in and say, oh my gosh, this has been really tough, and to get some support in terms of that. With the younger population, I would say eight and under, because some of these kids, and this is flexible, with those ages, but I'm a strong advocate for play-based therapy. With a lot of kids who have this type of trauma who are in foster care, their experiences can be pre-verbal. They're early on. Their body can hold on to it.

40:30 And so doing interactive therapy or play-based therapy is what helps them get at those early experiences and work through them. Kids really aren't able to do cognitive processing or like traditional talk therapy until after the age of eight because of how their brain develops. And even, there was times that we would do play therapy with like 13 year olds who or had traumatic experiences when they were five, because they needed to go back and heal that five-year-old self. So I'm a strong advocate for that interactive therapy for the young ones. And on the website that I gave you, the one for the center for (interference drowns out Stephanie) case is the one that I gave you,

41:15 it has a list in every state of providers who've been trained in the Permanency and Adoption Competency certificate. So that's a good resource too. I'm sure that there's some in North Dakota and South Dakota as well. Also having somebody who specializes in some attachment-based therapy is gonna be important. Something that I learned along the way was, initially, at the start of my career, I was hesitant to engage foster parents in attachment therapy because there was that fear of like, what if this kiddo attaches to this foster parent and then foster care isn't forever? But what research shows and what we learned is that if kids can form an attachment to someone, it can be transferred. And so involving foster parents in that isn't going to harm them. It's not going to make the loss

42:00 of that foster provider any more difficult. Providing these kids with the ability to form a healthy attachment is gonna to serve them lifelong. So don't be afraid to do attachment-based work as a foster care provider. It can be transitioned. Another important thing to look into is psychological testing. Depending on when these experiences happen to the kids, their brains can form very differently. Pathogenic care prior to the age of two can really impact parts of the brain that help the right side and the left side communicate. And so doing psychological testing to kinda figure out where they fall, how they learn best can be really important, especially in the education setting.

42:47 Some of these kids, I had one that I worked with, and she was six years old and she could read and spell and write and just was way beyond her years. She went into kindergarten able to read and able to spell out like full sentences, super smart. She had to be, she had that survival skill because her parents weren't taking care of her. And so she taught herself to read, but her ability to understand what she was reading and comprehend was not there. So even though some of these kiddos can present, like they've got it, they're really smart, some of those are survival smarts and there's still pieces that are missing. So psychological testing can be really helpful with that. Occupational therapy. So with talking about kids getting dysregulated

43:38 and having their amygdala be a little bit more reactive, occupational therapy can really help kids get more control and more comfortable within their body. So when we talk about kids who've experienced trauma or kids who've experienced abuse, occupational therapy can really be a nice addition to be able to help with that calming, regulating, and getting them to a place where they feel more comfortable with their body because our body is what holds on to the trauma that we experience. And so the more comfort that they have with it and more control they have over it, the better it goes. Case management. That's what my position is now. It's a free service. I think that it's so important, especially for the foster parents,

44:27 because it's somebody who can help manage all these other services or somebody who can help make the referrals and somebody who can be an advocate. So case management services are through the county. Like I said, they're free, they don't cost money. I think most of these kiddos come with some pretty complex behaviors, complex histories. And so having somebody who can kinda help you keep track of all that stuff, help arrange transportation is just a really good resource. And then school-based services. And the school providers on here, you probably have worked with many of these kids. And so 504 plans, IEPs. And I'm not gonna say that you jumped to them right away, but it's just something to kinda keep in the back of your mind and to have conversations with school about.

45:13 If you're bringing a kid to a new school that isn't familiar with them, just giving them that information, as much information as you can and just... I really believe in front-loading. So giving people more information than maybe they even need, not that we're sharing lots of private information, but just more information so that when things come up, they have that to fall on. So if you have a kiddo who may steal food or who gets dysregulated easily, talking to that teacher, the educational professional beforehand, that preparing them is really going to help both them and the child. And like I said, not every kid is gonna need an IEP or a 504. It's just something really good to have in your mind and let them know that you're thinking about.

46:00 So is a quote that I want to leave you with: "In my world, there are no bad kids, just impressionable, conflicted, young people wrestling with emotions and impulses, trying to communicate their feelings and needs the only way they know how." And I just feel like that sums up so much about these kids in foster care and kids in general. And that it goes back into that lens of, people are doing the best they can with what they have. And a lot of times these kids are doing the best they can with the experiences, the resources, the skills that they have. So I just like that quote. So we will go into questions and I also, in the handout that you will get, I have my email.

46:47 So if there's something that you come up with later, please feel free to email me. Like I said, this is a topic that's really near and dear to me. So I love to talk about it. I'd love to answer questions. And then I did put on our website for a mental health consulting company that I'm also part of. - Wonderful. Thank you so much, Stephanie. I was taking a lot of notes because I'm going to referred to them and also talk about them in my classes, as well with students, so thank you. We do have a couple questions in chat. - Oh, great. - And if there are others, please take some time to type those in as we're discussing. We've got some time yet for questions. So the first one was, "Will these items,

47:34 some of the tips that you gave, they're appropriate for high school students, as well as the younger kids?" - I would say it depends on the kids, but yes, the breathing exercises, the yoga, mindfulness, those kinda strategies. It also depends. So the thing with high school kids is that a lot of them are walking around in 16, 17, 18-year-old bodies, but really their developmental age is more like eight or nine. So I guess my advice would be, try to figure out where, not their developmental age, their emotional age is, yeah, their developmental/emotional ages, and parents can base their interventions off of that.

48:21 So again, they might be 16, but some 16 year olds I've worked with are like five. And that's what they need when they're in a state of dysregulation or if they're struggling. And the breathing exercises, you can tailor that to be for older kids, too. I know that a lot of watches, my watch has like a breathing app on it that has a visual. You can do things like that too so it feels more age appropriate, but yes, I would say most of them work for high school kids as well. - Another question. "What suggestions do you have for single parents who are foster parents?" So when those kids are raging or having regulation issues, any tips, if you don't have someone to tag out with?

49:11 - Yeah, absolutely, and kudos to you for doing that. It's a hard role to provide foster care, and especially as a single person. So in those moments, I think that giving yourself breaks, if possible. Obviously, if the child is raging and not safe, you're not able to do that, but if they're just kinda having a meltdown and you can get them to their bedroom or a room where they can kind of be, at a lot of houses, they'll have like calm down spaces, if you have one of those, getting them to that space and then even going outside for a couple minutes. Leave the door open so you can hear them, but just getting out of the thick of it, even, like I said, for a couple of minutes,

49:57 taking some deep breaths, just getting yourself to a place where your lid is covered. You're not flipping your lid, you're not getting emotional, I mean, you can be rational because depending on our own experiences and just natural human instinct and nature is when people are getting big, we match them. And so if somebody is in a rage or they're getting really big or they're really angry, it's really hard to not match that same thing. So if you can take breaks, if it means going to the bathroom and just locking the door for a couple of minutes. Obviously safety is important, but taking that time. I just listened to a podcast with Brene Brown and Glennon Doyle and they talked about how, in those moments,

50:43 when you are getting to that point of overwhelm, or she calls it burnt, "I'm burnt," you need to do like pretty much nothing. Don't go read a book. Don't go to your phone. The only way when you're that far gone to come back is to do pretty much nothing, so stand outside, smell the air, listen to the leaves, listen to the bird, something like that to bring you back down. - I really like that. I feel like anything to engage those senses, that brings them kind of back down. - Yes. - Another question here. Someone has had some cases with kids who were wetting the bed and

51:29 is that something that you see commonly? And if so, are there any interventions or things that you can do to help with that? - Yes, super common, especially with kiddos who've experienced sexual abuse. That was one kind of our warning signs in therapy and one of the things that they would tell us that even if we didn't know about sexual abuse, it'd be kind of like a, ooh, I'm gonna tuck that in my hat or remember that for later. It also can be common because of kids who are in this heightened state of fight, flight or freeze, their bodies are tenser. And so throughout the day, their bodies are tense. So think of them as being like tight. And then when they go to sleep, they relax, the muscles relax, and then acts like they wet the bed and accidents happen.

52:17 So yes, super common. Can be really difficult to address because, again, you're working on that body trauma. So I feel like it's like a multifaceted approach. OT can help because they can gain more control over their body, doing some of that co-regulation and getting them to calm down during the day so that they can actually start to be in touch with their body. With that, also mindfulness is so important. So doing body scans and checking in, and that can be as simple as just saying like, all right, we're gonna sit here, let's check in. How does our head feel? And going through the whole body, just to bring that awareness. But yes, unfortunately, super common, somewhat hard to address. We always recommend that don't shame them

53:03 because they don't have control over it. So what a lot of people do is if they wet the bed, then they just know that their job is, I mean, if they're old enough, you just clean off the bed, put it in the dryer or the washer, put it in the dryer, make your bed again. And that's not to be like shaming that they have to like take care of it, but it's just, it gives them a sense of responsibility within it too, so. - Excellent. So someone is working with a thirteen-year-old girl who is autistic and she's wondering about breathing exercises. Are those things that you would recommend or any other specific strategies for youth on the autism spectrum? - Always such a hard question. It's a good question.

53:50 It's just, it's tough because I feel like, especially with autism spectrum disorder, I mean, it says it in there, there's such a huge range of functioning. And so with high functioning kids, absolutely. I think our brains and our nervous system, every single person can benefit from these regulation strategies, from the breathing. There's studies that show the benefits of... I mean, there's even different ways of doing like left nostril to right nostril and the benefits that they have on you. There's these huge benefits. I think deep breathing doesn't get enough credit. So if you can do that with them, if they're higher functioning, absolutely. The body work might be something that you have to watch out for.

54:38 Some kids with autism need that deep pressure, some don't. So I think if they have an OT, going based off of that, or just what you know their sensory preferences are, and it might be mirroring. So you might just have to sit across from them and kinda show them. And sometimes when kids are dysregulated, you can just do like a really, I wanna say, (Stephanie loudly exhaling) like do really loud breathing so that they're hearing you. So you're... (Stephanie loudly inhaling) (Stephanie loudly exhaling) so that they're just hearing that in the background. And that's enough even just to hear that, sometimes can be calming and they might pick up on it. People typically, if somebody sitting next to you

55:23 doing breathing like that, loudly, you will start to modulate, like with them. So for the people who are the kids who are more on the, like more lower functioning on the autism spectrum, that's where I would kinda go with that. And it might be also just even like take, they're okay with it and putting it on you and doing that deep breathing so that they can feel it too. Hopefully that helps. - Some really good questions in here. Another one is, this also a really broad group and we probably do another whole webinar here, but "any specific recommendations about youth who identify as LGBT specifically?"

56:12 - So that's another. There's so many common things, working with this population. And I think kids, even kids who haven't had this experience are struggling. But when I think of LGBTQ and not to say this in like a negative way, but it, to me, it says identity. And I think identity is something that a lot of these kids struggle to find. And we see some of the kids kind of, in foster care, who don't have that strong sense of identity questioning some of that stuff. Again, not to say that it's not true, you don't wanna disregard it, but it is pretty common because they don't have that set identity or a strong sense of self. So I think one of the ways that I would approach it is acceptance.

57:01 So making sure that whatever they're telling you, and I know that that can be hard, that there's some acceptance with it. Another again, not to disregard, they may wholeheartedly be LGBTQ, but something that we see with kids is a lot of testing. And so sometimes they might throw things at you just to test it. They might come to you and say, "I have to tell you something, I'm gay," because they wanna see what your response is and they wanna see that acceptance. And so giving them that acceptance piece. And then I think if you can find a therapist, because obviously if kids are identifying as LGBTQ, we're looking at, potentially, I mean, some kids do at younger ages, but we're looking at a little bit older population, but somebody who has some specialty in that or identifies as a safe person for that community

57:49 so that they feel like it's being honored and that they have somebody that they can talk to who would understand that. So outpatient therapists and just, you wanna check for that. A lot of the people who work with LGBTQ population or specialize in it will have that in their profiles if you look them up or their bios. - Excellent. Thank you so much. I don't see any other questions in the chat, but I'm sure if there are things that come up, Stephanie's email is there. I'm sure you'd be happy to answer those questions outside of the webinar. Thank you so much. Again, just tons of tips. This was wonderful. I'm going to put another plug in for finishing our survey.

58:34 So please take a minute. It's really quick. Get yourself registered for a chance to win that $25 gift card. And with that, thank you all for attending and I hope you have a great day. - Thank you.