TJJD clinicians get training in the Neurosequential Model of Therapeutics
By Barbara Kessler, TJJD Communications
TJJD is expanding its therapeutic program by providing training for selected mental health professionals in an approach known as the Neurosequential Model of Therapeutics.
NMT, as it’s called, is an internationally known program that carefully considers the brain development of a youth and how that may have been hindered or disrupted by adverse childhood events and traumatic experiences.
Using NMT methods, therapists see a child’s (or adult’s) behaviors in a new light, as having become engraved at different stages of brain development in response to frightening situations, such as abuse, neglect, family chaos and witnessing or suffering violence.
This groundbreaking approach, developed by acclaimed psychiatrist Dr. Bruce D. Perry, helps therapists better analyze a youth’s trauma background and develop a more well-rounded, sensitive and individualized program of care.
NMT “takes trauma informed care to the next level,” said Evan Norton, TJJD’s director of Treatment Programs. “It peels back the onion and gets to the heart of it all, the neurobiology.”
Put another way, NMT helps therapists and those in their care see the full impact of trauma’s toxic legacy, and how it can sustain maladaptive behaviors and short-circuit learning, impulse control and decision making.
“Everyone’s brain develops differently and this enables us to not generalize but really, truly address what these kids’ needs are,” Norton said.
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In early 2020, TJJD selected 20 of its mental health professionals to receive training in the Neurosequential Model of Therapeutics. The participants are stationed across all five of TJJD’s secure facilities. They met for virtual classes led by Perry’s Neurosequential Network and also gathered for follow-up virtual discussions within their discrete TJJD group.
Dr. Perry, the principal of the Neurosequential Network and Senior Fellow of The ChildTrauma Academy, also is a Professor (Adjunct) in the Departments of Psychiatry and Behavioral Sciences at the Feinberg School of Medicine at Northwestern University in Chicago and previously served as Chief of Psychiatry for Texas Children's Hospital in Houston. The author of numerous papers and three books, Dr. Perry’s latest book, What Happened to You? Conversations on Trauma, Resilience, and Healing(2021), is a New York Times bestseller co-authored with Oprah Winfrey.
The 20 professionals in NMT training at TJJD are set to receive their completion certificates in August for this first phase of what is becoming a highly sought-after training, Norton said. A smaller group of clinicians will continue with a second year of advanced classwork in NMT.
Already, TJJD clinicians have been putting their new skills into practice and reported to Norton, who’s also taking the training, that they’re gaining deeper insight into the needs of the youth they see.
NMT is helping them better tailor treatment plans to individual needs and assist youth who’ve suffered multiple complex traumas.
“They feel more effective, like they can connect more effectively,” he said. “And they appreciate getting a better biological look at the kids, getting a more holistic picture of the child.”
The therapists use an NMT metric along with a close review of the youth’s developmental and social history and current behaviors. They may call on caseworkers, parents and guardians to get a detailed picture of a youth’s past.
“The metric identifies risk-age ranges and brain development areas for me,” said Kathryn Hallmark, a longtime TJJD therapist taking the NMT course. She records the background information she has gathered into a timeline detailing the “psychoeducation” of the child.
“For example, a kid was removed into a CPS foster home in infancy with multiple changes of homes before he was adopted and suffered peer bullying throughout school, but he doesn’t understand why he became so angry and aggressive. I can break it down for him in terms of care-giver connection drops (losses) at each age of risk and later with his peers.”
Those many caregiver changes, Hallmark said, “led him to struggle with trust and connection, which later impacted his problems with peers.” As the therapist, she can help such a youth unpack these early challenges and see how the lack of connection fueled his frustration and anger.
“I can talk to him about how he avoided his feelings,” she said.
In Hallmark’s example, the youth lacked the “mirroring” or “attunement” experiences that young children need from stable, nurturing caregivers to develop emotional range, cope with angry feelings and make the strong connections that underpin healthy development.
Research shows that sturdy connections with caring adults are critical to a child’s healthy neurological and social maturation. When those relationships are disrupted, absent, sporadic or harmful, a child’s biological brain development can be impeded. The result can cascade through the years, resulting in behavioral, educational and social difficulties.
The NMT program, like TJJD’s Texas Model set of reforms, emphasizes the power of connections as the key to healing. NMT urges therapists to track a youth’s relationship history as they work together to repair or build new healing connections.
With a deeper understanding of a child’s complete background and neurobiology, the NMT-trained therapists can help kids move past that fight-or-flight response they learned as a traumatized toddler or the paralyzing hypervigilance that took root when they were abused. Those reactions may no longer make sense, but until a youth’s trust in others is restored, and new neural pathways built, these maladaptive behaviors can continue.
Hallmark gives the example of another youth who “lived in a chronically violent neighborhood, witnessed violence, lost a parent in childhood, experienced a head injury, and began a pattern of reactive aggression. He tended to view everyone as a potential threat.”
“After completing his NMT metric, we were able to map out ages of trauma and difficulties with communication and connection, which affected how he looks at others, then and now, from a reactive survivalistic manner that can explode in violence towards others and himself,” she said.
With that understanding, and new positive connections with others, a youth can navigate his way past the negative behaviors holding him back.
The bottomline: NMT training will be an important tool for TJJD therapists and would be for any therapist working with at-risk youth, Norton said.
“It’s great that we can get so many clinicians trained in this program, because this takes us much closer to have a truly trauma informed system.”
Photos: Top, Dr. Evan Norton; Right, Youth talk after a therapeutic seminar at Giddings; Bottom: Tamayo Halfway House youth connect and reflect after a run at a park.
Ayres House treated to cutting edge presentation on a possible vocation
Patty Garza, Community and Family Resource Coordinator, South District
Human Services Specialist Stephanie Trujillo Ramirez, fondly known at Ayres House as Ms. TR, keeps constant lookout for ways to help the youth prepare for the working world.
With COVID limiting the youths’ ability to get out in the community, Ms. TR has had to think creatively over the past year. She recently reached out to a barber in the community to see about presenting to Ayres House after discovering that several of the Ayres youth were greatly interested in this possible vocation.
Lauren Ozuna, a barber at Bexar County Kutz, jumped at the opportunity to share her knowledge in the field. Several youth signed up for her virtual workforce development workshop and were treated to her thorough "Barber Career 101".
Ozuna gave an overview of her experience attending Williams Barber College and obtaining her license. She worked hard, she said, and built on her skills as an independent contractor to become the manager of the barbershop after just five years. She gave a virtual tour of the barber shop, showing the tools, products and offering tips about the trade, and also answered questions from the youth.
She shared experiences about client interactions and the importance of safety for both barbers and clients. Some of her clients, she said, had even become barbers.
The youth’s eyes and smiles grew bigger as she talked about career earnings and business opportunities. One youth enthused, “I wasn’t really thinking about becoming a barber, but that sounds pretty legit!”
At the end of the presentation, Ozuna encouraged the young men to follow their dreams and career aspirations. They can make it “out here,” she stressed, if they work hard and connect their skills to a trade.
She spoke frankly to them about how she understands the appeal of “easy illegal activity” money, but she showed that a barber career can be lucrative and really is “legit” with none of the worries that come with illegal activities.
The youth greatly appreciated hearing from someone in the barbering trade and immediately asked for more virtual tours about other trades and other career-building programming.
Photos: Youth listen to the virtual presentation (upper right); Ozuna spoke from the barbershop (lower left).
Donated flowers brighten Willoughby House
By Y. Denise Caldwell, Community Resource Coordinator, Northern District
Blossoms abound at Willoughby House since the students, led by volunteer Cassie Green, spruced up the flowerbeds in front of the house and in the backyard.
According to Green, they had to plant the flowers before it got too hot.
“If it’s too hot the flowers will burn up,” she said.
Green took the lead on this project again this year, ensuring that the flowers would bloom once more. She donated personal funds and time to this project. She also received generous donations from the McFadden Community Advisory Council and longtime volunteer Bridget Marchetta to buy the necessary supplies, which she delivered to the halfway house. (The McFadden council has turned its attention to Willoughby since McFadden House closed this spring.)
The donated items included hardwood bark mulch, petunias, hydrangeas, azaleas, iris, lavender, jalapeno, sweet mint other colorful flowers and various herbs.
All of their hard work will pay off, Green said, because “the front landscaping will come back year after year and grow to be really beautiful and full.”
Green said she plans to do even more next year to beautify the grounds.
Staff and students were especially pleased with the finished results. “It looks a whole lot better,” Green said proudly.
Tamayo boys team up for spontaneous rescue mission
TJJD Staff Report
Boys at Tamayo House put some good karma in the bank last week when they put their heads and hands together to help two dogs out of a fix.
“We were in the back of the house playing basketball, when we all began to hear crying and whimpering from close by,” Coach LeeRoy Diaz recalls. “Behind Tamayo house, we have a drainage canal for stormwater. As a few youth looked over our cedar fence they heard the crying coming from the canal.”
The boys ran back to Diaz, saying they could hear a puppy stuck down below and wanted to investigate.
“As we approached, we saw two stranded pups. As soon as they saw us you could see the pups were happy, as they kept on trying to jump toward us while whimpering,” Diaz said. “We imagined they had been down there for a few days due to them being wet and covered in mud.”
Diaz called the local pet shelter but they were not open yet. Meanwhile, construction workers fixing a road nearby told the group that the dogs had been there for a couple days.
“The day was hot and being stuck down there in concrete, I’m sure the pups were dehydrated and hungry. Our boys immediately wanted to help them out,” Diaz recalled. “We looked around and found an area where we could attempt the rescue."
The group assessed how to safely access the pups and extract them and then went into teamwork mode. "We made sure the youth were safe at all times as they made their way to the dogs," said Tamayo Supt. Eduardo Garza.
Working together the young men were able to lift the frightened canines to safety.
“Ours boys were as joyous as the pups,” Diaz said. “We brought the pups home and the boys bathed and fed them. It turned out that one pup was Blue Heeler, and the other one, a bulldog.”
But wait, the story gets better.
Tamayo staffers called the pet shelter the next day and the dogs were checked for chips and examined for health programs. Both were deemed healthy, but unfortunately, they were not chipped and no owners had been by looking for them.
Two Tamayo staffers stepped up and each adopted a dog.
Diaz and the young rescuers were thrilled. “These puppies will have good homes. Our youth did a good deed and gave these two pups a second chance.”
“This is what we try instill in our youth, that regardless of one’s past, everybody deserves a second chance with hope for a better life,” Diaz said.
Garza agreed that this exercise in empathy and taking action surely affected the youth: "It is my firm belief that if they can put themselves in another's shoes -- a human or an animal -- it can be healing."
TJJD’s Shandra Carter honored with Outstanding Leadership Award from Governor’s Commission for Women
By Brian Sweany, TJJD Communications Director
The list of women serving with distinction in state government is long and impressive—from executive directors of agencies to entry-level staff members looking to make their own mark serving the people of Texas. On Tuesday, one such rising star from the Texas Juvenile Justice Department will be honored with the Outstanding Leadership Award for 2020 from the Governor’s Commission for Women. Shandra Carter serves as the agency’s deputy executive director for state services, and she has played a key role in the agency’s reform efforts since she joined TJJD in 2018. Carter agreed to answer a few questions about the award below. If you’d like to watch the virtual ceremony on Tuesday, June 8, at 11 a.m., register at this link: https://bit.ly/3m6g7Me
Congratulations, Shandra, on winning such a tremendous award for your leadership at TJJD!
Thank you so much. The award is an honor, but it’s not just about me. I see it as a representation of the work of my entire team. They make my job fun and easy and rewarding—and they are the ones who are moving critical reform efforts forward because they believe in the work and our youth.
Can you talk a bit about your responsibilities at TJJD?
As the deputy executive director for state services, I have a fairly large piece of the pie—anything that relates to direct care, treatment, programming, and education for the youth in our care is my responsibility. However, I’ve learned that the benefit of having those areas under one person is that it allows me to connect the pieces of the puzzle. Rather than having the departments in silos, I can look at the big picture and figure out in the continuum what is the best interest of our youth overall. The most exciting responsibility I have is moving reform forward and weaving the Texas Model through all these departments.
You have been instrumental in rolling out the Texas Model, which is key to the agency’s reform plan. How would you explain that to someone?
I think it’s important to recognize that the Texas Model isn’t about program implementation—it’s about a culture change in how we interact with our youth. When I joined the agency, I knew I was signing up for something that would take time: it would absolutely be a journey, not an event. To help people move from a traditional correctional approach to an approach that is trauma informed—one that is relational, that has connection as the foundation, that sees the need behind problematic behavior--would take a lot of training on fundamentals of neuroscience and trauma. Once those seeds were planted, we could begin implementing new strategies, new skills, and new processes to align with those concepts. Our system is unique in that it is very large and there is not an existing correctional approach that we can cut and paste. It feels a little bit like building the plane in the air, but I’m proud of the success that we have shown. The feeling was, and still is, “Hey, team, let’s figure this out and build something amazing.”
Where do you see signs that the Texas Model is working?
I think that happens often now, which is super exciting. We have so many energetic people spread across our system who believe in our reform efforts. Every day new ideas and initiatives are being created without my input. Our staff is coming up with new approaches, interventions and programs on their own to help our youth in ways that are in line with the Texas Model, and for me that’s like a receiving a gift.
How has your view of leadership changed since you joined TJJD?
My time here has certainly deepened my appreciation and respect for our direct care staff. I started my career as a direct care staff in a juvenile justice setting and have not forgotten what it’s like. We have some warriors on our team. We have people at our facilities who work harder and are more committed than I could hope for. They show up and give 100 percent on behalf on these youth, and they keep doing it because they care. We are fortunate to have those people. They are our MVPs.
Given the profound challenges of the past year, how would you sum up the agency’s progress?
Despite COVID, despite forces of nature like winter storms, despite labor shortages, our staff remains dedicated to our mission. Reform is happening, and we are still experiencing great successes. We don’t have a magic wand but we are seeing the progress, we’re gaining momentum, and it’s making a difference. That is why we are all here--to make a difference.