These include making a distinction between Care and Treatment, and understanding that behavior management techniques, while often times essential, are part of Care and not Treatment.  Several organizational traps of becoming too focused on behavior management are explored, including the key distinction between interventions that inspire mindless compliance and interventions that inspire thoughtful cooperation.  The importance of respect for a transformational treatment experience is also highlighted.  

House Meetings are the single most powerful structure for building a positive unit culture that supports the formation of a resilient residential team of staff and clients.  This episode arc starts out by presenting a vision for how House Meetings can contribute to team-building efforts and especially to the kids developing a sense of belonging, a sense of purpose, a sense of agency, and a sense of meaning to their residential experience.  At the same time House Meetings also provide an effective forum for encouraging the development of social skills and executive skills in the kids.

This episode also addresses the first step in developing House Meetings to meet their full potential; creating a shared vision among all the staff involved in the residential unit.  This requires aligning the development of House Meetings with the mission and vision of the residential treatment agency, creating a shared understanding of the purposes and goals of House Meetings, empowering direct-care staff to take an active role in developing House Meetings, and helping people find meaning in putting work and effort into the design and implementation of these meetings.  

When that happens the entire residential experience shifts from having to spend an excessive amount of time on behavior management to a treatment environment that promotes mental health. 

Developing that kind of positive peer and staff culture takes time.  It also takes solid strategy and understanding of team development.  This episode blends together the basics for resilience (a sense of belonging, purpose, agency, and meaning) with a well-known model for understanding the phases of team development – forming, storming, norming, and performing.

This episode also presents a way to understand four major ways in which our brain’s regulate our emotions, thoughts, and behaviors.  With time-tested structures like check-in’s, House Meetings  become a time for practicing executive skills, learning emotional sensitivity, acquiring prosocial beliefs, and healthy values.   

At the same time, House Meetings can become an effective way to teach listening respectfully, stating opinions appropriately, giving and receiving feedback maturely, and learning how to negotiate and compromise with others. 

Check-ins are an excellent way to start House Meetings.  Literally, people take turns giving a brief report on how they are doing that day. 

Structured effectively, the practice of conducting Check-ins can become a foundational technique for a program providing a treatment experience for the kids. When used in a group setting, Check-ins are steered by the facilitator to focus not so much on the kid doing the check-in, but on how everyone else on the team can support that kid in having a good day and a good week. In this way the check-in structure supports the development of a high-performing team and supports the kids improving at emotional sensitivity. Emotional Sensitivity is taking other people’s feelings and moods into account for how you interact with them. Improved Emotional Sensitivity helps kids be successful in any shared living setting, and with all the important relationships in their lives.

It’s as a high-performing team that the kids develop their own self-regulation and resiliency; through helping their team-mates manage their daily emotional, cognitive, and behavioral challenges.  One of the best structures in which to develop a residential unit into a team is the, at least weekly, House Meeting. 

House Meetings have several parts, such as announcements, group problem-solving, feedback, celebrations, and team-building exercises; however, the heart of House Meetings, at least in my mind, is the structured check-in.  This episode focuses on using check-ins to encourage kids’ skills at emotional sensitivity which then leads to consideration and cooperation.  Unlike empathy, emotional sensitivity doesn’t require feeling what someone else is feeling.  Instead, it refers to consciously perceiving another person’s feelings and moods, potentially simply because they have told you how they’re doing.  Emotional Sensitivity is then taking that knowledge and modifying your interactions out of consideration for the other person’s state of being.  It’s being a good housemate, a good friend, and a good team-mate for experiencing residential treatment.

Developing a group of troubled kids into a high-performing team, that absorbs each other’s misbehaviors and promotes maturation, is a difficult task.  Storming behaviors are common among kids in residential treatment.  In House Meetings, a significant number of kids will deeply struggle with inappropriate meeting behaviors – ranging from aggressively menacing the whole room to simply not paying attention or actively distracting others.  

However, storming behaviors, that sabotage team-building efforts, can be leveraged by staff to actually speed up the team-building process.  One of the best ways to do that is to focus not on the misbehaviors, but on the impact of those misbehaviors on team-building.  That is greatly enhanced by repeatedly explaining to the kids the purposes of forming a strong team, the purposes of House Meetings, and really the purpose of their entire residential treatment experience.  

Each part, (1) check-ins, (2) announcements, (3) group discussions / agenda items, and (4) wrap-up provides a forum for promoting resilience, self-regulation, social skills, and team-building.

Regardless of the specific content of any single meeting, staff focus on four aspects of resilience, four aspects of self-regulation, and four aspects of “meeting behaviors” or social skills. 

Resilience is promoted through encouraging the kids to experience, due to their participation in House Meeting, a sense of belonging, purpose, agency, and meaning. 

Improved self-regulation is promoted through encouraging emotional sensitivity, through presenting evidence to support positive beliefs, through discussing values, and through giving the kids opportunities to practice their executive skills.

The “meeting skills” of respectful listening, stating opinions appropriately, giving and receiving feedback, and negotiating and compromising are taught and encouraged through every part of the House Meeting.

By using House Meetings to provide treatment aimed at improved resilience, self-regulation, and social skills the residential counseling staff will guide the kids through the forming, storming, and norming phases of team development to turn them into a high-performing team that provides each client with a transformative residential treatment experience. 

The key to effective design of these structures is understanding when and how to focus on performative behaviors versus when and how to focus on inner systemic change.  “Performative behavioral change” are changes in the kids’ surface behaviors while they are at the treatment program.  “Inner systemic change” are changes in how the kids manage their feelings, use staff feedback, put effort into their own personal development, and manage their relationships with others. Systemic change will lead to changes in surface behaviors that are much more likely to last after kids leave a residential program.

Both types of change have their place in a residential treatment program.  Depending on the design, both types of change can be encouraged through behavior-focused structures including things like point systems, point and level systems, coupon systems, token economies, and behavior contracts.  These techniques are, often times, the structural foundation of a lot of residential programs.  This podcast will give you the tools to understand how to better design and use these techniques. 

The key design difference is whether or not a point system, coupon system, token economy, or other forms of behavior contracts track observable behaviors or try to track the kids’ efforts at self-directed change.

This episode examines the profound differences between behavior-management systems and feedback-incentive systems.  On the surface these two structures look similar to one another, both involving kids getting some type of score based on staff observations and then rewarding them for attaining some goal number.  However, when designed and implemented properly these interventions are fundamentally different. 

Behavior-Management interventions track observable behaviors in an attempt to condition improved behaviors.  Feedback-Incentive interventions get kids invested in implementing feedback and then making more pro-social choices.  One is targeted at specific behaviors.  The other is a cognitive intervention designed to engage kids in making real effort to manage their own development.  Understanding this difference is key to designing these essential tools for effective residential treatment of children and youth.

Episode 67 presented the underlying conceptual difference between using point systems, behavior contracts, and other “behavioral” change techniques to impact performative surface behaviors versus impacting inner systemic change.  Both have their place. 

Episode 68 expanded on these distinctions by introducing the idea of a “behavior-management” system versus a “feedback-incentive” system.  Both use the same elements of tracking some behavior or other aspect of performance, giving it a score (or coupon or other token), the accumulation of which results in a pay-out.  However, feedback-incentive systems are a fundamentally different intervention aimed at cognitive change in how kids manage themselves, their beliefs, their values, and their relationships with others.  The focus is not on discrete behaviors but on increasing the efforts kids make to develop themselves.

This episode takes that understanding and explores concrete ways to take the feedback-incentive model and turn it into a focused Expectation Contract.  A structure is presented to empower listeners to create customized Expectation Contracts for their residential units or for individual clients.