healing begins with understanding…

Mental Illness

Juvenile Justice Ministry: Reintegrating Juvenile Offenders


Youth incarcerated in juvenile detention centers are undergoing significant stress related to arrest, the uncertainties of their legal issues, and the potential loss of freedom, trust, respect of family and community, and future dreams. Effective ministry to these individuals should be based on the expected duration of the sentence (30 days vs. 1 year) but should also be focused more on the transition out of incarceration and reintegration back into the community. The better this transition is the greater the likelihood that the youth will not recidivate back into illegal behaviors.

SAMHSA Substance Abuse Treatment for Individuals in the Criminal Justice System identifies the following key factors to consider when helping an individual coming out of incarceration:

 Substance Use

  • Substance use history
  • Motivation for change
  • Treatment history

 Criminal Involvement

  • Criminal thinking tendencies
  • Current offenses
  • Prior charges/convictions
  • Age of first offense
  • Type of offenses (violent vs. non-violent, sexual, etc.)
  • Number of offenses
  • Prior successful completion of probation/parole
  • History of personality disorders (unlikely if under 18 years of age)

 Health

  • Infectious disease (TB, hepatitis, STD, HIV, etc.)
  • Pregnancy
  • General health
  • Acute conditions

 Mental Health

  • Suicidality/History of suicidal behavior
  • Any diagnosis of MH
  • Prior treatment/counseling and outcomes
  • Current/Past medication
  • Symptoms
  • Trauma

 Special Considerations

  • Education level
  • Reading level/Literacy
  • Language/Cultural barriers
  • Disabilities (physical, intellectual, learning, etc.)
  • Housing
  • Family issues
  • History of abuse (victim and/or perpetrator)
  • Other service providers (counselor, probation officer, social worker, etc.)

 This is a long list of issues that require attention. Remember, you are not alone in service this youth. Partner with others that are investing as well. Establish open communication between you and the others so you do not unintentionally work against each other. Have the other providers come do trainings for you and your staff so that you can better understand the complexities involved in serving juvenile offenders. The more you can work together with the community the greater the odds are that your youth will overcome the obstacles they are facing.

 What are ways you have partnered with individuals attempting to reintegrate after returning from incarceration?

 Are there special considerations for juvenile offenders vs. young adults?

 How have you been successful in engaging resistant families?


I Have An Aspie In My Youth Group!


In a setting which relies heavily on spoken and written words the Asperger’s child is at a disadvantage.  With a growing awareness of Asperger’s and its nuances youth ministries need to adjust some of their practices to make it more accessible to those who have traits of or a diagnosis of the disorder.

 There are three main interrelated general areas of functional liability in children with AD:

  1. Visual-spacial processing and sensory-motor integration
  2. Information processing and organizational skills
  3. Social skills and pragmatic language development

These areas will need to be discussed in greater detail by youth ministries as this is largely misunderstood people group that are not being effectively impacted with the Good News, not for a lack of want but likely from a lack of understanding and awareness on our part.  For the time being we’ll simply provide an overview of these three areas of difficulty and leave it up to you to contextualize in your ministry setting.

Visual-spacial processing and sensory-motor integration

Examples of visual-spacial skills include the ability to walk a narrow beam or to run while accurately throwing a ball to another person.  Most of us take these skills for granted.  You probably think nothing of the fact that you know the relative size of things.  When going to pick up a stack of books, you know that they will be heavier than the single book you just put down, and you’ll adjust your motor movement to account for that difference.  You take for granted that you can find your way from one place to another in a large building.  For youth with AD, the visual-spacial and visual discrimination skills required to accomplish all these activities are often impaired, contributing to a natural clumsiness and frequent experiences of getting lost.

Visual-spacial processing impacts learning in many ways and this has a direct impact on discipleship efforts, given that we primarily teach about our Christian faith like a classroom subject.  Students with AD find tasks such as handwriting, taking notes, and filling out forms and worksheets difficult at best and often impossible.  Given the difficulties these children have in visual spacial processing and coordinating sensory-motor integration, seemingly simple tasks are not simple and can impede their ability to grow and develop spiritually as their peers.  The problem is not one of failing to understand the task or not having the knowledge to complete the task (i.e., bible study); rather, the problem is that these youth have a specific disability that interferes with the processing of visual-motor and visual-spacial information.

Information processing and organizational skills

Processing the many forms of information that you encounter daily is dependent on a complex set of interconnections between multiple parts of the brain.  In students with AD this process is impaired, leaving them unable to easily or quickly make sense of simple day-to-day tasks (like homework or chores), or individual expectations (grooming or managing relationships).  The information goes in, but once it enters the labyrinth of the mind it becomes jumbled and their ability to organize, recall, or use the information is hindered by their cognitive processes.  Imagine trying to relate a parable of Jesus to a student with AD.  This can often appear on the surface to be oppositional in nature but upon further inspection it is simply the result of a complex cognitive process that has gone off the track.

Social skills and pragmatic language development

In the development of social skills and day-to-day language that conveys social meaning the AD child struggles.  This is partly due to the first two issues addressed above.  The student’s difficulties processing information and accurately comprehending the actions of others, along with spacial, motor, and organizational problems combine to create pain nd anxiety for the child.  Normal social interactions occur on so many levels at the same time, some overt (verbal messages) and some covert (hidden messages, tone of voice, nonverbal, gestures, body language, etc.).  Youth with AD do not fully grasp these nuances, missing social cues and implied meanings that others understand.  Aspies often take things at face value, interpreting statements literally, often missing sarcasm, subtly humor, or even threats. 

Just because a child has AD does not mean they will skip being a teenager.  The student is just as  likely to go through the normal variations of mood and personality as any teen; they just go through adolescence with more baggage.  The good news is that, developmentally, most of these teens are slower to become aware of adolescent issues of sexuality, drugs, or rebellion, but these issues will eventually come up  The social culture that our youth are a part of is difficult at best, and many of these teens are not prepared to deal with the pressures they face daily.  We have a tremendous opportunity to show the love of Christ to Aspies and their families by entering into the potential messiness of their day-to-day living and getting our hands dirty.  The message this sends when we seek to understand is that they matter.  They matter to us and more importantly, they matter to the God who created them.


Building Bridges (art of connecting pt. 1)


One of the Apostle Paul’s most famous speeches took place at Mars Hill, the Areopagus, in Athens.  He noted that they appeared to be a very religious lot of people due to the sheer number of statues they had to their gods.  In a brilliant move he identified the one statue that was for the “unknown” god and he saw his bridge.  Paul then launched into his epic sermon about the “unknown” God and described our Father to the Greeks.  He masterfully used a technique called bridge building to connect with his audience.

Kids today are completely enmeshed in pop culture.  We could, and should be aware of what is shaping our youth today and much of what we see and hear impacts them more than we know.  But I’m not simply talking about knowing what the newest Katy Perry song is blazing up the charts, what I’m talking about is building a bridge with a language of the soul.

In order to connect with young people they first have to know that you’re interested and trustworthy.  They are most likely already suspicious of adults anyway.  Too often we have an agenda for them and they know that.  It’s what drives them underground many times.  What we’re talking about here is a fundamental belief that we have something in common with the young people we love and hope to reach.

If we say things like, “Teens today are just so much more _________ than we were.” or “Kids today are just lazy and apathetic.” we create distance between us and them.  If we fail to see that they have the same longings that drove us then and drive us now there will be no bridge to walk across.  All we will have to work with is a shallow relationship and all the change we’re likely to affect is shallow compliance to an empty belief system.  We have to find common ground and that common ground should be our shared humanity.

In his ground breaking book Hurt: Inside the World of Today’s Teenagers, Chap Clark identifies six intrinsic longings of all students.  Those longings are: to belong, to matter, to be wanted, to be uniquely ourselves, for a safe place, and to be taken seriously.  Who among us can’t relate to those longings?  I work with drug addicted emerging adults.  Daily they express to me their desire to satisfy those very longings and that much of their behavior was an attempt to do just that.

After some small talk I usually ask a student where in their life do they feel they belong.  Where do they and what do they do that makes them feel like they matter?  Who takes you seriously?  Where are the safest places for you to just be yourself?  These are the questions that matter to students even if they don’t have the language to articulate them.

What the Apostle Paul did was provide an opportunity for those in the crowd to have their longings satisfied in a permanent manner by depending on the One true God.  A civilization that worships everything is an empty civilization desperately searching for meaning.  They apparently hadn’t found that in the many false gods they worshipped.

We have the same opportunity to connect the kids in our community to the very God that Paul preached about to the Greeks but first we must take to time to build a bridge by learning about them and their longings.  There is ALWAYS a bridge and it’s up to us to find it.


The Art of Connecting with Kids on the Fringe


After a workshop I facilitated on working with kids who have been abused, an elderly woman approached me to ask me a question.  She shocked me with the simplicity and depth of the question.  Here’s what she said,

“I love the kids in my community but I don’t know how to connect with the.  I want to reach out but don’t know where to start.  How do you do it?”

I can’t really remember what I told her, probably an overly simplified answer.  I never thought about it to be honest.  I just did what felt natural when reaching out to others.  Plus, I have the added benefit of being pretty simple, if I didn’t know someone I would just introduce myself and talk to them.  It wasn’t until I talked to my wife that she opened my eyes to the idea that for some this comes easy.  For others though it is an anxiety inducing event.  Imaging, you long to reach out to this generation, a generation that is slipping through the cracks right before your very eyes, but the words escape you when needed.  You don’t know how to connect beyond a simple “Hello, how are you today?”

My wife and I talked about this for several hours over the next few days.  We explored what is involved in connecting with these kids that seemed so different from us.  Asking me how I connect with fringe kids is like asking a fish to describe water.  I spend so much time out there on the fringe that it has become normal.   I have developed, over the years, skills to navigate those waters.  But many others haven’t and don’t know where to start.  That’s what this series in aimed at doing, equipping willing adults to connect with a generation where the gap is ever increasing.  Our thoughts are not exhaustive and it is my hope that other voices will chime in with their experience, wisdom, and insight.

We will cover the following over the next several weeks:

  • Bridge Building – How to make that initial contact in a meaningful way?
  • Cultivating a spirit of learning – Curiosity is key in connecting with others.  How do we foster a spirit of curiosity?
  • Law of the Lid – We will explore our preconceived expectations of these fringe kids and how they impede our interactions with them.
  • The Culture of an Individual – Each student is a culture unto themselves.  We will discuss how to explore that culture as it relates to effectively ministering to them.
  • Doing away with my Agenda – How my agenda actually breeds a distrust that is nearly impossible to overcome.
  • What is our Purpose of our Interactions – Moving from meaningless to Meaningful interactions.
  • Checking our Personal Bias at the Door – Often our personal biases impact how well we connect with others, especially those different than us.
  • Finding Common Ground – Discovering shared experiences, dreams, fear, and failures.
  • What is being said without Words – What story are they telling with their clothes, hairstyle, and nonverbal communication.

I hope you will contribute to this discussion because at the end of the day it will close the gap between us and the adolescents that reside in the world beneath…


National Eating Disorder Awareness Week


For more information on and help for eating disorders please visit the following:

 

National Eating Disorders

National Institute of Mental Health

Something Fishy

Conversations on the Fringe

Mercy Ministries


Forgiveness: A Leap Of Faith


There are a few stumbling blocks when considering forgiveness.  One is feeling that if they forgive they are in some way condoning wrong actions.  Another is the finality of it and releasing the hope of ever righting the wrong or getting retribution.  Another is letting go of the wish of finally getting what they always wanted.  Still another is the implication that forgiving means that they wish to continue having a relationship with the person they’re forgiving.  But forgiving someone who has hurt us doesn’t necessarily mean we want to continue a relationship with him or her.  Forgiveness is not a one-time event, and it doesn’t mean we relinquish our right to continued feelings about an issue.  Some people feel that if they forgive they have to eradicate any residual feelings of hurt and anger or they haven’t really forgiven, but this isn’t necessarily true.

Forgiveness typically plays out as a wish or a need to place a particular issue into a different internal context – moving something from the foreground to the background.  Those who consider forgiveness as part of their healing process are coming to terms with all of these issues and recognizing that they want inner peace more than a grudge to nurse.  They are seeking forgiveness to free themselves and to have God restore their equilibrium and sense of joy that had been stolen from them.  It is also a statement about where they are in their own healing process.

Sinful behaviors are often attempts at running from our own inner turbulence, misguided attempts at quieting the inner storm.  The storm is often about feeling hurt by others or hurting others through our own behavior.  The two are intertwined, feeding off of an fueling each other.  Asking for or granting forgiveness offers a way out, a way to make an attempt at restitution, to restore peace. 

We humans seem to pass through a predictable set of stages before forgiveness occurs much as in the grief process.  This is not intended to be a programmatic response to manage hurt and forgiveness.  These stages are meant to only suggest a process and make it a workable one, to provide a framework.  They may be experienced in a different order, leapfrogged or some skipped entirely depending on the severity of the issue and the person involved.  Also, the goal is not to get rid of feelings like anger or sadness but to experience them and integrate them into a greater understanding and insight and through doing so moderate them and reframe the issues at hand.  Once people understand that they are hurting themselves by nursing resentments and undermining God’s healing, then reframing has begun.

Waking Up.  We realize we’re holding onto something that’s hurting us maybe even more that the other person, or that we need to forgive ourselves for something and stop beating ourselves up on the inside.

Anger and Resentment.  We’re hurt and angry.  We resent the other person because we see him or her as being the cause of our pain.

Sadness and Hurt.  We’re in pain.  We feel wronged or wounded, and we’re probably also worrying that we did something wrong that we don’t quite understand.

Integration, Reorganization.  We feel and experience split-off emotions associated with internal blocks and place them into a new context.  We reintegrate them into ourselves with new awareness and insight.

Reinvestment.  The process of forgiving and working through blocked emotion frees up energy that can be reinvested into improving relationships with God, others, and life.


Sobering Statistics On Eating Disorders


PREVALENCE

It is estimated that 8 million Americans have an eating disorder – seven million women and one million men One in 200 American women suffers from anorexia

Two to three in 100 American women suffers from bulimia

Nearly half of all Americans personally know someone with an eating disorder (Note: One in five Americans suffers from mental illnesses.)

An estimated 10 – 15% of people with anorexia or bulimia are males

MORTALITY RATES

Eating disorders have the highest mortality rate of any mental illness

A study by the National Association of Anorexia Nervosa and Associated Disorders reported that 5 – 10% of anorexics die within 10 years after contracting the disease; 18-20% of anorexics will be dead after 20 years and only 30 – 40% ever fully recover

The mortality rate associated with anorexia nervosa is 12 times higher than the death rate of ALL causes of death for females 15 – 24 years old. 20% of people suffering from anorexia will prematurely die from complications related to their eating disorder, including suicide and heart problems

ACCESS TO TREATMENT

Only 1 in 10 people with eating disorders receive treatment

About 80% of the girls/women who have accessed care for their eating disorders do not get the intensity of treatment they need to stay in recovery – they are often sent home weeks earlier than the recommended stay

Treatment of an eating disorder in the US ranges from $500 per day to $2,000 per day. The average cost for a month of inpatient treatment is $30,000. It is estimated that individuals with eating disorders need anywhere from 3 – 6 months of inpatient care. Health insurance companies for several reasons do not typically cover the cost of treating eating disorders

The cost of outpatient treatment, including therapy and medical monitoring, can extend to $100,000 or more

ADOLESCENTS

Anorexia is the 3rd most common chronic illness among adolescents

95% of those who have eating disorders are between the ages of 12 and 25

50% of girls between the ages of 11 and 13 see themselves as overweight 80% of 13-year-olds have attempted to lose weight

RACIAL AND ETHNIC MINORITIES

Rates of minorities with eating disorders are similar to those of white women

74% of American Indian girls reported dieting and purging with diet pills

Essence magazine, in 2008, reported that 53.5% of their respondents, African-American females were at risk of an eating disorder

Eating disorders are one of the most common psychological problems facing young women in Japan.

While the previous statistics are sobering there is hope.  This hope is in direct proportion to those who are willing to get involved in the messiness that comes with loving those with an ED and an increase in awareness and education of this horrible condition.  If you have suffered from, or someone you love has suffered from an ED we invite you to join the fight.  We invite you to use your voice and influence. We invite you to share your experience, strength, and hope to those who have lost theirs.  You can do that in one of several ways:

1.)  Leave a comment here.

2.)  Refer your friends and loved ones to this and other websites as an ED resource.

3.)  Utilize your social networking sites (Facebook, Twitter, etc.) and provide links to ED websites.

4.)  Talk to your local school/park districts/churches/etc. and educate them on ED.

5.)  Share your stories of overcoming ED. (If you have a story you’d like to share to inspire others feel free to email us at cschaffner@fringeconversations.com.


Dangers and Diseases Associated with Eating Disorders


ALL Eating Disorders are Dangerous

It is important to understand that even though a person may be suffering specifically with Anorexia, Bulimia or Compulsive Overeating, it is not uncommon for them to exhibit behaviors from each of the three. It is also not uncommon for one Eating Disorder to be swapped for another (Example: a person who is suffering with Anorexia switches to Bulimia; a persons suffering with Compulsive Overeating switches to Anorexia). This is why it is important to be aware of THE DANGERS BELOW, all of which are risks no matter what Eating Disorder you suffer with.

DO NOT FALL INTO THE TRAP OF THINKING “I ONLY DO THIS A FEW TIMES A MONTH SO I CAN’T BE AT RISK” OR “I DON’T DO THIS ALL THE TIME, I JUST GO THROUGH HEALTHY AND NON-HEALTHY CYCLES” — THAT DOES NOT MEAN YOU ARE NOT IN DANGER, NOR DOES IT MEAN YOU DO NOT SUFFER FROM AN EATING DISORDER.

For a list of eating disorder associated dangers and diseases click here.


Adolescent Mental Illness


Young people can have mental, emotional, and behavioral problems that are real, painful, and costly. These problems, often called “disorders,” are sources of stress for children and their families, schools, and communities. The number of young people and their families who are affected by mental, emotional, and behavioral disorders is significant.

It is estimated that as many as one in five children and adolescents may have a mental health disorder that can be identified and require treatment. Mental health disorders in children and adolescents are caused by biology, environment, or a combination of the two.

Examples of biological factors are…

more…


The State of Male Adolescence Today


Statistics and stories about our homicidal adolescent males are dramatic enough to garner most of the headlines; the fourteen-year old in Mississippi who killed two children and wounded seven; the fourteen- year old in Kentucky who shot three dead; the thirteen-year old in Washington who opened fire in his school and killed three; the eleven and thirteen-year olds who killed five on Jonesboro, Arkansas.  But they don’t describe the whole picture.  It seems impossible for us to fully comprehend the state of male adolescence in our culture, yet it is essential we do so.  There is hardly any social or personal health indicator in which adolescent boys do not show the lion’s share of risk today.  The following show just some of the areas of distress experienced by adolescent males as a group.  You likely know such boys.  Your family life, your business, your neighborhood, your school and your ministries have met them and been affected by them for years.

The Declining Safety of Our Adolescent Boys

  • Boys are significantly more likely than girls to die before the age of eighteen, not just from violent causes but also from accidental death and disease.
  • Boys are significantly more likely than girls to die at the hands of their caregivers.  Two out of three juveniles killed at the hands of their parents or stepparents are male.
  • Boys are fifteen times as likely as peer females to be the victims of violent crime.
  • One-third of male students nationwide carry a gun or other weapon to school.
  • Gunshot wounds are now the second leading cause of accidental death among ten – fourteen-year old males.

The Mental Health of Adolescent Boys

  • Boys are four times more likely than girls to be diagnosed as emotionally disturbed.
  • The majority of juvenile mental patients nationwide are males.  Depending on the state, most often between two-thirds and three-fourths of patients at juvenile mental health facilities are male.
  • Most of the deadliest and longest lasting mental health problems experienced by children are experienced by males.  For example, there are six male adolescent schizophrenics for every one female.  Adolescent autistics out-number females two to one.
  • Adolescent males significantly out-number females in diagnoses of conduct disorders, thought disorders, and brain disorders.

Drug, Alcohol, and the Depression Link

Depression in males has often been overlooked because we don’t recognize the male’s way of expressing depression.  We measure depression by the female’s model of “overt depression”.  She talks about suicide, expresses feelings of worthlessness, shows her fatigue, and is overall more expressive about her emotional state.  Unaware of the male’s less expressive, more stoic way of being, we miss the evidence of drug and alcohol abuse, criminal activity, avoidance of intimacy, and isolation from others, especially family.

Suicide

  • Adolescent males are four times more likely than girls to commit suicide.  Suicide success statistics (i.e., death actually occurs) for adolescent males are rising; suicide success statistics for girls are not.

This statistic is one of the most startling to health professionals not just because lives are lost but because it indicates dramatically how much trouble adolescent males are in and the degree to which adolescent male mental illness is increasing.

Body Image

Steroid use among adolescent boys is now on par with their use of crack cocaine.  Consequences of steroid use range from increased rage to early death.

Attention Deficit Hyperactive Disorder (ADHD)

This brain disorder, like so many others, is almost exclusively a male disorder.  Only one out of six adolescents diagnosed with ADHD is female.

ADHD is one of the reasons for the high rate of adolescent male vehicle accidents and fatalities.  Adolescents with a history of ADHD (or, in fact, any conduct disorder) are significantly more likely to commit traffic offenses and be in accidents.

Sexual Abuse

One out of five males has been sexually abused by the age of eighteen.  Most of our sexual offenders are heterosexual males who have been physically and/or sexually abused as boys themselves.  These numbers should frighten us terribly.  A sexually abuse adolescent male is more likely than his female counterpart to act out against someone else, generally someone younger and weaker than himself, through rape, physical violence, and sexual molestation.

Questions:

The basic fragility of the male self becomes increasingly clear when we see beyond the terrible and reprehensible acts and the internal histories that led up to them; we begin to understand the process to the product.  We are dealing with adolescent males who broke down internally and had no resources to repair the internal damage to their fragile structures.

  1. What are the criteria for masculinity that adolescent boys are expected to meet?
  2. What price do adolescent boys pay for adherence to male gender roles?
  3. Compare the attainment of masculinity for boys with the attainment of femininity for girls.  Which has more advantages?  More adverse outcomes?
  4. What have we overlooked the drop in worth/value that occurs for boys during adolescence?  How do we contribute to their perceived lack of worth/value?
  5. How can, not just our youth ministries, come alongside of our young boys, but how can the entire body embrace our adolescent males better?

References

Pollock, W. (1998).  Real Boys.  New York: Henry Holt

Thompson, M., & Kindlon, D. (1999) Rasing Cain.  New York: Ballantine


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