Ryther - Healthy Children, Stronger Families

Ryther’s Sub-Acute Residential Treatment Program provides a safe living arrangement for children ages 6-13 struggling to overcome the effects of trauma, violence and mental illness. Ryther’s three cottages, located on our ten-acre campus, each treat twelve children at any given time, employ psychiatry, psychology, evidence-based and experiential therapies as well as parent coaching and shadowing. Most of Ryther’s children (70-90%) show significant improvement in specific behaviors with treatment, such as aggressive tantrums, self-injury, assaultive behaviors, running and others. However, behavioral improvement is not the whole story.

Abuse and neglect can also affect the child’s developing brain and in many realms. In Ryther’s cottages we see relatively high incidences of developmental delays and learning disabilities. Neglect has a profound impact as does in-utero exposure to substances such as alcohol and drugs. Additionally, children who bounced from foster home to foster home tend to have what teachers in Ryther’s on-campus K-8 school call a “Swiss cheese education.”  Because they’ve attended multiple schools sometimes within one school year, they have been taught only pieces of subjects. Every foster home move puts a child approximately 3 months behind in school. On average, a child at Ryther will have moved 9 times before entering one of our cottages.

Ryther’s partnership with the Seattle Public Schools allows children to continue their education while receiving intensive treatment 24/7. The school features 5 classrooms staffed by Special Education professionals and classroom aides, with specific lesson plans tailored to each child’s educational needs. As children get ready to transition out of Ryther, they work on returning to the public school setting as well. First they attend just the morning classes sometimes in a block. If successful they start to stay for another block, lunch and eventually the entire day. This transition accompanies their return to family or relatives, or to a foster home or other long-term living arrangement.

It is promising to see that from 2006 to 2010, the children discharged from Ryther demonstrated substantial academic progress in the following areas:

• 71% saw improvement in their basic reading skills

• 71% saw improvement in their basic math skills

• 88% saw improvement in their reading comprehension skills

In past years, Ryther’s Sub-Acute Residential Treatment Program has seen a steady increase in severity of behaviors in children. Despite this increasing acuity, we continue to see positive outcomes. We also have seen shortened lengths of stay to an average of 9 months. A testament to the children, staff and programs also manifests itself in the six children who will be adopted from within Ryther’s own therapeutic foster home program.

The Sub-Acute Program provides consistently successful therapies for children overcoming traumatic histories.

An interview with Dr. Elina Durchman, Psychiatrist at Ryther.

How can parents tell when their child needs professional help?

There is no easy answer for that, but anytime a parent is concerned about their child, they should seek professional advice. When there is a behavior or mood change, parents should seek professional help. The most common symptoms are acting out in a school setting or daycare. Very young children who don’t know how to verbalize their feelings can be aggressive at daycare or preschool. This can be a warning sign that something is going on. Parents should check with their child’s teacher to see how their child is acting in the classroom and compare this to their home environment. There is often a difference between home life and school. Kids can be very calm and happy in the home environment, but very fearful at school.

Why might a child become anxious or defiant regarding school?

Children may become defiant at school because they don’t understand their teacher or what the teacher is saying, which is very difficult for children to deal with and also difficult to explain to their parents. Sometimes, a child has a learning disability that hasn’t been recognized or diagnosed, and it’s very difficult for the kids to explain that they have a learning disability. Parents often think the kids are just defiant and don’t do their homework, and in this situation school can become a stressor for the child. For example, we know that ADHD is a developmental problem that we can measure in the brain, and if it’s severe enough the child may need to be on medication. It seems unfair to require a kid with ADHD to struggle in school when a medication  exists that can help them improve their school experience.

What are the most common psychiatric issues that you address?

The most common struggles that kids have are with anxiety, depression and, of course, ADHD. I also work with some teens in the co-occurring program that addresses both mental health and substance abuse issues. There are other mood disorders to be evaluated. These include bi-polar disorder, or other disorders on the psychotic spectrum. There are also children who have stressors in the family because of parents separating and other home issues. These are often triggers for anxiety, mood disorders like depression and other psychiatric issues.

It is important to note that many people are predisposed to depression, anxiety or other mental conditions. When a traumatic event happens, this can trigger an episode of these pre-existing conditions. However, if children receive mental health treatment, they will often have the tools they need later in life to successfully deal with these events.

What are some common stressors among young children?

 A stressor might be that kids don’t know how to express their unhappiness or that they want something, or don’t like something. So the most common way the kids show these feelings is to act out, by having a temper tantrum or something similar. I often spend time explaining these behaviors to the parents. The parents sometimes don’t understand why the kids are acting this way, and kids are unable to explain to their parents in any other way except by acting out. A child might get diagnosed with something like Oppositional Defiance Disorder because they don’t want to go to school or to soccer practice. So they throw a huge tantrum, but often the tantrum isn’t about soccer practice at all but rather some source of anxiety or fear related to that particular activity. These conditions cause anxiety and fear for the kids. Think of a young child being fearful and not knowing how to explain to their parents that they don’t want to go to a certain place. Often their only response is to fight back.

A lot of people (parents) don’t recognize these behaviors or know where these behaviors come from, and they are often times very grateful and happy when the situation is explained to them.

If you have concerns or questions, you may call Ryther at 206.517.0234 or visit our website for information or to make an appointment with one of Ryther’s psychiatrists.

Dr. Elina Durchman

The boys went golfing in the morning and went to the Mariners game in the evening! The weather was so beautiful, no one cared about the Mariners’ loss! Good day at Cottage B.

Jason & Sue, Kids in Motion Facilitators

Ryther’s New After School Group Helps “Garrett” Succeed

“What’s the first rule of Kids in Motion?” A few children sitting in the circle raise their hands, and one of Ryther’s therapists Jason Franklin, MA LMHC CMHS, calls on “Garrett”: “Be safe! Don’t be crazy and, like, crash into things—respect other’s space.” Jason and his co-facilitator Susan Prescott, MSW LICSW, nod in agreement and move on to the second rule. Ryther’s Kids in Motion (KIM), a new program being offered to children ages 8 to 12 and teen mentors in the community, is a therapeutic group that focuses on developing cooperation, impulse control and concentration. The evidence-informed curriculum incorporates experiential activities, theatre games, exercise and teamwork to build a range of therapeutic skills in a supportive, fun and creative environment.

While KIM can target ADHD symptoms, it really is for any kid who needs extra help with coping skills, relaxation techniques, feelings identification or expression, social skills or communicating.

When Garrett first started KIM, he was very anxious, shy and quiet. His parents were afraid he would get overwhelmed by more rambunctious kids. However, by the time KIM fi , he became a leader. He experienced what being more confident and advocating for himself looked like and learned to tolerate frustration. His mother and teacher both noticed this change in Garrett and attributed it solely to KIM as it was the only program or therapy he participated in. But it didn’t feel like therapy to him.

Children performing "body sculpting" exercise

One of the activities that really helped Garrett was “body sculpting”—an exercise where volunteers freeze in space and the other participants label their positions with descriptive words or stories. By recognizing what body language is communicating to others, kids experientially learn to identify feelings and social skills in themselves. These activities work with all different types of learning styles. By seeing what anxiety or shyness looks like in other people, Garrett could work on his own traits.

Ryther therapists Jason and Susan tailored their interactions with Garrett based on goals set with his parents. Jason noted that “Parents always give great feedback. If a child has certain strengths or challenges, we can adapt the program to help each kid succeed. Parents love it.”

Whether it’s more respect for physical boundaries, increased impulse control, better social skills and self-esteem or another goal, children come out of KIM having fun and being motivated to return each session.

Ryther offers Kids in Motion, developed and facilitated by Jason Franklin, MA LMHC CMHS, in the fall and spring of each year for an hour and fifteen minutes a week for 8 weeks. The next group starts September 30. For more information, call Jason at 206.517.0295.

By Ryther Staff

At age 17, “Eric” needed a second chance…

Despite being adopted at age three by a strong, loving mother, his life took a turn for the worse as he became gang involved and started stealing and dealing. After a few failed attempts at outpatient treatment, his mother got him to Ryther’s Cottage B inpatient program.

It is not uncommon for depression to be masked by rage, and Eric was soon diagnosed with depression by Ryther’s psychiatrist, Linda Ford, M.D. At Ryther, when clients are not progressing or are close to failing, they are also given hope with a “Phoenix,” or a second chance to step up.

Eric had earned a Phoenix, and it was then that he realized staff were going to stand by him and be consistent and that his behavior was not going to distract from the work that needed to be done. After a particularly emotional argument with a family member, Eric was able to draw upon self-soothing skills he learned. He calmed down and acknowledges this was the turning point. When staff elected him community leader that same week, Eric had to set the standard for the other boys by being respectful and following directions. They began to look up to him, which boosted Eric’s self-esteem. He led a treatment group, succeeded on Ryther’s Challenge Course, and graduated from Ryther with his mother at his side, arm in arm.

He called a few weeks ago to let staff know that he is consistently attending therapy and treatment meetings, has enrolled in a GED program and that he and his mom are getting along well. Eric is spending a lot of time at home since he’s worried about running into old acquaintances, but there is a benefit to that: he gets to spend time with his little sister, too.