In their own words: Why I’m here at Ryther By Emily Pringle, Behavior Specialist Cottage A

IMG_1702 - CopyI have been at Ryther for a little over a year now. What keeps me here every day is working with the kids in the cottages. It’s a unique job because you get a really cool opportunity to build relationships with the kids. It’s a fulfilling experience when you walk into work and the kids are excited to see you, and want to tell you all the great things they’ve been up to in treatment and school. When you build a positive relationship with a child it completely changes the interactions you have with them. We have quite a few kids who are extremely relational and until you have built that with them you won’t get anywhere. A lot of these kids just see you as another adult who is there to tell them what to do or where to be; they really don’t have much attachment to you. It’s when you get the opportunity to have a relationship – it changes everything. You are able to reflect back and say, “We’ve been here before. Remember when this happened – you were so upset and we worked through it together and you used your coping skills to handle it?” Being able to reflect like this can really help children learn and move forward.

I’m not going to lie, it can be frustrating at times when you try so hard to show these kids that you are safe and here to help them. But most of our kids have been through a lot of trauma and abuse and they aren’t always ready or capable of trusting another adult. We see a child’s history and we figure out where we want them to end up in treatment. The end goal is for them to leave Ryther and live a happy life with a wonderful family. The tough part is implementing that plan, and working with them through the ups and downs of daily life. A lot of these kids don’t always have a good grasp on what a healthy relationship looks like. Some don’t even know that safe and trustworthy adults even exist. Many aren’t even used to having three meals a day or know that you wash your clothes when dirty. You can make a huge difference in the smallest ways here and give them opportunities they never thought possible. It’s really a neat experience to see the kid who comes in the door and then to see that kid who leaves. They’re usually two different people and it’s inspiring to see the changes that they make.

I believe we can change children’s futures by teaching coping skills and better ways to work through their emotions. We teach them to identify their feelings and frustrations and help them work through that in a safe way. Over time they learn what a safe environment really is; they start to relax and they get the opportunity to just be kids. Toward the end of treatment most kids have a whole different idea of where they can go in life and what they can do. Ryther 100% changes the way a kid can imagine their life and when that happens, their whole future can change. They leave here with so much potential and excitement for life. Ryther helps kids who need a second chance at life, and it gives them one.

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Interview with Lisa Lester, former Ryther therapeutic foster parent

family editedHow did you learn about Ryther?

I actually started working in the Cottages in 2001.  I worked in Cottage D until 2004. I enjoyed my work there even though it was probably the hardest job I’ve ever done.  But it was also my favorite job – honestly.  The kids were great.  They had baggage and they had tough times and they acted out.  But they didn’t always act out.  They were just normal kids that you could do fun stuff with and hang out, so the majority of the time it was really enjoyable.

 Why did you decide to open your home to a Ryther child?

Just working there I saw the need for that, and I thought we could fill it.  I thought it would be doing respite care when we began.  And so we got licensed through Ryther.  I knew the TFC person who ran the program at the time, and she would always say, ‘Hey, we have this kid, we have this kid.’  And then finally Dasia came along and she’s like, ‘We have this kid, really.  You’ve got to come see her.  You know, I really think she’d be a great fit for your family.’  So we said, ‘OK, well . . . we’ll go.’  And it ended up she was! So she was right.

 How did you get to meet Dasia?

It was more observing than an introduction.  We went to the Cottage and we watched her play. We didn’t get to meet her at that point.  We could tell just what a cool kid she was. It wasn’t too long after that we decided that that we could do this, and so we did!

What is she like?

She is incredibly artistic.  She’s very resilient and very resourceful.  She’s really smart.  She’s incredibly athletic.  She has so many strengths.

How did Ryther help?

Ryther was incredibly helpful.  Our caseworker was great.  Our case aide was great.  Anytime I had a question I could call and they would help me.  They were there at least once a week, and then we’d have case aide time.  If you’re going to do foster care you should do it through an agency like Ryther.  That’s what I tell friends who are interested because there’s so much support there and it was so valuable.  They were so valuable.

 What were some of the biggest issues early on?

Dasia was an eight-year-old coming into our home, having had nine prior placements. That was probably the most difficult part for us – the attachment issues that we had to deal with.  You’ve got to give them time to build trust. Being able to have her go through therapy was pivotal for her being successful in our home.  And for us to have the support we had from Ryther was instrumental, because there were days when it was stressful.  They were always there to listen and to help.

 What was Dasia like when she first came to your home?

I would say she was pretty socially awkward. She had never lived anywhere for more than a year. She didn’t have an opportunity to make friends or learn how to be a friend so we decided to get her into sports. She met some kids and that worked out really well. Now she’s got tons of friends on her softball team.

What do you think Dasia would say about what she’s gained?

She’s gained a sister and she’s gained a home that can give her stability and can nurture her. We are excited it worked out so well.  You don’t know what’s going to happen really, but certainly with the help of Ryther, and Dasia being as resilient as she is and as strong as she is, it’s worked out really well.

Why should someone consider taking a Ryther child into their home? Here is what Dasia had to say:

“If you put forth an effort to help them, I feel like they can do really well in life. But the longer you wait, the harder it gets because they’re older and they try to make their own decisions but they haven’t been taught how to make those decisions.

I came to this home when I was eight and I learned a lot and I’m really successful in school, and in sports, and I’m able to make a lot of friends. And so I feel like if other kids got that opportunity then they could do as well as I am doing.”



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Not your typical Intensive Outpatient Program (IOP)

An Interview with Ryther’s Co-Occurring (Substance Use & Mental Health) Program Director, Deanna Seather-Brady, MSW CDP

Karen's goodbyeWhat is Intensive Outpatient Treatment (IOP)? “IOP” is basically the middle ground between inpatient and outpatient substance abuse treatment. It’s for teens who are transitioning or stepping down from a more restrictive substance abuse treatment program such as inpatient treatment or when there is a need to bump up from a less intensive program.

How do you know if IOP is appropriate? Once a teen has been assessed at Ryther using the American Society of Addiction Medicine or ASAM, the course of treatment is identified. ASAM looks at six criteria: the risks associated with withdrawal; biomedical conditions and complications; emotional, behavioral or cognitive issues; the client’s willingness to change; continued use despite consequences; and, the recovery environment. IOP is recommended when a teen’s substance use has crossed the line from experimentation or abuse to chemical dependency. At this point it’s physiological – the brain has changed. We often see issues such as cravings, preoccupation with getting high, higher tolerance, more drug seeking, difficulty concentrating, memory problems, continued use despite consequences, exacerbating medical or psychological issues, or behavioral and peer group changes. These teens also tend to do more poorly in school and sometimes even start getting in trouble with the law. In addition to the verbal assessment, the parents are asked to provide information about their teen’s strengths and difficulties, and we get information from sources such as court, family, teachers or other therapists/ psychologists. Urinalysis is also done at the time of assessment.

Is Ryther’s Intensive Outpatient Treatment Program different? What I am excited about is that we are making the leap to co-occurring treatment. On Ryther’s campus we have psychiatric and psychological services, dual-certified mental health and addiction therapists, experiential therapists and therapists trained in Dialectical Behavioral Therapy (DBT) skills. The data shows that over 80% of teens who abuse substances also have mental health issues so we treat both simultaneously. A part of the initial assessment dimensions includes mental health challenges, and such issues would be flagged. In these cases, if a client needs a psychiatric or psychological evaluation, an internal referral would be made.

What does the program entail? We use evidence-based practices such as Dialectical Behavioral Therapy (DBT) skills as well as experiential therapies and science-based psycho-education. DBT skills include mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. Among teen boys in our inpatient program, this is what they say was most helpful. DBT skills help answer recovery questions like, “What do I do instead of use drugs when I get stressed out? How do I communicate effectively with other people?” Mindfulness is essential to being able to use the other DBT skills and will be practiced in creative/ fun ways at every group session. With DBT, there are three states of mind: emotional mind, logical mind and wise mind. DBT teaches how to take the best of the emotional and logical minds and find that wise mind for effective decision making. This is about how to be present in the moment and not get bogged down either in the future or the past.

Additionally, participants will at some point in their IOP experience be asked to mentor someone entering the program and will be required to co-lead various modules and the experiential components of those modules.

What should clients expect? There are three sessions per week. Monday and Wednesday evenings for group sessions (each 2.5 hours) and a third day is for individual therapy. Group sessions include experiential activities during the last hour. The activity relates to the DBT skill that is worked on during the first part of the session. The activities are fun and active as well as developmentally appropriate based on adolescent brain development. We have a low ropes course, a climbing wall and a portable ropes course so we can do activities inside or outside. Random urinalysis will be done at Ryther.

IMG_9002How long is the program? In order to graduate from IOP the client must participate in the entire 12 week program. If a client misses a session it can be made up. Clients can join anytime. Among other things each participant’s individual therapist will help support DBT skills group and review the Mindfulness module if missed to get him or her up to speed in order to step right into the group.

What about family involvement? We offer a twice monthly parent group. Plus, once or twice a month a parent might join the individual therapy session. We keep parents in the loop about what we’re working on and provide psycho-education. We will also offer family therapy.

If you would like more information, please call us at 206.517.0234. Currently for this program we only accept private pay or insurance.

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Program Profile: Eric’s story

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.

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