mark tidsworth

My first clinical position was in a high management group home for boys, ages 8-14. This was a long term environment, wherein children would stay up to two years. After the first week, I seriously considered quitting. This was the most difficult job I had experienced so far. Two Living Skills Counselors were placed in a house with up to eight boys, all of whom were labeled with several mental health diagnoses, while being heavily medicated. A strict behavior modification system was in play, wherein each child earned a check or minus every fifteen minutes on their goal sheets. Each day was highly structured with a schedule to be kept. When a child had a melt down, or escalated up into violent or escapist behavior, the time-out room was available. This was a room with thick wooden walls and a heavy door with serious locks. Getting a child there was an ordeal, usually involving physical restraint by both staff persons, carrying the child to the time-out room and locking the door as quickly as possible. Sometimes we had to call for back-up staff members to assist. Yes, the entire time-out-room-experience was as disturbing as one might think…for the children and staff.

After the first few days of long 12-hour shifts, quitting was a real consideration. But then I looked at my options. The work schedule involved long shifts on, with then plenty of time off; ideal for completing that masters degree in counseling while working full time. This children’s home had a psychiatrist on staff and several therapists around. Families too were involved in treatment, making it a great place to engage in Family Systems Therapy. What a great learning environment for an aspiring therapist. Besides all that, I needed a job and this was my only option at the time. So, I decided to sink or swim. Staying on this job required that kind of commitment.

About six months in, the unthinkable happened. The time-out room door broke. Well, it didn’t mysteriously break on it’s own. It was blasted off its hinges by a large out of control boy. This in itself was not unthinkable, happening on a regular basis (the entire time was there I couldn’t believe these small human beings could generate that kind of destructive power). What was different this time was that the maintenance guy was not available. Mr. Brown worked at the children’s home on weekends to supplement his military pay, and he was out on a three week field exercise with his other job. So, no time out room was available.

What? I couldn’t believe it when the director informed us of this crisis in staff meeting before my shift began. What in the world were we expected to do when the kids were out of control, or one tried running away, or several began to fight, or one picked up something with which to attack one of us staff people?

“Use your skills.” That was the director’s answer. That’s it. “Use your skills.” Instant dread.

So, we informed the kids, who already knew. The last boy who occupied the time-out room quickly informed the others about his success in disabling it. He enjoyed his hero status.

That day, the day the time-out room broke, led into a remarkable three weeks which became high management children’s home lore passed down among staff members to this day. There we were, in a high management children’s home, with the highest management tool unavailable to us (Actually, we could call the police, an even higher management activity, but we didn’t want to wear them out too much). The kids knew the time-out room was broken, the staff knew it was unavailable, and we all knew it was what we used when kids were too far out of control. Now what?

Strangely, that first day, we didn’t need the broken time out room. It was like we all developed an unspoken understanding…”the time-out room is not available, so getting violent or running away or threatening people are not really options for a while…at least not until the time-out room door is fixed. Mr. Brown (maintenance guy) is out of town and the rest of us don’t have time to shop for parts and fix the thing.”

Yes, kids still escalated, moving toward what previously would result in a physical restraint plus a time-out room stay. But something different happened. We staff people adjusted our approaches. We found different ways to relate. We discovered new or dormant intervention skills. Our engagement with the children rose to a new level. We headed-off dilemmas and conflicts way before they resulted in violence. We intervened in more caring and respectful ways. Somehow, our awareness that behavior requiring a time-out room stay could no longer be accommodated, changed things. The children did not escalate to that point so much, dramatically reducing the number of critical incidents. The staff raised their intervention and relational skills to far more effective levels, changing dynamics before hands-on restraints were needed. For that three week period, we didn’t need the time-out room.

So, what do we make of this? What’s this say about group norms? What’s this tell us about how our expectations of what’s acceptable in an environment shape our behavior? Even more, what does this mean about the relational, engagement, and negotiation skills of human beings when they know controlled physical interventions are not options? Is this what happens when parents decide they won’t spank their children…they develop more effective ways of relating which makes spanking obsolete anyway? And what about on a larger scale? What if human beings knew violent interventions were not options? Would we find our interactional styles and skills rising to new levels, making violent problem-solving techniques less needed?

Well, eventually Mr. Brown returned from his field exercises. He went to Home Depot and bought their strongest, thickest door along with an industrial strength lock and hinges. He cut out a small window in the door, installing thick child-proof plexiglas so that one could see in/out. He repaired the framing around the door, attaching the hinges and hanging this new time-out room door. He replaced the log on the door’s front, where staff could write the reason for use and note the time intervals for observation.

After he reported to us (children and staff) the door was operational again, we pretended not to know this the best we could. None of us wanted to return to the way things were. But before the day was out, the time-out room was in play again. When escalating to that level of “out-of-control” could again be accommodated here… then escalation happened.

Evidently, when violence is an option, human beings will exercise that option. Conversely, when violent intervention is not an option, we human beings find all kinds of other, less hurtful ways to engage one another and resolve problems.

May the time-0ut room doors in the world around us break more often.

-For The Common Good