On Being Significant

I was listening to John Lewis being interviewed (On Being, Krista Tippett, NPR) about his civil rights work on this MLK weekend – impressed by this 74 year old who is still able to speak of hope…even when discussing congress! I can only imagine what he envisioned as success when he was a 25 year old working with Martin Luther King, marching in Selma. And how much faith and hope he has had to muster for the past 50 years. There have been many successes since 1965 but the work is far from complete, and I am curious if it progressed the way Lewis thought it would.

These past couple of weeks have challenged my vision of success at UrbanPromise. A couple of the young women that I have been mentoring since the spring of 2012 have made choices that have damaged their health and put their lives at risk. Not what I thought would be the outcome of hearing a mother/nurse practitioner/loving voice speak into their lives for 3 years now! Perhaps the honeymoon is wearing off. Perhaps this is a continuation of my ‘on-boarding’, as one colleague said in response to my mourning. Perhaps, perhaps…

It’s funny. I’ve consistently – and rather glibly, I now realize – said that “I can’t fix them, I can only walk alongside them and empower them with knowledge.” But there is clearly a part of me that believes by speaking and modeling what I consider a successful lifestyle, I expect these young women to let go of their trauma-filled childhoods and make good choices. The rational part of my mind laughs at that sentence – all research points away from such a straightforward solution. But my heart yearns for them to see themselves the way I see them – as beautiful, whole and beloved children of God with just. so. much. potential. To simply wash their hands of their damaging pasts and walk forward, confident in their potential.

J. Herbert Nelson, a Credo colleague and friend of mine, speaks of how “We are not called to be successful. We are called to be significant.” I have been chewing on this one hard for the past few weeks. I do believe I am being significant in these young women’s lives. But I don’t know – I can’t know – I can’t expect that significance will lead to successful living. At least not in the way I imagine it all playing out.

And maybe that’s a good thing. Because thankfully, I am just an instrument of God’s plan for them, and experience has taught me that God thinks way bigger than I do. Already both of these young women have shown a level of resilience that I didn’t see coming: a re-alignment with values and priorities, sprinkled with statements of self-appreciation. Will it hold this time? That’s not for me to decide. But I will be there to walk alongside and to witness.

2015/01/img_4127.jpg

A Lesson in Forgiveness

Enjoy this post, written by Ashley Williams, a student whom I mentor and fondly ‘mother’. Shared with her permission.

A heart of a mother is a deep abyss at the bottom of which you will always find forgiveness” – Honore de Balzac
Growing up, I never knew how people would look at me after I answered their questions about this lady whom I have never seen. I didn’t know whether to lie about her or tell them the truth. If I told them the truth would they feel sorry for me? I wanted to hate this lady because I had no idea who she was and I never liked hearing about this stranger. It’s not easy talking about a woman whom you’ve never seen before. There were times where I referred to her as the lady who birthed me, meaning my dad just picked her to have his baby. Although, I knew it was not true, I convinced myself that it was. Everyone made it seem like her absence was hurting me, and maybe it was.
When I was younger I asked my dad who she was. The look on his face told me that I had no business asking. I figured that maybe he wasn’t prepared for this question. That day he just looked at me but eventually he explained to me the situation. At the time, I didn’t quite understand, but recently it came to me. I wondered how I was going to explain my situation to people when they asked. Would they accept me for me, and the issues that come along with me? There is a whole group of people who would look down on me just because I finally figured out who this lady was.
November 16, 2013 I spent the day thinking about this stranger, who should have meant so much to me. I asked myself why I hated her. The only reason I came up with was that I didn’t know who she was. As I tried to understand why she wasn’t here with me, I thought to myself, “Hate is a strong word, I don’t hate her. I’m just misunderstanding the reasons for her absence.” Deep down I continued to pray that this lady would show herself. Looking back, I’m kind of glad she’s not here because it’s helping me understand the absence of certain people who were never in my life.
I am a 16 old year girl with just one parent and that’s my dad. In Camden, statistics show that more dads walk out of their children’s life than moms do, I became the “chosen one” whose mom decided to leave. It’s rare that you hear about a mom leaving her kids, and when you do there are many questions you ask as you try to understand why she left. My mom’s absence made me realize that you may never really know a person’s situation, so you shouldn’t judge others. But, then again, a mother leaving her kids, just doesn’t sound quite right to me. Though, it made me realize that it doesn’t matter what the situation is, you should never leave your kids. However, I believe you should try to understand the situation of mothers who have left their kids. As a young lady without a mother, I choose to forgive this lady because she made me a better person. My life gave me the passion to want to work with kids when I get older. Especially, kids who are missing a parent, or maybe don’t have any parents. This will give me a chance to show kids that just because they don’t have the ideal home life, that there are people who are still going to love them. This situation made me realize how real and strong my passion is for kids.

img 7919

img 7919

Are We Mis-Medicating Traumatized Children?

A Penn student of mine, Giulliana Gonzalez, wrote this compelling editorial – food for thought for parents, youth workers and prescribers alike. I am honored that she is allowing me to share this:

Are We Mis-Medicating Traumatized Children?

According to the American Psychiatry Association (APA), Attention Deficit Hyperactivity Disorder (ADHD) is the most common neurobehavioral disorder in children in the United States. Over the last few years, the rate of ADHD diagnosis has increased dramatically, and the CDC reports that five percent of children currently have ADHD. Changes in diagnostic criteria and increased advertising encouraging the use of medications to treat “problematic” behavior and “reveal his true potential” have both contributed to this increase. Additionally, sensational media’s emphasis on the over-prescription of these “dangerous” drugs has lead to public concern. The true issue, however, is whether these drugs are being misused in children who might not have ADHD.

A lack of awareness of how symptoms of post-traumatic stress disorder (PTSD) can resemble ADHD can lead to misdiagnosis and unaddressed trauma. There is little research discussing the misdiagnosis of ADHD in children presenting with PTSD. Children with PTSD may experience hyper-vigilance, irritability and difficulty concentrating which may resemble ADHD symptoms. Despite these similarities, the APA does not include PTSD as a differential diagnosis of ADHD.

While an ADHD evaluation focuses on behavior, a PTSD evaluation focuses on identifying trauma. Thus, a lack of adequate history may lead to misdiagnosis. Furthermore, symptoms of PTSD can present a year after the trauma occurred, thereby making the assessment process more challenging. Sexually abused children most commonly develop PTSD, but children who experience other types of trauma such as family dysfunction, car accidents, or gun-related violence can also develop PTSD.

Studies show the tendency of abused children to develop ADHD-related symptoms. Despite these findings, there is little discussion about the importance of including PTSD as a differential diagnosis of ADHD. Although in some cases both ADHD and PTSD may be present, failure to diagnose or misdiagnosing PTSD can have devastating effects. If medications aimed at improving symptoms of ADHD mask the PTSD related behavioral concerns the underlying trauma might not be identified. Unaddressed trauma may lead to more pervasive problems. In contrast to treatment for ADHD that focuses on behavior and academic functioning, treatment for PTSD focuses on the emotional distress the child has experienced. Thus, treatment for ADHD centered on the child’s “problematic behavior,” can aggravate feelings of guilt or shame in victims of PTSD.

Inclusion of PTSD as a differential diagnosis of ADHD may cause speculation that opening this can of worms can further traumatize children. However, studies demonstrate that this is not true— asking victims about trauma does not cause further harm. Instead, addressing their emotional distress is the first step on the road to recovery. Additionally, childhood traumatic experiences are greatly associated with poorer health outcomes, increased risky behavior, and chronic diseases in adulthood. Thus, it is important to encourage open communication about trauma and implement appropriate interventions to prevent lifelong consequences.

Although the media’s coverage on ADHD medication overuse raises concerns, the lack of attention to the potential mis-diagnosis and subsequent mis-medication of children with PTSD bears consequences too serious to disregard. As Steven Sharfstein, President of the APA said, “Trauma is to mental health as smoking is to cancer.” Perhaps the media should shift their focus on shunning medication use for ADHD, to advocating for improved ADHD and PTSD diagnostic criteria in children.

The Eyes Are the Window to Your Soul (sayeth Shakespeare)

I heard Margot Starbuck, author and speaker, say something last week at the UrbanPromise International summit that really resonated: “What we are saying to kids is, ‘I know who you really are.’ I see you I hear you I care for you. No matter what the outside looks like.” No matter what foolish choice you made, I thought. No matter what barriers you erect to protect yourself. I wrote down this quote in my notes and followed it with…”and you know they have heard you and felt your love when they allow you to look deeply into their eyes.”

It made me think of my most recent experience of teaching developmental skills to the sophomores at UrbanPromise Academy. Of how the first week I was the stranger and the walls were up; trying to get a meaningful answer was like pulling teeth. But gradually as the weeks have passed there has been a growing acceptance and even appreciation of the class and of me. They are letting me in as they learn that I am trustworthy, and honoring me by sharing their stories.

And further back thoughts of April, a young woman whose mother abandoned her at birth. When I met her almost 3 years ago now she told me straight up that she would never love or trust a woman in her life. It took two years of persistence – of staying calm through troubling news, of showing up consistently, and of spoiling her a few times on outings! Now she calls me ‘Mom’ and wants me to walk her through the college application process. Her 3.2 average in school shows her self-respect, as does the way she carries herself.

The little ones let you in quickly. I was the mystery reader in Kindergarten on Thursday and most of the class let me look deep into their eyes. Then there are the 5th graders in cooking class – an even-keeled bunch with only minor guarding. By middle school and especially high school though, meaningful looks that reveal vulnerability are hard-won – and deeply satisfying when they arrive.

My last note from Margot’s talk is, “And there’s not one thing I want to change about you.” Because God created you to be exactly who you are. How powerful would it be if every child – every person – knew that deep down? That’s some serious healing. Perhaps that’s the essence of being well.

To Be Angry for Love…

I had a crash course in homelessness and shelter-seeking recently. A family with whom I have been involved for about 3 years now became homeless September 1 because of the complicated world of section 8 housing. This led to a frantic scurry of putting most belongings into storage then crashing at a friend’s home. But you know the adage about guests and fish…they both go bad in 3 days…having 4 stressed guests in a small apartment already holding 4 others didn’t end up well. By the end of September, having lived at another friend’s home for a few days, our family was out on the street, and out of options.

I figured this out when I got a text at 3:45am: “Ms Becky, do you think I could take a shower at the Peace House? It’s been a few days since I had one and I smell. I am embarrassed to go to school.” A younger sibling had received “a bird bath” in the bathroom at Wawa, but that wouldn’t do for the older kids. Quickly at UrbanPromise we formed a small care team, and our students took showers and we fed them breakfast, then I started calling shelters. “I’m sorry, we’re full.” “They don’t fit our criteria.” “They would need background checks and that takes 3 days.” “We are full.” “We are full.” “Sorry, we are full.”!! We tried to pull strings, calling the head of Volunteers of America. Could they find space? We were told to send Mom to downtown Camden, where we were promised she would be given a motel room if all the shelters were full.

One minor detail that was forgotten – she works – so she didn’t qualify for help!! Even though she only has 2 part-time jobs right now, had just enough money for food and the down payment she would need for a new home. That’s when I got angry for love (a favorite John Philip Newell quote of mine) – something I can feel again burning in my chest as I type this. Why don’t I read about all the shelters being full in the news? Why does someone get penalized because they work? How many families are out there like this that don’t have a place like UrbanPromise helping them? This was crazy.

We let them stay for a few days in the Peace House. That’s not what it’s meant for, and we were lucky that we are currently low on professional interns and happened to have the room. I finally found a church that provides shelter from 7p-7a in a near by town – although one county over, so there was concern about crossing the county line. And the new section 8 house was supposed to be available on October 17…but a call last week pushed it back to this weekend.

There is so much going on beneath the radar of those of us who live in stable conditions. My stress level was off the wall, and I have a roof over my head, full belly…and I don’t smell because I have ready access to my daily shower. Imagine functioning well in society without all that. What a challenge.

Resilience Trumps ACEs

This past week has been marked by some seriously sad stories coming from our teen employees, the StreetLeaders. I’ve been giving them brief physicals for work; of course all their blood pressures are ok, their hearts are regular and their lungs are clear. But that doesn’t tell you much about their health. At least not long term health. I made sure to ask them about their sleep and stress levels too – along with coping mechanisms – and out poured stories of parents with terminal illnesses, of sisters being abused and of not enough food at the house. Those were the stories that some were willing to share. I could see that others were holding back.

This is consistent with the blog I wrote last week, citing the results of the ACEs plus (Adverse Childhood Experiences) survey I gave to 92 teens, thanks to grant support from The Horizon Foundation for New Jersey (@HorizonBCBSNJ), which showed that 60% of our youth 14 and up have already lost a loved one to accident or illness. That 49% have a family member who has been incarcerated…leading to even more profound poverty at home. The numbers are numbing – some of our youth are numb, too – a common response to trauma.

So what does one do about this? Certainly if a youth is in imminent danger we call the child protection services. But so many of our youth live in a gray zone – those services may already be initiated, but the child isn’t removed from the home, and hunger from food insecurity doesn’t warrant an emergency response from our government agencies. Looking at the research available on how to help youth with high ACEs, there is no one answer. There is a knowledge gap here – ask the questions, then what? But that doesn’t mean that their aren’t answers. And one of the strongest is to promote RESILIENCE in our youth.

Resilience: the ability to get through adversity intact. I want more than intact. I want healthy and whole and empowered. I want successful and wise and self-assured. Much of the funding from our Horizon grant has gone toward developing curriculum specifically designed to help our UrbanPromise staff promote resilience. Working with a curriculum design expert out of Chicago, we developed an evidence-based approach to resilience made up of 3 parts: what resilience at UrbanPromise looks like, emotional intelligence and the ability to have tough conversations.

My vision is to see all of UrbanPromise – our schools, our after school programs, our teen employment programs, UrbanTrekkers and Boatworks – everyone – on the same page with regard to our approach to traumatized youth. So that we are even more of a healing environment, a place where it is safe to tell your story and where you can trust you will get the help you need. It’s building on the relational foundation already so present at this special ministry in Camden.

Training has started in multiple departments and so far so good – we are hearing things like, “This is going to be a game changer.” And, “I never really understood resilience before but now I get why it’s so important.” We expect to be completed by the end of November…and our youth will be reaping the benefits, I believe, with every important discussion stemming from this training.resilience at up.jpeg

The UrbanPromise Resilience Model

By The Numbers – UrbanPromise ACEs

How did you spend your summer? The perennial fall question asked of students and teachers alike. I spent part of my summer gathering data from our youth by asking the Adverse Childhood Experiences (ACEs) questions, thanks to a grant I received from The Horizon Foundation for New Jersey (@HorizonBCBSNJ). This past spring I created what I refer to as the ACEs Plus survey – which included the original 10 ACEs questions (www.acestudy.org) plus additional questions derived from ongoing research about urban ACEs. I began collecting this information this past spring and exceeded my goal of surveying 90 students this summer.The original 10 ACEs include 5 questions about personal trauma (abuse and neglect) and 5 about household dysfunction (witnessing violence in the home, depression, substance abuse, incarceration). Urban ACEs look at racism, witnessing violence outside the home, neighborhoods feeling unsafe, foster care and bullying. Heavy stuff.

ACEs are important to recognize because they strongly correlate with the likelihood of both physical illness (heart disease, lung disease, cancer) and mental illness (depression, mood disorders, difficulty maintaining a job or home) through adulthood. Indeed, a person who scores 6 or more on the original 10 questions is likely to die 20 years earlier than someone without a history of childhood trauma. Trauma is difficult, sometimes impossible, to talk about – and yet talking is key. With the original ACEs study, completed in 1998 on mostly white, middle class participants, it was recognized that just being asked the questions – and having the yes answers affirmed – was healing. Physician office visits went down by 35% when patients were regularly asked these questions as a part of initial history gathering.

So I asked our youth all these questions, and I was stunned this summer when I did the numbers:

  • 60% of the youth I surveyed (92 of them between 14-19 years old) had already lost of loved one to accident or illness.
  • 45% didn’t feel loved at home
  • 49% had a family member who has been incarcerated
  • 40% live with someone who abuses a substance
  • 64% have experienced racism

And these are just the biggest numbers. 52% of our youth have ACE scores > 3; 30% > 4 meaning the likelihood of depression increases 460 percent over their lifetime! (http://acestoohigh.com/got-your-ace-score)

High ACEs scores are not destiny – it is important to realize that. But they do put people at high risk – and our youth at UrbanPromise are definitely in the high risk category. Fortunately there is also research being done on what to do about all this – one remedy being: to have a close relationship with a trustworthy adult, something at which UrbanPromise excels. My next blog will discuss what else we are doing, thanks again to funding from the Horizon Foundation.

Our 8th grade graduation class of 2014

Jobs. Camden Needs Jobs.

“If drugs are legalized then even more people in Camden won’t have jobs. How will they feed their families? Pay their bills? Poverty will get worse and there will be more crime.” (paraphrased). Whoa. That’s not the answer we expected when 2 medical students and I conversed with StreetLeaders about substance abuse in their community. But they make a valid point. I asked what is the solution and one wise young woman answered, “jobs.” A young man chimed in, “low skilled that you can start working immediately.”

And so it is with interest that I read in the paper this morning about the plant Holtec International is planning to build in Camden, which will bring 3,000 jobs to this city of 77,000. The unemployment rate in 2010 was 20% – one in 5 out of a job. It would be great if more industries were willing to give Camden a chance.

Our StreetLeader program has been able to employ 80 teens this summer – and you should see what that paycheck means to them. It goes to pay for electricity, for Dad’s prescriptions, for food. “I am going to buy my little cousin a new pair of sneakers – her old ones are too tight and have holes.” “My family went to Clementon Park last weekend – thank God I got paid because I could pay admission.”

And what happens to the teens who aren’t employed…and have too much time on their hands? They have too much time to cause trouble on social media, to hang out with the wrong crowd, to make poor choices. And then feel really bad about themselves.

Jobs. Camden needs jobs.

Fruits of Our Labor

It’s starting this week and I’m so excited that I was in the kitchen jumping up and down. Chef Camille, our newest employee who is starting our UrbanChef program, is for now working out of the kitchen at the Peace House, cooking meals for our 48 college-age interns USING HERBS AND VEGGIES FROM OUR GARDEN. This evening, when she serves the first meal (Australian lamb and potatoes with rosemary, thyme and basil – all donated), she is going to speak of our bountiful produce and extend the invitation to spend time in the garden.

It’s becoming a healing place – this morning when I arrived one of our staff was there, watering, “because I woke up feeling grouchy and thought I should be here for awhile”. I have found others too – walking, or sitting and taking it in.

So enjoy these pictures, and kudos to Nadia VanderKuip, who by far can take the most credit for all of this.

Transformation and Grace

One week she came in angry at everyone and everything. Face in a scowl. No acknowledgement in the hallway. Sick of her teachers, sick of counseling, sick of life. It was a little frightening, the lack of hope so evident at only age 17 – what 17 year old doesn’t feel hope? But hers had vanished, thanks to chronic stress at home and poor choices she had made. I felt compelled to ask my suicide screening questions – thankfully she said no – and I felt the grip of anxiety when her name would come up on my phone with a text, waiting for this self destruct mode to escalate further. I’ve worked pretty closely with her for 2 years now…at times I’ll admit I think, “for what?”

Wednesday afternoons our UrbanPromise leadership team meets to have devotions, touch base and seek input from each other. Recent discussions have centered around core values…and I have really appreciated insights I’ve gained as a result. One is that as a Christian organization we believe that transformation is always possible. Think about that – do you believe that people and situations always, always have the potential to change? More than change, I guess…transform into something new?

Another is that grace abounds. People are given second chances. and third. and fourth and fifth and sixth. Not that there aren’t expectations of behavior and performance, and not that sometimes people don’t need to step away for awhile. But when someone shows readiness to try again – to commit to a different path, to rejoin the community, grace is extended. At least, that is the desire that we try to live up to.

This past week she came in with hope. Something rather final at home – a last straw – had occurred, and instead of fueling hopelessness and self destruction, a new determination sprouted, much like all the seedlings in our garden. “I need to succeed. I need to face my demons. I look forward to a fresh start in school this fall, so that I am not always playing catch up.” Her voice was calm and strong, her eyes were clear and looked straight into mine. Which of course made mine a little watery! I hugged her, praised her and recommitted to walking by her side.