Guest Post: All About Psycho-Social Rehabilitation (PSR)!

Hello from the Potato State! My name is Stacey and I am co-runner of a little Idaho blog called: A PSR Gathering. I am here today to give a little insight on what we do!

In Idaho we have an awesome service offered to children and adults called PSR or Psycho-Social Rehabilitation. PSR is not available to everyone (it is a Medicaid only service and not in every state) which examples the blank stares I often get when I tell people what I do. Katie and I work with children (ages 4-19 is the general range of clients) but, adult services are available! Clients who qualify for PSR have been diagnosed with a Serious Emotional Disturbance (SED) for children, or a Severe and Persistent Mental Disorder (SPMD) for adults. I am going to keep this simple and sweet for you today, if you have a questions feel free to ask!

Who?

Have a Bachelors degree (in Social Services, Early Childhood Education, Sociology, Social Work, Psychology, and the like)? You can do PSR! You will have to gain a USPRA certification though, if you wish to work in the state of Idaho. Some states even require a master’s degree.

About us:

Katie (on the left): I graduated with a BAS in Child Care and Development from Boise State University in 2009. I have lived in Boise the majority of my life, am married with two dogs and with what spare time I can find love to travel, run, camp and read.  I have worked with kids for about 15 years in many different ways, from camp counselor to tutor to Pre-school teacher! I have been working as a PSR Specialist for about two and a half years now, and am just feeling like I’m getting the hang of it!

Stacey (on the right): I graduated from Boise State University in 2010, with my B.F.A in Drawing and studies in Psychology and Art Therapy. My family moved us to Boise when I was 10 and we have been here ever since. I just bought a house a street over from my childhood home and live there with my boyfriend of many years and our bully breed pup, Penny. I have too many interests to list but the tops are: creating, motorcycles, bargain hunting and kicking back! I have always had a passion for helping others, which has given me the opportunity to work in an array of jobs.  From working with animals, to slinging coffee or advising college students… I’ve done it all! I have been a PSR specialist for going on two years and can’t wait to see where it takes me.

What do we do as PSR workers?

PSR is individual skill based training, such as anger management, social skills emotions recognition, etc.

When do we work?

Each client qualifies for about 4-5 hours per week. We work in the community so our hours are outside of school hours–afternoons, night and weekends. As you can imagine we love summer for its flexibility!

So…an office? School?…where do you work?

PSR is a community-based position, no office (unless your car counts–I haven’t used my trunk for purposes other than hauling around ‘PSR’ tools for 2 years now-ha!). We work in the homes or take them out into the community to work. Libraries, malls, Barnes and Noble, coffee shops, parks–you get the idea.

Why?

Our goal(s) in PSR are simple. When a client comes into PSR a treatment plan is designed that consists of measurable and behaviorally specific objectives. PSR is there to build skills to better communicate, interact within society, build relationships, handle situations and overall be the best kiddos they can be!

How?

We do an array of activities with clients (based on age, understanding and needs). Being out in the community and in the homes, we get a good glimpse on what our clients are like when their ‘guard’ is down, which lends to a lot of  ‘real life training.’ We also get to be silly kids our selves by using play and art to teach our clients new skills! Check http://www.psrideaweb.com/for awesome activity ideas!

Another Step In “All Tied Up with Worry”

If you have read my blog, you know I love sharing great therapeutic activities. I have already posted one of my favorites, which is using yarn to learn more about a person’s worries (see original post below). I added another step during a family therapy session that provided a strong visual impact and gave them an option to continue this technique at home.

• I found face shapes of varying shades at a craft store and asked the client to choose a face that will represent them.

• Instead of cutting paper squares to label the yarn, I used address labels since they are also stickers.
• I then asked the client to stick each worry in the “brain” of their face shape. Once this was done, we talked about how worries can fill up their head and make it hard to think of other things, such as school work.

• We then took each worry out of their “brain” and talked about various solutions and ways to deal with the worries. If the client chose, they could cut the worry down to make it shorter to indicate they felt a little better about the worry.

Since we used address labels to stick on the face shape, I demonstrated removing some of the worries. I emphasized the importance of talking about our problems and applying any stress reduction techniques we have reviewed in our sessions together. For this particular client, we referred to the relaxation flip books completed in a prior session.

• The client took home their project and some blank labels so they can remove worries, or add worries. This was helpful for the mother to understand more about her child’s worries and removing or cutting a worry down also felt really good for the client!

Mom actually told me the whole family is on board in discussing their worries and the size of their worries with one another. This dialog has already improved the family’s communication and given the child permission to share their feelings with the parents. I was very excited to hear this!

Therapy is always full of opportunities for creativity. If you find another twist to this activity, or any others, please feel free to share!

Original Post On 4/16/12: 

Therapeutic Activity: All Tied Up With Worry

This is a great activity for helping someone to visualize their worries and gives great insight into what they may be worrying about the most. You can do this for yourself, your children, or professionals can use this on their clients. Great for all ages!!

The pictures below are from an actual client and I’ll discuss a little more about what I found.

What you will need: yarn, small squares of paper, and something to write with.

Next, talk about something the person worries about and pull out a string of yarn that represents how big the worry feels. Write the worry down on a piece of paper. Be sure to attach the worry to the string of yarn so you can keep track of which wory goes with which string of yarn.

Once all the worries have been mentioned and the yarn pulled, you can evaluate what you see. In my experience with this activity, I have found that some people have A LOT of worries. Others only have a few worries, but they may be really big. This also puts into perspective what worries are bigger than others. It’s a wonderful tool for gathering AND processing information!

This isn’t the greatest photo, but you can get the idea. There are three worries pictured, ranging in length from small to very long. The smallest worry is “worrying about mom not being able to support me” and the longest worry is getting in trouble for things he didn’t do. This is a school age child who had been getting into trouble so much lately that he was the first one pointed at when something went missing or a fight broke out in class. He was given an opportunity to talk about this issue and how he feels about getting in trouble so much.

This particular child did not have many worries, but some do. For those who have a lot of worries, we have balled up the yarn and talked about how all these worries in their head feel. Another option is to string the worries up into a web. I did this with a child around Halloween and he had a lot of fun, and actually added in some of those plastic spiders!

Many times the topics we are talking about can be emotionally heavy so adding in some fun and light-heartedness can help the person through the activity without leaving them feeling weighed down!

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Commitment, Success, Then JOY

A Lesson From One Child’s Triumph Over Anxiety

“Joy Is the Feeling of Grinning Inside”

This quote by Melba Colgrove is a good description of how I felt today when I took note of a client’s success in therapy. Of all the topics I have to discuss, I felt it most appropriate to share a success story with you. What I hope you take from this example, is that success does come! Those who find success in the journey to self-improvement, whether they are children, teens, or adults, endure many challenges and sometimes harsh moments of self-reflection, to reach that place of “grinning inside.”

Therapy is not much different than committing to an exercise routine. In fact, they are very much the same as each are forms of self-improvement- one of the body and the other of the mind. Each require you to make a decision, a commitment for change and self-improvement. Each are more successful with the guidance from a professional. And each have both painful, challenging moments, as well as personally revealing and rewarding moments.

Joy in Her New Confidence

My success story today is about a young client. I will call her Shelly for the purpose of this post. Shelly is an elementary age child who came to me to address her severe anxiety, which was coupled with a very low self-esteem and poor self-confidence. Shelly had difficulty in her school and other activities because she would become so emotional and anxious over the tasks presented to her. In Shelly’s therapy sessions, I allowed her to direct her play and make the decisions about what she called the toys and how she played with them. In other words, I gave Shelly a safe environment to test herself and encouraged her to develop confidence in her capabilities. At first, this was so difficult for her. She wanted me to identify every toy and tell her where to go and became visibly upset when I encouraged her to decide. Shelly would also attempt puzzles and other mastery type toys, only to give up and express defeat when they became a challenge to her.

Fast forward about 9 months. In recent sessions, Shelly has come into the playroom with eagerness and excitement. She looks around the room and makes a quick decision on what she wants to play with or complete. Sometimes, she chooses more mastery toys and makes sure I watch her as she attempts the challenge over and over again until she is satisfied. Other times, she will choose an art activity in which she will decide what to paint and what colors to use (yes, she sought my approval on her colors at first!). Shelly will also choose to play with dolls or house items, such as the kitchen. I am no longer needed to name the items for her, as she will confidently tell me she is serving cake and pizza! This new self-confidence has also revealed her excellent ability to problem solve. I was so excited to observe her solve several of her own “problems” today during play by coming up with unique solutions and actively seeking items in the room that may help her with her dilemma. When she needed my help, she would appropriately ask for it. What a treat to witness!

So, if you are in therapy, have a child in therapy, or are a professional, you know that feeling like nothing you do makes a difference or that progress is moving so very slow. I’m here to remind you today that success can be possible. Please join me in this joyous feeling today as we now all know of one little girl will enjoy a fuller and healthier life!

LIFE IS…
by Mother Theresa

Life is an opportunity, benefit from it.

Life is beauty, admire it.

Life is a dream, realize it.

Life is a challenge, meet it.

Life is a duty, complete it.

Life is a game, play it.

Life is a promise, fulfill it.

Life is sorrow, overcome it.

Life is a song, sing it.

Life is a struggle, accept it.

Life is a tragedy, confront it.

Life is an adventure, dare it.

Life is luck, make it.

Life is too precious, do not destroy it.

Life is life, fight for it.

For more inspirational poems or quotes, check out Affirmations-for-Success.com and athorsden.com.

For more information on counseling services, click here.

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Therapeutic Activity: All Tied Up with Worry

This is a great activity for helping someone to visualize their worries and gives great insight into what they may be worrying about the most. You can do this for yourself, your children, or professionals can use this on their clients. Great for all ages!!

The pictures below are from an actual client and I’ll discuss a little more about what I found.

What you will need: yarn, small squares of paper, and something to write with.

 

Next, talk about something the person worries about and pull out a string of yarn that represents how big the worry feels. Write the worry down on a piece of paper. Be sure to attach the worry to the string of yarn so you can keep track of which wory goes with which string of yarn.

Once all the worries have been mentioned and the yarn pulled, you can evaluate what you see. In my experience with this activity, I have found that some people have A LOT of worries. Others only have a few worries, but they may be really big. This also puts into perspective what worries are bigger than others. It’s a wonderful tool for gathering AND processing information!

This isn’t the greatest photo, but you can get the idea. There are three worries pictured, ranging in length from small to very long.  The smallest worry is “worrying about mom not being able to support me” and the longest worry is getting in trouble for things he didn’t do. This is a school age child who had been getting into trouble so much lately that he was the first one pointed at when something went missing or a fight broke out in class. He was given an opportunity to talk about this issue and how he feels about getting in trouble so much.

This particular child did not have many worries, but some do. For those who have a lot of worries, we have balled up the yarn and talked about how all these worries in their head feel. Another option is to string the worries up into a web. I did this with a child around Halloween and he had a lot of fun, and actually added in some of those plastic spiders!

Many times the topics we are talking about can be emotionally heavy so adding in some fun and light-heartedness can help the person through the activity without leaving them feeling weighed down!

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A Therapist’s Tote of Techniques: Deep Breathing!

When I mentioned I was going to be sharing my “best therapeutic techniques,” I imagine some of you were surprised when I said deep breathing would be first on my list to share. This should tell you how important it is to know good breathing technique and how often it is used in treating all kinds of symptoms- anxiety, anger, nervousness, worry, and so on. (By the way, this image is meant to get you in the mood to relax!)

I’ll also share some fun ways to teach kids about deep breathing exercises!

5 Reasons to Practice Deep Breathing

1. It’s FREE! There is no cost for you to learn or apply this technique and it is an excellent tool for stress and anger management.
2. It tricks your body into thinking it is in a calm state (as opposed to the fight or flight state).When we are in a state of stress, our bodies are in a “fight or flight” response, meaning it is reacting as if there is a threat present and we either need to stay and fight the threat or run away. When our bodies are in this state, our heart rate rises and our breathing becomes rapid and shallow.
3. Deep Breathing gives you energy! The act of breathing deeply helps to deliver nutrient rich oxygen throughout your body.
4. This delivery of oxygen also helps to eliminate waist in the body an help maintain healthy cells.
5. It’s a useful technique to have ready when the time comes. Practice now so when you are feeling angry, anxious, etc., you will be prepared to use it!

When To Use Deep Breathing

• If you are nervous about an important meeting, public speaking engagement, or personal situation you are about to face.
• When you feel angry. You may notice your heart beating faster, face getting hot, and an urge to react to the source of your anger.
• If you are feeling an urge to do something you don’t want to do.
• Anytime you feel the need to relax and de-stress.

Teaching about deep breathing proved to be difficult without a visual aid. Unfortunately, I could not find one that I was comfortable adding to my blog. So… for your entertainment, I made a short video of my own to teach you proper deep breathing technique (no laughing!).

VIEW MY TUTORIAL VIDEO HERE FOR PROPER BREATHING TECHNIQUE! 

Deep Breathing (Diaphragmatic Breathing)

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NOW, FUN WAYS TO TEACH THE KIDS!

I have found that teaching kids about deep breathing is similar to teaching them other things… you have to trick them into thinking they are not learning or practicing something important! Here are some fun activities to help your kids learn about deep breathing. Once they learn the skill, teach them how and when to apply deep breathing.

 

Blowing a Pinwheel

Such a simple, yet fun toy! Who doesn’t love to watch the pinwheel colors mix together as it spins?

1. Have your child take a deep breath (remind them slow and deep)
2. Hold their breath for 2 seconds
3. Release their breath by blowing the pinwheel
4. Repeat 2 more times

Candle and Flower

1. Gather together a candle (you can light it if you feel your child is old enough) and a flower
2. Starting with the flower, have your child take a deep breath (remind them slow and deep) through their nose as if they are smelling the flower
3. When they are breathing in the flower, have them pretend they are breathing in good, calm feelings
4. Hold their breath for 2 seconds
5. Release their breath by slowly blowing out the candle, pretending that they are breathing out the angry, yucky feelings
6. Repeat 2 more times

References: www.webmd.com www.kidsrelaxation.com http://www.stress-and-relaxation.com/deep-breathing.html

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