(this list from very well mind)
Very Well Mind-Reactive Attachment Disorder
My Experiences Working with Children with Reactive Attachment Disorder
Information for people thinking about working for CALO
By Dawn Kohler
I worked at CALO preteens in Lake of the Ozarks, a center for children with Reactive Attachment Disorder (RAD), for a few months in the fall of 2018. At this point in my life I had volunteered as an A+ tutor in the elementary schools in my district when I was in high school. I also had a year of experience working with adults with disabilities. When I read the job posting for CALO preteens, I was so excited this sounded like just the job for me. This would be a way to combine my experience and education as well as allow me to move to Eldon, Missouri with my boyfriend.
At CALO they had a week long paid training period before we even got to start working with the children. During training, I learned that Attachment disorders like RAD were generally caused by lack of care for children and babies, who were often ignored when they cried or left to sit in soiled diapers, and or not given enough food. However, some children who are adopted at birth to loving families can also develop RAD. For these babies, mom swayed different than their birth mom did when they were in utero, and sounded different. Also, during training, we learned to do a large number of restraints, or assists as they called them. The most severe of which involved two or three people physically pinning the child to the floor as the child struggled and tried to hurt staff. Of course, we learned these by practicing on our fellow trainees who were no where near as violent or squirmy as the kids we would work with.
At that facility we had children from age 8 all the way up to 18 years old. I had been hired to work with the preteens. These kids ranged from 8-14 years old. Most of our children were adopted from orphanages. Some of these kids even came from Russian orphanages where they got very little human contact. In the preteen housing CALO had team houses or dormitories with locking doors for everything but the fire escapes (which the kids eloped out of constantly). Two dorms were for girls and two for boys broken into separate buildings. There were 8-12 kids per dorm when I worked there. The kids in these teams ate, lived, and went to school together at the facility. There were two staff working in each team during the day and just one staff working in each dorm at night.
The other staff and I preformed assists or restraints daily as one of the children in our room was always struggling. One of the kids told me that she only trusts staff after she knows they can assist her properly in order to keep her safe. These restraints were really hard to preform as many of them lasted hours and I have bad carpool tunnel and wear wrist braces for support. My hands would often be numb when I got out of an assist that lasted over fifteen minutes. I often had to tap out, because of my hands. I also had issues with students trying to break my glasses during assists.
When students showed signs of harming themselves, others, or running from the facility or not following their therapy, they were put on a safety closeness and made to wear a brightly colored shirt with the CALO logo. These students were always supposed to stay in arms reach of staff. It was common place for staff to have to chase down students who were eloping from the building and even the property.
When we started at CALO we were issued Radios and Uniforms that we had to pay for out of our paychecks. One of the students’ go to moves is to break staff’s radios or put them in inappropriate places such as down their pants if they got a hold of them. This was mostly done for them to get extra attention, or in frustration for staff being strict. When a student broke or took my radio it really distressed me. Not only because I would have to spend $50 to replace it if it broke, but they were taking away my access to help if something went wrong, such as if I had to assist someone or if a student ran.
My typical second shift day involved going to school with my team of girls at the preteen school. I really respect the amazing teachers who help to teach these kids. Then we would go back to the upstairs part of the team home, eat dinner and play cards and talk, before going downstairs, the girls would start their bedtime hygiene and showers and get ready for bed. That meant moving any kids on Run risk, Harm to self or harm to other’s beds to the living room area so that night staff could watch them easier.
One girl who was about twelve and kind of heavy, was on all four safety closenesses. She would try to run from the building a couple times a day, and would often wait until one staff left the room to run in order to delay staff from coming after her as the other kids couldn’t be left alone. The worst chase I had while working with CALO was with this girl in October of 2018. She ran out the fire exit she was barefoot, as she was not allowed to wear shoes while on run risk. I yelled to my other staff to watch the other girls, and radio help for me, and ran out the fire escape after her. Both preteen buildings had a large back yard surrounded by a picket fence. Earlier that week one of the kids had broken a board in the corner of the yard so there was a big enough gap for a person to fit through. While I was chasing the girl, she kept looking back at me taunting me on to chase her. I knew she was mainly doing this to get the attention but I had to get her back to the building safely. I was about twelve feet behind her when she sat on the cross bar of the fence and looked back at me before sliding through. Out of breath I yelled at her to stop and we could go back inside and talk about what was going on. She slipped through the fence as I got closer and ran a few feet away and stopped as she watched me climb through the hole. As I approached, she took off running again. She didn’t stop until she got to the edge of the property that bordered the lake of the Ozarks. She looked back at me again I told her to stop and wait we could talk. She jumped in and stopped. The water was about two feet deep at that spot. This gave me time to radio that she was going into the water, take off my shoes, phone, keys, and radio, before jumping in after her. At this point I felt absolutely alone and solely responsible for this child’s well being if she would happen to get hurt or drown. I know how to swim. I took swim lessons when I was little, and am pretty good at treading water and swimming, however I don’t have life guard training and had never done a water rescue before.
Again, the girl went forward so far ahead of me then stopped. Eventually she got even with the edge of the dock where the water dropped off and realized she couldn’t touch the bottom and didn’t know how to swim. As she struggled, I swam using a breast stroke and reached her. She immediately grabbed me and wrapped her body around me, which made it very hard for me to swim. At this point the trained lifeguards from the teen building finally arrived. They through us life jackets which I was unable to reach. I was severely out of breath from the run and the swim, and freezing cold from the October lake water. I eventually made it to the dock and handed the frighten and freezing child to the lifeguards before being helped out of the water myself. I felt bad that the life guard did end up having to get wet as well to get the life jackets.
They wrapped us in towels and took us up to the main building to get dry clothes and to get looked at by the nursing staff. My adrenaline was so high that I didn’t even realize I had cut the bottom of my foot on the lake bed until I noticed I had bloody foot prints, suddenly being out of breath and my sore foot was all I could think about. There were leaves and debris from the lake bed stuck in the cut. I cleaned it the best I could and figured I would clean it better when I got home that night, I needed to get us back to the other girls and my other staff.
Once we got back to the team house all the other kids wanted to know what had happened. Most were concerned that my foot was hurt. I sat on a chair in the living area and took my shoe back off because my foot really hurt. I had the girl sit close to me; she was still coming down from her adrenaline rush as well. She asked to go to the bathroom which was on the same hallway as the fire escape. I asked the other staff to take her as I needed a minute to regain my strength and composure after my swim. The other staff was newer and didn’t realize with this girl it was always best to position yourself between that child and the fire escape door. Instead of going to the bathroom the girl ran right back out the door. I said I word I generally don’t use around the children as the other staff just stood there. I pulled my shoe on yelled at the other staff to radio and ran back out the door. This time the girl ran into the front, down the driveway and into the tree line by the entrance. It wasn’t until I was chasing her that I realized I had forgotten my radio on the couch in the team home. We were both still very out of breath from our earlier run and swim. She consistently stayed just out of arms reach. When I finally got a hold of her I had no strength left to restrain her I grabbed a hold of her shirt. And together we walked to the driveway. She was struggling against me and punched me. I shouldn’t have said, I didn’t mean it, but in the moment, I said, “You Bitch!”
I had absolutely no strength or energy left to restrain this girl. I noticed that there were people outside down the driveway at the preteen boys building. I yelled for help and one of the more experienced staff helped me restrain the girl and get her back to the building.
Later that night at bedtime as I was talking to the girl about her therapy she started crying and asked “You don’t really think I am a bitch? Do you?” At this moment she was back to the sweet child that she is 80% of the time. I gave her a hug and explained that no I didn’t think she was a Bitch, and that I had said that out of frustration and exhaustion in the moment. I knew she was struggling and I did not mean to say that. After this experience I had a really good friendship with this girl and was one of her favorite staff for the rest of my time at CALO. I often wonder how she is doing.
During my last day at CALO I had my glasses broken for the second time since working there (thankfully CALO pays to replace them) and was punched in the nose and got a bloody nose from it. This was done by another girl who I had struggled to for a working relationship with since I had started there months earlier. I reminded this girl of an old staff who treated her badly so she decided that I was a terrible staff and was determined to hate me. When she found out I had put my notice in the day before she was thrilled that she had driven me away. When really, I was just tired of working in such a dangerous environment and being assaulted almost every day. I was very sad to be leaving some of these kids as I felt that I was finally in a place where I was helping some of them. I decided to leave that day after being given a bloody nose after being punched in the face. My boyfriend and the rest of my family had been encouraging me to leave for months and I couldn’t take being hurt anymore.
My time working at CALO really affected me. I have had anxiety and depression since high school, but the level of anxiety that I experienced during and after my time working at CALO doesn’t even compare to my previous experiences with anxiety. While I was working at CALO and for about three months afterwards I had symptoms of PTSD. I was very uncomfortable having anyone behind me, even in my own house. My first reaction to any type of physical touch was defensive. One time I was standing at the sink doing dishes and my boyfriend, Joe, came up behind me and hugged me from behind as he has done a million times. This triggered me badly and I almost elbowed him hard, but stopped myself just in time. I burst into tears and told him what I almost did. I was worried that he would leave me. That was the first time he had seen the extent of my anxiety. I was terrified that he would think “she is crazy and so not worth this.” Joe is an incredibly understanding man, and he has stood by me through the worst of my PTSD and anxiety and depression. He has even opened up to me about his own struggles with OCD. If you would like to learn a little about it you can read his story Worry, Check, Double Check, Triple Check, and Don’t Let Anyone See.
Though it has almost been a year since I left CALO, I still occasionally struggle with lingering issues from my PTSD. I have gone through talk therapy and am on anxiety medication; however, if I see a child who looks similar to one of my CALO students I still occasionally have flashbacks or nightmares about being assaulted at CALO.
My purpose in writing this article is not to vilify CALO, which is an organization that does amazing things for the kids with attachment disorders that are in treatment there. In fact, this facility is often a last resort for parents and keeps those kids from being arrested for their behaviors. I deeply respect the individuals that have been working there for years and the new hires who are able to stay on. It just wasn’t a job for me as those kids really triggered me. If you are thinking about working at CALO and still want to after reading this article I wish you luck and thank you for what you are doing for those kids. Remember self-care is very important. Have someone you can talk to, without breaking HIPPA of course. Don’t take every extra shift you are asked to take, because you will get burnt out. Sixteen-hour days are not good for anyone. I did four in a row once. Good luck and have fun.