Social Services: Beat Burnout

Mental health “workers” are chronically overworked, underpaid, and not appreciated. “Workers,” given a variety of job titles, are the day-to-day staff who work in group homes and residential treatment facilities, and provide some in-home services. Unlike licensed clinicians and supervisors they’re in the trenches with us and our kids. They’re often just as exhausted as we are.

A few summers ago Natasha was one of our Intensive In-Home services workers. She was absolutely wonderful and dedicated to our success. She was on call 24-7 and when Devon flew into a rage she would hurry over, once rolling straight out of bed in her pajamas. “You go on and do your stuff,” she would say waving me away. “I’ll take care of him.” Natasha knew how much control Devon had over our family during his rages. It was debilitating, keeping me from my job and Devon’s siblings from soccer practice. Natasha was determined to put a stop to it. Day-after-day she spent hours shut in the garage or a back room with Devon while he screamed and raged.

While this respite breathed some life back into me, Natasha burnt out before my eyes. She was working 60+ hours a week plus taking paperwork home every night. Her employer was sometimes ‘late’ on her paychecks and she was over loaded with clients. 

It’s a sad truth we must face: even the most well-intentioned worker doesn’t have the capacity to give our child the quality care they otherwise would if they’re burnt out. 

Here are some ways you can counteract mental health worker burn out and make sure you child receives the highest quality of care possible.

Be Kind–Be polite. Often these workers can’t control the things that are upsetting you so it’s unfair to yell at them. Compliment them when you’re impressed with their work, or even just to tell them you like their new haircut. Offer the in-home workers a cool drink and snack. It is these in-the-field, on-the-ground workers that can make a huge difference in the quality of services your child receives so investing kindness is well worth it.

Do Your Research–Carefully research the agencies you receive services from. In most cases, the ones that can “get you in right away” are the ones to steer clear of. A long waiting list, or at least a few weeks wait for an intake appointment, bodes well for the quality of service you can expect. Ask for referrals from your pediatrician. It can be difficult to find people to ask for personal recommendations when you are first starting to get services, but once you’re “in the system” you’ll find yourself sitting in a lot of waiting rooms chatting with other parents. Take advantage of these opportunities to ask about their experience with various agencies even if you aren’t currently looking to switch services.

Demand Quality Service–Your first priority is your child. Don’t accept sub-standard services! When you first start services with any provider they hand you a stack of papers that outline your rights and the policy to file complaints. I used to dump those in the trash as I walked out of the building, but now I know how valuable they are. You need to know what you are entitled to and what procedures to follow if you need to escalate a complaint. If it becomes necessary, switch agencies or providers in order to get better services. Also check for a parent advocate organization in your area. They can refer you to services and will send an representative with you to meetings to advocate on your behalf.

Whenever you can, advocate for better working conditions for mental health workers. Our kids are only going to be safe if workers are qualified, well-trained, and fairly compensated. Not long ago, there was a riot in a psych facility in my area and the workers were blamed for not handling the situation better. I wrote an op-ed suggesting that we’re asking too much of these entry-level, hourly employees and that working conditions must be improved. You can read my full op-ed here: Charlotte Observer/Don’t blame workers for psych center woes

College $$$ for foster care alumni

Sadly, only 3% of foster care alumni will earn a bachelor’s degree compared to 60% of the general population.

Many states now offer full tuition exemption to state and community college for kids who spent anytime in foster care including adopted foster children.

Most states also offer Education and Training Vouchers (ETV). These are federal funds, up to $5,000 per year.

A few notes:

  • Most of these programs have upper age limits. For example, ETV is only available until age 23.
  • Many states offer reciprocity.
  • There are of course many deadlines and details. Please start working on this well ahead of when your child graduates high school

The good news is that every state offers something!

Here’s my list.

State ETV Waivers, Scholarships, Grants
Alabama EVT
Alaska Tuition Waiver!
Arizona EVT Tuition Waiver!
Arkansas EVT
California EVT
Colorado EVT
Connecticut Tuition Waiver!
Delaware EVT
Florida Tuition Waiver!
Georgia EVT
Hawaii EVT
Idaho EVT
Illinois EVT Grant
Indiana EVT Scholarship
Iowa EVT
Kansas EVT Tuition Waiver!
Kentucky EVT Tuition Waiver!
Louisiana EVT
Maine EVT Tuition Waiver!
Maryland EVT Tuition Waiver!
Massachusetts EVT Tuition Waiver!
Michigan EVT Scholarship
Minnesota EVT  
Mississippi Tuition Waiver!
Missouri EVT Tuition Waiver!
Montana EVT  
Nebraska EVT
Nevada EVT
New Hampshire EVT Tuition Waiver!
New Jersey EVT Tuition Waiver!
New Mexico Tuition Waiver!
New York EVT Scholarship
North Carolina EVT Scholarship
North Dakota EVT
Ohio EVT
Oklahoma EVT Tuition Waiver
Oregon EVT Tuition Waiver
Pennsylvania EVT
Rhode Island EVT Grant
South Carolina Grant
South Dakota EVT
Tennessee EVT Grant
Texas EVT Tuition Waiver!
Utah EVT Tuition Waiver!
Vermont EVT  
Virginia EVT Tuition Waiver!
Washington EVT Scholarship
West Virginia EVT Tuition Waiver!
Wisconsin EVT Feb 2018 – WI is considering a bill to offer a Tuition Waiver!
Wyoming EVT

(If you can add to this list, or have any corrections please be sure to let me know.)

Photo by William Stitt on Unsplash

Why I use the word “rage” and not “tantrum” for my child with developmental trauma

What kind of parent calls the police when her kid has a tantrum? Or, even worse, tries to check him into a mental health hospital? Me.

Every time the cops arrived or we got to the hospital, my young son Devon transformed into an angel. I’d explain that he’d been throwing a terrible tantrum. Yet, his serene affect and puppy dog eyes would belie my words. It was hard enough to ask for help but to imagine the eye-rolls behind my back was humiliating. I probably reminded them of the woman who called 911 because McDonald’s had run out of chicken nuggets.

Time and again, I was turned away without the help I so desperately needed because we all know what a “tantrum” looks like—a kid kicking his or her legs, crying and screaming, for maybe 10 or 15 minutes. By calling Devon’s episodes “tantrums” I was unwittingly minimizing what was actually going on and no one was taking me seriously.

These were no tantrums. Devon was:
  • Screaming, spitting in my face, and making himself throw up
  • Ripping his bedroom door off the hinges, and putting holes in walls
  • Punching, kicking, and attacking his brothers and sister
  • Pulling out his eyelashes, and banging his head on the floor

These episodes of extreme behavior were happening several times a week and would often last for hours. I was in over my head and needed help, but because I was using the word, “tantrum,” people thought I was overreacting.

These weren’t “tantrums,” they were “rages.”

When I began to use the correct terminology to describe Devon’s behavior, health care and mental health professionals, even police officers, were more receptive. “Rage” was a magic word that made people pause, listen to my story, and try to help. Instead of brushing me off, they called in psychiatrists and social workers. They made referrals for local services. They stopped treating me like I was just a high-strung mother.

If your child’s behaviors are extreme, way beyond being a tantrum, your child may be having rages too. “Kids with developmental trauma can tantrum but they can also rage,” said Institute for Attachment and Child Development Executive Director Forrest Lien. “A child has a tantrum to attempt to get his way but it is contained. A rage is out of control and stems from the child’s fear and anger. It’s irrational and almost dissociative.” It can be difficult to tell the difference between a rage and a tantrum, especially when your child’s episodes have increased in severity and length gradually over time.

Here are some distinguishing hallmarks of a rage:
  • Rages are explosive

  • Rages feel scary and out of control

  • Rages last longer than a few minutes

  • Rages become physically violent and aggressive

  • Rages may include acts of self-harm

  • Rages often end in destruction of property or harm to others

These behaviors are not normal for a child of any age. If children acts out in these extreme ways, they need real help. Parents need help, too.

So, how does a parent get help? How do they get someone to understand the seriousness of the situation? They need to adequately describe and use the word “rage” when talking to therapists, pediatricians, and other professionals. The word “tantrum” paints a picture that is nothing like the extreme episodes the child experiences. When they start with, “My child has rages…” and then describe specifically what the episodes look like, how long they last, and how frequently they occur, people seem to listen more closely.

“Rage” is a word that works.

Has this worked for you? Are there other words that “work” you can share?

Published by:

Williams, Keri. “Home.” Institute For Attachment and Child Development, IACD, 14 Mar. 2018,

Life, Animated: A Story of Sidekicks, Heroes, and Autism

An inspiring story of a family who used Disney animated movies to communicate with their non-verbal autistic son, Owen. Ultimately this creative approach led Owen out of the darkness. He went on to graduate from high school, get a job, live independently, and connect in meaningful relationships.

While this story is about autism specifically we can all learn from this family’s ability to recognize an opportunity to creatively connect with their child and help them live the best life possible.

Find it on Amazon: Life, Animated: A Story of SideKicks, Heroes, and Autism

Be sure to check out the excellent documentary as well, available via Amazon Prime here.

(These links are provided for your convenience. I make no Amazon affiliate fees.)


Don’t blame workers for psych center woes

Here in Charlotte, NC we’ve recently had a lot of news about Strategic Behavioral Center, a Psychiatric Residential Treatment Facility (PRTF). You can read the full story from the Charlotte Observer here describing a disturbing riot on January 1st. Here’s an excerpt:

Patients at Strategic Behavioral Center — some wielding wooden boards — attacked one worker, barricaded themselves in a room and escaped through a broken window. Others fought with each other or vandalized the building.

Amid the mayhem, some hospital staff watched in fear and did not try to control the situation. They initially delayed calling for help because a former executive had erroneously told them to not call the police for trouble with patients.

Having dealt with workers at PRTFs and other mental health facilities, this article bothered me–or rather people’s response to it bothered me. I saw calls for the workers to be fired, and disgust by their behavior. What this article didn’t convey is the untenable position workers like this are in.

Here’s my op-ed response published by the Charlotte Observer:

Stripping naked is just one way my teenage son, Devon, thwarts workers at psych centers. Afraid of sexual misconduct allegations, they’re unlikely to physically restrain him despite the mayhem he causes. This trick has worked for Devon (an alias to protect his privacy) at multiple psych centers in Charlotte and throughout the state including at the Strategic facility in Garner.

The recent investigation into the Strategic facility in South Charlotte paints a picture of workers, afraid for their lives, standing by watching a riot unfold without trying to control the situation. While the workers’ actions are shocking to many, as the parent of a child who has been a resident of five different psysh centers, I understand why and really don’t blame the workers. Continue reading here.

What do you think?

RAD Resources

A child with reactive attachment disorder (RAD) has been subject to neglect or abuse and fails to establish the expected bond with his primary caregivers, resulting in irritability, sadness, fearfulness and difficulty interacting with adults or peers. This guide will help parents understand how to spot reactive attachment disorder, and how it’s diagnosed and treated.

“Reactive Attachment Disorder Basics.” Child Mind Institute,

Nancy Thomas Parenting

Institute for Attachment and Child Development

Request entry to the private Facebook support group:  The Underground World of RAD Contact @TheMotherRanch to request access.

Do you have other great RAD resources to recommend?