Dawn Thomas remembers why she is a psychologist, now working at the Stonewall Jackson Youth Development Center in Concord.
It's a memory from long ago, when she was a very young girl enjoying the summer pleasure of children spraying each other with a garden hose. Suddenly, the water stopped. “I searched and searched until I found the source of the problem and announced that there was a ‘hink' in the hose — not a kink, but a ‘hink,'” Thomas recalls. She untwisted the hose, the summer fun resumed and her aunt hasn't stopped teasing her about the “hink.” That hink is an insight into Thomas' identity: She is a fixer.
“So maybe what I'm doing is all about the challenge of ‘fixing things,'” Thomas said. “In that case, I'm right where I should be.”
The treatment model used in the Juvenile Justice Division's youth development centers aims to repair the students, because they have histories that have disrupted their progress toward socially and legally responsible behavior. Licensed mental health clinicians at the centers employ therapies designed to build on students' strengths, while also addressing what has been broken or damaged.
“I like helping the students figure out their problems and achieve their goals,” she said. “I like things that work out, when you can see where you've been.
“I like to help them know why they hurt — it helps them heal — and then I teach them what to do.” Thomas said many students committed to YDCs come with developmental histories marked by sexual, physical and emotional abuse, neglect, traumatic losses — such as losing a brother by murder — and victimization, as well as exposure to domestic violence and crime-infested communities. In fact, youths involved in the juvenile justice system experience such adverse events at much higher rates than do average children. As many as 93 percent of those in juvenile detention centers report exposure to an average of six adverse childhood events.
Researchers have found that exposure to adverse childhood events can adversely affect personality and brain development, leading to youths who fluctuate between feeling too little — to the point of numbness, and too much — to the point of rages and explosive behavior.
“Many of the students exhibit these and other symptoms of post-traumatic stress disorder,” Thomas said.
While cognitive behavioral therapy has proven to be a wonder tool in treating troubled youths, in cases where adverse childhood events have played a signicant role, an intervention called Trauma-Focused Cognitive Behavior Therapy (known as TF-CBT) is even more powerful.
Over recent years, the North Carolina Child Treatment Program has been providing counselors across the state with an opportunity to learn TF-CBT. The Child Treatment Program — operated by experts affiliated with the University of North Carolina School of Medicine and Duke University — is dedicated to improving the health and well-being of traumatized children and families across North Carolina.
Being aware of the high rates of trauma in the histories of juvenile-justice-involved youths, the program in 2009 reached out to Dr. Jean Steinberg, manager of Clinical Services and Programs for the Division of Juvenile Justice, inviting mental health clinicians working in youth development centers to participate in the intensive training.
Since last fall, Thomas has been a member of the second team of Juvenile Justice clinicians to participate in the training. Thomas said she was excited at the chance to acquire a new, evidence-based treatment approach.
“The application and Clinician-Trainee Participation Agreement should have scared me away, but I jumped at the chance to be a part of the learning collaborative in TFCBT,” she said. “As challenging and daunting as the training and graduation requirements appeared, I knew this was something I could not pass up. What better training could I receive for the population that I serve?”
Thomas has nearly completed her training, which has included treating two students with the TF-CBT approach. She has been successful.
“One of my students has completed the treatment, and his depression and post-traumatic stress disorder symptoms have significantly been reduced,” she said. “Actually, on the post-treatment measures, he no longer meets full diagnostic criteria for PTSD.”
In a bit of creative irony, the student developed his own tool kit, one that helps him remember coping skills that keep him on an even keel.
The second TF-CBT student will complete his treatment components by June, Thomas said.
“I'm excited for him, too,” she said. “He's doing well and showing much improvement in behavioral and emotional symptoms ...
“I knew it would be worth the extra effort to have another tool in my toolbox, so to speak.”
The Ararat native has her undergraduate degree from High Point College (now university).
She had nearly completed the requirements to become a certified public accountant when she took an elective in psychology, “thinking that would be great fun, and it was!”
With a chuckle, she admitted to being somewhat influenced by the Bob Newhart television show character. Thomas changed her major and graduated with a degree in industrial and organizational psychology, looking forward to eventually becoming a licensed therapist. Earning a master's degree in psychology from Appalachian State University allowed her to seek and obtain her license to practice psychology.
The “fixer” within her won out over accounting. Thomas wasn't new to Juvenile Justice when she started working at Jackson YDC in 2005. She had a stint as a clinician at the now-closed Swannanoa YDC a few years earlier, and had experience in private practice and in other public agencies, serving mostly adult clients. The Swannanoa experience helped Thomas realize how much she enjoys working with youths. When she and her husband moved to the Concord area, she was excited to see that Jackson had an opening for a staff psychologist II.
Typically, a clinician at Jackson YDC will have a caseload of 16 students, and part of the responsibility is con ducting psychological evaluations of the youths. Thomas and another clinician provide specialized treatment, which has reduced their caseloads to eight students each. However, they were assigned to conduct evaluations for the students of the other six clinicians as well.
“A typical workday is full and varied,” Thomas said.
Day-to-day activities include:
- Meetings for service planning and student staffing.
- Individual and family therapy.
- Facilitating psycho-educational groups.
- Psychological assessments, including assessment scoring, interpreting the results, developing treatment recommendations and completing the written evaluation.
- In-service training, which provides refreshers on such topics as the principles of trauma-informed care, learning theory and identifying and managing students at risk for suicide.
- Entering reports and other information into databases.
- Intake assessments/screenings for new admissions.
- Crisis management.
- Case consultation and support for counselors and counselor associates.
“On-call duties are rotated by the week among the clinicians at the facility, which places me on call for mental health emergencies seven to eight weeks per year,” Thomas said. “The learning collaborative with TF-CBT requires that I participate in bi-weekly consultation calls with my assigned clinical faculty member at the N.C. Child Treatment Program and monthly peer supervision group consultation.”
Thomas said she is deeply grateful to be in the learning collaborative.
“I look forward to applying what I've learned to better assist the juveniles we serve.”
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Contact: George Dudley
Phone: (919) 733-5027