Part 5 Baldwin on Mental Health for Arctic Fasd

It's the expectations of the environment that really come into play when we're looking at adapting our interventions. When we're talking about interventions, mental health interventions interventions of any sort, it's really a continuum of individuals that we're dealing with, or working with. At one level we all know this, that everybody is unique, and that everybody has different patterns, and strengths, and assets. The system seems to be more focused on deficits though we're trying to, and doing a much better job, of shifting to strength based. For the most part we're training, everybody is unique we need to do individualized treatment plans for everybody. That's real intellectual and we forget that when it comes to actual work. We try and do a one size fits all intervention. Mental health, frequently in the educational system, and in a lot of other systems. One size doesn't fit all We can still work with a wide variety of folks and give them individualized treatment. So, what are the implications? This list brings us back again just to show you that the expectations we have in designing the interventions, that we need to take these into consideration. We need to, not all of the folks we're working with are going to have maybe, a particular language or communication problem. But many do. We have to at least be thinking about that. Hi. Come on in. So we have to be thinking about the possibilities that there may be some problem areas in their functioning. But more importantly, thinking about whether or not there are strengths in these domains. Because when we're talking about treatment, when we're talking about assessment we tend to focus on what's wrong, what's the disability, what's the disorder. In each of these areas of functioning people can have strengths and some of these strengths can offset weaknesses in other areas. When your developing interventions and you know that someone has a strength in one of these areas, you counter intervention in terms of those strengths. Emotional dismaturities, one of the strengths that sometimes comes with that is that sometimes folks are really good at working with younger populations. If you have someone who is not able to keep a job in a more commercial environment, who may not be able to handle fast food, or may not be able to meet whatever the demands are. But they have the strength of working with kids or youth that are, that are younger. Why not shape an intervention that helps build skills related to that. So, again highlighting everything that I said in a different way an impairment in one area of functioning might often interfere with functioning in another area. And this is a care where an interferer could be good or bad. I probably should look for a different word instead of interferer because it tends to have a negative connotation. It's always good to keep that in mind. As a result of these problems, and again, this is also one of the challenges of talking about something like mental health, education, or behaviors, when you go back to this list one size doesn't fit all. Not everybody has all of these challenges. Unfortunately one of the things we do when we're talking about fetal alcohol syndrome or fetal alcohol spectrum disorders is we have this global person with fetal alcohol syndrome in mind, who has learning problems and memory problems, and executive functioning problems, and emotionally dismature, and who has poor coordination, doesn't pay attention, and so on We've got almost like this, like, I want to say monster but I just did. (audience member) It's like the worst case scenario The worst case scenario. It scares the crap out of people. Because it's like, "well, what am I going to do with that." As a clinician or when working with someone what can I do with that. "Well I can't do anything with that." With this person because they just have too many problems. I think the other piece of that is that you end up trying to focus on this worst case scenario when the actual range and continuum of folks is pretty vast. So, here in a second when you comes to what works in terms of formal therapies and what doesn't, you know what? There is a range. One of the, you get some truisms out there. Things like, "Talk therapy doesn't work." Well guess what? It does for some folks with prenatal alcohol exposure. They can function, and they can have benefit from some forms of talk therapy. Many folks can't. So we really have to be cautious about that one size fits all kind of thing. Another things I hear, especially in residential settings, which I think happens, is that point systems don't work. You know what? For most people point systems that are affected, and in residential settings, point systems and token economies require a higher level of functioning than they're capable of. You dig into that a little bit, but for some they function better. It's kind of like thinking about school. How many were grade A students in school? Okay, there you go. Overachievers. How many were B students in school? Okay. How many were C students? Thank you for those honest people out there. It's kind of like the joke: What do you call someone who graduates from medical school with a C average? Doctor. Someone who graduated from medical school. I just totally lost where I was going. So if we look at my functioning tonight, highly distractible. It was brilliant, I'm sure. I'm sure I will come back to it. Okay. We've this range of folks who may have challenges in how to access, and in figuring out how to access the mental health system.