Teach to ALL Learners

Contra Costa County Office of Education

California Department of Corrections

Developmental Disabilities

Drug DetoxificationPsychological Disabilities

Defining Developmental Disabilities

Life-long disabilities attributable to mental and/or physical or combination of mental and physical impairments, manifested prior to age twenty-two.

People with severe or multiple disabilities may exhibit a wide range of characteristics, depending on the combination and severity of disabilities. There are some traits they may share.

Can you guess what they would be?

?

Limited speech or communication Difficulty in basic physical mobility Tendency to forget skills through

disuse Trouble generalizing skills from one

situation to another a need for support in major life

activities, e.g., domestic, leisure, community use, self care.

If you guessed:

You were absolutely correct!

Developmental Disabilities is synonymous with the use of the term learning disability.

Cognitive disability is also used synonymously in some jurisdictions.

Traumatic Brain InjuryVisual ImpairmentsDeaf and Hearing LossCerebral PalsyMental RetardationDown SyndromeEmotional DisturbanceAutism or PDD (Pervasive Developmental Disorder)Attention-Deficit/ Hyperactivity Disorder Spina BifidaEpilepsyLearning DisabilitiesSpeech and Language Impairments

Developmental disabilities are usually classified as severe, profound, moderate or mild, as assessed by the individual's need for supports, which may be lifelong.

Indicators of Developmental Disabilities

Physical AppearanceSome Developmentally disabled inmates/parolees have physical handicaps in addition to their intellectual and adaptive functioning deficits.This is less common among those functioning high enough to be included in the CDCR population.

SpeechDevelopmentally disabled inmates/parolees generally have limited vocabulary and use simple speech.They may speak slowly and have or have an articulation problem, e.g. stuttering or slurred speech.

Developmentally Disabled Inmates may avoid speaking, possibly to hide their disability or to escape from potentially embarrassing situation.~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Many of these inmates/ parolees may have difficulty understanding what others say and be reluctant to ask for clarification.

BehaviorThe most obvious maladaptive behaviors displayed by developmentally disabled inmates / parolees are in the area of: •social skills•safety skills •activities of daily living (ADLs)•some exhibit aggression toward others

Emotional Disturbancea)An inability to learn that cannot be explained by

intellectual sensory, or health factorsb)An inability to build or maintain satisfactory

interpersonal relationships with peers and teachers

c) Inappropriate types of behavior or feelings under normal circumstances

d)A general pervasive mood of unhappiness or depression

e)A tendency to develop physical symptoms or fears associated with personal problems

Attention-Deficit / Hyperactivity Disorder (AD/HD)… What is it?It is a condition that can make it hard for a person to sit still, control behavior and pay attention.Doctors do not know just what causes AD/HD. However, researchers who study the brain are coming closer to understanding what may cause AD/HD. They believe that some people with AD/HD do not have enough of certain chemicals (called neurotransmitters) in their brain. These chemicals help brain control behaviors.

How common is AD/ HD? 5 out of every 100 children in school may have AD/HD.Boys are three time more likely than girls to have AD/HD.

What about Adults???? What is much less well known is the probability that, of children who have AD/HD, many will still have it as adults. Several studies done in recent years estimate that between 30 percent and 70 percent of children with ADHD continue to exhibit symptoms in the adult years.

What are the signs of AD/HD?

being very active (called hyperactivity) problems with paying attentionacting before thinking

1. Inattentive type, where the person cannot seem to get focused or stay focused on a task or activity

2. Hyperactive-impulsive type, where the person is very active and often acts without thinking and

3. Combined type where the person is inattentive, impulsive and too active.

There are three types of AD/HDbased on the Diagnostic and Statistical Manual of Mental Disorders

(DSM)

Inactivity Type of AD/HD often:Do not pay close attention to detailsCan’t stay focused on play or school workCan’t seem to organize tasks and activitiesLose things

Hyperactivity-impulsive typeBeing too active is probably the most visible sign of AD/HD. This person is always “on the go” (As he or she gets older, the activity may go down). They act before thinking (called impulsivity). They may be surprised to find themselves in a dangerous situation. They may have no idea of how to get out of the situation.

Hyperactivity and impulsivity tend to go together. They may:

Fidget and squirmGet out of the chairs when they’re not supposed toHave trouble engaging in an activity quietlyInterrupt others when they’re talking andButt in on activities that others are doing

To be effective, educational programs need to incorporate a variety of components to meet the considerable needs of individuals with severe and/ or multiple disabilities.

Tips for Teachers

Figure out what specific things are hard for the inmate/parolees. For example, one inmate/parolee with AD/HD may have trouble starting a task while another may have trouble ending one task and staring the next. Each inmate/parolee needs different help.Post rules, schedules and assignments. Clear rules and routines will help a inmate/parolee with AD/HD. Have a set time for specific tasks. Call attention to changes in the schedule.Teach study skills and learning strategies and reinforce them regularly.Help inmate/parolees channel his or her physical activity (e.g., let the inmate/parolee do some work standing up or at the board. Provide regularly scheduled breaks.

Tips for Teachers, cont.Make sure directions are given step by step and that the inmate/parolee is following directions. Give directions both verbally and in writing. Many inmate/parolees with AD/HD also benefit from doing the steps as separate tasks.Let the inmate/parolee do work on a computer.Regularly share with the inmate/parolee how he or she is doing in class.Have high expectations for the inmate/parolee, but be willing to try new ways of doing things. Be patient. Maximize inmate/parolee’s chances for success.

Learning Disabilities (LD)

What are Learning Disabilities?It is a general term that describes specific kinds of learning problems. Learning disability can cause a person to have trouble learning and using certain skills. The skills most often affected are: reading, writing, listening, speaking, reasoning and doing math.

LD vary from person to person. One person with LD may not have the same learning problems as another person with LD. Researchers think that LD are caused by differences in how a person’s brain work and how it processes information. People with LD are not “dumb” or ‘lazy.” In fact, they usually have average or above average intelligence. Their brain process information differently.

How Common are Learning Disabilities?

Very common! As many as 1 out of every 5 people In the United States has a LD. Almost 3 million children (age 6 through 21) have some sort of LD.Adults? There is a growing body of reliable data that indicate that learning disabilities (LD) in adults are a wide-spread problem. Until recently, we have only had estimates of the incidence of adults with LD in specific segments of the population including various formal and informal educational and workplace training settings. Some estimates have been alarmingly high. For example, the United States Employment and Training Administration (1991) estimated that between 15-23% of Job Training Partnership Act (JTPA) title IIA recipients may have a LD. Based on the Department of Labor observations, the percent of adults with LD increases to between 50-80% among those reading below the 7 th grade level.

During a lecture, pause occasionally allowing inmates/ parolees to take

the time to assimilate the information and catch up with note taking. Pauses can be used to erase

a board or change a video. _____________________

When presenting abstract concepts, support the concepts with concrete examples or visual materials such as charts and graphs.

Tips for Teachers

Borderline Personality

Disorder

Depressive Disorder

Anti Social Personality

Disorder

Post Traumatic

Stress Disorder

Bi Polar Disorder

NOS

Psychological Disorders

Borderline Personality DisorderBPD

A commonly used mnemonic to remember some features of BPD is PRAISE:

P- Paranoid ideasR- Relationship DisabilitiesA- Angry OutburstI- Impulsive Behavior, Identity disturbanceS- Suicidal BehaviorE- Emptiness

A diagnosis of BPD requires, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM), five or more of the following to be present for a significant period of time:

Frantic efforts to avoid real or imagined abandonment. [Not including suicidal or self-mutilating behavior covered in Criterion 5]

A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

Identity disturbance: markedly and persistently unstable self-image or sense of self.

Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, promiscuous sex, eating disorders, substance abuse, reckless driving, binge eating). [Again, not including suicidal or self-mutilating behavior covered in Criterion 5]

Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.

Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

Chronic feelings of emptiness. Inappropriate, intense anger or difficulty controlling anger (e.g.,

frequent displays of temper, constant anger, recurrent physical fights). Transient, stress-related paranoid ideation or severe dissociative symptoms.

DSM IV-Criterion 1 focus is on the frantic efforts to avoid real or imagined abandonment. They are isolated, anxious and terrified at the thought of being alone. If a person with BPD was neglected as a child or raised in a severely dysfunctional household, they may have learned to cope by denying or suppressing their terror at being abandoned. After many years of practice, they no longer feel their original emotion.

Several parolees confessed that being incarcerated was actually an easier life style. “When you are locked up, you don’t have to worry about anything. You know what you are going to eat, when you are going to sleep and all that. Out here, there are so many things to worry about… and when you do try to make it out here in the world, so many people judge you and don’t give you a chance.” STAR Parolees/Inmates Interview, 2007.) The fear of abandonment is climaxed when the BPD parolee is released from jail.

DSM IV-Criterion 2 focus is on a pattern of interpersonal relationships characterize by alternating between extremes of idealization and devaluation. People with BPD look to others to provide things that they find difficult to supply for themselves, such as self-esteem, approval and a sense of identity.

“It is no wonder that many find a sense of identity in the gang culture or in imprisonment.” Most of all, they are searching for a never-ending love and compassion will fill the black hole of emptiness and despair inside them. The intense neediness of people with BPD can put a strain on any relationship. People with BPD often have highly unstable patterns of social relationships. While they can develop intense but stormy attachments, their attitudes towards family, friends, and loved ones may suddenly shift from idealization (great admiration and love) to devaluation (intense anger and dislike). Thus, they may form an immediate attachment and idealize the other person, but when a slight separation or conflict occurs, they switch unexpectedly to the other extreme and angrily accuse the other person of not caring for them at all. Even with family members, individuals with BPD are highly sensitive to rejection, reacting with anger and distress to such mild separations as a vacation, a business trip, or a sudden change in plans. These fears of abandonment seem to be related to difficulties feeling emotionally connected to important persons when they are physically absent, leaving the individual with BPD feeling lost and perhaps worthlessness.

DSM IV-Criterion 4 focuses on impulsivity and self –damaging behavior (spending, sex, substance abuse, reckless driving, binge eating). BPDs are aware of the long term consequence of their behavior, but find it very difficult to resist or control their impulses. If a person feels empty and anxious most of the time, pleasant activities are a welcome diversion. Mood-altering drugs provide an even more immediate relief and therefore can be a powerful distraction. Harmful activities may be a way of expressing rage or self-hate.

BPDs have no sense of “self.” They do not know who they are; hence, they try to fill the emptiness and create an identify for themselves through impulsive behaviors such as indiscriminate sex activity, shoplifting, compulsive drinking or substance abuse. BPD and substance abuse goes hand in hand. Recent statistics show 23% of BPDs had a diagnosis of substance abuse. Borderline substance abusers are likely to abuse more than one drug (a frequent combination is drug and alcohol abuse.)

People with BPD are quite intuitive and have the ability to read others very well. In the presence of others, the person with BPD is able to fit in much like a chameleon lizard by pretending to blend in to their surroundings. Self-image is based on the people around them. This allows the person with BPD to feel in control and liked by those present. The person with BPD tends to go in whatever direction the wind is blowing. There appears to be no depth of identity or individuality to their own thinking. People with BPD often have self-destructive behaviors that may threaten their life or physical well-being. It’s estimated that as many as 9% of all people with BPD commit suicide.

DSM IV-Criterion 5 focuses on recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior. Drug and alcohol abuse falls into this category of dangerous and compulsive behavior. Another common behavioral trait many is provoking physical fights with others. Self-injury is a coping mechanism that BPDs use to release manage overwhelming emotional pain-usually feeling of shame, anger, sadness or abandonment. Self-mutilation may release the body’s own opiates, known as beta-endorphins. These chemicals lead to a general feeling of well-being. People with BPD see themselves as in control of these behaviors, which provides a false sense of security.

Avoidance and denial is a sense of security and protection. Projecting blame, showing apathy and remaining distance geographically and emotionally are just some of the ways people with drug addiction and criminality cope with obvious toxic problems. Many would rather die alone in prison than admit they are afraid, confused and need help.

DSM IV-Criterion 6 focus is on the affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

People with BPD may experience dramatic mood swings from being very happy and in control of their world, to suddenly feeling very depressed, lonely, helpless, and hopeless. In similar fashion, people with BPD can move from a state of total independence to one demanding lots of attention.

It is reassuring to know that there is hope. Astonishingly enough, researchers commonly believe that BPD results from a combination that can involve individual genetic vulnerability and environmental stress, neglect or abuse as young children, and maturational events during adolescence or adulthood. Numerous studies have shown a strong correlation between childhood abuse and development of BPD. Many (but not all) individuals with BPD report having had a history of abuse, neglect, or separation as young children. Patients with BPD have been found to be significantly more likely to report having been verbally, emotionally, physically, and sexually abused by caretakers of either gender. They were also much more likely to report having caretakers (of both sexes) deny the validity of their thoughts and feelings. They were also reported to have failed to provide needed protection, and neglected their child's physical care. Parents (of both sexes) were typically reported to have withdrawn from the child emotionally, and to have treated the child inconsistently. Additionally, female borderlines who reported a previous history of neglect by a female caretaker and abuse by a male caretaker were consequently at significantly higher risk for being sexually abused by a non-caretaker (not a parent).

Post Traumatic Stress Disorder (PTSD)

The traumas that cause PTSD are as unique as the individuals suffering from the disorder. Any fearful trauma can produce symptoms of PTSD. “I remember being in a tornado a few years back, and for the longest time, any wind, and I mean any wind, would send tremors through my body.” ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~PTSD can be either acute or chronic; the acute phase occurring directly after the trauma, while the chronic phase can come along much later. In the acute phase, PTSD is said to be treatable and curable. In its chronic phase, it is only treatable. One must learn to live with it and to cope with it.

People with PTSD are famous for self-medicating (drugs, alcohol), and may have an additional addiction that often lands them in trouble, or jail: an addiction to adrenaline. We love danger, even when trying to avoid it. Deep down inside, we love adrenaline.

It has recently been learned that prolonged stress actually changes a person’s brain chemistry. PTSD is a physical disease. There is no escaping it. Even if most of the symptoms are suppressed, a person with PTSD will make all his/her decisions through the veil of this disorder, simply because one’s brain chemistry determines one’s thought patterns.

PTSD: The Time BombInside every person with PTSD is a time bomb. It is merely a matter of time before symptoms begin to show up. One might exhibit all manner of symptoms in nearly everything s/he does, and still live what appears to be a normal life. However, it doesn’t take much to bring out full-blown symptoms of a full-blown case of PTSD.

Keeping busy keeps the symptoms down. Free time (and worry) exacerbates PTSD symptoms.

Additional Stress: Stress kills; we know this. Additional stress in the life of a PTSD sufferer will bring out their PTSD symptoms. Even good stress can increase one’s symptoms; good stress such as a birth, or a new love, or a promotion at work. Anything that wobbles the apple cart—little changes, big changes, good changes, bad changes—will promote PTSD symptoms. Then there are the huge stressors; the larger the stressor, the more virulent the PTSD symptoms. Reminders: anything that reminds the PTSD sufferer of the original trauma will pique symptoms. This includes odors, sounds, and sites. Additionally, the anniversary of a trauma will cause a rise in PTSD symptoms. If a woman was assaulted near an elevator, elevators will trigger her symptoms. If she remembers the date of her assault, as the anniversary approaches, symptoms increase.

PTSD &…Anger

Flashbacks/Hallucinations

Fear

Dread

Hyper-Vigilance

Anxiety

Intimacy Issues

Intrusive Thoughts

Depression

Here are some more symptoms of PTSD

Drug and Alcohol AbuseAddictions do come in handy sometimes: at least you have to get out of bed for them.Martin Amis

Avoidance/ImmersionOf all the…alternatives, running away is best.Chinese Proverb.

GuiltGuilt always hurries towards its complement, punishment; only there does its satisfaction lie.Lawrence Durrell

Memory Loss/Cognitive DysfunctionThe effectiveness of our memory banks is determined not by the total number of facts we take in, but the number we wish to reject.Jon Wynne-Tyson

Teacher’s Tips for PTSD•Teach Symptom Management, Anger Management, and attending rap groups (such as AA or NA) is a way of keeping one’s symptoms at bay. •Help inmates/ parolees know when to reach out for help, is a second strategy; one to fall back on when the others don’t work.•Practicing relaxation, meditation have an enormous healing power for the PTSD sufferer.

Anti Social Personality Disorder (APD or ASPD)

This is a psychiatric diagnosis in the DSM-IV-TR recognizable by the disordered individual's disregard for social rules and norms, impulsive behavior, and indifference to the rights and feelings of others.

Diagnosis of antisocial personality disorder is significantly more common among men than among women Central to understanding individuals diagnosed with antisocial personality disorder is that they appear to experience a limited range of human emotions. This can explain their lack of empathy for the suffering of others, since they cannot experience the emotion associated with either empathy or suffering. Risk-seeking behavior and substance abuse may be attempts to escape feeling empty or emotionally void. The rage exhibited by psychopaths and the anxiety associated with certain types of antisocial personality disorder may represent the limit of emotion experienced or there may be physiological responses without analogy to emotion experienced by others.

Research has shown that individuals with antisocial personality disorder are indifferent to the possibility of physical pain or many punishments and show no indications that they experience fear when so threatened. This may explain their apparent disregard for the consequences of their actions and their aforementioned lack of empathy.

Diagnostic criteria (DSM-IV-TR)The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV,

currently DSM-IV-TR), a widely used manual for diagnosing mental and behavioral disorders, defines antisocial personality disorder as a pervasive pattern of disregard for and violation of the rights of others occurring since age 15, as indicated by three (or more) of the following:

failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest

deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure

impulsivity or failure to plan ahead irritability and aggressiveness, as indicated by repeated physical fights or

assaults reckless disregard for safety of self or others consistent irresponsibility, as indicated by repeated failure to sustain

steady work or honor financial obligations lack of remorse, as indicated by being indifferent to or rationalizing

having hurt, mistreated, or stolen from another

MnemonicA mnemonic that can be used to remember the criteria for antisocial personality disorder is CORRUPT:C - cannot follow law O - obligations ignored R - remorselessness R - recklessness U - underhandedness P - planning deficit T - temper

Teacher’s TipsThe most important goals of treating antisocial behavior are effectively teach him or her the positive behaviors that should be adopted instead.

Teachers need to be modeling and reinforcing appropriate behaviors as well as in providing appropriate discipline to prevent inappropriate behavior.A variety of methods may be employed to deliver social skills training, but especially with diagnosed anti-social disorders, the most effective methods are systemic therapies which address communication skills These probably work best because they entail actually developing (or redeveloping) positive relationships between ASPD and other people.

Teacher’s Tips, cont.

Methods used in social skills training include modeling, role-playing, corrective feedback, and token reinforcement systems. Regardless of the method used, the level of cognitive and emotional development often determines the success of treatment.

A supportive, nurturing, and structured classroom environment is believed to be the best defense against anti-social behavioral problems.

WHAT IS A DEPRESSIVE DISORDER?A depressive disorder is an illness that involves the body, mood, and thoughts. It affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people who suffer from depression.

TYPES OF DEPRESSIONDepressive disorders come in different forms, just as is the case with other illnesses such as heart disease. There are three of the most common types of depressive disorders. However, within these types there are variations in the number of symptoms, their severity, and persistence.

Major depression is manifested by a combination of symptoms (see symptom list) that interfere with the ability to work, study, sleep, eat, and enjoy once pleasurable activities. Such a disabling episode of depression may occur only once but more commonly occurs several times in a lifetime.A less severe type of depression, dysthymia, involves long-term, chronic symptoms that do not disable, but keep one from functioning well or from feeling good. Many people with dysthymia also experience major depressive episodes at some time in their lives.Another type of depression is bipolar disorder, also called manic-depressive illness. Not nearly as prevalent as other forms of depressive disorders, bipolar disorder is characterized by cycling mood changes: severe highs (mania) and lows (depression). Sometimes the mood switches are dramatic and rapid, but most often they are gradual. When in the depressed cycle, an individual can have any or all of the symptoms of a depressive disorder. When in the manic cycle, the individual may be overactive, overtalkative, and have a great deal of energy. Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment. For example, the individual in a manic phase may feel elated, full of grand schemes that might range from unwise business decisions to romantic sprees. Mania, left untreated, may worsen to a psychotic state.

SYMPTOMS OF DEPRESSION AND MANIANot everyone who is depressed or manic experiences every symptom. Some people experience a few symptoms, some many. Severity of symptoms varies with individuals and also varies over time.

Depressive disorders make one feel exhausted, worthless, helpless, and hopeless. Such negative thoughts and feelings make some people feel like giving up. It is important to realize that these negative views are part of the depression and typically do not accurately reflect the actual circumstances. Negative thinking fades as treatment begins to take effect.

DepressionPersistent sad, anxious, or "empty" mood Feelings of hopelessness, pessimism Feelings of guilt, worthlessness, helplessness Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex Decreased energy, fatigue, being "slowed down" Difficulty concentrating, remembering, making decisions Insomnia, early-morning awakening, or oversleeping Appetite and/or weight loss or overeating and weight gain Thoughts of death or suicide; suicide attempts Restlessness, irritability Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain

ManiaAbnormal or excessive elation Unusual irritability Decreased need for sleep Grandiose notions Increased talking Racing thoughts Increased sexual desire Markedly increased energy Poor judgment Inappropriate social behavior

Help your parolees/ inmates: •Set realistic goals in light of the depression and assume a reasonable amount of responsibility. •Break large tasks into small ones, set some priorities, and do what you can as you can. •Try to be with other people and to confide in someone; it is usually better than being alone and secretive. •Participate in activities that may make you feel better. •Mild exercise, going to a movie, a ballgame, or participating in self-help meeting, clean and sober social, or other activities may help. •Expect your mood to improve gradually, not immediately. Feeling better takes time. •It is advisable to postpone important decisions until the depression has lifted. Before deciding to make a significant transition change jobs, get married or divorced discuss it with others who know you well and have a more objective view of your situation. •People rarely "snap out of" a depression. But they can feel a little better day-by-day. •Remember, positive thinking will replace the negative thinking that is part of the depression and will disappear as your depression responds to treatment. •Let your family and friends help you.

Treating Depression

The good news about recognizing and understanding depression early is that it can be treated. Antidepressant medications are widely used, effective treatments for depression. Antidepressant drugs are known to influence the functioning of certain neurotransmitters (chemicals used by brain cells to communicate), primarily serotonin, norepinephrine, and dopamine.

Psychotherapy is also effective for treating depression. Certain types of psychotherapy, cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT), have been shown to be particularly useful. More than 80 percent of people with depression improve when they receive appropriate treatment with medication, psychotherapy, or the combination.

Drug Detoxification (Post Acute Withdrawal)Post Acute Withdrawal SyndromePost Acute Withdrawal is an adjustment the brain has to make while in the process of returning to life without chemicals. It is the time period when neurotransmitters start acting again.During periods of addiction to drugs, alcohol and/or other substances of abuse there is artificial stimulation and disruption to normal brain function. During the adjustment period difficulty in thinking clearing, expressing emotions, memory, coordination, sleep disturbances and stress are all common.

What is Post Acute Withdrawal syndrome?(PAW)In this section symptoms are identified, and a portion of the process which may be required during addiction treatment are outlined.The process of dealing with post acute withdrawal syndrome differs from person to person, making it critical to enlist professional help.The guidelines presented to aid in overcoming frustrations and bring back a normal balance to the brain and life in general are similar to those adhered to by drug rehab centers.The most common symptoms of Post Acute Withdrawal when overcoming addiction are:Unclear thinking.Difficult emotions.Difficult physical coordination.Sleep disturbances.Stress.

Help for Overcoming Alcohol and Drug Addiction Post Acute Withdrawal SyndromeListing Strengths and Weaknesses in the Above Areas May also be Required: Example:Strength: Plays basketball for fun.Weakness: Runs into objects or appear off balance at times.Setting a Plan for Overcoming Areas of Weakness, is Usually Encouraged: When thinking is unclear breaking tasks into portions may be recommended.(EG: Read a part of a book, or directions at a time, take a break and return at a later time.)Journaling feelings to remain calm when issues are discussed may be recommended.If a period of depression becomes apparent, watching a funny video or taking time to ‘play’ may be encouraged.Walking a dog or taking a child to a park to assist in re-engaging in life could be suggested.Other suggestions may include:

Making a lists, including ‘daily priorities’ or ‘shopping lists’ to remove frustration.Staring uncompleted tasks on the following day.Being cautious of ‘simulative substances’ (caffeine, sugars, etc.) prior to sleep.Reading a book which might assist in relaxation prior to sleep.* Taking more frequent ‘breaks’ during the day, even if ‘resting’ in a car while repeating positive affirmations, are encouraged on occasion.Further recommendations may allow for:Keeping expectations reasonable, to avoid ‘over-stressing’.Sobriety, followed by support group attendance similar to AA, other sober activities, and/or church group attendance.Eat three regular meals a day with ‘snacking’ between.Vitamins to help regain lost nutrition.Meditation and/or other similar relaxation techniques.

Symptoms of Post Acute Withdrawal May Contain:Lack of confidence.Denial. (Examples of ‘denial’ thoughts: ‘It wasn't really that bad’, or ‘I can handle it now’.)Lack of commitment to a support system.Trying to change others before they are ready.Defensiveness.Compulsive behavior. (Becoming compulsive or out of balance in other areas of life.)Impulsive behavior. (Acting before thinking, or sudden outbursts.)Daydreaming.Depression.Easily Angered.Irregular sleep.A ‘don't care,’ attitude.Feeling hopeless.Self pity.Conscious lying.Loneliness.Controlled drinking. (Attempting to limit or control use.)Loss of control. (Returning to the original state of consumption (relapse).)

Change often begins within post acute withdrawal syndrome.Watch for internal changes, which may carry:Increased stress.‘Why bother?’ emotions and thoughts.Change in feelings; mood swings.Change in behavior.Putting on a facade. (Look good on the outside but feel terrible inside.)

Ideas which may be suggested for triumphing over post acute withdrawal syndrome:Look for balance living.Limiting work to 40 hours per week.Maintaining family relationships.Continuing a spiritual connection.Education or new learning. (Mental stimulation.)Personal time.

Plans for calmness, sobriety and relapse prevention may entail:1.) Say the serenity prayer.God grant me the serenity to accept the things I cannot change.Courage to change the things I can, and the wisdom to know the difference.2.) Call a counselor.3.) Call sober friends.4.) Jog around the block a few times.5.) Eat regularly.6.) Prayer.‘Stinking Thinking ’ in Post Acute Withdrawal.Examples:I don't listen at AA and pass when it is my turn.I get exhausted.I don't like eating regularly.I have high expectations.I think the dangers of drugs are overreacted too.I get tired of this Higher Power stuff.

The Map to Relapse in Post Acute Withdrawal:Denial.Resentment.‘I don't care,’ attitude, no confidence.Drop sponsor.Blaming others.Lie on purpose.Don't ask for help.Eat and sleep irregularly.Associate with chemically abusing people.Begin to relapse.Don't expect your desire to consume to go away quickly.Using Thoughts to Help Overcome Urges Might Include:‘I can wait till tomorrow.’Remembering some of the pain drugs, alcohol or substances have caused.Thinking of the good attributes of sobriety.

You Can Be a Great Teacher for Inmates / Parolees with:

Developmental Disabilities

Drug Detoxification

Psychological Disorders

“Create a bridge between curriculum and Parolees/Inmates-all kinds of Parolees/Inmates with all kinds of minds.”

A great teacher UNDERSTANDS the relationship between emotion and cognition. The great teacher does not assume that the learning difficulties are the consequence of bad behavior, acting out or refusal on the Parolees/Inmate’s part to comply.

Rather, the teacher understands that these are coping mechanisms triggered by the stress generated by frustration and fear of what many see as an inevitable failure.

The great teacher does not use this understanding to excuse the behavior, but to work through it or around it. The great teacher knows that may of these negative emotions and troubling behaviors go way when Parolees/Inmates feel competent and successful.

A great teachers KNOWS that Parolees/Inmates learn in different ways, but does not trivialize this.

A great teacher FOCUSES on the learner first and the curriculum second. Her takes the Parolees/Inmates ot a place of cognitive and psychological safety before venturing into deeper waters of new material. This teacher understands the importance of creating a positive connection to prior learning, or tapping into a Parolees/Inmates’s positive emotions about a task or a topic, and helping Parolees/Inmates recognize and reduce negative influences on learning (e.g., automatically saying or thinking: I can’t DO math!”). By practicing thought-stopping techniques and generating positive self-statements that are tied to actual successful experiences.

A great teacher DEMONSTRATES the ability to expose Parolees/Inmates to a variety of stimuli and knows when Parolees/Inmates are connected emotionally and cognitively to the experience. He also gives Parolees/Inmates the opportunity to demonstrate what they have learned ion a variety of ways, and publicly values these alternative ways to display knowledge and skills.

A great teacher is GUIDED AND ENERGIZED by finding out what facilitates effective learning and what gets in the way. The focus of teacher is to minimize the impediments of educating the learner about his or her own cognitive style, modifying the curriculum without lowering standards and creating a learning space in which Parolees/Inmates can feel safe and competent.

A great teacher PRAISES THE PROCESS that Parolees/Inmates use as often or more than the product, since the product may be sub-standard (in the Parolees/Inmates' eyes or in reality) even if the process is right. When a great teacher gets a blank stare in response to a question, they offer alternative choices. This can generate an “Oh yeah” response; the next time a question is asked, the Parolees/Inmates is more likely to come up with an answer that addresses how s/he figured something out. That is the behavior of a successful learner.

A great teacher UNDERSTANDS that it’s not about having Parolees/Inmates work harder, but rather that they work smarter. Great teachers Parolees/Inmates what strategies they have used in the past to be successful in any kind of learner (in school or outside of school) and helps to translate that skill and recreate the positive learning experience in the classroom. We all know the Parolees/Inmates who can take apart and rebuild a computer but can’t read. The great teacher focuses on how the Parolees/Inmates learned to do the former an uses the knowledge as a basis for specialized instruction in reading. If a child says, “I remember everything I see” ought to be able to capitalize on the strength by developing a sight word vocabulary that will jumpstart more difficult reading.

A great teacher is WILLING to take a risk when it comes for advocating for a Parolees/Inmates/ parolee. “This Parolees/Inmates will not be successful without some significant supports—more than I am able to give in this classroom even though I’m awesome.”

A great teacher EXAMINES his classroom practices to identify what works and what doesn’t. These teachers are more likely than other teachers to want to work with another adult, ask for feedback about performance, go to professional conferences and in-services with the needs of individual Parolees/Inmates in their heads, and be willing and able to teach others what they know.

A great teachers knows how to work as a team with Parolees/Inmates as a key member. Building and maintain relationships with the POC, social workers, parole agents, correctional officers takes time and sincere effort. Reaching out to psychiatrist and psychiatric technicians to get and give information if medication or health issues are involved is an important skill. Working with ancillary personnel in CCCOE/ CDCR and helping them help you as a teacher incorporate therapeutic interventions in the classroom is critically important.

A great teacher UNDERSTAND that cultural and language factors play an important role in learning. Great teachers are able to read subtle but important behaviors such as eye contact or physical proximity, and accurately interpret them in the social /cultural context of the parolee/ inmate.

Communication and Interaction

“The goal of effective communicating is to understand and to be understood. Communication may occur verbally, non-verbally, and/ or in written form.”

Active ListeningNon-verbal communication is defined as an exchange of information, without speaking, through the use of gestures, body language or facial expression. Non-verbal communication is generally used in conjunction with verbal. The ‘unspoken” message can alter the meaning of the communication. Be aware that there is considerable danger of misinterpretation of the non-verbal component of the message, especially if it is not consistent with the verbal message.

Non-Verbal Active Listening

Body Language: Leaning forward, facing the speaker and maintain an open posture may indicate tto the speaker that you are paying attention.

Facial expression: Smiling, looking interested an making eye contact may communicate interest to the person.

Gestures: Head nods and open hand gestures provide non-verbal encouragement that says, “Go on please.”

Verbal communication is the exchange of information through the use of the spoken word. The volume, inflection and tone of voice may alter the meaning.

“Stop shouting! I can’t hear what you are saying!”

13 Verbal aspects of active listening:1.Verbal Encouragers: Small brief words or phrases

that encourage the inmate/parolee to continue talking, e.g., “Uh-huh,” Really,” “Hmmm,” “You’re kidding!”

2.Clarification: Helps the inmate/parolee express unclear feelings, ideas and perceptions. This process can be used to point out inconsistencies between an inmate’s word and actions, e.g., “ You said you are not sad, but you have tears welling up in your eyes.”

3.Restating: Repeating the main thought or idea the inmate has expressed, also called paraphrasing, e.g., “You say you decided not to go inot the room?”

4. Open-ended Questions: When possible, avoid questions which can be answered “yes” or “no.” Ask open-ended questions such as who what when and how questions.

5. Focusing; Make statements or ask questions that help focus the inmate on the main issue, e.g., “You have lots of complaints but he main one seem to be problems with your cell mate. Please tell me more about that.”

6.Avoid “Why” Questions. Questions beginning with “why” tend to make the inmate defensive. Try rephrasing an ‘why question” by stating it as a personal statement or “I’ message, e.g., don’t say “Why did you refuse to come out of your cell? “ Instead try, “I thought you enjoyed school and now you are refusing to go. What changed? “ [or] “When did you start feeling differently?”

Now, let’s practice!!!!