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«Barbara Lutz A Dissertation Submitted to the Faculty of The Chicago School of Professional Psychology In Partial Fulfillment of the Requirements For ...»

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Rey: An Intensive Single Case Study of a Probation Youth with Immigrant Background

Participating in Wraparound Santa Cruz

Barbara Lutz

A Dissertation Submitted to the Faculty of

The Chicago School of Professional Psychology

In Partial Fulfillment of the Requirements

For the Degree of Doctor of Psychology

Unpublished Work

Copyright © (2012) by Barbara Lutz

All Rights Reserved

ii

Rey: An Intensive Single Case Study of a Probation Youth with Immigrant Background

Participating in Wraparound Santa Cruz A Dissertation Submitted to the Faculty of The Chicago School of Professional Psychology In Partial Fulfillment of the Requirements For the Degree of Doctor of Philosophy Barbara Lutz

Approved By:

Nancy Peddle, PhD, Chairperson Faculty, The Chicago School of Professional Psychology Leslie Wolowitz, PhD, Advisor Faculty, The Chicago School of Professional Psychology Stanley Einhorn, PhD, External Reader Program Manager, Santa Cruz County Children’s Mental Health iii Acknowledgments My dissertation would not have been possible without being WRAPPED in a highly skilled as well as genuinely supportive and caring network: Dr. Nancy Peddle, Dr.

Stanley Einhorn, Dr. Leslie Wolowitz, Dr. Jean Cooper, Dr. Nausheen Pashazaidi, Dr.

Cecilia Vasquez, Dr. Jonathan Fay, Dr. Robert Clark, the First Cohort in International Psychology, “Rey,” “Joe,” “Monica,” “Alonso,” “Marga,” “Leo,” “Felix,” Santa Cruz County Children’s Mental Health, Holly Heath, Linda Judson, Dr. Meg Sandow, the WRAP program, Santa Cruz County Probation, Gina Castaneda, Alan McRae, Dr. Rollin McCraty, Dieter Peissig, David Child, Jose Santana, Dr. Joachim Lutz, Elisabeth Zander, family and friends, Orange Kitty, and Chunks.

The welfare and well-being of each... [sentient being], though admittedly impossible to attain, is nevertheless the goal. (Marsella, 2007, p. 358) iv Abstract Rey: An Intensive Single Case Study of a Probation Youth with Immigrant Background Participating in Wraparound Santa Cruz Barbara Lutz This intensive single case study highlights the impact of the local wraparound program (WRAP) on a 16-year old probation youth of immigrant background. A holistic lens emphasized the interactive spheres that made up Rey’s (pseudonym) and his family’s world. Theoretical considerations from individual and systems orientations highlighted the complex interrelated factors: social ecology; community psychology; wraparound;

attachment; complex trauma; emotion regulation; interconnectedness; family therapy; and coherence. A session-by-session synopsis of Rey’s interactions with the program was followed by an analysis of defenses, receiving support, connectedness, participation, exploration, and emotion regulation. The holistic model offered detailed insight into Rey’s experiences during his work with WRAP. Although the results are individualized, the focus on the single participant allowed for sensitization and increased awareness regarding WRAP’s impact on Rey’s world. The use of the holistic model and the themes that emerged should be examined in further research with different populations and sociocultural surroundings.

–  –  –

Copyright page

Signature page

ACKNOWLEDGMENTS

Abstract

CHAPTER 1: INTRODUCTION

The Purpose of the Study

Background

Significance of Research for International Psychology

Theoretical Framework

Key Characteristics of the Research

Research Questions

Assumptions

Definitions

CHAPTER 2: LITERATURE REVIEW

Social Ecology

Community Psychology

Public Health Model

Wraparound

Historical, Cultural, and Ethnographic Background of Santa Cruz County......... 38 Culture

–  –  –

Cultural Identity Development

Complex Trauma and Society

Psycho-Physiological Effects of Trauma and Post Traumatic Stress........ 60 Attachment Trauma

Implications for the Trauma Treatment of Adolescents with Multiple Vulnerabilities

Emotion Regulation and Action Systems

Interventions from the Holistic Model

Emotion Regulation and Coherence with HeartMath

Connectedness

Elements from Structural Family Therapy

Adventure and Experiential Interventions

Participation

Interfacing Culture, Relationship, and Emotions as Adaptations............. 79 CHAPTER 3: METHODOLOGY

Introduction

Research Paradigm

The Case Study

The Single Case Study

Research Setting

Research Design:

Access and Selection of the Participant

–  –  –

Assent and Consent:

Safety and Confidentiality

Mandated Reporting

Coercion

Team Safety

The Role of the Researcher

Data Collection Strategies and Instruments

Archival Materials:

Case Notes

Field Diary

Observations

Trauma Assessment

Wraparound Questionnaires

Tonal Connectedness Map

Instrumentation for Heart-rhythm Monitoring and Feedback

Research Credibility and Dependability





Addressing Researcher Bias

Factual Accuracy and Interpretive Validity:

Theoretical Validity

Data Management

Method Triangulation

Data Analysis

viii

CHAPTER 4: NARRATIVE DESCRIPTION, ANALYSIS OF THEMES,

ASSERTIONS

Bounded System

Rey, the Participant

Family

Monica.

Alonso.

Joe.

Eva and Lila.

Treatment Providers

Felix.

Marga.

Leo.

Barbara.

WRAP

Description of Events and Observations

11.02.11

11.04.11

11.07.11

11.08.11

11.10.11

11.14.11

11.16.11

–  –  –

11.21.11

11.22.11

11.30.11

12.02.11

12.05.11

12.06.11

12.07.11

12.09.11

12.12.11

12.13.11

12.14.11

01.11.12

01.12.12

01.18.12

01.20.12

01.21.12

01.23.12

01.24.12

01.25.12

01.31.12

02.02.12

02.03.12

–  –  –

02.08.12

02.09.12

Reflections on WRAP

Alonso

Monica

Joe

Felix

Marga

Leo

Rey

Analysis of Themes

Theme 1: Defense

–  –  –

Episodes related to receiving support in the sphere of community.

Assertions on WRAP’s impact on receiving support in the sphere of community.

Theme 3: Connectedness

Episodes related to connectedness in the sphere of family......... 190 Assertions on WRAP’s impact on connectedness in the sphere of family.

Episodes related to connectedness in the sphere of culture......... 192 Assertions on WRAP’s impact on connectedness in the sphere of culture.

Episodes related to connectedness in the sphere of community.. 196 Assertions on WRAP’s impact on connectedness in the sphere of community.

Theme 4: Participation

Episodes related to participation in the sphere of family............ 198 Assertions on WRAP’s impact on participation in the sphere of family.

Episodes related to participation in the sphere of culture........... 200 Assertions on WRAP’s impact on participation in the sphere of culture.

Episodes related to participation in the sphere of community.... 202 Assertions on WRAP’s impact on participation in the sphere of community.

–  –  –

Episodes related to exploring in the sphere of family................. 205 Assertions on WRAP’s impact on exploring in the sphere of family.

Episodes related to exploring in the sphere of culture................ 207 Assertions on WRAP’s impact on exploring in the sphere of culture.

Episodes related to exploring in the sphere of community......... 208 Assertions on WRAP’s impact on exploring in the sphere of community.

Theme 6: Emotion Regulation

Episodes related to emotion regulation in the sphere of family.

Assertions on WRAP’s impact on emotion regulation in the sphere of family.

Episodes related to emotion regulation in the sphere of culture.

Assertions on WRAP’s impact on emotion regulation in the sphere of culture.

Episodes related to emotion regulation in the sphere of community.

Assertions on WRAP’s impact on emotion regulation in the sphere of community.

Final Thoughts

–  –  –

Summary

Discussion

Limitations of the Study

Implications for International Psychology

Conclusions

Future Research

REFERENCES

APPENDIX A: INSTITUTIONAL REVIEW BOARD APPROVAL

APPENDIX B: LETTER OF SUPPORT FOR PROJECT

APPENDIX C: MINOR’S ASSENT AND CAREGIVER’S CONSENT

APPENDIX D: SPANISH MINOR’S ASSENT AND CAREGIVER’S CONSENT.... 264 APPENDIX E: ADULT WRAP TEAM MEMBER CONSENT

APPENDIX F: SPANISH ADULT WRAP TEAM MEMBER CONSENT.................. 271 APPENDIX G: WRAP FIDELITY QUESTIONNAIRE

APPENDIX H: QUESTIONS ADAPTED FROM CHRISTINE ARTELLO’S (2010) WRAPAROUND ASSESSMENT

–  –  –

Figure 1. General juvenile hall population in Santa Cruz County, showing decrease over time; provided by Scott McDonald, Chief of Probation of Santa Cruz County, and used with permission.

Figure 2. Decline in incarcerated Latino youths in Santa Cruz County, showing decrease in average daily population over time; provided by Scott McDonald, Chief of Probation of Santa Cruz County, and used with permission.

Figure 3. Decline in Santa Cruz County rates of juvenile felony and misdemeanor offenses; youth criminality in Santa Cruz County; provided by Scott McDonald, Chief of Probation of Santa Cruz County, and used with permission.

Figure 4. Holistic concept for study.

Figure 5. Working concept for this study.

Figure 6. Wraparound model.

Figure 7. Data collection strategies.

Figure 8. Holistic concept with examples of events, WRAP interventions, and impact.

Figure 9. Areas of WRAP impact

Figure 10. Tonal Connectedness map.

Figure 11. Initial HeartMath session.

Figure 12. Second HeartMath session.

Figure 13. Third HeartMath session

–  –  –

The emerging paradigm of International Psychology embraces “micro-cultural groups,” such as youths from immigrant communities and “their dreams and aspirations, while remaining mindful of the emerging global macro-culture of global interdependence” during the process of cultural shifting and re-forming caused by migration (Larsen et al., 2011, p. 2). To respond to the surfacing psychological needs on micro- and macro-cultural levels, International Psychology “attempts to integrate indigenous, holistic, and scientific psychologies” (Larsen et al., 2011, p. 2). The need “for more multi-disciplinary approaches to understand and enable the human capabilities that both (i) drive and (ii) result from global mobility” (Carr, 2010, p. 1) is also called for by the United Nation’s Human Development Report for 2009. The wraparound method of service delivery is one of those multi-disciplinary approaches that have been successful nationally and internationally: In New Zealand’s Ministry of Justice and Ministry of Education, wraparound is widely used for such populations as “recidivist young offenders” (Broad, 2008, “Youth Development”), and support for children with special educational needs (New Zealand Ministry of Education, 2012). The National Wraparound Initiative focuses on providing mental health services, such as support for foster youth and juvenile offenders, with wraparound within the U.S. (2012).

For the treatment of youths with behavior problems—including those with an immigrant background—many skilled approaches have been developed with the focus on outcome and cost effectiveness. Choices include “group-based, residential, and ‘lifeexperiential’ options, like survival camps [and] boot camps,” as well as “family-based and multisystemic” treatment programs (Alexander, n.d., “What kinds of treatment will work?”) such as wraparound, although wraparound services have been applied to a wide variety of different client populations (National Wraparound Initiative, 2012).

However, few studies related to these programs took the time to pay detailed attention to the experiences of the youth participating in these programs, such as their life journeys, their culture, and their ways of understanding the different worlds they navigate. Wraparound programs embrace a holistic view of the participants and support integrative interventions. Still the voices of the youths requiring help can get lost in the efforts focused on treatment success. Yet listening to the concerned youths is the key to a better understanding of the complicated realities they face and to creating the appropriate networks of support for sustainable positive outcomes.

This research applied a holistic lens to understand the complex and interrelated world of the participant and focused on the experience of a youth on probation with an immigrant background, as he participated in a local wraparound program (WRAP).

Although WRAP introduced a strengths-based, participatory treatment approach that provided the context for this research, it is the voice and experience of the adolescent who took part in it that was highlighted along with the process of the designated WRAP team.

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