The Development of Routines, Anchor Points, and Outside Limits (Outside Limits – Part 3 of 3)

– Alvin Weaver

Regional Administrator of Residential Services 

Outside limits are rules on which there can be no negotiation because they concern areas in which the safety or well-being of the child is at stake. An outside limit is involved if a child is either endangering himself, another, or property, in a way that will have lasting consequences or is acting in a fashion that will jeopardize his position in the community or his continued stay at the residential treatment center.

In the handling of routines, conflict should be avoided, but in the handling of outside limits, the point at issue should be approached directly and the handling must be absolute. No alternatives can be offered. For example, you would not tell a child who is hitting another child over the head with a baseball bat that he will lose a week’s allowance if he does not stop because this would give him a choice; he could stop hitting the other child and save his allowance or he could forego the allowance and go on hitting the child. Such a choice does not protect either the child being hit or the child doing the hitting. The staff member must step in and, if a verbal command fails, take the baseball bat out of the hands of the aggressor with great haste and definitive action. The following are areas and examples in which outside limits may present themselves:

1. Getting up. On days when a child is going to school or work, he must be out of bed by a certain time. If the special handling of the wake-up routine fails to mobilize him, the situation becomes an outside limit. Intervention should not be done harshly or punitively, and threats or penalties should not be offered. It is simply a question of the adult providing the motivation the child lacks at the time.
2. Getting Dressed. If the child gets up but refuses to get dressed, and not getting dressed would interfere with normal, daily functioning, the staff person must dress the child. Again, there should not be coercion or threats.
3. Personal Appearance. It is essential that the adult responsible for the child concern himself with the child’s appearance outside the house. He should make sure the child is adequately covered, that the clothes he is wearing are suitable for the prevailing weather conditions and are not likely to provoke ridicule or retaliation from the community. With teenagers, it should be remembered that the standards of the peer group are more important than the standards of the older, more conservative members of the community. It is a normal routine to check a child’s appearance before he goes out into the community. It becomes a limit if a child refuses to alter his appearance after the staff has assessed it as unsatisfactory.
4. Going to Bed. Eventually, all children must go to bed. For the most part, bedtime problems can be handled as routines. Paying attention to the underlying factors in a child’s protest about going to bed will usually give the staff member clues that make routine bedtime handling possible. But in the rare instance where the bedtime routine fails to accomplish its purpose and the child refuses to get undressed or into bed, then it must be treated as an outside limit.
5. On Grounds. The limits on where a child may go without permission will vary with individual cases, but the children are expected to get permission. The staff must immediately bring a child back and talk to him about his behavior, but again without penalties.
6. Medication. All prescribed medication must be taken at the proper times. The act of giving a resident medication will also show the resident concern for his well-being. If the resident refuses to take his medication, it becomes an outside limit and the staff will have to intervene.

In creating a program that has children who have anger, it is vitally important to provide a safe, secure house. Therefore, the household must set and maintain certain limits which apply to all residents, both staff and children.

The basic limits are:

1. The use of physical force against self, another client, or staff in a harmful manner.
2. Leaving the grounds of the program or a specifically designated area without staff permission.
3. The theft of any article not belonging to oneself.
4. The use of any chemical substance not prescribed by a licensed physician.
5. Any act that causes willful damage and defaces property, i.e., carving furniture, breaking items, etc.
6. Any sexual behavior between clients or any sexual act with another participant. Clients are not permitted to engage in sexual activity while in placement.
7. The possession of an instrument that could harm oneself, i.e., knife, gun, hammer, any sharp object, etc.

Beyond these obvious rules, there is an important aspect of safety. The child must feel secure. Any action which reduces this feeling is unsafe. Staff must always be attentive to any indications that the safety of the house is in question. For example:

1. A child asking another about drugs.
2. Conversations about hot-wiring cars.
3. Conversations about previous delinquent exploits.
4. Unusually “good” behavior.
5. An unusual combination of clients.
6. Excessive spending money. (Where did they get it?)
7. The sudden appearance of new items, i.e., clothes, music, mp3s, etc.
8. A tendency for kids to converse alone, without staff, or make or receive clandestine phone calls.

Equally, staff must always:

1. Keep money safely in lock-up.
2. Keep care keys safely in lock-up.
3. Drive children in an appropriate, safe manner in a well-maintained vehicle using seat belts.
4. Set an example around honesty, integrity, and sobriety.
5. Keep a close eye on clients in stores.
6. Take immediate action if worried about safety, i.e., call a supervisor (on-call) and ask.

Remember: If in doubt, barrel in, do not be afraid to accuse. If you have the feeling something is wrong, 99% of the time you will be right. On the odd occasion you prove to be wrong, take time to get back to the client you have suspected and apologize for your actions, but explain that because you really care about him and the other clients, you had to check it out.

If there has been a breach of safety, a child hits a staff or vice versa, a child runs away, a member of staff carelessly leaves his wallet, phone, or keys lying around, the house will remain unsafe for a couple of days, at least.

The staff must re-establish safety by energetically & openly restoring the limit and letting the offender know that you are disappointed with them. The house may remain at a high level of unsafety for a day or two, and time off for the staff may need to be considered.

These areas need to be constantly thought about. Awareness and sensitivity are needed when dealing with children. Occasionally, one or two children can be used as a barometer for attitudes and actions on the floor. Keep a particular eye out for children who give off clues toward the wellbeing of the group.