This is the second story in a multi-part series that will explore Calo, a residential teen and pre-teen facility located in Lake Ozark that specializes in treating developmental trauma in adopted children. The next story in this series will focus on feedback, results and Calo's role in the Lake community.
To understand Calo’s unique treatment plan, you first must understand the kids and families for whom it is designed.
Only 30 percent of Calo’s 100 plus residents (including teen and pre-teens) suffer from RAD or reactive-attachment disorder, a rare but serious condition in which a child’s basic needs of comfort, care and nurturing are not adequately established by caregivers. However, 97 percent of that total are adopted.
Landon Kirk, CEO and co-founder, said his staff is getting away from the RAD language, because of the stigmatization it carries. Kirk said it’s more accurate to say they treat kids for developmental trauma, which describes the conditions and actions that have been brought on from emotional, physical or sexual abuse or neglect or any other trauma inducing situation that can have lasting developmental and behavior effects such as a survivor’s mentality, lack of empathy and trust and the inability to create positive relationships with caregivers or parents.
The spectrum of patients range from those who appear to be functioning normally as in maintaining good grades or staying out of trouble, but whose parents feel they may not be connecting or respecting their relationships. Others are prone to self-violence, temper tantrums or withdrawing to themselves, difficulty engaging or interacting with adult figures and more issues that can most often be traced back to early childhood and developmental trauma.
“There is sometimes a misunderstanding that Calo works with children and teens who don’t have families or that the parents of our students have given up on on their child so they placed them at Calo,” Kirk said. “Nothing could be farther from the truth.”
Calo does not accept children who have been court-ordered, have a history of sexual violence and criminal activity or those whose primary diagnosis is substance abuse. Calo chooses families as much as families choose Calo.
“It’s not about the money for us,” Kirk said. “We only want kids who we know their families are committed and who we know we can help.”
The Calo model known as CASA (Commitment, Acceptance, Security and Attunement) is based on a different school of thought from the traditional behavior modification which relies on classical conditioning based on neurotypical lessons and punishment, which can be seen in prisons and behavior academies around the country.
“Dr. Ken Huey (co-founder) quickly realized those strategies don’t seem very effective,” Rob Gent, Chief Clinical Officer, said. “We had to redefine, no one was doing that, so we focused on a super relationally intensive model. There are about five other similar programs for younger children (4-13), but for adolescents they’re really isn’t, we’re the only one. There’s always been a huge need, but the reason there is not more is the difficulty in degree without leveraging some sort of punishment.”
Calo asks its staff to be fully committed, fully accepting of the child’s difficult behavior, to be building and maintaining security with children and to be attuned with them as in engaged and focusing energy on building lasting bonds through relationships. Instead of telling a child to ‘be quiet’ staff ask if they’d like to talk. Instead of taking away freedom, staff try to offer options that don’t isolate. Instead of assuming what’s wrong, staff exhaust every available resource to find answers.
“Emotionally, they’re more like 3- to 5-year olds, they’re really stuck in their traumas developmentally,” Gent said. “They are filled with a constant sense of pervasive shame, they don’t know any different. The damage that has been caused is lower (in the brain) than the rational part of the brain, they can make sense of normal approaches, but don’t rely on the rational part of the brain.”
The first part of the brain to develop is the brainstem, where survival and instincts are thought to thrive. The next part is the hippocampus, the center of emotion, memory and nervous system, which is developed and nurtured throughout childhood. And last is the neocortex region, where logic and reason are thought to reside.
One of the main issues from developmental trauma is that it disrupts the growth and alters the chemistry of the brain, which does not fully develop until the early 20s. This trauma during early childhood forces them to rely heavily on instincts and personal survival tactics - rather than using logic and reason or regulating appropriate emotion, which was not given the chance to develop properly due to external circumstances such as abuse, neglect or other traumas.
“The connection to be separated from the parent is a trauma itself,” Gent said. “Then the biology of the kid says, ‘What? My gosh, there is something wrong with me.”
Most of these kids do not know how to regulate emotions, because that part of the brain simply did not develop the way it should have. Often times it’s why they can’t explain themselves or their actions, or act impulsively or are highly active and on high alert, or wary of outsiders.
“It’s crucial to realize that not all therapy is created equal. There are vast approaches on how to intervene and heal families with developmental trauma,” Kirk said. “The problem is many of these approaches are varied and inconsistent, if not altogether contradicting.”
Calo’s CASA model depends on not only the commitment of staff and patients, but also the families.
“Our students have committed and highly involved parents actively engaged in therapy. If not, we usually discharge the family from treatment,” Kirk said. “While that sounds cold, the reason is simple, successful long-term outcomes are based on parents being engaged and implementing treatment at home.”
Kirk explained that parents are required to do emotional work with their child at Calo, or else they won’t afterwards. Parents are expected to engage in weekly family therapist sessions via Skype or over the phone. They receive homework assignments and challenges from therapists, and are also expected to visit Calo for campus events such as seminars, retreats and family days.
The kids are never alone in this battle, and that’s part of the model.
Calo has 16 different departments, including 40-50 specialists, 24-hour nursing station with eight RNs and several other staff totaling 217 employees who implement Trauma-Informed Yoga, Sensory Integration, Adventure Therapy, Bio-Therapy, Neurotherapy, Group and Individual Therapy and Canine Therapy involving the breeding, care-taking and adoption of golden retrievers, to name a few. Children are also accompanied by coaches and mentors, who are not licensed, but act as chaperones throughout the campus, facilitating activities, supervising and building bonds as part of the CASA model.
Kirk said sometimes it’s a matter of trial and error in determining what sort of trauma this kid has suffered or what kind of condition they’re suffering from and what’s the best way to treat it. What works for one, may not work for all. Some symptoms can mirror those of depression, anxiety and other mental diseases, which can also disrupt proper treatment if misdiagnosed.
“Automatically, people think it’s neat that we work with dogs though they don’t really understand just how integrated and powerful it is. Most people believe we just have them on campus as pets,” Kirk said. “Our canines are regulating companions accessible to all students. While some of our students dismiss or, at a minimum, can’t trust adult feedback given their past experiences, students are much more accepting of the feedback from their beloved animals.”
Here’s how it works: New residents at Calo are entered into a foster parent relationship with one of the canines. The residents undergo grooming, caring and discipline trainings with their canines, and using canine therapy teach lessons and build relationships through their interactions. As they progress, children are offered the choice to fully adopt their pet and even take them home when they leave. While at Calo, canines travel everywhere with their companion and sleep in their rooms, whether they’re going to therapy or class or recreation time.
“Students, essentially, go through a process similar to what their own parents went through when adopting them — anxiety, vulnerability, work, pressure, and so forth, though much more toned-down and in a controlled setting,” Kirk said. “In fact, the process mimics the steps of a real-life adoption process— placement, finalization, etc. The experience is powerful as it connects students to their parents in ways that talk therapy never could.”
It’s this sort of out-of-the-box, highly-specialized treatment that has allowed Calo to not only expand their efforts, but change the way we think about adoption, developmental trauma and treatment methods.