Kuala Lumpur: Orphanage Caretaker Intervention: Managing Behavior, Attention, and Emotions

We started the orphanage caretaker intervention by a training of the group leaders. I was delighted by the risk-taking of the Generasi Gemilang NGO staff when I trained them in how to do the orphanage caretaker training intervention, based on the refugee teacher training intervention. Note the slippers I wear - most of Asia leaves its shoes by the doorsteps and this NGO gave me slippers to wear, in their place.

One thing I love about Malaysia, is the exuberant, constant laughter

Trainers being trained

We had HELP University clinical psychology graduate students partner with Generasi Gemilang NGO staff to run each orphanage caretaker group, as they did with Harvest staff to run the refugee teacher groups. These students are doing some last-minute panicked preparation before leading the groups because the trainer's manual is in the Malaysian language - Bahasa Malay - a stretch for many of them who have English or Mandarin/Cantonese as their first languages, with many years having passed since they learned Bahasa in school.

GG used a translator to translate the manual from English into Bahasa. I was thrilled to have it translated and finally used with Muslim Malays in a government institution that's notoriously opaque and tough to crack.

The name of the NGO we partnered with for the orphanage intervention -
Generasi Gemilang (GG)

Training agenda - Positive Behavior Management in morning;
Discipline, Managing Emotions, and Caretaker Self-Care in the afternoon

A HELP University student, flanked by two GG staff.
This partnership may have been a matchmaking service too ;)

The stars of GG doing the introduction to all the caretakers before they broke into small groups - Andy and Noelle. Noelle is the COO who coaxed me into doing this intervention a week before I moved my family of 5 out of KL, and she did it over dumplings, wise woman. That's why she's a COO.

Noelle introducing the training to the all-Muslim Malaysian group of orphanage caretakers. Note that the national orphanages are run by the Muslim Malaysian government which only hired Muslims as its caretakers.
Andy and Noelle asked the caretakers how they felt about being there. I'd prepped the trainers that the caretakers may take a lot of work to get enthused and pumped up since the caretakers were reportedly burnt out on numerous training programs done with them that had been shelved and boring. And, the caretakers had seemed so flat in their affect, at times, when we visited the orphanage. To our delight, the caretakers said they felt a 10 out of 10 in happiness. Why? Because they got out of the orphanage for the day! They were the most enthusiastic, bubbly group of trainees I may have ever seen.
How happy was I to be wrong!

The caretaker on the left goes by the nickname "Lady Gaga." So much for stereotypes about Muslim women. I'd also warned the trainers that the caretakers seemed very reserved and may take a lot of coaxing to do the role play-heavy training activities. Boy, was I wonderfully wrong, yet again. And, Lady Gaga proved me wrong in the first seconds of the intervention, by jumping up to volunteer to role play during the first activity: "How to welcome a new orphan to the orphanage." She loved performing so much that the trainers nearly had to pull the plug on her performances, which brought the house down in her group, all laughing hilariously. Still, they took their welcoming protocol and ritual very seriously. The trainer, Jeng Mun, on the right, pretended to be a shy new orphan, scared to be joining the orphanage.

The Magic Workbook had an activity where the caretakers had to fill out what behaviors they wanted to increase, like "Walking slowly" and how they would teach the children how to walk slowly.
Since the caretakers complained of the orphans not wearing their "slippers" around the compound, the trainers said they could make a rule of "Wear your slippers" and demonstrated how to teach the orphans the new rule -- physically show the children your rule and to teach it to them in the most explicit, nonverbal way possible.

Asking the "child" to demonstrate how to follow the rule - "Wear your slippers"

Each training group chose an animal as their group name, which was a fun "break the ice" activity. Andy's group chose "Kung Fu Panda" which the group members are acting out in this photo. Haya!
Another break the ice activity, Lady Gaga loved kicking it off, often holding the ball to make a joke, once she had everyone's attention. The group loved this activity which you do when a new child joins the orphanage. They would yell out someone's name in the circle then throw the ball to them, and so on.

Lady Gaga cracking up the group, and herself!
Time to share the spotlight, er, the ball, Lady Gaga!

Andy and his coleaders flanking him, teaching the group how to do the ball-throwing, name-learning activity when a new member joins the group.

Jeng Mun, Yoke Yoke, and Angeline's group in hysterics, as usual.
This group was laughter therapy for its caretakers.
Given the heavy and unsupported nature of their work at the orphanage,
they are desperate for a good laugh.

Andy explaining the activity of turning their Old Rules into New Rules --
New Rules are simple, clear, and positively stated

New Rules activity in Magic Workbook

Again, the trainers also couldn't stop laughing in Yoke Yoke and Angeline's group.
I loved being in that room. It was downright effervescent.

One of these trainees had been an orphan, herself, raised in a national orphanage.
The other introduced herself as the caretaker who is most bullied by the children, and, said provocatively, maybe as a cry for help from other caretakers present, that she was bullied by the other caretakers. She said it laughing, and the caretakers laughed in a playful, supportive, slightly teasing (and bullying, did she think?) way, and she started crying as she laughed. She seemed like she'd held that feeling in for many years, of her tenure as a caretaker. She is one of the first examples of the effectiveness of this training being magically more in the training being a laughing, caretaker's support group than anything I empirically measured pre- and post-intervention.

Lady Gaga and her entourage of sassy caretakers

Yoke Yoke, the trainer, describing how to use positive discipline,
highlighting how to make it positive, labeled, and clear when giving commands and rules

PRIDE caretaker-child relationship-building skills,
translated into Bahasa -- what a thrill to see it in Bahasa, for me!

Andy explaining how to do the PRIDE skills on the flip chart.
The trainers gave me feedback later that the PRIDE skills were the most difficult skills to teach,
with specific sub-skills like "Reflect" being really hard to translate, and requiring
much more demonstration of each of the PRIDE skills, because the
caretakers didn't seem to get it, simply role playing enthusiasm and a bit of praise over and over,
not doing the other skills, like "Imitate" or "Reflect"

The head honcho of all the caretakers, to retire soon. She was a natural, joyful caretaker, evident in her glowing, warm role plays of how to build positive relationships with the children, using the PRIDE skills.

Wow, this caretaker sure had nearly-violent enthusiasm in her voice in this role play of her using the PRIDE skills with a caretaker pretending to use enthusiasm with a child drawing a picture. We weren't sure if the caretakers would think that they would have time or the opportunity to use the PRIDE skills with the orphans, since the caretakers are already so overwhelmed with too few staff and too many physical caregiving demands for the overwhelming number of children under their care. So, we were relieved to even have the orphanage cook say he thought he'd use the PRIDE skills with the most shy, hard to reach children he's been wishing he could connect with.

How to use Positive Reinforcement

Stars for the Star Chart training

Andy, the trainer's, star chart as an example

One participant's practice star chart --

A star chart is used to target one problem behavior in one child, rewarding him for the number of stars he accumulates.

Time out -- One staffperson putting a "child" in a time out.
This group thought a time out was too short and mild to be effective.
They thought the orphans needed more strong, maybe even harsher, punishments to change their behavior.

Time outs consistently make trainees giggle

FEEL technique: Helping children manage their strong feelings

One caregiver practicing helping a "child" with their hurt feelings,
using the FEEL technique.

Caretaker self-care activity: All the roles they play at home and at work
With the goal of underlining how stressful it is to juggle so much

A pie chart with the different roles they play at work. Then we make a pie chart of their roles at home. At work, they play roles like nurse, etc.

Jeng Mun, making the point that they are juggling a huge number of roles in their lives.

The certificate we gave the trainers and trainees at the end, with my signature. This was Huay Ping's certificate, one of the trainers.

Huay Ping running a physical activity in her group, to give them a break
and to teach them an activity they can do with their kids as a release, reward,
and to get the kids' attention

Surprised Huay Ping had been a flight attendant in her previous career life?
She asked them to race to one side of the room or the other, depending on which kind of food they liked. They LOVED this game. Malaysians LOVE food.
At the beginning and the end, the trainees completed Confidence, Knowledge, and Satisfaction forms. The program showed a significant increase in trainee confidence and knowledge and had high satisfaction ratings. We were pleasantly surprised to see a significant increase in confidence and satisfaction, given there were only 25 or so trainees.

The Diploma Awards ceremony, for each trainee and trainer.
There was crazy enthusiastic, bubbly applause for everyone.

Huay Ping, a trainer

Lady Gaga!

Angeline, a trainer

Andy, a trainer

A HELP trainer

Yoke Yoke, a trainer

Noelle, the COO

Jeng Mun, trainer

Everyone gathering at the end to say goodbye, and some to thank me

The head supervisor of the orphanage caregivers, set to retire, and much beloved

The orphan caregivers gave me a thank you gift that made me cry, I was so touched. Some of their orphan "kindergarteners" drew a picture for me.

June 22, 2011