'Vicarious trauma' part of the job at Paradise youth counselling centre

It's not the kind of work you can easily walk away from. 

The Tuckamore Centre in Paradise, where a dozen youth aged 12-18 with complex mental health issues can live for up to a year, is a 24/7 operation. As is its sister facility, Hope Valley, in Grand Falls-Windsor. 

That means staff work intimately with the troubled youth in their care. 

"I think I could give you a different story for every young person we've had here so far," said Susan MacLeod, program manager at the Tuckamore Centre. 

She said any combination of things could lead someone to the centre for help. 

"A lot of those behaviours resemble typical adolescent behaviours except they're pretty extreme for some of the young people we deal with."

Trauma, limited services in rural areas, and diagnoses of anxiety, depression, personality disorders or being on the autism spectrum may combine to bring a young person into one of their rooms. 

Before the two $12.5-million residential facilities in Newfoundland and Labrador opened in 2014, young people had to leave the province for this kind of help.

Real-time counselling

In an average day, residents make their own food, go to school (taught by school district teachers in-house), do recreational activities, and therapies — individual, group and art. 

We do become very close with the young people and we do have very strong feelings of caring for them.- Susan MacLeod, Tuckamore Centre

They follow a dialectical behaviour therapy (DBT) model, which MacLeod explained as "teaching the skills that may help them to be able to help themselves."

That includes coping skills and life skills like cooking – with knives hidden behind a roll-down door when not in use, so as not to trigger those with thoughts of self-harm.

"In terms of mental health treatment, oftentimes if you go to see a counsellor one-on-one in an office, you tell them whatever it is you choose to tell them in the run of how your week went," said MacLeod.

"Whereas here we have the real-time, 'here's what your day was like and here's what we experienced with you,' and we can help them in the moment."

Which means trust is critical, as it's also a very intrusive kind of therapy that doesn't work for everyone. MacLeod said it's an alternative when someone is finding life "really tough" and really isn't doing well at home. 

MacLeod said 41 young people have come through the Paradise centre with just one person returning a second time. Everyone is there voluntarily, and they work on a plan for life after Tuckamore before they leave. 

Wait times vary, but she said there can be several people waiting for a room and several more on a referral list. 

"For some young people who leave here, they're much better able to cope and better able to manage in their community."

"For some, it's just not enough or they're still going to struggle," but MacLeod said the hope is they have skills and support to fall back on. 

Support for youth, support for staff

"I always quote one of our staff who once said that we'll never know how many young people didn't hurt themselves because of an intervention we did, or didn't go down a bad path." she said.

"You only sort of hear of the ones that do end up in crisis." 

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Interventions can take a toll on the caregivers as well. 

"The issue of living in the life space of a young person who's dealing with these issues is we do become very close with the young people and we do have very strong feelings of caring for them, and that sometimes leads to vicarious trauma for our staff."

But MacLeod said taking care of staff, and talking with each other about the kids they support, is a critical aspect of life at the Tuckamore Centre as well.