Clinicians Can Be That 'One Caring Adult' Who Changes a Life

Elizabeth Millard

December 12, 2019

When he was 17 years old, Josh Shipp spent a long, thoughtful night in lockup, waiting to get bailed out by his then foster parents, two out of dozens he'd had since he'd become adept at getting himself kicked out of placements, even as a child.

This pair, Rodney and Christine Weidenmaier, were coming up on 3 years with Shipp, and when he got arrested for forging checks, they wanted to show how much they loved and cared about him. So they didn't post bail.

"That decision ended up being a catalyst for everything that was to come," Shipp said. "I had to sit overnight, thinking about a life filled with pushing people away, and actively rejecting them before they could reject me. In the morning, while I was still in that frame of mind, Rodney told me they would never give up on me, because there was good in me, and they could see it even if I couldn't."

That's when Shipp realized they actually cared, deeply. That shifted his perspective toward being willing to accept help and to take accountability for his actions — not just with the check fraud, but with his habit of being oppositional to everyone who'd tried to be supportive toward him.

"Early on, I had an adult who broke my trust, so I assumed that's what every adult was like," he said. "So I became proficient at reading people's weakness and doing whatever would be the most painful or insulting for them. When a kid is doing that, it feels personal to you. But it was never about them," he said.

Shipp shared his story at the recent American Academy of Pediatrics conference in New Orleans in a keynote presentation on the theme of "The Power of One Caring Adult."

"When we think about who makes a difference in kids' lives, we picture parents, teacher,s and coaches, the people who see them nearly every day and have frequent interactions with them," he said. "But what I wanted to get across to the AAP audience was that you can have a single interaction with one of these children and still make a profound difference."

He urged pediatricians and other healthcare professionals in the audience to see themselves in that role, even if their interaction with children and teens in difficult situations, such as foster care, is minimal.

For example, Shipp recalls a pediatrician who taught him the proper way to shake hands. He doesn't remember the doctor's name, but the memory of that 30 seconds of coaching is vivid. Not only did Shipp learn to shake hands with confidence, even as a child, but he recalls feeling respected and seen, which still resonates with him to this day.

"You may not even know it as it's happening, and [the child] may not either, but it can have a ripple effect in the years to come," he said.

A Ripple Effect

"That one act, so simple, has had a tangible impact on my overall well-being and self-esteem as a person," said Shipp. "I still think about [that doctor] and that lesson. In the midst of feeling abandoned and rejected, here was someone who saw me as a person, not a problem."

For Andrew Garner, MD, PhD, a primary care pediatrician and member of the AAP Committee on Psychosocial Aspects of Child and Family Health, Shipp's keynote represented a sea change in terms of how trauma is perceived in the healthcare community.

"Up until this point, we were thinking about trauma in terms of a deficit, focusing on what the child was missing," he said. "But Josh's talk was timely, because it shows the shift toward these pivotal, positive moments that build resilience. Of course we don't want children to have trauma, but we need to understand they will face adversity. And our role can be bolstering this sense of strength and skill building that comes out of that adversity."

Although Shipp underscores the need for "one caring adult," he recognizes that it often takes multiple caring, stable, supportive adults to make an impact.

Garner believes "one caring team" is the best approach since it can give children like those in foster care the understanding that wherever they turn — the doctor's office, school, on a sports team, at home — they are part of a community.

"What's toxic is loneliness and social isolation," said Garner. "Community is the antidote to adversity. It allows these children and teenagers to flourish in a highly resilient way."

Pediatricians "Get Attached"

That's not always easy to keep in mind when you have an "early Josh" type of child in front of you, admitted Gina Posner, MD, pediatrician at MemorialCare Orange Coast Medical Center in Fountain Valley, California. For pediatricians who treat foster children regularly, it can be challenging to show empathy and compassion while feeling pushed away more often than not, Posner said.

"It can be tough to maintain your own emotional health because pediatricians do get attached and you want the best for them," she said. "Sometimes I cry along with the foster parents. But as tough as they might make it, and as difficult as the situations might be, I always emphasize that I'm not going to ever give up on them. You can tell they need to hear that, even if they act like they don't."

Sometimes, the things in our lives that have hurt us the most can be what we use to help other people. Josh Shipp

In addition to being a motivational speaker and author, Shipp now trains other young speakers and develops educational curriculum for parents, educators, and social workers. Something he frequently reiterates — as well as the power of small moments like the handshake instruction — is the value of being vulnerable and human with one another.

He recalls the first time he really talked about how hard it was to be in foster care, about his own fear and sadness, and the ways he pushed people away so aggressively. After the talk, a teen approached him with a folded-up note and said, "After your talk, I don't need this anymore."

Later, Shipp retrieved the paper from his pocket — it was a suicide note.

"That's when I realized that sometimes, the things in our lives that have hurt us the most can be what we use to help other people," he said. "Everyone can take action to become the one caring adult, no matter who you are or what you're doing. Often, it's enough for kids to know they're not alone, and that they matter."

American Academy of Pediatrics (AAP) 2019 National Conference: Opening Keynote Address, "The Power of One Caring Adult."

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