Home > News
23/03/2007: Helping Traumatised Children with Difficult News
Communication can be defined as the process of ‘imparting, transmitting or receiving information’ (Aldgate et al, 2006). Communicating with traumatised children presents many challenges, as the impact of the abuse they have suffered has far reaching consequences for every aspect of the child’s development. Traumatised children often have an emotional age far below that of their chronological age, such as a nine year old with the emotional presentation of a toddler. It can therefore be difficult to gauge a child’s level of understanding when faced with such disparity.
In order to communicate successfully with traumatised children, practitioners should be able to build relationships with them, based on a genuine warmth and interest in the child (Koprowska, 2005). It is important to bear in mind that rapport building is likely to take longer with children who have emotional and behavioural difficulties (Jones, 2003). When grown-ups come to SACCS, they are encouraged to spend the majority of their time within the house with the children, in order to build and maintain relationships with them. This would include spending time together playing, taking children to school and settling the children to bed, so that the new staff member can also become integrated within the child’s life and to allow attachments to develop.
Practitioners need to ensure they are clear about what is to be communicated, and to use simple, child friendly language, in order to aid the child’s understanding of what has been said (Koprowska, 2005). For example, rather than saying to a child “We have boundaries within the unit to help children feel safe”, we might say “We have to have rules at our house to help children understand how to get along with other people and to protect them from being hurt.” The first phrasing sounds institutionalised, jargon filled and works on the assumption that children would understand words such as “unit” and “safe”, which is unlikely when they have never been kept safe by the adults entrusted with their care. It is beneficial for practitioners to have a good understanding of child development, and how development is affected by negative experiences (Aldgate et al, 2006), in order to develop and in form best practice.
Every SACCS practitioner receives a wide-range of training throughout their career in all areas of therapeutic care, beginning with an extensive induction process. Practitioners attend fortnightly training on each of the 24 outcomes of recovery, an approach which is unique to SACCS as it offers measurable milestones by which to evaluate children’s progress through the recovery process. They the progress to the pioneering degree program developed by SACCS with North East Wales Institute in therapeutic child care. Staff are encouraged to keep a reflective practice log in order to think about their work and how to link theory learned in training with practice within the house. This also encourages awareness of one’s own feelings, thereby ensuring that workers’ difficult feelings are not unknowingly transferred onto these incredibly vulnerable children.
At SACCS, the child’s key-carer would usually impart sensitive and potentially difficult news to the child. Time is spent thinking around the best way to do this, either with the home manager as part of supervisions, or involving the whole team in weekly meetings and fortnightly group consultancy with a child psychotherapist. The key-carer supports the child following any difficult communication, providing nurturing care and opportunities for feelings to be discussed, acting as a container for the child’s emotions, by remaining with him regardless of the difficult feelings or behaviours displayed by that child. In this way, the child is shown that their emotions and behaviour can be contained and boundaried, in a way he may never have experienced before. This is particularly so for children placed within SACCS and whose turbulent behaviour has often resulted in numerous placement breakdowns.
Often, children appear to take serious news in a rather blasé manner, for example a child who needed to be told that his mother had been sent to prison and reacted as if his key-carer had said it was sunny outside. Feelings related to such news may often take a while to manifest themselves, frequently in the form of violent or aggressive outbursts, and it is often only through the preoccupation and skill of the residential workers that the real reason for such incidents can be identified and worked through with the child.
A grown-up’s leaving is an understandably anxiety provoking issue, for both the children and the remaining staff members within the team, particularly due to the issues of loss and abandonment the children have already experienced on numerous occasions in the past. This is especially notable when it is a child’s key-carer that is leaving, as this person may be the first attachment figure the child has had. At SACCS, adults are required to give three months notice prior to leaving, in order that it can be planned and thought about, so that the children can experience a positive ending with that person. The leaving is discussed first of all with the line manger and then with the team so that the impact of the leaving and feelings involved can be considered and worked through. Supervision and consultancy sessions are used to support this process. Only when the team have done this work can they plan how and when to inform the children. This is to prevent any unresolved feelings from the team being passed onto the children, whether consciously or unconsciously. The children are then told individually, either by the person that is leaving, or by their key-carers. This should be done as far in advance of the actual leaving as possible, in order that the children’s feelings can be acknowledged and worked through prior to the leaving.
The person leaving would continue to receive regular support in order to deal with the projection of feelings from either the children or the grown-ups, and to prevent any accumulation of negative feelings, which may adversely affect the work being done with the children. After the person has left, the feelings of both the children and the remaining team would continue to be discussed and worked through, as it is often the case that the children can struggle to process the loss of the person leaving until they have actually gone. To minimise the risk of grown-ups leaving, and to promote continuity of care for the children, grown-ups are expected to commit to three years service with SACCS in order to see a child through the average time it takes for the Recovery process to be completed.
Katy Reader – Residential Childcare Worker
References
Aldgate, J. (2006) – The Developing World of the Child, Jessica Kingsley Publishers
Jones, D. (2003) - Communicating with Vulnerable children, DofH
Koprowska, J. (2005) - Communication and Interpersonal Skills in Social Work, Learning Matters
