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Oct 2007 Jul Jun May Apr Mar Feb Jan Dec 2006 Nov05/10/2007: Reflection, understanding and responding with traumatised children
In doing this, we encourage our adults to accept total responsibility for the children in their care. A mother with her child doesn’t ask for permission to do what she thinks is right for her child. She assumes this responsibility and acts on it to care for her child. In most families, the needs of the child, not the adult, are paramount but it is the adults who decide how to meet these needs. If a child is engaged in potentially harmful behavior, our adults will intervene to protect the child. We encourage our parental figures to respond with benign authority, maintaining the child’s best interests at all times, and to use each other, supervision, training and consultancy to guard against an abuse of this power.
Consider another example, if a mother and toddler are together in the kitchen. The mother could be ironing clothes while the toddler plays at her feet. If, for example, the mother left the kitchen to fetch some more clothes to iron and the toddler pulled the iron on top itself. Who would be at fault, what would be the appropriate reaction to the toddler? Most under twos are unable to recognize danger and their playful interactions with world help them learn about it. They also learn through the responses of their main care givers who provide information but also relationship based emotional learning. So too our children in SACCS, they learn they are valued, loved, cared for and this enables them to later show these qualities in their relationships with others.
It is often misunderstood that adopting a therapeutic approach based upon the emotional needs of traumatised children means the children are allowed to do whatever they like. This is not what we advocate at SACCS. Firm boundaries are required as the young child does not know enough to be able to keep itself safe. This is why we encourage the adults to take complete responsibility for the child until we assess the child as being more able to take their own responsibility. The boundaries are consistent and repetitive delivered uniformly by all adults. An analysis of an adult’s time in SACCS would show how much time is given over to discussion with other adults about their work. This helps all adults to adopt a common approach to the children despite their very different parenting experiences as children.
If one of our children breaks a boundary then the response from the adults should be quick to reassert safety followed by an explanation as why this was unsafe. As described earlier, if we are attempting to replicate how a parent would respond to their child as much as possible, then it is appropriate that all adults feel they can respond to a child in our care on behalf of the team as a whole. There are some occasions when pausing to allow time to think is appropriate but as a general rule, the adults will respond to children’s behavior as quickly as possible. Firstly to reassert safety and secondly to give a parental message which is in keeping with our recovery programme for that child. The adults are helped to overcome their own resistance to taking responsibility and to learn from each other
As the child grows, it is important for them to learn that they are not the only person who has thoughts and feelings. They share the world with other children, and adults, whose needs and requests are to be met fairly. In SACCS, the house group will meet at least twice a week to discuss how we are living together and what has happened in the interim. The children are encouraged to share their thoughts and feelings in response to each other. Likewise, the adult may share some of their feelings in response to the child’s behavior to help the child to understand they have an impact upon others. The goal of the interaction is to reassert to each child they are cared for, and the boundaries are for their well being. This is mirrored in the individual responses from the adults to the children at other times also.
It is important that the boundaries are fair, and that there is consistency of approach by all adults to all children. This does not mean that the adult team have to treat all children the same but it does mean that the adult team have to respond to each child according to its individual programme. The adults will take time to explain to the children why they have taken a course of action, or made a parental decision. As with all families, this is made more difficult with the onset of adolescence. The children will have a strong need to develop separately to the adults, the find a place in the world independent of their adult relationships. There will be inevitable boundary battles over trust and permission. Within SACCS, we take these decisions very carefully in order to balance the adolescent need with the vulnerability of our emotionally young children.
The collectivity of the house group can be strengthened by discussing these issues together regularly. This doesn’t only take place in the house group meetings but in impromptu discussions in front of the television or across the meal table. The children will instinctively seek reassurance from the adults on the issues which are perturbing them.
Unlike in other family groups, the people in this SACCS’ family will change over time. The children will grow and move on to foster families to continue their recovery, new children will join. The adults will move on also, although this is kept to a minimum as it the relationships they form with the children which is fundamental to recovery. Therefore, it may be helpful to have some shared beliefs and understanding written, “this is how we do things in our house”. If this is done, it must be a live document owned by all, children and adults alike and regularly reviewed. The discussion, understanding and ownership of these principles is more important than what is written. Otherwise, the children and adults will adopt a concrete referencing system that doesn’t allow for thinking and understanding. This will lead to institutionalisation if used inappropriately. In SACCS, we encourage the adults take the lead in these discussions but to use the children’s growing sense of appropriateness and fairness to allow them to participate fully. This is an important part of our culture, and key to the development of empathy towards others based on mutual respect.
Maintaining this culture is difficult, it will be attacked by the children due to its unfamiliarity and difference to their previous experience. If we think again about the types of family relationships our children will have experienced prior to SACCS, then it is logical that they will perceive the adults as a threat and fear further abuse. They will also be very confused about their role in a family group, some may feel that they have to be aggressive to prevent being hurt, others may believe that they are subservient and evoke aggressive responses in others. The chaos of the traumatised child’s mind will be represented in their relationships and it will take thoughtful unpicking by the group as a whole. The culture will also be attacked by the adult team who will find the pressure of living with our children unbearable at times. They will occasionally wish to relieve this pressure by punishing the children. This must be resisted by the management of the house, and the organization as a whole. The adult team may protectively identify with the unfairness of what has been done the children, and often they will assert that the culture is unfair to them. There will be pressure upon the home manager, and organisation to respond in a way which makes the adults feel temporarily better. This must also be talked about and understood.
The role of external consultants can help all members of the organisation to understand the processes involved in looking after traumatised children, and re connect with their primary task of helping the children to recover. They provide a function which is separate to the running of the family, and is less likely to get caught up in the dynamics of the children’s disturbance. At SACCS, we employ nationally renowned consultants to help our adults to process their relationships with each other and the children. This builds in to the system planned occasions for de briefing and understanding. The teams are encouraged to think about their interactions and reflect on patterns of relationships which may mirror the children’s previous experiences. This is also done at the end of each evening in each of our houses. A senior member of staff will take responsibility for leading a discussion on the day’s events. Each person’s contribution is valued and collective learning strived for.
When we achieve this process of reflection, understanding and responding then we create a virtuous cycle. The children’s need to seek resolution for their trauma is understood and contained by the benign authority of the adult team, the acting out recedes and emotional growth occurs. The house is a positive place to be for children and adults and the work feels achievable. Inevitably, given the extreme and complex needs of some of the children we help, we can lose our way sometimes. In this situation, a vicious cycle is created. The children’s needs are not understood and are over whelming for the adults, the acting out intensifies and previous family breakdowns are repeated. The house becomes a very different and difficult place to be and the work feels impossible. Here it is important to understand that both states are part of the recovery process. It is the role of management, in the first state, to keep a weather eye on the development of concrete thinking and complacency, possibly reminding the group that we must always look upon the issues of the child freshly and consider the best response. In the second state, it is important to hold on to hope in the face of seemingly over whelming despair and reassert the positive virtues of reflection, understanding and responding.
When the culture is positive and strong enough to with stand these challenges, then true reparation for harm done will be shown by the children. This must be recognised and valued. The children will seek parental approval through their actions and when they experience appropriate praise for their contribution it will have a very strong positive reinforcing effect on their relationship with an adult and through them the house culture. With our children, the adults are encouraged to seek out moments of achievement and positive contribution and give feed back. Conversely, reparation enforced by the adults will have little emotional meaning for the child and undermine the culture. The child will not feel their contribution is valued but rather it is expected as part of a process of paying off their debt to the group. This reduces their ability to learn from their experience and its meaning to them, and the group.
This is not meant to mean that group participation is voluntary, that the child can opt in or out of the process according to how tough it is. Group participation is mandatory, but each child will need differing levels of support to achieve this. If the process breaks down then we repeat again, and again, until completion. The collective will of the group and its firmly held belief in the recovery process will overcome the resistance in time, determination rather than coercion is necessary.
Another form of attack on our house culture comes when adults feel that the culture is unrepresentative of the “real” world. This is often most prevalent when dealing with adolescents. Adolescents are neither child nor adult but exist in an in between state. On some occasions, they behave and invite treatment from others which is child like. On other occasions, they will request, or demand, to be treated as an adult. The children who come to SACCS will demonstrate this conundrum in an extreme form. Their behavior oscillates between extremes and invites extreme responses. This is very difficult to live with and survive intact. The greatest containment for the adolescents in our houses is the ability of the adult team to continue to think. This will be supported by the management of the house. When an adult is feeling overwhelmed they may ask that the adolescent is given a dose of the real world, and usually they mean some form of sanction, retribution or punishment. What is lost in this thought process is the fact that often these children have already experienced much worse in their lives already. A hundred punishments increasing in intensity won’t help them recover, nor will a hundred rewards increasing in value. The children require that the adults help them with the effects of their trauma before they can engage with the real world upon equal terms.
None of this is easy, and it can’t be done in one gesture but needs repeating hourly and more. SACCS is committed to helping the children placed with us in this way and to supporting our staff with the tough task of doing so. For our children, this is the only way to recover.
Niall Kelly
Deputy Director
