Best Practice Forum Oct 17 2014

The Earl of Listowel, IRCT Patron opened the meeting with a warm welcome and reminded us about the importance of reflection and peer discussion.

Stephen Bell, Chair of IRCT then explained the vision of the Institute as an organisation committed to focussing on the recovery of the traumatised child. He said that it aims to bring the body of knowledge about trauma recovery together and then disseminate this knowledge to others who support traumatised and vulnerable children. 

Presentation A

Sylvia Duncan, a clinical psychologist since 1972 introduced herself and spoke about the current speed of society that doesn’t facilitate enough time for thinking and reflecting. She asserted that a theme of her work and the concept of her presentation at the BPF was the importance of providing a space of containment for children and professionals to allow for reflection and thinking time. 

Sylvia suggested that when we think about the impact of trauma we need to think it exists as a continuum and have an awareness that it is often the response to the trauma can be more traumatic than the event itself. The best-case scenario and worst-case scenario of trauma recovery were explored as a foundation of the exploration of the work with traumatised looked after children.

The therapeutic re–parenting partnership (TRP) was set up as a partnership between Kent County Council and Sylvia’s practice as a collaborative approach to work with looked after children from pre school to 10 years of age who had experienced multiple placement breakdowns. Sylvia shared that as a staff team they have had only one change of staff in 11 years as consistency is the vital ingredient for the success of this project. The foster carers are delighted to have the level of care that the TRP offers and at any one time there are 15 children involved in this scheme. The foster carers agree to a 2 year placement as a minimum; they have peer mentoring and meet together frequently for support. All the children are assessed by a clinical psychologist and this assessment includes an assessment of attachment strategies, relationships, behaviour, educational process and special needs.

The TRP structure aims to support the foster carers to re-parent the child by facilitating a safe entry into their care with routines, repetition and a simple, small, nurturing routine. There are monthly network meetings for each child, monthly support groups for carers and supervision with fostering TRP lead social workers.  The meetings are focused on the psychological experiences and not on decision making and are aimed at progressing towards a guided transition to permanence with a transition period of authentic involvement. An example was shared of a child who needed to be nurtured like a baby when he was in year one in order to make the appropriate development and went onto make extraordinary progress including academic success.

Presentation B

Dr. Hazel Douglas, also a clinical psychologist then continued the presentations by introducing the Forum to the research that showed that the UK children’s happiness is 21st out of 21 nations. Why is that? The Netherlands were seen as the best country in raising happy children and Paul Vangeert, Professor of Developmental Psychology explained that the Netherlands is a child friendly society where there is a high focus on young children and a focus on relationships. Hazel asserted that there is not enough focus in the UK on the child and parent relationship and the major resilience factor for children in having one stable, consistent adult parent. She asserted that the systems could help but often they don’t. 

Hazel continued to explore the concept of epigenetics which suggests the importance of nature AND nurture. This illustrated why relationships are the main focus of the Solihull approach. She explored how within relationships, containment is key and facilitates the ability to restore the capacity to think and helps the parent to think about their child, relate to their child, helps the child with anxiety and emotion so that the child is free to relate and helps the parent process the ‘old’ emotions (often from trauma) so that the parent can relate to the actual child in front of them. Containment is the key to the ability to create a coherent story as it activates the brain to process it.

The aim of the Solihull approach is to increase the quality of relationships in a low cost way by supporting relationships from antenatal to late adolescence. There are currently 10,000 trained family and child practitioners who work in this field and the training is facilitated in children’s centre’s and schools across the UK and in many nations around the globe.

The conclusion from Dr. Douglas was that the children in the UK have the lowest rate of emotional wellbeing and a focus on relationships would be the key to changing this.

Presentation C

Dr. Alex Hassett then followed in his presentation, which focused on a research project involving schools.  He emphasized the importance of the Solihull approach as a model for understanding and thinking about relationships and for providing a shared language and framework to help provide containment for  professional worker.  He explained how the Solihull approach supports the work that schools are doing around SEAL, including making the link between containment, reciprocity and learning more explicit. The approach emphasises the relationships between educator and pupils and the relational context of effective behaviour management. 

Dr. Hasset then explored the impact of emotions on children’s capacity to concentrate, learn and think. The staff in schools that engage with the Solihull approach are encouraged to think and reflect about the children can be calmed down and also reflect on how teaching and learning has to take place in a containing environment. He asserted that traumatised children sometimes need specific approaches to enable them to engage in education where there is an understanding of what they have experienced and why they can’t always respond in a manner that is expected.

The aim is to help school staff think about brain development alongside behaviour management with a specific focus on containment and reciprocity in order to help the children learn to regulate themselves.

He then presented the results of a pilot study in four primary schools, where the Solihull approach was introduced. It saw an increase in children’s well being and an increase in teacher’s health and reduction in stress.

John Diamond then facilitated a time of reflection and discussion about the main themes that were elicited from the presentations. 

Stephen Bell concluded the Forum by stating that whilst we are a prosperous country there is a fundamental issue with relationship poverty.  The three speakers were thanked for their insightful presentations and all present were encouraged to  join the IRCT if not already members.

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