Working with Traumatised Children and Young People – a personal reflection
One aspect of my work is supervising therapists working in schools – @90% of whose caseload is with children who in their first few years either witnessed domestic violence, were physically abused, were neglected, emotionally abused or sexually abused. In a couple of cases violence was experienced in utero. This is becoming more of the usual caseload for these therapists. I feel privileged to support the therapists and together we can often reflect on the process of healing that remains inherent in most of the children we work with. However, one of my concerns is that not enough support is given to the home environment so that children aged seven or eight are left unsupervised playing video games which are age inappropriate and highly charged, e.g. Call of Duty, Grand Theft Auto and Assassins Creed. There is often no adult to help the child make sense of (and soothe) the excitement generated (or an adult is playing competitively with them). In other cases the Dad who had been abusing the Mum is back on the scene and the child’s anxiety goes up. In another case, the child has disclosed harsh reactive punishment by the kinship carer. Social Services haven’t responded in any of these cases as the “threshold has not been met. In my experience some schools feel there is no point in contacting Social Services.
The effect is that the impact of therapy is undermined and the child’s capacity to feel safe is under assault. Schools often struggle in the face of a dysregulated child and sometimes feel reluctant to change their behavioural polices so the child’s emotional needs are not met there. Bruce Perry has pointed out, ” One therapy session a week will not provide sufficient healthy relational interactions and opportunities to permit the child to catch up from years of relational poverty…. Therapeutic process must include a “therapeutic web” of people invested in the child’s life – teachers, coaches, foster carers, (and social workers) can all help provide therapeutic opportunities”*. At a recent meeting Perry described this as therapeutic doses.
If we continue to act in silos so that if schools do their thing and social services only respond to high threshold crises and families aren’t encouraged to seek help and foster carers aren’t given the emotional equipment to respond to traumatised children we may be building the foundations for another battalion of Troubled Families.
When the school and the family and the therapist and the social workers come together and think about the child and interact with the child and stressed parent, significant and enduring changes in the child’s brain happen which enables them to feel safe, explore and begin to fulfil their potential.
* “Applying Principals of Neurodevelopment to Clinical Work with Maltreated and Traumatised Children” Bruce Perry 2006 – available on line.