Storing up trouble: NCB report exposes major failures in the system

In September 2017, the All-Party Parliamentary Group for Children (APPGC) launched an inquiry into the causes and consequences of varying thresholds for children’s social care. The Inquiry’s findings are published in the report ‘Storing up trouble: a postcode lottery of children’s social care’.

This vital document exposes major failures in the system designed to support families and children. The main concerns raised:

ā€¢ Thresholds for child protection or enabling access for support are often too high and thresholds vary significantly between local authorities
ā€¢ Children in need of a child protection plan are, in 2/3 of cases, being left vulnerable to continued abuse or neglect
ā€¢ Only a ā€œsmall proportionā€ of resources is spent on early help and family support
ā€¢ Families and children in need experience a high turnover of social workers assigned to them

A persistent theme in the report is that support often comes very late, i.e. when a child is at risk of being taken into care. This increases cost to the state and delays the opportunity to relieve suffering. ā€œToleranceā€ for early help is ā€œbased on resourcesā€ ā€“ there is simply not enough capacity in the system.

One major conclusion that we can draw is that short term failure to offer appropriate services leads to long term increased cost and more children suffering the impact of developmental trauma and needing more complex services later on.

The report acknowledges (without specific reference) that there is often a combination of Adverse Childhood Experiences present for children in need of early help.

Help us help children and adults recover from early developmental trauma ā€“ a right acknowledged by the United Nations and signed by the U.K. under the UN Convention on the rights of a child.

Turning Childrenā€™s Lives Around

At our latest Best Practice Forum in June 2018, our keynote speakers Richard Cross (Head of Assessment & Therapy for Five Rivers Child Care) and Alison Hodgetts (a Registered Clinical Psychologist) gave a talk entitled ā€œTurning Children’s Lives Aroundā€ – overcoming the impact of childhood adversity through therapeutically focused integrated care.

The presentation focused on the Five Rivers model of ā€˜trauma and attachment informed careā€™ and the knowledge, organisational structures and supports that are required to ensure good outcomes.

Five Rivers Child Care is a social enterprise that has been dedicated to addressing the impact of abuse, trauma and neglect for almost three decades.

The care provider has made significant investments into developing knowledge and understanding about what works in accurately identifying the needs of the child or young person. This has ensured the right therapeutic environment to meet the needs of children and young people who have experienced trauma.

Richard shared how this unique approach was embedded across Five Rivers Integrated services of Education, Care and Assessment & Therapy – and how a partnership with researchers from University College London and The Anna Freud Centre was successfully developed.

Richard and Alison further explained how Five Rivers Integrated case management maximises the use of the assessment comprising ā€œthree key strandsā€ (attachment, trauma and disassociation). The approach aims to transform and maximise the impact in responding to the emotional needs of the child or young person.

Fountain House, a Five Rivers residential facility, has developed an attachment and trauma informed residential therapeutic environment. Richard explained that this approach has demonstrated how it can ā€˜transform childrenā€™s livesā€™ by minimising the impact of their traumatic experiences as they developā€™.

Concluding the talk, Richard made an important point to the audience, that ā€˜the integrated model provides the glue and a shared understanding helps people to connectā€™. Summing up the necessary steps to develop an integrated service, he stated that the following key areas were essential to successfully delivering this model:

1. Develop a relationship-based therapeutic model
2. Capture the hearts and minds of the workforce
3. Help children and staff to understand what is happening
4. Provide training and a toolkit for staff
5. Develop a supportive culture for staff
6. Undertake a full assessment of the child/young personā€™s past experiences and current issues to identify their needs

The Earl of Listowel thanked them for their presentation and the audience then took the opportunity to ask questions.

Our Speakers

Richard Cross is Head of Assessment & Therapy for Five Rivers Child Care – an innovative and progressive social enterprise dedicated to ā€˜Turning childrenā€™s lives aroundā€™ who have experienced trauma, abuse and neglect. His focus is on ensuring the development of effective identification of need (assessment) and deliverer of therapeutic interventions that make the difference.

He is a UKCP, EAP, WCP registered Psychotherapist and Child Psychotherapist who has worked with children, young people and adults who have experienced trauma since 1991. He has sought to support the development of a range of relationally based therapeutic programs to improve outcomes for maltreated children e.g. New Zealand advanced EQUIP program (2002), Adapted SOTP for adolescents (1998) and piloted a trauma informed approach across 16 residential homes (2007 ā€“ The Sanctuary Model). He is a member of the European Society for Trauma & Dissociation (ESTD) and a member of the International Society for the Study of Trauma and Dissociation (ISSTD).

Alison Hodgetts is a Registered Clinical Psychologist who has worked with children, young people and their families over the last 10 years, both in the NHS and privately. The focus of her clinical work has been with children and young people who are fostered or adopted; providing assessments, therapy and consultation, as well as training carers, parents and professionals.

Her professional interests include Attachment Theory, Developmental Trauma and attachment-based psychotherapy. She has completed her Level 2 Dyadic Developmental Psychotherapy (DDP) training and is working towards completing the DDP practicum. Alison joined Five Rivers 12 months ago and works with the Fostering teams in the West Country.


Campaigners call for new vision for children in care

Campaigners call for new vision for children in care

The Alliance for Children in Care and Care Leavers is calling for a clearer definition of what care is aiming to achieve. The group wants a statement in law defining theĀ principal aimĀ of the care system for those children who spend a significant time in care, as promoting psychological healing from past harm, building resilience and achieving wellbeing.

In order to achieve this change a new framework is required to measure how all children and young people are coping in care which can be used to hold local authorities to account.

ā€˜A new visionā€™ is published at a time when the care system continues to fail too many children, despite the evidence that care can be the right option and can provide the security, stability and love that children need.

The Alliance is also calling for:

  • Greater support and training for primary carers and key workers in childrenā€™s homesĀ – so they can help children overcome past experiences and build positive relationships.

  • Mechanisms for assessing the quality of care from the childā€™s perspectiveĀ – and accountability when a placement doesnā€™t work for them.

  • Measurement of childrenā€™s wellbeing and progress throughout their care experienceĀ – rather than one-off outcomes, so we understand when children are doing well and when they need more support.

  • Care that meets the day-to-day emotional needs of childrenĀ – but with timely access toĀ specialist mental health supportĀ if needed.

  • Continued support when young people leave careĀ – so they are not expected to become independent earlier than their peers.

Enver Solomon, Director of Evidence and Impact at the National Childrenā€™s Bureau and co-director of the Alliance for Children in Care and Care Leavers said:

ā€œThe care system is not just about removing children from harmful situations and putting a roof over their heads. Many children in care have been seriously abused or neglected, and rely on local authorities as corporate parents to help them get back on their feet. Ultimately, the care system should help children overcome their past experience and forge the lasting and positive relationships that we know are vital to their future wellbeing.ā€

Emma Smale, Head of Policy and Research at Action and co-director of the Alliance for Children in Care and Care Leavers said:

ā€œCare is the right option for many children and young people. It can provide them with the love and warmth that they need to have happy and secure childhoods.

ā€œBut, despite the collective efforts of national and local government, the focus on the best outcomes for children has been lost.

ā€œThe impact of traumatic experiences like severe neglect and family breakdown is enduring. Yet too many young people say that the reasons they come into care are not addressed. It is time to renew our efforts for children in care and care leavers.ā€

The Alliance for Children in Care and Care Leaversā€™ ā€˜A new visionā€™ is available atĀ Ā

A Young peopleā€™s version is also available.

The Alliance for Children in Care and Care Leavers is comprised of:

A National Voice

Action for Children

British Association for Adoption and Fostering (BAAF)


British Association of Social Workers (BASW)

Children England

Coram Voice

Family Rights Group

Institute of Recovery from Childhood Trauma

National Association of Independent Reviewing Officers (NAIRO)

National Childrenā€™s Bureau (NCB)


National Youth Advocacy Service (NYAS)

Office of the Childrenā€™s Commissioner


The Care Leaversā€™ Association

The Childrenā€™s Society

The Fostering Network

The Princeā€™s Trust

The Who Cares? Trust

Together Trust

Young Minds

Best Practice Forum Oct 17 2014

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

Stephen Bell, Chair of IRCTĀ 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.Ā 

Presentation A

Sylvia Duncan, a clinical psychologist since 1972 introduced herself and spoke about the current speed of society that doesnā€™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.Ā 

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 reā€“parenting partnership (TRP) was set up as a partnership between Kent County Council and Sylviaā€™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.Ā  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 childrenā€™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.Ā 

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 ā€˜oldā€™ 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 childrenā€™s centreā€™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 HassettĀ then followed in his presentation, which focused on a research project involving schools.Ā  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 forĀ  professional worker.Ā  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.Ā 

Dr. Hasset then explored the impact of emotions on childrenā€™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 canā€™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 childrenā€™s well being and an increase in teacherā€™s health and reduction in stress.

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

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

What will the journey look like for the survivors of Rotherham?

What will the journey look like for the survivors of Rotherham?

In order to comprehend the recovery journey for a child such as those in the recent sexual exploitation cases in Rotherham, this paper shall paint a picture of the journey for a child victim from the point of disclosure.

The first disclosure

For a child to disclose abuse of any nature, it takes immense courage and usually requires them to have a relationship with an adult that they know cares for them deeply. In the context of this trusting relationship, a child may feel able to question the events in their life that are causing a sense of confusion and pain and if the listener is actively listening rather than being dismissive, the child may begin to disclose a few crucial details. These details are often mentioned with tension and nervousness to test the adult, to explore if that adult will respond or dismiss with mocking, blaming words. If the exploration is facilitated gently in a warm and respectful environment the child will feel safe and believe that the adult will ā€˜make things better.ā€™ Sadly, for many children, they test the waters in conversations with trusted adults to find that they probably wonā€™t be believed- or worse still- they will be reprimanded for any suggestions that another adult has done anything so awful. For many children, the right environment to share their concerns was never facilitated and shame and fear silenced them, often for years.

Disclosure to appropriate professionals

Following the initial disclosure the child then has to find the courage to speak to many different professionals about the events that are too horrific to share. Trauma shuts down the broca area of the brain that is responsible for speech and language, so to ask a traumatised person repetitive questions about the most awful experiences that words would struggle to describe, can further re traumatise a child unless there is great effort made to enable them to feel a sense of safety. The use of small hand held toys to enable them to squish, fiddle or puzzle while they speak softens the clinical questions of a professional who needs details in order to fulfill their role of protection of children and prosecution of the perpetrator. A warm, engaging, empathetic approach can make the difference between the child remaining in a state of shock and horror or feeling understood and cared for. The need for forensic medical examinations exacerbates the stress levels of the child, but a caring adult bringing reassurance can reduce the horrific intensity of the traumatic invasion.

Facing the everyday world

Often a whirlwind of appointments and professionals can materialise and then stop just as suddenly. The child is often left to ā€˜get on with lifeā€™ as if nothing has happened. School seems like a different world, full of noise and chaos; laughter and innocence. The child can feel dirty, different, ashamed, awkward and isolated in the midst of the happy faces. Panic can rise quickly and without warning, for example when a teacher shouts, because that angry face resembles other abusive adults shouting commands or sly manipulating requests. Flashbacks, panic attacks, the sound of internal screams all become things to be managed whilst attempting to avoid being told off for fear of more anger and pain. If the school grasps these challenges the smallest things can transform the childā€™s experience. If the child has a teacher greet them kindly, warmly and say something gentle such as ā€˜if you need some time out, if you need to chat, if you need to find somewhere safe, just come and find me in room 2 and Iā€™ll/ or Miss R Ā will be there for you.ā€™ If the child could find school to be a place of understanding, with staff who are kind, non-judgemental, accepting and with genuine warmth, this can lower the stress levels of the child immediately which in turn reduces the intensity and quantity of trauma symptoms that develop to enable the child to survive.

A child needs support

The CPS Guidelines on Prosecuting Cases of Child Sexual Abuse recognizes that children need support.

ā€˜Children and young people who have been the subject of sexual abuse are likely to require a very high level of support. The police will be responsible primarily for facilitating this, although they will not be responsible for delivering emotional or psychological support.ā€™

The DSM-5 lists the reasons that emotional support will probably be needed. Trauma symptoms could become part a childā€™s narrative having experienced traumatic, abusive experiences that render a child powerless. These symptoms range from dissociative reactions such as flashbacks, persistent avoidance of stimuli associated with the traumatic event, avoidance of or efforts to avoid distressing memories, or external reminders that arouse distressing memories, thoughts or feelings closely associated with the traumatic event(s). The child could experience frightening dreams, marked physiological reactions, persistent and exaggerated negative beliefs or expectations about oneself others or the world. Persistent negative emotional state, markedly diminished interest or participation in significant activities, feelings of detachment or estrangement from others, persistent inability to experience positive emotions, irritable behaviour and angry outbursts, reckless or self destructive behavior, hypervigilance and so the list goes on.

These symptoms generally do not subside with time. They can become more entrenched as behavior patterns that protect and enable a child to survive in the harshness of a world that would allow such horrific things to happen to them. The CPS guidance ā€˜Provision of Therapy for Child Witnesses Prior to a Criminal Trialā€™ is clear that the best interests of the victim or witness are the paramount consideration in decisions about therapy. There is no bar to a victim seeking pre-trial therapy or counselling and neither the police nor the CPS should prevent therapy from taking place prior to a trial.

The United Nations Convention on the Rights of the Child (UNCRC) 1989 says that is essential ā€˜to take all appropriate measures to promote the physical and psychological recovery and social reintegration of child victims of violenceā€™.

Therapy as an essential intervention for recovery

The NSPCC report in 2001 discovered an estimated 55,000 children who have been sexually abused received no therapeutic support each year due to a short fall in the availability of therapeutic services. Yet it is recognized that;

Long term therapeutic work for children who have been abused is a necessary and important way of helping with issues of confused feelings, including those of boundaries, intimacy, anger, abandonment, control and lack of control.ā€™Ā (Murphy. J. 2001.p123)

Children need a safe place to process their experiences in an environment that doesn’t rush them and gives them time and space to go at their pace. The three phase treatment plan of most trauma therapy intervention begins with the stabilization and safety phase and this can take time as the children learn how to build trust with another adult having had that trust shattered through the abuse experience. The focus is on building safety for the child and often the first piece of work is identifying and reflecting on the very concept of ā€˜safeā€™. Often therapeutic provision stops at this stage and doesn’t allow the time to progress into the processing of the experiences to enable the memories to be become part of the childā€™s narrative, with emotional appropriate language and an understanding of the experience. The feelings of shame, guilt, confusion, distrust, powerlessness and negative belief patterns need to be processed. The final stage is the rebuilding and future focused work where the child no longer feels their identity is the abuse experience but rather has a greater and richer sense of who they are in the world. This can take years but prevents long term mental and physical health challenges in their future.

Other helpful recovery aids

Every child benefits from supportive, warm, genuine, kind adults who are safe, playful, curious and affirming. Children also find recovery is faster if they develop hobbies and interests that build resilience, such as sport, music, or art based activities experienced in safe, group times. They need their basic needs met of exercise, rest, play, healthy food, positive routines and a sense of belonging to a family and a community.

Recovery is possible

We need to prioritise the recovery journey for children who experience trauma. A recovered child is a child who is confident, at ease and has a voice. For this to happen there needs to be an increased investment into therapeutic services for children, increased parenting support projects and increasing training for professionals such as social workers, police, doctors, barristers and teachers on the impact of trauma on a child.

Betsy de Thierry

Founding Director of the Trauma Recovery Center ( and trustee of IRCT (www.

IRCT Best Practice Forum – Launch Day

Lord Francis Listowel, IRCT Patron, opened the Forum by welcoming members. He stressed the importance of the Forum members to join the IRCT to share good practice and he ably articulated the personal element of working to ensure that recovery is available to all children who have experienced trauma.

Stephen Bell, Chair of the IRCT Board then offered a reminder of the moral imperative of not only recovery work, but also of knowledge-sharing and dissemination of this best practice to the wider workforce.

To that end, Dr. Janet Rose, Principal Lecturer at Bath Spa University, presented on her work in building ā€œAttachment Aware Schoolsā€, tracking the three strands of attachment, neuroscience and emotion coaching. Her work focuses on addressing unmet attachment needs of children by equipping schools (both primary and secondary) with appropriate whole school policies and practice. Some of the more keys ideas to the programme include:

Introducing emotion coaching as a contrast to behaviourist theories of practiceā€¦transforming how we perceive student behavior in a practical way.

Encouraging empathy with the emotional state of children no matter the behavior while also maintaining standards.

Appointing an attachment lead/trauma lead for each schoolā€™s senior team

Using Pupil Premium funding to support the training for all school staff and developing consistency for support/canteen/duty staff who have contact with children.

Dr. Rose reminded the forum that the imperative for schools, and the child-centred workforce at large, is to help students heal from trauma, and not simply deal with the manifestations of that unresolved trauma. Her inspirational work has already produced positive initial data and outcomes and she shared feedback from a primary student who explained the effect of the new approach in his/her school as helping to ā€œStop the volcano in (my) tummyā€. A worthwhile exploration/reminder of the power of a teacher to make a difference and, in a wider sense, of the role all of us can play in transforming the sense of self for vulnerable children.

Following on, Betsy de Thierry, Director of the Trauma Recovery Centre, spoke on Working with trafficked children and sexually exploited children. She began with a view of the general focus on awareness raising and the push for ā€œrescueā€ of children in such traumatic situations, asking what happens when children get ā€œrescuedā€? How are they best supported? What are we rescuing them to?

Betsy discussed her practice centred on therapy, training and creative work to aid recovering children as well as support for parents/carers/families while raising a number of provocative points. When discussing therapeutic mentoring, de Thierry asked what is the equivalent of the first aid level of access for children who have come through trauma? Again, for professionals working with students caught in or removed from such exploitative situations, we must ask and, more importantly, we must ensure we all know:

What is the road to recovery?
What does it look like?
How do we build consistency and attachment for these young people?
What is the difference between CSE v. Trafficking?
Further, what is the difference between Complex trauma v. trauma?

So, as the session came to a close our moderator, John Diamond (CEO of The Mulberry Bush Organisation) led a reflective discussion through the need for commitment for this sort of work, and explored some of the key recovery links between the efforts of our two speakers, including the focus on enhancing the childrenā€™s workforce through:
empowering professionals to heal
establishing a base level of empowerment/knowledge for all involved (including volunteers and foster carers) in supporting children who have experienced trauma.
Reducing negative emotions and feelings of being ā€œde-skilledā€
Building empathy, passion and consistency

With the points raised, questions asked and ways forward discussed, the forum was an excellent lead-in to the launch of the IRCT as well as a catalyst for the work we have begun.