This week I posted three more videos drawn from my experience in child and family psychology practice, with a major focus in child protection and out-of-home care, across the last twenty eight years. You will find each video, below. If you like them, please do not hesitate to hit the like tab and even subscribe to my channel as this helps get my knowledge shared more widely.
Needs Trump Reason
This is one of my favourite sayings when helping people to better understand why children and young people approach life and relationships in the way that they do. Specifically, I discuss the influence of needs over goal-directed behaviour. I make the point that when you are managing complex and challenging behaviour exhibited by a child or young person, needs trump reason. The video is intended to be of most interest to those who interact with children and young people who are recovering from a tough start to life in care and professional roles, and their caregivers.
Avoiding Self-Fulfilling Prophecies
In this video, I indicate that children and young people who are recovering from a tough start to life typically approach life and relationships under the influence of negative beliefs about themself, others, and their world. In turn, this usually leads to them feeling bad, and acting bad. When we admonish them for their behaviour, we run the risk of reinforcing their belief that they are bad and unlovable, and perpetuating the cycle of negative feelings and behaviour. If we want these children and young people to approach life and relationships in a different way, we need to interact with them a way that avoids reinforcing, and rather challenges, their internal narrative.
Therapeutic Care is an Enrichment Process
In this video, I highlight how our needs are much the same, whether we are 1 year of age, or 101. What changes is how it is presented and responded to. Children and young people who are recovering from a tough start to life are often preoccupied with needs that were met inconsistently or inadequately during the developmental period. Their behaviour often reflects their preoccupations. If we want to respond therapeutically to their preoccupied behaviour, we must provide an enriched response to the need.
I have taken the plunge into making videos of my content, and what appears below are my first three. Do like and share this post if you took something useful from the content. More to come!
Responding Therapeutically to Behaviours of Concern
In this short video, I present three key reflective questions you might consider when seeking to better understand and respond therapeutically to behaviour of concern displayed by children and young people who are recovering from a tough start to life. The questions are based on the Triple-A Model, a model for understanding the impact of early adversity and trauma on the developing child. The video is intended to be of most interest to carers of children and young people who are recovering from a tough start to life, and professionals who support them (both).
Connection Repairs and Regulates
In this video, I present an activity I regularly use when delivering training in the CARE Curriculum to highlight the importance of relational connection in regulating behaviour. I make the point that when caring for children and young people who are recovering from a tough start to life and exhibiting behaviour of concern, an important source of influence over their behaviour is the connection you are able to make and maintain with them. The video is also intended to be of most interest to carers of children and young people who are recovering from a tough start to life, and professionals who support them (both).
Selective Attention, Self-Care, and a Child’s Self-Image
In this video, I discuss selective attention and its role in leaving us feeling overwhelmed and defeated when caring for a child or young person recovering from a tough start to life. I make the point that this, in turn, impacts the emerging self-image of children and young people in our care. Once again, this video is intended to be of most interest to carers of children and young people who are recovering from a tough start to life, and professionals who support them (both).
A couple of weeks ago I posted on LinkedIn that I was interested in releasing more online video content, including long-form conversations, on the subject of my work these past twenty-eight years. I had been reflecting about access to knowledge I have built up over this time, and whether there might be a better way to share it. I had a positive response, including from well-known author, trainer, and consultant, Lisa Cherry, who invited me on to her podcast. I have included a link to the podcast in this post. Let me know what you think.
NB: If you have a podcast and are interested in speaking to me about appearing, you can contact me at colby@securestart.com.au.
The content of this post is drawn from my self-paced learning module on the topic of Early Trauma: The Infant’s Experience. It was developed for carers of children recovering from early relational trauma that necessitated placement away from home. The complete module can be accessed here. I have included a sample of the content of the module, below. I anticipate that it would take less than one hour to work through the full module. You can purchase a PDF version of this and other self-paced learning modules here.
The trauma I am going to focus most on today is that which arises in circumstances where the child’s parents are struggling with their own challenges, such as:
Mental health challenges;
Substance misuse;
Domestic and family violence;
Poor parenting knowledge;
the infant’s experience of these; and their impact.
In talking about the infant’s experience I will refer to the infant’s experience of the caregiving environment and their primary caregivers. A concept I find useful when referring to these qualities is their AURA.
In converting the term AURA to an acronym, its component parts represent four key aspects of the infant’s experience of early trauma, and a clue as to where to focus remedial efforts.
A: Accessibility
In a conventional, nurturing early caregiving environment, we spend time with the infant and attend to them whether they are crying or quiet. During temporary separations we check-in regularly with the infant. We don’t leave them alone for too long. We are probably just as likely to check in on them when they are quiet as we are when they are crying. In these circumstances, the infant experiences their caregivers to be present and accessible. In time, this develops into an understanding of reliable access to their caregivers, and a caregiving response, that supports exploration, with all the developmental benefits that accrue from this, and tolerance of separations.
A particular aspect of development that is important here is the development of object constancy and object permanency. Object constancy reflects a developmental competency whereby the infant recognises recurrent aspects in their environment, including the qualities and attributes of the recurrent object. With respect to their caregivers, infant’s first learn to recognise their own primary caregivers based on them being recurrent aspects of their experience, and them presenting with qualities and attributes that are consistent and can be relied upon. That is, with respect to recognition and reliance on caregivers, they need to be accessible and consistent in the way they look and feel to the infant.
Later, in conventional nurturing care environments infants develop object permanency. Object permanency refers to the infant’s ability to form a mental representation of the object in those times when the object is absent from their direct sensory experience. That is, the infant understands that the object exists independently of their direct sensory experience of the object. What extends from object permanency is the infant’s capacity to trust in the continuous existence of their caregivers independent of direct sensory experience of them. What is likely to support this understanding is regular and recurrent separations and reunions.
When caregiving is hampered by mental health challenges, substance misuse, relational difficulties, and/or poor parenting knowledge, the infant’s experience of the accessibility of their caregivers is impacted, with adverse consequences in terms of their understanding of who their caregivers are and what can be expected of them, especially in the context of temporary separations. These infants later present with diffuse or impaired attachment relationships and a style of relating that sees them obsessed with proximity of their primary caregivers and inordinately distressed during temporary separations. This will also be seen where the infant has had a mixed experience of parental accessibility, wherein the lack of consistency between caregivers supports uncertainty.
Interventions that begin to address this aspect of the child’s behaviour need to enrich the child’s experience of caregiver accessibility. In undertaking this task, it is important to remember how infants learn about the accessibility of their primary caregivers in a conventional nurturing care environment. They need their contemporary caregivers to attend to them whether they are crying or quiet. That is, they need to attend to the child proactively. They also need to do so at a consistent rate, such that the child can anticipate caregiver accessibility. Interventions with caregivers need to address barriers to this aspect of parenting.
The content of this post is drawn from my self-paced learning module on the topic of Behaviour as Communication. It was developed for carers of children recovering from early relational trauma that necessitated placement away from home. The complete module can be accessed here. I have included a sample of the content of the module, below. I anticipate that it would take less than one hour to work through the full module. You can purchase a PDF version of this and other self-paced learning modules here.
Children learn to communicate with words in a care environment where their caregivers:
1. Acknowledge their attempts at communication,
2. Speak the words that go with the child’s experience, and
3. Use words to communicate about their experience.
Regarding the first of these, children learn words in a caregiving environment where, in amongst their babble, their caregivers respond with joy and encouragement when they babble something approximating a word. For example, think about the reaction of the mother when their infant first babbles “Ma” in a conventional nurturing care environment. The mother communicates joy and encouragement to the infant. Through the emotional connection that is in place in such moments, the infant experiences a corresponding positive emotion that reinforces their vocalisation of “Ma” when orienting to their mother. As time passes, the infant babbles other approximations of words and is similarly acknowledged and reinforced for those vocalisations over others that do not sound like words to their parent. In this way, the infant begins to express sounds that lead to a response from their parents over sounds that do not.
In addition, in a conventional nurturing care environment parents can be observed to speak to their infant with ‘their voice’. That is, the parent says out loud what their infant is believed to be thinking or feeling, or what they need from the parent. If you are unsure of what I am talking about and have a pet, think about the way in which you speak to them. Through many such interactions, the infant begins to learn what words go with their experience and needs. When able to do so, the infant uses these words and, in conventional circumstances, is acknowledged with joy and pride at having done so, thus increasing the likelihood that they will use their words again.
Further, in a conventional nurturing care environment, the infant observes their parents using language to communicate about their experiences and their needs. In such an environment, the infant learns to use words to communicate about their experiences and needs via parental modelling.
In combination, these three aspects of the infant’s care environment support the development of language to communicate, and its use.
If we then turn our minds to children and young people who are recovering from a tough start to life, what then for their language development and use? When parents struggle significantly in the caregiving role due to their own mental health difficulties, substance abuse issues, relationship difficulties, and/or inadequate parenting knowledge, it is clear to see that the language expression of children and young people who come from that environment is likely to be limited. Put simply, due to inadequate acknowledgement of, and responsiveness to, their attempts to communicate with words, these infants grow with both a reduced vocabulary to express their experiences and needs through words, and less motivation to use them. Rather, they rely overmuch on gestures to communicate, and their behaviour can often be seen to mimic those first behavioural strategies to secure a caregiving response, namely the cry and the social smile. They can be described as overly emotionally demonstrative, though with a restricted range of affect, overly charming, or alternate between the two. These behavioural strategies serve to regulate caregiver engagement and responsiveness. They often communicate that the child or young person has a need that they are preoccupied with, or that they are feeling unsafe. Unfortunately, for the older child they are rarely seen as such by adult caretakers, leaving them feeling chronically misunderstood. This compounds a range of problems experienced by children and young people recovering from a tough start to life, and adults who interact with them in a caregiving role.
Children and young people who are recovering from a tough start to life benefit from the caregiving adults in their life seeing their behaviour as having communicative intent and reflecting their experience and needs. As occurs in conventional nurturing care environments, they need adult caretakers to communicate understanding of their experience and needs through their own words and actions.
The content, below, is drawn from my self-paced learning module on the topic of Trauma and Regulation. It was developed for carers of children recovering from early relational trauma that necessitated placement away from home. The complete module can be accessed here. I have included a sample of the content of the module, below. I anticipate that it would take less than one hour to work through the full module. You can purchase a PDF version of this and other self-paced learning modules here.
What do we mean by ‘trauma’?
I think the most appropriate place to start is what do we mean by trauma? In this context, trauma refers to an experience, or experiences, where the child or young person in your care was hurt or frightened or not responded to, such that their ability to cope was overwhelmed and they experienced significant and/or protracted distress. In this context, the trauma occurred at home in circumstances where mum and/or dad were finding life very difficult themselves due to mental health factors, relationship factors, addiction factors, or a combination of these, and where these circumstances negatively impacted the care they were able to give to their child. In circumstances where this was a very serious and ongoing problem, the child or young person in young care was placed away from home, ultimately with you. This was a protective intervention, but it was also one that comes with its own impacts from being placed away from mum and dad.
What is the impact of trauma on the developing brain?
This trauma usually began early in the child’s development and shaped their development; particularly, their brain’s adaptation to their environment and experiences. The infant’s brain is known to be very sensitive to experience. The infant’s brain also tries to establish a stable internal state in response to external conditions; a state referred to in the scientific literature as homeostasis. When the infant is repeatedly overwhelmed and in distress, their ‘normal state’ becomes one of being on high alert. Physiologically, we speak of the brain being in a state of high arousal, where arousal refers to the level of activation of the child‘s brain and central nervous system. Thus, when the infant is repeatedly overwhelmed and in distress, heightened arousal becomes their ‘normal state’.
What happens when heightened arousal becomes the ‘normal state’?
When emotions are high, arousal is too!
If we think of the brain, or central nervous system, as being like the motor in a car, the motor of children and young people who have experienced trauma runs faster than the motors of other children and young people who have not experienced trauma. This impacts them in a range of ways, including their emotions, their behaviours, and their learning. It leaves them prone to heightened distress and activation of the fight/flight/freeze response, which forms part of the brain’s protective system for managing heightened feelings of fear and distress. Unfortunately for them, the very behaviours that are deployed as part of the fight/flight/freeze response to manage feelings of threat and restore feelings of wellbeing are rarely seen as such, with the result that their fear and distress can be reinforced and perpetuated when adults become upset in response to the child’s behaviour.
Children and young people whose motor runs too fast make ‘mountains out of molehills’. Seemingly little things bother them a lot. These can be sensory experiences, such as certain noises, textures, and tastes, even the way things (eg people) look. They may dislike certain foods, or the way certain clothes feel on their body. They may prefer to withdraw to their room or keep their hood pulled up and their earphones in. They are often hot (and bothered), and they typically struggle to get to sleep and stay asleep through the night. They may be preoccupied with accessing and eating food, as food is a source of comfort and oral soothing. They have an exaggerated need for consistency and can be quite demanding of this, as consistency and sameness are also soothing.
Heightened arousal and diagnostic formulations
Children and young people whose motor runs too fast struggle with, and are easily overwhelmed by, the demands of daily life. They may appear uncoordinated at sport and struggle academically at school. Their behaviour is often mistaken as a sign of an underlying disorder, such as oppositional defiant disorder, conduct disorder, attention deficit-hyperactivity disorder, autism spectrum disorder, or a learning disorder. They often feel inadequate, helpless, and unworthy.
They do not, necessarily, have a disorder or lack ability or worth. They lack something else.
I have released another self-paced learning module on the topic of contact between children and young people who cannot safely be cared for at home, and their birth parents.
I originally delivered the content of this module to kinship carers and professionals who support them. In delivering this content I was asked to consider the following questions:
Why is contact with birth parents important?
Should contact stop if birth parents do not attend inconsistently?
Should contact stop when children have an adverse reaction to it?
I subsequently wrote this module for all adults who are involved in the care of children and young people who are cannot be safely cared for at home.
I want to preface the module by letting you know about what has informed my contemporary views about contact between these children and young people and their birth parents.
For the past twenty-eight years I have worked continuously, in various roles, in child protection. Among those roles, the most enduring have been therapeutic work with the children and young people and the provision of therapeutic caregiving support and guidance to adults who care for them at home and in other domains of their life (social workers, teachers). I have talked to a lot of children and young people in care, as well as adults who interact with them in caregiving and professional roles.
As the years have passed, I have remained connected to, or reconnected with, young adults who I knew when they were in out-of-home care. I have seen the longer-term outcomes of decisions made years prior about contact between children and young people and their birth parents. I have reflected on what theories that underpin practice in this sector, most notably Attachment Theory, provide by way of explanation for observed outcomes.
The conclusion I have come to, based on my work and reflections about childhood attachment, is that both strongly support the case for working towards and maintaining healthy connection between children and young people who cannot be cared for at home and their mum and/or dad, where possible.
An important caveat I will acknowledge is instances where the child or young person has been sexually abused by a parent, or cases of extreme and/or sadistic abuse. These are topics for other modules. Rather, I consider that the content of this module holds true for most children and young people in out of home care; that is, those children and young people who could not safely be cared for at home due to grossly inadequate care and protection.
I would also like to acknowledge that this can be a very sensitive topic; especially for carers of children and young people who are distressed or otherwise unsettled by contact with birth parents. It is not my intention to minimise this issue but, rather, shed some light on what may be happening for the child or young person, and propose a way forward.
Finally, I would advise that this module is intended to be widely applicable. As such, it does not replace professional advice and guidance in individual matters and may not be appropriate in all circumstances. I recommend that you consult with your colleagues and supporting professionals before implementing recommendations derived from this learning module.
For much of the past twenty-eight years working in child protection I have developed and delivered content designed to support the endeavours of carers and professionals who interact with children and young people recovering from a tough start to life. In recent times I have organised my content under the title The CARE Curriculum. This includes
The Triple-A Model of Therapeutic Care (continuously delivered in the TUSLA Fostering Service in Donegal, Ireland, for the last eight years)
The Kinship CARE Curriculum (currently implemented as part of the Martinthi Aboriginal Kinship Care program in South Australia)
Connected Classrooms (a school-based programme for implementing trauma-informed care in schools, currently delivered in Donegal, Ireland, by trained trainers in the TUSLA Fostering Service)
Responding Therapeutically to Complex and Challenging Behaviour: A Triple-A Approach (Recently delivered to the TUSLA Fostering Service in Donegal, Ireland).
Although I continue to deliver training in Australia alongside my ongoing psychotherapy practice (including the above), my commitment to the children and young people I work with means that there is a limit to my availability, currently.
In consideration of my commitments I have begun to make some of my training offerings available via online, self–paced learning modules. These can be accessed via the Secure Start website, including by using the link in the menu above. There are and will be a mixture of free and paid-for modules and handbooks, reflecting both my commitment to making my content widely available while also acknowledging the significant time that goes into the development of training content and modules.
If you would like to speak to me about any of the training modules or, even, my availability to deliver training on behalf of your organisation, please do still get in touch (colby@securestart.com.au). The world has changed and online delivery (including self-paced learning modules) is more possible than ever.
In addition to training, I offer trauma-informed consultation and supervision to organisations who interface with the child welfare sector. Click here to find out more.
Finally, if you have a topic you would like me to cover in a blog or training module, do get in touch.
Yesterday, I finished preparing this training package for delivery by my trained trainers in Ireland. It includes three PowerPoint presentations, comprehensive trainer notes (scripts and delivery notes) for each session, comprehensive participant handbooks (x3), and various other resources for use during delivery. As usual, I underestimated how much work I would put into such an endeavour, and how difficult it would be to make the time around my psychotherapy practice and statutory commitments. I now have the following comprehensive training packages:
The Triple-A Model of Therapeutic Care (Currently delivered in Ireland)
The Kinship CARE Curriculum (Currently delivered in Australia)
The Connected Classrooms Program (Currently delivered in Australia and Ireland)
Responding therapeutically to Complex and Challenging Behaviours (Implemented in Australia, (Coming soon to Ireland)
In addition, I have a number of ‘special issues’ training packages, on topics such as ‘self-care’ and ‘supporting strong developmental outcomes for children and young people recovering from a tough start to life’.
All of my training packages are based on almost thirty years direct work with children and young people recovering from a tough start to life, and adults who interact with them in a care and management role.
All of my training packages have been developed in my own time. I cannot compete with individuals and organisations that receive grants and other funding to develop education programs, and so I cannot make them freely available. Nevertheless, if you or your organisation might be interested in any of these packages, do get in touch.
Disclaimer: While great care is taken to ensure that the advice on this site is widely applicable and based on sound psychological science, it may not suit the individual circumstances of all visitors. If you have any concerns about applicability to your circumstances, please consult a qualified professional near to you.
Attachment and Resilience 