The Secure Start Podcast Episode One: Sally Rhodes

I recently started a podcast. This is a project I intended to launch more than a year ago. Unfortunately, life intervened.

My first guest is Sally Rhodes.

Sally has a Master of Social Work, and a Graduate Diploma in Family Therapy.

Sally, commenced working in residential care in 1985, then followed her passion for strengthening families through working intensively in family preservation services.

In 2004 Sally established Connecting Families, a therapeutic Reunification and Family Preservation service, which has grown to 17 practitioners.

Sally is trained in Narrative Therapy, Marte Meo, Dyadic Developmental Psychotherapy, the Neurosequential Model of Therapeutics ,and Signs of Safety.

Sally was awarded a Churchill Fellowship to work in the UK with the Resolutions Approach – Working with Denied Child Abuse.

Connecting Families is now the largest Reunification Service is South Australia and, together the team has safely reunified over 1200 children, and prevented the removal of many more. In Connecting Families, Sally has selected practitioners who share her commitment to social justice and human rights, and ethically driven practice.

Sally provides training and consultation to Government and Non-Government organisations and remains a strong advocate for vulnerable families. Sally has been integral in leading the development of a Partnering for Safety approach to child protection through training and consulting, and is passionate about family led decision making and bringing the child’s voice into child protection work.

I hope you enjoy our conversation.

About the Secure Start Podcast

In the same way that a secure base is the springboard for the growth of the child, knowledge of past endeavours and lessons learnt are the springboard for growth in current and future endeavours.

If we do not revisit the lessons of the past we are doomed to relearning them over and over again, with the result that we may never really achieve a greater potential.

In keeping with the idea we are encouraged to be the person we wished we knew when we were starting out, it is my vision for the podcast that it is a place where those who work in child protection and out-of-home care can access what is/was already known, spring-boarding them to even greater insights. 

Transcript

I think I always knew this, but I know it far more powerfully now, is that the decisions that we make, the things that we write, the recommendations that we make about families have long-lasting impact. So therefore, think very, very carefully about what you write, what you decide, because it has consequences. And I know that to be so true now, that I probably didn’t know as strongly back then.

Hi, and welcome to the Secure Start podcast. I’m Colby Pearce, and joining me for this episode is a highly respected practitioner in my home jurisdiction. Before I introduce my guests, I’d like to acknowledge the traditional custodians of the land that we are meeting on, the Kaurna people, and the continuing connection they and other Aboriginal people feel to land, waters, culture and community.

I’d also like to pay my respects to their elders, past, present and emerging. So my guest for this episode is Sally Rhodes. Welcome, Sally.

Thanks, Colby. So Sally is, as I said, a practitioner in my home jurisdiction here, and we’re both used to paying our respects to the traditional custodians of the lands we meet on. So for those who may be listening or watching overseas, this is a customary paying of respect to those traditional owners.

Now, Sally has a Master of Social Work and a Graduate Diploma in Family Therapy. Sally commenced working in residential care in 1985, then followed her passion for strengthening families through working intensively in family preservation services. In 2004, Sally established Connecting Families, a therapeutic reunification and family preservation service, which has grown to 17 practitioners.

Sally is trained in narrative therapy, multi-mayo, dyadic developmental psychotherapy, the neuro-sequential model of therapeutics and signs of safety. Sally was awarded a Churchill Fellowship to work in the UK with the Resolutions Approach, working with denied child abuse. Connecting Families is now the largest reunification service in South Australia, and together the team has safely reunified over 1,200 children and prevented the removal of many more.

In Connecting Families, Sally has selected practitioners who share her commitment to social justice and human rights and ethically driven practice. Sally provides training and consultation to government and non-government organisations and remains a strong advocate for vulnerable families. Sally has been integral in leading the development of a partnering for safety approach to child protection through training and consulting, and is passionate about family-led decision-making and bringing the child’s voice into child protection work.

Wow, there was a lot there, Sally. Obviously, I’m going to move the editor. All right.

So, Sally, I guess I just really want for our listeners to hear more about you as a person and also as a professional. So, my first question to you is how did you come to this field of endeavour? Yeah, well, you know, I had cause to think about this last year when we were celebrating 20 years of Connecting Families, and I actually really stopped and thought about how did I get here, really? Because nothing’s ever by accident, is it? So, I started to think about my childhood and where I grew up and what my influences were, and it occurred to me that my dad was a really big influence in my life in terms of thinking about injustice and standing up for the oppressed. He always stood up for me, which was something that was, I was a bit of a naughty kid.

So, I used to get in trouble at school a lot, and he always wanted to know my side of the story, which was refreshing and not normal back then. I’m talking the late 60s, early 70s. And also, mum and dad volunteered at a children’s home.

It was run by nuns, and there were homes. There was about four. My memory was that there were like four homes on this property, and they had 10 kids each in them, and mum and dad would go there on weekends, rostered on, to support the nuns looking after the kids.

So, I would tag along. And it just struck me that this was a really unusual situation for children not to be living with their families, and I think that that was my first exposure to it, and I was exposed to it for a long time, over three or four years, probably, that mum and dad went there, that I would go with them. And I knew these kids, too.

I went to school with a lot of them. So, that was that, and then I think that sparked something in me that I wanted to do. So, I didn’t know what it was, and then I didn’t go straight into social work, but I knew that that’s what I wanted to do.

But I went and did nursing first, which I hated, and I left very quickly. And then I went and studied, and I found my way. So, this was in northern New South Wales, so not the state that we currently are in now.

This was in a little town called Grafton. But then I moved over here to South Australia in 1985, and I got a job with the Department for Community Welfare, as it was known then, in residential care. And I was 22, and I just thought at that point I was too young to do generic social work, and I wanted to work with young people.

It felt the right thing to do. So, I was there, and I stayed in residential care for eight years. And I think that experience really fuelled, again, this sort of kids just need not be in these situations.

We really should be working to try to keep children at home. So, a family preservation service in South Australia started in 1993. That was the first one, called Keeping Families Together, and I won a position in that.

And I stayed in doing that from 1993 to 2004 in various different roles, but all working intensively with families, and either in family preservation or reunification. And then the agency that I worked for, Anglicare, lost the tender to continue doing that work. And I was approached to set up on my own, well, set up to work with the families that had been in our service, because the agency who won them that contract to carry on the work for whatever reason didn’t set up.

And so, fortuitously, these sort of families fell into my lap, and that’s how it started in terms of connecting families. Just, yeah. And that’s all I’ve ever wanted to do, really.

It’s a long-winded answer to your question, Colby. No, not long-winded, but very interesting. It really goes to show, I guess, that when you, you know, how influential our experience is growing up, our experiences in childhood are in terms of the future course of our life.

And, in fact, research that I can remember hearing about a long time ago about who enters the helping profession, who enters the helping profession, so to speak, tend to be people who have been in some sort of caring role as they’ve been growing up. And, yeah, and I think that rings true not only for myself, but a lot of people I’ve spoken to about this. And interestingly, just to pick up another point that you made in there, that is that the impact that residential care had on you and on practice, and a sneak peek into another podcast episode is that I’ll be speaking to someone who ran a residential care home in the UK for a very long time and then moved across to run the UK’s first therapeutic fostering service.

So our listeners can listen out for that as well. So just moving on, you’ve talked about your dad as being a significant personal influence on you growing up. And you’ve probably also referred to your observations of the children and the environment that they were living on as major influences.

But who were your professional, major professional influences, would you say? Yeah, look, many and varied, really. But, you know, and I guess I didn’t really, I suppose I did, but I can’t even remember who they might have been, but certainly when I came to Adelaide and I did the narrative therapy training with Michael White, so Michael White was a really big influence on me, and local therapists here in South Australia. So a therapist, well, psychologist called Alan Jenkins, his partner, Maxine Joy, Rob Hall, a social worker.

These were locally based Adelaide, but I think world renowned, really, in their craft and their expertise. And Alan used to come to our team meetings when I worked in keeping families together and consult with us, and I just used to sit there in awe, really. So he was a really big influence to me.

And of course, you know, Michael White and the whole narrative therapy, Dulwich Centre, in terms of, you know, I guess I was a bit of a, I had the values and the attitudes and the beliefs about why I wanted to do this work, and I really needed to get some skill, I guess, in terms of how to talk to people and to think more deeply about that, I suppose, you know. And so they were a big, and then over the years, people like Dan Hughes, Bruce Perry, you know, yourself, Colby, in terms of your writings around attachment and the science of safety, people, like, you know, all of that has influenced have influenced me, and I’ve been, you know, that all of those people I’ve named, their work and their way of thinking just resonated with my way of thinking. And it helped me, you know, move forward in being able to help families have that breadth of sort of knowledge and expertise, I suppose, to be able to think, come to, you know, talk with people with a whole lot of different things in your head and frameworks to operate from.

Yeah, so quite a diverse group there. I think, you know, thinking about my own professional journey and the work of Michael White and others, and Alan, and the Dulwich Centre, who I was probably exposed to at a similar time to you when I was a developing practitioner. I think a lot of what I heard from them resonates more and more with me as I move on with my life and career.

Certainly, the stories that we tell about ourselves, I think, are very powerful in the way in which we approach life and relationships. Yeah, yeah. Yeah, I think that’s true, actually, in terms of, for me, you know, probably at the time, I didn’t realise how influential they were, and that they were, and how privileged I was to have them so accessible.

You know, they’re in my hometown. I, you know, I’ve got video of Michael White interviewing me, you know, it’s precious now to look back on that. And, yeah.

And maybe we need to be, you know, maybe we need to have practised, I guess, for a period of time to be able to join the dots up, I guess, in a sense around those early influences and, yeah, and the impact that they’ve had on us and our professional journey and the way in which we approach our professional and personal life. Yeah. It’s very interesting.

I’m also aware, and I mentioned to you, mentioned in the intro, that you did do a Churchill Fellowship in the UK. And I know a little bit about what a Churchill Fellowship is, but I wonder if you would mind just describing it, what a Churchill Fellowship is, and what it was like completing it, who you did it with, or who you, yeah, work with, and how it’s influenced your practice going from there. Yeah, so the Churchill Fellowship was actually set up by Winston Churchill, really, for, you know, Australians to have the experience to be able to go abroad, you know, to expand their skills and knowledge in a specific area that they weren’t able to get in Australia, you know, like, so this was the original sort of thinking around it, and that you could then bring back that skill and knowledge, and to better the community.

So that was sort of the broad, and I think that still holds true. However, you know, with modern technology these days, you really don’t have to travel, you know, you can do it, but, you know, they’re still offered. So I, when actually talking about influences, there’s some other people who were very influential in my life before I did the Churchill, and they were the John Gumbleton, Colin Luger, Susie Essex, three UK social workers therapists who worked for the NSPCC, is that right? Yeah, National, yeah.

And they started writing about the resolutions approach, which is a way of working with families where there’s denial around, and particularly around injury, unexplained injury to infants. So those very, you know, polarising as well as perplexing cases where you’ve got a baby that’s got injury, and parents who basically say they don’t know how it happened, and in a medical profession saying, well, this is how we think it happened. And so, you know, they become very stuck cases that, you know, and I was coming across them in my work of, you know, families with seemingly no other kind of factors that would have caused concern to anybody, but a baby that had these unexplained injuries.

And so you ended up with a situation that either the children just didn’t go home because of this stuckness around the acknowledgement, or they did go home because people just gave up and put them home, and so no work was ever done. And I didn’t think either of those scenarios were good, basically. So I started looking for, you know, any ways of working around this, really.

And I came across these guys, and made contact with them in the UK by email and phone, and started having some consultation with Colin Luger, one of them. And then the idea of applying for Churchill came up, so I did. And it’s quite a daunting process, really.

You know, they give away about 100 nationally a year, but in South Australia, I think the year I went, there were nine given away. And you have to, you know, put in an application, it has to be very succinct to, you know, to basically explain to a group of people not from this profession, you know, wide range of people making decisions about who gets them, and then go to it, get to an interview process, which is, you know, 20 people there was sitting around a big boardroom table and coming in and actually doing a presentation and then getting questions. Anyway, I was lucky enough to get one.

I think it was so interesting. You know, I think it is interesting. You know, I think it really piqued the interest of the people who were making that selection.

So I went to the UK, I went to Bristol, which is where Colin and John live. Colin has sadly passed away. He passed away in 2015.

But when, you know, see when I went, he was still alive. And I spent six weeks there in the UK with them doing, you know, traveling all around England, because even though they’re based in the UK, their referrals came from all different parts of the of the UK. So we would travel to meet with family.

So I watched them, I talked to them, I talked to families about their experiences, I interviewed judges, children solicitor, I met with some other academics, I met with I met Peter Dale, who’s another influencer male is Peter Dale. He wrote a book called fine judgments. He’s another UK social worker, psychiatric social worker.

And yeah, and then I came back, I had to write a report about that for the trust. And I went and met with the youth court here in South Australia to talk about it, because really, if I could get the court understanding it, that was going to help. You know, I did presentations to the department about it.

And I think it has it influenced me, you know, in a sense around that there were people on the other side of the world thinking exactly the same way that I do. Yeah, I think there was something really heartening and a sense of security about that, that, you know, that these issues were happening everywhere, and that there were people who were turning their mind to how can we actually help these families stay together, but in a safe way. And, you know, they are the trickiest cases, because people do take such a stand about, we need to know, we need to know what happened, if we don’t know what happened, how can we ever make this safe.

So there’s a, I’ve done a lot of talking with people over the years around trying to get them to think about that in a different way. And why people wouldn’t talk about it, you know, the sense of shame, all of the disincentives to talk about how an infant got injured, you know, the criminal charges, loss of friends, family, whole range of things, you know. So, yeah, and as far as I know, we are probably the only service that provides resolutions way of working, certainly in South Australia, if not across Australia, I haven’t come across anybody else.

So it’s a niche. And I think that nicheness, you know, that, you know, helped in terms of gaining reputation across the sector around, you know, here’s some people who will actually work with these kind of families and, but rigorously, it’s not fluffy work in any sense. Yeah, and so Colin and John continued to be, Colin, particularly up until his untimely passing, like he was very unexpected.

And in terms of him getting sick, that was, but he, I continued to consult with him up until then. And then John, for a little while after that as well, but, and I’m still in touch with John, he’s retired. Yeah, they were great, great influences, really.

Yeah, they are difficult cases. Yeah, from my own work, while you’re talking, immediately thinking of a couple of cases, one in particular, that I became involved in, or was asked to become involved in very early in my career. And similarly to you, I was aware that the local child protection authorities, the emphasis that they placed on admissions, and admissions as being a precursor to looking at the possibility of reunification or reunifying.

And I remember even then, being very much aware of, or thinking a lot about all the impediments to those to making those admissions. And whether, as you say, whether there is actually another way that can ensure safety, but doesn’t rely on an admission. Yeah.

And I think there are ways to go about doing that. And you referenced one of those models or approaches. Yeah.

I think it’s very much a way, I mean, they are approaches, but it’s very much a way of thinking rather than a way of doing in a way, there are certain things, steps through the process, but it is, you can’t actually do the work if you don’t, if you don’t sort of think about this in, it’s about being able to hold a degree of uncertainty and not knowing, but also, suspending doubt, like all of these, all of these sort of principles of the model really around, thinking about denial, like when I’ve done some training on this, I remember talking to a bunch of supervisors when I first came back, and I said to them, I want you to turn to the person next to you and tell them the thing that you are most ashamed of in your life. And they all just stood there and stared at me, like I was mad. But the point I was trying to make was, that’s what you’re asking families to do.

You’re asking them, if we take on that belief that yes, they’ve unintentionally caused some injury to their child, that they then have become aware of. And then you’re asked, and they’re so deeply ashamed of that, you know, that you’re asking them to tell you a pillar of power in their life, what you did. And I just think it’s, unless you get alongside of people and approach them with empathy and compassion, in a non-judgmental stance, you, you’re, that’s going to shrink shame.

And you may get some partial acknowledgement. You certainly get people motivated to make sure that what happened will never happen again. And that’s all we want to do is just to make sure future harm doesn’t occur.

Yeah. I think the shame element is a powerful impediment and the regulation of that shame is a powerful way forward. Yeah.

And I remember something that we said something a little bit earlier where you were saying that not only the making of the admission means that not only do child protection authorities know about what happened, but it comes out one way or another that, that family and friends may also find out more about that. And I’ve done a similar activity with when I’ve done training in the youth justice area, and I had practitioners come one by one in and disclose similarly to me, an act that they were, it’s going back a few years ago now, but it was, it was an act that they were ashamed of doing, and it may well have also had a, an offending element to it. And they had to disclose it to me one by one.

And they had a choice about whether they come in and do that or not. Everyone did it, but everyone seemed to be quite uncomfortable about it. And I will note that I was never asked back.

I had met one of those, one of the person, and I, in subsequent training that I also delivered in the court, youth court, but I was never asked back. And I think it’s when we, where we expect families to make admissions and the whole movement forward depends upon it. They’re not just making admissions to child protection authorities, they’re making admissions potentially to their family and friends as well, as you say.

So that little activity that you did, and that, and that I did, as, as uncomfortable as it was, probably still doesn’t really get at what it’s like to make admissions in child protection processes, because to make it similar, we would broadcast what they, what was disclosed to the group, at least, and to family and friends. And so, yeah, there are very powerful disincentives to make admissions. And yeah, when I, I always thought that, I always think that nobody does anything for no reason.

And it’s, and I’ve always applied that in my practice with children, or, you know, for as long as I can remember. And I think that in trauma-informed practice, it’s all about responding to the reason. And I think similarly, it is possible to navigate a way forward by responding therapeutically to the reasons for a child to become, to be hurt, without necessarily hanging it all on an ambition.

Yeah. And, and also, you know, you know, there’s this big focus on acknowledgement and admission, or whatever. And, you know, and I guess my way of thinking after years and years of working with families in this area, is that acknowledgement on it, of its own, doesn’t necessarily bring about safety.

You know, people can acknowledge that they’ve done something, or they’ve behaved in a particular way, doesn’t mean they’re not going to do it again. So, you know, it’s not enough. And, and I think that’s what certainly the, you know, the science of safety model, you know, the principles and practices of that model, and that approach got me really thinking about that as well, that you have to be actively demonstrating a change, or doing something differently over a period of time.

It’s not enough to say, oh, yeah, you know, yeah, you know. There seems to be a belief that an admission is as an acknowledgement of a preparedness to change. Yeah.

And it’s, it may be the case in some instances that that, but my thinking about it is that the admission is probably not the main incentive to change. Rather, it’s the therapeutic relationship that we develop with the parent client, and our endeavours to regulate shame and regulate their closed, them being closed off, and rather to opening them to meaningful conversations. And, and what follows from that as being probably the, what we should be putting most emphasis on as a starting point.

Yeah. Parents engaging with the process, rather than parents making an acknowledgement. Yeah.

Yes, certainly saying, you know, and because I think that the focus on you must acknowledge, and this is not necessarily even in denied childhood, just in anything, really, you must acknowledge this, or you must acknowledge the harm that you’ve caused your child, or you must, you know, the way that the statutory organisations come to try to get people to do that is just not therapeutic in any way. It’s very shaming. And, you know, potentially quite frightening, really, for people, because they don’t know the consequences of if they do acknowledge, you know, so, yeah, I agree.

And I think it’s, you know, when, you know, thinking about this work, I mean, I don’t think I, I would have known this 30 years ago, you know, this has been a process for me also around just, you know, I remember, way back, there was a book written by Maluchio and Pine, which is around reunification, and because people just talk about the stages, you know, the steps and the thing, and it’s, it’s not like that, you know, it’s because of this, what we’re just talking about now, you know, it’s a really around understanding the complexities of people’s lives and experiences and building relationships so that they can navigate their way through that, to come out of that, you know, in a way that they can demonstrate to people that I want to be a safe parent and I can be. Yeah, shame is such a destructive or can be such a destructive emotion and a process that deepens shame works against a goal of a safe reunification between a child and their parents. Yeah, I feel like we could talk about it for a long time.

There’s some other things I wanted to ask you, though. I wanted you to just, you’ve given a little bit of an intro to how Connecting Families came about, but perhaps you can tell me a little bit more, or tell us, the audience as well, a little bit more about the work of Connecting Families, and you mentioned 1200 Safe Reunifications since 2004. What do you think, what are the ingredients for both the success of Connecting Families and reunification work more generally? Yeah, I mean, that’s interesting, isn’t it, too, because, you know, Connecting Families in 2004 was me.

So, and then by 2006, there were three of us, but the three of us were, so Deb Pickering and Sarah Gray, whom I worked with in Anglicare in reunification and family press services. So they were, we’d already had existing relationships, and they had the same values and attitudes and beliefs that I do. And I, because I was just getting inundated with referrals, I just couldn’t, and you know what it’s like in private practice, you just never say no to anything.

So I needed to bring people on to help with that. And so that’s kind of what happened over a period of time. More and more people came on board that I had, I had selected based on my previous working relationships with them, knowing what their attitudes and values were to sort of over the time.

So Matt Davis, another person from, you know, when I was in Anglicare, Tracey Laddams, who I worked with in residential care. So Tracey and I have been now have a 40 year long working relationship. It’s amazing to think about really.

Tracey was in Keeping Families together as well, and then Connecting Families. And Matt, you know, 30 years, Deb, 30 years, we’ve been working together for a really long time, the core group of Connecting Families. That is now expanded, 17 in that bio since then with one person has left, so it’s 16.

And they are people that I have come across in my career, where we have, we’ve gelled and I’ve known that they approach the work the same way that I do. So, you know, we’ve got a large team now with three men, and we did have three Aboriginal practitioners, we now only have two. And I think the reason why we’ve been so successful in the work is because we are a collective voice.

You know, when I stopped to think about it, there’s, you know, it’s hard work, you know, this Colby, you know, it’s really hard work. And often, we are butting heads with the statutory agency, we are butting heads with the court, we’re butting heads with everybody, because we might approach it differently and have a different view. And I think with us being having so many people in the team, and we all approach the work in the same way and think about families and that the children ought to be with their families, if that’s at all possible, and if not, with very close enduring connection to family, that having many of us speaking that, I don’t know what it is, but it just brings about a sense of safety in the team to be able to do that.

And in a sense that, you know, we are, we’ve got each other’s backs, we can support each other, and to continue to do the work. So I think, you know, I despair at competitive, I don’t know what happens in other parts of the world, but competitive tendering processes where agencies win a tender to provide a service for three years, and then they put it out again, and then someone else might win it. So no one develops long term practice wisdom, you know, long term, and that you have people that are really passionate about this work, it’s not just a job, it’s not, it’s actually a career.

So I think that’s what I’ve been able to gather together. And when I think about 21 years now, almost that we’ve been going as Connecting Families, you know, that’s a long time for one service, and I don’t see it ending anytime soon. And so that collective wisdom just grows and grows and grows.

And I think that’s why we are successful, because the values and the attitudes and the beliefs, but but also the skill set that people develop over time, and then can pass on to each other is immeasurable. I don’t I don’t know how you measure that. I don’t know how you replicate it.

And, you know, I feel really lucky to have this group of people around me. So I think that that’s why I think Yeah, yeah, thank you for that. I think what you’re what I’m hearing you say is the importance of a team that is aligned in their approach to practice.

And is speaks with a consistent voice. And I think there is something very psychologically safe about teams where people are all on the same page and aligned in their practice. I think, you know, in some respects, we we celebrate diversity.

But also, I think we need to acknowledge that teams work well, in the this kind of way of being aligned and supportive of each other. And being and speaking with a collective voice. I think the collective voice provides is authoritative in the work that we do.

And I think you mentioned, go back to one of your responses about the Churchill Fellowship. We think about we’ve talked a little bit about in in our backwards and forwards conversation here about things that are really powerful in, you know, factors in human behaviour and, and the way in which people approach life and relationships, we thought a bit about the role and importance of shame, but also validation. You know, the the the experience that that we’re not just the only one thinking and working in this way, that our thoughts and beliefs and approach are valid, are acceptable, are worthy.

These are very powerful conditions, I think, in which to in our shared areas of endeavour approach, approach the work with as much psychological safety as we can muster to protect ourselves, because it is it is a difficult area of endeavour. And when you when you work in a over a long period of time, I don’t think you can do it. I don’t think you can do it without depleting yourself drastically if you don’t have a team and peers who, as you say, have got your back, but who also believe in what you believe in.

Yeah, yeah. And I think also it can challenge you, you know, because, you know, I think about, you know, the work of Eileen Munro and, you know, her talking around, you know, the I can’t remember the actual quote, but the most protective thing is to admit that you might have got it wrong. And I think and I in child protection work, you know, and I think that having a team around where we can talk about, you know, you can get different perspectives on things.

You can be going, you know, am I am I not am I missing something here? You know, I think that having a collective voice is not just about being, you know, gee, we’re all right. And that’s not what I that’s not what I mean. And it’s really more around saying where we want to come at things with rigour.

You know, we want to make sure we’re doing things properly and right and thoroughly. And I think when you’re on your own, you can lose you can lose that objectivity. You know, you basically it’s good.

It’s healthy to have people around to sort of go. Yeah, I’m not quite sure about that. So we do a lot of co-working in this as well.

A lot of the team, you know, will work with two practitioners. Sometimes we might have a family where they might they might end up with five of the team because someone’s doing someone’s doing security. Tracy might be doing a relapse prevention plan around substance misuse.

So they’re seen by a lot of people in the team. And we don’t always agree about where the families are on there and the progress that they’re making. And I think that’s really healthy.

It is. I agree. And I guess most people who talk about teams, I would anticipate, talk about the importance of having diversity of background and diversity of beliefs and opinions.

And yet I would say that those things are fantastic where there is a secure base within the team. And the secure base is one that regulates shame or is non-shaming. And the secure base is one where we feel of togetherness and connection and belonging.

And in another podcast, shout out to Lynne Payton and her success is never accidental podcast. I talked about how teams are very functional teams are very much like an attachment relationship. And I think in order to explore other ideas, to take risks, carefully managed risks, to make mistakes, own up to them, learn from them, move on from them.

You need the security that we’re talking about, the psychological safety that we’re talking about. Yeah. I think the preparedness to be vulnerable and know that you can be vulnerable in that space and people will just hold you really in that.

And for me, it’s very much a parallel process about what we’re trying to do with families is to support them to be vulnerable, but to feel that there’s safety in doing that. So… That’s very much aligned with what an attachment relationship is. Yeah.

Looks like what we’re talking about with attachment. Attachment is about a relationship in which the person can be vulnerable or is vulnerable and can orient to someone who is able to support them, protect them, respond to their needs and create a situation and a circumstance where the person can grow. So just moving on because it’s been a long chat already, although I’m aware that there are podcasts out there that run to three hours.

Oh my goodness. But I wanted to ask you what advice you would give to your younger self starting out in your professional journey now? And you’ve made some reference to it, but if you could just expand upon that. Look, lots of things probably, Colby.

Yeah, look, I feel like I have touched on certainly… I don’t think I ever thought that I knew everything back then anyway, but I would certainly be saying to myself, you’re going to learn a lot along the way. You know, this is continuous learning and continuous growth. And in fact, you’re going to change your mind about things as well.

And that’s okay, you know, because some of our ideas are shaped and we haven’t really had enough time to actually think about really, really is that do I really think that, you know? So I think that and I know we had talked about this once before, but there’s not a hierarchy of knowledge. I think when I was a younger social worker starting out, and this is no offence to psychologists, you know, I think, but you know, there was always this thing, and there still is, that psychologists trump social workers in terms of, or then, you know, psychiatrists trump psychologists and doctors, somehow the medical profession are revered and they can never get it wrong. I don’t hold that to be true anymore.

And that’s not to be disrespectful about any of those professions. You know, I have respect for all of them, but I have respect for my own and I have respect for the knowledges and wisdom that comes with people who’ve practiced things for a very long time. So I don’t feel, so I think what I would say to my younger self is don’t be intimidated by those other knowledges.

They’re valid, but they’re not the only way of thinking about things, and your way is just as valid, you know, I think that. So I think, you know, I probably hold, you know, these days, I hold great respect for people, you know, like yourself, like other practitioners who have stuck it out, and have an immense amount of knowledge and wisdom. And, and, you know, I see people in the Department for Child Protection here that have been there for, you know, 30, 35 years and doing a hard job, and I respect them that they’ve stayed there and done that.

And they have a lot of knowledge, you know, so that, and you know, it’s okay to make a mistake. What I really liked, I liked all of that answer, but I think the acknowledgement that you will change your mind. And I think two things about long careers.

One is that you’re never, you’re never going to have the same view, I think, or at least it’s healthy to not have the same view, a year down the track, five years down the track, 10 years down the track, then you then you have right now you need to be open to that and prepared to accept that with, with experience and observation, you are, you are going to change your thinking and opinions about things, unless you have a very rigid adherence to what you and who would, who would argue that it is healthy to maintain a rigid adherence to what you knew when you were fresh out of university or first in this, I don’t know that anyone would, would do that. Wouldn’t we call it stuckness? You know, similarly, and I have changed my position on things across a long career. And in particular, one area that has been particularly influential with me, for me, two areas, actually, one, one is working very closely with families that are on the cusp of statutory intervention.

And the and the validity and importance of intervening in those circumstances where, you know, it’s 50 50 as to whether whether statutory authorities should and could get involved. The other area that has been very influential for me is working with care leavers is, and in particular, seeing care leavers that I knew as children taken into care. So both of those areas have been very influential in my position.

Yeah, as I’m sure it is with others. Yeah, yeah. We’ve got a family at the moment in the service that is for Mac, one of the workers in the team, fourth generation.

So the family. Yeah. Yeah.

Yeah. So, you know, the dad was an injured infant, actually, back back when. And so we worked with his parents.

I was the manager of the team at that point. This is back in Anglican days. And then Mac had worked with the this dad’s father was in residential care.

And then so Mac had met the great. Well, I don’t know. We were just like, yeah, well, we’ve been we’ve been at this for too long.

We’re getting to this. But, you know, it was really interesting because this dad, what you know, when when Mac realised that, you know, he was who he was, he you know, we talked about it. And I said, you have to tell him, you have to let him know that you you knew him as a baby, which he did.

And and that worked. You know, that that was fantastic because they, you know, they formed a really close connection, actually, now. And and this dad has successfully had his three children returned to his care and is doing really well, you know.

And I think that that longevity of, you know, of him knowing that that Mac knew his story was very helpful, you know. So whilst it was sad, it was also really it was fortuitous that Mac was the one that, you know, coincidentally picked it up. Yeah.

Yeah. Yeah. But I do I do think that those knowing knowing what’s up, you know, I think that’s the other thing, Colby, is that I think I think I always knew this, but I know it far more powerfully now is that the decisions that we make, the things that we write, the recommendations that we make about families have long lasting impact.

So therefore, think very, very carefully about what you write, what you decide, because, you know, it has consequences. And I know that to be so true now that I probably didn’t know as strongly back then. No.

Because, you know, I even think back to families where we recommended that children go into long term care that would I do the same now? Probably not. You know, I even though they weren’t fantastic home situations that were better than what got provided in the long run. So I’d probably go back and undo some of the things that I if I could, if I could, based on the knowledge that I had at that time, I was probably doing what I felt was the right thing.

Yeah. Yeah. Similarly.

Yeah. Sally, that that’s, I think, a very powerful and bright place to bring our conversation to a close. Thank you very much for agreeing to be on my podcast.

And maybe in the future, we might get you back to talk a little bit more about some of this, this and similar. That would be good. Thank you, Colby.

It was a good conversation. Yeah. Awesome.

Thanks, Sally.

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Breaking the cycle of children entering state care

One of the more insidious impacts of early relational/developmental trauma lies in the area of language development and, especially, inner state language. In an environment where parents are grossly preoccupied with their own challenges, opportunities for language growth are stunted. Put simply, there is not the regularity of sensitive back and forth interactions between parent and child, where the child tunes into what the parent is saying, and the parent is speaking the words that go with the child’s experience, such that in time they will become the child’s own words. The parent may not even have the words, themselves, to put to the child’s experience, as a consequency of their own history of early relational/developmental trauma.

In the absense of a sophisticated inner state language, the child is unable to articulate about their experience, just as the parent is unable to articulate their own experience and that of the child in a sophisticated way. Language expression is limited to simple dichotomies, such as “good” or “bad”, or “happy” or “angry/sad”.

In turn, in the absense of sophisticated language, the child can only internalise whether they have been “good” or “bad”, or are “happy” or “angry/sad”. The parent can only use these concepts when referring to the child.

Children and young people who struggle to articulate about their experience rely overly on primitive gestures to communicate about their experience and get their needs met. The most primitive are crying and the social smile. They become alternately charming and demonstrative.

Unfortunately, as they progress through childhood, these primitive relational behaviours are inadequate to fully communicate about their experience and secure needs provision. Adults may frequently misunderstand the intent of the child, such that they inadvertently confirm the negative, about themself (“I am bad”) and others (“you are mean”).

These, then, become central components of the child’s inner voice, and influence how the child approaches life and relationships, right into adulthood.

The sad reality is that the parent and child both struggle to articulate themselves effectively, resulting in maladaptive behaviours that have negative impacts for them both.

If we are to break the cycle of children in care growing into adults with children in care, we need to focus therapeutic endeavours on language development (and the motivation to express oneself in words) as much as anything else.

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Update About Me

In this post I share with the reader a statement of my competencies and experience that I bring to my work and any role I am engaged for. It is also represented on the About Me page of this site. Do let me know if you think I would be a good fit for you, your team, or your programme, to offer supervision support, training, and guidance.

Statement of Competency and Experience

Preamble:

Please note that as a recently departed national Chair of the Psychology Notifications and Compliance Committee (PNCC1), and a national Deputy Chair of the Psychology Immediate Action Committee (PIAC), I have a demonstrable history of maintaining the highest standards of practice and integrity in the service of public safety. As such, all statements made below regarding my competencies and experience are made matter-of-factly and truthfully.

General:

I am a Registered Psychologist in the National Health Practitioner Regulation and Accreditation Scheme (NRAS), with an area of practice endorsement in Clinical Psychology. I have maintained continuous registration as a Psychologist since 1995. I am also the owner of the independent psychology practice, Secure StartÒ. Secure Start has operated continuously since August 2002. At the present time I deliver psychotherapy services to children and young people for whom the Department has authority to place (and adult stakeholders in their life) through my Belair rooms and clinics I deliver on behalf of DCP Psychological Services in Kadina and Port Pirie. I am also a consultant supervisor for local social enterprise, Connecting Families, and consultant supervisor and trainer for Martinthi, a program supporting kinship placements for Aboriginal and Torres Strait Islander children in care that operates as a joint initiative of InComPro Aboriginal Organisation and Uniting Care Wesley Bowden (UCWB). Further, I provide consultant supervisor services to two Directors (Owners) of social care enterprises in the UK, and I provide occasional support in relation to three of my training programs currently delivered by the TUSLA (Child and Family Agency) Fostering Service in Donegal, Ireland. In addition to my psychotherapy service provision to children and young people under guardianship, I provide psychotherapy services to community members referred via their general medical practitioner and the National Disability Insurance Scheme (NDIS). I am also the author of two books.

To the best of my knowledge, I have the longest history of continuous and direct service provision to children and young people in out-of-home care, and adult stakeholders in their life, of any Clinical Psychologist in South Australia, spanning almost thirty years. I also note that, alongside my clinical work, half of my career has been spent in the service of public safety through the regulation of the psychology profession.

Shapes Strategic Thinking and Change

In my years of employment, this aspect of my work started in 1991. Between 1991 and 1995 I was employed as a Research Officer at Southern Child and Adolescent Mental Health Services. As part of this role I provided advice and guidance to Emeritus Professor Graham Martin OAM about research strategy, implementation, and outcomes in adolescent mental health, with a special focus on teenage suicide. Please refer to my curriculum vitae for further information, especially a list of publications in peer refereed journals. Of note, Professor Martin’s first (jointly authored) peer reviewed publications in international psychiatry periodicals were achieved as part of this collaboration. Of further note, one of my first-authored publications[1] became the evidential basis for the assessment framework in a national teen suicide prevention initiative (Youth Suicide: Recognising the Signs), targeting general medical practitioners.

Between 1995 and 2002 I was employed as a Clinical Psychologist in what is now known as the Department for Child Protection (DCP). During my employment I recognised the need for a broad-based explanatory framework in which to embed the Department’s work and decision-making. Ultimately, this led to me developing (with help from Patricia Rayment and Kylie Eitzen) the Department’s first in-service training on Attachment Theory, which was first rolled out to staff in 2002. Since then, attachment theory has become the most enduring theoretical basis for child protection decision-making in South Australia and is embedded in the current legislation. Of note, when the new legislation came into effect I delivered training to the judicial officers of the Youth Court of South Australia in attachment theory and its application in child protection decision-making.

From August 2002 I began my private practice, part-time. I transitioned to full-time in January 2003. Across the past 22 years I have fulfilled all duties that come with being a practice owner, including the management of staff, finances, ethical and legal obligations, and practice direction.

Supervision of psychology trainees was an enduring interest and I supervised my first trainee (now a senior manager in child protection in South Australia) in 1997. Many of the trainees I supervised between 1997 and 2005 were subsequently employed by the Department for Child Protection. In 2005 I was separately approached by representatives of the psychology departments of the University of Adelaide and the University of South Australia to establish and manage child psychology training clinics. This represented an opportunity to scale supervision to meet a growing demand for psychologists in child protection. Ultimately, I went further with the University of South Australia and negotiated a collaboration with the Department for Child Protection which directly supported significant growth in the employment of graduate psychologists in the Department’s Psychological Services. At one stage, nearly all of the psychologists employed by the Department has been trained by me and/or through the Child Wellbeing Clinics I established at the Salisbury and Marion offices. It is worth noting that the clinic model I established was subsequently adopted by Flinders University of South Australia and the University of Adelaide in clinics that operated for almost a decade after my departure in 2008.

I have maintained an enduring interest in the care of children and young people who could not be safely cared for at home and developed resources for foster carers and others in association with this interest. These resources ultimately coalesced into the first edition of my book, A Short Introduction to Attachment and Attachment Disorder (2009). Prior to publication, the book had also served as an orientation manual for trainees I supervised, including the more than thirty trainees that went through the Child Wellbeing Clinics between 2006 and 2008. While I was directing the Child Wellbeing Clinics there was a significant change in placement arrangements in South Australia, and exponential growth in so-called ‘emergency care’. At this time I considered that I had the resources and the ‘workforce’ to assist the Department in the prevention of placement breakdowns (and reliance on emergency care). While this did not proceed, this led me to developing carer resources and training programs that resulted in:

  • The implementation of the Triple-A Model of Therapeutic Care (Centacare Family Preservation Foster Care Program, 2014-2015)
  • The implementation of the Triple-A Model of Therapeutic Care (TUSLA Fostering Service, Donegal, 2016-present)
  • The implementation of the Kinship Care Program (DCP funded, sector-wide program, 2018-2020)
  • The implementation of the CARE Curriculum (Martinthi Aboriginal Kinship Care program, 2021-present).

In addition, between 2010 and 2024 I held various appointments as part of the National Health Practitioner Regulation and Accreditation Scheme (NRAS), which operates under the Health Practitioner National Law in each State and Territory. In July 2022 I took over the role of Chair (Acting) of the NT/SA/WA Regional Board of the Psychology Board of Australia and was subsequently chosen by the National Board to Chair a newly formed Psychology Notifications and Compliance Committee (PNCC1), and act as a Deputy Chair of the Psychology Immediate Action Committee (PIAC). I held these positions until the expiration of my three-term limit (nine years) for appointment to National Committees and Regional Boards, in June 2024. The PNCC was a new committee formed as part of the Psychology Board and NRAS scheme’s transition to nationalisation and comprised a membership of practitioner and community representatives drawn from regional boards around Australia. In this role I was responsible for on-the-ground change management and the delivery of a cohesive and successful committee that served and protected the public interest. I was also responsible for maintaining a culturally safe environment for aboriginal members and practitioners who had matters that were considered by the Committee. For more information about my role I would ask that the selection committee seek a response from the Chair of the Psychology Board of Australia, Rachel Phillips, during consultation with referees.

A final note, applicants for registration as a psychologist who must pass the National Psychology Examination are referred to a recommended reading list that is approved by the Psychology Board of Australia. Since the inception of the Exam requirement, in 2011, my book A Short Introduction to Attachment Disorder has appeared on the list and, for much of the intervening period to date, was the only child psychology resource on the list. At the time of its appearance on the list, my only involvement in the National Scheme was as a member of the Health Practitioner Tribunal of South Australia, and I had no knowledge of the book’s inclusion until 2012, nor interaction with National Board and Committee members until 2013. I am mentioning this here as the book’s placement on this list represents that my work was considered to support the goals of the National Scheme, which was the provision of competent and safe psychology services to the Australian public.

Achieves Results

Between 1991 and 1995 the research program I supported achieved its first international, peer reviewed publications in Psychiatry journals, two of which achieved positive mention in yearly reviews in the Archives of General Psychiatry. The program also secured funding to implement the Early Detection of Emotional Disorders research program, which commenced in 1995 and continued for a further two years after my transition to a role in DCP. In addition, and as mentioned above, one of my first-authored publications[2] became the evidential basis for the assessment framework in a national suicide prevention initiative (Youth Suicide: Recognising the Signs) targeting general medical practitioners.

Since this time, some of the results achieved include:

  • The integration of Attachment Theory into child protection decision-making and practice in South Australia
  • The development and delivery of psychology training clinics as a joint initiative of the Department for Child Protection, the University of South Australia, and Secure Start.
  • The development and delivery of staff and carer training programs that guide service delivery locally and internationally
  • A successful psychology practice, spanning 22 years of operation
  • Successful support of the transition of psychology notification and compliance matters to a national committee structure in the NRAS scheme.

I would add that these are macro results and do not reflect results achieved on an individual level with children and young people in need (and adult stakeholders in their life) across a long career of service provision.

Drives Business Excellence

Aside from my twenty-two-year-old independent psychology practice, I would point the reader to the following.

Though not the highest status person on the team, between 1991 and 1995 I was responsible for providing direct support and guidance into a research program that was immediately successful in developing the careers of Professor Graham Martin and myself. Our first joint publication was in the Journal of the American Academy of Child and Adolescent Psychiatry. At the time, this was a top-ranked psychiatry journal (maybe, it still is). This publication was influential in my gaining entrance to a Clinical Psychology Master’s Degree at the University of Adelaide.

Again, though not the person with the highest job classification, between 1995 and 2002 I drove the Department’s psychology service towards embracing a broad-based explanatory framework in Attachment Theory and led the development of the first in-service training module for the wider Departmental staff.

After I left the Department, I was approached by two local universities to set up child psychology training clinics. The Child Wellbeing Clinics operated under my direction between 2006 and 2008 and established a training structure that was operationalised for almost a decade afterwards and further met the Department’s need to expand its psychology workforce.

In October 2015 I met with representatives of the TUSLA (Child and Family Agency) fostering service in Donegal, Ireland. The outcome of this meeting was the service adopting the Triple-A Model of Therapeutic Care for its foster care program. For the next three years I travelled to Donegal each year to conduct training for TUSLA staff and foster carers, and in 2018 I trained twelve local trainers (six foster carers, six staff members) in the delivery of the Triple-A Model of Therapeutic Care. It is noteworthy that the Model was positively referenced by local carers far more positively than any other packages that are in this market (Ref: Training Needs Analysis conducted by the fostering service in Donegal) and was positively mentioned by Ireland’s independent assessment authority for health and social services (HIQA) when reviewing the TUSLA Fostering Service in Donegal. It is also noteworthy that this training package, and related packages I developed for school staff and the therapeutic management of complex and challenging behaviours, continue to be implemented by the Fostering Service in 2024.

Finally, I would reference my work mentioned above in the NRAS Scheme, particularly in relation to the leadership I provided as part of the transition from a Regional Board structure to a National Committee structure. I would also reference the consultant supervisor (and trainer) roles I provide to Connecting Families, Martinthi, and two social enterprises in the UK. In my work in the NRAS Scheme, with Connecting Families, and with Martinthi, I have been responsible for demonstrating and maintaining cultural safety for aboriginal professionals, carers, and members of the public.

Forges Relationships and Engages Others

Across the past thirty-four years, and especially across the past thirty, building effective relationships has been the cornerstone of my work, from organisational leaders to the deeply hurt and troubled young person referred to me and adult stakeholders in their life. My success in doing this extends from my capacity to consider the individual experience of each person (and organisation) I am engaged with in an open, reflective, and compassionate manner. Much of my work, including my books, periodical articles, blog articles, training packages, podcast appearances, and YouTube videos reflect relationship-oriented practice that achieves strong working alliances through accessible and respectful communication. I would add that across the past thirty years I have delivered training programs to diverse audiences, including professional staff, parents and caregivers, and high school students studying Psychology, reflecting my capacity to tailor my communication to the needs of my audience.

In recent times, my capacity might best be reflected in my role in leading and supporting practitioner and community members through a significant change period, as part of my appointment as inaugural Chair of the Psychology Notifications and Compliance Committee of the Psychology Board of Australia. In this role I was required, in a very short space of time, to create an effective and happy team from diverse members, in the pursuit of an effective committee that safeguarded the Australian public who access psychology services. In this role I was also required to effectively perform all of the duties of a leader, especially managing diversity of opinion in the pursuit of consensus decision making. I took on this role at the request of the National Board and demonstrated my capacity to be a team player in successfully promulgating the nationalisation agenda of the Psychology Board of Australia and Australian Health Practitioner Regulation Agency (AHPRA).

Across my career I have built a network of connections in the child protection and out-of-home care space locally, nationally, and internationally, including in the UK, Ireland, and the USA, and refer the reader to my programs and recent podcast appearances that have been cited on my curriculum vitae in evidence of this.

Exemplifies Personal Drive and Professionalism

I believe that the career I have had reflects my commitment to taking on and responding effectively to the problems others struggle with. I have also been privileged to be entrusted with some of the highest roles and offices in my profession in Australia with respect to the regulation of the psychology profession and protection of the public. I have valued and learnt from high achieving mentors and anticipate continuing to do so. Across a long career I have worked in public, private, university, and regulatory sectors, and extensively in highly scrutinised roles and environments.

Final Comments

I believe that family connections are the most healing connections, and I continue to advocate for the safe reconnection and return of children and young people to their birth parents and family. My blog and YouTube videos reflect this. I particularly support connection to culture, community, country, and family for our Aboriginal and Torres Strait Islander youngsters and endeavour to promote this in all my work and especially through my supervisory and training roles in the Martinthi program.

[1] Pearce, C and Martin, G (1994) Predicting Suicide Attempts Among Adolescents, Acta Psychiatrica Scandinavica, 90 : 324-328

[2] Pearce, C and Martin, G (1994) Predicting Suicide Attempts Among Adolescents, Acta Psychiatrica Scandinavica, 90 : 324-328

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Diary of a Psychotherapist #3: The impact of a long career in child protection and out-of-home care

This video stems from preparations for supervision I was delivering to a social enterprise that works in the child protection and out-of-home space, with a mind to they might feel acknowledged, and acknowledge each other, in the challenging and rewarding work that they do.

Transcript

I caught up with some old friends yesterday that I haven’t seen or interacted with in more than a decade. As you do when you come together with old friends there was an exchange of information about our children and what’s happening in their lives and also what’s happening for us professionally in our work. This was nice and it got me thinking about when was the last time I was asked by someone in my own profession or in related fields what it’s been like providing a frontline continuous psychology service to children and young people who have experienced a tough start to life for nigh on 30 years.

In turn, it got me thinking about what would I say and probably the truth of the matter is that it impacts you. All my career I’ve either worked in a local child protection department or agency or been a private provider for them. Having had my own practice for more than 20 years it means that I have been continuously involved in service delivery to deeply hurt and troubled children and adult stakeholders in their life and that does impact you in both positive and negative ways and in terms of those negative impacts it’s got me thinking about what is a simple and straightforward way to mitigate any adverse effects of the work for people like me who have had a long career of continuous service provision.

The answer that I’ve come to is that it’s not that dissimilar to what is the answer to mitigating the adverse effects for the children and young people and that is that we need to feel acknowledged for the work that we do, feel listened to and understood and it is disappointing to consider that even after 30 years of working in the child protection and out-of-home care space my experience is that I haven’t been asked.

So if you know a practitioner who has had a long career working at the coalface providing frontline services to deeply hurt and troubled children young people start a conversation with them ask them about their experience ask them what knowledge and wisdom they have garnered across a long career. It’ll help them and it may help you too.

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Diary of a Psychotherapist #2: Attachment

This is the second of what I plan to be a series of short videos about my thoughts on psychotherapy service delivery, with a special focus on service provision to children and young people who have experienced relational and developmental trauma.

In this video I speak about what psychotherapy is and the first instalment of the therapeutic framework that informs my approach to psychotherapy service provision with deeply hurt and troubled children and young people.

Transcript

This is the second of a series of diary entry type videos that I’m making about psychotherapy process, and in particular, psychotherapy process with children and young people who are recovering from a tough start to life. Amongst my client group, these are children who have experienced developmental slash relational trauma at home with mum and or dad, such that they couldn’t be safely cared for at home.

In part one of this series on case noting, I talked about the importance of having a theoretical framework that you’re working to. And I alerted to that I will talk more about this in subsequent videos.

Now, the definition that I like to use for psychotherapy is that it involves the application of psychological knowledge and techniques to the therapeutic remediation of a client’s presenting difficulties. I have an overall theoretical framework, the AAA model, which you can read about on my web and blog sites and in my books. AAA stands for attachment, arousal, and accessibility to needs provision.

In terms of attachment, which I’ll talk about briefly here now, the majority of my clients have been deeply hurt in the context of their primary dependency relationships. And indeed, some have also been hurt again and again as placements have become troubled and broken down and they’ve cycled through placements in the out-of-home care system. So by the time they come to see me, they’re often highly defensive about relational connection. And this tends to be at the heart of the presenting behaviors of concern for which they are often referred to me.

So alongside defensiveness about relational connection, the children and young people that I see present with a set of internal working models or attachment representations as I refer to them. So these are beliefs deeply and generally subconsciously held about self, other and world that influences the way in which the child or young person approaches life and relationships.

Now, we all have a spectrum of beliefs from positive beliefs about self, other and world, commonly referred to as secure attachment representations or secure working models, interning working models, down to very disordered ones at the other end of the spectrum. And we all just move backwards, forwards a bit along that spectrum. And we’re relatively under the influence of positive and negative beliefs, depending really on what’s happening in our life contemporaneously and what’s happened in the past, in particular, in past relationships.

So a person who’s had a conventional nurturing upbringing, they predominantly sit up the secure end of that spectrum of attachment beliefs. A person who’s had very difficult and traumatic upbringing primarily sits down the needy end. So this is how the children and young people that I see present. And as I said, their behaviors of concern that they are referred to see me for stem from these negative beliefs about self, other, and the world.

So in terms of the methods that I use to address that, I’m just going to touch on them very briefly and I can expand upon them in another video. The first is, I think of the impacts of relational trauma as being a bit like a phobia, where the phobia is relational connection. So our children and young people present very defensively about relational connection and exhibit a range of transferential behaviors that are problematic in terms of their contemporary relationships. So in psychotherapy service provision, I deliver what psychologists and others know to be the best methodology for, the most evidence-based methodology for addressing a phobia, which is exposure, graded exposure. So I deliver in a graded way, exposure to relational connection, building up to quite an enriched experience of relational connection for the young person that is alongside that, experienced as fun and safe and satisfying for them. So exposure is a key component.

The other thing that I do, and bearing in mind the child or young person’s often subconsciously held negative attachment beliefs about themselves, other people and their world, I intend to facilitate during therapy experiences that directly challenge that, directly challenge the idea that they’re unworthy, unacceptable and incapable, directly challenge the idea that adults are unkind, unresponsive, untrustworthy, and that they’re unsafe in the world. Now I do that through play and other activity. It needs to be about the child or young person’s experience of the interaction, more so than what we say to them about their worth, the trustworthiness of others and their safety in the world.

They’ll easily discount the things that we say about those topics. They find it harder to discount direct experience that they are a worthy, acceptable, adequate and competent child or young person, that adults are kind and understanding and can be trusted and that they can be safe in the world.

So I think this video has gone a little bit longer than I intended it to. So I think I’ll sign off here, but do look out for my next video where I’ll talk a little bit more about theoretical framework and methodologies associated with that. And perhaps two or three down, we’ll talk about the importance of the theoretical framework in informing what we’re looking for in terms of meaningful change. So desired outcomes.

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A message to those who provide care and support to our most vulnerable

This video stems from the deeply saddening stories and images we see about neglect of the elderly, those who are living with a disability, and children and young people who could not be safely cared for at home.

Transcript

This is a message for those who provide care and support to the most vulnerable members of our community. This includes the elderly, people who are living with a disability, and children and young people who could not safely be cared for at home.

If you provide support or care to any of these vulnerable members of our community, or have oversight of people who do, I’d like you to remember this. Care and support fulfills the most basic need humans have for survival, human connection.

Connecting with the recipient of your service in your words, in your actions, and in your outward and expressed emotions is not just an ethical responsibility. It is more important than that.

You are performing a role that sustains life and gives it meaning.

So when delivering this vital service to our most vulnerable, ask yourself this one question:

What is the experience right here, right now, of this person I’m providing care and support to?

Respond to their experience. You will have made their day and supported them to feel like their life has meaning.

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Diary of a Psychotherapist #1: Case Noting

This is the first of what I plan to be a series of short videos about my thoughts on psychotherapy service delivery, with a special focus on service provision to children and young people who have experienced relational and developmental trauma. In this video, I address the issue of case noting. I hope you like it.

Transcript

In addition to your ethical responsibilities to keep good case notes of your sessions with your clients, they’re actually really important in keeping track of and monitoring progress in psychotherapy.

In terms of what I think are really important things to include in my case notes, first thing I do is I keep very good records of how a client presents.

Now, my clients are primarily children and young people who are recovering from a tough start to life. Mostly, that has taken the form of relational and developmental trauma when they are in the care of their mum and or their dad. I keep very good notes of how they present each time they come to see me. That includes how they’re dressed, how the care that they’ve taken around their appearance, how they respond to me arriving in the waiting room, how readily they separate from whoever brings them along to their sessions with me, how well they engage with me in the session, and particularly what their verbal output is like, what their emotional presentation is like throughout the session. Do they converse freely with me or is their verbal output restricted? What their emotions are like, are they animated and expressive? Are their emotions congruent with content and context? How well do they regulate or respond to co-regulation by me?

I’m also interested in their defensive behaviours during the session. Do they try to set the agenda, both in terms of activities we do and conversations we have? Because my approach to psychotherapy is highly relational, and I’ll talk about why that is the case in another short video, what transferential behaviours am I seeing?

Of course, I also keep a record of the interventions that I have delivered during the session. I’m quite interested in how they go at the end of the session. Do they seek to delay or extend the session or do they go easily?

Now, all of this is predicated on having a good, solid theoretical framework that you’re working in relation to. I’ll talk more about that in another video like this. Having a good, solid, coherent theoretical framework from which to reflect on your client’s presentation and behaviour, particular transferential behaviour and approach to the therapeutic relationship during the consultation, is really important also in having an idea of what changes you are expecting to see as part of an effective delivery of a psychotherapy service.

Okay, back to case noting, and I’ll see you in the next one.

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Child Protection Systems Stand or Fall on these Four Pillars

I was recently asked what I would recommend to improve the delivery of child protection systems in my local jurisdiction. This formed part of my answer.

Transcript:

Hi, I’m Colby Pearce. In this video I want to talk about four pillars upon which, I believe, child protection systems stand or fall.

The first pillar is information. Child protection systems function best when they receive good quality information from an informed and knowledgeable public. Remember, child protection really is everybody’s business.

The second pillar is care options. Child protection systems require safe and nurturing care options for children and young people who cannot safely be cared for at home. So, if you’ve ever considered getting involved, please do get in contact with your local child protection authorities.

The third pillar is reunification. Child protection systems function best when they are able to return children and young people home to mum and or dad and or family where it is safe to do so.

The fourth pillar is a trained and knowledgeable workforce. So, of course this applies to child protection authorities but it also applies to the workforce in health, education, family services and disability services. We need the workforce from each of those sectors to be able to communicate with each other using a common knowledge and language framework. We can’t all be doing our own thing. This only results in a fragmented child protection system that ultimately fails in its primary task which is the protection and care and where it is safe to do so, the return of children and young people to the care of their family.

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Do I support late stage reunification?

Recently, I was asked the question that is the title of this post. The context in which I was asked aligned with my view that this is an important topic for me to share my views on. Just a disclaimer; this is my opinion based on thirty years working directly with children and young people who could not safely be cared for at home, and adult stakeholders in their life. I have included the video, below, and a transcript if you prefer to read it.

Video:

Transcript:

In a recent conversation I was asked for my views about late-stage reunification. Now these are reunifications that typically occur during the teen years and when a young person has not been able to form deep and lasting connection within the out-of-home care system, or when they’ve initiated reunification with a birth parent or birth parents themselves.

Now let me be very clear about this.

This eventuality represents a failure of the out-of-home care system to provide and support deep, meaningful, and lasting connection for our children and young people who could not safely be cared for at home by their mum and or their dad. Let me also be clear that these eventualities point us to the enduring importance that mum and dad play in the lives of our children and young people, even though they may not have been able to live with them.

Late-stage reunification is not just a matter of convenience. It is a professional responsibility to ensure that our young people have at least a chance of maintaining long-term connections, including with their birth parents and within their birth families. There is also a duty of care to ensure that these reunifications and even reconnections occur at a time when the young person has our support. We should not leave it up to the young people themselves to manage reconnection and reunification post-18 and without the professional support that is available to them prior to them turning 18 years of age.

So do I support late-stage reunification? I certainly do in most instances. What about the risks you might ask? Well the risks just need to be managed as part of our professional responsibility and duty of care and I would make this final point. The risks associated with our young people transitioning from care without any deep meaningful and lasting connections include serious, sometimes lifelong disturbance in their emotions, their behaviours and their capacity to build and maintain mutually satisfying relationships.

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How can I tell what need or experience is the real reason for the child’s behaviour?

Watch this video to hear hear me talk about the real reasons for behaviours of concern exhibited by children and young people recovering from a tough start to life. You will hear about three key reflective questions to ask and answer in your own mind about the experience and learning of the child or young person, which will help you better understand their needs and experience, and how to respond therapeutically to them. I have also included an article upon which the video is based, below.

A central pillar of trauma-informed care and practice is to respond to the unmet need that is giving rise to the behaviour.

The reasons for this are (at least) threefold:

  1. Children express their needs and experiences through behaviour from the first minutes after they are born, and continue to do so throughout their development. In fact, we all do. We just do it less and less as words and speaking replace behavioural expressions. It is entirely normal to express ourselves through our actions and emotions.
  2. Children who spent time in a very inadequate care environment learn that in order to get attention and a response to their needs they need to make a fuss. Their language development can also be restricted, such that they do not always have the words to express themselves.
  3. If we don’t respond to the need or experience that gives rise to the behaviour of concern, the child’s needs and experiences may continue to be inconsistently or inadequately met, leaving them feeling and believing that they are undeserving and unworthy, and feeling and believing that us, the adults involved in their care, are uncaring, unresponsive, untrustworthy and, in some instances, unsafe.

A little caveat here. Why “unsafe”? This is because adults who very inadequately responded to their needs in the past may also have been responsible for, or struggled to respond effectively to, the child feeling unsafe. In such circumstances, any adult subsequently involved in the care of the child may make them feel unsafe due to the same processes that occur when for example, we feel nervous in circumstances similar to those where we were previously hurt or frightened in some way.

Moving on. So, if we accept the idea that we must respond to the need or experience that gives rise to the behaviour, how do we know what this is?

In my work I have observed that, though they may accept this pillar of trauma-informed care and practice, adults involved in the care of the deeply hurt child have difficulty identifying what the unmet need or experience actually is.

A consequence of this is that the deeply hurt child continues to experience adults as failing to understand them, and inconsistently responsive to them, which only perpetuates their demanding and demonstrative behaviour, or problematic self-reliance.

Consider taking food without permission, or gorging on it when it is available, for example. This is a big problem in many households providing reparative care to children recovering from a tough start to life. Many a parent will say that the child cannot have been hungry, I give them plenty to eat – and they do. Many then see the behaviour as something that needs to be managed by making it harder for the child to gain access to food.

Unfortunately, this misses the point that the reasons for the behaviour include:

  • Reassurance that the child has access to food where, historically, this may not have been the case;
  • Anticipating rejection, and uncertainty about future access to food; or even
  • That they are hungry.

It follows that successful management of this behaviour does not lie in restricting access to food but, rather, in making it easier for the child to access food and helping them to experience that conflict and disapproval are not the end of a relationship.

If you are still with me, that’s great! I won’t keep you much longer. It would be hard for me to keep your attention as I go through an exhaustive list of behaviours of concern and the reasons for them, though I could. Rather, I refer you to three simple reflective questions I developed, based on the Triple-A model, to help you come up with some ideas about what common reasons for behaviours of concern are. These questions are:

  1. If they could or would, how would the child truly describe:
  • Themself?
  • Others?
  • their World?

2. What did the child learn about the accessibility and responsiveness of adults in a caregiving role in their first learning environment(s)?

3. Typically, how activated is the child’s nervous system (aka: How fast does their motor run)?

The answers to these key reflections is often the real reason why the child approaches life and relationships in the way that they do.

You can watch me speak about them in the video in the top left of the screen. You will also find other videos about how to respond to the unmet need and experience of the child in the playlist in the top right. The video about verbalising understanding is likely to be of further use to you, as it deals with an important way we can facilitate verbal expression, as opposed to behavioural expression.

Finally, remember this. If we don’t respond to the reason for the behaviour, the deeply hurt child will struggle to ever fully heal.

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