Children’s responses to traumatic events vary. For some, the ‘fight or flight’ response is activated and they become hyper aroused (demonstrated through hypervigilance, anxiety and panic). For others, fighting or fleeing is not possible so the child ‘freezes’ and uses avoidant ‘fleeing’ mechanisms that are dissociative. Examples of a dissociative state include a distorted sense of time and a detached feeling of observing oneself. In extreme cases children may withdraw into a fantasy world (Perry, 2003).
Traumatised children need help to work through their trauma as they may continue to experience the neurological, developmental and psychological impact from their early histories even when they are placed with a supportive and loving family. Traditional parenting techniques may not work with these children and foster carers and adopters need to develop alternative therapeutic parenting techniques to help build their resilience (Pennington, 2012).
Children who have been abused or neglected are likely to have developed strategies for staying safe that involve not letting carers 'gain' control. As a result, they resist being protected and cared for by substitute carers. They may show a range of 'controlling' behaviours that help them to feel they are in charge of their own care and protection. This can annoy and upset adults who are trying to care for the child and can trigger responses from a place of frustration. This serves to confirm to the child that they should not let down their defences and that they need to remain in control (Howe, 2009).
Parenting children with histories of abuse and neglect requires sensitive caregiving. The more carers understand about the impact of abuse and neglect on children, the more likely they are to offer nurturing care (Howe, 2009).
Schofield and Beek (2009, 2014) present a framework for therapeutic parenting known as "The Secure Base Model," which aims to facilitate children's progression toward greater security and resilience. This model centres on the interactions between caregivers and children and revolves around five essential caregiving dimensions:
Schofield and Beek (2014) propose that the model can be applied in various scenarios:
How can we support foster carers and adoptive parents?
Parenting a traumatised child can involve high levels of stress. These parents need appropriate support to help them care for their children and to help them make sense of their children’s behaviour (Lotty et al., 2021). Foster carers and adopters may struggle to maintain a positive attitude. Social workers need to be alert to this possibility and avoid reinforcing these negative feelings (Bradley & Kinchington, 2023).
Research suggests that foster carers need support in the following areas: close links with family placement social workers, clear and consistent communication between fostering teams and foster families, access to out-of-hours and other professional support services feeling part of a wider team supporting a child (Coulter et al., 2022 and Naish et al., 2019). This is no different for adopters who also need the same support.
Certain children may necessitate more intensive interventions to aid in their recovery from early trauma. Several evidence-based programs have proven effective in enhancing outcomes for children and young individuals in out-of-home care. These programs share a fundamental approach centred on intensive work with the young person within the context of their birth or foster family setting. Common features of these programs include engagement with both the child and their parents or caregivers, fostering positive family relationships, encouraging pro-social peer interactions, enhancing parenting skills, and establishing clear and consistent boundaries (Blaustein & Kinniburgh, 2023). Negotiated boundaries support a sense of agency which is important in a trauma informed model; done with, not done to, with trust and transparancy.
These programs encompass:
Multi-dimensional Treatment Foster Care (MTFC) designed for children and young people grappling with significant challenges in various aspects of their lives.
Keeping Foster and Kinship Parents Trained and Supported (KEEP), aimed at enhancing the parenting skills of foster and kinship caregivers of children aged 5 to 12 years.
Fostering Changes, which equips foster caregivers to respond more effectively to the needs of children and young individuals in their care.
Finally, AdOpt is a program designed for adoptive parents, aimed at addressing particular challenges that may arise with adopted children.
It is also important that we remain aware that compassion fatigue can also be experienced by those providing care and consider what we can do to support. This phenomenon pertains to the emotional numbness, suppression, and defensiveness experienced by individuals engaged in demanding helping professions. The term "compassion fatigue" encompasses not only the direct impact of providing assistance or care in stressful situations but also the interplay with job satisfaction and the quality of support an individual receives (Singh et al., 2020). However, it is important to note that 'compassion fatigue' is a term that locates the problem in the person rather than instead, recognising that often, the demands of this deep work is exacerbated by lack of support, reduced services and relational poverty.
So, what can we do to help?
Establishing a secure environment for caregivers to address both the child's and their personal traumas, and to openly discuss challenging matters without the fear of criticism or penalties, is equally crucial. This protective environment should be present within support groups, the active encouragement of informal peer support, as well as during professional supervision and support. Without this safeguard, caregivers may find themselves persistently judged and held responsible for their own challenges, as well as those of the children under their care, with their needs going unnoticed.
If you need any help and support in or just a general chat about ‘all things Trauma Informed’, please get in touch with Lyndsay, our Working Together Lead at lyndsay@ticservicesltd.com and our team will support you in your journey.
References
Bradley, C., & Kinchington, F. (2023). Trauma in Children and Young People: Reaching the Heart of the Matter. Taylor & Francis.
Howe, D. (2009). ‘The impact of histories of abuse and neglect on children in placement’ in Schofield G and Simmonds J (eds) The Child Placement Handbook. London: BAAF.
Pennington, E. (2012). It Takes a Village to Raise a Child: Adoption UK survey on adoption support. Banbury: Adoption UK.
Perry, B. and Winfrey, O. (2022). What happened to you? Bluebird publishing.
Schofield, G. and Beek, M. (2009). Growing up in foster care: providing a secure base through adolescence. Child and Family Social Work, 14, 255-266.
Schofield, G. and Beek, M. (2014) The Secure Base model: promoting attachment in foster care and adoption. London: BAAF.
Singh, J., Karanika-Murray, M., Baguley, T., & Hudson, J. (2020). A systematic review of job demands and resources associated with compassion fatigue in mental health professionals. International Journal of Environmental Research and Public Health, 17(19), 6987.