Evidence based trauma therapy for children and young people

The field of evidence based, or emerging evidence approaches to support children and young people to heal from trauma is a growing field and definitely hopeful.

What we do know is that healing does begin in the home and with the relationships around a child. To care for a child that has come into care due to neglect/abuse ideally means you are a willing to take a peek around the world of trauma and healing from trauma.

Below is a snapshot of two key areas to consider when you are caring for a child in care.

Step 1. Creating a trauma informed home space for children in care.

Whether a child is with you for a few days, a few months, a few years or a lifetime, it is important to set up a trauma informed home. In NSW and South Australia, courses in reparative parenting are available to help us learn these skills. I hope this is now mandatory for all carers (or something similar), but I am assuming there are plenty of carers who have not received this level of training.

Carers that are skilled in reparative parenting learn about:

• Impacts of trauma

• Types of attachment (Secure, Ambivalent, Disorganised, Avoidant)

• How to help a child feel safe in a relationship (including learning how to repair when we adults make mistakes – which we do!)

• Learning how to use ‘special play’ to build connection, safety and attachment for a child in fun ways.

• Creating a trauma informed home space for children in care.

  
  

Once we learn the skills, we then need to apply, adapt and sustain to help a child in care feel safe over time. I really enjoyed using the special time approach to provide C a space to lead safely and have my undivided attention. I still use this approach with both my children at times when I feel we need some re-connection time. I adapt it but continue to apply the principles.

The question to ask yourself before moving to Step 2 is ‘Have I and the other adults in the household been able to create a trauma informed household to support the child/ren?’. If you are not sure, then it may be worth having a conversation with your agency about this to help unpack. If you are confident this is established, then read on for more information about evidence based trauma therapies.

Step 2. Trauma therapies

Before we reach for trauma therapy, I believe it is important that we consider whether we ourselves are feeling stable and able to do this. Once we are clear if we are ‘ready’ then we need to consider whether the child/ren in our care is ready.

Some trauma therapies work directly with the primary carer/s, others the child/young person and others will work with both the primary carer/s and the child/young person.

There are a few things you need to consider and have conversations with your agency about progressing to trauma therapy:

1. Is trauma therapy really necessary at this point? It is possible a child in a loving, safe environment is receiving healing in the home.

2. What therapeutic support has been provided to the child/ren in my care in the past? How long for and how did this go? Were there any recommendations at the end of the therapeutic period?

3. Given the circumstances of the child/young person, myself and other household members, what type of therapeutic trauma approach will be most suitable?

   
   

Below is a list of some evidence based trauma therapies to help you with your conversations and decision making with your agency.

• Neuro-feedback (also known as EEG)

• Parent Child Interaction Therapy

• Trauma focussed Cognitive Behaviour therapy

• Eye Movement Desensitisation EMDR

• Functional Family Therapy FFT

• Theraplay

• Multi-Systemic therapy for child abuse and neglect MST-CAN

  
  

It is important to access support from your agency around what evidence based trauma therapies would be suitable for a child/ren in your care, what financial support they will provide and have this built into the case plan.

I was lucky enough to be able to have conversations with a friend/colleague/psychologist who could help me to unpack what would best suit my foster daughter. Note – C (foster daughter) had been with our family for 7 years when we agreed it was time to embark on therapy where the therapist would work directly with C. The reasons for waiting so long related to a sustained period of change that was constantly disrupting C (note – mentors and school counsellors have been used during critical periods of change).

After a year of stability (including good school support and living in a quieter area) I was able to better understand C’s baseline. That was a time where I felt C was ready for a different approach to support her.

If you have accessed trauma therapy for a child in your care, I would love to hear how this went.