The ESSENCE of Autism and Other Neurodevelopmental Conditions.  Rethinking Co-Morbidities, Assessment, and Intervention by Christopher Gillberg (2021)
Published by Jessica Kingsley.
 
Physically, this is a small book, a mere 141 pages which can be read quickly.  Yet, despite its size, the information contained within is of HUGE importance.  Its huge because the ESSENCE approach challenges how health systems are currently organised for children, and how professionals understand, identify and support children who present with varying conditions and/or challenges. 


So, what is ESSENCE?  Professor Gillberg outlines that ESSENCE stands for Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations.  ESSENCE refers to a group of neurodevelopmental disorders, which includes the commonly known Autism and ADHD and other lesser-known conditions such as Avoidant Restrictive Food Intake Disorder (ARFID) and Speech & Language Disorders, amongst others.  In short, ESSENCE focuses on children who are showing symptoms and concerns with some aspect of their development, such as social interaction, communication, attention, behaviour, mood, sleep and feeding etc.  ESSENCE reminds us that diagnosis is complicated and can be misleading.  Children can show different symptoms and concerns at different times, and these can have different implications at different times.  For example, symptoms of one diagnosis or the other could easily be identified at the beginning of a child’s life but then a different diagnosis could become more salient later on, when the child is older.  For example, a 4-year-old could be deemed to primarily have autism, only to then grow older and better fit the criteria for ADHD.  A key point from the book is that children may fit different diagnostic boxes at different times in their development.  Children keep growing and changing, which means that assessment/diagnosis needs to be dynamic rather than fixed at any particular point in time.  As Gillberg writes, ‘Making a single definitive diagnosis in early childhood is always wrong’.

Gillberg sets out the lifetime prognosis of ESSENCE, examining the common co-occurrence between conditions and the symptoms they present.  He presents these conditions in a coherent context, using a holistic approach, rather than the usual isolated approach where conditions are assessed for in isolation.  It is common to see health services organised so that there is a pathway or clinic that assesses for ‘autism’, or ‘ADHD’ or ‘attachment difficulties’.   Gillberg shows that these separate single-issue approaches do not fit the evidence which tells us that it is more common for conditions to co-occur.  For example, if a child is autistic, they are more likely to also have ADHD.  

Gillberg sets out what is known about the two diagnosable attachment disorders: Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED).  Of note, to those of us working with care experienced, fostered and adopted children, is Gillberg’s point that ‘virtually all children with RAD/DSED have symptoms of other ESSENCE problems, sometimes even to the point of meeting diagnostic criteria for conditions such as speech and language disorder, autism, and/or ADHD’.  Gillberg recommends that a child who presents with RAD/DSED symptoms always needs comprehensive neuropsychiatric examination and evaluation.  This fits with my clinical experience that we need to take a broad lens when assessing and understanding children with complex backgrounds and presentations.  Child development is key.  A narrow focus on only trauma and/or attachment runs the risk of missing important neurodevelopmental issues. 

Gillberg suggests that a diagnostic process should not just say whether a child fits a specific diagnosis but instead impart a comprehensive description of the child’s difficulties and strengths.  This then forms the basis for support, interventions and treatment.  Also, good assessment and diagnostic processes need a joined-up and long-term approach which utilises the expertise of different professionals. 
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I believe that the ESSENCE approach is much-needed when understanding and supporting adopted, fostered, and other children who are living in complicated circumstances.  ESSENCE is crucial for everyone who has a stake in truly understanding what children need to grow and thrive and identify support that will make a difference.  ESSENCE knowledge is necessary for social workers, health professionals, teachers, therapists and so on.  This book is a crucial read (and a quick one!) for people who commission and organise health services for children, and, it could be argued, adults too.  As Gillberg succinctly writes, ‘ESSENCE must be considered a public health problem given that it affects at least 1 in 10 families.’
 
Review by:
Dr Helen Rodwell, Consultant Clinical Psychologist
Co-author of: Parenting with Theraplay; An Introduction to Autism for Adoptive and Foster Families; CoramBaaf Good Practice Guide on Supporting the Mental Health of Looked After and Adopted Children. 

Play Is The Way: Child development, early years and the future of Scottish education. Edited Sue Palmer

This compact volume is a rich and engaging resource for educators, health professionals, policy makers and parents which sets out a comprehensive argument for establishing a relationship-centred and play-based education for Scotland’s under 7 year olds. Edited by Sue Palmer, who has gathered an impressive array of voices from education and health professions, the book summarises and expands the campaign of Upstart Scotland whose aims include establishing a statutory play-based ‘kindergarten stage’ for Scottish children and stressing the importance of play as a natural part of human development. 

Throughout the book, there is a thorough examination of existing Scottish guidance and legislation on early years education and care, and an overt frustration at the current mismatch between what is on paper and existing practice in nurseries and schools.
The reader will find the book divided into three sections.  The first considers ‘What we know about where we want to go’ and is a fascinating insight into the cultural and historical barriers in Scotland regarding the efficacy of play in early education.  The myth of early acceleration is skilfully outlined through examining the historical contexts that have brought about the persistent but unfounded belief that educating children as young as 4 or 5 years in the 3 Rs (Reading, wRiting and aRithmetic) is the most beneficial for later outcomes,  and that the stubborn suspicion of the validity of play is part of Scottish identity, proud of its early start to formal education. Psychological and neurobiological studies are set out to highlight how human brains are built from the bottom up ie gradually building connections on top of existing foundations of understanding so that incoming information has something to grasp onto.  Trying to accelerate this process by top-down pedagogy goes against the natural development of human brains yet the myth of starting early seems engrained not just in Scotland but throughout the UK.

Section two sets out to consider ‘How can we get to where we want to be?’ with real examples of existing projects leading the way and projected scenarios of what might be possible including harnessing the power of parents.  I was particularly drawn to the arguments for raising the status of the workforce in the early year’s arena and an emphasis on the relational experiences needed to build the foundations for literacy and numeracy before formal learning begins.  As a play therapist, I am delighted to read segments about the vital role of play for children’s social, physical and emotional development; that play is not just a fun way of learning cognitive concepts but is the fundamental language through which children first understand themselves and interact with the world.

The final section examines the wider context in which the authors’ arguments sit and the challenges ahead.  A prime block seems to be the persistence of the Scottish government to require formal assessment of P1 students (age 6 years) rather than moving towards more holistic assessments such as the Early Development Instrument (EDI) which considers social, emotional and physical developments in addition to cognitive and language developments. EDI is already used by other English-speaking countries such as Canada and Australia but has not (yet) found a place in UK education.

In the 2nd edition of this book (it had two reprints within a few months of being published in October 2020), there is a super additional chapter from Shaddai Tembo in which he challenges the often positive and idealised environment in early years settings which may be masking ongoing inequalities and not giving space for recognition of celebrating diversity in all its forms right from the start of a young child’s educational experience. Play, he argues, is a means by which young children can take flight into aspects of themselves that may be constrained in the culture of their setting.  A powerful read which comes from a standpoint of experience and compassion and is well worth a read on its own.
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The excellent reference bank at the end demonstrates the robustness of the research related to the topic of play in early years education and in itself provides a rich source of further reading.  Whilst stemming from Scotland and referring to particular cultural and historical aspects of early education in that country, the book is of equal importance to those of us working elsewhere in the United Kingdom.  I smiled when reading that a copy was sent to every Member of the Scottish Parliament for Christmas!  Bravo to the whole team who put this gem of a compendium together during the pandemic lockdown and are keeping the momentum going for appropriate and life-enhancing early education and care. 
 
Julie McCann, London
Former primary school teacher, BAPT Play Therapist, Theraplay Practitioner, Visiting Lecturer Roehampton University

Crafting Secular Ritual: A Practical Guide by Jeltje Gordon-Lennox. Foreword by Isabel Russo.

This book is an incredibly helpful resource for practising celebrants.  Although the author suggests readers leading ceremonies and rituals could easily skip Part 1, which provides a holistic appreciation of the history and meaning behind human rituals, I thoroughly recommend reading the book in its entirety before utilising the practical aspects as Part 1 really helps to understand how religion is not necessary as the framework for rituals and symbolic acts.  Whilst mysticism and "spiritual" elements have always been important aspects of human ritual, it is very helpful to be able to strip rituals and ceremonies to mark life events of their religious overtones, and explain to potential clients the ancient use of such and the benefit to our psyche of undertaking such rituals and how a secular ritual can be just as meaningful, impactful and creative as a religious ceremony.

The practical sections of the book are written in the same interesting and accessible way and really tie together the abstract and practical aspects of crafting rituals and ceremonies.  The inclusion of logical planning steps, safekeeping considerations, physical space logistics, checklists and practical examples relating to all the major life events is incredibly valuable for a practising celebrant and help break down the crafting of a ceremony into the various elements involved which makes the process less overwhelming for celebrant and client alike.  Similarly, if a client is put off by the idea of a complex ceremony, the book has helped me to introduce small and simple ritualistic elements and how to incorporate them into a more "traditional" event.  

Now I've read the whole book, I dip into the practical sections as I carry out my role - as well as the ideas for symbolism and ritual suggested by the author I've found my own creativity is stimulated, helping me to come up with fitting and personalised rituals for my clients, depending on the circumstances.  Crafting Secular Ritual has become a vital part of the toolbox I use as a practising funeral celebrant to help people move through the pain of losing a loved one in a way which is helpful for their long-term emotional and mental wellbeing.             
Jodie McCombie
Civil Funeral Celebrant

Tiny Spark of Hope: Healing Childhood Trauma in Adulthood by Kim Golding and Alexia Jones  

This is a very beautiful, vulnerable and brave story of healing.  Kim and Alexia together weave this story and the stories Kim writes through the therapy form the story within the story, bringing the process alive with imagery and narrative.

Alexia brings the ‘spark of hope’ with her as she seeks out Kim, a figure from her childhood who really saw her when others could not.  Kim holds this spark so carefully with her acceptance and her empathy and this part of their journey begins.

Alexia’s courage, openness and determination to do this journey flows through the pages.  She brings to life the ups and downs of the therapy journey and the realisation and eventual acceptance that we will not be ‘fixed’ by this journey.  I am so grateful to you, Alexia, for sharing your path with us and I have no doubt that this book will bring healing and connection for many who also walk a path that is similar to your own.

I recently heard Irving Yalom speak about his career and how important writing has always been to him.  He spoke about it being part of what helped him with his work and his desire to understand.  Kim’s art of narrative and desire to share what she has learnt feels to me that it resonates with my understanding of Yalom’s words about his writing.

Kim openly explores her hesitation with starting individual work with Alexia not having received a formal training in an individual psychotherapeutic approach.  She is encouraged to call on the DDP model to help inform her work, a model she is so very familiar with.  When I started to learn about DDP I was struck by how the work of Carl Rogers seemed to weave through all aspects of the model.  Dr. Dan Hughes had created a way of facilitating an environment where safety could be created between the therapist, the parent and the child.  An environment that could be gradually taken by the parent and the child back onto their own home.   Much like a blanket of empathy, unconditional positive regard and congruence for Carl Rogers or, in the language of DDP, Playfulness, Acceptance, Curiosity and Empathy  (PACE).

Kim allows herself to become the kind person, guided by DDP, to come alongside Alexia to walk with her on her journey.  Kim helps us to see how the dyadic aspect of DDP means that there is a structure within which another very significant other can join the journey Alexia and Kim are on.  It allows the environment in which Alexia’s day to day life continues to be very much a part of the therapy.  This  ability to bring significant others into the work feels so very important for the adult who experienced early neglect and developmental trauma.  I am not aware enough of whether other approaches are able to incorporate the significant others into someones therapy, it was not recommended during my own integrative Counselling Training and for good reason.  But in finishing this book it struck me that Kim used DDP to help guide her into a beautiful piece of interpersonal and integrative therapy and introduces us to how DDP could help guide individual psychotherapists into working with a clients wider network.

This is a gift of a book for me as it brings two of my worlds together, that of DDP Practitioner and Psychotherapeutic Counsellor.  I will be recommending it to the professionals in both sides of my working life as well as some of my clients at the right time.

Thank you.

Anna Binnie-Dawson
Occupational Therapist (RCOT), Psychotherapeutic Counsellor (UKCP) and DDP Practitioner, Consultant and Trainer (DDPi)

Working with Relational Trauma in Schools: An Educator's Guide to Using Dyadic Developmental Practice 
(Guides to Working with Relational Trauma Using DDP) by Louise Michelle Bombèr (Author), Kim Golding (Author), Sian Phillips (Author), Dan Hughes (Foreword)

A collaboration between practitioners of such esteem as Kim Golding, Sian Phillips and Louise Bomber cannot fail to grab the attention of anyone who seeks to learn more about developmental trauma. 



​The first of a planned series examining how DDP (Dyadic Developmental Psychotherapy) principles can be applied in different settings, this book is a welcome addition to the growing literature on how schools and educators address the needs of vulnerable pupils.  The focus on the theory and practices associated with DDP and how these may be applied by school staff is timely and informative. 

The authors very much focus on educators rather than just teachers as they are keen proponents of the team pupil approach, something which is crucial if trauma-informed approaches are to become embedded in whole school practice and ethos.  The premise of the book is that educators are not therapists, nor should they be expected to be, but that using the principles of DDP and accepting them as a ‘way of being’ is essential if we are to address the needs of our vulnerable pupils.  It is enlightening, then, that the educator remains at the heart of the theory explored in the book.

Chapters 1 to 3 introduce some key concepts providing theory in typically easy-to-access manner.  We learn about blocked trust, the reasons behind it but, most importantly here, how it can impact on a daily basis within the classroom.  Intersubjectivity and the powerful, though often overlooked, consequences of shame are discussed in chapter 2 and, again, they are skilfully related to what happens between educator and pupil.  Where the writing is interspersed with specific examples it is most impactful as we find ourselves recognising behaviours we may have encountered in our own experience. Moving on to how we may address these behaviours, chapter 3 looks at building connections encouraging educators to be ‘trust builders’ and ‘emotional detectives’.  The analogy of the river of integration in which we are tasked with remaining open, engaged and flexible is a useful one while the section on mind-mindedness reminds us of the skills we can all develop. 
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Many readers of this book will be familiar with the need for PACE (playfulness, acceptance, curiosity and empathy) in our interactions with young people but chapter 4 goes beyond simple information-giving and prompts us to consider how we demonstrate and live PACE as a philosophy rather than label it as a set of strategies.  Like driving a car, the authors write, each of the skills involved are crucial parts of an even more significant ‘whole’.  Similarly, it is not something that can be learned overnight.  Chapter 5 provides a very useful set of frequently asked questions which heads of service might find helpful for training purposes.  Chapter 6 looks on the surface like a collection of ideas but here we consider, amongst other areas, the use of praise and rewards with vulnerable children.  The language used throughout is about ‘supporting’ behaviour rather than ‘managing’ it and practices are critiqued constructively with very clear and thoughtful advice provided. 

Chapters 7 to 10 offer further practical advice but steer clear of doomed-to-fail ‘tips for teachers’ instead asking us to consider how we may adapt our mindsets and predominant modus operandi in order to build relationships, create safe learning environments and become authoritative educators.   That said, the consistent message remains that this is no easy or simple task and that the challenges faced when trying to do this can be immense.  The authors accept that all of this is often easier said than done and they are clear that educators need time, self-compassion and support from colleagues.  Far from being a supplementary thought, as is often the case, this point is reiterated in particular with chapters 11 and 12 where we are asked to consider our own attachment patterns and how we may look after ourselves.  

It is here where this book excels.  That is, the authors have managed to steer clear of the sometimes idealistic-sounding advice that educators get and produce a work that acknowledges the challenges, places the educator at the centre and offers sensitive, practical and realistic guidance. The interlacing of examples illustrates both how common and understandable it is to ‘get it wrong’ as well as how scenarios may be approached differently.  Ideas are presented concisely and a number of broad strategies, like ‘follow-lead-follow’ and ‘rupture-repair’, are clear and difficult to contest.  Practitioners with some knowledge of DDP and PACE as well as those who are beginning this particular journey will both benefit from this work.  A highly recommended read!

Dr Christine Hadfield
Lecturer in Teacher Education at the University of Glasgow.  
I worked as a secondary school teacher in England for 10 years before becoming an adoptive mum, moving home to Glasgow and educating myself in all things attachment and trauma.  I now work at the School of Education, University of Glasgow where I teach Modern Languages and Health and Wellbeing. 

Theraplay® – Theory, Applications and Implementation edited by Rana Hong and Sandra Lindaman
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When the latest Theraplay publication landed, I was excited to see the list of contributors. The Forward is written by Theraplay founder, Phyliss Booth, she provides the history of Theraplay. It’s followed by a Preface from Sandra Lindeman and Rana Hong, Editors. In these troubled times, it’s refreshing​ to know practitioners around the world are adapting the model to use in Covid safe ways (including virtually). Theraplay brings such joy and hope to many.

 
The body of the book is comprised of 12 chapters each focusing on a different application of Theraplay. They are well organised with introductions, key points, subsections, case studies, concluding comments, questions for reflection and references. Chapter 1 provides an overview of the Theraplay model with updated reference to Polyvagal theory, attachment theory and neuroscience.
 
I was drawn to Karen Doyle Buckwalter’s chapter 2, ‘Ghosts in the Theraplay Room – Exploring, Considering and Understanding the Impact of the Caregiver’s Own History on Theraplay Treatment’. I attended Karen ‘s training on applications of the Adult Attachment Interview last year and was fascinated to read applications of this, and other tools, in Theraplay. The chapter offers powerful insight and navigates an area my supervisees often bring to supervision.
 
I was also trained by Saara Salo and Hannah Lampi last year, authors of chapter 3, Prenatal and Infant Theraplay. The descriptions of Theraplay applied   in the prenatal phase are full of hope but also backed up by Saara et al’s own research (2019) which is outlined.
 
Chapter 4, Theraplay with Adolescents was written by my amazing supervisor, Fiona Peacock. I loved how Fiona highlighted the need to be conscious of our own cultural identity and how our attitudes and values may impact on our work and clients. Fiona brings her ideas to life through a description her own child gave growing up with a ‘Theraplay Mother’, case work about applications of Group Theraplay and using Theraplay to support a teen mother.
 
Kay Schieffer has contributed chapter 5, ‘Sunshine circles, Universal Best Practice for Young Children in Preschool Classrooms’. As well as giving a rationale for the approach, Kay provides a detailed case description showing how Sunshine Circles was used to form community and stimulate interaction.
 
Annie Kiermaier who inspired my Theraplay journey, writes about ‘Home-Based Theraplay’ in chapter 6. She highlights the thought process the family and practitioner need to consider around the possibilities of home-based Theraplay. Annie knits the realities of all of her experience into her chapter to give practitioners a true reflection of working in this way. She highlights the nuanced support the home-based practitioner may be able to offer.
 
Chapter 7 by Danielle H. Maxonight, ‘Theraplay Adaptatios for Anxiety Disorders’, focuses on the need to consider both children’s and caregiver’s anxiety as it can be intergenerational. Adaptations are described alongside a full case description (including intake).
 
Elizabeth Konrath and Eliana Gil contributed chapter 8, ‘Using Theraplay to Treat Clients of Child Sexual Abuse’. A rationale for Theraplay as an approach is provided alongside theoretical underpinnings and neuroscience related to trauma. The case description highlights the complexities of this work alongside adaptations.
 
Vivien Norris, in chapter 9, writes about ‘Using Theraplay to Help Children Who Are Moving Families’. Vivien describes how Theraplay can be used to support transitions. Vivien has developed her own training and resources (By Your Side, Norris 2019). This is discussed. Vivien outlines how the principles of her work are used within her case description.
 
Chapter 10 is written by Donna M. Gates, ‘Theraplay with families Affected by Domestic Violence’. Donna provides an overview of the impacts domestic violence can have and describes how to work with the non-offending caregiver before beginning dyadic work. A full case description is provided to illustrate Donna’s work.
 
Lauren C. Smithee writes  about ‘Adapting Theraplay for Affirmative Intervention with LGBTQ Families.’ The chapter begins with a focus on understanding the impact of minority stress and internalized stigma. There’s focus on use of terminology and a helpful glossary is provided. Lauren’s case description is of working with a 12 year old transgender girl. It highlights many different issues practitioners may encounter in this application of Theraplay.
 
The final chapter 12 is written by Alexis Greeves and Nicki Melby, “Theraplay with Children who are Deaf or Hard of Hearing’.  It outlines the need for the practitioner to understand how families identify themselves and their culture around hearing loss. Links are made again to Polyvagal theory and further work with caregivers, who may have unresolved grief around their child’s hearing loss is described. Alexis and Nicki describe specific adaptations to Theraplay for work in this context.
 
This edited collection is a fascinating read and the case illustrations bring the theory to life. It has enhanced my love for Theraplay and increased my understanding and sensitivity across a wide range of applications. I highly recommend to all practitioners and organisations with an interest in Theraplay.
 
Dr Amelia Taylor
Child and Educational Psychologist
Theraplay Practitioner and Trainer
Lifecycles Psychology

This is a book for anyone who has an interest in Theraplay, who is thinking about undertaking Theraplay  training, and most especially for those who have some years of experience in Theraplay.  It does, as they say ‘what it says on the tin’, in that it provides relevant theory, the various ways of applying practice/ theory to different ways of using Theraplay, and gives excellent examples of implementation, which I found particularly useful, as a I know my learning style is one of ‘learning by doing ‘ with an underpinning of theory that I can see/recognise as evidence.
 
Chapers are written by a number of people, which also gives a variety of voices to their contribution, with each contributor writing about how she uses Theraplay in her given specialism - and there are plenty of specialisms shared here - Prenatal and infant Theraplay, Children being prepared to transition from foster care to adoption, Sunshine Circles, Home based Theraplay, Theraplay with adolescents, Using Theraplay to treat clients who have experienced child sexual abuse, families affected by domestic violence, Theraplay adaptations for anxiety disorders, Adapting Theraplay for affirmative interventions with LGBTQ families, and Theraplay with  children who hearing impaired.
 
 I enjoyed reading this book, I found the content and the layout to be exceedingly helpful. The blend of theory and practice worked very well, as does the references to more recent experts such as Stephen Porges Polyvagal Theory, BasselVan Der Kolk’s work, as well as other known names like Fongay, Perry, Siegel and Shore.
 
The biggest message I have taken from this excellent book is the importance of getting the foundations right, i.e preparation / background work with the care giver. This being critical to effectively working with the child. As an adoption support worker, this rang true for me. My experience is often one of ‘listening and acknowledging’ a care givers own life experiences, and reflecting with them how and what is happening for them in their relationship/life regarding their child and presenting difficulties. I would strongly recommend this book as a valuable resource and practical support to practitioners using Theraplay in their work. 
 
Rita Grant
Adoption Support Manager
St. Andrew's Children's Society

Riley the Brave is an endearing story which has a powerful message for children who have a history of trauma; bravery isn’t what you think. The message is charmingly delivered through Riley and his other animal friends. It is accompanied by an afterword which helps grown-ups to understand what might be going on with their ‘cubs’ too. 

We are first introduced to a cub called Riley. We learn that although he has lots of friends, he feels different to them- and we begin to discover all the reasons that Riley has had to be brave in the past.

​The story guides us through the way animals might need to do things to survive and feel safe, just like Riley did.  These may resonate with early life trauma experiences that children have in their past; however, by telling these scenarios through the animal characters, it helps to minimise any experiences of shame for the child. Indeed, we learn why these have actually been useful in the past! It strikes me that so many children we work with may not realise why they do the things they do, and this book will help to gently explore this. We then learn new ways that Riley is learning to be brave, and the story ends with a sense of acknowledgement for what he finds difficult, and also with a sense of hope.

The afterword discusses concepts for grown-ups, such as using the ‘upstairs or the downstairs brain’, safety blindness, and why children may continue to experience difficulties long after their circumstances have changed. It helps to prompt grown-ups about how to use the book safely; that perhaps you may only read a couple of pages to begin with, the importance of going slowly, and of recognising whether the child is having a “turtle” moment or a “tiger” moment. 

This will be a lovely addition in my therapy toolkit, and I thoroughly enjoyed reading it.

Emma Shedlow
Specialist Occupational Therapist

Our second review of Know Me To Teach Me by Louise Bomber
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I was excited to receive Louise’s latest book, given the benefit her previous work has given my clinical practice with fostered and adoptive children.  Louise’s previous books have usually been my first recommendation when school staff have asked how they can best support a child who has experienced trauma and/or attachment disruption.  This latest offering did not disappoint. 


Louise has a talent for pulling together the findings from influential clinicians and researchers within the trauma world, and showing us how we can apply this to educational settings. 

The book begins with a clear introduction regarding the effects of adverse experiences upon children and why relationships matter. I adore her quote that, ‘relationships provide social air’ and it is the adults within school that need to breathe, relationally-speak for children.  I felt the call for us all to become ‘relational activists’.  I was familiar with all of the research and theories outlined in the book.  Louise drew on the work of Stephen Porges’ Polyvagal Theory, Dr Daniel Hughes’s PACE model and Dr Bruce Perry’s Neurosequential model amongst others.  This book is packed with the main ‘must know’ theories.  These models are outlined in a simple manner which makes them accessible.  The practical implications and how to use these theories are clearly set out. 

Louise starkly sets out the current crisis within education with so many of our most vulnerable children being given school exclusions.  She also sets out the financial benefits, and savings, of taking a relational approach within schools.  It would be hard to argue with why a new approach is needed within many of our UK schools.   

The book explores the need to reframe discipline.  It includes examples of zero tolerance strategies typically seen within many schools and what the consequences of this are for children.  The need to recognise behaviour as communication is highlighted, and then ideas for how to respond in a more relational and trauma-focused way are set out.  This is a ‘how to’ book.  Many of the typical challenging scenarios I hear about in schools are included.   There are useful question and answer sections which are reminiscent of the many conversations I’ve had with teachers about adoptive children.  Such as “don’t they need to understand that bad behaviour has consequences?” Louise empathically and logically answers this and other questions.  

Louise walks us through the biology of trauma and how bodies respond to stress.  She discusses attunement – what it is and how subtle it can be to convey safety to a traumatised and dysregulated child.  She provides a useful table which outlines the different states a child can be in – and suggests a specific intervention.  Exercises and questions for the reader are sprinkled throughout the book, which invites useful reflection.  An example of a relationship policy is included. 

To sum up, this is a book for everyone working within education to read, absorb, reflect upon, share with colleagues and then put into action.  And, the timing seems perfect given the challenges we’re all facing during the Covid-19 pandemic and the likelihood that many children will need extra thought, time and relationship-attention currently and in the future.
 
Review by:
Dr Helen Rodwell, Consultant Clinical Psychologist, 
Co-author of: Parenting with Theraplay; An Introduction to Autism for Adoptive and Foster Families; CoramBaaf Good Practice Guide on Supporting the Mental Health of Looked After and Adopted Children.

The Little Book of Attachment: 
Theory to Practice in Child Mental Health With Dyadic Developmental Psychotherapy 
​by Daniel Hughes and Ben Gurney-Smith

In ‘The little book of attachment’, Dan Hughes and Ben Gurney-Smith carefully consider the relevance of attachment theory and research for practitioners working in child mental health. 

They notice how understanding attachment theory and the importance of relationships can bring an extra dimension to formulation, diagnosis, and treatment of mental health difficulties within children. They emphasise that this goes beyond recognising children with difficulties of attachment and finding interventions that can reduce these difficulties. It is a recognition that children who do not experience security of attachment can be left with core difficulties in trusting and feeling safe in relationships, regulating emotions and reflecting on experience. These developmental areas, associated with attachment, are critical for emotional well-being and development and therefore can usefully inform how we intervene to help children who present with mental health difficulties. 

Much research, described in this book, has highlighted therapist variables as a more accurate predictor of outcome than mode of intervention. Here Dan and Ben present a powerful discussion of why this might be so. Therapist qualities such as building a therapeutic alliance, empathy, recognising and repairing ruptures, affirmation and holding clients with positive regard are the very same relational qualities that parents bring to parenting a child with a secure attachment. Dan and Ben propose that ‘if we utilize the qualities of human relationships, found in secure attachment, we might begin to enhance the developmental outcomes attachment theory would predict as being important to mental health; named here as the developmental triad of safety and trust, regulation and reflection.’

Dan and Ben are clinicians and they bring all their clinical experience into helping us to translate these ideas into practice. They draw upon Dyadic Developmental Psychotherapy as one example of a therapy that has a relational approach central to the intervention and which actively uses principles derived from Attachment Theory in the therapy. This approach helps families to work towards developing their child’s trust in reciprocal relationships which in turn can help them to develop the emotional and reflective skills needed to both experience attachment security and to move towards improved mental health and emotional well-being. The book is illustrated with many examples of DDP interventions, providing a very practical focus to understanding the ideas being discussed.

This book is called ‘The little book of attachment’. I think it is misnamed. Although the book is little, the ideas within it are huge and have profound implications for the practice of child mental health. All clinicians working with children and families will recognise the importance of understanding the attachment relationship. As one clinician once told me: ‘it always comes down to the attachment stories in the end.’ Our early attachment relationships impact on us in many ways developing both our resilience and our vulnerabilities. By attending to these relational qualities in the therapy room, and within the families, we can only enhance the interventions we use, from whichever model we are comfortable working within. As a DDP practitioner myself, I am persuaded of the benefits of DDP as a relational model of therapy which is helpful for children who have experienced developmental trauma in their lives. Within this book we are invited to broaden our thinking to consider how this, or similar approaches to therapy, can enhance our interventions for all children and families who have been touched by poor mental health and reduced emotional well-being. In doing this there is no ‘throwing the baby out with the bath water’, such an approach to intervention can add an extra dimension to the therapies currently on offer.

I recommend this book to all practitioners interested in improving children’s mental health. It will not necessarily change your practice, but it will enhance it. In bringing relationship to the fore, our interventions will be more successful. We are relational beings, living in a relational world. Attending to relationships within our therapy has to make sense.
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As I ‘tweeted’ when I first read this book: ‘Thanks to Dan and Ben for this gem of a ‘little’ book. Like a Tardis it is bigger on the inside!’

Kim Golding, Clinical Psychologist, DDP trainer and author
August 2020

Review of “Building Sensorimotor Systems in Children with Developmental Trauma: A Model for Practice” by Sarah Lloyd
 
Sarah Lloyd brings her rich experience as a Specialist Occupational Therapist and Play Therapist working in children’s mental health services to the fore in this comprehensive and passionate book for families and practitioners working with children who have experienced early adversity and trauma. 
 
Her innovative BUSS model considers that these children have not simply missed out on nurturing relationships, but also the physical movements which complement these relationships. It’s important to note that this book is not designed as a manual for treatment, but rather a number of ideas and suggestions which can be adapted to meet the needs of your own child or a child you are working with in a health or educational context. It also differentiates between the functional sensory processing disorders which are typically found in neurodevelopmental conditions and the under-developed sensory systems resulting from developmental trauma. The BUSS model fits nicely with established models of trauma and development, such as the work of Bruce Perry, Dan Hughes and Kim Golding.
 
Sarah writes in a clear and accessible manner, particularly when describing the early stages of motor development, and this is greatly supported by lovely illustrations of infants and practical examples of what these stages might look like in your own house. When considering the sensorimotor challenges which children may face in everyday life, she asks us to concentrate not just on “what” is difficult, but also “how” the child functions. There is a clear theme about the need to spend time noticing how children move and gathering information about their particular needs, before considering intervention.
 
Perhaps one of the most positive aspects of the book is the idea that these sensorimotor systems are “underdeveloped, but not broken”. Several of the chapter headings refer to “rebuilding”; that the children described within the case studies lack the essential foundations of bodily awareness and emotional regulation and thus have to exert a great deal of attention and effort to get their bodies to do what they want them to do. This empathetic perspective is crucial in placing the emphasis firmly on the need to build the capacity of these systems.
 
The book offers a range of fun activities and games which can be utilised to rebuild the various systems, such as touch, core strength and stability, taste and movement. I particularly like the focus on getting things “just right”. For example, if a child with an underdeveloped sense of touch struggles to discriminate between objects in a feely bag, an alternative suggestion is to hide objects in a bath with lots of bubbles. Sarah has clearly put a lot of thought into these hands-on activities and considered the need to take a step back and gradually increase the level of challenge.
 
While a number of case studies are referred to throughout the book, she helpfully summarises these studies in a “catch up” chapter later on; outlining the key points from each child’s assessment, the kind of activities used in the first four weeks of intervention and the initial review with the child’s parents. The fact that the final part of the book is dedicated to parents’ own experiences of applying the model - offering a range of top tips from everyday practice - means that we finish as we started: with a hopeful and optimistic perspective about growth and rebuilding.
 
Dr Christopher Moore
Educational Psychologist

Mum’s jumper by Jayde Perkin
 
Mum’s jumper is a beautifully illustrated story about death and childhood grief. The little girl in the story remains nameless so that anyone’s name can be used in the telling of it. We meet her on the first page saying goodbye to Mum in hospital. She smiles as she walks home with dad and Mum’s favourite flowers line the street.  Dad’s downcast expression conveys the weight of the goodbye, but the child appears oblivious.

I have recently been listening to a podcast by Helen Culhane from the Children’s Grief Centre in Limerick, in which she discusses the need for children to be included in all aspects of death processes and rituals to help them form a coherent narrative and integrate the loss.
 
Too often adults try to “protect” children from the realities of death, which only complicates their grief. This book, in which the child says goodbye to Mum while she is still alive, offers an opportunity to discuss death with children who may have a parent or grandparent with a terminal illness.  Goodbyes can have different meanings in different situations, stories like this give us a chance to talk with children about those contexts and their understanding of them. The visual impact also reminds us of the importance of images and stories, photographs, drawings and memory books to help with the integration of loss.
 
Mum’s favourite flowers crop up throughout the story. In the dark pages featuring the funeral, the child clings to the flowers as the adults around her are absorbed in their own grief. It reminds us that children are often the forgotten mourners. They grieve differently, typically jumping into puddles of grief then finding a toy, a game or a film and jumping into a puddle of giggles. This spontaneity may lead adults to think that children don’t feel things quite as deeply, when they just process emotion differently, mainly through body and behaviour.
 
The book reminds us of the challenges for a child in the grieving process and the tasks for supporting adults. The girl feels her grief as a whole body experience, barely hearing the words that people say around her and certainly not understanding ambiguous terms adults use to avoid saying death, dying or dead. Hence, Mum is “gone”, what does that mean to be gone? People are “sorry”, why? What did they do? The disease was “terminal”, how can a child make sense of medical terminology? She feels tired but cannot sleep, hungry but cannot eat. She can’t concentrate in school and is angry because other children still have a mum who picks them up. Grief is so much for a child to carry.
 
Thankfully, she has Dad and Dad is great. He is grieving too but he’s not overwhelmed by it so he can model ways to remember Mum and mourn her loss without getting lost himself. When a parent dies children often cling to the other parent (or other carer), not just for comfort but out of fear that they too, might disappear.
 
Dad and the girl sort through Mum’s things and the child’s wondering, “Why would she leave them behind?” indicates her developmental inability to understand the nature and permanency of death and the need to tell and retell Mum stories for years to come. The wondering also shows that children don’t always say out loud what they think and feel and we don’t always notice everything we could. That’s okay too. None of us is perfect, we just have to be good enough.
 
Sorting through belongings is another process in which children can have a part. Too often we get rid of things before children can go through them, get absorbed in the sensory reminders of the dead person and pick what they want to keep. In the rummaging through, the girl finds Mum’s jumper. Mum loved that jumper, which is evidenced by a photo of the girl with Mum and Dad and Mum is wearing the jumper. The jumper smells of Mum so she wears it. And so, the jumper becomes a transitional object, a way of the child staying attached to Mum as she moves from the dark incomprehensible days of early grief through the process of rebuilding a new life that still holds and honours Mum even though she is not physically present.
 
This integration process is beautifully illustrated and articulated over pages of the child playing, skipping, cycling, drawing, painting – living in - Mum’s jumper!  And then, gradually the jumper starts to smell like the child. We know then that she has begun to internalise her mother and is able to carry her with her as she grows. When Dad washes the jumper we get a sense that everything will be okay. She can now keep the jumper in a drawer rather than wear it every day. Dad has allowed that process to happen at the child’s pace. The girl has been in control of when to put the jumper away.
 
Mum’s jumper is a metaphor for the grief process. The child still misses Mum but her tolerance has grown so she can now think, feel and play all at the same time without getting lost in grief. She tells us:
“Dad says the grief is like Mum’s jumper.
The jumper stays the same size but I will eventually grow into it.
The grief may stay the same size.
But my world will grow bigger around it.”
 
How lovely is that? Great job Dad. This is a book that beautifully illustrates and articulates ways of managing and “thinking with” children through the massive loss of a parent in childhood. It highlights the complexity of human attachment relationship and reminds us of the painful truth that we are wired for attachment in a world of impermanence.
 
We can’t have relationships without loss. The challenge is to find ways to integrate the dichotomy of attachment and loss for good mental health through a lifetime. That work begins in childhood. We invest significantly in teaching and modeling how to build relationships, we must also invest in teaching children how to manage when relationships change. A much-loved parent may die but that doesn’t mean she has gone from a child’s life, she just has a different presence. At the end of the story, our wee lady is smiling again, she’s outside with Dad and she feels Mum is everywhere, “She’s in the air, and in the sea, she’s in the flowers, and in me.”
That is what you might call a good outcome.
 
Sheila Lavery

Book Review: Living With The Long Term Effects Of Cancer – Acknowledging trauma and other emotional challenges by Dr Cordelia Galgut. Published by Jessica Kingsley 2020.
 
As someone who has experienced cancer diagnosis and treatment, I would strongly recommend this book. It is not only for those who have been through, or are going through, cancer treatment but also for the GP’s, consultants, other health professionals, and for the families and friends of those who have.

This book chimed with me because like many people I have struggled with the long term emotional and physical after-effects of cancer treatment. This book validated my experience, letting me know that it wasn’t ‘just me’ that felt the way I do, and analyses the attitudes and prevailing beliefs that surround cancer ‘survival’.

Dr Galut, a psychologist who has experienced cancer and its’ treatment, lifts the lid on this rarely spoken of world. She exposes why the subject is still avoided, the obstacles to talking about the long term affects, the feelings of shame and guilt that many who have lived through cancer feel, and the dread that it might come back again. It looks at the impact of diagnosis and treatment as a trauma and advocates that it should be treated as such.

This is not a handbook of how to survive, although there is a lot of good advice, information on sources of support and strategies that individuals can use. It is more a validation that you are not alone in having some of the feelings that you do. As such it is a welcome addition to cancer resources.
​
The book also focuses on the subjects of Relationships and Cancer, Work and Cancer and has a chapter specifically on the issues raised by the treatment of male cancers. Dr Galut has also included the views of other health professionals on the long term impact of cancer treatment on their patients. She rounds of with an appeal for an appeal for more discussion, research and recognition that the long-term effects are real.

- David Lettice

The Handbook of Therapeutic Care for Children: Evidence-Informed Approaches to Working with Traumatized Children and Adolescents in Foster, Kinship and Adoptive Care. Edited by Janise Mitchell, Joe Tucci and Ed Tronick.  Foreword by Stephen W. Porges.

I began reading this book as an Educational Psychologist currently working towards both DDP Practitioner and Neurosequential Model in Education Trainer status & having completed Parent Child Therapy training many moons ago. So, it should come as no surprise when I say that this book gave me deep, deep joy and had my neurons firing & wiring together & may have lead me to reach Peak Geek.

Porges begins by reminding us from the outset that Therapeutic Care incorporates not only a respect for the child, but a respect for their physiological state.  He talks of how this biological state is  the intervening variable in the  ‘opening or closing the (child’s) portal for trust & co-regulation’ and ‘ this will either facilitate the child feeling safe & trusting of others or become defensive & bias the nervous system to detect risk, even when there is no risk in the environment.’ 

Tucci, Mitchell & Tronick then take on the mantle of guiding us through this new paradigm – the principles of Therapeutic Care – the ways in which we help traumatised children to feel ‘biologically’ safe and how we navigate the complexities of all that this entails. While emphasising the primary importance of biological safety, the authors do not shy away from how this interacts with poverty, culture, power and organisational behaviour e.g. in Kickett, Chandran & Mitchell’s Learning from the experiences of Culturally Strong Therapeutic Care for Aboriginal & Torres Strait Islander Children and in Farmer & Kiraly’s exploration of the experiences of children in Kinship Care. 

Here, in one volume both the science and the art of supporting children to recover from developmental trauma is outlined. A crystal clear framework for practice lies within. I read it muttering to myself ‘Yes!! 100% this is what we do! A Therapeutic Specialist?? Never heard of that in this context but OF COURSE we can be.’  (Therapeutic Care expands the role of therapist to become relational brokers, network enablers & systems advocates for children in out of home care) The text gives life and a coherent framework to the many emerging & inter-related evidence based approaches to supporting children with developmental trauma. It pulls them together into a cohesive whole and is a seminal text for anyone and everyone involved in the hopeful endeavour that is being with children who have experienced developmental trauma. Unusually, it is both highly academic in its accessible theory and evidence, and practical with examples of real life approaches and of the framework applied in different ways in different settings. 

One of the text’s greatest strengths is the way in which it outlines a whole system approach: that healing is both brain based & relationally based in the ‘experience that occurs in the micro opportunities of the every day’ and that these experiences are rooted in the formation of trust, safety and relational practice across the totality of people who the child interacts with.  It takes a village, but it takes an organised, coordinated, well-regulated village immune to vicarious trauma & blocked care that is able to remain regulated. But hey, if the village slips up, the paradigm gives us some acceptance and self-compassion that allows us to pick ourselves up and get back to supporting each other in order that we can support the child. The approach enables relationships, thinks over the long term, pays cognisance to each individual child’s set of needs and pattern of developmental risk and strengths. It considers the physical and sensory environment and it cares for the caregivers, resourcing the network of relationships around the child to allow the child’s felt sense of safety to develop.  

Teicher & Munkhbaatar’s chapter on understanding the importance, type and timing of maltreatment on brain development and developmental risk was simply mind blowing, their emphasis on adaptive neural plasticity and the snakes and ladders impact of differing types of abuse and neglect at different developmental stages on different sexes was absolutely fascinating & has real implications for intervention. It is then later followed up with Perry’s chapter on a developmentally sensitive, neuro-scientifically informed approach to clinical problem-solving with its wonderful, hopeful reminder of the power of relationships:  ‘the best predictor of current functioning in youth is current relational health, not adversity’ and how its the ‘therapeutic web’ of relationships that lead to positive change & that felt sense of biological safety.  Later still, Malchiodi, gives us a highly practical guide to using the creative arts in keeping with Perry’s chapter on the brain’s need for somato-sensory regulation.

Both Schore and Hughes & Baylin in their chapters write beautifully about the humanity of love, inter-subjectivity an attachment.  Schore expands on Fromm’s work, looking at what we now know about our neurobiology and that our ‘motherly (carer’s) love makes the child feel: it’s good to have been born; it instils in the child the love for life and not merely the wish to still be alive…Mother’s love for life is as infectious as her anxiety’. In this way, we begin to understand the coping mechanisms children have learned to survive adversity – they have developed ‘mistrusting brains’ adaptively prioritising protection over connection. One of the primary goals of therapeutic care is to gently, sensitively and respectfully provide developmentally appropriate experiences, in every day interactions, across multiple settings, to allow these neural connections to reconfigure, allowing the child to experience  relational connection and feel and know the beauty of unconditional love. In Golding’s chapter, building on Hughes & Baylin’s work, both the reality & the humanity of healing that can take place are explored in an adoptive family when we keep in mind the principles of Therapeutic Care and principally DDP to affect longitudinal change. 

Throughout the book, Tucci, Mitchell & Tronick, sensitively offer us Practice Reflections from each chapter, weaving the thread of the principles of Therapeutic Care throughout and facilitating our learning. This is without a doubt a book that I will go back to and read time and time again, that will help me cement my practice and that of our team. It’s a book that made me proud to be a part of such a vibrant, hopeful and child centred area of work and reinforced both my belief in the power of relationships to affect change and my complete respect for children and the myriad of ways their neurobiology helps them adapt to promote their survival. This is a seminal text that helps us all become better informed as to how we might best help the children we support, love, care for and educate to move from survive to thrive. While predominantly focussed on Care Settings, there is so much in the chapters that those of us in education can apply to our interactions with the children in our care. It is a must read for everyone involved in enacting The Promise from the Care Review in Scotland.  And, as an Educational Psychologist I’m hopeful that a second tome follows, applying these same principles to a different setting to help expand that therapeutic web: The Handbook of Therapeutic Education ❤️ 

Ruth Miller 
​Depute Principal Educational Psychologist.  
East Ayrshire Psychological Services.

The Power of Showing Up: How parental presence shapes who our kids become and how their brains get wired. 

By Dan J Siegel and Tina Payne Bryson
​
I was asked to review this book just as the COVID-19 lockdown was kicking in.  A social worker “to trade”,  I currently work as a Support for Learning Assistant in a local Primary School with children presenting with attachment and trauma related issues and children with autism. 

So when the schools closed, I thought I would have loads of time – however, with my own children at home, my husband also a key worker and our Education Department providing “learning at home” opportunities, time has not been on my side!!

However, reading this book has been a very welcome, and indeed comforting, distraction during such a strange and worrying time when connections, physical, emotional and “virtual” have become more important than ever.  When spending time at home with my children who are also feeling anxious, has meant I have become far more aware of how I am responding, reassuring and being mind minded – showing up for them.

Reading this book has helped me to reflect on my own parenting of my children, making sense of my own experiences and how these have shaped and influenced my attachment style and coping strategies and how these in turn have shaped my children and my relationships.  It is an optimistic book which says “you can do this” and I could actually hear Dan Siegel’s friendly voice as I read through the pages!

The book opens with what it means to “Show Up” and explains with clarity what is meant by the Four S’s (Safe, Seen, Soothed, Secure).  It goes on to explore what happens when parents don’t show up and, without using any incomprehensible jargon, enlightens us about the science of Attachment in a way which sets the scene for the rest of the book.  The Four S’s – Safe, Seen, Soothed, Secure are then assigned a chapter each to explain what happens when parents show up to provide these in a predictable, attuned way and also what the impact on children and adults is when this doesn’t happen.

Dan Siegel and Tina Bryson use neuroscience and attachment research as the basis for the book.  They share with the reader in a way which is easy to makes sense of,  what is meant by a secure and an insecure attachment and effectively describe the categories of attachment – Secure, Avoidant, Ambivalent, Disorganised – highlighting and explaining the causes, meaning and implications of each.   This provides a platform for the reader from which then to make sense of the Four S’s set out in each of the following chapters.

The Four S’s provide a concise, helpful and easy to understand “summary” of attachment research – not an easy task given the breadth of research, books and articles written over the years – but somehow Dan Siegel and Tina Bryson have indeed managed successfully to do this in a way which is easily accessible to parents, carers and indeed anyone involved in supporting and working with children and young people – and also adults who may struggle as a result of the impact of their early experiences.  The Four S’s are the building blocks of healthy development.

The book is full of helpful visual reminders and diagrams which illustrate what is explained throughout the text.  As a visual learner, I found this extremely helpful.  Throughout the book, themes are repeated in a beneficial way e.g. the importance of children feeling safe, seen and soothed and examples of what this looks like.  Reminders within each section pulling you back to the attachment research.   This “repetition” is helpful as it pulls all the themes together.   All Four S’s are pulled together in the final chapter which focuses on security.

One of the things I like about this book is that it repeatedly reminds parents that we are none of us perfect – nor do we need to be.   It is encouraging in that it highlights that it is impossible to get it right all the time and acknowledges that we all get it wrong.  The emphasis is on the balance that most of the time we are getting in right,  creating a predictable experience and world for our children.  It also provides the strategy of repairing things and apologising when we get it wrong – and that this in itself is an opportunity for building security and trust in our children.   Importantly, we are told this does not mean “spoiling” our children, letting them off with things, “being soft”, being permissive – that we can be attuned and connected and show up in a way which still keeps children safe.

There are explanations throughout the book about how the brain works in terms of areas of the brain, how these interact, and how these are impacted by the responses of parents, how the areas integrate and how this integration is the key to our health and happiness as adults.   There are numerous explanations around how we internalise our experiences of being parented.

I also like the way that the book tells us how to “show up” consistently for our children whether they are experiencing success or failures.  How we can provide safety, ensure they are seen and provide soothing, even when we are saying “no”.

An important theme throughout the book is that even those adults who have not had a positive experience in our own childhood of being safe, seen, soothed and secure, can successfully provide this for our own children.  We don’t have to repeat what we experienced.  The writers explain optimistically that providing we can make sense of our own experiences, however negative, that we can reflect on our past and understand how the absence or unpredictability of these building blocks impacted on our own mental model, we can then build positive attachments and can show up for our own children ensuring their development is healthy.   We can become attuned to our own children’s needs, emotions, feelings and thoughts.  

I think this book will be quite a revelation to some parents and carers and professionals reading it, specifically making sense of their own past, their own childhood experiences – there are questions at the end of each chapter which serve to make us think about our own experiences, our parenting of our own children and what we might do differently.  The authors explanation that the way we adhere to the Four S’s shapes not only our children’s’ emotional development but actually physically wires their brains, is fairly mind-blowing (though not alarming!)... but at the same time, makes so much sense and provides irrefutable evidence and examples of the importance of consistently and reliably being present – showing up – for our children in a way which allows them to thrive and get through life’s tough stuff.

As someone who feels I have a “relatively” good understanding of attachment and trauma (and also someone who appreciate a jargon-free text!),  I found this book well written with clearly explained themes, science and research.  It has condensed a huge amount of research into a clear and concise text.  This is a grounded, reader-friendly, optimistic and encouraging read, and most importantly, is easily accessible for parents and carers.  I would thoroughly recommend this book for all parents, carers and anyone involved in working with or supporting children and young people.

I thought I would just include this quote - from the page of the book just before the Contents page, as I feel it reflects these times:-
“If ever there is tomorrow when we’re not together...
There is something you must always remember.
You are braver than you believe, stronger than you seem,
And smarter than you think.  But the most important thing is,
Even if we’re apart ...... I’ll always be with you.
- Christopher Robin to Winnie-the-Pooh (Pooh’s Grand Adventure)

Shona Thain
Support for Learning Assistant (and former Social Worker of 25 years)

Theraplay® The Practitioner's Guide by Vivienne Norris and Dafna Lender 
 
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PREVIOUS REVIEW FOR THIS INVALUABLE NEW RESOURCE READ HERE!

Special offer - buy Theraplay The Practitioners Guide and Parenting With Theraplay for just £35, saving £5.98 off the RRP


I was really excited to read Theraplay The Practitioners Guide by Vivien Norris and Dafna Lender as I found and continue to find Parenting with Theraplay really useful and I wasn’t disappointed.

The book starts with a description of the Theraplay Guiding Principles and beautifully describes what makes it such a powerful intervention, the reader is taken through the underlying principles with great attention to detail and practical explanations linked to the theory underpinning them. 

I think the short paragraph describing the simple Mantra of Theraplay attitude  ‘NO hurts, stick together, have fun and the adult is in charge’ gives a simple and memorable framework that those at the beginning of their theraplay journey will find invaluable and for those further in their journey a helpful reminder of what theraplay is.

The dimensions are helpfully described and I love the inclusion of considering raising the need to think about cultural differences between ourselves and our families and the different way they can impact and the exploration of adaptations needed for older children, physical or cognitive limitations, gender etc.  Not every situation can be listed but it’s helpful to raise this need especially in the UK as my experience has been that adaptation of some description has invariably been needed in my work with families.

The table which constitutes the summary at the end of this chapter is a really helpful quick reminder of what the practitioner needs to hold in mind in different situations in sessions, the explanations illustrate key pointers for good practice clearly based on the theoretical principles underlying.  It will be an invaluable resource to dip into for a quick reminder both prior to sessions and afterwards when reviewing the video footage and I think will be invaluable in helping one think through where their practice can be improved.

I loved the chapter called Nuts and Bolts which takes you step by step through using Theraplay, as well as giving the ideal practice it helpful raises questions that help to identify where adaptations are needed and the examples used illustrate the points made clearly.  It was great to see how the importance of the therapist relationship with the parents is highlighted and the challenges that this can bring. Again there were great examples which really bring the theory to life such as the importance of a simple as a cup of tea in offering nurture and building relationship.

It really feels as though you have someone walking besides you as you read through the steps that lead to your first theraplay session.   Again the joy is in the detail of the writing and the thoughtful examples used that illustrate the work so well.  The careful consideration given to each step makes it seem so simple but the practicalities and the theory are written in such a way that they prompt both the new and experienced practitioner to be thoughtful about their practice and remind you how complex this intervention is when it is truly delivered.   The decisions made at each stage of the work from the parent feedback, the sessions themselves to the importance of working with parents and the challenges this can bring are worked though so that the reader gets a real sense of what’s needed from them.

The chapter titled Theraplay Outtakers and Bloopers – What No One Ever Told You is great encouragement to us all and illustrates how we all learn from practicing and how important it is to never stop looking at the detail when preparing our sessions or feedback or examining what we did.  That we all get it wrong sometimes but if we remember the Theraplay Mantra it will be okay.
The examples illustrate that there’s always learning, that the best plans need adaptation, that children can be unpredictable, the need for safety and the practicing with theraplay attitude are illustrated again and again and how using the theraplay guiding principles allows what can feel like failure to be turned round to positive experiences for parent and child. 

Part 3 looks at Becoming a Theraplay Practitioner and It is helpful to have such a detailed look at what it means to become a theraplay practitioner, what one needs to consider if one wants to takes one’s practice forward.  The challenges that one might face and how to think about them within the context of theraplay.

There’s a super chapter on the supervision process, the practicalities of supervision as well as what might come up personally and the process required to become certified is fully explained.

There are very helpful examples of supervision forms which will be invaluable to those considering whether qualification is the right path for them as well as invaluable for those that in the process of qualifying.

And finally a wonderful array of resources to further support those working with theraplay.  I was so pleased to see the inclusion of how to work with Sensory regulation and the adapations that might be needed.  And it is helpful to have a chapter addressing the need for reflective dialogue in some cases and to have examples of where it can and has been useful.

There is such strength in this book in that it clearly supports workers drawing on all the tools in their tool box to enhance their Theraplay Practice.  The illustrations of where its important and indeed vital to look at adaptations are well illustrated and I think will give workers confidence to ask the questions they need to ask and go looking for answers in how best to meet the needs of their families.

And just to finish - I loved this statement. ‘This does not mean that the relationship will be without its difficulties because therapeutic work is hard , but if we attend to the rupture and repair cycle that happens within relationships, this gives us a strong basis to move forward’

I often talk to parents about how rupture in relationship with their child is not the end of the world but can be seen as an opportunity to repair and deepen attachment.  And I love that theraplay is about relationship and if we can show parents how to rupture and repair successfully not only do we strengthen the trust and strength of their working relationship with us but we also see them  grow in capacity and stretch themselves further than they ever thought possible.

I would recommend this book to anyone wanting to develop their theraplay practice.  It will be invaluable to those at the beginning of their journey with Theraplay and also a lovely refresh for those of us that have been practicing for some time.  It is full of wisdom as well as a ton of practical tools to support practice.  I know that I will be re-visiting it again and again.


​I did my Level 1 Training in London at the beginning of 2010 and immediately loved it and started using it in my work. I used the games in  groups for new adoptive parents and in my direct work with families as part of my role as Children’s worker at Scottish Adoption. In 2013 I did my Level 2 and realised that I needed to start formalising the work I was doing, using MIMs and being more structured with my parent and Child work.  I started talking to Fiona Peacock at this point although it wasn’t until Feb 2016 that I started my Foundation Level.  Fiona is still my go to person for supervision and my Mid-term report for my Intermediate has been on hold since I took on the Practice Manager Role at Scottish Adoption in 2018 – my New Year’s resolution is to complete Intermediate this year. 
 
Fiona Peacock has been working with us an organisation since 2017 and has been invaluable in supporting the understanding and use of theraplay principles in our work.  All our Senior Practitioners are trained to Level 1.  Our adopters are introduced to Theraplay games in prep group, again after approval on our Practical skills for Attachment Training day and post placement in our group programme.  Additionally we use MIMs for all families looking for After Adoption support – its invaluable as an assessment tool and parents are very positive about the process. 
 
I love theraplay - for me it’s a great fit both with me personally and the other tools that I use in my work and through Fiona’s support my practice is growing.  I look forward to dipping into The Practitioners Guide by Vivien Norris and Dafna Lender as part of my Theraplay journey going forward – I can see that it will be invaluable.
 
Julie Connaway
Practice Manager
Scottish Adoption

Theraplay® The Practitioner's Guide by Vivienne Norris and Dafna Lender 
 
IN STOCK NOW

FURTHER REVIEWS FOR THIS INVALUABLE NEW RESOURCE COMING SOON!

Special offer - buy Theraplay The Practitioners Guide and Parenting With Theraplay for just £35, saving £5.98 off the RRP

​Anyone interested in Theraplay® will know how difficult it is to find Theraplay® Institute approved information and activities. It can also be a challenge for people who use Theraplay® within their wider practice to get appropriate supervision for the Theraplay aspects of their work. In both areas Norris and Lender’s book is an invaluable resource.

It is a book packed full of reflection, imagination, problem solving and trouble shooting. The case studies are particularly helpful; they feel real, with honest acknowledgement by the therapists of their own countertransference, defences and complex feelings. They also highlight without any blame or shame how difficult it is for some children and parents to adapt to news ways of relating.  
 
One of the complexities of Theraplay® is that it looks incredibly simple in theory but can be remarkably difficult to practice with efficacy. The authors have considered numerous challenges for the newly qualified and perhaps even the more experienced practitioner, from choosing sequences of activities that allow the therapist to stay relaxed while the child remains engaged, to working with complex parents and understanding and supporting children with deeply challenging forms of resistance, anxiety and control. In fact, in many ways, this is a treasure chest of support for anyone working with children and families, even those who are not Theraplay® trained. By that I mean the Theraplay® attitude and perspective provide a great model of engagement and relational connection that has a true attachment-in-action focus .
 
The book packs in a lot of reading, helpfully structured into five sections.
Part 1 covers the overarching principles of Theraplay® and places it firmly within the context of trauma and attachment theory, dyadic developmental psychotherapy, social engagement theory and neurobiological research.

Part 2 is entitled Nuts and Bolts. I found this “troubleshooting” section particularly valuable. It deals with the “lived experience of engaging in Theraplay®”, answering many questions that I’ve never seen addressed anywhere else. It illustrates the real complexities of using the apparently simple activities in depth with traumatised children and their parents. All too often we focus on challenging children and fail to prepare for the parent work. The authors consider the skills needed for parent work and the challenges of engaging complex parents who could (often unconsciously) sabotage work with the child. As it says on the tin – the nuts and bolts!

Part 3: Becoming a Theraplay® practitioner is a much shorter section, obviously of particular interest to anyone consider training in the approach, trainees and new therapists. Again, although clearly focused on Theraplay®, it also addresses many aspects of supervision that would be of interest to therapists of other creative disciplines who work with children and their parents.

Part 4: examples of completed supervision forms looks at the MIM-based assessment form and shows examples of completed supervision forms, plus a final evaluation supervision form, complete with feedback. It is a practical section that should leave you in no doubt about the meticulous detail required in the paperwork. This detail is made possible through the use of video recording sessions and playing them back so that therapist, parent and supervisor can view the detail of interactions, proving yet again the power of the most subtle relational exchanges in creating connection or disconnection.

Part 5 is the resources section. It includes session plans for different types of clients, a guide for parents, including handouts with checklists to help parents see what the four dimensions look like within the parent-child relationship.  It’s also great to see a section on sensory regulation and children’s tolerance of touch.  As you would expect there is an updated list of Theraplay® activities. I had mixed feelings about this section. It was good to see the guidance for different age groups, but I tend to find the description of Theraplay® activities brief and often vague. Also, no group activities are included. These are small quibbles in an otherwise super resource. I have no doubt that this will be the Theraplay® bible for years to come. 

​Sheila Lavery

Parenting Traumatized Children with Developmental Differences by Dr Sara McLean

​Parenting Traumatized Children with Developmental Differences is a book for Foster and Adoptive Parents. It is written with the possible feelings and perceptions of the carers in mind; those who may be new to their child or the Fostering/ Adoption world, or indeed those who may be experienced.

The book introduces the concept of developmental differences and is sprinkled throughout with how these may relate to early experiences. We found it an easy and digestible book to read - it has a unique method of unpacking ‘jargon’, whilst still addressing the complexity of the developmental process. It dedicates a chapter to each of the different aspects of development to consider, empowering readers to understand how these components may influence their child.
 
This book considers the shared and familiar experiences of carers being unsure of how to raise and support children in a way which meets their specific needs. It encourages looking beyond diagnoses, to focus on the presenting needs of the child. In our experience this can be overwhelming for carers who are unable to prepare for the complex needs of the children they may support.
 
It provides an overview to principles relating to attachment and sensory processing difficulties, in a manner which introduces these concepts and empowers the carer to begin to consider how these may be impacting on presentation. It provides some examples and foundational strategies for what sensory and attachment difficulties might look like. Importantly for us, though it provides some strategies and interpretations, it empowers parents and Carers to know when and where to ask for help from and does not suggest that presenting difficulties should be remediated by family intervention alone.
 
The book provides a wealth of examples of what and why things may be difficult, without being overwhelming. The focus is on understanding differences, discouraging compliance, moving away from "discipline" or punishment, and bringing into focus children's past experiences and how this may impact upon their perception of danger.
 
This would be useful for families to consider the wide-reaching impact of early developmental experiences, and we would certainly be recommending this to some of our families.
 
Emma Shedlow & Nick Smith
Occupational Therapists
Juniper Tree Therapy

Beyond Behaviors: Using Brain Science and Compassion to Understand and Solve Children's Behavioral Challenges by Mona Delahooke PhD

If you are a parent, teacher, mental health professional or find yourself working with any children who struggle with behaviour at home, in school or in the wider community then go buy this book NOW…. It makes so much sense?

Looking after a child with trauma and anxiety, who is neurodiverse or autistic, or who has received any diagnosis which include symptoms of challenging behaviors (RAD, ODD, PDA, DMDD, PTSD, DTD, IED, ADHD, etc.) is highly complex and often demanding. It is impossible however, to have the positive influence we would all wish for without a good understanding of the causes.

Child Psychologist, Dr. Mona Delahooke has put into words so clearly and brilliantly what needs to be known about the most challenging kids in our communities and classrooms. In a compelling, compassionate, and easy-to-read format, she has addressed many of the false assumptions that underpin out-dated behaviour management systems. More importantly she proposes a refreshingly compassionate and brain-based approach. Instead of following the traditional path of rewards and consequences to try to motivate children to behave, she focuses on the importance of building an environment of safety, respecting individual diversity, and understanding children’s sensory and nervous systems. Her emphasis on the importance of relationship in a world where discipline has been interpreted as punishment rather than "to teach" is a key message for all of us.

With plenty of scholarly research, along with helpful examples and informative diagrams, her book clearly and beautifully demonstrates the importance of figuring out the root causes of the behaviour as the prerequisite to finding compassionate solutions that work!

This book Is also important because it addresses both sides of the relationship equation (adult/parent and child) and offers effective tools, worksheets and strategies to help meet and understand the complex, and at times overwhelming, emotional needs/behaviours of children.

For so many of children, reward/punishment/consequences/privilege systems for managing behaviour challenges simply DON’T WORK. So often, kids with trauma, chronic stress, and neurological differences who behave in non-compliant ways are presumed to be manipulative, defiant, and in need of more discipline. What’s missing in these children’s lives is NOT “accountability” or “consequences”— most of these kids have been punished more harshly and consistently than most of us can imagine.  What they need most is human connection! Warm, attuned, positive relationships with adults who accept them the way they are. Dr Delahooke has compelling neuroscientific evidence to back this up. Behaviourally challenged kids generally have an overactive stress response system which keeps their brains from developing in line with their peers. They aren’t unmotivated or unwilling to behave better; they simply can’t.

What will help?
According to Dr Delahooke, providing an environment that supports the child in coping with stress and attaining a state of calm security. No one can learn or acquire new skills when they are in a constant state of fear, anxiety, tiredness and/or stress.

Dr. Delahooke has done an amazing job of explaining complex material in a very readable way. This book raises vital issues for the way we treat children in our nurseries, pre schools, child care settings, after school clubs and programs, and in many homes throughout our communities. When we focus only on observable behaviours and labels, we miss the most important thing - that all children have rich inner lives that need to be valued and understood.

This book needs to be in the hands of every parent, teacher, therapist, pediatrician, and other professionals who attribute negative behaviour to matters of poor character and manipulation rather than as a way to communicate needs. The worksheets are clear and applicable for both therapeutic and caregiver interactions. This book has the potential to transform many readers' perspectives which would be the best possible news for all children.
 
Kevin Denvir
Freelance parent mentor and behaviour coach at Kevin Denvir Consultancy and Training.
www.calmerfamily.com

Help! My feelings Are Too Big!
​Making Sense of Yourself and the World After a Difficult Start in Life by K.L.Aspden
 
Help! My feelings Are Too Big! Making Sense of Yourself and the World After a Difficult Start in Life is an easily accessible book which talks directly to young people and not about them. 

Written from their perspective, it navigates around the topics of attachment in a sensitive manner, being careful not to allocate blame or fault. 

It feels as though the reader is taken by the hand and walked through the book providing clear and simple explanations as to why they may struggle with regulating their emotions and behaviour because of their early experiences.  The basics of attachment theory develops through two fictional case studies.  The comparative stories of a child who develops a secure attachment and a child who develops an insecure attachment and how this plots your emotional trajectory is a useful way to illustrate how young people develop their ability to regulate their emotions and behaviours.  This book provides an explanation as to why young people might feel the way they do, providing a potential ‘light bulb’ moment as they recognise and understand their own emotional development.

Starting with early experiences and moving onto school experiences, the author describes what lies behind behaviour and uses appropriate examples and effective illustrations to do this. The book contains a handy section about the brain with reference to specific parts and their functions, which complements the explanation of behaviour.  It talks about feelings and normalises big emotions. It goes on to helpfully suggests realistic and achievable steps to make relational links with adults who can help and tasks to help alter how you feel about yourself. 

This colourful and attractive book covers a lot but does not use scary language or labels; instead it provides explanations in a calm, non threatening, well paced, sensitive manner.  It presents the information in large text interjected with text boxes, bullet points and illustrations allowing the reader to work through the book easily or dip in and out.

This book offers a simplified, accessible explanation of how our early experiences and interactions with our caregivers influence and shape our emotional development, our self perception and ability to navigate and interact with the world around us appropriately, positively and successfully.
The message is comfortably and cleverly repetitive and does not offer a quick fix but instead the hopeful reality of life after a difficult start.

Katriona Hirst
Trainee Educational Psychologist
Clackmannanshire Educational Psychology Service

​By Your Side Foster Carer and Adopter Guide: support for children moving families
by Vivien Norris (The Family Place 2019),
reviewed by Sheila Lavery
 
Transitions are understandably difficult for care-experienced children, not least because of the huge losses they involve or rekindle. Chief among these are the transitions from birth family to temporary foster care and from foster care to permanency.  

We expect a lot from children when we leave them to manage these moves without respecting their relational history and their ability to make sense of the conflicting and potentially overwhelming feelings such transitions involve.
 
So I was thrilled to read and review By Your Side, by Vivien Norris, Clinical Director of the Family Place. This genuinely trauma-informed guide for supporting both children and adults involved in the move to permanency joins the ranks of Norris’s other publications including Parenting with Theraplay (with Helen Rodwell) and Not Again Little Owl. This review is in respect of the foster carer and adopter guide, which forms part of a wider resource package including a practitioner guide and training programmes.
 
By Your Side acknowledges that starting well is crucial in adoption. It aims to do this by establishing a model of collaboration and containment. It employs DDP and Theraplay to provide consistency, playful connection, a coherent narrative, routines and rituals and a level of caring engagement so a child remains seen, heard and valued at a time when practicalities and planning often take precedence over emotional connection. The book aims to help the adults develop greater insight and empathy when moving a child. That means the adults must cooperate, manage their own feelings and model mind-mindedness and containment for the child.
 
It’s interesting that even though we know how attachments are built through rupture and repair we fail to use the huge rupture of transition as a critical attachment building opportunity and indeed, a key responsibility. Likewise, we may fail to recognise that the liminal space of transition between what was and what is yet to come is not a void but an opportunity for growth. Norris’s guide is hugely valuable in addressing this area.
 
 The manual begins by listing the seven core principles of the approach (see above) and defines the terms attachment and trauma, which helps to clarify the content that follows. The principles give a framework, goals and everyday examples of the By Your Side approach while providing the flexibility needed for every child and family’s unique experience.
 
By Your Side recognizes that the practical tasks of permanent placements and the excitement of a “forever” family means that adults often minimize or ignore the very real feelings of anxiety, grief, frustration, sadness, confusion etc., that a child may struggle to manage. In doing so we begin or continue a culture of, “if we don’t look at the tough stuff, it will go away” or we wait until a child is settled before addressing challenges. Norris addresses the reality of dealing with what comes up, as it comes up, in the here and now because that’s what being present for a child really means. She also asks us to consider our use of language and a child’s understanding of terms like “forever family”. It’s important to be curious about how those words fit with the child’s experience of family and the concept of forever, given the child’s current feeling state and developmental stage. For example, might we not distinguish between “first family”, “helping family” and “keeping family” rather than the usual fostering, adoption and care-order terminology.
 
What I liked most about this guide is that it puts attachment into action in this minute and every minute that we engage with a child, not somewhere down the line. It makes attachment the responsibility of each one of us involved in the child’s journey, not just the job of the “forever family”. Despite the abundance of attachment and trauma language on everyone’s lips, attachment is still not alive in the detail of care planning. There is still an expectation that a child will transfer attachment from one set of parents to another because it’s in their best interests. The system struggles to hold simultaneously the view of what is needed in the here and now with a long view of permanency. In reality minimising the pain of the transition undermines the chances of “permanency” or ‘forever” from the outset. When placements are not managed well subsequent transitions often become problematic and the adolescent transitions can become so difficult as to challenge the stability of everyone’s place in a “forever family”.
 
The sensitivity of the transfer of care from foster carer to permanent parent in the By Your Side approach means the adults can hold the child and the practitioners can hold the adult carers throughout the transitional process. For anyone familiar with DDP and Theraplay the detail of this approach will seem very familiar. I guess what is new is the packaging of those principles into a practical resource with a refreshing view of the space between temporary care and permanency as a bridge rather than a void.
 
As an adopter I questioned how some of the approach would work in practice. I was reassured that the midway review in the process could pick up on the fragility of some situations and the professionals could bolster any support needed for the child. Practitioners using the approach would need to be very skilled, hence the accompanying training, and the support system would need to be very robust. I’m also curious about what other supports might be available to help the adults in this vulnerable period. Still, it’s a great resource. Thinking as I often do these days about adoption disruption, the content of this guide is not only relevant to getting off to a good start in permanent placements, but together with the practitioner guide and training it would be a hugely valuable resource for repairing the hurt in families when the “forever” bubble is fit to burst and it provides a model of collaboration and support that gives adoption placements their best chance of success throughout the lifespan.

​“Gilly the Giraffe Self Esteem Activity Book" by Dr Karen Treisman.

Another attractive cover which invites you and children into the book.  Very accessible and comprehensive. The graphics instantly suggest this is a child-friendly resource.  As with Neon the Ninja, plenty of activity sheets which can be photocopied.
​
Exploring this resource I held in mind the children I primarily come across in my role as a Social Worker in a Family Placement Team.  Self-esteem is something which many of these children lack significantly as a result of their early experiences, poor attachment relationships and trauma.

There is a broad spectrum of strengths-based activities within the book – some more cognitive and also many creative and sensory focussed resources with which children affected by poor attachment and developmental trauma could more easily engage.

The story of Gilly the Giraffe explores the message that we are all unique, its ok to be different and it’s important to notice and celebrate the positive things about ourselves and to believe the positive feedback from others.

Many children and adults find it difficult to see the positives in themselves.   Children affected by developmental and relational trauma even more so.
The story is easy to follow and engage with.  It’s important to read the story to your child before embarking on any of the activities so that your child has an understanding of the message.

The structure of Gilly the Giraffe resource is the practically the same as that of Neon the Ninja in that it begins with the story, then provides some activities which are fun, some further,  more in depth activities, and the Adults Guide which has some additional activities.

It’s important to read through the book and familiarise yourself with the activities.  However, you shouldn’t commence using the activities until you have read through and understood the information, advice and guidance within the Adult Guide.

Once the story is familiar to your child the parent, carer or professional should explore their own relationship to praise and positive feedback.  Dr Triesman, in the Adult Guide section emphasises how important it is for the adult to have awareness of this prior to instigating any activities with their child.  This provides an understanding of expectations or bias.

The activities within the Gilly the Giraffe resource range from more cognitive exercises e.g. sentence completion and thinking about situations to more creative activities involving making things, drawing, collages and more sensory based strategies which asks the child to associate positives with smell, taste, touch, sound, sight.  I liked the activities which look at a childs’ various “parts” like the “Russian dolls” exercise and the positive puzzle person.  It brought to mind “parts language” developed by Holly van Gulden (Adoption Counsellor, Author and trainer/consultant), which begins with noticing positive parts and accepts that we also have some less positive parts AND that we are still the same person.
The activities provide strategies for noticing, appreciating and celebrating positives and storing up positive feelings and thoughts which the child is encouraged to remember when things are tricky e.g. another child saying mean things.

Some activities focus on encouraging success and optimism for the future and ask the child to explore their hopes and dreams.

As with Neon the Ninja, the activities and exercises are not prescriptive or exhaustive.  Tools and strategies are provided which can be adapted and added to depending on the needs of the individual child.

Time can be taken over how the resource is used.  The story can “stand alone” or can be used in conjunction with whatever activities are appropriate.
Dr Treisman makes it clear that the parent, carer, professional should know and be attuned to the child and have a trusting relationship with them prior to embarking on the activities so that the child feel safe to explore the issues through the tools in the book.   The child requires to be regulated and calm so they are in a “thinking and learning space”.  The Guide explains that issues of self-esteem and obstacles to accepting praise and positive feedback need to be assessed and understood for each child.

There is a helpful and comprehensive section in the Adult Guide which determines that the adult should explore their own position, experiences and biases.  There is clear explanation as to how this impacts on the adult’s capacity to support the child and enable them to model thinking and feelings.   There are helpful questions to ask yourself in order to explore this.
I liked how the Guide provides exploration of the reasons why children struggle with poor self-esteem and how negative self-esteem develops including poor early experiences, domestic violence, neglect, abuse and trauma.  It also suggests how we parent or are parented impact on our capacity to believe in ourselves including blaming, shaming, rejection, being ignored, positive affirmation and how these are internalised, creating a negative cycle.

There are lots of helpful strengths-based suggestions, tools and strategies for children, particularly those who find it difficult to hear praise and identify positives about themselves and believe the positive feedback they receive from others.

The guide explores barriers to positive self-esteem including cultural, familial and generational differences in how we view praise and positive feedback.
All in all, this resource is extremely comprehensive and accessible.  Some adults may find exploring their own history and position with regard to praise and positives quite challenging and may require some support to do this in a safe way.

There are clear challenges working with children affected by developmental and relational trauma, however Dr Treisman acknowledges this and provides additional strategies whilst emphasising the need to “know the child” and take it at the child’s pace.

The scope of this resource means you can dip into it and adapt the wide range activities which fit with the child you have in mind.

Many of the activities are fun and creative and provide opportunities for conversations, expanding these conversations and enhancing connection with the child.  

This resource would be helpful to use in schools, as with Gilly the Giraffe, with groups of children as well as individuals.  Of course it would be important to have knowledge of how each child managed praise and positive feedback.   It would be an effective resource to promote inclusion and diversity and provide opportunities for individual children to feel noticed, heard and valued.
I tried a couple of the activities out with my 11 year old daughter.   She found some of the sentence completion activities more/less fun and enjoyed some of the more visual, creative exercises. 

I would want to use this as a resource with families in a systemic way which would allow exploration of how the adults manage praise and support modelling to the children in the family.

A valuable and comprehensive resource which clearly explores the issues.  Some parents or carers may benefit from support to explore their own position prior to initiating activities with their child.

Shona Thain, Family Placement Social Worker
(and my 11 year old daughter, Jenna)

Neon the Ninja Activity book for Children who struggle with sleep and nightmares by Dr Karen Treisman”

When I was asked to take a look at this resource, I felt it would be really helpful to seek the views of a friend, Liz Innes (retired Home Link Worker) who is a Sleep Scotland counsellor, parent and grand-parent.  I also engaged the services of my 11 year old daughter, Jenna to “test drive” it.
​
So, instantly, the cover of the book suggests that children will engage with this colourful character Neon the Ninja.  The visuals throughout the book are excellent.   On a practical note, the activity sheets can be photocopied.  It would be great if they could be downloaded and printed off as required – or the book came with a spiral spine to make it easier to photocopy.   This is a very accessible and comprehensive book.
​
I have used a variety of resources in my role as a front line Social Worker including workbooks and activity sheets – some of which can be basic, a bit too cognitive, or open to interpretation.  Most children with developmental trauma, gaps in early development and poor capacity, find it difficult to engage in more cognitive activities.   It is primarily through this lens that I explored Neon the Ninja.

There are indeed some such cognitive activities within the book, however, there are also many sensory focussed resources with which children affected by poor attachment and developmental trauma could more easily engage.
What I particularly like about the book is it’s optimism and hopefulness – predicting success – that things will get better and the nightmares will go away.   I also liked the activities which “rescript” the nightmares – changing the narrative which accepts that a child has nightmares for a reason AND that the child can have some control over how their fears are played out.

I agree that, as Dr Treisman explains, the reasons behind or causes of nightmares will differ from child to child, and this needs to be explored carefully prior to embarking on using the tools and resources within the book.  However, there is a comprehensive and varied range of activities and options which can be tailored to suit individual children depending on age, developmental age, experiences, circumstances, trauma and capacity.
Giving a sense of agency to the child about how they can be instrumental in banishing their nightmares empowers the child, particularly when supported by a trusted, attuned adult.   I was curious about whether some (developmentally) younger children might be expecting Neon the Ninja to be “real” and to actually materialise before their eyes to help – that bit about not being able to separate fantasy and reality – so this may need a conversation at the start.   Parents and carers need to walk it their child’s shoes and be able to communicate at their child’s developmental level.  The idea of course is that the child themselves becomes their own nightmare ninja.

Parents and carers need to be supported to validate their child’s fears from wherever they originate.   Validation/acceptance is key in the first place, lots of empathy and curiosity and of course where appropriate – the playfulness (PACE – Dan Hughes). 

The activity book should be parent/carer/professional lead rather than the child themselves, working through the book.  The activities are useful in supporting parents and carers to connect to and to build closer, trusting and secure relationships providing the child with the feeling that those caring for them can keep them safe.   Where a child does not have this kind of relationship with their parent or carer, some work would require to be done initially or alongside to facilitate this eg Theraplay.

What the book does well is offer the tools to open up opportunities for conversations with children and supporting them to share their worries.  This in itself is an important process.

Many of the activities provide opportunities for conversations and expanding discussion.   Some in a more creative way by encouraging the child to draw, colour or make something which would help chase away the nightmares.   Again, this gives the child capacity to influence the outcome/change/story.   The activity in itself when done alongside a primary attachment figure/trusted adult creates connection, safety and security.

The book begins with the story of who Neon the Nightmare Ninja is and what he does.  The story provides a sense of empowerment to the child and reassurance that someone is there to help and that the nightmares can be conquered with the help of a trusted adult.  Neon is not along and teams up with his friends.   He has a treasure chest full of lots of creative tools, tricks and suggestions for how to conquer your nightmares in different ways.

Once children become familiar with the story it can be followed up with some fun activities to do with the child which gently and creatively introduces them to Neon and opens conversations about their worries and fears and provides that sense of empowerment.  There are some more relaxing and calming activities to help with the feelings and sensations evoked by the worries and fears which involve some more sensory and mindful resources and strategies.  So it’s a bit of a pick and mix – one size doesn’t fit all – so it’s important that you know your child.

The Guide for Adults in the last section of the book, is very thorough, clearly set out, encouraging and helpful.  It should be read thoroughly prior to embarking on any of the activities.  As I worked my way through the Activity section of the book I paid attention to the range of tools and activities, holding in mind children with developmental trauma and gaps in early attachment development – wondering which activities would be most helpful for them (the more sensory activities) and which they would find difficult to engage with (ie the more cognitive activities).   Dr Karen Treisman sets out very clearly throughout the book, what to hold in mind when using this resource – about which I was really appreciative.

I was extremely impressed with the Adult Guide section.   Dr Treisman goes to great lengths to confirm that “one size doesn’t fit all” and that each child is unique and comes with their own experiences.  She emphasises the need to know your child and know their nightmare(s) before you are able to assess which resources are most appropriate.   She helpfully suggests that any of the tools can be adapted or tailored as required and gives examples of what this could look like.  There is solid exploration and advice around the many issues which cause children to have nightmares and how the impact of nightmares themselves, and the fear of having the nightmares, materialises and affects the individual child.

Dr Treisman reminds those adults using the resource to ensure that the child is supported to experience safety and provides various strategies for creating this in terms of both physical and emotional safety and space.

I was pleased to see a separate section devoted specifically to children affected by relational and developmental trauma.   She explains the impact of i.e. abuse, neglect, bereavement, trauma, domestic violence, bullying.   She explores how memories and flashbacks can be triggered by a range of experiences particularly of a sensory nature ie smells, sounds, temperature, colours, time of day and so on, and discusses how children affected by early trauma may respond when in a state of fear ie flight, fight, freeze and become extremely dysregulated.

She re-iterates how, before addressing the child’s nightmares, the adults involved require to carry out a “whole-child, trauma-informed assessment”.   If found this very encouraging.

This resource provides a range of child-focussed, fun and friendly ways to explore their nightmares and find ways to share their anxieties, whilst providing the tools to empower them to believe they can do something, in the safety of their relationship with a trusted adult, to banish their nightmares. 
Helpful suggestions and ideas are provided as to how to encourage a child to engage, items and materials and methods which can be used in the activities including many which are sensory-based eg massage, music, scents and oils, snuggle toys and blankets, transitional objects.  Methods for rescripting, creating new narratives, changing the outcomes using visualisation, guided meditation etc are also explained giving clear circumstances in which these would be helpful.

Each section of the Adult Guide tells you which activities within the book are relevant.  Lastly, the Guide suggests how to measure success and keep a record so you know what works and how to proceed.  The Guide contains prompts and instructions for the adult to reflect, read over, and review what they have learned.

I really enjoyed exploring this resource.  It provides for individual children with a range of experiences and clearly explains when, why and how to use the activities/tools.  Although the book is aimed at children aged 5-10, it could be tailored for older children and teens,  particularly those functioning at a younger developmental age. 

Parents, carers and professionals would find this book a useful resource in helping with sleep related issues and nightmares.  It may be that some parents may require support to have the confidence to understand and use the resource.
​
The book, whilst focussed on supporting children to overcome their fears and deal with nightmares, I believe has a broader application in supporting children, whether affected or not by early experiences of trauma,  to manage fears and anxiety in general.

Both myself and my friend Liz (Sleep Scotland counsellor), were impressed with the depth of the resource and the scope of activities provided.  My daughter, Jenna, who always likes to help try out resources, really thought the book was fun and helpful.   So thanks to Liz and Jenna for their valuable contributions.
Get the book – its great!

Shona Thain, Family Placement Social Worker
In consultation with Liz Innes, Sleep Scotland Counsellor, and my 11 year old daughter, Jenna