The Meltdown kids: Sensory solutions to everyday situations
[Box Set of 7 books]
By Linda Plowden OT and Hugo Plowden, illustrations by Peter McNaney

Reviewed by Lucky Lucy, a sensory challenged 22 1/2  year old.

First up, this is the story of my school life in a box! I found school really really hard even though I went to a very good school and these books explain some of the reasons why. I picked up the books because the title was intriguing. I laughed at it at first and then got annoyed. The books described me, but if anybody had used the term ‘meltdown’ to describe my behaviour when I was growing up they would really have seen what a meltdown was. Meltdown implies a bit of a strop, like just not getting your own way, it doesn’t convey the level of distress involved for the kids in these stories. There are seven books in the box covering the seven days of the week- why not just call it The Sensory Seven?

Mayhem Monday is completely relatable. The wee girl Jody has to get up for school on a Monday morning and because her mum, dad and sister all hound her to get out of bed and get dressed for school she loses it with them all. That’s spot on. What people don’t get is that wearing scratchy or uncomfortable clothes feel so overwhelming it completely dominates your thinking so if somebody talks to you at the same time as your clothes are irritating you it feels like the voice is part of the irritation - you can’t shout at your clothes so the person talking to you gets a mouthful. I always took it out on my mum because she was the one getting me up in the morning and you don’t want to leave your cosy bed, which is your safe place.
​People don’t understand how stiff and uncomfortable school uniforms are. We had plastic bits in the shirt collars, we had to keep the top button closed and we had to wear a tie – seriously, that feels like you are hanging, especially when the shirts are new or freshly ironed. Then you get that weird static feeling from acrylic jumper like its clinging to your skin. It is so claustrophobic you can’t think of anything else. I used to open my top button so I could breathe and then I’d get a note. If you got three bad notes in a week you’d get a detention. Can you imagine what it feels like to do the one thing you know will help you feel better and then get punished for it? Schools need to understand that when you feel better you learn more.

Tricky Tuesday. Just reading this makes me feel what William is going through. I would have hated all that change. Having a new teacher coming up and touching me would instantly make me feel 100 times more alert. You just don’t come up behind somebody and touch them, especially if you are bigger, more powerful and a stranger! I need to see someone face on so I can size them up. The teacher also expected William to sit in the middle of the room.
Kids like William and me need to sit with a wall behind us or in a corner, so you can see everyone, nobody can come up behind you and you know where the door is if you have to leave quickly. Where you sit makes a big difference to how vigilant you need to be in class. When William goes into survival mode and climbs the tree, Mr Shah says he will climb up and get him because it is not safe up there. But William is up there because it feels a lot safer than being on the ground. The tree becomes William’s safe space, and it is never okay to go into somebody’s safe space? You always ask permission. William’s mum gets called to the school. Mum gives him some crunchy cheese and crackers to bring him back to his senses and water in his sports bottle. Brilliant! I mean who doesn’t love a flip-up lid? It is a perfectly disguised, socially acceptable baby bottle – an instant soother and you can have a wee chew on it if you need to. 

Wobbly Wednesday. In brief, Wobbly Wednesday is about PE. I hated PE so I identify with Ben daydreaming in goal. Like him, I couldn’t be expected to concentrate when all the action was down the other end of the pitch. Also, why stand up on your own when you can sit down, make daisy chains and look for lady bugs like I did?  Anyway, goal is too much pressure. Practising does make a difference and encouragement from your friends really makes you want to do well. Friends make all the difference to school. 
Of course PE is also about the uniform issue again. As if it’s not annoying enough to put your uniform on in the morning, you have just broken yourself into it when you have to take it off, put on a PE kit with shorts! Not even jogging bottoms! And that horrible plasticky elastic around your waist, yuck. Then, when you are all sweaty you have to put your uniform on again and get back to school work. Let me explain what that feels like. It’s like putting a tight tee shirt on back to front and then wriggly around inside it to get it turned round but it doesn’t move properly. It feels like that all day after PE. It should be mandatory that PE comes at the end of the day, so you can go home in your kit and change into something comfortable.

Terrible Thursday. Oh what? This is definitely a week in the life of Lucy! Seriously, this is genuinely my life. Katie goes to the supermarket with her aunt, who sends her to look for four things. I couldn’t do that. One thing at a time please! Also, sending Katie for things where there is a lot of choice is a non-starter. She needs a description, or even better, like in the book, pictures. Bright lights are off putting – they’re not a huge deal for me but I can see why they would bother Katie. Sucking the lolly is a great idea because it regulates you. As the shop was new to Katie, her aunt should have done a walk around with her first so it wasn’t so frightening.
When I was at school, I wouldn’t walk the corridors between classes on my own. I was lucky because my friends understood my quirks and there was always somebody to walk with me, which anchored me. In shops, my mum used to say if we ever got separated just stay in the shop and she would find me because she would never leave without me. That helped when we did get separated because you can very quickly feel forgotten. Busy places with lots of people still scare me.

Frightening Friday. The restaurant scene. Again, the seating issue comes up. Sit in a corner or against a wall and look into the face of someone you know. In this story, things get so heated in the restaurant that Jack ends up under the table and his step dad tries to pull him out by the ankle. NO, NO, NO! I am pulling my feet under me as I read this. You don’t ever grab anybody by the ankle or the wrist. I don’t know what it is about it but its like having someone’s hands round your neck – it is terrifying! I would have stabbed him with my fork!
On a more positive note scoping the restaurant when its quiet is a good idea, previewing the menu – we do that! It sounds silly to some people but a new menu is not a pleasant surprise it is the suspense of the unknown – check it out first. Even seeing what the food looks like is a good idea. I mean I love gravy, but there’s all different kinds of gravy and I don’t want it poured all over my food. Restaurants can be intimidating, its not like being at home where your mum can scrape off the weird bits or pick out the green things, which can be a bit embarrassing, especially when you’re 22, LOL.  It made a big difference to Jack that the adults tried to understand what was difficult for him and helped him out. It is always calming driving around in the car and remember people need time to feel comfortable in a new place. If you are rushed into settling, you never settle.

Scary Saturday. I don’t have a lot to say about this book except I identify with the clothes thing. Also, don’t force a child to join in at parties, let him do his own thing until he finds his way. Any big exciting events can make you feel a bit wobbly so prepare children for change and excitement and the sensory environment of a birthday party. The scene where Nathan stuffs his hands into Danny’s birthday cake could easily be read as jealousy but I think its more about Nathan thinking if all the attention is on Danny, they’ll forget about me. It really helps to include Nathan in the preparation as the excitement can be overwhelming.
When me and my sister had birthdays my grandma always used to give the other one an “unbirthday” card and an “unbirthday” present. Blowing up the balloons is also a good idea.
  
Stressful Sunday. Sunday’s are always stressful because it’s the day before going back to school. Homework doesn’t help. But here’s the thing parents, don’t point out the obvious – we know we should tell you sooner that we have homework but we don’t want to do it so if we don’t write it down or talk about it then we can pretend it isn’t real until of course we are forced to do it. But going on about it will make us want to tell you less.
I completely identify with Ryan. I don’t think anybody gets how hard homework is – it’s not laziness, it’s mental exhaustion. I felt bad about not doing homework but I just couldn’t. However hard work is in school it is 100 times harder at homework time – even when it’s things you can do reasonably well at school – it’s like doing all your schoolwork in a different language. Ryan’s parents doing his homework for him reminds me of my mum. The colour coding and strategies from the senco also help, but more in school than at home.

I like these books. They highlight how difficult everyday things are for children with sensory challenges through simple stories and clear examples. They flag up the problem, why it might have occurred and offer easy solutions. Children with sensory difficulties are not bad kids, we do our best – we want to go shopping, do PE and join in but it’s not that simple. It’s pointless saying, “calm down”. Believe me, if we could we would! Adults need to recognise that when children have ‘meltdowns’ there’s nothing wrong with the child, there is something wrong with the situation so just take a step back, breathe and reflect. I also like that the adults in the books ask for help. I think it’s easy for parents and teachers to feel overwhelmed when they don’t understand the situation. It’s not the parents’ fault, it’s not the child’s fault, it just is what it is. We all need to help each other out.

Lucky Lucy
A sensory challenged 22 1/2  year old

“A Therapeutic Treasure Deck of Sentence Completion and Feelings Cards" 
(Therapeutic Treasures Collection) 
by Dr Karen Treisman
 
When I first received the Therapeutic Treasure Deck and had a quick flick through the cards, I have to confess I felt a wee bit cautious. 
​On reflection,  I think perhaps this was because I was busy with other stuff at work and that I have seen many different versions of “feelings cards” over the 23 years I’ve been a Social Worker.  So decided I would proceed with my cautious part! 

I would also just say that I haven’t (so far) read Dr Treisman’s “Therapeutic Treasure Box” book.  However, I was reassured that it wasn’t necessary to do so in order to use the Deck.

So actually, all it took was to read through the instruction booklet accompanying the Deck.  I began to feel rather curious about the possibilities of the cards, replacing my previous caution.

I like the cards themselves – the feel of them and the illustrations - I found myself wondering about children who would experience the Deck as a means of helping them connect with and communicate their feelings and story.  I quickly found myself connecting the application of the cards to DDP/PACE and Theraplay.

As a Social Worker in a small Family Placement Team, my role involves supporting families to build connections and attachment relationships with the children they care for and parent.  And it is important we acknowledge that parenting and caring for children with developmental trauma and attachment difficulties is not easy, particularly when children are resistant to our attempts. 

I chose to use the Deck with a 10 year old child to see how I could use them to connect.  I was curious - would they like them?   What sense would they make of them?  Would using the cards help them feel safe enough to communicate their feelings, hopes, wishes and fears?  Would it help me as a worker understand what they were communicating?  Lots of questions.

This child was immediately curious about the cards.   She was able to engage with them and recognise many of the feelings images. The cards provided opportunities for conversations about the less usual ones.  Exploring the cards, the child was able to verbalise what was going on in the image eg how is the swan keeping the cygnets safe?  Why do they need to be safe?   What might make them “not safe”?  She was able to reflect using her own words about when she feels safe and not safe, and what makes her feel safe when she is frightened.

She appeared relaxed about being able to choose and talk about what was on the cards.  This then lead us into talking about eg what the animal was feeling which flowed into how and when the child might experience this emotion.  It was helpful to use the sentence completion cards alongside the feelings cards which helped to fill in gaps in the stories.  Whilst using the cards I was mindful of the PACE attitude – using Acceptance, Curiosity, Empathy and, where appropriate, playfulness.

One of my colleagues used the cards with a 14yr old who finds it difficult to explore and talk about her feelings.  The worker found the cards helpful both for the young person, who was able to choose the cards she connected best with, and also for the worker in helping to notice also which cards the young person was avoiding.  The young person was able to check out with the worker what they (the worker) would feel/think/do or say.  The young person was also able to reflect on what her parent might feel.   There was exploration with the young person as to what they were experiencing/feeling eg a year ago, and what is different now – opening up further conversations and about what might happen in the future.   This young person finds it difficult to sustain conversations, so, with the cards, she felt she had some control over how long to spend on each and how much reflection was manageable for her.

The worker in this case felt that using the cards took the pressure off the young person in having to sustain an intense, one-to-one, conversation with another.   This particular young person asked if the worker could bring the cards back again.  The worker’s experience was that the cards opened the possibility of further explorations next time they meet.

The Therapeutic Treasure Deck lends itself to working with individuals, groups and families and it connects well with other approaches.  As I experienced, they can be used effectively alongside the attitude of PACE (Playfulness; Acceptance; Curiosity; Empathy).

The child or young person can have some control over which cards they wish to look at and talk about, without the pressure of having to answer direct questions.  They can control the pace, the choice of card, how much they wish to talk about, and how to connect with their own experiences, which is especially helpful for children with a limited emotional vocabulary.  I like the idea also of encouraging the child or young person to expand on what appears on the cards by drawing, painting, colouring and using other media like playdoh. 

Using the cards opens up all sorts of creative possibilities of how to use them to connect and communicate effectively with the child.  They can be tailored to the individual child or young person’s needs.  They help us to go at the child’s pace. 
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Using the cards keeps conversations open and engaged, letting the child or young person know you are interested in them.  You are noticing what they find tricky and you are alongside them, acknowledging with them that some of this stuff is hard.  Using the cards provides the worker with a raft of information about the child without using checklists or questions – including why they might be avoiding particular cards.  It helps us as workers notice what might be under the surface - what’s behind a child’s fears and anxieties and presenting behaviours, and what might help the child to manage the things they find hard to manage. 

The Therapeutic Treasure Deck creates opportunities to help children connect and make sense of their own story and to begin be open to the possibility that the adults who care for them can help them and accept and love them.   I will be sharing the Deck with my colleagues in the Family Placement Team here as well as generally within Children’s Services.

In conclusion - I have moved from having a rather large cautious part to having developed a rather inspired part!   I am in fact a total convert!  I really like the Therapeutic Treasure Deck and will most definitely be using it with the children and families I support.  So my advice would be – pick them up and give it a go!

Shona Thain
Social Worker (Family Placement Team)
and Adoptive Parent

Parenting Strategies to Help Adopted and Fostered Children with Their Behaviour by Christine Gordon

​The wonderful wisdom in this book is a most welcome addition for any parent, professional or educator supporting children with difficult to understand behaviour. Although the focus of the book is on children affected by early trauma, (especially children who are fostered or adopted) the strategies and
underpinning knowledge is universally valuable. I found the book to be full of insights which have deepened my understanding of parenting and working with children who have had a difficult start in life.

The book offers a unique contribution to the literature on parenting children with early life trauma due to the inclusion of the invaluable behaviour charts which make up the second half of the book. The charts explain the underlying causes of many common behaviours children affected by trauma display, with useful insights and strategies for interpreting and supporting behaviour when it arises.

It is very understanding of the struggles many adults have in caring for traumatised children and helps you feel understood and validated.
It is not easy caring for children with trauma histories and when a book like this come along it provides light at the end of an often very long tunnel. 

This book helps carers make the shift from seeing behaviour as:
Challenging to distressed
What is wrong with you? to What has happened to you?
What are you doing? to What is your behaviour trying to tell me?
and from focusing only on behaviour to wondering about the meaning and the deeper communication.

The uniqueness and value in this book lies not only in the author's obvious knowledge and expertise, but the clear and applicable charts which really do help decipher and translate behaviour into communication. I have my copy beside my bed and refer to it often. This not only helps me, but ensures my adopted children get a more understanding and supportive parent.

 Kevin Denvir
​(Adoptive parent, foster carer and ASN teacher)

Building the Bonds of Attachment: Awakening Love in Deeply Traumatised Children
(3rd Edition), Daniel A. Hughes PhD

This highly engaging and insightful book uses the story of Katie, a child at risk and then in foster care to explore the theory and application of Developmental Dyadic Psychotherapy (DDP), both in therapy in in therapeutic care.  Although the characters Hughes introduces us to (especially Katie) are an amalgam of real carers, children and Social Worker that Hughes and other practitioners have known over the years, they are believable.  The Inner World of “Katie” is well described, as is the seemingly endless patience of Jackie, Katie’s fourth foster mum.
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Through the narrative (novelistic) style, Hughes adopts, we get a revealing outline of blocked trust, blocked care, PACE in action and the process of PACEFUL parenting & therapeutic intervention.  Use of the Social Worker’s own developing relationship & parenting of his first child provides an opportunity for the reader to compare normal developmental pathways of relational styles, with the disordered reactions and thinking of Katie.

Each chapter is full of detailed descriptions of significant incidents followed by a reflective “commentary” section.  This allows the reader to refresh and summarise what has occurred, whilst checking their understanding of the trickier concepts and reviewing their own learning and development of ideas.

The introduction can be read alone as a helpful outline of attachment, why it is important and the role of therapy.  It also provides a helpful overview of the main aspects of attachment, and the important concepts that develop through early care, especially the role of attachment, empathy and intersubjectivity.  It provides a useful definition of trauma and the distinction between PTSD and developmental trauma.

At times the reader feels exhausted alongside the foster carers, especially Jackie, who are struggling to get it right for Katie and this is one of the books strengths – the ability to illustrate how difficult it can be to care for, and keep caring for highly traumatised children.  Although the outcome for Katie might be seen, by some, as too easy, for others it will be seen as an inevitable outcome of the hard work of therapeutic parenting where the aim is to build the bonds of attachment.  The reader never loses sight of wanting things to be better for Katie no matter how challenging she seems, because Hughes has drawn her character and the motivations for her behaviours so well.

Hughes skilfully outlines, through the examples he describes, the need for constant self-reflection on the part of therapeutic carers, including support to explore their own attachment history and the necessity of having access to the support of a therapist who is focused on the development of the relationship between carer and child.  By accompanying Jackie and Katie through their therapy sessions, the focus of the problem is shifted from a “within child” model (and the reader is given an example of this type of therapy in Katie’s first therapist) to a “within relationship” model.  By making the mind shift to seeing the problem located within relationship and knowing how they work, the message of this insightful, highly readable book is one of hope.  Things can change.  Children can be helped and healed.

Lesley Craig
Educational Psychologist
Clackmannanshire Educational Psychology Service.

Parenting with Theraplay®
- Understanding Attachment and How to Nurture a Closer Relationship with Your Child by Vivien Norris and Helen Rodwell.

Forewords by Phyllis Booth and Dafna Lender, illustrated by Miranda Smith

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I love this book for so many different reasons!  It unpicks Theraplay - a complex, but really useful tool that has been tried and tested in the professional arena.  We see Theraplay introduced for all families wanting to better their relationships, whatever their challenges. It makes it accessible to the key people in children’s lives – their parents, carers, grandparents etc.  It speaks directly to these adults that children need as the “bigger, stronger, wiser and kind” people they can feel safe and connected with.  The book provides just the right amounts of the Theraplay principles of structure, engagement, nurture and challenge in the text and illustrations. This makes the model something we can make our own in our families. 

The first part of the book explains the history, theoretical development and research that underpin Theraplay. It explains why it is needed in some families and how it works. It begins to show why “returning to early and simple ways of playing together is like building up the foundations of your relationship.” Key concepts such as attachment, safe base and emotional regulation are explained, if you want this level of knowledge; likewise, the importance of touch and creating “moments of meeting”. Theraplay is based on what happens in healthy interaction between carers and their infants/babies and the elements that make up these interactions - Structure, Engagement, Nurture and Challenge - are fully explored. Helpfully, each section and each chapter has the same format and is introduced, chunked into bite sized bits and then summarised, so that you can pick out what is useful to you right now. Every section is full of suggestions of what you can do to shift the way you interact with your children. There are scenarios and check lists to help you think about your internal life and that of your children and many ideas about what to do to support your relationships. There are loads of examples of things you can do in daily living situations and well as games for more specific play time. What I found particularly helpful is that while illustrating each relational element and aspect that makes up Theraplay there is as much support for parents – possible ways to practice, to find the way forward, to have their own needs met etc – as advice on how they can support their children.

The second part of the book looks at the stressors of daily living that our children often need help with, whatever their age. It also looks at some of the behaviours that are the outwards signs of our children’s response to these and more complex causes of overwhelming stress. Just how the principles and practice of Theraplay can help address these difficulties are discussed in a warm, empathetic conversational tone. You feel as though the authors are really alongside you and your children.

I think that this book successfully conveys the “being” and the “doing” nature of Theraplay. It gives so many ideas to work on, practice and adapt so that we can get to know so much more about ourselves and our children. It empowers us to find our way to safer, repairable , fun and joyful relationships.

Roberta Manners 
Mother, Adoptive Mother, Grandparent, Certified Theraplay Practioner and Trainer.
 
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FOR THOSE ATTENDING THE THERAPLAY TRAINING IN EDINBURGH AND THE THERAPLAY CONFERENCE IN LEICESTER IN SEPTEMBER 2017 - THIS BOOK WILL BE AVAILABLE AT A DISCOUNTED PRICE!!!

DON'T MISS 'MEET THE AUTHORS' BOOK SIGNING AT THE THERAPLAY CONFERENCE

The Boy Who Built a Wall around Himself
by Ali Redford, illustrated by Kara Simpson.
 
This little book is intended for 4-9 year olds but carries a message for people of all ages.

Written by adoptive mother, Ali Redford, it tells the story of “Boy” who, finding “everything  scarily wrong”, builds a protective wall around himself because no one seems to  care.

Fortunately for Boy, there is help at hand in the form of “Someone Kind “who persists in engaging with him and helps to break the wall down.

The text of the book is perfectly complemented with illustrations by Kara Simpson who captures, in comic book format drawings, the isolation felt by Boy and the playful and imaginative attempts by Someone Kind to help him. The use of “Boy” and “Someone Kind”, instead of names, allows any child listening to the story to relate to it at their own level.

There are messages in this book for all those involved in the care of traumatised children.  Firstly, that helping children to heal from past experiences takes persistence and time, that for a child to give up their “wall” can be very scary for them and that the way forward is through a positive and consistent relationship with a secure adult.  Dan Hughes would approve of the way “Someone Kind engages with the child in a playful way!  Most importantly the book gives a message of hope that, in time, children can heal from past experiences.
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Talking about “walls”, both physical and metaphorical, seems topical these days! There are lessons that can be drawn from this useful little book - that talking is better than silence and building bridges more helpful than building walls.  This book would offer encouragement to any child hearing Boy’s story and to parents / carers as well.  Although small in size it gives a big message!

Star rating ****
Heather Drysdale
(Systemic Psychotherapist/Adoption and Fostering Consultant)

The Body keeps the Score –
Brain, Mind and Body in the Healing of Trauma 
by Bessel van der Kolk, M.D  

NOW UNABRIDGED ON AUDIO CD
​read by Sean Pratt.
Duration: 16 hours 20 minutes
£35
 
What a wonderful book – authoritative, erudite, compassionate and beautifully written.

Dr Bessel van der Kolk combines the curiosity and analytical mind of the scientist with what Judith Herman calls, “the passion of the truth teller”, and the refreshingly humble outlook of a man in awe of his patients.

But a word of caution, this book is a challenge. Think twice if you are easily shocked, offended, or likely to wallow in guilt for doing what you believed to be best practice at the time. All we can ever do is our best and our best changes all the time, as van der Kolk himself has also had to acknowledge in his 30-year career.
 
To summarise the content I’m going to start in the middle of the book because it is here that van der Kolk makes the bold statement that developmental trauma is “the hidden epidemic” in society. As a trainer I talk to parents and teachers about attachment and trauma, many of whom think trauma is a fringe topic affecting a minority of children.  Van der Kolk would argue otherwise. He compares the (US) public health budget devoted to both heart health education and smoking cessation with the barely mentioned topic of childhood abuse, the cost of which exceeds cancer and heart disease in the USA.  To halve the rate of depression, drastically reduce alcoholism, IV drug use, domestic violence, suicide, prison admissions and improve workplace performance he believes we need to eradicate child abuse.
 
Even obesity comes in for a radical rethink. Diets, bariatric surgery even a sugar tax may look like a solution to a major health crisis, but for the trauma survivor society’s problem may actually be their solution, eg, being big may be a health risk in the long term, but for now being the biggest boy in class may be a way to feel safe from bullies, or being an overweight girl may stop unwanted sexual attention. Brace yourself for the research from one chief of medicine that most of his morbidly obese patients were survivors of child sexual abuse. Van der Kolk wants to get this “hidden epidemic” out in the open. When he asks, “how do you turn a newborn baby with all its promise and infinite capacities into a thirty-year-old homeless drunk?  He gets us to acknowledge how much relationship rather than genetics shapes development. So, while there may be a gene for alcoholism, for example, stressful experiences impact on genetic expression both in the womb and after birth.
 
Throughout the text van der Kolk gives us a glimpse of his own childhood and family traumas. He also tours the many dubious practices of the psychiatry profession over the course of his career, from the brutal to the inspired, focusing frequently on the profession’s more recent obsession with pharmaceuticals. Drugs such as Prozac transformed the lives of many depressed patients from the late 1980s onward, but in van der Kolk’s experience they did not work for war veterans with PTSD. The difficulty arose when medication was seen as the go to “fix it” for mental health problems rather than being part of a holistic treatment package. Drug benefits lay in their ability to dampen reactions not heal the illness. In the case of the half a million US children on antipsychotic drugs, medication has improved things for adults by making the children easier to control! Van der Kolk reports huge over prescribing in the children of low-income families and children in foster care. Shockingly, even thousands of under fives have been prescribed antipsychotics, reducing their aggression but also their motivation, playfulness, curiosity, general functioning and socialization.
 
Thankfully, amid the horror stories are accounts of the author’s inspirational teachers, such as the psychiatrist Elvin Semrad who discouraged him from relying too heavily on psychiatry text books and diagnostic labels which obscured his perceptions of real patients. Instead, he urged getting to know and respect the person while acknowledging that, “most human suffering is related to love and loss”. Teachers have also appeared in the form of patients such as Marilyn who told him his reassuring platitudes only made her more lonely and isolated because, “it confirms that nobody in the whole world will ever understand what it feels like to be me.”
 
Through his experience of working with patients Van der Kolk has  concluded that “all trauma is preverbal” whether it happens in infancy or adulthood. This doesn’t mean that it can’t be talked about but that talking rarely gets to the truth because it reactivates the experience of trauma in the body. Experiments with fMRI scans show that trauma activation stops the brain’s speech centre (Broca’s area in the cortex) from functioning. Consequently, the traumatised continue to live in isolated “speechless horror”. He questions accepted therapeutic practices in the light of what we now know from brain scans, research and experience and advocates alternatives such as yoga, EMDR, mindfulness and others that put trauma survivors back in touch with themselves.
  
There is so much in this book that cannot be summarised. I have only selected morsels to tempt and tantalise. In doing so, I feel that I have done it an injustice by missing out so much of the content on attachment, traumatic memory, the anatomy of survival, neuroscience and the numerous and varied paths to recovery. There is a huge focus on relationship and connectedness and our innate drive to be part of a tribe, which goes against the cultural norm of being an individual, competitive and self made. You have to read it to begin to grasp the breadth and depth of its reach but I’ll leave you with this summary by the author himself, “Trauma results in a fundamental reorganisation of the way the mind and brain manage perceptions… For real change to take place, the body needs to learn that the danger has passed and to live in the reality of the present. [We need] to think differently not only about the structure of the mind but also the processes by which it heals.”
 
Happy listening!
 
Reviewed by Sheila Lavery

The Simple Guide to Child Trauma by Betsy de Thierry


‘The Simple Guide to Child Trauma’ by Betsy Thierry is exactly as the title suggests - straightforward,  informative  and easy to read.  

I highly recommend this little book – it is so accessible and  so kindly written. A book as the author says ‘designed to bring hope.’ 

In reviewing this book I cannot do better than David Shemmings who has written the foreword.

‘What the guide does is elegantly and quickly is bring a large amount of research – from psychology, social work, neuroscience, biochemistry and genetics – directly to the busy but interested parent and carers and professionals working in this field.  It translates complex ideas into practice-rich language for adults who need to understand the inner worlds of children, rather than simply explore their wishes and feelings.

I particularly like the way the author ‘speaks’ to birth parents as well as adoptive parents and foster carers,  and this compact book could also be read by young adults who have experienced relational trauma.

This is a book to regularly return to when we are struggling to make sense of behaviour and looking for workable and practical ideas for ourselves and for the children we are loving and teaching.

Edwina Grant 
January 2017

The Neurobiology of Attachment-Focused Therapy - Enhancing connection & trust in the treatment of children and adolescent by Jonathan Baylin and Daniel A Hughes 

The focus of this book is set with a quote from Colwyn Trevarthan Emeritus Professor of Child Psychology and Psychobiology, University of Edinburgh.
“If we are to protect young children from harm …we will have to value more and give response to what children bring to human life-the eager spirit of their joyful projects beyond their seeking to survive.” 

How can therapists and caregivers help maltreated children recover what they were born with: the potential to experience the safety, comfort, and joy of having trustworthy, loving adults in their lives? 

In order to address this question this book shares the work of Dan Hughes and Jon Baylin in their development of a science based model of attachment focused therapy that links clinical interventions that are informed by an understanding of brain functioning on attachment and relationships. Thus Dyadic Developmental Psychotherapy (DDP) is linked to neurobiological processes.

Neuroscience shows that negative experiences lead to the development of a neural “alarm system” called the mid brain defence system linked to chronic defensiveness- the core of blocked trust.

The treatment is to target the mid brain alarm system – the part of the brain sensitised by pain suppression and chronic defensiveness evident in children who have developed blocked trust –the suppression of inherent relational needs due to poor care. 

The prefrontal cortex is activated in order to support new learning and move from mistrust to trust. This is done through techniques of reversal learning, fear extinction, memory reconsolidation, reflection, and reappraisal. The therapy ensure adults send messages of approachability and trustworthiness into child’s brain. i.e. not being defensive adults in order to ensure provision of comforting enjoyable experiences with adults. Safety is key in developing this trustworthy environment. 

Underpinning this approach are the key DDP elements of PACE – playfulness, acceptance, curiosity, empathy which are utilised by the therapist in work with children, parents and families. 

The content of the book is laid out in such a way that the reader is informed by the new science of attachment and the bio behavioural processes of trust, mistrust and trust building. This is rich and informative. The focus then leads on to the means of change in the brain functioning in order to bring about therapeutic intervention. There are summaries for some chapters (those providing theoretical background) which are an excellent learning aid. The chapters on intervention are very well illustrated with clinical examples which bring alive the approach as well as reminding the reader of the pain for the children and families involved. 

In drawing the book to a close the focus is directed to the future and the possible expansion of the DDP model looking at more processes to decrease chronic stress and defensiveness. 

The linking of the constantly developing information on brain functioning with attachment focused therapy is very successfully achieved in this book which will provide those working with children and families with potentially both an increased body of knowledge and an improved skill base.

​Ann Rooney
Consultant / Trainer

There is no better guide to how children develop their rich emotional, relational, and creative lives than is the wisdom of Colwyn Trevarthen, Jaak Panksepp and Phyllis Booth.  In this book, all three make it clear that reciprocal play--play that involves joy and delight, magic and music, often rough and tumble, always engaging in the back and forth of spontaneous encounters and movements--is a central component in the full development of children.  
            
In the first chapter Trevarthen and Panksepp summarize clearly their view of human development:  “We are born with a moving body, ready to share its rhythms and melodies of joy or anguish.  Our vitality is by nature that of a dancer or musician, and this intelligence in movement gives us signals to be shared. (p. 39).”   In the Forward, Booth gives us a brief glimpse of how Winnicott saw play between the child and psychotherapist as being at the heart of the creative changes that such meetings attempted to foster.   Play too, is the central core of Theraplay, a treatment modality developed by Booth that moves play from the focus on the symbolic play of traditional therapies to the reciprocal, expressive, movements of delight and engagement that occurs within Theraplay between the child and therapist and the child and parent. 
            
Attachment theory and research stresses the importance of safety that is established in the infant-parent relationship within which the young child learns within joint activities with the parent to regulate their affective states and begin to make sense of the world.  The reciprocal, moment-to-moment engagement--often characterized by music and  rhythms that have been called “the dance of attunement”-- between infant and parent is the foundation for the child becoming safe to explore the larger world of relationships with peers and developing interests.  Through reciprocal play, the rich inner world into the minds and hearts of others--family and friends--becomes open to the child.
            
When children have had the misfortune of developing a troubled or disorganized attachment with their original caregivers, these children need to develop relationships with their new caregivers that feature the presence of comfort (for attachment) and joy (for companionship).  Repetitive nonverbal communications that express empathy, delight, interest, and wonder are central in these children learning that they are able to trust these caregivers.  Joint activities that involve music and dance, spontaneous intentional movements requiring a shared focus and cooperation are important ways to engage these children to develop their trust.  Similar activities with their peers are often crucial both in helping the child to both return to the past with joint activities that they had needed but did not receive, as well as moving into the future into groups of friends. 
            
Inclusion, Play, and Empathy offers a great variety of ways to become engaged with children who have had difficult beginnings while guiding them to participate in those spontaneous, joint activities of creative play that they desperately need.  Music and dance, but also all sorts of shared intentions and activities, are presented in this book as ways that will facilitate children’s neuroaffective development in group settings.  Therapists from many countries and all persuasions share their insights attained through their creative therapies that are likely to offer ideas for engaging children to both parents and professionals alike.
 
These programs cannot replace the child’s need to develop safe relationships with their primary caregivers characterized by comfort and joy.  However they may well complement such relationships and, in fact, the child’s participation in these crucial experiences of play with peers, maybe actually help them to become more open to exploring a closer relationship with their caregivers.  The therapies presented in this well-edited book are excellent examples of “therapies that enhance the deep creative and restorative powers of human nature (p.49).”

Dan Hughes PhD
​Founder of DDP

Parenting a child who has Experienced Trauma.
​By Dan Hughes with Matthew Blythe
Published by CoramBAAF
​
Dan Hughes defines simple and complex trauma; explains the effects of both and the aims of supportive treatment programmes. This part of the book is tightly packed with vital information to educate parents and advice on how to begin to understand and support their children; particularly those who have experienced complex trauma. Hughes suggests that parents and therapists need to “mentally search for the child under the problems and help that child emerge”. 

By being Playful, Accepting, Curious and Empathetic (PACE) parents can communicate that they love their children “for better or for worse”.  Being and relating in this way helps parents give their children the experience of greater safety, even though their children are wired to distrust them. PACE also enables parents to be “emotionally strong, present, confident and comforting” and able to protect their ability to care. Hughes deals with the differing relational needs that traumatised children are likely to have at different developmental stages of their lives. He also provides a very useful introduction to the educational and social issues traumatised children contend with. Hughes theoretical introduction is complimented by the final section of the book in which Matthew Blythe describes his life as the father of his adopted twin boys. Here we hear how early trauma impacts on the development of each of the boys and how Matthew struggles to understand and support them. Their roller coaster journey together will be familiar to adopters and adoptees as well as full of insight.      

My 21 year old son has also reviewed the book. He says: “As a young adult who has experienced complex trauma, I found the section about the effects of childhood trauma very useful.  It helps explain why I feel the way I do sometimes and why I behave in the way I do sometimes. This information has given me ideas about how to help myself”.

“The chapter on symptoms, prognosis and treatment describes how my early life felt to a point of scary accuracy! The treatment suggestions, based on Playfulness, Acceptance, Curiosity and Empathy (PACE) make sense and, if put into practice consistently, work well. However I would say I struggle with the empathetic response that Hughes suggests. I don’t want somebody walking in my shoes with me. I want them beside me, but pushing me on with reassurance. Some people may gain a sense of greater safety from empathy but I do not. That said, the section on helping your child develop internal safety is helpful. It explains that telling someone to ‘forget about it’ or ‘get over it’, is very likely to fail. This is because even as little as a smell or sound can make you feel unsafe/angry/irritated.”

“Some parts of the book seemed obvious to me, however not many people have been through interpersonal trauma. I think the people who will benefit most from this book are teachers, mental health professionals, the police and anyone else working with young people. They all need this knowledge and understanding to get beyond reacting to how young people behave.”

Roberta Manners and HH

​Improving Sensory Processing in Traumatized Children 
By Sarah Lloyd 
​
This excellent little book provides a timely reminder of the significance for fostered or adopted children of the sensory and movement experiences to which they have been exposed in early life.  


The author, Sarah Lloyd, suggests that when we think of trauma and neglect we usually draw on theories around Attachment and Trauma.  Bringing theories around Sensory Integration into the picture can add helpful insight and by helping babies and children to “go back” and become more in touch with themselves at a bodily level, they become more able to deal with their emotions.

Sarah Lloyd draws on her experience of working in Fife as part of the Springfield Project to write the book. Based on her considerable experience as a Specialist Occupational Therapist and Play Therapist, she reminds us that secure children have lots of movement and emotional experiences that allow the brain and central nervous system to develop good, strong pathways.  The things we take for granted such as rough and tumble play, carrying a baby on a hip, the “jiggling” interaction that we have with babies, are all helpful in developing their vestibular system.  By contrast, children affected by trauma and neglect lack not only the warm interaction from caring adults but also the movement experiences, beginning in-utero, that go alongside this. They often have poor muscle tone, poor posture and poor balance.  Sensory Integration Theory is thus very useful if used alongside Attachment Theory.

The third section of the book provides some helpful exercises which can be used to  increase sensory awareness in children. The author gives really good examples of how, starting with the tactile system, games such as taste tests, blow football, food that gives sensory stimulation, “feely” bags, “Simon says”, doing “wheelbarrows” and using a yoga ball can all be helpful. Many of these exercises and games fit well with what we know from PACE (Dan Hughes), from Theraplay, from the “Brainchild” work of Viv Hailwood or the interventions on perception and the senses offered by “Motorvate”. 

In this helpful little book Sarah Lloyd reminds us that, “relationship experiences combined with bodily and movement experiences form the development of social and emotional skills and learning”.  She offers us ways of identifying the gaps in the development of children who are affected by trauma and neglect.  Her generous sharing of exercises provide a valuable tool for parents and for professionals too. I feel sure that there’s another book to be written by this experienced practitioner and hope that she will write further.

**** star rating   
Heather M Drysdale 
Systemic Psychotherapist/Adoption and Fostering Consultant

The Little Book of Messy Play by Sarah Featherstone

The Little Book of Messy Play has long been a favourite publication for all practitioners involved in the area of early years education.

The book provides a range of suggestions for play using a number of creative methods to engage all the senses. Many of the activities described are useful not only for professionals involved with children but also for parents and carers who are needing inspiration to provide play which entertains and stimulates a range of age groups and abilities. 

The activities included not only promote communication and language skills but also promote gross and fine motor skills and the development of social and emotional skills. Although primarily aimed at 0-5 year olds, I believe the projects are easily adapted and transferable for older children; particularly those who have missed out on key developmental stages and would benefit from the opportunity to ‘catch up’ on early life experiences. The chance to regress and get messy, mucky and dirty can be irresistible and can reignite the inner child in us all.

Our own personal family favourite, which captivated two 2 year old girls, was “Catch a Creature”. We have already discussed our plans to recreate this at the beach and have talked about how we might adapt the concept (my word, not theirs) for Halloween by making scary green and orange jelly complete with edible worms!

My only minor criticism would be the use of a safe outside space is desirable. However, that aside, many of the activities suggested could provide the inspiration for a range of summer projects and could be put to good use at a Family Fun day or organised Summer event. Enjoy!

​Catriona Walker

‘A Guide to Therapeutic Child Care -What You Need to Know to Create a Healing Home’ by Ruth Emond, Laura Steckley & Autumn Roesch-Marsh

REVIEW
I am so envious of the authors of this book -they have written the book I really wish I could have written myself! This is not another outcome driven piece of research that leaves carers and practitioners feeling hopeless or undermined, nor is it a simplistic set of tips or techniques, instead it goes to the heart of what therapeutic care is all about. It recognises the passion and loving commitment that characterises the best intuitive practitioners but also encourages a reflective and thoughtful approach drawing on research and theory.  

The authors’ style is beautifully lucid and clear but this simplicity is deceptive, as throughout this work they have embraced the complexity and messiness involved in providing therapeutic care for desperately hurt and distressed 
children. All the authors currently hold academic posts and this book is embedded in theory but this is communicated in a totally non-intrusive way.
Concepts from psychodynamic theory are effortlessly interwoven with neuroscience, while an attachment based developmental approach underpins the whole work. Ideas from trauma and resilience theories help to make sense of the impact of adversities and children’s different developmental trajectories. 
Although theory never overwhelms the reader, the authors have ensured that references are available for those who want to explore particular topics at greater depth. 

The core of this book is deeply relational. Every chapter highlights the importance of connections between people as the essential route to healing and recovery. The pain underlying the perplexing behaviour of children is ever present but the authors also recognise the emotional cost to adults of staying in touch with this distress. Throughout the book there is an emphasis on the importance of formal and informal organisational support mechanisms as well as adults finding their own effective individualised self-care strategies. The authors model a relational approach in the way the book is constructed and also through their courageous and reflective sharing of their own practice. The authors address their readers directly as other human beings, posing questions, sharing practice and suggesting useful everyday approaches that might help their readers to connect in a deep and healing way with children.  

The content of the book addresses the opportunities and challenges that are central to the daily shared experience of adults and children in therapeutic care settings. Alongside an introductory chapter on child development the authors explore how to attune to children who may have experienced only hostility and danger from adults in previous relationships, explain the importance of providing containment to children who have never been helped to process their 
overwhelming emotional experiences and consider how to be alert to the different forms of communication, conscious and unconscious, that can happen between people. They examine the symbolic, social and psychological meaning of the everyday rhythms and rituals of life with a special emphasis on the importance of food. They also discuss some of the difficult or complicated areas of being alongside hurt children such as the importance and complexity of touch between adults and children and also the challenge of responding firmly but lovingly to ‘pain-based behaviour’.  

Finally they locate the therapeutic work firmly in the context of the child’s chronological journey by explaining the critical role of ‘memory keeper’ that those caring for children should take on. In addition to this developmental 
perspective they highlight the need that all children have for connections to the wider world through their relationships with other important adults, their friends and the communities in which they live.
 
The particular needs of children with disabilities are recognised throughout the book in an inclusive and helpful way. The authors have successfully achieved their self-imposed task of ‘acknowledging the difficulties and celebrating the magic of healing care’. Residential child care workers and foster carers, interested in providing therapeutic care, have waited far too long for this book! In my opinion all new carers and residential workers should be given a copy before they even meet their first child! I have already begun the distribution process!!
Judy Furnivall  
Lecturer/Consultancy Lead CELCIS
Trustee SAIA

​Review of  “The Great Big Book of Feelings” by Mary Hoffman and Ros Asquith
 
At first glance, this book is jam packed with child-like illustrations that are colourful and exciting to look at.  These show mixed emotions in picture form which I feel a young child would find easier to relate to than a sentence exploring a feeling.
​
Excitement, happiness, fear, boredom and cheekiness are some of the emotions explored in this book.  It moves through the different feeling visually with illustrations and minimalistic narrative.  However it provides ways to deal with feelings we don’t enjoy such as boredom or sadness, which is such a positive way a child could look at these feelings. 

​The use of questions throughout means a child could interact with you when reading, thus opening up to you; something that may be difficult for them, in a casual and less pressurising way.  Mary and Ros look at feelings in the family, school and out in the big bad world.

This book is full of wit and charm as well as sensitivity and I would encourage you to read this to young children to allow them to open up or to provide answers on how to cope with strong emotions and feelings in a calm way, with the book even containing a hide-and-seek game with a cat that will keep you and the child on your toes!
 
Reviewed by Anna Laidlaw

Review of My Big Shouting Day
Author-illustrator Rebecca Patterson.

I love this book.   I am sure there are several  reasons  as to why it was awarded the Roald Dahl Funny Prize… the illustrations and narrative are just two.  Anyone who has had the care of a child will identify with what looks like a rough day from beginning to end.  

Bella, the child in question (and star of the book, though the mother  is the real heroine  for her patience) starts her day off with finding her baby brother in her room, crawling on the floor licking her jewellery and that is the start of the shouting. Nothing…..absolutely nothing in her day goes well from here on in…..her egg, her shoes, the broken biscuit, not letting her friend be a princess, the itchy ballet outfit, lying on the pavement with her leg stuck up in the air are just some of the problems Bella, her mother and brother suffer throughout the day.  

It is a book that you can read with a child (preferably when they are not having a’ Bella Day’). The large shouty writing encourages the reader to provide the volume and tone of each thing Bella is complaining about. The wry looks of Mum and other bystanders are also noticeable. Eventually after the ‘too hot bath’ and ‘too minty toothpaste’ Bella eventually succumbs to being tired and gives in to her mum reading her favourite book to her.  Bella recognises she had had a big shouting day, and apologised to her Mummy (now, I know that may seem unbelievable  but stick with me on this!).  The heroine Mum says we all get those days and offers the hope of a better day tomorrow.  And like all good stories,  Bella has an absolutely fantastic day all day.  And they all lived happily ever after. 

Well maybe not really, but do give this book a go, I bet your little ones and big ones will enjoy it.  Reading this out loud, making funny voices and faces with story telling can be a great way of connecting and enjoying a bit of time with your child.  I think this could become a favourite for children and parents alike as it affords the opportunity for fun time together, and you can also slip in a few messages along the way.  Enjoy.

Rita Grant
Adoption Support Manager
St. Andrews Children’s Society.

​The Body keeps the Score – Brain, Mind and Body in the Healing of Trauma by Bessel van der Kolk, M.D      £21
 
What a wonderful book – authoritative, erudite, compassionate and beautifully written.

Dr Bessel van der Kolk combines the curiosity and analytical mind of the scientist with what Judith Herman calls, “the passion of the truth teller”, and the refreshingly humble outlook of a man in awe of his patients.

But a word of caution, this book is a challenge. Think twice if you are easily shocked, offended, or likely to wallow in guilt for doing what you believed to be best practice at the time. All we can ever do is our best and our best changes all the time, as van der Kolk himself has also had to acknowledge in his 30-year career.
 
To summarise the content I’m going to start in the middle of the book because it is here that van der Kolk makes the bold statement that developmental trauma is “the hidden epidemic” in society. As a trainer I talk to parents and teachers about attachment and trauma, many of whom think trauma is a fringe topic affecting a minority of children.  Van der Kolk would argue otherwise. He compares the (US) public health budget devoted to both heart health education and smoking cessation with the barely mentioned topic of childhood abuse, the cost of which exceeds cancer and heart disease in the USA.  To halve the rate of depression, drastically reduce alcoholism, IV drug use, domestic violence, suicide, prison admissions and improve workplace performance he believes we need to eradicate child abuse.
 
Even obesity comes in for a radical rethink. Diets, bariatric surgery even a sugar tax may look like a solution to a major health crisis, but for the trauma survivor society’s problem may actually be their solution, eg, being big may be a health risk in the long term, but for now being the biggest boy in class may be a way to feel safe from bullies, or being an overweight girl may stop unwanted sexual attention. Brace yourself for the research from one chief of medicine that most of his morbidly obese patients were survivors of child sexual abuse. Van der Kolk wants to get this “hidden epidemic” out in the open. When he asks, “how do you turn a newborn baby with all its promise and infinite capacities into a thirty-year-old homeless drunk?  He gets us to acknowledge how much relationship rather than genetics shapes development. So, while there may be a gene for alcoholism, for example, stressful experiences impact on genetic expression both in the womb and after birth.
 
Throughout the text van der Kolk gives us a glimpse of his own childhood and family traumas. He also tours the many dubious practices of the psychiatry profession over the course of his career, from the brutal to the inspired, focusing frequently on the profession’s more recent obsession with pharmaceuticals. Drugs such as Prozac transformed the lives of many depressed patients from the late 1980s onward, but in van der Kolk’s experience they did not work for war veterans with PTSD. The difficulty arose when medication was seen as the go to “fix it” for mental health problems rather than being part of a holistic treatment package. Drug benefits lay in their ability to dampen reactions not heal the illness. In the case of the half a million US children on antipsychotic drugs, medication has improved things for adults by making the children easier to control! Van der Kolk reports huge over prescribing in the children of low-income families and children in foster care. Shockingly, even thousands of under fives have been prescribed antipsychotics, reducing their aggression but also their motivation, playfulness, curiosity, general functioning and socialization.
 
Thankfully, amid the horror stories are accounts of the author’s inspirational teachers, such as the psychiatrist Elvin Semrad who discouraged him from relying too heavily on psychiatry text books and diagnostic labels which obscured his perceptions of real patients. Instead, he urged getting to know and respect the person while acknowledging that, “most human suffering is related to love and loss”. Teachers have also appeared in the form of patients such as Marilyn who told him his reassuring platitudes only made her more lonely and isolated because, “it confirms that nobody in the whole world will ever understand what it feels like to be me.”
 
Through his experience of working with patients Van der Kolk has  concluded that “all trauma is preverbal” whether it happens in infancy or adulthood. This doesn’t mean that it can’t be talked about but that talking rarely gets to the truth because it reactivates the experience of trauma in the body. Experiments with fMRI scans show that trauma activation stops the brain’s speech centre (Broca’s area in the cortex) from functioning. Consequently, the traumatised continue to live in isolated “speechless horror”. He questions accepted therapeutic practices in the light of what we now know from brain scans, research and experience and advocates alternatives such as yoga, EMDR, mindfulness and others that put trauma survivors back in touch with themselves.
  
There is so much in this book that cannot be summarised. I have only selected morsels to tempt and tantalise. In doing so, I feel that I have done it an injustice by missing out so much of the content on attachment, traumatic memory, the anatomy of survival, neuroscience and the numerous and varied paths to recovery. There is a huge focus on relationship and connectedness and our innate drive to be part of a tribe, which goes against the cultural norm of being an individual, competitive and self made. You have to read it to begin to grasp the breadth and depth of its reach but I’ll leave you with this summary by the author himself, “Trauma results in a fundamental reorganisation of the way the mind and brain manage perceptions… For real change to take place, the body needs to learn that the danger has passed and to live in the reality of the present. [We need] to think differently not only about the structure of the mind but also the processes by which it heals.”
 
Happy reading!
 
Reviewed by Sheila Lavery

THESE REVIEWS ORIGINALLY APPEARED ON THE SCOTTISH ADOPTION WEBSITE AND ARE REPRODUCED WITH PERMISSION

The Huge Bag of Worries tells the story of Jenny and her struggles with her increasing number of worries. Big worries, small worries, worries about all manner of things. No matter what Jenny tries to do, the worries just won’t go away and worse still, they keep growing...

Thankfully, help is at hand, in the shape of a kindly neighbour, who knows a thing or two about tackling a worry. Her words of wisdom and range of strategies soon help Jenny to lighten her load and finish up with a smile on her face!

This is a lovely children’s book, which would appeal particularly to those in the early years of primary school. It is enhanced by lively and witty illustrations, which help bring the story to life. The depiction of worries as furry creatures living in a bag also offers great creative options for working with children in a similar vein, to conceptualise and manage their own personal worries. The story has a reassuring message and the strategies offered by the neighbour are widely transferable and could be used by children again and again.

As a story, it stands alone as enjoyable read. For children struggling with worries on a range of levels, it is a terrific resource for supporting them to understand and manage these.

This months review comes from Naomi Head, a Senior Practitioner in the Placement Team.

THIS MONTH'S REVIEW IS A LITTLE DIFFERENT -
A POSTER AND PRACTICE NOTES FROM THE FAMILY PLACE
​
Using Theraplay to support transitions from fostering to adoption by Dr Vivien Norris and Sally Twigger.

Dr Norris begins the practice notes by stating “Although it is widely recognised that support over the transition from fostering to adoption is essential, many are uncertain how best to do this in practice”.

We recognise that transition is a complex process which carries with it many hopes and expectations for all involved.  It can be a tense and emotional time for the child the adopters, the foster carers and professionals.

Prospective adoptive parents will all have had their own particular journey to adoption, they will have attended preparation groups, have under taken an intensive home study , been to an approval panel and will have known the details of the child they have been matched with for a number of weeks, and will be desperate to meet and claim the child.  The adopters will want to begin to get to know the child to establish a relationship as soon as possible.  They may also feel nervous about being surrounded by other people who know the child well.  This can result in adopters feeling vulnerable and intimidated by an experienced foster carer who has effectively built up and managed a relationship with their child. 

The co-ordination process can be emotionally painful for foster carers who have cared for the child for a long time sometimes from birth.  Foster carers will have supported the child through some difficult experiences.  They will have integrated the child into their family and will have developed empathy for the child’s experience.  They will have supported the child to meet their developmental milestones and will have established rhythms’ and routines that the child will be familiar with.  Many foster carers can experience difficult feelings about the imminent separation from a child in their care.  This can be even more complicated and sensitive if the foster carers have previously expressed an interest in caring for the child on a permanent basis.

The workers have also known the child and supported the child through difficult and distressing times.  They will have contact with the birth family and will have facilitated family contact which is often fraught.  They will have been instrumental in removing birth parents parental rights and responsibilities and are invested in securing a good outcome for the child parents who will meet the child’s life long needs and offer the child an opportunity to heal, grow and develop.  In my experience everyone comes to co-ordination with hopes, dreams and high expectations, and it is possible to lose sight of the child’s needs when so many conflicting adult needs are at the forefront.

In her piece Dr Norris reminds us that children who are transitioning from one family to another, and who have a history of developmental trauma face complex difficulties.  They are likely to have a fragile sense of trust in adults and sensitivity to being triggered into a survival state, or to regress to earlier ways of relating which means they may move away from rather than towards their main attachment figure (the foster carer) at times of significant stress.  They are also likely to hide their fear and miscue; that is to give signals that they are fine and self-sufficient when they are feeling frightened.  In addition their capacity to think and make sense of what is happening to them is likely to be highly compromised and exacerbated by fear.  They may not be able to process and retain information or respond to logic and their sense of time may be distorted. Foster carers will often report that things have been explained clearly to a child but ‘they act as if they haven’t heard it’.  Alongside age related development and a child’s concept of time, children who are highly anxious may be able only to think in minutes or seconds and any discussion of the future beyond that may be meaningless.  This obviously presents challenges in terms of how to be of most help to children who are moving family.

The purpose of a transition is to move a child from their foster carers to their  adoptive parents.  This is usually achieved.  In my opinion that makes how we do the co-ordination even more important as we should be child focussed and protective of the child recognising their distress as described by Dr Norris.
The co-ordination plan focuses on practical arrangements but these arrangements should be put in place to support the child to transfer their sense of trust from his primary care giver to their adoptive parents. 
Dr Norris’s approach helps us to put the child in the centre and supports the child to make use of their main attachment figure.

With my colleagues I have put into practice Dr Norris’s approach to good effect. The use of theraplay in transition has made everyone more aware of the importance of transferring established loving ritual.  We are more conscious of need to know more about the child’s rhythms and to transfer these from the foster carer to the adopters. We are more conscious of putting in place a co-ordination plan aims minimise the trauma that the child will experience during the transition.  We want to know what soothes and what excites the child.  We pay greater attention to the continuity of the sensory environment and to the non verbal means of communication such as touch, play, music and transitional objects.

I have found the poster helpful, as it supports us to think about the impact of developmental trauma and the implication for the child when they are experiencing another move.  It is helpful to think about potential issues, the implications and goals that underpin the transition process.

This model recognises the foster carer as central in supporting the child throughout coordination and it is essential that they are well prepared for and well supported throughout this process.  Their social worker has a crucial role in relation to this and needs to be available to the foster carer during the co-ordination process.  Foster carers need to be enabled to undertake this piece of work and it is important that other departmental demands are kept to a minimum where possible (e.g. additional foster placements, LAC Reviews for the child).

As Dr Norris points out even children who are well prepared for moving placements can find the experience confusing and anxiety provoking.  This model recognises and accepts the child’s experience and helps us all to remain child focused throughout this difficult and challenging process.

I would recommend that all workers, foster carers and adopters read Dr Norris’s piece alongside her chapter in "Healing the Hidden Hurts".

Anne MacKenzie 
Senior Practitioner at City of Edinburgh Council