​The Simple Guide to Sensitive Boys: How to nurture children and avoid trauma, by Betsy de Thierry. 
 
I love small clearly written and accessible guides, especially about heavy or difficult subjects. Betsy de Thierry’s books usually fit that brief and this one is no exception. Sensitive Boys landed on my desk at a time when I was working with a sensitive boy who felt he had to put on a helmet and wield a toy sword before he left the therapy room, and I had been reading All our Sons by Allan Schore (2016).
 
De Thierry is clearly aware of Schore’s research, which evidences that boys - not just the sensitive ones - need more nurture than most of us give them. Boys are born more stressed and harder to soothe than girls. It is more difficult for them to attach and their brains and regulatory capacities develop at a slower pace than girls. Common sense would then suggest that we have to lavish them with nurture to avoid traumatizing them and yet our culture is one of “manning up” and telling hurt children that, “big boys don’t cry”. We punish, shame and humiliate our boys for their neurobiological vulnerabilities in the hope that it will toughen them up for a cruel world and then wonder why we find ourselves in the grip of toxic masculinity on a global scale. Clearly, as this book suggests, something has to shift!
 
With extra sensitive boys the problem worsens. De Thierry likens the sensitivity of some children to being “skinless”. It’s a wonderful metaphor for highlighting how tiny scratches can wound. I’m thinking of boys who cannot touch another child when lining up at school without feeling picked on, how falling in the playground can make them feel like the whole school day is unbearable, or contact sports send them into fight or flight. Add to that the sensory challenges, bullying and misunderstanding of children who are neurodiverse and we begin to see how some children who do not appear to have a trauma history can display symptoms of trauma. “But there is no trauma history,” is something I hear from school staff regularly when I do trauma training. Understanding how feeling things deeply, hurts deeply, can help us make sense of children’s responses to experiences that often seem normal.
 
This book delivers a lot for such a slim guide. There is information on the early years and the importance of managing children’s fears and anxieties instead of leaving them to deal with the tough stuff on their own.
 
The content is enhanced by short stories from sensitive boys about their own experiences and invitations to stop and reflect on some of our own perceptions of boys and ourselves in relation to them. As expected with de Thierry there are references to the power of shame and a lot on the importance of attachment and relational connection in terms of resilience building, soothing and regulation.
 
We are reminded of the number of men who suffer depression and anxiety yet never ask for help, perhaps because they feel to display such vulnerability is weakness. Sadly, we are also informed about the high rates of suicide in people over the age of 15 years, 78 per cent of whom are male.  The author encourages us to become agents of change by teaching emotional literacy and encouraging nurturing connections with boys and men. Most of all in this book, however, there is a sense of hope and an urge to believe in children, to support their psychosocial development and build their confidence. We are invited to help our children redefine the concept of masculinity, and to support them to use their gifts, gentleness, strengths and intelligence in ways that they can feel proud to be a boy and safe to live in the world.

Sheila Lavery

Therapeutic Parenting Jumbo Cards by Sarah Neish & Sarah Dillon
Initially I wondered about the use of cards for adults but the Therapeutic Parenting Jumbo cards are fabulous.  They are designed for parents or carers who are using therapeutic parenting techniques and for professionals who are introducing others to this style of parenting. 



​These cards compliment the book ‘A quick guide to therapeutic parenting’ by Sarah Neish but can be used independently.  I would say, however, that a knowledge of therapeutic parenting would be beneficial as the cards act as useful reminders of concepts, principles and parenting techniques, but do not provide in-depth explanations or theory.

The 56 cards come in a sturdy box and are a lovely quality.  They cover a wide range of issues and topics and each card features a statement or quote from Sarah Neish’s book.  They have a cartoon picture on one side with a statement or quote relating to an element of therapeutic parenting, then on the flip side there is a more detailed but concise explanation. 

Each card is numbered and belongs one of 9 categories which are outlined in the useful booklet which comes with the cards.  Another useful and thoughtful addition is that each category is also given a separate colour, so can be easily found in the pack if you are looking for cards pertaining to a specific topic.

I like the fact that difficult issues are tackled such as why others, including family and professionals, can often sit in judgement (Category 3 ‘Ignorance Is Not Bliss: The Unhelpful Others’) or that progress is sometimes hard to see and measure (Category 6 ‘Where Did That Come From?! Progress Isn’t Always Linear).   Encouraging parenting tips are provided within each category and often come at the end of each concise explanation.

The cards are a useful tool for those times when the going is tough.  It is during times of stress when something easy to access is needed to help us to hold onto what we have learnt and why therapeutic parenting really works. You could choose some cards pertinent to what you and your child are experiencing and have them close to hand to give you encouragement.  They may also be useful to help others understand certain behaviours or difficulties a child might be experiencing. There are many different ways these cards could be used and there are suggestions in the booklet. One thing Sarah Neish points out is that these cards are for adults and I would agree with her that you may not want your child to read them as it could induce negative feelings such as shame.

Although the cards are designed for use within the field of developmental trauma they could be used for any parents who want to adopt a therapeutic approach and could be useful for children with developmental disorders such as Autism Spectrum Disorder and Attention Deficit Disorder where therapeutic parenting can really help.

I know that I will be using these cards in my work with parents and carers to help them think about some of the more difficult concepts and would recommend them for anyone working with or caring for children who have experienced developmental trauma. 
​
Lesley Bell
Therapeutic Social Worker

My Intense Emotions Handbook: Manage Your Emotions and Connect Better with Others
by Sue Knowles, Bridie Gallagher and Hannah Bromley. 
Illustrated by Emmeline Pidgen

This is a great book. The authors condense huge amounts of beneficial information into just over 200 easy-to-read pages.

​From the outset, the tone is set for what the reader can expect; wonderful concepts introduced and revisited from chapter to chapter to build on what went before or stand alone. Concepts such as emotions are not good or bad, they just are, the importance of feeling OK in our own bodies and why emotions are vital and helpful.
Notice the why here? This book not only delivers on understanding intense emotions and learning how to manage them but why the authors make their many suggestions. In the process, I think this empowers the reader.
 
Strategies on managing emotions and relationships are abundant. Lots of practical tips for people who wish to ‘do’ something, like practicing mentalizing by watching a foreign language movie clip to see if I can work out what a character is intending, thinking and feeling, with the idea of staying curious rather than making assumptions. There is also information and explanations on letting feelings just ‘be’ and I particularly loved the chapter about riding your emotions. The authors interweave humour and often use personal examples to emphasise a point. This works, as it shows them not in the sole role of educator but as humans experiencing intense emotions too.
 
Aimed at young people aged 14+, I personally think anyone who wants to understand the role of trauma, their relationships, attachment and how their own past influences their emotions and responses to them, will find something helpful in this book.
 
Review by Jane Burton
Counsellor. Trainer.

Superparenting: Boost your therapeutic parenting through 10 transformative steps by Dr Amber Elliott. 
 
The Super parenting approach involves learning and using Empathic Behaviour Management (EBM) to parent with empathy and connection while still trying to guide children towards more acceptable ways of communicating their needs. To understand EBM you’ll have to read the book but basically think Dan Hughes, Dan Siegel and even take yourself back 20 years to Caroline Archer and Christine Gordon, who set us all on the right track for therapeutically parenting survivors of childhood neglect and abuse.
 
Parents familiar with attuned empathic parenting know only too well that relationship is the key to regulating and repairing childhood hurts and that traditional behavioural management strategies are ineffective at best and more often than not, re-traumatising. In reality, seasoned adopters may be so familiar with the concept and the daily practice of therapeutic parenting that we forget it’s not the norm for most other parents or indeed many adults who engage with children. Regular reports from my granddaughter about, “what happened in school today” indicate that, sadly, shame-inducing, punitive reward and consequence approaches are still alive and well! Reflecting on that, I wondered what Amber Elliot could bring to an already well laden table of therapeutic parenting books…
 
Super parenting is so called for a couple of reasons. The first and most obvious one is that children with trauma histories need parents who have super-sized capacity in terms of understanding, empathy, psychological mindedness, resilience, tolerance, advocacy, etc. For me it also taps into the notion that as adopters and carers we are often expected to be superhuman, to “turn children’s lives around”, to do it quickly,  and without any psychological cost to ourselves. Thankfully, Amber Elliott recognises that our own stuff – our childhood experiences, attachment styles and cultural conditioning – can get in the way of the best intentions when emotions run high and the parenting rewards are few. She uses a tortoise and hare analogy based on fast and slow life history theory to explain how we act and react as parents because we parents have histories too you know and they are definitely going to get triggered by our kids. She identifies the need for awareness, self-acceptance, curiosity and compassion when dealing with our own shame and mistakes. This balance of meeting our own needs as well as our children’s is an important and often understated part of the parenting role. It was good to see the author give it the attention it deserved. Good also to see shame get addressed – it’s a big player in our family dynamics and is often avoided in parenting conversations, which probably says something about how society as a whole uses shame.
 
Dr Elliott considers the main obstacles to children being motivated by rewards and consequences: regulation of stress responses, poor impulse control, lack of trust, the power and control dynamic, and shame, being key. For readers familiar with DDP and the Dan Hughes PACE/PLACE approach, this will not be new territory but Dr Elliott presents the content in a helpful and logical way. Using the 10-step approach she explores family situational examples to illustrate how the relentless everyday stuff can wear you down and how things can get worse when we overreact or rely on praise, reward charts or relational deprivation for example. Best of all, there’s helpful suggestions that could turn around even really challenging situations.

Regulation of self and child, minimising shame while maintaining connection and boundaries are essential to the success of Superparenting. Parents (and teachers) often wonder how we can maintain boundaries and be flexible enough to meet the needs of the child. Flexibility does not mean giving in, it’s more about bending without breaking and that’s why we need to keep our own self- regulation and intersubjectivity skills in top condition. Without flexibility we find ourselves engaging in control battles that frankly we rarely win. It’s also helpful to remember that parenting is a marathon. The author does not offer any magic bullet approaches or fixes of any kind. I say that with relief, not as a criticism.
 
Superparenting proposes 10 helpful steps to transformation, while acknowledging that transformation can take time and can look different for everyone. It allows for the fact that we will all screw up (again and again) and that’s okay, relationships are built through rupture and repair - as long as the parents model repair – another reason to befriend our shame!  And, of course, there is a place for rewards in all family relationships. We all need our efforts rewarded and the author gives examples of inspiring and hopeful relational rewards that can work to motivate children and young people without the usual overtones of power and control.
 
At over 200 pages there is lot of reading here for busy parents and Amber Elliott is aware of this. She bookends the content with reminders to use it as a guide rather than a cover-to-cover must-read.  I like the suggestion that parents keep using techniques of their own that work as long as they align with the five-point nuts and bolts checklist. (Obviously, some techniques might look like they work when children are young because they secure obedience, but fear and shame can do that too). The super-short checklist neatly reminds us of what therapeutic approaches look like. All in all, I think this is a valuable text for new parents, or more experienced parents who have discovered their current strategies might need reviewing. It would also have real value for groups exploring and sharing parenting approaches.
 
Sheila Lavery
Adoptive parent, art psychotherapist and trauma educator

Michael Rosen’s Sad Book - illustrated by Quentin Blake
 
Reading the first page of this wonderful and tragic book, I felt as though I had taken a punch to the gut.

​Below a grinning portrait of author Michael Rosen reads the words, ‘This is me being sad.’ I read this book for the first time whilst on sick leave with anxiety and depression. After months of plodding on and ‘putting on a face’, these words resonated.

Reading on, there is a rawness to the writing; understandable as driving the subject matter is the death of the author’s son, Eddie, from meningitis. This is not the Michael Rosen of ‘Bear Hunt’ fame and not at all what I expected, but it is awesome and terrible all at once. The book speaks simply and truthfully about the maelstrom of emotions that come with bereavement. Rosen’s language is accessible to kids without being patronising to adults.

Quentin Blake’s illustrations lean towards a slightly older audience than my children (2 and 5) and my youngest was a little disturbed by the haunting, monochromatic portrait depicting ‘What makes me most sad’. However, they really do bring the text to life and would make excellent prompts for a discussion on recognising emotions or the different forms sadness can take.

​This book should have a place in almost every home or classroom. In a one-to-one setting it could support children dealing with grief, loss or confusing emotions; in a classroom or other group setting, it could help introduce and build on emotional intelligence. And for adults, it serves as a reminder that ‘sad’ can encompass so many different thoughts and feelings; and that it’s ok to feel them.

​Jocelyn Skaaning

​Goldilocks (A Hashtag Cautionary Tale) by Jeanne Willis, illustrated by Tony Ross
 
Three bears, porridge - you may think you know the drill; but this is Goldilocks for the SoMe generation. Driven by the need for more and more ‘likes’, Goldilocks becomes increasingly reckless and ultimately, her need for online recognition becomes her undoing.

Although it’s written in rhyme and retells a familiar story, the text feels modern, helped in no small part by the quirky illustrations.

This is the third in Willis and Ross’s series promoting internet safety and while my two (aged 2 and 5) were a bit bemused by the references, this book would doubtless be a hit with slightly older children keen to navigate the online world.

Both writer and illustrator are award winning and this engaging book showcases their talents.

My one gripe is that the moral seemed to be more ‘watch what you post’ and less ‘breaking and entering is a crime’ - but nonetheless, this is an excellent starting point for the inevitable and necessary conversations about staying safe online. 

Jocelyn Skaaning

The Nervous Knight: A Story About Overcoming Worries and Anxiety by Anthony Lloyd Jones

This book is about a knight who is rarely seen without their shiny armour. A protection from anything bad that might happen: a fall, being taken away by a dragon, spilled ice cream (sound familiar?).




​It is a story of building friendships and overcoming anxieties through connecting with others. It is also a story which has inclusivity at its heart. The knight’s pronoun is ‘they’, and a whole spectrum of human beings is included in the book.  

This is a book that will allow parents, carers and trusted adults and their little ones to relate to the knight in their struggle to deal with anxiety, and how it can manifest in various physical ways.

The knight, alongside their knight friends, navigates through not being able to control ABSOLUTELY EVERYTHING and that not knowing what’s going to happen next does not mean the worst thing will indeed happen.

It’s a story of friendship where the knight learns to trust others, and the book gives the reader strategies and ideas they can take forward in real life.
​
A brilliant book, with plenty of opportunities to lead discussions and questions for your own little ones and with resources at the end of the book to support further learning and reflection. 

The Devil You know: Stories of Human Cruelty and Compassion by Dr Gwen Adshead and Eileen Horne 

I have a passionate aversion to violence and cruelty.  Before holding Adshead’s book in my hand I would look away, change the channel, on anything related to cruelty – be it news, educational or (so called) entertainment.

So, it more than raised eyebrows at home that I was embarking on this book.  But why?
I had come to know of Gwen Adshead’s through her passion for attachment and her belief that ‘no psychiatrist should be without a working knowledge of attachment theory’*.  I instinctively felt curious.  But the word ‘compassion’ in the title was the deal breaker – a sense I could be safe to explore what I fear.

Gwen Adshead is a Forensic Psychiatrist and Psychotherapist.  The book is built on the case studies of 11 of her patients from across Broadmoor, the prison system, and the community.  In it Adshead is as much someone who walks alongside her patients as they tell and make sense of their story, as she is their therapist.  It is readable – in a language sense, with the input of co-author Eileen Horne.

For Adshead, the study of attachments in relationships has been a major influence on her thinking about human behaviour, and in this book the thread of childhood attachments in relationships and their association with later violence weaves through some of the cases.

The book seeks that we open a window on compassion and close the one on condemnation.  Adshead is very conscious not to fall foul of being accused of being soft on perpetrators.  To think so is to miss the point.  She advocates that as a society we can and should learn from their stories, to promote measures that encourage pro-social attitudes and reduce childhood adversity and making a powerful case for mental health services well before the point of crisis. 

The book was worth the emotional investment. Not one to be galloped through but contemplated with compassion, on how such behaviours make us feel about the perpetrators, and what it is for us all to be human.

Maggie McManus
Development Manager, Scottish Attachment in Action
(All views my own)

*https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/security-of-mind-20-years-of-attachment-theory-and-its-relevance-to-psychiatry/F730F989CACEF1AB43581D309616547A

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. 
​
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.
​
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.
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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.