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for those living or working with the impact of trauma

Book of the Month May 2022 - The Simple Guide to Sensitive Boys

10/5/2022

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​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

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Book of the Month January 2022 - Superparenting

6/1/2022

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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

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Book of the Month April 2020 - The Power of Showing Up

1/4/2020

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Book of the Month February 2019 - The Simple Guide to Understanding Shame in Children

5/2/2019

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The Simple Guide to Understanding Shame in Children: What it is and How to Help by Betsy de Thierry 

Betsy de Thierry has such an accessible way of explaining complex issues. ‘The Simple Guide to Understanding Shame in Children’ is a ‘must read’ for adults of all ages, parents, carers and professionals working with children and their families: in other words for everyone!
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From explaining the difference between shame and guilt, ‘....guilt says you made a mistake, shame says you are the mistake’ (p17), de Thierry moves on to demonstrate how shame lurks everywhere  - in our families, in our schools, in our society, in religion, in social media. Often used by adults - consciously and unconsciously -  to motivate children shame does  the exact opposite impacting negatively on brain, body and self sometimes cripplingly so.

The book weaves theory, research and the impact of shame seamlessly,  with both vignettes and also self-reflection points built into every chapter. 
Shame-based symptoms and behaviours are well explained.
Being shamed or feeling shame are unavoidable consequences of being human;  the unhealthy and toxic impact of shame is avoidable.

Betsy de Thierry provides practical information for everyone on how to promote healing from shame – the message is:  ‘’...the way to help the child is through understanding, empathy, kindness and emotional connection,  fun  and laughter’ (p81).  

An essential, informative and hopeful read, highly recommended. 

Edwina Grant
Chair, Scottish Attachment in Action
Edwina is an independent chartered Educational Psychologist and certified DDP (Dyadic Developmental Psychotherapy) practitioner and trainer.

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Book of the Month April 2018 - The Therapeutic Treasure Deck

1/4/2018

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“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

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The Boy Who Built a Wall Around Himself - Book of the Month June 2017

1/6/2017

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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)

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Book of the Month November 2016 - Inclusion, Play, and Empathy 

1/11/2016

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​Inclusion, Play, and Empathy : Neuroaffective Development in Children's Groups
Edited by Susan Hart
Forward by Phyllis Booth

Susan Hart, Colwyn Trevarthen, Jaak Panksepp, Marianne Bentzen, Marlo Winstead, Christine Lakoseljac-Andreasen, Pat Ogden, Phyllis B. Rubin, Serena Potter, Ulla Holck, Stine Lindahl Jacobsen, Dorothea Rahm

​Reviewed by Dan Hughes
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
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