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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Life Work with Children Who are Fostered or Adopted: Using Diverse Techniques in a Coordinated Approach by Joy Rees

​The author of this book, Joy Rees, is already well-known for her previous writing on life story work (Life Story books for Adopted Children: A family Friendly Approach 2009) where she put forward the model of working with children incorporating Present- Past-Present-Future.

This time, Joy Rees takes a wider look at the purposes and different aspects of life work as well as offering ideas on how best to approach this work. The title of this book sets the tone and immediately moves the reader away from any preconceived ideas about this being a one-off piece of work. She discusses the right of children to  know their history and also to receive help in making sense of it. She believes that “Life work should be at the heart of our involvement of all children in care” and regrets the confusion amongst professionals and the tendency to tag on this vital work as an afterthought. This has come about, she feels, because of lack of training in this area and also because of the emphasis on performance indicator-led social work practice. She sees the child’s Life Story Book as only an aid to ongoing life work and not as an end product.

Joy Rees prioritises the need to understand each child and to take into account their emotional and cognitive development, not their chronological age. “Think toddler” is her mantra. In order to do this, she believes that all those involved with the child should have an awareness of child development, neuroscience and attachment theory. She advocates a team approach and suggests that life work should not be the responsibility of the child’s social worker alone. She suggests including foster carers, the adoption and fostering team workers and anyone from other, independent agencies, who knows the child.  There is also an expectation that adopters or long-term carers will continue this work. Birth family members contributions are vital, too, as they are “the most significant source of information about the child’s early experiences”, though she does acknowledge that the timing of their involvement may depend on where things are in terms of future planning. In some instances, she writes, life work should start prior to the child being accommodated and, of course, it should continue throughout their time in care. She believes that the issue of life work should be raised formally at each review meeting.

I really appreciate the approach which Joy Rees advocates, coming as it does, from her experience in this area of work and her understanding of children’s needs. As well as offering a theoretical justification for life work, she covers practical issues and tackles some ethical dilemmas, such as balancing the rights of children to have an understanding about their past v the dangers, in a digital age, of giving identifying information.

This is a wide-ranging book that touches many important issues. At its heart, life work is helping children with their story, which may need to be told and re-told many times. However, the story must be given with honesty and transparency. I felt like cheering when the author referred to Lorne Loxtercamp, who has written so convincingly of the need for honesty in telling the child’s story and for this to be integral to any on-going contact!  Joy Rees comes from 40 years’ experience as a social worker specialising in children’s social care services.  As such, she appreciates that helping a child to understand their past can touch issues in those around them. She reminds us that we need not do this work alone and that anyone involved in helping a child with life work should have access to good support. As she writes towards the end of this excellent and insightful book, “To help the child in care, it takes a team”.
 
Heather M Drysdale
Systemic Psychotherapist/Adoption & Fostering Consultant

Healing Relational Trauma with Attachment-Focused Interventions. Dyadic Developmental Psychotherapy with Children and Families
Daniel A. Hughes, Kim S. Golding & Julie Hudson (2019)

I work as a Consultant Clinical Psychologist with fostered and adopted children.  This book landed into my hands as I approached the end of the Practicum to become a Certified Practitioner in Dyadic Developmental Psychotherapy (DDP).  And, wow, what a wonderful resource to have.  Its like having a DDP Consultant on hand!
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This is a ‘must have’ resource for anyone who wants to learn about DDP and develop their practice of it.  It begins logically with chapters that explain the guiding principles, theory and what is known about the neurobiology of attachment and developmental trauma.  It explains PACE (which stands for Playfulness, Acceptance, Curiosity and Empathy) as the attitude which helps to provide children with a foundation for safe and healthy relationships.  The experience of DDP is described.  One chapter addresses the ‘nuts and bolts’ of DDP; wisdom that I wish I’d had when I first began practising with this model.  Basically, you are told everything that you need to know to get started with DDP in a practical way. 

There is a chapter on working with parents therapeutically and helping them to develop parenting that conveys PACE.  The book then explains how Dyadic Developmental Practice can be used to create safe settings.  There is an emphasis on thinking about a child’s wider system and network, such as education, social work teams and mental services.  This chapter shows how DDP is more than a psychotherapy.  DDP is a framework for professional practice.  It is a framework for creating strong unified and connected teams around a child in which a shared understanding of the child can be explored and created.  This networking approach is essential for helping children to feel safe, understood and regulated, and it can provide the foundation for successful psychotherapy.  The book explores DDP in residential care, fostering and adoption, individual therapy.  Specific populations are focused upon such as children with learning disabilities, children who show violence to parents and adolescents.  The combining of Theraplay and DDP is described.  The experience of having supervision for developing one’s own DDP practice is described.  To conclude, the book finishes with a chapter on the evidence base.   

This book packs a lot of information into its 335 pages.  It is aimed at professionals although it has little jargon in it so would be accessible to a wider audience.  It is very easy to read and the inclusion of many powerful case examples bring the concepts and ideas to life. 

As I finished reading this book, I was delighted to successfully complete the DDP Practicum and become a Certified Practitioner.  I’m confident that this book had helped me in those final stages by giving me knowledge, support and motivation.  It’ll certainly be a book that I keep accessible, especially when I need reminding of how to maintain a PACEful approach in my work. 
 
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. 

​It’s not fair! by Jane Foulkes and Wendy Picken
 
Some children’s bereavement books are stories written to be read or listened to by the young people themselves.  Some are for adults who want to help through understanding how a death might be experienced by their children or those entrusted to them.   “It’s not fair!” could easily be read by either but all the way through reading it,  the sense is of an adult and a child sitting together turning the pages.  It’s easy to imagine adult and child, sitting together, leafing through the pictures of faces in the first part of the book.  The words and the simple images of different feelings offer potential for conversation and reflection as well as learning.  However, I wonder if most children will skip past the faces looking for the stories, but this is a book for more than one reading so I don’t suppose it really matters. 
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There are two stories.  In the second part of the book, Frankie lives with her mum and her grandma and her dog Jason who we are told has “three good legs and one not as good as the other three and sometimes stuck out to the side when he was running”  When her mum dies, Frankie doesn’t want to play with her friends anymore and only Jason, the dog, remains as her companion and, when others don’t, she senses that he understands, “when Frankie didn’t want to talk Jason put his head on Frankie’s lap”. There is a lightness in the storytelling and a simplicity in the words but allow the reader to hear the voice and the thoughts of the bereaved child.  

In the third part of the book, Albie’s story tells of boy who is often cross and angry as he struggles to understand himself in this new world of bereavement following his dad’s death. Wrapped around both stories are the voices of the two adults in the stories, Frankie’s grandma and Albie’s teacher.  For the reader they model the words that will explain, without creating confusion, and comfort, without denying the reality of death or the hurt of separation. 

The two authors, Jane Foulkes and Wendy Picken are to be commended for the way in which they have managed to capture the voices and the thoughts of the children they have worked with and embed them in the narrative. The result is a very readable book full of insight and wisdom wrought from experience.

Rev. Liz Henderson
Richmond's Hope

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.

Not Again, Little Owl by Vivien Norris

Not Again, Little Owl is a therapeutic story book specially written for children moving from short term foster care to a permanent placement, whether adoption or foster care.

The writer, Vivien Norris, is a clinical psychologist, music therapist and DDP practitioner who has many years of experience of therapeutic work with families and adoption.

She wrote the book because she found that the transition to adoption books available tended to have an adult agenda and focus only on the positives. She saw the need for a story which would acknowledge the child’s distress and help the adults to see and engage with it.
 
The book tells the story of Little Owl who is living with his Mummy, who doesn’t look after him properly. Rabbit decides this is not good enough and takes him to his Granny who can’t keep up with his energy. Fox and Hedgehog can’t manage to look after him either, but then Rabbit takes him to stay with Badger who understands his fears and helps work out his “muddles”. When Rabbit arrives again to take him to say with Squirrel who will look after him forever, Little Owl is upset and wary. However, Rabbit, Squirrel and Badger work together to help him move and at last Little Owl can begin to settle into his new home.
 
The book is nicely illustrated using children’s drawings and offers opportunities for conversations about the realities of the multiple transitions that children can experience before moving to an adoptive family.  While the sadness and loss associated with these moves is acknowledged in the story, there is also hope and understanding. This book would be an invaluable tool for social workers, foster carers and adopters who need to open up discussions with children about moves in a sensitive and non-threatening way.
 
Jane Steele
Trainer/Consultant
Adoption and Fostering Alliance (AFA) Scotland 
The Adoption and Fostering Alliance (AFA) Scotland is an independent, charitable organisation dedicated to Not Again, Little Owlimproving outcomes for children in care by providing support to all those working in the field of adoption, fostering and the care of looked after children.

Can I tell you about self-harm?
A guide for friends, family and professionals 
​by Pooky Knightsmith
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Pooky Knightsmith  is a mental health trainer and educator who is also Vice Chair of the Children and Young People’s Mental Health Coalition. She has provided an excellent and accessible book that helps explain the difficult and complex issue of self-harm among young people. 
She brings to this task her own rich experience that includes her personal struggles with emotional difficulties, including self-harm.  

She has also, however, achieved a PhD  in child and adolescent mental health  and is an Associate of the Evidence Based Practice Unit, a joint venture between UCL’s Faculty of  Brain Science and the Anna Freud National Centre for Children and Families.  This short book distils her first- hand experience, her knowledge of the evidence about self-harm and her deep understanding of the potential damage caused by ill-considered controlling reactions and the result is a resource that should be widely disseminated.

The book is written from the standpoint of fourteen year old Asher. The text and the clever illustrations mean that Asher could be either a girl or a boy, allowing every young person to identify easily with the central character and preventing easy assumptions that self-harm is a gender specific problem. The illustrations and text make it clear that self-harm may affect anyone regardless of ethnicity or gender.

Asher explains why young people might hurt themselves, how hard it is to give up this way of coping and what friends, families and professionals can do to help. As well as helping people affected by the self-harm of others to feel less anxious and helpless, the book also addresses the loneliness and sense of shame that can be experienced by young people who self- harm. It provides practical suggestions for young people to begin to get control over their feelings and engenders hope that, ultimately, they will be able to find alternative methods of coping. Without ever advocating self-harm, it makes it understandable and also explores how to make self-injury as safe as possible. The language is simple but not patronising and the book explores a wide range of experiences and ideas in less than seventy pages.

Having read this book I will be incorporating it into any future self-harm training I may do. It is intended to be accessible to children as young as seven and its vocabulary and language construction certainly meet this aim. Yet, this book includes within its covers many of the most difficult and at times counter-intuitive ideas that still evoke resistance and anxiety among practitioners and managers in care, education and health settings.  It demystifies self-harm without normalising it and reduces anxiety for all involved, by providing helpful ideas for responding to anyone who use self-harm to cope with their distress as well as suggestions for helping young people to gain some control over their own self-injurious behaviour.

I wish every young person who self-harmed could have a copy of this book.  Its audience, however, should stretch well beyond this particular group of young people- their family, friends, teachers and any other professionals involved with them would benefit from reading this. Its messages that self-harm can be understood  and that children who hurt themselves need people to listen to them rather than to control them, are ones we all need to hear.

Judy Furnivall
Consultant
CELCIS
University of Strathclyde
Trustee of Scottish Attachment in Action

Dealing with Foetal Alcohol Spectrum Disorder: a guide for social workers
​by Mary Mather

As the title clearly states this is a guide written with social workers in mind, however it is also a useful reference for parents, carers and other professionals working with FASD affected children.

With chapters that cover the historical development and growth of alcohol use and trade; the impact of alcohol on the developing foetus and much more the book takes you on a journey that enables you to build up your knowledge, understanding and hopefully by the end compassion for those children living with the effects of pre-birth exposure to alcohol, and the challenges they and their parents/carers face in supporting them through life.

Written in a concise and authorities style, it can either be read from cover to cover or easily navigated to provide answers to specific questions.  The first chapters consider how alcohol impacts the development of the unborn child, prevention and diagnosis. Chapter 7 considers why a diagnosis matters.  Chapter 8 is key in understanding the signs and symptoms associated with FASD as well as the strengths of the FASD child.  The remaining chapters focus firstly on what interventions do not work and then provides help and hope by providing advice and strategies on what does work.  At the end of each chapter there is a useful summary of key learning points. 

As adoptive parents the two chapters that stood out most where chapters 7 ‘Why diagnosis matters’ and chapter 9 ‘What dose not work and why’.   Chapter 7 states “These ‘missed diagnosed’ children will instead be viewed as ‘poorly behaved’, ‘non-compliant’ or ‘conduct disordered’ children. ... The lack of understanding has led to many parents and carers being unfairly blamed for their child’s problems and then given the wrong strategies for managing them.”  We are sure that most adoptive parents / carers are able to associate themselves with at least one of these descriptions of their child, and have felt a similar sense of blame.

Chapter 9 discusses the approaches which are not effective in helping alcohol affected children with organic brain damage.  These include: traditional parenting techniques which rewarding “good” behaviour and ignore the “bad; talking therapies, as these children have a poor understanding of complex verbal language and; being punitive to the carers of children with FASD as bizarre behaviours are often blamed on the child’s parents or the home environment. 

​The reader is left in no doubt as to the importance of diagnosis and that the wrong interventions are likely to make the child’s behaviour and family situation worse.  The final chapter provides a lists of ‘Dos’ and ‘Don’ts’ for social workers, which is set within the context of the absence of national guidelines on how to best support these children, the complexities that these children often present with, their back stories and often the gaping wholes in their life history. 

Overall we found the book to be interesting and thought provoking and although personally maybe there were not to many ‘new’ things discovered, it has helped us to consolidate our thoughts and been helpful when explaining to family/friends and the professionals.  The comparison tables in particular are really useful for this purpose.  It is defiantly a book we would recommend for both parents and professionals alike. Easy to read and access, with good references and pointers to further reading and support.  This is definetly a book worth having on the shelf and something we think you will refer back to many times.

Reviewed by Aliy Brown and Rich Brown
Adoption UK in Scotland

The A to Z of Therapeutic Parenting
Sarah Naish (2018)
Published by Jessica Kingsley
 
I work therapeutically as a Clinical Psychologist with adoptive and foster families.  I’m always on the look-out for resources that are accessible, quick to read, affordable and that make good practical sense. 

The A to Z arrived and I immediately loved the cover. 
It was also bigger than I expected. 

​I began by giving this book a first road test.  Would I be able to read it during the little time I have as a busy working parent?  I have so many books which don’t pass this test!  So, I checked whether it could be read in short snatches of time - during visits to the bathroom or while waiting outside school for pick-up time.  I covered a lot of ground quickly! 

The book is split into two main sections.  The first part contains just enough theory to explain important concepts such as ‘inner working model’ and ‘developmental trauma’.  It provides a simple, logical overview of therapeutic parenting, what it is and what it looks like.  It does all this, while also being realistic, kind and empathic about just how hard parenting a traumatised child can be. Even the font and writing style is friendly.

The second and main body of the book looks at common concerns, dilemmas and difficulties.  The topics are (of course!) listed from A to Z.  For each topic, the reasons for why it may be happening is explored, followed by strategies that can be used to prevent it, during it or after it has happened.  There is no ‘one size fits all’.  This book helps parents to be curious about their child and encourages exploration about what their child’s behaviour might mean and what the underlying need may be.  The strategies described fit well with Theraplay and Dyadic Developmental Psychotherapy, two of my favourite interventions (because they are effective).   

This is a book that can be read at a calm and leisurely pace or, when needed quickly referred to in the midst of a crisis.  This book feels like adoption and fostering gold-dust.  I wish it had been around when I first began working with adopted and fostered children many years ago.  I’m recommending it to most of the parents that I’m supporting, along with social workers and schools. 
But, the real test of a book for therapeutic parents is to ask parents what they think of it.  They are the experts by experience.  Here’s what they had to say:

As an adoptive parent, I wish I’d this book from the beginning, when we first adopted our older sibling pair. It offers an invaluable, user-friendly guide to help parents / carers find ways to deal with their children’s behaviour but, most importantly, to understand where it is coming from. I would recommend this book to all adopters, foster carers and anyone else involved in the care of traumatised children. As well as being a very clear source of helpful, and much-needed, advice to parents and carers, the book is also very useful for dipping into and finding information to help others to understand, e.g. family and friends, as well as school staff and other professionals.

My criticisms, completely outweighed by the positives, are that there are certain, possibly minor, topics which I couldn’t easily find. Part of the difficulty is that we don’t all use the same words in exactly the same way. Also, some important themes simply run through the book, but are not included as separate entries in the A-Z. I think navigating quickly through the book would be easier if there were a contents list for the A-Z part in the printed version, as there is in the eBook. I also think an index would be helpful.

From an adoptive dad:  
I now understand why people are being so positive about this book. It is written in an easy to take in style and doesn't make you feel like you've done it all wrong again but offers simple advice about why some of the behaviours we witness exist. I can see us using this to dip into to support what we already know (and regularly forget) between traumatic events as well as using it afterwards, whilst crashed out in bed with the customary bar of chocolate and/or cup of tea, to explain why the latest meltdown happened. It would have been really useful to have had about 5 years ago!

And another adoptive dad:
As an adoptive parent I'm finding 'The A-Z Therapeutic Parenting' incredibly helpful and encouraging.  It's written in a friendly and accessible style, gives insight to the minds of children who have suffered trauma, offers tried and tested strategies for dealing with difficult behaviour, and is structured in a way which facilitates accessing the wisdom within quickly as required.  This book should be made available at an early stage to every adoptive parent!
 
Review by:
Dr Helen Rodwell
Consultant Clinical Psychologist, Co-author of Parenting with Theraplay
and Jane, Dave and Andy
Adoptive parents (experts in adoption by experience). 

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

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

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

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

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

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

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

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

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

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

Lucky Lucy
A sensory challenged 22 1/2  year old

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Lesley Craig
Educational Psychologist
Clackmannanshire Educational Psychology Service.

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

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

​




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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The Simple Guide to Child Trauma by Betsy de Thierry


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

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

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

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

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

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

Edwina Grant 
January 2017

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

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

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

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

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

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

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

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

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

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

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

​Ann Rooney
Consultant / Trainer

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

Dan Hughes PhD
​Founder of DDP