Unit objectives

• To explore the implications of separation and loss in the context of looked after children’s experiences.
• To explore the impact of trauma on children’s behaviour and capacity to learn.

Resources to deliver unit

• Presentations: Understanding Trauma 2. Loss and Separation
• Handouts: 1. The process of bereavement 2. What is trauma?
• Video clips: 1. Helen Minnis: Trauma and neglect 2. Craig’s story: Domestic violence 3. Craig’s story: Classroom

Introduction to trainer

The material in this unit is difficult in a number of ways. Firstly some of it may be an intellectual challenge as it requires people to struggle with concepts and ideas that may be unfamiliar to them and to apply it to real experiences. It may also cause distress to people who have experienced loss or trauma themselves or worked with people as clients or colleagues who have undergone such experiences. Finally, participants may find themselves reflecting on how they have worked with children in the past and feel that in some cases they made the child’s experiences worse because they did not properly understand what was happening for them. Be alert to signs of stress in individuals and the group and provide plenty of opportunities for people to contribute or withdraw as necessary.

It is important that you model hopefulness as some of the material you present can lead participants to feel despair at the enormity of the experiences children have undergone and the level of emotional injury they have incurred. It is always helpful to have a stock of stories that can illustrate recovery and good practice and always invite participants to share their own good stories!

Outline of Unit

• Presentation on loss
• Individual activity and feedback on trauma
• Presentation on Trauma including video clips
• Video Clip Helen Minnis 2 Trauma and neglect

Presentation on separation and loss (10 minutes)

Introduce this theme by highlighting that separation and loss are universal experiences. Individuals deal with these experiences in different ways but there is a recognised pattern of grieving. Loss is a very personal experience and for some people the loss of a pet or a change of house may be very significant while for others such experiences may have much less meaning. Individuals’ capacity to ‘manage’ grief and loss is determined by factors such as their previous experiences of loss, their support networks, and their physical and emotional health.

Remind participants of the information in the previous unit about the number of moves and changes that looked after children may have. This is very clear for children who are looked after away from home who may experience multiple placements. We also know, however, that many children who are looked after at home experience chaotic home circumstances which may include several changes of house and the loss of significant adults.  The experience of repeated losses may impair a child’s ability to work through the grieving process. They may ‘stick’ at some part of the grieving process, guilt and anger may become an entrenched part of their functioning, their physical development may be impaired or they may regress to an earlier developmental stage. Give out the hand-out on bereavement.

Key Messages

• Separation and loss are universal experiences.
• Many looked after children have experienced repeated loss and separation.
• Following a loss, there is a recognised series of phases through which individuals pass if they are to be capable of continuing their lives and able to form new, positive relationships.
• Some children may be blocked at different phases in the grieving process and this can impair both physical and emotional development.
• It is important to acknowledge and help children understand the “normality” of some of the powerful responses they have towards the people from whom they have been separated.
• It is important to ensure that children do not take on a burden of responsibility for the loss or change that has occurred.

Trauma

Individual activity and large group discussion (20 minutes)

Ask participants to remember an occasion when they were very frightened. Without asking them to share the actual experience, invite them to share some of their physical or emotional responses in the large group. Some people will be remembering very intense experiences at this point and it is important not to exert any pressure on participants to share anything at all unless they feel ready to do so. It is equally important that the trainer states the importance of maintaining personal boundaries to ensure that no participant shares any material they may later regret.

Video Clip: Helen Minnis. (10 minutes)

Helen explains the differences between and implications of both neglect and trauma in childhood.

Trainer presentation and video clips (50 minutes)

Use PowerPoint slides to develop a presentation outlining the impact of trauma on children’s development and behaviour. There is a hand -out associated with this section which will expand the material on the overheads. Give this to participants at the end of your presentation.  The resources that support the unit will also be helpful in preparing for this session.

Always be aware that there may be people in the group who have experienced trauma themselves either recently or in the past. The presentation and any discussion may trigger flashbacks or the physiological manifestations of increased anxiety. Remind participants before the presentation that it is acceptable to find means of withdrawal either physically or through silence if this is necessary.

Define what trauma is and explain its impact on children’s development and functioning. Distinguish between the type of losses discussed earlier that, however difficult, are a normal part of human experience and the overwhelming nature of trauma. Ensure that participants understand that the experience of abuse, neglect and witnessing domestic violence may be just as traumatising for children as living through major disasters can be for adults. Emphasise that traumatic events can occur at any point throughout an individual’s life and that they always have a powerful impact. Point out, however, that trauma may be particularly damaging at a very early stage of brain development as it prevents the development of normal stress regulation capacities which in turn makes it more difficult to manage future traumatic events. It is also important to help participants understand that evidence is accumulating that prolonged neglect early in life is even more damaging for children than more overt abuse. The worst situation for children is an environment in which both are present- an experience all too common for our looked after children.  In very extreme cases of sensory deprivation neglect there is some evidence that this can affect not only the organisation of the brain but its size –slide 12. Emphasise, however, that this is very unusual and is a result of a level of neglect that very few looked after children will be exposed to.

Outline the factors which make it more likely that a child will have a long-term negative response to trauma and link these to the common experiences of looked after children. Ensure that participants are clear about the physiological and psychological responses to trauma. Point out the particular implications for children attempting to learn especially in a formal school setting. Ensure, in particular, that participants fully understand that children may present with "difficult" behaviour when they are still trying to cope with the impact of trauma and that this may not be restricted to the immediate aftermath of the experience. Remind participants of Craig’s experience in the film and explain how sensory triggers can induce terror in children and that without sustained and sensitive help they may be unable to control their responses. Show the relevant sections of the film again to emphasise this point.

Involve participants in discussion throughout this presentation asking for examples from their own work and ensuring both that they are understanding the content and not becoming too overwhelmed by the content. It is essential to emphasise that children can be enabled to recover from even the most adverse childhood experiences and that as direct carers and educators they are the people best placed to help them to do this.

Before you finish this session check out how participants are feeling and emphasise that other units will focus both on how to work with children who are traumatised and on how to help children develop and maintain resilience.

Key Messages

• Traumatic events in childhood can have life- long negative consequences.
• In very young children trauma can have a permanent effect on the brain’s organisation.
• Even when traumatic events are over, the body may develop a state of permanent arousal or dissociation which affects cognitive, emotional and behavioural responses.
• Many looked after children have suffered trauma.
• The chronically adverse experiences of many looked after children and their families makes it hard for children to recover spontaneously from trauma
• Trauma evokes primitive survival mechanisms which interfere with children’s capacity to learn.
• Children can and do recover from trauma.

Resources to support unit

• Neurosequential Model of Therapeutics (NMT): Core slides
• Using a neurodevelopmental lens when working with children who have experienced maltreatment