11/04/2006
HELPING CHILDREN RECOVER FROM ABUSE - Therapeutic Interventions
Monday 27th March at AECC
Speakers:
Dr Patricia Crittenden PhD
Family Relations Institute, Miami, Florida
Julia Donaldson
Consultant Clinical Psychologist (Glasgow LAC)
Richard Rose
Assistant Director, Practice Development & Training SACCS
Kate Cairns
Director of AKAMAS
Delegates: 233 booked to attend (225 actual attendees on the day)
Of these delegates 191 came from within the North East of Scotland and 42 outwith the North East.
Aim of Conference:
To offer professionals in the North East of Scotland the opportunity to hear a variety of eminent speakers describing some of the current theories in the area of successful therapeutic interventions for children (and carers) affected by the trauma of child abuse.
This was a successful day, chaired by Mr Colin McKerracher, Chief Constable of Grampian Police and Chair of the NESCPC.
Nicol Stephen MSP, Deputy First Minister for Scotland and Minister for Life Long Learning and Enterprise opened the conference with an address which emphasised the Scottish Executives commitment to child protection. He outlined the three year Child Protection Reform Programme, including the establishment of a set of child protection standards for childrens services, multi-agency inspection of all local authority areas to ensure these standards are being met, to ensure that children are being offered high quality child protection services across Scotland.
He offered his encouragement and support to staff in the front line of service provision in this area of work and acknowledged the commitment of staff present at the Conference, and their colleagues not present, to the children and young people of Scotland.
Dr Crittenden: This presentation focussed on attachment theory, returning to Bowlbys theory of attachment as an evolved survival mechanism. She suggested that most abusing parents may not interpret the physical punishment as abuse but as a way of protecting or teaching the child i.e the intention of the parent may be different from the effect. She suggested that in this situation childrens anxious attachment is a healthy response for endangered children as it helps to protect them.
She examined how prior trauma affects parental behaviour, presenting some controversial ideas about the need to offer intervention where evidence exists of many years of trauma, as in the case of some parents, rather than simply intervening where we know of a shorter period of trauma, for example in the case of a child or infant. This idea was challenging for many of us to take on board as it may seem to conflict with our working principal of the welfare of the child being paramount. None the less the ideal of working with families and adopting a supportive and therapeutic approach rather than a blaming approach is one most professionals would sign up to.
She proposed some strategies for intervention with these families using a model of attachment patterns in adulthood to explain her proposals. These strategies will be useful to many of the professionals present and gave us all food for thought.
She also advised not to define abused children or adults as survivors or victims as this puts individuals into a passive role and is not helpful to mental health.
Many of those present expressed the need to go away and consider carefully the implications of what Dr Crittenden said in terms of the longer term reduction of child abuse and the implications for practice. This was an excellent and thought provoking presentation.
Julia Donaldson: Examined the need for early intervention in cases of trauma and abuse in childhood and looked at the effects of trauma on the developing brain and subsequent health and developmental progress. She also examined the mental health implications for children being accommodated by local authorities: research shows that 45% of children who were looked after either in residential of in family settings had mental disorder of some kind. She suggested that all children entering the care system need full psychological as well as physical review and that multi-disciplinary and multi-agency discussion and strategic planning is required to meet the complex needs of this group of children and young people. We need to promote the resilience and psychological well being of this group to prevent the development of further mental health problems.
Richard Rose: Opened the afternoon session with his presentation describing his work with SACCS, an organisation that offers an integrated service to severely traumatised children. He explained how such children find it difficult to trust adults after their experiences and using an integrated approach involving therapeutic parenting, therapy and life story work can help these children to recover.
Richard went on to explain Life Story Work with its emphasis on information collation, interpretation of meaning and identity for the child, and had some examples to show the delegates of wallpapers that children had completed in the course of their treatment. This is a tool which allows children to explore emotions and fears which are difficult to express in more conventional ways.
Richard also spoke about the importance of effective assessment; thorough and integrated assessment helps the team to identify what might be effective outcomes for children and allows clear communication of these. It also helps to evaluate what works and importantly, what doesnt work in this difficult area. Outcomes are considered in 6 developmental areas and measuring progress in these areas is carried out at the start and completion of therapy to evidence progress.
Kate Cairns: Completed the day with a presentation on an examination of how we can help to ensure successful foster placements for these traumatised children by examining the needs of the carers involved. Much of what Kate said could be applied to staff working with these children in many settings as well as foster carers, and had resonance for many of the delegates. She spoke of the needs of these children for recovery and adaptation to allow them to live effective lives. Her optimistic message was that all children can be helped to adapt and gain resilience, however great the adversity they have experienced.
Kate described the impact of Secondary Traumatic Stress on carers and the effects of unresolved stress on children. She reminded us of the health and safety issues we need to be mindful of for carers and staff alike and looked at some practical ways of preventing and treating stress disorders. She encouraged us to realise that having a stress related illness is not a failure and it is definitely not fatal all respond to treatment, often the hardest part of this being the acknowledgement that there is a difficulty in the first place.
Throughout the day there were interludes in which Jennifer Dick, an actress, interpreted for us the account of a young girl who was sexually abused and after disclosing this was referred to the Corrieneuchan project at Children First in Aberdeen. She received therapy here and the interludes movingly told of her struggles, first to tell what was happening to her and then the effect this had on herself and her family. This put the academic presentations in sharp focus, taking us all back to what all of this actually means for children and their families.
The conference was positively evaluated by the delegates who attended, all having received some new ideas to consider and some new approaches which will help them to re-examine more familiar ideas.
Angela McKinnon
Training Co-ordinator
NESCPC
31st March 2006
OVERVIEW OF EVALUATION SHEETS
All participants indicated that the day was valuable and relevant to their practice. Dr. Crittendens presentation was easily thought to be the most controversial but each of the speakers were highly rated by almost all of those who completed evaluation forms.
Representative comments on:
Dr. Crittendens presentation:
Controversial, thought provoking challenging preconceived ideas forced me to re-examine my own thinking good link of theory to practice made me want to hear more will inform my practice when assessing gathered information
Julia Donaldsons presentation:
Very interesting Good to be reminded/ informed of physical and biological changes in body Notes in pack will help me reflect and internalise this information Clear and relevant
Richard Roses Presentation:
Wished he worked here! Very, very good water analogy very useful and meaningful life story work is such a powerful medium we need to use it more
Made me feel optimistic about childrens futures there is hope out there for these damaged children
Kate Cairns Presentation:
This made sense- something weve always thought but great to see that there is evidence to support this Inspirational comment on organisational change is spot on great to acknowledge and deal with the stresses in this area of work
Jennifer Dicks input:
A very good insight powerful a good teaching tool poignant Moving
Disturbing in a good way A focus back on the reality as opposed to the theory
Organisation and housekeeping were universally approved of; all found the chairs leading of the day to be good particularly in terms of time keeping and setting the tone of the day, and some commented positively on Nicol Stephens input, although some would have liked him to stay and answer questions.
There were a few comments that workshops would have been welcomed, but more said that they enjoyed the lecture type presentations and gained more useful information in this way.
Comments on the packs were nearly all positive with some comments on the font size in a couple of cases and 1 person wanting all the slides in colour (I have emailed these to him) . People commented that they would have welcomed a reading list/ website addresses from speakers and that is a well made point.
Generally a great day, enjoyed by all.
30th March 2006
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