1. Together We Can!
Family Engagement that helps Children and their Families Heal and Thrive

2. Learning Objectives
Connection between Trauma and Attachment and how this connects and impacts CASA advocacy
Understanding of intergenerational trauma and the impact on the child/parent/system interaction
Understanding of child trauma and impact on their outcomes
Power of healing through relationship (child/family/system)

3. Family
How do we define ‘family’?
A circle of care and support that offers enduring commitment to care for one another. Related biologically, emotionally or legally.

4. Self Reflection What beliefs do I bring to my work?
Spend a few minutes filling out Dalgleish Tool
Family Decision Making K&A scale

5. Dr. Nadine Burke

6. How We Got Here
Our journey

7. Risk vs Well-Being
•Increased awareness of child death, child sexual abuse and new risk consciousness = changes in the environment of trust/risk, and relationship between expert systems and lay people. (Ferguson, 1997)
•Preoccupation with risk lies at the heart of child protection practice
•‘Risk’ overtaken ‘danger’ – ‘risk’ has an aura of science and conjures the possibility of accurate prediction.
•Focus of policy becomes lessening of ‘risk’, not the meeting of ‘need’ (Scourfield & Welsh,2003)
Risk Shift in Foster Care
•Drift occurred which resulted in little or no contact between foster parents and primary parents
•Minimal agency support for foster parent to be involved with primary parents even upon their request.
•Minimal support for maintaining relationships following reunification
•Culture of moving placements when difficulties arise
•Behavioural based approach child behaviour difficulties – foster parents and workers

8. Systemic Issues
Total average length of placement was 10 months (18mths CW’s vs 23mths Provincial average)
Moves in care - first 6 months;
•48% of children experience 2 or more moves.
•17% move 3 or more times
Admission procedures included placement in ‘temporary placements’ – move within 2 weeks
•Limited ability to focus on replacement in previous homes upon re- admissions
•Minimal attention to maintaining relationships with previous foster parents

9. Building Enhancement Attachment, Capacity and Knowledge - BACK Project Model

10. The goal of the B.A.C.K. meeting was to help families, alternative caregivers and staff work as part of a team to develop a plan for the time that the child was away from their family.
•Elements of restorative justice circle
•Used 'Signs of Safety' Format (Turnell Edwards, 1999)
•Focus on child's ‘needs’ rather than protection ‘risks’
•Attachment based questioning
•Structure of meetings attempted to equalize power of participants.

11. Randomized control trial

12. Alternative Caregivers
Satisfaction with Agency
Competence in Parenting
The Foster Family Satisfaction Survey was developed to assess the foster family’s satisfaction in working with the agency (Prohn, 1993; Reid & Gundlach, 1983 ). The Foster Family Satisfaction Survey is a 10 item scale designed to assess foster family’s satisfaction in working with the agency. The first 9 items are answered using a 5-point Likert scale, ranging from 1 point indicating ‘never true’ to 5 points indicating ‘always true’, and the 10th item asks alternate caregivers to take everything into consideration and rate how satisfied they are in being associated with the agency from 1 point, indicating ‘very dissatisfied’ to 5 points, indicating ‘very satisfied’. The mean of these ratings provides an overall satisfaction measure.
Everyday parenting scale – confidence enjoyment and competence (belief in their ability to get the everyday job of parenting done)
When we look at the scale as a whole we saw that signficant increase in research group’s positive feelings about parenting over time – Over time the control group’s feelings decreased but not signficantly
When we examine the individual scales – there were no signficant differences between research and control or over time in relation to confidence and enjoyment
But with regard to competence
At time 1 we see that parents in research group were reporting more feelings of competence but this is not a significant difference – but the interaction between time and research over time is significant

13. Alternative Caregivers
What AC said
Perception of Child Behaviour
Listening to PP’s talk about their children gives them a contextualized understanding of child’s behaviours
“it was good. I was, I was happy that I met him because it gave me an understanding of why she behaved the way she did”

14. What Alternative Caregivers Said...
Becoming Part of the Team
Visibility
(before ….) they weren’t comfortable with you meeting the parents”
It felt like you were…
“that person in background that they hate because you’re the one taking care of their kids and you’re (CPS)”.
“the (....) meeting is an extremely positive way to make (CPS) and myself, specifically, as part of that team, to bring the biological parents and us together to foster a team atmosphere.”

15. What Primary Parents Said...
They’re on My Side
Empowered
“You get to tell them what you want, - instead of them feeling like you know you’re in the background and you’re in the shadows…”
“I had all those supports behind me, everybody that was at the (….) meeting, wasn’t even family, but it was still people that you know had our back, and were on our side, even the foster family, that’s what it felt like, was they’re on our side”

16. What Primary Parents Said...
Changed Perception of Worker
Changed Relationship with Worker
“pretty much ever since the (....) meeting is when I’ve been telling her the truth”.
“ I think the (....) meeting kind of opened it up more, because then she started to realize, and instead of judging, she’s understanding, which is what you want from a CAS worker”.

17. What Mother’s Said Mothering Ability Changed
Get a chance to showcase self as mother
“just from going to these programs and being able to learn things. Like…these kind of programs just helped me realize how to make that connection properly with my child. And, a lot of parents, like a lot of young moms I know, they’ll sit on the couch and do nothing and their kid will just run around… So, I mean, I wouldn’t have thought of stuff like that before, you know? …I would have been one of those moms that sat on the couch and just watched TV and not really know what to do with [child]”
“It felt like everything I taught them or I did in their lives were completely wrong… I understand I’m not a perfect mom. I never claiming to be … I felt they looked at my age not at me…they never gave me a chance”.
(Later she says..)
“I think they understood that I knew a lot about my kids. I hope that they seen how much I love them… that I was a good mom… that I care about my kids and that I know about them”.

18. Child Protection Workers

19. Child Protection Workers
GOOD/VERY GOOD
Meetings
•96% - enhanced relationship between primary caregiver and alternative caregiver
•91% - helped build relationships
•86% - gathering info about placed child
Project
•68.2% - improving placement stability
•59% - improving relationship between child and alternative caregiver

20. What Child Protection Workers said...
“I think the thing they appreciated was that we were going to listen to what they had to say”.
“I thought oh, my goodness, if this doesn’t go well, you know, it’s going to be really nasty”
“the meeting is the gateway to developing that positive relationship with families”
“a different way to engage families”
“level the playing field…to change the power dynamics”

21. What Child Protection Workers said...
Interaction Changes
“so we were starting with some different questions than we normally would and trying to keep the focus really specific on the kids. So that was, that was different because as a frontline child protection worker, sometimes the initial starting point with people is about - you know - people usually want to get out the protection concerns”

22. Implications A little goes a long way!
Positive relationships protect children!
Benefits of a collective response!
To build attachment we need strong structural foundations!

23. Critical connection in our child welfare work
Trauma and Attachment
Critical connection in our child welfare work

24. Attachment is a biological drive. Proceed with caution
Trauma is universal.
Attachment is a biological drive.
Proceed with caution
Stand and stretch- discuss research about inactivity

26. What is Attachment? Biologically determined behavioural system
aroused in response to stress or distress and signals anxiety in dangerous situations.
-Bowlby
CRADLE TO GRAVE
BIOLOGICALLY DETERMINED LIKE HUNGER
CULTURAL CONSIDERATIONS- LIKE HUNGER EAT DIFFERENT THINGS BUT STILL AHVE THE SAME BIOLOGICAL DRIVE

27. What Is The Definition of Trauma?
Every emotionally traumatizing event has three characteristics:
It is unexpected.
The individual was not prepared for it.
The individual could not prevent it.
Dr. Bruce Perry
GIVING BASIC DEFINITION OF TRAUMA
PAUSE TO THINK OF SOMETHING THAT HAS AFFECTED YOU IN THIS WAY
MAKE LINK TO HELPLESSNESS
THIS IS TALKING ABOUT AN EVENT-- WANT TO DISTINGUISH IT FROM CHILDHOOD RELATIONAL TRAUMA

28. What Is Childhood Trauma?
•Witnessing or experiencing something that poses a real or perceived threat.
•The event or experience overwhelms the child’s ability/capacity to cope
•Is often threatening to the life or physical integrity of the child or someone critically important to the child
•Elicits feelings of high psychological arousal
this definition does not include neglect- definition of neglect needed? video? Changed the word event to something because we need to consider omission and commission-- i.e. neglect- the absence of care-- this is the lead into intergenerational transmission of trauma
POINT 2 EXCEEDS THE CHILD’S COGNITIVE ABILITIES

29. Complex Developmental Trauma/Relational Trauma
•Complex trauma describes both exposure to chronic trauma—usually caused by adults entrusted with the child’s care—and the impact of such exposure on the child.
•Children who have experienced complex trauma have endured multiple interpersonal traumatic events from a very young age.
•Complex trauma has profound effects on nearly every aspect of a child’s development and functioning.
•Source: Cook, A., Spinazzola, J., Ford, J., Lanktree, C., Blaustein, M., Cloitre, M., ... van der Kolk, B. (2005). Complex trauma in children and adolescents. Psychiatric Annals, 35(5),
NOW ADDING ANOTHER LAYER
common physiological responses- already described in the ted talk by nadine burk harris heart racing, dizziness, loss of bowel or bladder control, emotional responses, fear, terror, helplessness--nadine talked about the affects on the body when it endures constant stress what about behavioural responses? disorganized or agitated behaviour

30. Re-examination of Practice
Not: WHAT DID YOU DO?
Rather: WHAT HAPPENED TO YOU?
NEGLECT- GOOD THINGS THAT SHOULD HAVE HAPPENED TO YOU THAT DIDN’T
ASK: WHAT TOOL DO PEOPLE USE TO COMMUNICATE WHEN THEY DON’T HAVE WORDS TO EXPRESS THEIR EMOTIONS OR CIRCUMSTANCES? ANSWER: BEHAVIOUR
One of our most typical responses is to ask WHY DID YOU DO THAT? Many memories may be preverbal and the child will not be able to explain his/her behaviour. What we want too be able to say is something has happened and there is good reason that you are responding that way. Together we need to figure this out.

31. . Biological responses to threat stimulus-connection to attachment

32. Window of Tolerance
THINK OF A TIME WHEN YOU HAVE SEEN A CHILD THAT YOU ARE WORKING WITH/SUPPORTING AND THEY HAVE A REACTION THAT SEEMS OUT OF THE BLUE.
TOOL: when you see a reaction of o to 60 in seconds- wonder if there is a trigger to a trauma
Remember shift in practice- not what did you do rather what has happened to you to bring about this reaction
COULD THEY HAVE BEEN TRIGGERED?

33. Complex Developmental Trauma
Childhood trauma can affect development.
Behaviours which include the fight, flight or freeze response can make children more vulnerable to subsequent trauma
Parents who would normally be the ones to help children through their trauma may be unavailable because of their own trauma histories.
In the cases of neglect/deprivation, incest, sexual abuse, physical abuse, abandonment, the caregiver is the actual perpetrator of the trauma or has failed to protect.
The child grows up with the belief that the world is not a safe place. The very person that is supposed to be keeping them safe is the one creating the trauma
POINT 3-BLOCKED OR UNRESOLVED TRAUMA CAN KEEP PARENTS FROM HELPING THEIR CHILDREN HEAL FROM THE CHILD’S EXPEREINCE OF TRAUMA

34. More Impact…..
•A child’s response to a traumatic event may have a profound effect on his or her perception of self, others, the world, and the future.
•Traumatic events may affect a child’s:
Ability to trust others
Sense of personal safety
Effectiveness in navigating life changes

35. The child grows up with the belief that the world is not a safe place
The child grows up with the belief that the world is not a safe place. The very person that is supposed to be keeping them safe is the one creating the trauma
A child’s response to relational trauma may have a profound effect on his/her perception of self, others, the world and the future.
Among these impacts are:ability to trust others, sense of personal safety and effectiveness in navigating life changes
A great deal of work was done in the early days of understanding the collective impact of trauma on children. why were children behaving the way that they do?Understanding internal working models was very helpful. Internal working models are the messages we tell ourselves about how the world works. Messages about ourselves-- eg. I am safe. I am worthy of love and kindness, caregivers are safe or unsafe, the world is a safe place

36. Every Person Has Infinite Worth
Kent Hoffman

37. Understanding Internal Working ModelsV

38. Parallel Process Child Caregiver Helper Cognitive Emotional
I am unlovable, bad, not worthy of your time and attention
I am an ineffective parent
My child does not love me
I am ineffective, not able to connect or make a difference to this child and family “ the family needs to work harder”
Emotional
Deep sense of shame, anger. lack of trust, I have no impact
Frustration, Ambivalence, Distancing, Sadness
Frustration, “I am working harder than the family”
Behavioural
Avoidance, aggression,
overreacting, shutting down
disconnection, ending professional relationship
The Cycle
blocked trust
no one has worked harder that me and it does not make a difference
take out?

39. Think about a time…
}When a child’s attachment system was activated and your physical and emotional closeness made a difference? }
}What did you do?
}What was the child’s response?

40. KEY TAKEAWAYS- WHAT HAPPENS IN THE ATTACHMENT RELATIONSHIP EARLY SHAPES THE CHILD ATTACHMENT STRATEGY
THIS IS THE TEMPLATE FOR ALL FUTURE RELATIONSHIPS
THE CAREGIVERS RELATIONSHIP TO THE CHILD CAN BE SHAPED BY THIER OWN UNDERSTANDING OF THE WORLD BASED IN PART ON THEIR VIEW OF THE SELF, OTHERS AND HOW THE WORLD WORKS
THIS UNSERSTANDING CAN LEAD TO A SHIFT IN THE CAREGIVERS RESPONSE TO THE CHILD
THE HEALING OCCURS IN THE RELATIONSHIP
THE CHILD BRINGS ALL OF THIS TO ALL FUTURE RELATIONSHIPS INCLUDING YOUR VERY IMPORTANT ROLE WITH THE CHILD

41. Healing Happens In Relationship
this is why we MUST engage the family-- intergenerational trauma is transmitted through unresolved trauma in relationship

42. Using a trauma lens to understand behaviour
trauma lens activity using the Stone and Rhodes Case Study

43. Trauma Informed Principles:
safety
consent
choice
voice
empowerment
trust
collaboration
compassion

45. Child and Youth Outcomes
“When I emancipated out of foster care, I was very alone,”
Child and Youth Outcomes
Youth exiting foster care;
less than 30% obtain employment
roughly 50% complete high school
Are at higher risk of;
Involvement in justice system
Homelessness
Substance abuse
Becoming parents earlier
Living in poverty
Using public assistance:
Mental Health difficulties

46. TOGETHER WE CAN!
Take a moment to ask yourself- one one thing will stay with me that I can do differently after being a part of this discussion today.

47. Questions?
Comments