Working with Children Who Have Been (Or Still Are) In the Foster Care System- Attachment Trauma

Many of my therapy experiences with kids who have had multiple placements have been cut short due to, yes, another move. Foster parents are only human, of course, and can only handle so much disruptive behavior before they meet their limit of patience. Treatment of this kind is a lengthy process, and results in the form of “good” behavior don’t come quick. Placements are lost; kids are moved. And so the system goes. 

Without running off on a complaint tangent over the current state of DHS/CPS affairs, and without focusing on the many reasons that total reform is imperative, I will give some hopefully helpful advice on working with these precious, hurting kiddos:
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1. Expect non-compliance. Expect it. Do not be shocked, bewildered or otherwise surprised when your young "client" or "placement" does all manner of indiscretion. (Also expect continuous and ongoing bad reports from other caregivers or teachers.)
2. Likewise, expect (though not as common) overly-compliant, super-charming behavior. Expect it. Do not show favoritism to these hurting little ones. They aren't "better" and they don't like you more. They have only found a more effective way to manipulate others and hide their pain.
3. Do not, under any circumstances, take their words, actions, disrespect, avoidance, resistance, hot-cold, or other interesting behaviors personally. (Well, unless you are a jerk and you deserve it. Otherwise, definitely do not take it personally)
4. Remain calm at all times. Part of hurting kids’ technique is to stay in control. (Actually, that's an adult technique, as well.) If they can keep others (especially those in “power”) off balance, they have created a false sense of control for themselves. If you are busy dancing around random chaos, you won’t be able to address their emotional wounding or allow them to get close to you (which, in their mind, will lead to more hurt). By remaining calm and neutral, you can help 1) establish environmental/ external safety which the child can eventual internalize, 2) establish relational safety by giving the child permission to “act out” without judgment and/or punishment (which can trigger issues related to abandonment, rejection, abuse, and all sorts of other unpleasant emotions).
5. Focus on the relationship more than the behavior. If you charge in 'locked and loaded' with your arsenal of behavior management techniques, you’ve lost before you ever even began.  Behavior modification is not the goal; teaching the child to have healthy relationships is. Rewiring their over-responsive fight-or-flight response is.  Relationships do include a strong component of safety. Therefore, it is imperative that safety be addressed, but in a manner that conveys not “rule following,” but rather an emphasis on mutuality of “I care about you and want you to be ok/happy/not hurt/etc.”
6. Ask questions. Be interested in the child. Every heard of the phrase “People won’t care how much you know until they know how much you care”? This is especially true for kids, doubly true for hurting kids and thrice true when you understand that they have laser straight BS detection.
7. Explore the environment through visits to local attractions (zoo, discovery lab, botanical gardens, aquariums, etc.); through the use of textile toys (sand tray, homemade snow globe/stress bottle, squishy toys, bins of beans, rice or un-popped popcorn kernels), and through expressive mediums (coloring books, clay, paint, music, dance, etc.). Help him or her discover his or her own likes, opinions, thoughts and interests. (Most of the time they don’t know yet, as there is usually a trauma response of alienation from self.)
   
8. Likewise, treat each incident of unpleasant behavior as a neutral yet interesting topic for exploration: no blame, no judgment. Just curiosity. “Ask yourself (and the child, if appropriate) "I wonder why…?” Or, “If I did that, it would probably be because (fill in an age-appropriate and safe therapeutic hypothesis)… is that kind of close to what you were feeling/thinking?”
   
9. Help them explore their own strengths and learning.  You may Ask, “What kind of advice would you give someone who has been through…?” If they can't answer, offer what you have noticed about their healing journey.  Don't forget to reframe difficult behavior as a technique for self-protection.
10. Be curious about the child or teen as a human person. “Tell me about… (that, your day, your thoughts, why you like ____________?)"  The interest, positive attention and 'serve and return' interactions you provide will go a long way.  These interactions may not manifest in healing until later.  Think of it as planting seeds; the harvest will come in season.)
11. Celebrate. Every. Little. Thing. Treasure boxes and verbal praise are a must.  “Whoa, dude!!! How did you do that?! You (fill in small accomplishment)!!! What?! High five!!!”  Catch them being good so you have more opportunities to help fill their empty bucket with appreciation, appropriate human affection and feelings of “I’m noticed/worthy/cared for.”  This is more about relationship than behavior modification, so keep your expectations focused on long-term attachment abilities rather than short-term behavior adjustment.
12. Collaborate with other professionals. We can get stuck in our own groove-thang, fail to remember we have a “blind spot,” or become used to the new normal of perpetual resistance- any of which can further stall already difficult progress. Bounce situations, parenting techniques and/or therapeutic interventions off other professionals’ heads. Be willing to receive feedback, advice and critique.
13. Self care, self care, self care! Working with high-need kids is challenging and draining… and those results-oriented rewards can be few and far between. Taking time to unwind, decompress and re-charge your emotional batteries is a must.

​Photo credit: Stock photo (Microsoft)

Bless you, my fost-adopt friends and much, much love to anyone who was raised in the system.  You are stronger than you know. -M

Subscribe to the therapist's mental health vlog at Can We Talk? or find me @TweetmentPlan. 
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foster care, behaviors, foster parents
#fostercare #fosterparenting