Ask Ann

"The Therapist"

By Ann Houck

3 minute read

What's your thought on children's shelters contracting full-time therapists?

True confessions time. I am an enormous advocate for Trust Based Relational Intervention (TBRI).

This is not a new term to this space, but in case you are new, let me give you a short introduction.

A number of years ago, a couple of developmental psychologists (Karyn Purvis and David Cross) from Texas Christian University started looking at what happens to children from “hard places.” In other words, kids that have suffered complex trauma from the get-go.

They discovered a lot about these kiddos through research and experience. And, they developed what has come to be known as TBRI.

What did they discover?

These kiddos need caregivers with good parenting skills. They need caregivers who can provide them with a safe, trusted connection. They need caregivers who know how to empower them and they need caregivers who build a foundation of safety, trust and empowerment that gives them the ability to correct their maladaptive behaviors. They need caregivers who create a family.

They need caregivers who create a family.

So these children who have been maltreated, frequently from the time of conception, arrive on our doorstep needing a family that will give them what they have not yet experienced. Where do you start? You want to help these kids and maybe think that if you just love them, it will be enough. Then reality sets in.

 

There are those children who won’t talk; won’t look you in the eye; will refuse to do anything that is needed or asked or scream uncontrollably when touched. There are many, many other maladaptive behaviors.

The reality is, you probably have no idea of their full history. You will not know what harms they have suffered and if you did, you would most likely be very, very sad and angry.

So, the topic of therapy usually comes up. Where is the therapist?

And here’s my answer—

Ultimately, it is you.

Most often, children are treated through the traditional medical model—consisting of visits to a practitioner’s office, with caregivers playing a superficial role in the child’s treatment. However, interventions that include caregivers may be more effective because treatment occurs in the child’s environment where challenges occur. While children may spend an hour a week in a professional’s office, they spend vast hours in the care of their parents or caregivers. In particular it has been noted that relationship-based trauma can only be resolved through loving, stable relationships, such as can be offered by nurturing caregivers.”

(Purvis KB, Cross DR, Dansereau DF, Parris SR. Trust-Based Relational Intervention (TBRI): A Systemic Approach to Complex Developmental Trauma. Child Youth Serv. 2013 Oct;34(4):360-386. doi: 10.1080/0145935X.2013.859906. PMID: 24453385; PMCID: PMC3877861.)

Begin with the love, then move into learning how you can provide what the child needs. In some cases, you may feel the need to supplement your caregiving with therapy. There’s nothing wrong with that, depending on the situation. But what happens when there are none available, or you have limited access? Fortunately, one of the wonderful things about the world wide web is that you can access so much information to help you learn what you need to take care of these children.

After the love, create a family environment in your home. Begin with a relationship among the caregivers; you are the parents and you want to be providing the same kind of care. Watch videos, read and discuss. Once you realize what a child needs, you can meet that need, and move that child into a better place.

Start here:

The Connected Child, Purvis et.al., McGraw Hill

Ann Houck

Licensed clinical social worker; volunteer social work supervisor for Oak Life interns; experience working with children of trauma in child protective services and school social work settings.

Ann Houck

Ann Houck

Licensed clinical social worker; volunteer social work supervisor for Oak Life interns; experience working with children of trauma in child protective services and school social work settings.

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