Parental Consultancy - Initial contracts and other agreements
I had been recruited to work with the agency and their safer recruitment procedure was followed. This included an application form, referees taken up, and an enhanced DBS check required. I received regular supervision and worked with 6 different families over about 5 months.
The referral to work with Kate and David Brown was made by an adoption support social worker from the Regional Adoption Agency. I held an initial consultation (over Zoom) with the parents and then drew up a therapeutic contract, which we all signed. We agreed on a total of 6 weekly sessions, with a review midway and at the end. Each session would last for an hour. Kate and David initially wanted to concentrate on their parenting and explore what therapeutic support may be appropriate for their children. They were sent the confidentiality and safeguarding procedures together with details of the comments, compliments, and complaints procedure. The work was to take place over Zoom, which meant that face-to-face safety and working in other premises was not an issue. However, I used an email address from the agency and only gave my mobile number. At no time during my work as a Parent Consultant did I see Oliver or Marcus. The work was with their parents.
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Parental Consultancy - Therapeutic Plan
Parental Consultancy - Outcomes
My hopes for the parents were that they became more confident in their parenting, gained further understanding of their children, and had additional strategies to use. I also hoped that they were clearer about what further therapeutic support might be useful for their children.
Parental Consultancy - Therapeutic process
Initially, we looked at self-care and the importance of putting your own mask on first, even for 5 minutes at a time. We also considered The Wall (Adoption UK, 2005) and which bricks might be missing for each of the children, leading on to discussing therapeutic parenting and starting from the bottom upward to rebuild. We looked at how their behavior is their communication, and we need to be 'detectives' to decipher this at times; guesswork and trial and error are involved too. Using two strategies from Non-Violent Resistance (NVR) xxxxx the parents agreed to break the behaviors into baskets (priority, can leave it for now, and ignore) to focus on key issues they wanted to consider. The second one we looked at was reconciliation gestures such as leaving a note on their pillow at night and a little chocolate bar in their school bags. Both Kate and David agreed to try these. It was important that we had a few 'quick wins' at the beginning to build confidence and also to increase connection and attachment. Both Oliver and Marcus loved the reconciliation gestures.
Moving on from this, we considered developmental trauma and brain development. I used the online resources from Beacon House as these are relevant and easily accessible, with clear explanations. We discussed the 'Bottom-Up Brain Diagram' and the implications of the 3 brains and how both children often operate out of survival mode. I explained the work of Bruce Perry and his Neurosequential Model of Therapeutics CITATION Bru03 l 2057 (Perry, 2003) Although it is not a technique as such, but rather a theory related to trauma-informed and neurodevelopmental practice. Leading on from this and relating to the sensory needs of both Oliver and Marcus, I introduced the BUSS Model (Sarah Loyd). I linked this to 'The Wall' and the work of Bruce Perry, explaining how the model provides a way of rebuilding some of the brick in the wall and also starts work from the bottom up, so fits well with the other ideas we had covered. Following the sessions, (Kate and David Brown attended an introductory BUSS session to develop their understanding.)
We looked at putting some of this into practice with PACE (playfulness, acceptance, curiosity, empathy) (Hughes, 2009), which Kate and David were familiar with. I felt it would work well with their style of parenting; they both have a gentle sense of humor and show empathy toward their children and the trauma they have experienced. Hughes explains that 'PACE encapsulates an attitude, an interpersonal stance toward one another that cherishes and invites the development of one person without hurting the development of the other'.CITATION Dan09 p 69 l 2057 (Hughes, 2009, p. 69).
A difficult situation in the family can be Marcus' homework and it can lead to a meltdown. We discussed this and considered setting a target of 5 minutes per evening, eventually aiming to increase this to 10 minutes. Marcus has a strong sense of justice, as do many children who have been looked after. However, some of his perceived injustices, do not sit well with others and again can lead to meltdowns. We have talked about the importance of acknowledging these injustices, using PACE xxxxxxWe considered how PACE is an overall attitude, not a one-off action, and how empathy can be used to develop secure attachments, including using facial expressions. Kate commented that Oliver often appears to be searching her face, asking if she is okay. This seems to be a way for him to check that she is not annoyed with him.
We looked at how Hughes discusses intersubjectivity and explains connecting with the parent is the way that a child learns. The connections need to be positive and responsive. For example, if a child is struggling to do something and they can't do it, and their parent helps, this calms and contains the child. The child can then regulate and feel supported by the parent. By this focus on the child, their needs, and emotions, the child feels listened to, and valued, and recognizes that they are important.
Kate and David were concerned that Marcus may have Autistic Spectrum Disorder. Whilst this may be the case, I was keen to point out that that some of the signs and symptoms of developmental disorder can be the same as those of ASD. Many areas of the brain can be affected by developmental trauma and the signs and symptoms can mimic those of Autistic Spectrum Disorder. We also discussed how sometimes this is diagnosed and found later not to be the case, with the child then stuck with an inappropriate 'label'. I was clear that I could not, and would not diagnose, and that if they wished to have this assessed further then they would need a full diagnosis by a relevant professional. Reflecting on this, they decided to pursue developmental trauma first.
Parental Consultancy Prognosis
Both Kate and David Brown are excellent parents for their children. They give unconditional love to them and aim to be therapeutic in their parenting, understanding that much of their behavior comes from their traumatic past. I believe that, even though there may be difficulties in the future, they will parent their children to the best of their ability.
Parental Consultancy Concluding remarks
The sessions went well. This was the first time that I had worked with parents on a consultancy basis, and I was pleased that I had theories and strategies at my fingertips, many of these directly from the MA course. I also used supervision to discuss and reflect on my work, which enabled me to think clearly about the family and their needs.
Therapeutic Life Story Work - Initial contracts and other agreements
On the completion of the Parent Consultancy work and one of the outcomes being that life story work would be appropriate for both children, I approached the parents again in a different capacity. I explained that I was a sole trader and was studying for a Professional Diploma in Therapeutic Life Story Work with Richard Rose, a key practitioner in this field, and that I was looking for a family to work with. They were interested and felt that as I already had a relationship with them, it should work well with the children.
I approached their Regional Adoption Agency (RAA) to request that they support me in this work. Although initially tricky at first, it was agreed that they would work with this. I was to be treated as a 'Provider' but without any money being involved. The RAA requested that I develop various policies and procedures: safeguarding, confidentiality, comments compliments, and complaints, GDPR (General Data Protection Register), and a privacy notice. I also became registered with the ICO (Information Commissioners Office) and increased my insurance to cover therapeutic life story work as well as training and consultancy.
A meeting was held with both Kate and David Brown, a manager from the Post Adoption team, and myself to discuss the work. I explained that the work would be in 3 sections, with us meeting once a fortnight over 18 sessions and I would work with each child for an hour, with some sessions together as needed. The 3 sections were: information gathering, working with the children, and providing each child with a record of the work we had done together.
Therapeutic Life Story Work - Therapeutic Plan
Therapeutic Life Story Work Outcomes
The outcomes for both Oliver and Marcus were the same: to enable them to understand their present and the connections to the past in a way that was appropriate for them. As Oliver was 12 years old and asking questions about the other families he had lived with, I felt that he was likely to be more comfortable going further than Marcus might be, as he appears to be uninterested in his past and is emotionally immature. I explained to both parents and the adoption support social worker and her manager, that I would work at the children's pace and it may be that we got so far and it could then be picked up again at a later date.
Therapeutic Life Story Work - Therapeutic process
Our introductory session was held at a park. This was the first time I had met the parents face-to-face and also the boys. They like dogs so I took mine (who has attended all sessions since), some dog treats, duck food, and chocolate buttons for the children. We spent an easy hour in the park, just chatting, laughing, feeding the ducks, having hot chocolate, and getting to know each other. The children were easy to talk to, both having a lot to say about their friends, their own dogs, and their family. Kate also brought the signed permission form for me to work with the children.
We have now done six more formal sessions at their home, recording all the work on wallpaper, showing that we can go backward and forward in life. We have followed Covid regulations with lateral flow testing and Kate, John, and I have all had both vaccinations. I spend an hour with each child and a parent is also present and joins in; both Kate and David attend sessions and are fully supportive of the work I am doing. At each session, we played games ' Jenga, uno, pontoon, yes and no, or double, and during the first three sessions, we did some activities about our likes, dislikes, etc (drawing around our hands and recording our views). Whilst continuing with the games, and if it got too difficult for either Oliver or Marcus could request a game, we then moved on to looking at feelings and how we manage these.
Oliver was 100% focused on this and we developed a good trusting relationship early on. He spoke to me about school, expressing his unhappiness at not having friends and what was important to him. He was able to talk about himself and ask questions about his past, explaining the parts he consciously remembered. At times, he would well up with emotion and quickly ask to play another game. We looked at the needs of babies, keeping them safe, and how his birth mother (or first set of adoptive parents) could not do that. He has found it easier to accept his emotions as time has gone on and, at the last session, expressed a desire to see his 'tummy mummy'. (Kate was there at the time and managed this request well even though, it brought up tough feelings in her, 'he's mine'. We discussed it later and she said she would manage this and meet with their birth mother as and when it was appropriate if that was the best thing to do.) Kate has said that Oliver 'gets me' and I 'get' him, and I agree with this.
Marcus also engages well ' he waits for me at the window as soon as I pull up and know what game he wants to start with. His behavior can be erratic, sometimes he is focused and shows real insight into his behavior, explaining why he runs, how he is feeling, and how he wants to come back to the family home. At other times he struggles to stay in the room and is hyperactive. I have provided a sensory box for him to use, which he has enjoyed (along with Oliver), choosing different items to try at home and to take to school; his teacher is supportive of this. The family is now building their own sensory box, and everyone is contributing to its contents. Any suggestion of feelings by me or either of his parents result in shut down ' he says he does not want to talk about it. I have used the book, 'Invisible String', X which he enjoyed. He was able to draw his heart and add all his invisible strings to it, naming the people (and animals). He included his birth mum and dad and me. We then moved on to look at how much love there was in his heart, asking what else was in his heart. He did not want to talk about it or record that he did not want to talk about it. We have referred to his invisible strings and he has responded well to this. I have also used the book, 'The Huge Bag of Worries' xx. Again, he enjoyed the story but was unable to talk about the worries in the book or his own, even though Kate and I talked about our worries. Kate and I have discussed this, and I will bring it to my next supervision, but my plan for next time is to do a body map and talk about him as a baby, with Kate bringing his red baby health book. Kate feels that Marcus sees my role as playing games with him, so we feel it is time to be proactive and see how he responds to this.
Therapeutic Life Story Work ' Prognosis
I believe that, with both children, we will make progress toward their understanding of their lives and emotional acceptance of this. I am not sure how far we will get but feel that it is likely they will want to meet their half-sibling and Oliver may want to pursue meeting his birth mother. Once all the sessions are finished (November 2021), I will then work on creating a book for them on the work they have done with me. I will email a few pages over each so that, even though the sessions have ended, we still have contact, and the ending comes about 3 months afterward, when they have agreed on the pages in the book, and I send a final one over.
Therapeutic Life Story Work ' Concluding remarks
I have found working with the family, both the parents and the children, to be a learning experience for me. Until I worked as a parent consultant, my work was facilitating support groups or delivering training and I did not work in depth with individuals. I realize how much I have learned from the MA course and how this has provided a sound basis for my work as a trainee Therapeutic Life Story Worker.
I intend to continue with this work, developing my understanding and practice in relation to the theories I have learned as well as continuing as a trainer. I feel that my learning from the course, the reading, the tutors, and colleagues has been life-changing in my career. This has been the first time I have undertaken formal training, since my teaching certificate, over 40 years ago!
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