Thank you to all who attended DDP Level 1 training here (27-30 January) with Julie Hudson. DDP is a treatment model for professionals working with traumatised children to improve attachment relationships. You can find out more about DDP (Dyadic Developmental Psychotherapy) and our other training courses for professionals here
Where is the support to make adoption a good option for traumatised children?
The Children’s Minister, Michelle Donelan, recently wrote to all Directors of Children’s Services urging them to consider adoption as a permanence option, stating: “we are determined to see adoption pursued whenever it is in a child’s best interests.” This follows a steady decline in the number of adoptions in the past four years, in spite of rising numbers of children in care.
Permanence and stability, whether it is in an adoptive home, special guardianship home or foster care is rightly what is needed for children who cannot live with their birth families but we are still missing the point. You can’t just transplant a traumatised child into a new family and think the child and family are going to thrive. Children who have suffered ‘significant harm’ through abuse or neglect in their early years need long term therapeutic support. The Adoption Support Fund (ASF) has been a welcome step forward for adoptive families to access support, but the capped level of funding means that those families who need more than a low level of intervention are still not getting their needs met. Without more support, over and above the capped ASF, adoption is setting many new families up to fail.
What is needed is a more systematic approach to assessing children in a multi-disciplinary way so that their complex needs can be addressed, and a streamed allocation of ASF funding would ensure these children and their families get the appropriate level of support. Our research shows the significantly improved outcomes for adopted children with complex needs who received holistic therapeutic support. As a society, we need to design an adoption system that works for the families who come forward to provide a loving, stable home to our most vulnerable children.
Our Sensory Integration OT team have put together some great sensory activity ideas to try and tips for the festive season which you can see here.
Season’s Greetings from all of us at Family Futures!
Contacting Family Futures over Christmas – please click here.
Great creative arts work by an adopted young person here who created this landscape for his favourite soft toy, then told a story of the toy’s self-sufficient lifestyle.
Alex Soteriades, Teacher and Trainee Art Therapist, reflects on how art therapy can help developmentally traumatised children
Children are naturally creative, as are adults and sometimes it’s easier to explore a feeling by ‘making’ rather than by ‘talking’. Art therapy is a vessel for dialogue. Its nonverbal and non-threatening approach allows children to tackle difficult and sometimes traumatic issues they are experiencing.
When a child makes art, the therapist along with the child can attempt to interpret and make sense of it; this is sometimes called the triangular relationship. This approach is useful in organising, describing and integrating emotions and memories but also allowing the child to sit with and tolerate the unknown.
Adopted children can do to the artwork what they can’t do to people and this is so profound and empowering for many children that come to Family Futures.
In this way, art can be loved or unloved, survived or destroyed, but ultimately, it can preserve imprints of one self and provide an opportunity to express metaphor. In fact, one of the benefits of art therapy is the ability to embolden and enrich storytelling and narratives through the use of metaphor.
When a child experiences something tragic and terrifying this gets buried in their unconscious. Storytelling and art making through use of materials such as paints, pencils and clay can help bring these suppressed emotions to the surface and in some cases, help to reconnect with the body when it has been cut off from feelings.
With the support and guidance of the therapist, these narratives serve as a way to gently and safely release disturbing or terrorizing experiences and offer children a sense of choice and control in order to begin the healing process.
Family Futures will be closed from 5pm on Monday 23rd December 2019 and will re-open at 9am on Thursday 2nd January 2020.
If you are a family in treatment with Family Futures and have a serious emergency or crisis during this time and you think that the crisis requires the emergency services, we suggest you call them first. You can then ring into Family Futures on the main number 0207 354 4161.
On the days when the office is closed (Tuesday 24 December to Wednesday 1 January inclusive) a Duty Manager will be available between 10am and 5pm. On days when the office is open you can contact a Duty Manager between 5–9pm.
If when you ring in, you then press 3 as instructed on the answerphone message, it will divert your call to the Duty manager’s mobile.
Please leave a message with your name, number and why you are calling and the Duty Manager will call you back as soon as possible. We hope however that you have an enjoyable Christmas and New Year.
Julia Press, Senior Social Work practitioner, reflects on Adoption Assessments at Family Futures
Joining the i-Adopt team at Family Futures really enlightened me as to how assessments of prospective adopters can, and should be done. That is, effectively, therapeutically and meaningfully, while always holding the ‘developmentally traumatised child’ in mind – the child who will, if all goes well, be placed for adoption with the families who are being assessed.
While following the standardised two stage assessment process, Family Futures ventures away from the traditional style of assessing, which may typically involve a social worker travelling to the home of a prospective adopter and asking questions which enable the professional to get to know them and assess their ability to adopt.
An assessment at Family Futures is approached quite differently – it is an education programme, for both the prospective adopter/s and the professional team – a two-way process where each party is learning, and equal to the other.
Stage one of the assessment entails completing a Taster Day at Family Futures which helps the team and applicants to understand their attachment histories and styles. This includes their ability to confide and the active use of their family and friends network. Prospective Adopters also gain insight into the therapeutic tools used with families who are engaging in post-adoption therapeutic support at Family Futures. These tools are experiential and incorporate creative arts and drama techniques. For example, we utilise paint, clay, sand and movement to explore a variety of issues which help prospective adopters to emotionally engage with the material.
Those who struggle to relay information verbally also have the opportunity to convey information in an alternative format. The tools are powerful in terms of their ability to unlock what’s beneath the surface (the unconscious) and they allow the Assessor to observe the capacity of prospective adopters to engage with difficult material, their openness to a variety of therapeutic approaches and their capacity to be creative and playful – crucial information for us when we are considering placing complex needs children within these families.
Using the approach and tools described above, Stage two of the assessment process builds on Prospective Adopters’ understanding of themselves; their histories, relationships, strengths, vulnerabilities, stress responses and triggers. This stage also addresses each applicant’s journey to adoption, paying meaningful attention to experiences of loss and possible unresolved feelings associated with infertility or miscarriages. Crucially one module of learning is devoted to the experiences of children who are removed from birth families and the impact of this, with particular focus on Adverse Childhood Experiences and Significant Harm.
In my experience an in-depth understanding of trauma, plus a commitment to apply, and the ability to deliver, therapeutic parenting, aids the success of a placement.
Crucially, an assessment and education program at Family Futures also involves a multidisciplinary team, including a Social Worker, Therapist, Occupational Therapist and Education specialist, who are there to guide and support, offering varied experience and insights from diverse perspectives. Family Futures also pledges to continually nurture a family’s support network, to strengthen the placement by assisting their understanding of the reality of adoption today and what it entails. Our team also identify what support people can offer the family to avoid isolation often felt by adopters post placement.
While I fully endorse the Family Futures approach to assessing prospective adopters and think that this acts as a strong foundation to healthy family life, I am sure this is not enough for children who have suffered trauma and abuse. Matching children for adoption is not the happy ending of a nightmare. Wounds do not disappear. They may reopen, become infected and hurt. They need thoughtful and ongoing aftercare, to help the healing process. Scars are a reminder that we need to care for families’ long term needs. Families require ongoing therapeutic support to ensure that they can continue to heal, grow together and thrive – this is something that urgently needs to be secured for adoptive families now and in the future.
After 21 years at the helm of Family Futures, our co-founder Alan Burnell, retired in September 2019. You can read a Q&A with Alan which featured in Adoption Today magazine (October 2019) here, about the highlights of his career and his hopes for the future of adoption services.
Adoption Today is a magazine for Adoption UK members. If you are interested in more information about the magazine visit: https://www.adoptionuk.org/adoption-today.
New research by Family Futures, to be published in the Journal of Child Abuse & Neglect, November 2019, provides supporting evidence that a therapeutic intervention which is neuro-developmental and holistic in approach improved outcomes for children who had experienced developmental trauma and who had later been placed for adoption.
There is substantial evidence regarding the life-long impact of early maltreatment and adverse childhood experiences (ACEs) on health and social prospects, mental health, violence, criminality and poor engagement in education. Children who have been maltreated and subsequently fostered or adopted are more likely than others to have been subject to ACEs prior to their removal into care.
There is limited published research, however, that indicates what is effective in treating older adopted children who have experienced maltreatment and sustained trauma in their birth families. This study is the first to compare outcomes for adopted young people who received an integrated multidisciplinary treatment intervention with those who were recommended the approach at assessment but were unable to receive it (mostly due to funding restrictions).
Family Futures’ neuro-sequential and multidisciplinary treatment model, NPP (Neuro-Physiological Psychotherapy), is informed by neuroscientific research on the impact of maltreatment on the developing child and by therapeutic models such as Ayres Sensory Integration, Theraplay and Dyadic Developmental Psychotherapy (DDP). Alongside regular NPP family therapy sessions the model supports applications of its principles at home, school and in the wider family network. In doing this NPP provides wrap-around therapeutic support for adoptive families and children in alternative care settings.
Dr Elaine McCullough, author of the research said:
“This is currently the strongest evidence for a therapeutic intervention for adopted children who have experienced developmental trauma. The results indicate the potential far-reaching improvements the NPP model can have for adoptive families. However, the findings have also highlighted the detrimental consequences for some families of not receiving appropriate support.
Therapeutic interventions need to influence all aspects of the child’s system to improve outcomes and long-term impact. It is important that health, education and social care provide consistent and joined-up support for children and their adoptive families. This support should be informed by neuroscientific research on maltreated children and acknowledge the impact of developmental trauma on the underlying neurological and physiological aspects of their emotional, cognitive and behavioural presentation.”
These research findings are consistent with the recent Adoption Support Fund study (Gieve, Hahne and King, 2019) which concluded that although moderate improvements were found from interventions offered through the ASF, there is a need for wider support than traditional individual therapy, to support children with complex underlying difficulties. It is hoped that this research can inform policy and practice in effective support for children who have experienced maltreatment, abuse, neglect, and/or Adverse Childhood Experiences.
The full research article was published in Child Abuse & Neglect, 97, 104128: McCullough, E., & Mathura, A. (2019). A comparison between a Neuro-Physiological Psychotherapy (NPP) treatment group and a control group for children adopted from care: Support for a neurodevelopmentally informed approach to therapeutic intervention with maltreated children Child Abuse & Neglect, 97, 104128.