I Don’t Have That Badge Anymore – a child free from PTSD

I Don’t Have That Badge Anymore – a child free from PTSD

I don’t think I have ever shared direct words from any of my clients before. I have thought long and hard about doing it now, and the reason I am sharing what this incredible boy wrote as part of our closing process, was because HE wanted it shared. The idea that his experience can inspire school staff to know that children can change, was really important to him. The idea that others – even adults – who still find themselves journeying through PTSD, could be encouraged by his words and his journey was equally important.

“Since working with Claire I have changed in many different ways. I have changed the way I act around people. I have changed the way I see things. Everyday I think about how much Claire has helped me come to be who I always tried to be, how I don’t try to be any body, I don’t even try to be myself – I just be the person I am.

I used to say the words PTSD (Post Traumatic Stress Disorder) like I had to say it or like I had to make everybody know that I have PTSD, however now I have changed. I no longer wear a badge that says ‘I have PTSD’ because I don’t.  I am not ashamed of having had PTSD nor am I proud. I don’t think about PTSD and I havent even spoke about it in so long because I don’t need to anymore. I feel free from and unleashed from the horrible badge called PTSD.

My time with Claire has been an unforgettable experience and has been a roller coaster, not always easy and not always fun, but for sure it’s one of those one-time life-time changing experiences you just can’t say no to.”

Boy, aged 12,Shared with permission – as he hoped it might encourage others with PTSD that things can change.

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What to Say and Do When a Therapist is Absent

What to Say and Do When a Therapist is Absent

What can seem like such a small thing can actually have a massive impact on a child.

When a child is working with a therapist in school, when that therapist cannot be there HOW THE MESSAGE is communicated to that child is CRUCIAL.

I know from personal experience what can happen if this is not done well. For one boy it meant he no longer had trust in me and shut down his therapy sessions all together. (The full story is here).

I have seen this situation mishandled in schools since and it has bothered me enough to put together a short guide which you can download now for FREE.

Procedures for Therapist Absence-cover

  • Understand WHY this is such a big deal
  • Procedures ALL your key staff (including admin team) to follow when this happens
  • WHO should communicate with the child, HOW and WHERE
  • EXACTLY what to SAY to keep the child as emotionally safe as possible
  • Other things to consider around this time

Get FREE download

“This is a great document that will be really useful for staff to see the gravity of their/ our actions and the impact it might have on a child.”

HEAD TEACHER, Staffs

“This is an extremely useful document that I am about to pass on to all the schools I work in. Easy to read and understand and something that all schools and other organisations who employ play therapists should read.”

PLAY THERAPIST, Cambs

“Thanks so much for this. It’s brilliant! Thank you for enabling us all to share this in our practice and well done for putting together such a concise and helpful piece of work.”

CREATIVE ARTS THERAPIST, Bradford

The Day I Wasn’t There – how poor communication impacted a child’s therapy

The Day I Wasn’t There – how poor communication impacted a child’s therapy

Any professional play therapist working in a school or other setting will have a set of procedures that their colleagues know to follow if, for any reason, they cannot be there unexpectedly.

16-To-Do-List-Managers-as-Open-source-Web-AppsI went through my procedures with every single school who referred children to me, during the pre-clinical phase of setting up work with each child.

Not sure what a good procedure should be in this case? Click here for a free download that will explain all.

The sessions with this particular client had taken a while to get set up; the meeting with school was ok, but the parent meeting got scheduled and cancelled twice before we changed tack and the school got Dad’s consent and initial SDQ completed over the phone.

I was just 3 weeks in, and already had a special place in my professional heart for this street-savvy boy. With a background of pain and chaos, I remember him still being too cool for school, but starting to open up to the  possibility of a relationship – enough to ask me about my experiences and what I thought about stuff…

It was early days, but it was looking good, and I was hopeful.

Then I was ill.

A special combo of laryngitis and pharyngitis had me in bed with no voice and feeling rubbish. I had a week off work. I made the necessary calls and emails, I did everything I could to let the key people for each of my clients know it was time to follow the procedure I had outlined at the start of my work.

This was the only occasion where for whatever reason, the message I left didn’t get passed on. I understand that schools are busy places. I know that school staff on average deal with a million or a billion, (or is it a bazillion?!) things each day. I know that even with the best intentions, it is easy for things to get missed. It is just a shame that this was the thing.

It got missed.
message-in-a-bottle-1The message didn’t get passed on,
The child was brought to the venue by his support worker.
They couldn’t get in.
There was no answer to their knocking.

I can only imagine, what that experience may have been like for him.

This woman who he had started to like and started to trust, was suddenly not there for him. He didn’t know why. He would likely have felt stupid, but that would have been the least of it. The sense of abandonment, confusion, shame, anger and bewilderment may have been acute. His special Gran had died 2 months before, and his mum – an addict – had left him years before. My sudden absence; the hat trick confirming to him that women leave you and that people are not to be trusted.

When I came back to work the next week, unaware of what had happened (some schools’ communication with external workers is truly stunning), expecting him to turn up for his session….now I was the one left waiting.
It turned out he was digging his heels in at school and refusing to come. They didn’t know why– ‘he’s been fine every other week’.

He agreed to come the week after, and told me that he was not coming any more. We explored a good enough crisis ending. He heard my apology for not being there, my understanding that it must have been horrible for him and my sadness that the message I had left for him never got to him, which he seemed to hear… But his mind was set. This was the end and I didn’t blame him.

Want to ensure children you know don’t go through this experience?  This free download will tell you what to say and do to support them best.

I have often thought about him since. Wondering if he has had opportunity to find someone who he feels safe enough with to develop a therapeutic process and start to heal his pain? Wondering what might have happened if my illness had occurred further into our therapeutic journey when we had established a stronger relationship – strong enough to work through what the experience meant for him? Wondering what would have happened if I had not been ill?

I know it is unrealistic to expect that we can never be ill. However, I do believe that those of us in jobs where we work with hurting children, have a duty of care to ensure we are doing all we can to ensure our health is as optimal as it can be. It is not just about minimizing the time we are off work, but reducing time when we are there in body, but not physically able to be fully present with them, distracted by coughing, pain, etc. Children always know if we are ‘not normal’, and it often worries them. And obviously, no-one appreciates the germ spreaders – self care when we are ill has to be a priority for all sorts of reasons. Who we are always has an impact on the children we work with.

Things to Consider

?   DOES your setting have procedures that are clearly followed when a visiting practitioner can no longer attend a session but a child is expecting them?

?   DO the staff in your setting understand the impact their absence can have on certain children? (and let’s be honest -some will be thrilled if it means they don’t have to do PE or music or that test or whatever else… but others really will be wobbling inside).

?   DO your admin/office staff understand the importance of their part in  information sharing in these circumstances?

?   DO you ever consider if a child has had a strange behaviour episode – whether it may be related to someone they connect with being away?

?   Want something to pass on to your Senco / deputy head / admin / key staff to have to hand should this happen at your place? Click here for the Free Guide to what to say and do when a therapist is absent.

 

Occupational Hazard – secondary trauma at work

Occupational Hazard – secondary trauma at work

I don’t watch much TV, but yesterday I caught 2 interviews that moved me.
The first was a politician in local government who had taken up the cause over the last 2 years, of numerous people who had been sexually abused as children.
The second was a firefighter – one of the first responders to the London Underground on July 7th, 2005.

Q : What could these 2 men living at opposite ends of the country, have in common?
A : Both of them were in a state of post traumatic stress as a result of the work they do.

So often we think of ‘trauma’ as being connected with things that happen in personal lives. Maybe abuse…or being a direct victim in a horrific life-threatening experience.

Enduring FreedomWe understand that the military are exposed to traumatic situations in their ‘day job’ when they head to the front line. Sadly, many people still think PTSD is only really associated with war veterans.

However, there are so many professionals doing jobs that require them to put themselves in the line of life-threatening danger… Or require them to deal with horrific scenes…. Or get their heads around the details of the worst of society.

The TV interviewer made some comments about people not really thinking of a politician developing PTSD and co-morbid depression through his work. And maybe there are many other jobs that people don’t think could lead into the muddy pit of PTSD…

For example, would people outside of education think that those working closely with families and children in main-stream schools could be at risk of secondary trauma?

Infact, do those INSIDE those very same, local, down-the-end-of-my-road, mainstream primaries have any concept of how this is increasingly becoming an occupational hazard?

As anyone who has heard me speak about this will know…Secondary Trauma, or Vicarious Trauma is real and powerful.
AAEAAQAAAAAAAALQAAAAJDlkYTY4OTRhLTRhMWItNDU0MS1hYmY0LWZmM2Q0NDZjZDRmNAFlashbacks, poor sleep, altered moods, increased aggression, depression, tension, trouble concentrating, relationship break downs, addiction, not being able to switch off and be fully present away from work, needing to talk over and over about things, or not speaking at all, are just a few possible symptoms.

Child & family support workers, mentors, inclusion teams, TAs, LSAs, teachers, heads, deputies, child protection officers, therapists… anyone who gets close to children and families and their stories, are all at risk.

The impact of trauma is huge – some are calling it an epidemic in our time.
Around the world, military are increasingly being prepared: being educated, being helped to build their resilience and being equipped with tools to reduce the impact of trauma on their bodies and minds BEFORE they go to the field.

18668_77-bomb-memorial-bombing-terror-London
Today is the tenth anniversary of the 7/7 terrorist attacks on London.
It’s a wild and ‘out-there’ kind of thought I know, but wouldn’t it be amazing, as part of the positive legacy of that and all the other events that have taken or altered so many lives here in UK, for all workers in jobs where they are at risk of secondary trauma, to get the education they need to be fully aware and the equipping with tools that really work, to help them be ready and to minimize their risk of developing PTSD from their day-job?

‘You can say I’m a dreamer…. ‘
…but it feels like the right thing to do.
The honoring thing for employers to offer,
….and the wisest economic decision too.

I’m proud to be working with schools choosing to journey in this very direction. It’s a start!

Endings… Before they happen    ~    How to ‘end well’ for mental well-being

Endings… Before they happen ~ How to ‘end well’ for mental well-being

Fact – life is full of beginnings and endings
Fact – both beginnings and ending can be precious or painful, significant or nondescript.

The kind of endings I am thinking about right now, are the ones that you know are coming, the ones you get to do a count down to, the ones that, even though you would quite like them not to happen, and for things not to change from how they are now, you also realize they are going to happen, things are going to change and that’s how it is.

In fact in truth, sometimes these endings are, in part OK – there is an excitement about what might come next and the adventurer in me, who likes to develop and grow and evolve is fully accepting of this season of counting down to the next chapter… Let me explain.

unnamed (20)I have been doing all my clinical work for the last 7 years in the same room. It is a lovely, lovely room. Both adults and children often comment how safe and calm and peaceful it feels – for one boy “it is my best place in the world”. I like it in here too. Special things happen here.

I found out a few weeks ago that my days here are numbered. Literally. I know when the end of this term is and the date of the day I will work here, pack up and leave – not to come back to work in this place in this way again.

I feel sad. As I sit here in the peace on my own, no clients imminent, I have to acknowledge I have so many memories. Tiny tots, KS 1s, KS 2s, KS 3s, parents, teachers, other professionals have all had special moments in here.

I look round the room at my tool kit – the memories of different people who had breakthrough in expressing themselves with different toys and tools.

There is more than I can remember. Special things. Moments. Memories. Treasures. So why do I feel so sad? Because they have been special and leaving a special place or ending a special time is hard. I am grateful for all the lives that have changed though the journey’s people have felt safe enough to take in this room. I am grateful for the privilege of even having access to a clinical room for 7 years.
remembering-heart
I am human. I have connected with people and this place – just as children connect with their teachers and classrooms. I hope the treasures – the memories and moments that have happened in groups and classroom communities over the last academic year will be able to be collected, heard, remembered.

I hope that the ‘do you remember when…’ game I am playing on my own due to confidentiality (with highlights being shared with my clinical supervisor!) – will be well played out loud in the communities in schools and families…and given proper time so each memory can be honored.

Ending well is such a special healthy process. It is like grieving while the person is still alive…. The biggest gift we have though is the time and chance to say what this place / person has meant to us, before we have to say goodbye. So often in life we try to not talk about the endings, put all our focus on the ‘transition’ to the new thing, or leave it until the last minute when we can’t really process the emotions as we are too busy doing the practical.
It happens in life. It happens in schools each year.

This time is important. These memories are special and the feelings we go through as we realize just how much, are to be honored and expressed.
Before we really start a transition, and looking to the future, let’s all give ourselves time to see what we remember …. and acknowledge and celebrate all that has been.

MemoriesQuote

Too Many Cooks… Things to consider in school when a child is really struggling

Too Many Cooks… Things to consider in school when a child is really struggling

What happens when a child is clearly really struggling in school?

Their behaviour changes; maybe they get more withdrawn, or more aggressive. Maybe they stop communicating or start shouting. They become explosive or hard to reach at all.

angry-exposive-composite

They become unpredictable…and it can be really hard to know what to do for the best..
So here is my question…

What happens when a child is really struggling in school?

…and I am not meaning with the child.
Experience has shown me that when things get really tricky with a child in school (and it happens in the nicest of schools from time to time), it causes an increase in staff stress. It is understandable. It is hard to be with a child when you don’t know what they might do next, when you don’t understand what is making them tick…or what is making them boom.

In your school when this happens with a child maybe it is time to stop and check-in with the list below…

1.  Consider that 1 child may be being dealt with by up to 8+ people… too many cooks (19)

who may include Learning mentor, CFSW, Teacher/s, Class TA, Senco, Deputy and or Head, and then any external professionals…
For children who are already struggling this many interactions or number of adults involved directly with them, increases the amount of people they need to ‘work out’. It actually increases their sense of needing to be on alert, and keeps their nervous system activated at such a level that explosions can happen easily from one seemingly small trigger.

2.   Every one of the above adults may each have an increase of their own emotions around what is happening.

Anxiety at what might happen next, fear about how they may be criticized or regarded for not being able to ‘control’ the child, anger at what other staff do or don’t do, mixed with emotional and physical exhaustion (these kind of times can start to affect sleep)… Etc etc.
Every one of these internalised emotions will change each of the adults nervous system activation. The child will sense the tension in the individuals they spend time with as well as any lack of unity or respect between the adults and again this fuels their sense of not being safe. Another way of looking at it is the way children get nervous when they know things are not ok between their parents or close family members. They don’t have to hear disagreements or shouting to know things are not all ok… And ‘things are not ok between my special adults who look after me’ also means ‘I am not safe’.

3.  Each of these adults will have their own take on what needs to happen.

too cooksIf there is no cohesive and shared understanding of what is going on with this child and why they are behaving like this, then each adult will start to chip in their own ideas as to what needs to happen.
Very quickly the struggling child now has several different changes happening and may or may not understand why, may or may not feel happy with the changes and may be caught in the middle of mis (or non) -communication between the various adult parties and their various new ideas for how things should be. This can so easily add to their sense of being out of control and too much change. If it doesn’t help increase their sense of safety, it will almost certainly significantly DECREASE it…leading to more of the ‘I’m struggling’ behaviour.

4.  Children can be complex. They can also be incredibly straightforward. There will always be a reason for a change in behaviour.

At times like this it is so important for a school staff ‘sub-team’-around-a-child to be contained, well led, clearly guided, trained-up and brought together to work as a complete container for the child. If it is not clear to those in school as to what is going on and why, then it can be really helpful to get an outside perspective. But not one that only looks at the behaviour!
The home background may be a significant factor and if the child is not understood in light of this then the child is not understood.
The issue may be something in school.
The issue may be a combination of home and school dynamics.
The issue may be finally they are no longer able to keep a lid on their previously internalised feelings about something that happened to them a while ago (that others may have forgotten or thought didn’t affect them).

When a child is struggling it can be really easy to put all the attention and focus on the child and changing them. The big unspoken desire of the adult – collective involved is often for the behaviour to just stop. This focus may mean missing out noticing some of the key ways a child is being helped or hindered by school staff, through a difficult time. Above all, children and adults want and need to feel safe.
Qu: What needs to happen to increase that sense of safety during the school day?
Ans. child:……………………………………………………………
Ans. each key adult involved:………………………………………………………………………

Further Questions to Consider If/When this situation arises

  1. Is the reason for the behaviour or why the child is struggling clearly understood by anyone?
  2. Who are the adults in daily contact with the child & family?
  3. Is the behaviour understood in light of the reason by all the adults in daily contact with the child?
  4. How is this situation making each of the adults feel?
  5. Is there clarity as to how the adults and their emotions and subconscious feelings and thoughts might be affecting their own behaviour, their nervous system and the child?
  6. Is there clarity as to what helps this child feel safe?
  7. What do the key adults need to help them feel safer (ie to lower their own nervous system activation?)
  8. Are all adults briefed and agreed together before any new changes are brought in?
  9. How is the communication between these staff?
  10. How is the sense of respect, team and being on the same page between staff?
  11. Who and how and when is this sub-team around the child being supported / contained through this time?

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