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Childhood Trauma


Caring for a child who has experienced trauma

In this section: Learn about the impact of trauma, the importance and role of therapeutic assessments, how you can become trauma-informed in your caring and tips for settling the child into your home.

Overview

Research tells us children who come into care require security and stability above all else. They also need support, time and consistency to be in a position to begin to recover from the trauma they have experienced. Research also tells us children will not suddenly be ‘better’, ‘happier’ or ‘fixed’, because recovering from trauma takes time. As a carer, you, along with other significant people in the child’s life, have an important role in helping the child every day on their healing journey.

As mentioned, it is likely the child you are caring for has been exposed to some form of abuse and/or neglect. Irrespective of the extent of this abuse and its impact on the child, they will have also experienced trauma caused by their separation from their birth parents and the move into kinship or foster care. This trauma may stem from the change and/or loss of familiar relationships, connection to their culture, siblings, school, friends, pets, community and belongings, as well as uncertainty about what is happening, why and what it means for them.

We also know exposure to continued trauma can lead to permanent changes to a child’s brain and the way it develops, including impacts on particular skills such as paying attention, managing emotions, organising and planning. For this reason, soon after a child enters care a general health and wellbeing check and a therapeutic assessment will be undertaken. These assessments help inform case managers, and carers, about how they can best help the child emotionally, physically and developmentally. Following these assessments, a range of support options are identified and made available from government and community organisations. Information about these is provided in the section ‘Supports and services’.

Throughout this handbook, information about caring for a child is provided in the context that the child has experienced trauma. It is normal for you to feel concern for the child now in your care and what they experienced. If this is you, don’t hesitate to speak to your case manager. They will help you understand the situation and may connect you to supports and services to help. Your case manager can also connect you to training about caring for a child who has experienced trauma. Please speak to your case manager about accessing this training.

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Trauma informed care - initial carer consultation

A key part of the therapeutic approach CYPS and ACT Together follow focuses on practices and strategies that build staff and carer knowledge of how trauma can impact a child. This trauma-informed knowledge then helps improve the support your case manager and you can provide to the child in your care.

Very soon after the child comes into your care, a therapeutic assessor from the CYPS Therapeutic Assessment team will contact you to organise an initial carer consultation. This is an initial conversation to help you understand the child in your care and the trauma and adversity they have experienced. The assessor will share with you information and resources about trauma-informed therapeutic care with particular relevance to the child you are caring for. This could include information about neurobiology, child and adolescent development, attachment and relationships or many other important topics. The assessor will help you with practical information and you should feel free to ask questions and share any concerns you have. Your case manager has also undertaken trauma training and can help you with information and support.

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Therapeutic assessments

All children in care in the ACT (except those on a Voluntary Care Agreement or youth justice order) will receive a therapeutic assessment. During your initial carer consultation with the CYPS therapeutic assessor, they will tell you about the assessment process and when it will likely happen (it may take a number of months before an assessment can be done).

The purpose of the assessment is to:

  • review the child’s history of abuse and neglect, and the impact it has had on them
  • identify early relevant therapeutic needs specific to the child
  • recommend strategies to appropriately address the child’s needs
  • assist you and the child’s Care Team to understand the impact trauma has had on the child and help to establish a healing and therapeutic care environment for the child.

The assessment process usually takes a number of weeks to complete and provides a holistic assessment of the child’s needs across different areas of their life, including:

  • health and development
  • education
  • behavioural and emotional development
  • culture and identity
  • family and social relationships.

The assessor will focus on gathering information about the child’s history, exposure to trauma and development from others who know them or have previously assessed them. This can include you, the case manager, their birth family, teachers, doctors, counsellors and other professionals. Where possible, the assessor may also attend the child’s initial health and wellbeing check when the child first enters care. When conducting assessments for Aboriginal and Torres Strait Islander children, assessors are mindful of the impact caused by past government policies that fractured family structures and traumatised whole communities. Assessors will work sensitively with everyone involved, including the child, and will consult with the CYPS Cultural Services Team during the assessment process.

Once the assessor has reviewed the information, they will prepare a Therapeutic Assessment Report and arrange a Care Team meeting to discuss the content, help prioritise goals for the child and recommend supports to assist with their identified needs. Once the report is presented, the assessor is no longer involved. From this meeting, your case manager will develop the child’s Case Plan incorporating the goals and strategies agreed to by the child’s Care Team.

If the child is under 12 years old, or is at risk of developing severe and complex physiological and behavioural problems, the child may be referred to Melaleuca Place. Melaleuca Place is a specialist treatment service for children who have experienced trauma.

For children being case managed by ACT Together, they may be eligible for support through the ACT Together Therapeutic Services Team. This team provides a range of services including direct intervention, support and referral for children and their carers. For more information, speak to your ACT Together case manager.

Therapeutic assessors have a separate role to case managers but work closely with them to integrate therapeutic strategies into Case Plans specific to the needs of the child. Therapeutic assessments are essential to the delivery of trauma-informed care and were introduced through the implementation of the A Step Up for Our Kids Out of Home Care Strategy 2015-2020.

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Building a relationship

Building a relationship with a child who has experienced trauma takes time. It is important to keep your channels of communication open at all times so they know they can come to you when they are ready. When communicating with the child in your care, there are four key things that will help build the child’s sense of safety and increase their trust in you as their carer. These are:

  • Playfulness – Create an atmosphere of interest and fun by using a light tone of voice, like in storytelling. This can trigger chemicals in the child’s brain causing feelings of trust and help them to feel safe with you, the adult. For example, if the child drops a glass of milk and it breaks, say ‘Whoops, let’s clean this up together…let’s not cry over spilt milk’.
  • Acceptance Unconditional acceptance is key to the child’s sense of safety and to know they are loved and accepted without judgment. Whatever the problem is at hand, it is important you ensure the child knows you will support them. Try using statements like, ‘That did not go well. Let’s try again and see if it goes better this time’.
  • Curiosity – Even if the child is guarded, there are ways to show your interest and curiosity in them and your desire to understand. You can do this by wondering aloud about the meaning behind their behaviour, without expecting an answer, from them. Try statements like, ‘I wonder if you are finding it hard to be patient at the moment because you are hungry or tired’.
  • Empathy – Being empathetic shows the child you are doing your best to understand how things are and have been for them. This can in turn, help the child make sense of and better manage their own emotions, thoughts and behaviour. For example, when you can see the child is distressed, let them know you see this. You could say something like, ‘I know things are tough right now, but this is a problem we can share and solve together’.

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Settling a child into your home

Some children with a history of complex trauma have grown up in environments characterised by chaos, lack of structure and lack of predictability. These types of environments are considered ‘normal’ for some children. Adapting to a safe, secure place can take time as children may have a lack of trust in adults and relationships with others. They may have also lived with other carers who have chosen not to, or been unable to, provide longer-term care. Multiple changes to a child’s care arrangements can compound the child’s trauma experience.

As a carer, establishing a trusting relationship with the child in your care at a time when they are likely experiencing feelings of fear, uncertainty and loss, can be hard and can take time – this time can be additionally hard if you are a kinship carer. It is also possible for you to experience a ‘honeymoon’ period where the child initially settles in smoothly, but their behaviour becomes unpredictable or they push boundaries once they become more comfortable.

If other people live in your home, it is a good idea to talk to them about what is happening before the child arrives. Tell them what you can about the child (remembering confidentiality and privacy – see ‘Information sharing’), what it means for everyone and how they can all play a part to welcome and support the child.

There are many things you can do to welcome the child into your home and start to form a trusting relationship with them. If you are a kinship carer and already know the child well, you have probably already done some of these. Whichever type of carer you are, here are some tips to help you.

For children

  • Speak to the child in a calm, warm voice – think about how they may be feeling, for example shy, scared, worried.
  • Welcome the child to your home and tell them your name. Introduce them to everyone in the house, including any pets, but do this slowly and ask them first how they feel about animals.
  • Ask them what they like to be called and work together to decide what they will be comfortable calling you.
  • Tell the child you will take care of them and if they have any worries or need anything, you are there to help them, day or night.
  • Explain they can ask you any question and you will do your best to answer it. Tell them that sometimes you won’t have the answers but you will always try to find out for them.
  • Show the child around the spaces in your home, take your time and invite them to look and touch things as appropriate. If there are certain spaces that are unsafe or you do want the child to go in, respectfully tell them this. Establishing boundaries helps the child to feel safe, as it is clear what they can and cannot do. Show them the outside spaces too.
  • Show the child their bedroom, tell them that this is a safe space for them.
  • Ask the child questions about how they like to sleep, such as with a toy or a light on. Remind them that you are not far away.
  • Show them where the fridge is and tell them what food they can help themselves to, and where to get a drink of water. Explain how meal times usually work so they can know what to expect.
  • Ask the child about their favourite foods. Food is often very important to children and can go a long way to help them feel comfortable and settle in. Also ask them if there are any foods they really dislike.
  • Talk to them about what an average day looks like so they can see things are going to be predictable and consistent.
  • Make sure to keep your communication open. The child may be shy or reluctant and it can take time before they feel comfortable to open up. This is okay. Even if they don’t say much to you, talk to them and show interest in them – it will help them to know they are important to you.
  • Let them know about any particular rules, but understand it can take time to follow them. Being in a new home can be scary and children may try to test boundaries depending on their age and trauma experience.
  • Include the child in activities. Children who have been traumatised like to participate in rhythmic and repetitive activities as it helps their brains grow new, healthier pathways. Activities could include ball games, beating a drum or listening to music.
  • Ask the child questions about what they like to do and think about how you can incorporate these.
  • Plan an outing or an activity together the child can look forward to. It could be to play ball or go to the park, for older children it might be shopping for ingredients and cooking their favourite meal together.
  • Watch for any fears or changes in behaviour.

If you are concerned about how the child is settling in, talk to your case manager. It can be normal for this process to take time, but it is best to get advice or strategies early on what might help to make the process smoother.

For babies

If you are caring for a baby, it is still important to get to know them and form a trusting relationship, even though the baby cannot communicate with you using words. Babies need to learn the world is safe and there are people who will look after them. They learn this when you give them food, comfort, warmth, smiles and cuddles.

Here are some tips to help settle in and bond with a baby.

  • Spend time with the baby when they are awake. Talk softly and sing. Hold, cuddle and stroke the baby so it learns to feel safe and loved.
  • Look into the baby’s eyes when you are feeding or holding them – babies love to look at your face.
  • Watch and listen so you learn their different cries and signals, and what they mean.
  • Respond to these signals when the baby makes sounds, smiles or cries. Crying is the only way babies can tell you they need something. If you respond quickly to the baby’s needs and signals, the baby will learn to trust you and to know the world is a safe place.
  • Talk to the baby as you do things. Let them know what is going to happen next and use the same words every time, such as ‘I am going to pick you up now, ‘It’s time for a bath or ‘Here we go.’ Don’t just pick up the baby without warning as this can startle them.

Research has also shown babies do best if they have someone they are very close to in the first year of life. This person is often called a ‘primary attachment’ figure. The therapeutic assessor can help you understand the importance of attachment and give you more ideas to build a positive bond with the baby you are caring for. This can form part of the initial conversation you have with the assessor.

There are also helpful resources about caring for a baby and how their brains develop on the ParentLink External Link website.

Remember, if you are concerned the baby is not settling well into your home, it is important to address this early with your case manager who will work with you to address any issues and help develop a plan of what to do next.

Develop a ‘cover story’

One of the challenges for children in care can be managing their feelings of being different to other children they know. Not living at home with their parents can be stigmatising and difficult for the child to talk about or explain to others.

Depending upon the age of the child in your care, it is likely the child will get asked questions by friends and classmates about why they are not living with their parents. Questions like, ‘Where’s your Mum and Dad?’ and ‘Who’s that?’ when they see you pick them up from different places. These questions can be really hard for the child to answer, especially if they are caught off guard. One way you can help is to work with the child to develop a cover story.

A cover story is a planned response to questions that are likely to come up. If the child decides to make a cover story, they need to be the main author of it and feel safe and comfortable about what they want to share and what they want to keep private. It is important the child is supported by you and not feel shamed about their circumstances and experiences. The idea is not about needing to keep secrets, but rather the child having the right to share only what they want to share about their life with others.

Every child and their circumstances are different, so there is no universal cover story. Talk with the child and help them decide what works for them. Keeping it simple and short is often a good start. For example, the child might say: ‘I live with my grandparents because my mum is unwell and can’t look after me right now’. It is also a good idea to help the child practice their cover story so they can be more confident in managing conversations or questions about their life.

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What children seek from you

Children who are unable to live with their parents have certain rights while they are in care. These rights are provided under the ACT’s Charter of rights for kids in care, which sets out what children can expect from the people who look after them and work with them while they are in care. You can read the Charter later in this handbook at ‘Guiding legislation and policies’.

Along with the Charter, it is important for children in care to be listened to and have a say in important decisions that affect them. With that in mind, we asked children in care to tell us what helps improve their experience. This is what they told us.

Children want a carer who:

  • likes them and makes them feel they belong
  • understands their likes, fears and needs
  • provides them with nice food and asks what food they like
  • asks them questions
  • listens to them
  • is kind and loves them
  • has a sense of humour
  • helps them maintain connections with friends
  • sticks up for them
  • treats them the same as their own children
  • provides them with opportunities to try new and different things.

Each child is different and it can take time for the child in your care to open up to you, but talk with them and ask what they would find helpful and what you can provide. This is a good way to develop a bond with the child and to let them know you are there for them.

Have you connected with CREATE?

CREATE is an organisation especially for children in care. They link children with others in similar circumstances and provide opportunities for these children to get together. Being involved with CREATE can help ease isolation by helping children realise they are not alone and other children experience similar situations and emotions. Connecting the child in your care with CREATE can help not only in the early, settling period, but throughout their time in care.

For more information visit CREATEExternal Link or phone 1800 655 105.

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