How we work – Intervention

Processing experience
Objective: To help each family member process past experiences to gain insight into their current situation and develop a sense of hope.
What are the key elements of practice?
What we do and why:
We must actively maintain the level of profound trust generated in the previous phase. The trusting relationship enables people who have done dreadful things or have had terrible things done to them to tell their key worker without fear of humiliation, recrimination or losing a relationship they have come to value. This process includes: acknowledging, understanding, grieving and letting go of things that cannot be changed.
Using the secure relationship, the child/parent and their filed worker begin to explore difficult past experiences, with the field worker gently asking open questions and using a variety of tools and activities such as genograms and artwork, which can help the child/parent to access and re-tell experiences and feelings. The key worker’s role is to support the child/parent to cope with the pain that emerges. We show them that we are moved by the other’s experience and express sorrow that this has happened to them. Yet we must remain calm and contained in our response to show the child/parent that these experiences, and the pain they evoke, can be borne.

The following elements are key at this stage:

  • Continually questioning our understanding of the child/parent’s experience and how they have interpreted it, how they see themselves and others, and how this affects their present. Every child and parent is unique and so is their story, even if it sounds similar to someone else’s experience.
  • Refraining from judging, blaming or showing shock. Children/parents need to know that they are not the only ones who have gone through such experiences. We aim to get across the message: “many people do feel like this when they find themselves in that kind of situation.”
  • Showing we believe what we are told. Showing disbelief or doubting the child/parent may cause them to feel shame, to lose trust and withdraw from the process.
  • Working at the individual’s pace. After a session in which the child/parent has divulged something painful, they may not want to talk about it again for a while.
  • Helping the child/parent name what happened and their feelings, as they may not have the vocabulary or presence for this. We do this by checking with them whether our understanding is correct so as to “tell them” through your reaction how they might understand their experiences.
  • Being creative and flexible in choosing which tools will allow the child/parent to express their experiences in the way most acceptable to them.
  • Helping the child/parent reinterpret their story to develop a new understanding of themselves. The child/parent will have developed their own understanding for what has happened, one which may not benefit them. For instance, because children cannot reject the only attachment figure they have, they may conclude that their mother’s lack of love for them is because they themselves are unlovable. This belief, if not challenged by their subsequent experiences, will lead to them to expect and finally contribute to being rejected by others, as well.

Being prepared for a range of reactions based on defence mechanisms to cope with trauma, ranging from those who are unable to talk about the experience or unable to retrieve their memories, to those who can talk about it with the intention of shocking and testing.

Useful Techniques
  • Guided exploration through talking and answering questions
  • Art work where experiences can be communicated
  • Drama
  • Play or sand tray work where exploration or experiences is more metaphorical and can provide a bridge for the child/parent who is not ready to talk about what happened or cannot remember
  • Genograms, life lines, floor plans and other visualisation techniques
  • Games
  • Rituals
  • Guided therapeutic peer groups – children learning from peers whose experiences are similar. This group work helps children or adults see their experience with a more objective eye and can also help them to re-connect with similar experiences which they have kept at bay but which influence how they react when stressed.
Case Study – Angelina
Angelina has explored her personal history with Jorge, her key worker, over many weeks. She had a traumatic tale to tell and had been listened to sensitively and given a lot of emotional support in both telling and bearing her past. She had reached the point where she was beginning to “re-tell” the most upsetting incidents. Jorge was tempted to point out to her that she was thinking of herself while her own children struggled to get any attention from her. But Jorge knew that if he explained to Angelina what she should be thinking/feeling, he ran the risk of alienating her and depriving her of being able to arrive at the insight on her own
Jorge’s team helped him think about how he could help Angelina “see” what was happening without having it pointed out to her. Jorge decided to repeat with her the activities he used when he first asked her to recount her difficult past. With Jorge beside her, Angelina drew pictures to represent the most painful experiences in her childhood. Together, they felt the full weight of so much pain in the lifetime of one child. They spent a lot of time contemplating her dreadful experiences. In one of those moments of silence, Angelina very quietly said, “This is what I am doing to my children”. Jorge knew Angelina had now reached the point where she would be able to behave differently from those adults in her childhood who had caused her so much harm.