Making Visible: Preventing and responding to violence, abuse and neglect
Making Visible: Preventing and responding to violence, abuse and neglect
Episode 1. Therapeutic practice within child protection
In the first episode of Making Visible, Mim and Lis explore innovative therapeutic practice within child protection. We hear two practitioners share stories of educative approaches in working therapeutically with children who have been removed, and parents of children who have been removed, from their care. Listen to the practitioners as they describe the creativity in taking the practice outside of talking therapy in the counselling room and using trauma-informed narrative exposure therapy.
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More about Making Visible
Welcome to Making Visible, preventing and responding to violence, abuse and neglect. The podcast supporting you to deliver best practice in your work with people who have experienced domestic and family violence, sexual assault, child abuse, and neglect. The Agency for Clinical Innovation acknowledges the traditional owners of the lands that we live and work on. We pay our respects to elders past, present and emerging and extend that respect to other Aboriginal people here and listening today. We would also like to acknowledge those with lived experience. We recognize and appreciate consumers, patients, carers, supporters, and loved ones. The voices of people with lived experience are powerful. Their contribution is vital to enabling decision-making for health system change.
LIZ MURPHY:Information about accessing personal support is available in the show notes and at the end of each episode.
SPEAKER:This series is about preventing and responding to violence. We are Making Visible. This is a series that is about preventing and responding to abuse. We are Making Visible. This is a series about preventing and responding to neglect. We are Making Visible. From the Agency for Clinical Innovation, Violence, Abuse and Neglect. Network in collaboration with the University of Wollongong, and the Social Work Stories podcast, this is Making Visible, Preventing and Responding to Violence, Abuse, and Neglect. We are Making Visible. This is Making Visible.
DR. MIM FOX:Welcome to the Making Visible podcast, Preventing and Responding to Violence, Abuse, and Neglect. This podcast showcases complex stories from practice in the fields of domestic violence, child protection and sexual assault. I'm Dr. Mim Fox, and I'm here with my co-host, Liz Murphy. And we call ourselves Social work educators and Podcasters. But in our other life, I work as an associate professor at the University of Wollongong and I teach social work practice every day. Hi, Liz?
LIZ MURPHY:Hello, Mim? And hello to all our listeners? In my current life, I'm still working for health, where I've worked for over 30 years, and some of that time Mim was spent in a van service. So these recordings just sing to me.
DR. MIM FOX:These stories really open the door, Liz, to all that beautiful, complex work that our colleagues are doing every single day in what is a really difficult space, right?
LIZ MURPHY:Oh, I like the complexity of that work is mind-blowing. And that's why I really love these episodes, because I drill down to the detail of what they actually are doing with the families, the individuals, the couples that they're working with. And we hear some of the language used even. And, you know, Mim how much I love that.
DR. MIM FOX:I absolutely do. And for some of our listeners might actually recognize our voices, Liz, and that's because we also are the hosts of a podcast called Social Work Stories. And that's the podcast where we regularly analyze and debrief the practice stories from our colleagues, from all different sectors, right? All the different places and context in which social workers work in.
LIZ MURPHY:It's same, same, but different, I reckon Mim, and it's different because we go into a lot more detail in this series. This is a series for therapists that are working in this area of practice. And it is so detailed that we even hear the languaging, which you and I both know practitioners, students long to hear. It's not just about talking about this is what I do in my practice. We're hearing about the words, the therapeutic interventions that they're using in amazing detail.
DR. MIM FOX:One of the things we really love to do is not just witness and listen to these wonderful stories from practice, but also then get a chance to debrief them, to analyze them, to really look closely at the practice interventions that we're seeing play out in the stories.
LIZ MURPHY:It's like we have our own peer supervision session, as a result of listening to another person's work. And Mim when I was working the domestic violence team, we used to have peer supervision. So in some regards I feel like we're flicking, I'm flicking back to those times. But with you.
DR. MIM FOX:Yeah, and one of the things I'm always conscious of, Liz, is that although we always aim in any sort of this complex work to have regular supervision, it's not always possible for everyone. And so it's good, I think, for people to get a sense of what a supervision session can sound like as well, because when supervision does happen, you've got the tools to have that sort of conversation to go deep about your practice.
LIZ MURPHY:Exactly, because so often our supervision is done behind closed doors, right?
DR. MIM FOX:That's it, right.
LIZ MURPHY:So when do you actually get to hear another supervision taking place?
DR. MIM FOX:Yeah, it's exciting. So in this series, there's four episodes in this Making Visible podcast series. And throughout it, we're gonna` touch on issues around supervision and self-care, we're gonna touch on reflective practice, we're gonna talk about integrated care, which is so important in this space, as well as thinking through that really complex family work that often is just really embedded in the violence, abuse, and neglect sector work.
LIZ MURPHY:One of the things is your speaking I was thinking about Mim is we take a critical lens to this. But I also know that there are clinicians that will listen to this and they'll bring their own lens to it, too, and can have a great conversation as a result of listening to these sessions. So I'd recommend that people also do that.
DR. MIM FOX:That's right. This is a resource for you to go off and keep analyzing and keep being critical about your practice. So, Liz, let's get into it. What we're gonna do is we're going to listen to our first story, and then have a chance for you and I to have that conversation where we really pull apart some of those practice interventions and reflective practice that we're hearing. Then we're gonna listen to another story as well. So this is a chance to actually hear from two clinicians today, which is great.
LIZ MURPHY:And I love the fact the theme is around working in the child protection space. But both come at it from such creative ways. So very different interventions, if you like, but really sharing innovation in their practice. And I love this first story that we're going to hear because this particular social worker is talking about how they were experimenting in some regards. It was an educated approach to taking risk in the therapeutic space. But listen to how well she kind of talks that through. Listen to how she shares her vulnerability with us in relation to working in a different way. And I just wish that I could be part of her team because I think this is a type of practice set that you and I really herald and we value greatly. This is how our profession or how therapy grows, right?
DR. MIM FOX:Yes.
LIZ MURPHY:Where's the edge to practice, and how do we stretch it more? And this is this is a clinician who's doing this.
DR. MIM FOX:Before we get into it, Liz, I just wanna reassure our listeners that all the stories they're gonna hear on the Making Visible podcast are de-identified. So all of our stories come from practitioners practice experiences. They are grounded in real life stories, but they have been de-identified and changed in order to protect both our practitioners and of course our clients that we work with every single day.
SPEAKER:My role within health and within the band structure is as a child protection counsellor. So mostly seeing young people under the age of 18 who have experienced neglect, abuse, and trauma and have been there either at risk of removal from their family home or part of my work is to provide preservation of the family like early intervention, or they have been removed. They're in care and I work with them then. So I love that sort of work. Often I will have matters in which I am stumbling a bit. And in this case, this is what happened in terms of my work with these young people. I had two young people, a male who I'm gonna call Tim and a female, I'm gonna call Sue. And I had done work with them as individuals for about 18 months, which is quite a long time I know. But a part of my problem sometimes can be that I am you know, this work is long term. It's all attachment-related. And what I found with these young people during this 18 months, they'd gone from children to two teenagers. So they had shared similar presentations. And I had noticed this in my individual work. So, for example, both of them had experienced neglect and early trauma, and attachment-related behaviors. Both of them had been removed from their families and had been placed in care, one with a family member, one in the foster care system. Both were similar age, both were going through puberty, both were having conversations around their sexuality and identity, both were showing sort of behaviors that were connected at risk behaviors, impulsivity, both experienced significant isolation within their peer-based relationships, and just isolation on a personal level like lack of connection. And, and it was really puberty. They had been protected by their age when they were younger and puberty was really making them realize how isolated they were. Both of them had issues to do with depression and anxiety-related behaviors and that was becoming more and more obvious to them and their carers, their school communities. So I had worked individually with both of them. They both a hoot as well, like they've got great personalities and senses of humor. And in the holidays, I'd often thought, why don't I get some of these kids together who are all experiencing similar stuff? And the number one issue being that they were incredibly isolated. So I might do like a little holiday program. So I designed this. I'd watched narrative therapy, nature walks and using a narrative context of externalizing a problem, but using the idea of a walk to process something. So we picked up an item that represented the problem, and then we'd walk together and you have conversations along the way. I mean, I sounds incredibly professional in this and it didn't go very well. Actually, the walk, you know, someone picked up a stick and poke someone in an eye and someone had a grain of sand that they took was their item. It really failed. But what was successful was the connection between. So there was more than these two, than Tim and Sue. They formed a bit of a connection. So I was thinking in supervision, I was talking over with my supervisor and thought, what's going to really help these young people I think is doing some peer-based therapeutic work. Like my supervisor thought it was a good idea. So, I presented this idea to both carers to look at and, and the foster care agency that Tim was associated with. They both had similar struggles. So they both had struggles as I said before, with their interpersonal relationships forming connection, keeping, making friends, making and keeping friends, big issue. They both had struggles with their sense of personal boundaries. Actually Sue particularly more than Tim. And concepts of sort of body sovereignty and you know, she would often touch me or I'd be unaware of this, her spice in the world. They both really struggled with emotional literacy skills and and feelings, communication, and identification. they both needed some really good, healthy sexuality in relationship to education, they both would really value. So I thought from some protective behavior stuff, and they both were presenting with different but quite similar at times at risk behaviors in that, you know, trying drugs, alcohol, sneaking out, that sort of stuff. So I thought, right, let's give this a go. And we began by having sessions in my therapy room here. And that whilst the connection was great and we began with that healthy sexed stuff because they were 12 at the time and that was going OK. But the confines of this room seemed, particularly with Sue's inability to sort of keep herself in her body, I thought, we need actually more space sometimes. So then we started to balance, balance the intervention outside of this room, using nature, using walking, using sort of therapy in action. So we I started to think instead of the confines of this room sitting, talking about the issues, let's just do it. Let's do it, see them do therapy in action. Let's see them together. You know how they are in the community, how they are walking. So I use my local area of which there's really easy access to bush walking tracks and the beach. Not that we swam, but using motion actually. We'd go eat together, walk into shops, quiet together, go to a park. How they converse together, how they relate what was happening in their lives together, how they were in terms of their physical space. So I'd be using sort of interruptive conversations and hey, Sue let's take a step back let's look at... You know, Tim, do you like when Sue just jump on your back without knowing what's happening?"No, I don't really." How then how do you communicate that with her? And they both were pretty much on the same page is the purpose of what we were doing together, and that we're using this to form a friendship, but also to learn about ourselves in relation to other people, in relation to each other. So, they also trust me. And so I can have those very interruptive methods, which I wouldn't with people I didn't know well and used a lot of humor. For example, they would bolt to the car and then struggle with the car door.'I wanna get in the front seat, I wanna get the front side,' and it would be this. So we'd have to just stop and use stop sign and say, hey, let's go back. What do we do here? You know, let's talk to each other. How do we communicate what we want? And so this sort of started this educational component, but this relational component to them coming to understand each other. But I think what the value has been and what I've seen is it big, it's in action. It's actually in real-time, it's in real life. And with young people who are then going through puberty and they were going through puberty early. And this is this therapy is going on to the point where they're willing to sort of that, you know, nearly 14 and they have formed connection, they formed trust with each other, we've had sort of deep conversations when Tim has felt... When Tim's boyfriend broke up with him, he would tell us of his struggles. His emotional literacy has just skyrocketed. Sue still remains. She does have a diagnosis of FASD. You know, I think that keeps her you know, it has limited her capacity to still identify her feelings. But she's learning via his sense of trust and an ability to share and connect. So they've formed a sense of safety together and in deep intimacy. And it's had enormous value, I know, because Tim has shared. He said last week when we dropped him off, he came to the window. This is a kid when I first met him who hid in my sand tray and did not talk to me for numerous sessions. He was so shut down in my body feelings outline. He would only ever draw feelings from his head up. He never felt any sense of connection to his body or to his personal space. And he looked in the window as he was walking inside and said,"You're both really important to me." And I just yeah, and so that hurt somebody that is overwhelming. But for Sue to hear that when she literally has no friends. And it's just been incredible, you know. And also for me to as in this position to witness this connection form between two people that have that peer-based stuff, they have carers who love them and care for them. But to witness how this is really, really deepened, I mean, it poses some problems for me now though, I think where to from now, You know, I think there is a safety if they are together on their own currently, if they form a friendship outside of this therapeutic one because Sue's at risk behavior is quite high and Tim is dabbling in some drug use. So I worry about just that unsupervised sort of... They both like little firecrackers that would definitely go off when they were together. And when they see each other, it's like this could bang. So whilst for them to enjoy that time is really important is there also needs to be that reflective. I feel like on this sort of human boundary stepping into life, and so I've sort of talked to the carers about that. I know they exchanged phone numbers last week and I thought, oh God, you know, it's just a bit worried about that. But that I think as long as the carers know just and they do live 100 kilometers apart, maybe 100, maybe 80. So, it's not like they around the corner from each other and my pursuit to develop this more healthy connection will know hopefully it's the experience for them that we haven't just sat in a room individually and talked about what a healthy relationship looks like. We haven't just sat in an individual room and, you know, hypothesized about what would you do with this happened or that happened, we've done it in real-time and these young people have experienced it. Whilst one time they ran off on me in the down the park and I couldn't find them for five minutes. So that was one of those red flags and risks But it also I think going them fine, they came back in five minutes, but was an opportunity also to look at how a healthy boundary can be set and how Sue at that point was so scared of me sort of disciplining her or something, but I didn't. And you know, I use that emotion coaching in that. So in terms of that behavior, it wasn't OK, but you're OK, we're still OK. You know, she just thought I was gonna never say again. And so even those opportunities which you don't have sometimes in the confines of a very rigid structure, like a counseling room, not that yeah. It's my suggestion to do that all the time, but to use those opportunities in real life to practice this stuff, and then we could talk about it when we drove back to the center we had the opportunity. So I look at those behaviors as part of being a young person. You know, that's part of what your brain's doing, is just to be impulsive and to react. And we've got a switch on that frontal lobe. And how do we do that? We come back to the day and the time and look around and that ability to use our thinking brain to make good choices. And so it's been a really amazing process to be a part of. And I think the innovation around thinking outside the square of a counseling room literally, and looking at how we can use an environment, how we can use relationships differently, how we can use you know, the very privileged role of a social worker in these young people's lives, it's just like a big wide open road that we can go down. And I've just got to find when the roads ends. That's my next opportunity for learning, shall we say, and good supervision I think, I'm constantly talking about this case 'cause it's been so impacting on my practice and in my life and in terms of my social work. So yeah, I just wanted to share it with the wider community and be really interested to hear what other people think about this way of working.
LIZ MURPHY:Every time I listen to this story, I hear another element. I learned something again from this sharing. But I guess I just wanted to name some of the things that particularly struck me Mim, if that's OK?
DR. MIM FOX:Of course.
LIZ MURPHY:So again, that innovation in the practice. So taking this therapy with two young people to a different space outside of the talking therapy, outside of the counseling room. This is someone who wanted to do something different because the way in which she was working with them was becoming they were outgrowing it, you know? And I had never thought about that before, Mim. How as a person gets older, as a child emerges into an adolescent, you kind of have to change it up.
DR. MIM FOX:That's right. You have to go with them, don't you? And I think there's a lot of vulnerability actually, on the clinician's part here where actually to be able to look at your practice and say, this isn't working. How can I adapt? What I'm doing to meet the needs of my clients is actually, I think, quite a brave approach. And you really do need to be vulnerable to be able to do that, I think.
LIZ MURPHY:You do, absolutely. I totally agree with you. But whilst I agree, this therapist was being very brave in her work. It wasn't like she was free-falling, Mim.
DR. MIM FOX:No.
LIZ MURPHY:This is someone who checked the literature, who used supervision in such a beautiful way to be checking in in terms of her reflection around the therapeutic relationships and space. She checked in with the carers, but beyond anything else, she had 18 months working with these two young people. So she had a very strong relational dynamic with these people.
DR. MIM FOX:Yeah.
LIZ MURPHY:So, it was safe. It was a safe place in which to stretch that therapeutic practice.
DR. MIM FOX:Yeah, that's absolutely right. What I really liked was that she was going back to her interventions and reflecting on them in order to be informed for the future as well, right? So she was saying, going back to that body mapping, what happened in those body outlines and where am I at now with these young people? What is it that they're going to need going forward in terms of how they see themselves, how they see their bodies, where they're grounded, how present they are in a moment, in an interaction like that is reflective practice in action, right?
LIZ MURPHY:It is. And I loved how she used such a variety of interventions. And I loved how she didn't rely or lean too heavily on just the verbal language, right?
DR. MIM FOX:Yeah.
LIZ MURPHY:This is someone, as you're saying Mim, who's also using body this movement through space. There's teachable moments. There's working with the relationship of the two young people, building connection. This is beyond the counseling room. And she's, I loved that getting out.
DR. MIM FOX:Yeah, I absolutely think it's that basic premise is that you can't learn how to be in a relationship with others, how to relate to others without doing it, without relating to people and being in relationships. And unfortunately, in these sorts of situations, you've got adolescents who have become so isolated. So how do they learn those skills? How do they get better at relating if they don't have the people around them to relate to? And she actually brought that in for these young people, right? She actually allowed that relationship environment to support them in their development, in their skill building so cleverly.
LIZ MURPHY:To move from the abstract to the here and now.
DR. MIM FOX:That's right. That's right. Really, really clever. Some of those beautiful interruptive conversations, right? Where she's just there you are, you're playing, you're hanging out, and she's just slipping in a therapeutic question, that isn't necessarily loaded, i isn't heavy with the potential that it could be. But it's an important interrupter to actually bring them back to that present, and get them to reflect on what they are engaging with right now, bring them back to that present state.
LIZ MURPHY:This is a clinician who really liked these two young people. And look, I don't know whether we give that enough merit?
DR. MIM FOX:Yeah.
LIZ MURPHY:She really enjoyed working with them, and there was a sense of real partnership around this that I'm learning in this space as much as you are too. And I think there's something humbling about that. As a young person, you can smell a fraud from, you know, 50 paces. This is someone who's keeping it real. And in the moment and the talking with Sue around, we can still have a disagreement. We can still talk this one through. But this is not gonna impact on our relationship.
DR. MIM FOX:That's right.
LIZ MURPHY:The pulling apart from the... But this is a behavior that we'll talk about and that we need to learn from. But this isn't going to split our relationship. This is a safe relationship. And I would imagine, so incredibly reassuring for these two young people.
DR. MIM FOX:And fundamental to their development and growth, right? Like just that, how to function in relationships in the future.
LIZ MURPHY:Yeah, I also wanted to again talk about the beautiful use of supervision as a learning tool. This clinician, I think, has demonstrated how important it is to be going back to a space and having someone bear witness to your practice, and ask you some critical questions about what's the thinking behind that and how it went and what did you learn as a result of that?
DR. MIM FOX:Yeah.
LIZ MURPHY:What would you do differently? Because this intervention is essentially something that she's saying. This is formative in my practice. I'm learning so much from this that I will take into future you know, a therapeutic relationship. This is a really important lesson in learning there. And to have the supervisor there as a foil, as someone who can actually help stretch it with you.
DR. MIM FOX:Yes.
LIZ MURPHY:This is what it's all about, Mim.
DR. MIM FOX:Well, I think also it's a humbling process, isn't it Liz, to be able to walk into a supervision space with the vulnerability and to be able to say, I don't know everything. I'm still in the middle of learning. It doesn't matter how many years of practice I have behind me. I actually need to keep going, keep growing, keep learning to be able to respond to the client that's in front of me right now, not the many others, the one that is right now in front of me. I think there's a humbling process in that as well. So, before we move on Liz, I just wanted to kind of touch on the fact that actually the impact of these interventions, that stepping out of a comfort zone and trying something new, it has that impact on the long term of these young people, right? And I think that's what the essence of this work at this time in their lives is about. It's setting them up for the future. And we know that often clients come into the therapeutic space. They come in with the history, right? They come in with all those past experiences. But to be able to provide them with the tools, then to go forward into the future, the impact is lifelong, right?
LIZ MURPHY:And you could hear this tenuousness in relation to imagining herself outside of the lives of these young people.
DR. MIM FOX:Yeah.
LIZ MURPHY:So, always in her work, she's factoring in. I'm not always gonna be here. I'm not always gonna be the human boundary, as she calls herself.
DR. MIM FOX:That's right.
LIZ MURPHY:I have to actually be paving my way out of this relationship and knowing and trusting that these young people are going to be able to use some of the work that we've done together in future.
DR. MIM FOX:Yeah, absolutely. I mean, that's really how we know we're impacting people's lives, right? Yeah. Giving them those tools. Fantastic. Liz, let's hear now from a clinician who is showing us another side of working therapeutically with children, as well as with parents of children who've been removed. In this story, Liz, we get to hear a practitioner reading out the words of a client. And I just want to remind our listeners that all our stories are de-identified and changed to protect the identity of both our practitioners and our clients. The reason, though this practitioner is doing that in this story is because they're highlighting a really beautiful component to narrative therapy. It's a technique where you actually use the words of the client themselves as part of the therapeutic process. And I'm really pleased that we've actually still been able to include that in this story.
LIZ MURPHY:So am I mean, because it reminded me of not just listening to the words of the client, but the importance of documenting that. It was a great reminder. The other thing I love about this is the creativity that he brings into the narrative exposure therapy, something that I don't know about you, but I had never heard of it up until listening to this clinician. And really I think listeners will be really excited about this way of working in a creative way that combines both trauma practice and the concept of growth through trauma in the one therapeutic intervention.
DR. MIM FOX:Absolutely, let's have a listen, Liz.
SPEAKER:So my role is a child protection counsellor. I work with families. And then within the family I can work with children, young people, parents and carers. And these families have often come to us because there's child protection concerns identified or risk of harm to children. Often the way I work with families can vary, so I could work with the family as a whole. I could do individual work or dyad work with maybe both parents or both carers. I could do maybe a sibling group, I could work with it or just depends on what we deem appropriate for the family at that time. So firstly, therapeutic practices that really inform the way I work is narrative therapy and narrative practices. So I was trained at the Dulwich Centre in Adelaide in narrative therapy. And in particular, I learnt the idea of collective narrative practices. And there's a really great book by "David Denborough called Collective Narrative Practices" that has a number of different methodologies and ways of creating collective documents and collective narratives in particular. I'm often drawn to narrative timelines. So using narratives through time, and also engaging in like thorough documentation of stories and then creating opportunities for telling and witnessing of these stories, very similar to what we're doing today. So I think that as a basis of narrative practices from that training, I really draw on quite often. And then complementary to that, I also did training at the University of Konstanz in Germany in a modality called Narrative Exposure Therapy. So that is a quite a formalized, structured trauma therapy. In particular, it's focusing on complex trauma, and it is a type of exposure therapy. So its intention is to decrease trauma symptoms, but it also has this idea of autobiographical memory, and really reconstructing autobiographical memory through time. So it uses narrative timelines over the lifespan. And I think that this concept that we're moving towards perhaps is that trauma and the impacts of trauma actually collect over the lifetime. They're not just necessarily about one single event. And then we see the presentation of symptoms. It's really a combination of events, experience throughout time that kind of all collect together to then produce symptoms. So this type of therapy really acknowledges that, and it's kind of looking at autobiographical memory through the whole lifetime. But in terms of the methodology of narrative exposure therapy, the way we do it or the kind of plan at the beginning is you create a rope as a symbol of a lifeline as your life, and you plot throughout time flowers and stones. So flowers represent kind of pleasant, joyful experiences. Often, in my experience, they can represent people and loved ones that are in our lives or have been throughout our lives. And then we also plot stones along this lifeline. So stones represent really unpleasant, traumatic experiences. And I will talk a little bit about the relationship, I guess, between flowers and stones and using these symbols,'cause often we can find an experience of a flower, could turn into a stone or vice versa. So I'll talk a little bit about that as we progress through some of these stories. So we construct this timeline and then what we do is kind of systematically go through a person's life and kind of tell their life story with a specific focus of these really specific and intense events. So that could be really quite pleasant events. And talking about these loved ones that we have in our lives or these really great time periods in our life that really gave us strength and resilience. But also we talk about these really traumatic experiences. And we do this in quite a lot of detail. So what I would like to firstly present is two siblings that I've worked with. So I had a brother and a sister. One's 11 and 17 years old, and there was child protection concerns when they were under the care of their mother. So they got removed from her care and placed with their father. And both were presenting with quite significant trauma symptoms. And so we did this process of making this timeline with them. And we plotted flowers and stones. And I'd like to share part of a stone of the 11-year-old here. So living with my mother, there was always lots of arguing with her and her boyfriend. They would argue every day. It was usually over money or over drugs. They would invite their friends over and they would all get into fights. I remember one time they had knives and they were trying to stab each other. They used to do drugs when they were there with them. They would just act like idiots. There was lots of yelling and screaming all the time from everybody. Me and my brother just had to look after ourselves most of the time. We were always there for each other. We would sit and cry together. He would cuddle me and he would say, we're going to get through this together. The thing that got us through with each other, it was us being there for each other. I remember one time when first we were just all having fun. Then there was me, my brother and my mom and her boyfriend, and all of a sudden things turned bad. I can't even really remember what exactly happened. It all just went ballistic. Everyone was yelling at each other and hitting things. The place got trashed. I remember things were being thrown and smashed. I remember the windows getting broken and the TV got smashed. I remember the dog got hit and put outside. I remember us being really scared. I remember just running out the front door. I went down to my friend's house. I knew I'd be safe there. And this young person kind of talked about some of this experience and then going down to a friend's house and the friend and her mother were actually a flower. And we talked quite a lot about her relationship with them and how it was so great being able to get nails painted and things like that and cooking and baking things. And that was really a source of strength and a flower so often. Next to these stones we find flowers and vice versa. Similarly, there's the 17-year-old that I'd like to share, and this is a story about grief and how the person that they're grieving is very much a flower to them and was in their life that the loss of them is a stone. So we have this relationship between flowers and stones. Sometimes they're kind of linked. Very much so. And this is an example of that. So our grandma understood a lot. It was like she knew everything. She had this really big impact on me. She was good at listening. And you could tell just tell her anything. She passed away about two years ago. That was one of the worst days. I remember visiting the hospital. Most of the time, my sister and I were just sitting in the waiting room. I remember one of the last time I saw her. We just sat and watched videos together in the hospital. When she died, I wasn't at the hospital. I was in school. My sister and I lived with her and granddad for about three years. The house is somewhere where I feel safe, when I go there now it's still nice, but it also reminds me of how much I miss her. She used to love playing games with us. The last great memory I have of her is when we went out for a picnic together. We made her all her favorite sandwiches and was just a really, really great day. She would describe me as having a caring heart. She would say she's proud of me and my sister. She would tell us to keep going no matter how hot it gets. The most important thing I learned from her was to treat others how you would like to be treated. I love my grandma and I really miss her. So I've undertaken this work with a number of teenagers, and I think it's just, I guess the way I would say it's just a privilege to hear these young people sharing their experiences with me. I often thought it would be maybe more difficult or more challenging with teenagers than it would be with adults. But I've kind of found the opposite. I think sometimes these teenagers, if given the time to develop a bit of a relationship, they do really give you this gift of being able to share their experiences. And although heartbreaking as it is, we've had stories of young men being really physically abused and young women sexually abused often, and it can be heartbreaking. But it's also so inspiring to hear just the resilience of these young people and what they've been able to get through. There was a young 15-year-old girl who I worked with who was homeless, and she gave me kind of top tips of how to get through living on the street. I remember one tip she said, was to have a shower every day, and she gave me some clues as to where you could find a good free public showers, and she said she often said public pools were a good place to go. And another tip was to go to the fast food outlets at the end of the day, or possibly going to service stations at the end of the day when they had change over and try and get any free food that they were giving out. She said you often was able to get pizza and doughnuts this way, and this is coming from a 15-year-old who was homeless. But the resourcefulness and the strength that these young people show and if fostered, are able to take into their adulthood, I think is just really inspiring and amazing. And it really is a gift to be able to just witness their stories and to get the permission to be able to document them and even share them to other people who are experiencing similar things. I think there's a lot of power and there's a lot of joy in that, through the heartbreak and through the trauma, really. So I'd like to change gears a little bit in terms of changing my focus from young people to both parents. Now I have a history of working with both parents. I used to work overseas in the UK and I worked with the project just with both parents who have had children removed from their care. And I have heard a lot of stories of child removal, and the grief that comes with the removal of your children. And I'd like to kind of share, I guess, a mix of that, those experiences with these parents who often what you'd call disenfranchised grief. They experience this grief that often the wider society doesn't really acknowledge and they often don't feel really acknowledged in their grief. And a lot of these parents, in my experience, understand that they couldn't actually meet the needs of their kids. But that doesn't mean that they they're not grieving all the time. And this is both birth mums and birth fathers. I would say most of my work has been with birth mums, but I have worked with a few birth fathers as well. And the same grief applies. And a lot of these birth parents, there's a history of trauma. A lot of mums that I've worked with have been in foster care themselves, have experienced sexual assault or domestic violence. Often they've tried to manage parenthood on their own as a single parent. Quite often there's difficulties with substance use and even homelessness. And then having a child removed on top of all of that is just really difficult and you know, really heartbreaking recipe there. So I do try and advocate for parents and supporting parents even after children are removed. And I understand that the focus really does go into supporting the children. But I think there also needs to be some resources put to birth parents who can quite easily just drop out of society. So I'd like to share, I guess, some words that I've put together from birth parents just in terms of expressing that experience of what it's like once those children are removed. So once the kids are removed, we didn't see them again for a number of weeks. We didn't know what to say or what to do. We were just overcome by sadness. We just kept crying, I felt like our hearts had just been ripped out. I remember thinking, what's the point to anything? We would just sit in a loungeroom together, hugging and crying. It was like we were just hollow. We became completely disconnected from everything. We tried to make sense of it all, it was so hard. We still don't really understand. No matter what we did, it just seemed to work against us. We just felt so powerless. We just felt so helpless. I have to wonder what the kids are going through. Do they feel rejected or let down? Do they feel heartbroken? Do they think mom doesn't care about us? I just want my children to know that I love you, and that I'll always love you. That I never stop thinking about you. I want them to know that I care about you. And I want them to stay strong. And I want them to keep alive our love and carry it with them. Now, that was kind of a piecing together of a number of months that I've worked with. And a couple of them who I've met at the time have been pregnant, and have had children removed initially and then become pregnant and then a child removed at birth. And this mum in particular that I've worked with locally, when I met her, she'd had two children moved from her care and was pregnant at the time of my work with her. And in terms of our work that we done, we did a lot of narrative exposure and trauma work throughout her whole lifetime because it was just immense. I guess what this woman had been through. And working through that and documenting all of that and using that as evidence of her work and when she had her little baby, her and her partner and the dad of that baby were actually able to keep that baby and start rebuilding their family again, with a wider connection of their families as well,'cause often that gets lost so easily. I think those social connections and kinship and family support once children are removed. So I think that's a kind of a nice closure to a story which often you don't get in this line of work. And I wonder if other councils and therapists and social workers out there might relate to that? So I think generally speaking, that's some of my work and some of what I'd like to share today. I think the methodology that I really relate to and in particular I like being able to try and share stories and make it more grounded in my clients experiences and really try and put those voices forward, because I think if given the privilege of being able to share practice and share clinical practice, I think it's really important to me to use that platform to really put some of these clients voices up and above the clinician's voice,'cause I think that's actually where the power is and that's what's most important for me in my practice.
LIZ MURPHY:I am really curious about narrative exposure therapy. I mean, I've heard about narrative therapy, but this is the first time I've ever heard about narrative exposure therapy. And boy, it's it's something that I really want to learn more about Mim.
DR. MIM FOX:Yeah, I think it's also that often when you hear about these sorts of therapies, if you haven't seen it in action, it's quite hard to understand how it actually occurs, how it plays out. But I love the way this clinician steps it out, right? Like actually describes it step by step.
LIZ MURPHY:It's very trauma informed.
DR. MIM FOX:Yeah.
LIZ MURPHY:And so it's like that's been woven into the narrative therapy, right?
DR. MIM FOX:Yeah.
LIZ MURPHY:And I loved also the creativity in the timeline work.
DR. MIM FOX:Oh, beautiful.
LIZ MURPHY:And the tactile use of stones and flowers to represent that in life we experience both loss and growth.
DR. MIM FOX:Yeah.
LIZ MURPHY:Sometimes in the very same moment. And it's beautiful narrative therapy work where you look for the redemptive story within the loss story or within the trauma story. And also looking for those relationships that were of such value to these young people. I love that.
DR. MIM FOX:Ah, stunning. Absolutely beautiful. The words from those young people, just were heartbreaking, but also inspirational, right? And that's what the clinician said, that not only was it the good and the bad for the young person, but for him as the practitioner to actually get inspiration from those dark moments as well.
LIZ MURPHY:And then to use it with the parents.
DR. MIM FOX:Yeah.
LIZ MURPHY:So, one of the things, just taking a step back before we get to that point, I very much valued the way he gently checked in that he had accurately captured. But could you imagine being a parent and listening to that particular story, how powerful it would be to actually hear that your daughter's voices? And then to reflect on, who they are as people, but actually how I work with them as a parent, how I love them, how I know what's important to them.
DR. MIM FOX:Yeah. But on the flip side as well, with the second story, when you hear the words of the mother, right?
LIZ MURPHY:Oh!
DR. MIM FOX:And that just challenges all of your assumptions, doesn't it? I mean, well, one of the big issues around child removal is that often the judgment that comes on those parents and the issues of loss that exist for them are swept to the side.
LIZ MURPHY:Absolutely. Absolutely, I've seen this so often, especially in the hospital setting, when babies are assumed. The disenfranchised and unacknowledged grief is invisible.
DR. MIM FOX:Yeah.
LIZ MURPHY:And how powerful it is for this to be acknowledged, the parents' grief to be acknowledged. And I guess down the track for this child to actually hear this story and the impact that this has had on their parents.
DR. MIM FOX:Yeah, and for the children to grow up being aware that they were wanted and that they were loved. I think that that's really powerful, right? We were talking earlier in the episode about the developmental stages of the adolescent, right? And how it's about learning lessons that you can take forward into your life. And I think this last story here really shows that that actually all of these experiences, it's a continuum. And you know, there are lessons to be learnt going forward in life, yeah. You know what's gonna stay with me from this story, Liz, is really the emotions within the words of those young people and then that mother. I mean, really just having to do this work every single day. Really my heart goes out not just to the people who are experiencing these issues, but to the clinicians as well. This is hard work, Liz. It's complex work.
LIZ MURPHY:It's beautiful work, though.
DR. MIM FOX:It is. It is beautiful work and inspiring work, right?
LIZ MURPHY:If I could go back in time, when I was working the domestic violence service, I would have loved these two clinicians to be my team.
DR. MIM FOX:Yeah, I know, I know. And that's what's beautiful about this series. I think the Making Visible podcast series is that we're getting to hear from the clinicians at the coalface and getting that perspective behind the scenes, behind the curtain. The magic behind the curtain, Liz. Like it's just beautiful to get that perspective and to be able to shine a spotlight on actually what they're doing, which is lovely.
LIZ MURPHY:So as we draw to an end Mim, I guess I'm reflecting on the innovation, the creativity that these two clinicians brought to this episode in working with, as you say, a really challenging space in child protection. But it reminded me of how creative you can still be in this space. And I guess that's really what we're gonna be seeing in the next few episodes as well, right?
DR. MIM FOX:Oh, absolutely. Absolutely, I think you're really right about having that as the focus for this episode, the creativity just shone through. In the next episode, we're gonna be looking a little bit closer at domestic and family violence. And while we do that, we're gonna explore this violence, abuse and neglect sector a little bit more. And we're also going to look at integrated care because as we know, we don't work alone. We're not silos in this work, right?
LIZ MURPHY:It takes a village my friend.
DR. MIM FOX:It takes a village. So integrated care absolutely is vital to the work that we do. So we're gonna look at that in the next episode. Before we finish up, Liz, I wanna just say that if there are any social workers, psychologists, other health care professionals out there who are working in the violence, abuse and neglect space, then come on, join the violence, abuse and neglect network. By doing that, you can actually stay up to date with all the innovations in the area. You can join the Agency for Clinical Innovations, Violence, Abuse, and Neglect Network. It's a great network Liz, they do so much and the website is actually in the show notes. So get on that, everyone, come on board, come into the community. So that's it for this episode Liz, what a great start. hey,
LIZ MURPHY:What a great start, can't wait for the next one.
DR. MIM FOX:I know, I know, thanks so much, everyone.
LIZ MURPHY:Bye for now.
DR. MIM FOX:Bye.
SPEAKER:Thank you for listening to this episode of the Making Visible podcast. All client experiences discussed in Making Visible have been de-identified. The content discussed in this podcast may be distressing. If you live in Australia and need support. Please contact 1800RESPECT. 1800 737 732 or lifeline on 132 114. Making Visible is produced by the Agency for Clinical Innovation, Violence, Abuse, and Neglect Network in partnership with the University of Wollongong and the Social Work Stories podcast team.
