EP64 Bridging Childhood Trauma and Therapeutic Practices; A conversation with Sarah Dillon.

Philippa Kelly speaks with Sarah Dillon, consultant psychotherapist and head of therapeutic services for True Fostering and Safer Fostering, about how her own childhood in and out of foster care shapes her child-centered, trauma-informed work. Sarah explains why children react strongly to birth family contact, how sibling conflict can stem from trauma bonds, unmet needs, shame, and difficulty holding dual attachments, and how caregivers can use empathy, visuals (like her “pie” analogy), and consistent “PACE” narratives to keep relationships intact. She outlines her agencies’ proactive approach, including the Trauma Tracker tool and life story work, and describes compassion fatigue (including “blocked care”), how to spot it, and ways to support carers. They also discuss transitions, visual timetables, linking cause and effect without punitive consequences, and Sarah’s new children’s book, “Inside Big Me Lives a Little Me.”

Centre of Excellence in Child Trauma - https://www.coect.co.uk/about-us

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Transcript

Bridging Childhood Trauma and Therapeutic Practices; A Conversation with Sarah Dillon

[00:00:00] 

Philippa: Welcome to this week's episode of Pondering Play and Therapy with me, Philippa Kelly. And this week I'm really excited 'cause my guest is Sarah Dillon and she's a consultant psychotherapist and she's head of therapeutic services for two fostering agencies and for the Center of Excellence in Childhood Trauma.

She's an author, a keynote speaker and. Has spent most of her childhood in foster care, which I'm guessing Sarah has influenced how and why you do what you do. But first of all, welcome to the podcast. 

Sarah: Thank you so much. Thank you for having me, Philippa. Yes. I spent my childhood in and out of the foster care system.

We were in care, out of Care, in care, out of care. Had numerous foster homes and at children's homes, and I do think that [00:01:00] I know that lived experience has really formed a foundation upon which I've built my career and the way in which I work with families and the children they care for.

Philippa: Yeah. Do, when you say we, did you have brothers and sisters? 

Sarah: Yes. Yes. I'm the eldest of six, sadly now only five of us. But yes, I'm the eldest of six. And yeah I, was very much parentified. I spent a lot of my childhood actually. Being the parent to my siblings. And yeah, I think I still struggle with that role now a bit too.

Philippa: Yeah. And I guess when we work with, children and young people, we, although we try really hard to get into the space where a child might be and we use all our or our, empathy and pace and all, those sorts of things, I imagine. For a child, we don't quite [00:02:00] get where it is. Because we are coming from an adult POS position, aren't we?

Sarah: Yes. That's the crux of my work is that I spend my life in the world of the child. 

Philippa: Yeah. 

Sarah: All of my work, all of my writing is always the voice of the child. So my whole work life is spent thinking about how would the child view this situation? What does this look like from the child's perspective?

A quick example of that is only yesterday a child has begun having birth family visits again with family of origin. And this is a looked after child and the child's behavior has escalated significantly. And when we had the meeting, ES said to talk about the escalation of behaviors since the reintroduction of contact.

The narrative from the profe other professionals around me was [00:03:00] that yes. But the parent has done a lot of work on themselves. Yes. But the parent is doing really well now. Yes. But the parent has turned their life around and I've said Yes, and that's fantastic news. I'm really happy to hear that. But the child doesn't.

Understand that, 

Philippa: yeah, 

Sarah: the child remembers things as they were not as they are now, that part of the child is still stuck remembering how the parent was when they originally lived with them. And so it's about trying to get the other professionals around me to stay firmly in the space of the child, looking at the world through their eyes, through the lens of their historical trauma.

Philippa: And that, I imagine it is quite difficult 'cause there's lots of pressures isn't there, around keeping birth families together, prioritizing at times the needs of the parent to the needs of the parents have contact or family time. What, whatever you call it. [00:04:00] From the court, from the system, from the documentation, from the law.

Really? Yes. The, parental rights, although we have the Child Protection Act, the parental rights are really well established in that, aren't they? 

Sarah: Yes. And of course I support that our children should have ongoing relationships with their family of origin. If it is safe to do and that's, the deciding factor.

It shouldn't be a one size fits all, but Absolutely. I'm very grateful that I had ongoing relationship with my birth family. I consider myself really privileged to have more than one family. And, that's what's important for our children too, to understand. They don't have to choose because of course they have a false sense of loyalty to birth family.

And maybe it's not a false sense. Maybe they are. They can be authentically loyal, but sometimes we often find our children because they're so egocentric, they will put the birth family on a [00:05:00] pedestal. And they believe that they will only be worth something that their internal working model dictates the fact that they're not good enough.

And the only way I'll be good enough is if my parent becomes who I need them to be. 

Philippa: Yeah. 

Sarah: And it's very complicated. It's very messy. It isn't we can't tie it up with a nice bow and make it look nice. We really have to think about how is this truly impacting on the child? What's really going on for the child in this situation?

Philippa: And can I ask you about siblings? I've been doing some work and quite a bit of thinking around siblings and sibling relationships. I do fairplay as one of my main modes of supporting families and often see. See siblings and, parents will come along with the sibling relationship being at times violent and aggressive to, one another.

[00:06:00] And that's the bit that they want fixing. And what I'll say is actually we, need to see the children separately and help them. And then over time, hopefully that will help that relationship. You had six siblings how was that for you in that separation? And or I'm assuming you were separated.

Not many foster placements have six children all in one go, do they? 

Sarah: No. Only five of us were in care because my youngest brother was born a lot later on. There were times when all five of us were together, but mostly the girls were together and the boys were separate. And. We still have big issues in our relationship and in fact very fractured relationships.

The thing that's important to me is that I work very hard to do my best to try to keep sibling groups together. I think it's, It can be quite scary for supporting professionals to think how are we gonna [00:07:00] do this? How are we gonna manage that? You know what will that look like? There may need a lot of resources, a lot of help, and a lot of support.

I have worked out, I'm going to be writing a book about it, a bespoke way of working with siblings and diluting trauma bonds and keeping them together. It's a very specific way of working, and the first thing is two. Help the caregivers to understand the trauma bond, why it's there, what it looks like, how it's a fight for death, really.

I use the analogy of a pie, and it comes from our book, the Quick Guide to Therapeutic Parenting, where PI is an acronym for parental interaction and engagement. And of course, all children need a full pie. They need all of the parental interaction engagement to get all of their needs met. And a, when a child has been neglected, of course that hasn't happened, so they've only had a slither of pie.

So when another child is born. They vie for the pie they will vie for that interaction because [00:08:00] without parental interaction, I die. So it's a fight for survival. So when we think about a sibling rivalry it's, sibling rivalry there is really this need to survive.

And so my sibling is a threat to me getting my needs met. 

And also. Because our children are drowning in shame because of Egocentricity, because of that negative internal working model. When I look at you, I hate me more. So I used to think mom's had another baby to replace me. I wasn't good enough.

So she tried again. So of course my siblings, whenever I looked at them, I was reminded of how rubbish I was. So these trauma bonds have to be understood in a really. Deep, meaningful way. So an example of that is when I look at, when my foster parent or adopted parent, whoever it is, when my caregiver looks at my [00:09:00] brother and not at me, I'm going to attack my brother or attack my caregiver because the, even the interaction with my sibling.

I perceive as a rejection of me. 

And the other thing that my work, I've been doing this work for 22 years and the other thing that my work has shown me is that our children struggle with a dual attachment. So they cannot hold their attachment to more than one person at a time. And they cannot understand that their caregivers can.

So if you are spending that time bonding with my brother, caring for my brother, doing up his shoelaces. Then you have abandoned me. 

Philippa: And 

Sarah: so the violent reactions are as a result of feeling acute abandonment, a deep sense of shame, and utter survival because of the fear that I'm not gonna get my needs met.

Philippa: Yeah. Yeah. 

Sarah: So I work with parents to help them to understand this, the severity of it, [00:10:00] which is quite hard to hear. And then I say what we're gonna do about it, and the first thing we have to do is we have to help the children understand this. 

Philippa: Yeah. 

Sarah: The greatest gift you can give another human being is gift of understanding themselves.

When we help our children to understand why they behave in the way they do, it starts to dilute the behavior. 

So if I working with siblings, I help them to understand the reason why you struggle with your behavior with each other is because you see your brother as a threat to you getting your needs met.

When your mom or your foster parent or whoever it is, spending time with your brother or your sister, you are feeling rejected. So I use visuals, for example. I might use the visual of a pie, and I get the children to think about everything you'd want in a family pie. What would you want in a family?

And then I think, little, you didn't get that. You didn't get enough of that and big you is still worried. You are not getting [00:11:00] that now. And so then I divide the pie up into time that the parent gets suspended with each child and it works. And I've managed to keep siblings together. Who ordinarily would've part many hundreds of families keeping children together when even a, together and apart assessment has said they should be separated.

We've managed to turn that round. So I love keeping siblings together. 

Philippa: Yeah. Yeah. And it's, I guess though that understanding for children that it's not my fault is often. The first start of the conversation, isn't it? I, find just giving them that piece of information, can they, can I, know they still at times think it's their fault, but it gives a moment of doubt, doesn't it?

That maybe it isn't, maybe something else is going on and, I suppose what you are saying is then building on that kind of step by [00:12:00] step, and I'm guessing by. All the people around them, not just so that they're getting the same messages from, parents, foster parents around. Actually this is what's going on, and oh my gosh, I can see that this is really hard for you right now when I'm doing this with your sister.

I remember that. You find it tricky or sometimes I forget that you can't you don't know that I love you when I'm doing this. So those messages. 

Sarah: Yes, because it is that empathic commentary throughout the day, isn't it? And those therapeutics responses throughout the day from the parent. And of course as therapists we would back that up.

It's we use the narratives of pace. I can see you are struggling. I think you find it really difficult when I'm talking to your brother. Remember what we discussed before? Look, your time's coming up soon. We are gonna have our pie time shortly. It's all about that connection [00:13:00] and redirection.

But if all we do is redirect and reassure, we are working with the. The part of the child that's present now, but we are ignoring that younger part of the child that's still really frightened, and so it really is about the two together. I can see you are struggling. I know you are finding this difficult, but remember I'm still here for you.

Philippa: Yeah. 

Yeah. And what within the, fostering agencies that, that you support, do you do that work with foster carers? Do you support them? Do you have therapies? How, what's your role within that? 

Sarah: Yes I work for True Fostering in England and Safer fostering in Wales and myself and Sarah Naish and another colleague, Alison Douglas, we set up those agencies.

Sarah Na wrote The 87 Therapeutic Parenting. We do a lot of work together. So we set up the agencies and they are [00:14:00] truly therapeutic. So True stands for therapeutically reparented, underpinned by empathy and and safer is secure attachments formed through empathic repo responses. So we don't just give it the name of being therapeutic.

We don't just say we are trauma informed. It runs through everything we do, all our policies and procedures, all of our social workers, child support, everybody, and I head up the therapeutic service and. What we do is we have at least 98% stability across both agencies, which is unheard of. 

Philippa: It's very high.

Yeah. 

Sarah: Very high stability. And if our children move, it is never because of behavior. In seven years, I think we've had two, two children move because of behavior and that's where the foster parents didn't engage in the process. Otherwise, it's because of local authority decisions that the children move.

But what's most important in all of this is that our foster [00:15:00] parents are so well trained that they. Do not blame the children. They understand that the behavior is a mode of communication and the child is communicating three fundamental things. First of all, what they've not had, all those unmet developmental needs, how they feel emotionally, psychologically, sensory needs, and of course.

Trauma, what's happened to them? So we understand today through the lens of yesterday, and our foster parents understand that the behavior is the child's loudest voice. And for some of our children, sadly, it's their only voice. So I came up with a, tool that we use called the Trauma Tracker, and that's used nationwide and in fact it's used in internationally.

And it's in our book. The A to Z of therapeutic parenting prof for professionals. I'll just quickly show it to you. So it's a professional [00:16:00] companion. 

Philippa: Oh, perfect. 

Sarah: I've got 

Philippa: the A to Z of therapeutic parenting. 

Sarah: Yeah, that great. Yeah. So this is the professional companion and it's got our tools in it.

And one of them is the trauma tracker. And a colleague of mine who's also an author, wrote the trauma tracker for me. Excuse me. That's because I was writing another tool called the Developmental Foundation Planner, which is where we look in a bespoke way at meeting unmet developmental needs in older children where, those needs have not been met when they were younger.

Coming back to the trauma tracker, what that does is when a child comes into care or is moved into our agency, we glean as much information as we can from the local authority, not just the referral, but we wanna know what's not in the referral. 

And then I'm very much involved in matching. And then when we get all that information, we start to fill in the trauma tracker, which is a live document that if the child sadly did move, it would move with them.

In there, we can plot all the things that [00:17:00] have happened to the child and indeed all the things that haven't happened, and then we can say to our foster parents, these are the behaviors you are going to see. 

Philippa: Yeah. 

Sarah: This is what's likely to happen in your home and this is what you do about it. So they're already got all of that information.

And if it's not before the child is placed with them, it's very quickly afterwards. So very soon after the child comes into the foster home, because we don't call them placements because the placement is a temporary thing, we want them to stay and they do children. One child we've housed a few years ago, had 19 moves before she came home to us.

Philippa: Yeah. 

Sarah: And, we work in this way. And the beautiful thing about the trauma tracker as well is that when the child's behavior clearly tells us something else, so let's say for example, a child starts depl displaying sexualized behaviors, but we haven't got that in the history, then we're gonna put it in the trauma tracker anyway and say there's a [00:18:00] likelihood this child has been exposed to something of a sexual nature because of these behaviors.

And then when because we also deliver trauma informed life story work. So when life story work begins, we've got all that information in the trauma tracker, and we've got it in a way that is not just about what happened to me. But it's about what didn't happen for me and how that impacts my life today.

So yeah, we have this stability because we don't work in a reactive way. We are proactive and we don't put out fires if there's a spark. The whole therapeutic team are all over it until we can bring back stability to that family. And lastly, in answer to your question is that we are very we, commissioned the only research ser ish commissioned the only research into compassion fatigue in foster parents.

And of course, the block care [00:19:00] element of compassion fatigue. 

And secondary trauma and et cetera. And because we commissioned that research, we are experts in the world in compassion fatigue and how to bring parents out of block care back into relationship with the child. We're always looking at the whole picture in a holistic way.

And also we don't say to our foster parents, just tell me about your foster children. No, tell me about your other children. Tell me about you. Tell me about the rest of your family. Tell me about your mother who's in a care home. Talk to me about that, because we believe our families need that support in order to support the children.

Philippa: Oh that's, yeah. That's amazing. 'cause trauma informed is really. It is a word that's bandied around quite a bit. I, interviewed Karen trace a few weeks ago and she was talking about trauma informed and [00:20:00] being, and the difference between trauma informed and trauma aware. Yes. So lots of people are trauma aware.

You know that they have an awareness of it, that there's little bits of it, but actually to be trauma informed is something that has to run through everything all the time and it's what you do. So that's to have that in a fostering agency is amazing. And I could talk more about that, but I have another question that I'm thinking.

That people listening, I just wondered, you used the term blocked care and as professionals we often talk about block care, certainly social. My background's a social worker. We talk about block care, but actually if you are a new practitioner or maybe a family listening to this or a young person, can you just explain a little bit about what that is and the impact of it?

Sarah: Yes. I don't usually use the term block care, and I'm only using it so that people understand what I'm talking about. We talk about compassion fatigue, that's the correct terminology. And when we did our [00:21:00] big piece of research was what, which was through the Hadley Center at the University of Bristol Dr.

Heather Ottaway. What happened was they discovered that at least 85% of foster parents, and I think it's much higher. And of course, adopters, kinship carers will experience compassion fatigue at some point during the time that they're parenting children from trauma. And block care is an element of compassion fatigue.

Compassion fatigue is an umbrella term that covers burnout, that covers being in, in a defense mode, even with the local authority or other practitioners, so other supporting professionals or indeed the children. And you can be in compassion fatigue with one child and not another. That's a really important point to make.

Philippa: And 

Sarah: And then there's vicarious trauma. So we wanted to cover the whole picture really. And. What happens is in your brain you [00:22:00] have something called a cingulate, and it's in the limbic system of your brain. And the cingulate needs to be switched on to access empathy, and also to be switched on to not just access empathy, but to access your higher thinking, to access all your strategies, et cetera, et cetera.

And because the cingulate needs to be switched on, of course, it's a bit like a dimmer switch. It can switch off. 

And the reason that we have the singular is so that we can care for other people. People who care for family members with dementia and nurses, et cetera, may experience compassion with fatigue because you keep giving to somebody who can't give back in the same way.

So I use polystyrene cups and I pick one cup up and I put loads of holes in it to evidence all the things the child hasn't had between the ages of n to four. And then we have a cup full of holes and then I have a cup without holes. And I talk about reciprocity about that into subjective [00:23:00] relationship.

You give and they give back, you give and they give back. So with a securely attached child, there's all of that give and take and that reciprocal relationship. But when you are a cut with holes in it, when you are a child with developmental trauma, with all of these unmet developmental needs, as much as your caregiver is giving, you cannot authentically give back.

And because you are not able to give back, because there's no reciprocal relationship, not authentically the brain. Tells us this doesn't feel right. I need to take care of myself here 'cause I'm gonna burn myself out. So the cingulate starts to switch off to protect us. And so then the countenance of the caregiver changes.

They look different. Their eyes go dark. I can spot from across a room. If a, parent is in compassion fatigue, the language might start to change about the child. They may become quite blamey. They feel triggered when the child walks in the room. They house almost like PTSD markers of triggers [00:24:00] around the child's behavior.

And you may find that Johnny walks in the room and they have got this complete defense. 

Philippa: Yeah. 

Sarah: And Jessica walks in the room and they're fine. And then they get blamed. Because the system doesn't understand this. And they say Julie's a horrible foster parent 'cause she loves Jessica and she hates Johnny and know that could not be further from the truth.

She's in compassion fatigue with Johnny. And we have to be so careful here because this then taps back into all the sibling stuff where they might say, Johnny needs to leave. Johnny needs to leave, is getting in the way of Jessica. She's not thriving. We can't, so Johnny goes. And it's whack-a-mole because not very long afterwards, Jessica's baby behaviors start to surface because she now feels guilty and responsible for the fact her brother has left.

Philippa: Yeah. 

Sarah: And often the foster parent is then saying, oh, I think I've made a mistake too late. He's now 16 foster homes down the system. I want to stop children being moved so quickly. And [00:25:00] so working with compassion fatigue. Keeps families together and how do we deal with this? How do we switch the singular back on?

We are currently researching that at the moment, but what we do absolutely know is that empathy, sitting with that parent and not judging them, allowing them to offload with, without trying to fix it all of the time. 

Nurture. It's also about having regular breaks. I don't like the word respite.

Respite means a break from a difficult and troublesome thing, and I don't like how children described in that manner. But they will need regular breaks. And maybe it's not helpful for the child to go away, but we need to weave in ways that parent has a rest. And the other thing that I've discovered myself and Sarah, and that's also been used in our research, is we use something called havening, HAV.

E-N-I-N-G, and you can look@haveningonhavening.org.uk, and it is [00:26:00] neuroscience where we remove the triggers, the behavior triggers. From the parent and switch the cingulate back on. So using psychos sensory touch using slow brainwaves and distraction, I am able within 20 minutes to switch the cingulate back on and remove the behavior trigger.

Depending on how far the parent is into the compassion fatigue, particularly the blocked care element of it, they may need a few sessions. And even though I switch the cingulate back on. And I may have removed the behavior trigger as A-P-T-S-D marker. That doesn't mean the caregiver is out of compassion fatigue.

They still need to make sure it's never about self-care. It's about essential maintenance. It's about, this is selfish, not to be selfish. You have to look after you. What does that look like? It isn't gonna be a bath bomb and Prosecco. That's an insult. It's going to be. Somebody come around that we [00:27:00] do the ironing so I can have a lie down stuff like that.

So when it comes to compassion fatigue, we know how to help and we know how to help our parents out of compassion fatigue and the amount of times when children get moved because a caregiver is in compassion fatigue. So they move the child. And that doesn't resolve the problem. My foster mom used to say, my last foster mom, who was the wall at the side of my cliff that I walked along, she used to say, have, you've got mice in the kitchen.

Putting mice in the living room does not resolve the mouse problem. Keep moving. The child doesn't resolve the problem. So what we need to deal with is the cause of the problem. And so compassion fatigue needs to be better understood, and we offer. Very good training and compassion fatigue at the center of Excellence in child trauma.

And it is affordable and accessible, and we do our very best to ensure that supporting professionals get this stuff. 

Philippa: And that will link [00:28:00] in Will it with Dan Hughes and Jonathan Bailey. They, there's a book that they wrote, didn't they, about brain-based parenting, which really talks about, yes, I suppose it talks about one element of what you are talking about, which is the blocked care bit.

And you are talking about actually there's block care, but there's all these other things that go around it as well that we need this is what's happening. 

Sarah: Yes. 

Philippa: We need the, we need to understand this system. We need to offer this support. We need to, be in there because I suppose one of the things that are that parents that you work with on a day to basis, whether they're adopted, fostered, or birth, is the loss of joy.

In their child, but in their life. And that's hard when you lose those joyful moments where everything is that, oh gosh, she's gonna come in from school and put his shoes, and you're just in, that you that expectation of. Oh, he's just gonna leave his shoes on the floor of, or she's just gonna have not eaten a lunch that I made it, or, [00:29:00] and that, the nice, pleasant things that you expect a positive reaction from doesn't happen because, for a lot for, children, because they.

Often don't feel that they deserve it or it doesn't fit with their own internal working model. So those, I like the idea of, holes in the cup. So you buy them their favorite biscuits and then you give it to them and they say, oh yeah, but I preferred jam dodgers. I guess that's a hole in the cup, isn't it?

As in. I can't trust this interaction, or I don't feel like I deserve this interaction, so I have to minimize it or push it away or 

Sarah: sabotage it. Yes. 

Philippa: But yeah. But for a parent doing that over and over again, you can see that they get to a point and think there's no point doing it. 

Sarah: I agree. Because it feels there's no parental reward.

Philippa: Yeah. 

Sarah: And I often say to parents at the moment we can't look for gratitude. That may come many, years down the line. The child hasn't got empathy. They haven't even got empathy for self, let alone anyone else. [00:30:00] Developmental trauma, we, what we know about developmental trauma, and we know quite a lot now, is that our children cannot put themselves into the shoes of another person.

They're so firmly stuck in their own world of trying to survive and they suck you in and they spit you out. I want you, I need you. But I'm terrified of having you and I don't believe I deserve you. And if I let you get too close, you might hurt me. You might reject me, you might send me away.

And I'm being disloyal to my birth family. I was that child and I know what it's like to think, I wanna trust you. I would like to let you in, but I'm so terrified that if I do, you are gonna be another person to reject me. 

And still struggle with that today even. But for parents. Not getting that parental reward.

And I spent some time with my grandchildren the weekend before last. And the reward, they give me the joy the coming to me with their dolls [00:31:00] and dressing them together and giving me a kiss and a cuddle and, all that stuff. And it just reminds me every day of those parents who don't get that.

Philippa: Yeah. 

Sarah: And, the day I stopped feeling it is the day I stopped doing it and I wept. I just thought it's so hard. So I say to parents, find the diamonds amongst the muck. Go and look for diamonds. 

Train your brain to look for things that make you smile. And that may not be anything to do with your children at this moment.

It could be something completely different. I know Sarah Naish. Has got numerous dogs so there's a lot of reward from her dogs or whatever it is that, that you find comfort to you. As parents, we are so concerned with the wellbeing and the happiness of our children. We negate our own joy. I like that word joy.

Yeah. And we've got to go and find it. It doesn't find us. Joy doesn't find you. You've gotta go and find joy. You know my work. I [00:32:00] work far too many hours. I don't do anything except this. This is my life. It's my vocation, it's everything I do. I'm 60 in a few days time and I've only just begun working so it's, there's a lot of work to do.

And so people say, what do you do in your spare time? I've had to make myself do other stuff other than write about and study trauma. I've had to do other stuff. I love the theater listening to podcasts and videos. That's nothing to do with child trauma. 

I've developed an interesting steam trains, believe it or not, and that's 

Philippa: great.

Sarah: You need to find something. Yeah, you do. That's not about children. It's not about parenting, and it doesn't matter what it is. And you have to be like a dog with a bone and say, no, I need to put some scaffolding around that time. 

Philippa: Yeah. 

Sarah: When we approve foster parents, we use the therapeutic fostering assessment.

We don't use the standard form [00:33:00] form, and that is because we want to identify. A real true support network for you, not Auntie Mabel who lives down the road when once your children have moved in, she pretends she's not at home anymore 'cause she doesn't wanna open the door to you. Or your best friend who's had seven children and they're all perfect and went to university.

Those are not the people who are gonna be your supporters. You need people who have been there, done it, walked. The similar walk to you people with lived experience. So we identify other foster parents who are gonna be there to support you straight away. We want to know the stuff. We wanna find out about your resilience.

We don't wanna just find out about all the positive things that happened to you as a parent before you started to foster. We want to know about. The stuff that went wrong for you, and how did you overcome that, you know? What's your stickability gonna be like when you've got a child swearing at you and throwing a chair at your head?

And so you've got to have a very robust support network. Really strong [00:34:00] so that we are all right already identifying when you are gonna have a short break before your child's even come to live with you, or if you transfer to us. We want to identify very quickly how you're gonna get that support because.

We need to know that when, not if, when you experience some compassion fatigue, that we've already got a plan in place of how we're gonna support you. 

Philippa: Yeah, 

Sarah: and when I deliver my groups, I run about 70 groups a year and supporting foster parents mostly. But I would do work with a lot of doctors as well.

And, some of those groups are not just talking about the children and their trauma and how we understand that, but also let's celebrate you. We had a, big gala, a meal last week after our conference on trauma and technology and where we celebrated the achievements of our foster parents, where we gave them a lovely meal and we gave them an award and just recognize them as [00:35:00] individuals.

That you can tell. I feel very passionate about it. 

Philippa: Yeah. No, that's lovely. Yeah. '

Sarah: cause our parents can lose themselves in this work. Yeah. 

And 

it's important that doesn't happen. 

Philippa: Absolutely. And it's such a hard job, isn't it? I just have one more question. Sorry. It's lovely that you feel that and feel those and crazy.

Your foster carers will feel that. Don't, won't, they? I worked in a fostering agency as therapeutic lead for quite a while and yeah, I loved my foster carers and, children. And you do love them that they did. You do. You do. And Julie and I have done a whole podcast on professional love because it's a different kind of love what you.

You do, you have that love and respect and you see the little people come in and become big people and you see the challenges and, our jobs to be alongside that, isn't it? And championing them and holding them and scaffolding them and, I feel that my job is to [00:36:00] do. For the parents, what we want them to do for the children.

It's not it's not my job to do for the children, really, it's to do for the parents because they are the people and it hopefully is a little part of that support network. So it's lovely to see that. 

Really, although I don't want you crying on YouTube, I just have one more question that I, is a big one and it's probably a little bit more, is about transitions.

Because transitions I feel are often for children who've experienced. Early life adversity, however that is, transitions are really, tricky. And I, whether it's big transitions between different schools, but even just little transitions between playing and dinner between dinner and bed, and it often feels that.

They need to disconnect from the relationship in order to move on. Even with those little transitions and often [00:37:00] those disconnections become behaviors that are more challenging rather than the, yeah, okay, we'll just go and have a bath time now and let's play as we walk up the stairs.

They, now, why have I got to leave this now? And, because that's a way that they. Can leave what they're doing, but these transitions create these relational ruptures. I, feel lots and lots, but there's but, they happen for parents. They've got to transition all the time, haven't they?

From one thing to another. And it can be quite tricky. 

Sarah: I agree. I think we could talk for hours about this. Yeah. But, I always advise. In fact, I do a webinar called The 10 Vital Steps of Therapeutic Parenting. And step one is establishing yourself as the unassailable safe base. The parent has to be in charge.

Children feel safe when an adult is in charge [00:38:00] as long as they're dripping in empathy and nurture. You need to keep moving on with the thing you need to do, but. Again, with empathy and nurture. And one of the things, step two, is use a visual timetable. Children from trauma do not hear what you say. They see what you say they think in pictures which is why play therapy is very useful.

But they must have a visual timetable. It's not an optional extra. It shouldn't be. We, might want to use one. No, you have to have one. Or if the child doesn't want one, pretend it's yours. Pretend you are so important to me. I never want to forget anything that you need. This is what we're doing because the, that visual timetable as well acts as your map, and it tells the child, it gives the child the CPR of parenting, consistency, predictability, reliability.

That's the next thing we need to be doing. Every time we do a transition and we have developmental trauma, we experience loss. Every time we have to leave something [00:39:00] we are enjoying while we're enjoying it, we're having a break from having to stay alive. That's how big it is, and if there's lovely dopamine that's involved in whatever that activity is, it's very difficult to leave that because when I leave it, it isn't only about the moving onto something new and, a rupture.

In that relationship, perhaps with somebody that I'm spending time with. But it's also about leaving something I'm enjoying, much like a toddler screaming the place down when we take 'em away from soft play. But for our children, they also experience a loss. So I call them trauma hooks. And it hooks Into loss Into loss. So there's a. Big explosion within the child around this, of course, unless the child is hypo aroused, and then there's, they're very slow in their transitions and really difficult and dragging their heels. But it's important that parents and supporting professionals [00:40:00] understand that for the child it is.

An enormous task that they have to complete numerous times a day. Think about a child with developmental trauma who could be at least half the chronological age, emotionally, developmentally, much younger in a secondary school, having to navigate all those transitions, and then we wonder why they struggle.

One of the biggest transitions that I'm having a close look at the moment is the transition where people, particularly for foster children, where social workers start to talk about independence. You are, moving onto 18 now. We need to work on your independence skills. You've now got a pa rather than a social worker, fourteen's, the new 16, et cetera, et cetera, and I want to scream and rip my hair out. Because all you are doing is kicking a very big can down the road here, because that child is not ready for independence. [00:41:00] There is no such thing as an 18-year-old adult. They don't exist even in securely attached neurotypical children.

My youngest child is 21. And she's still at home and and she's trained to be a social worker. But I can tell you what, now at 18, she was very much still a child. And I say that respectfully to anybody on here who's 18, but your brain isn't fully formed until you're absolutely five anyway.

Yeah. So we are expecting children who are developmentally much younger than the chronological age, who are flooded with trauma, who are terrified about what might happen next to become magically independent at 18. And we start to talk about this, and that transition usually takes place over a couple of years.

And then we get this great big pushback. In the foster family because a child doesn't want this or they perceive it as rejection. So they sabotage their place in the foster home because they think you're getting rid of me anyway. And I want [00:42:00] control of the ending. Which is exactly how I always moved.

I will control the ending. You'll get me gone in my time because I don't want another rejection. So if we think about transitions, as you say, there are Big Ts and little Ts, but for our children. Every transition is experienced as a loss, and every transition creates a, an emotional explosion within the child.

So what do we do about that? The first thing we need to do is understand it. The second thing we need to do is stop trying to force. Children who are not old enough for independence to become independent prematurely so that people can save money. We need to stop doing that. And we also need to think about the fact that even with our smaller transitions, our children need to know that we can see this.

We're struggling with that. So rather than use requests, we will use instructions. [00:43:00] So I might say a chart to a child, Johnny, it is time to put your laptop away. We're gonna have our tea now. Oh, I don't wanna come off my laptop. You horrible person. I know you're finding that difficult sweet heartbeat. It'd be such a shame if we didn't have enough time for that film.

Later. Hopefully you'll change your mind. We do allow some natural consequences with nurture. Yeah. I'm not consequence driven. I don't believe in consequences for trauma, but I do believe in helping children to learn to link cause and effect. So sadly, if we've used up all the time in trying to get you off your laptop, there is gonna be less time for the film.

Yeah. That doesn't mean we won't watch some of it, but we won't get to watch all of it. And there may be another explosion. I always say that's an interesting choice you made. Yeah, hopefully you'll change your mind. Oh, that's a shame. 

Philippa: Like you said, that thing of oh my goodness, it's, I'm so sorry that we're not gonna be able to watch all that movie now.

I really, wanted it to so it, it's an inconvenience to them and I can be really empathetic about it. [00:44:00] Can't I rather done, and that's why I yeah. Rather than this is the consequence. 'cause I think then. It helps parents think. Think about, actually what we are doing is it's teachable moments

we are not punishing this child. We want theming 

Sarah: to learn 

Philippa: cause and effect, don't we? 

Sarah: Yes. However, the relationship must remain in tact throughout. Yeah, I can see you. Oh, that's a shame darling. 'cause if you don't put your toys away now we're gonna have less time for that and I was looking forward to that.

Such a shame. Hopefully you'll change your mind, darling. I'm just gonna put the kettle on so the relationship remains intact, but you are saying this is the expectation and we aren't gonna be able to access that. Until we've completed this. Everything is a shame. Such a shame and an inconvenience. And hopefully you change your mind, darling.

The important thing for parents is to not get sucked into that. Yeah. The child does this and you do that. Nobody wins. So if the child does this, you need to do that. I can see you are struggling. I can see that's difficult for you. That's such a shame. That's a real [00:45:00] inconvenience. 'cause I was looking forward to that later.

Hopefully you'll change your mind. So again. I don't use in requests. I'll use an instruction. Johnny, it's time to put your stuff away. 'cause if you, if someone said to me when I was a child, Sarah, please, can you put your things away? Yeah, I can, but I ain't gonna so it is time to, and then when it's done, thank you.

Move on. I understand we all want to be polite but we also need to get the job done. 

And it's, it keeps us going and moving forward in the right direction. And it helps. 

Philippa: And it's confusing. It's confusing when you're asked a question, isn't it? Do you know what I mean? Can you put your toys away?

That is literally a question. Yes, I can. What does that mean? Do, you know what I mean? And if we ask a question, that's what I will say. You have to be prepared for the answer you do. And it might not be the answer that you like. 

Sarah: Yes. 

Philippa: And then, but you have to live with it. If it's a negotiation, negotiate.

But no, you've got to give something. If it's an instruction, give [00:46:00] an instruction. And they are very different, aren't they? 'cause otherwise it's confusing. Confus they've got in confusing in their brain going round without deciphering. Is this. Actually a question, or is this an instruct? And that's hard then.

Sarah: It is hard. I remember my foster mom and I would say to her, I hate you. And she'd say, it must be so difficult living with someone you hate. Good job. I've got enough love for both of us. And I would go oh. And I still remember when I was about 13, I hated brushing my teeth. And so anyway, I, we'd always have these arguments about get brush your teeth they're gonna put that black mask over your face that they did in the seventies and take all your teeth out and all this sort of stuff.

And I'd be arguing, of course, I knew that it would get her going and I still remember the day when she shouted up the stairs, Sarah, what? I was horrible at times. She said, it is time to brush your teeth. I'm not brushing my teeth. And she said, that's a shame. 'cause we were gonna go down to Brixton later and have some ice cream and you can't put ice cream on dirty teeth.

[00:47:00] Hopefully you'll change your mind. And I thought, oh, I better brush my teeth. Because the consequence was as a result of the choice I'd made it was linking cause and effect. It wasn't about being punitive, it wasn't about throwing me in the shame pit. But it was about helping me learn that if this doesn't happen, that will happen.

That's very much about meeting unmet, developmental needs, isn't it? 

Philippa: Yeah. 

Sarah: But the most important thing in all of the stuff we've talked about is the relationship. Our children need to know that the relationship is intact with the caregiver. No matter what happens, there are three things our children fear the most.

Number one is you've stopped caring about 'em or you've stopped loving them. Number two, you're gonna get rid of them. And number three, you're not gonna meet their needs. So even if you have to have a tricky conversation about behavior, it's about saying, I want you to know I still care about you. If you love 'em, tell 'em you love 'em.

Don't be frightened of the word. I still love you. This is [00:48:00] still your family, and we are still going shopping tomorrow, but I'm not happy about that. 

Philippa: Yeah. 

Sarah: If you have a rupture in that tire that it represents the relationship, get your puncture, repair kit out quickly, fix the relationship, and then have a conversation about whatever you need to talk about.

Philippa: Yeah, I think that's, absolutely a lovely place to end there. But I just, before we, we completely end. One of the, things that we talked about was that you are an author. Yes. So you've just released a new book. Do you wanna show us what that is for YouTube and I'll describe it for the podcast.

It's inside, 

Sarah: inside Big Me Lives a little Me, and it's a story to help children who've been removed from their family of origin, adopted, fostered, and maybe even some children under a kinship care arrangement, children under special guardianship orders. And it's a book that helps us to understand that.

You are. You have got a child [00:49:00] who's a very fragmented child inside. This child here is trying to go to sleep, and little me is wide awake and it's helping a child to. Understand today through the lens of yesterday. It's a very small story that you can then build anything upon. So a quick example might be, do you remember we read inside Big me Lives a little Me, our children may push it away.

They don't wanna think about little me. They wanna reject that part itself. But the, parents need to understand that. You mustn't just care for the child who lives with you. Now you need to care for the child who never lived with you. That's the most important part of the child that you need to care for really.

And so when we are thinking about our trauma-informed responses, so say for example, a child is taking food, hiding food, hoarding food in their bedroom, we can revisit this story and say. Remember little U was very worried about food at times, but in this house there's always food. But because little U is wobbling at the moment and worrying, [00:50:00] and I've noticed that's been happening since you saw your mum last week, I'm going to give you a little container with some food in that you can take up to your room.

So in case little me wakes up in the night worried about food. You've got some, I've got children all over the country now saying That's me. That book's about me. That's my little me. I have children come to my private practice who say, I say how are you? I'm like, how's little me? She's not here today.

I'm afraid she has to come to the session. Mom, would you go out to the car and go and get little me please? And we have this wonder with wonderful conversations, and it really helps the child to begin to dilute the belief that they're bad and to accept themselves and understand it's not me, it's what's happened to me.

And it's not you. It's what I've been through. 

Philippa: Oh, that's beautiful. I'll put a link on the bottom of the podcast description to the book and also to the Center of Excellence for [00:51:00] childhood Trauma. And have you written books for adults as well? You've written other books you 

Sarah: shared?

That's my only, book at the moment for children. I'm writing seven books for children. The next one's going to be called the Trauma Tree. Inside Me Lives a tree. I call it the trauma tree. And on that tree are all the lights that represent all the bad things that have happened to me. It's a way to help children understand PTSD.

And. How we take the bulbs out, the lights, how we dim the bulbs and, really helping children to understand and manage complex PTSD. And another one that I've just written is called sad We Happy We, and it's about when children smear. Or they urinate in bottles and things like that. And so I really wanna cover things that most people haven't written about, and I want to write them so that parents can, and therapists can use them with children to really normalize what's [00:52:00] not normal.

Philippa: Because toileting issues are so big, aren't 

Sarah: they? So the other one that I wrote is therapeutic Parenting Rhyme and Reason this has got all of my poems in and the way it's been written is I've written a poem either from the parent or child perspective, and then I've put all the theory underpinning it.

So there's one in here called Liar. Talks all about why children lie. Writes the, poem as a liar from the child's perspective. Then gives us all the strategies within the poem and then the theory underpinning that, and that's called Therapeutic Parenting. Rhyme and Reason. 'cause parents say, I've got, there's no rhyme nor reason for the behavior.

So I give them all the rhymes and all the reasons. And this one is, I've summed it so much, it's well read that the Quick Guide to Therapeutic Parenting was written by myself and Sarah Naish. The green one that I showed you. 

Philippa: Yeah, 

Sarah: the Therapeutic Parenting Professional Companion. And we also wrote Therapeutic Parenting [00:53:00] Essentials, moving from Trauma to Trust which is a purple book and we are currently writing, which I'm very excited about.

And that'll be published by JKP next year. Oh no, June, I think. Anyway, it's called. The eight has had a therapeutic parenting for teens and tweens. 

Philippa: Oh, that'll be that'll be so well read and received, won't it? 'cause teens in general are quite tricky, but yeah. So that's really great. So thank you so much, Sarah, for your time and Thank you.

What an interesting conversation. I've got loads to take away. Thank you myself. I love these conversations 'cause it just helps my practice so much. I'm 

Sarah: very passionate, as you can tell, Philippa. 

Philippa: Yeah, and that's amazing. It is so lovely to see. So thank you so much. 

Sarah: You're so welcome. I hope I path across again.

Philippa: Absolutely. 

Sarah: Thank you so much. Bye-bye bye. Thank you. Bye.