Therapeutic foster care - Berry Street Childhood Institute

isolated physically and socially a family becomes, the
more vulnerable a child becomes (Perry, 2006).
Contact and access with biological family
Contact with family is vital to the well-being of
children while in care, and ongoing contact has been
shown to facilitate family reunification. However, in
the light of trauma theory, actual and felt safety needs
to be established in relation to contact and access
visits with family members. Establishment of this
kind of safety is often beyond the means of carers and
workers. Advocacy for safety is very important. This
also means that contact has to be properly supported,
and carers need to understand the child's experience
of contact.
Many children react badly to contact visits, returning
to placement with destructive and oppositional
behaviours. The reasons for this are complicated and
include:
Grief - the child may be reminded of both the care
they did receive from their natural family, and of the
care they should have but did not receive. Children
visiting extended family members can also be
reminded of absent parents. Loss for these children is
huge, loss of real people and loss of potential for love.
Trauma - children are sometimes reminded of traumatic
incidents when they see a family member who has hurt,
frightened or neglected them. Children may be afraid
that the adult will hurt them again, no matter how much
supervision is provided, so they have a compounded
reaction, the memory of hurt is activated, in the presence
of the possibility of further hurt.
Guilt - children often feel responsible for abuse - it is
part of childhood to believe that everything that
happens is somehow due to something you did or did
not do - trauma is no exception, and many children
feel responsible for the breakdown of the family, as
they might be the one who disclosed, or who didn't
keep their bruises hidden. Children in these situations
are also sometimes blamed by the parent for the
disclosure or for the abuse.
Abuse - there are many examples of abuse continuing
during contact visits, sometimes physical or sexual,
sometimes threats.
All of the above responses can create intense feelings,
they can be confusing for children, and can easily lead
to acting out behaviour, distress, rejection of the carer,
or regression. This is not to say that contact should
not happen, but the experience of the child must be
acknowledged and understood.
References
Allen, Jon, G. (2003) “Mentalizing” Bulletin of the
Menninger Clinic 67(2) Spring, 91-112.
Beaulieu, D. (2003) Eye Movement Integration
Therapy: The Comprehensive Clinical Guide. Crown
House Publishing, Carmarthen.
Fonagy, Peter (1999). “Transgenerational Consistencies
of Attachment: A New Theory” (web version:
www.dspp.com/papers/fonagy2).
Herman, Judith, L. & van der Kolk, Bessel, A. (1987).
'Traumatic Antecedents of Borderline Personality
Disorder' Psychological Trauma. American
Psychiatry Press Inc. Washington.
Herman, J., Perry, J. van der Kolk, B., (1989)
“Childhood trauma in borderline personality
disorder” American Journal of Psychiatry, Vol 146 (4)
Herman, Judith (1992/1997) Trauma and Recovery.
Hughes, Daniel A. (1997) Facilitating Developmental
Attachment: The Road to Emotional Recovery and
Behavioral Change in Foster and Adopted Children
Rowman & Littlefield Publishers, Inc. Lanham.
Matsakis, Aphrodite (1996). I Can't Get Over It: A
Handbook for Trauma Survivors (Second Edition)
New Harbinger Publications, Inc, Oakland.
Perry, B. (2006). Applying principles of neurodevelopment
to clinical work with maltreated and
traumatized children. The Guilford Press: New York.
Stern, Daniel (1985). “The Interpersonal World of the
Infant”.
van der Kolk, Bessel, A. (1996c). “Trauma and
Memory ”.
van der Kolk, Bessel A., McFarlane, Andrew &
Weisaeth, Laars (Eds) Traumatic Stress: the effects of
overwhelming Experience on Mind, Body and
Society. The Guilford Press, New York.
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