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 <strong>care</strong>, 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 <strong>care</strong>rs and workers. Advocacy for safety is very important. This also means that contact has to be properly supported, and <strong>care</strong>rs 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 <strong>care</strong> they did receive from their natural family, and of the <strong>care</strong> 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 <strong>care</strong>r, 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) “<strong>Childhood</strong> 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. <strong>Therapeutic</strong> Foster Care 39
40 <strong>Therapeutic</strong> Foster Care