The Child's Own Story: Life Story Work with Traumatised Children

Abstract

by Richard Rose and Terry Philpot London : Jessica Kingsley, 2005 ISBN 1843102870, 160 pp, £14.95 (pb) The New Life Work Model: Practice Guide . by Edith A Nicholls Lyme Regis : Russell House, 2006 ISBN 1903855810, 198 pp, £19.95 (pb) Life story work has had a mixed history in social work practice. Specialist social workers preparing a child for a home with a new adoptive family have seen life story work as an essential part of their task. Its aim is to help the child understand what has happened in their life so that they can move into a new family with some sense of where they come from. Ryan and Walker (2003) have explained how to do it well. However, one effect of huge workloads and constant reorganisation of teams in social services has been to put life story work under threat. Most social workers could write a life story book of their own about the changes they have been subject to; changes which have something of the same disruptive effect for them as do a succession of disrupted placements for the child. The task of life story work is sometimes given to a student on placement and then considered done. These books explain why this will not do. Edith Nicholls’The New Life Work Model grew out of her frustration with the sidelining of life story work through the rigidity of the child protection system. She argues convincingly that all children in the looked after system need help in making sense of their identity and the opportunity to grieve separations and losses. Therefore, the work must start ‘from the very moment a child is separated from their family’ (p. ix) and be a continuing and integral part of the care planning process, not something that takes place only when plans for permanence are being made. She suggests that a specialist fostering and adoption team carries out the work in parallel with the work of the child protection team. Nicholls goes on to describe practically how such work can be performed, initially for, rather than by, the child, with the worker collecting information relevant to the child's identity development whose value might otherwise be overlooked. Her book, enlivened by drawings and charts, conveys a sense of how aspects of a child's experience can be caught and preserved. She discusses memory books and boxes, photograph albums and family history books. The book is supported by three Memory Books designed to record the experiences at different ages of a child separated from their birth family (My Memory Book 0–4; 4+ and 8+. £12.95 each). She emphasises the importance of life story work being a shared responsibility, with foster carers and adoptive parents not only becoming the guardians of the child's memory books and albums (with copies kept safely elsewhere) but also continuing the work into the future. She includes a welcome recognition of the need to attend to carers’ feelings, such as their loss and grief when a child moves on, without which they become less able to continue the involvement that the next child needs. The Child's Own Story: Life Story Work with Traumatised Children is one of a series of books from SACCS about how to provide treatment for the most damaged children, those whose earliest life experiences involved neglect and abuse, and whose attachments were most damaged. Their inner worlds lack any coherence or integration and they view the world as hostile and themselves as unlovable. They are the children who have had numerous broken foster and other placements. There are a large number of such children on the books of social work agencies but few get the integrated therapeutic residential or foster treatment which can lead to recovery. Such integrated treatment involves ‘therapeutic parenting’ where every aspect of the child's daily experience is thought about and managed by those directly caring for the child. For example, the meaning of violent and demanding behaviour around bedtime can be seen as a sign of the child's fear connected to previous abuse or abandonment. Once the underlying symptom of fear has been identified it is possible to work out how to lessen it. Through reliable and thoughtful provision the child can start to feel safe and so is more able to think rather than act out. The provision of one-to-one therapy sessions is a vital support to therapeutic parenting but cannot replace it. The third strand of the recovery programme is life story work. Once children feel safe to begin to think and feel, and to connect the two, they are ready to start to make sense of what has happened to them in their lives. A pioneer of residential childcare, Barbara Dockar-Drysdale (1990), explained how an unintegrated child requires first a version of the good primary experience they have missed, with help to realise it is good, then the opportunity to internalise it through symbolisation and symbolic communication; and finally help to put experience into words where it can be thought about. This last stage of conceptualisation is the particular (if not exclusive) province of life story work. A child cannot simply ignore the past and move on. The past must be ‘understood, analysed and accepted as a means to progressing’ (Rose and Philpot p. 18). Distorted views of what happened, including self-blame, can be let go. Attachment theory makes clear that mental health requires a reflective capacity, the ability to give a coherent narrative of one's experience, however difficult that experience was. Multiple placement breakdowns mean that these children's histories are essentially lost. (Nicholls’ suggested procedures would improve matters). The painstaking work of the SACCS life story team is to carry out the detective work needed to reconstruct this history, using much the same tools as those engaged in the current popular occupation of researching their family history; that is, searching through documentary records and interviewing family members and others in the community to hear their stories. The aim is similar: the search for identity and meaning. On visits to places where they have lived or gone to school the children, where possible, accompany the worker. Richard Rose and Terry Philpot have plenty of helpful suggestions to aid the research, including the need to learn a lot about the complexity of a child's ethnic background. They emphasise that life story work takes time, going at a pace that is bearable for the child, and expect the whole process to take up to two years. As the information is gathered, fortnightly life story sessions with the child help with the process of internalising what has been understood and integrating it into the child's inner world. Amongst the arrays of tools such as family trees, ecomaps and so on, wallpaper rolls allow the child to collect material and write about their lives without ever turning over a page, where it may be forgotten. Only then comes the final task of writing the Life Story Book, the responsibility of the child's life story worker. This is written in the first person if possible, but sometimes it is only bearable for the child if the story is told in the third person. The worker needs to stay with the truth but express it in ways which the child can bear to hear and to learn from. The aim is a narrative that avoids either idealisation or denigration. This raises the issue of the power of the child's painful feelings which the worker must be able to tolerate and think about, providing emotional containment. This ‘holding’ demands a great deal of the worker's own capacity to stay with painful feelings rather than defend against them. The exercises at the ends of chapters hint at the necessary and usually painful task for workers of reflecting on their own experience, a task best performed in the context of a supportive facilitated group. So here are two thought-provoking books, very different in style; Rose and Philpott's a fluent and engaging narrative and Nicholls’ a breezy, informal unpolished handbook. Both are passionate about the place of life story work for children in the childcare system. They show what change is needed and how it can be performed.