the book. Our life started to make sense. The authors clearly understood children like Allan—here were some answers to my quest. I had no illusions that the road ahead would be easy. But now my despair was assuaged with hope.
—Faye Hall
Predicting treatment success begins by assessing two factors: the family’s engagement in treatment and their faith in the treatment professionals. Our new model offers a third factor: Treatment success for children with a history of early trauma and attachment disruptions rests on the parent’s paradigm shift of viewing the child and his or her disruptive behaviors through the “trauma lens” and accepting and using a different parenting model.
Imagine the impact of parents and professionals educated in trauma, child development and attachment before the child is placed in the home. Parental expectations will be aligned with the child’s capacity for healthy relationships. The parents and professionals will be equipped with effective interventions to support restructuring internal belief systems, emotional maturation and opportunities for attachment. Parents will have support and encouragement from trained professionals. The child will be encompassed by treatment consistency while developing relationships that heal. Treatment will be difficult but energized with new hope.
Even after a child is placed in the home and the family is coping with disruptive behaviors, hope is not lost. An educated treatment team can help the family repair damaged relationships and spur new connections through trauma psychoeducation and healing interventions. It may take more time, but these parents will truly understand that trauma impairs a child’s development, decision-making skills and the ability to form healthy and reciprocal relationships. Underlying parental issues, attitudes and personal characteristics may prevent the paradigm shift, thus hindering success. When these barriers are identified and addressed, they can be diminished, if not fully removed, by the parents and the treatment team.
FLAWED ELEMENTS OF FAMILIAR PARENTING STYLES
1. All Human Beings with Problems Respond to Behavioral Interventions.
The current therapeutic culture strongly emphasizes behaviorism and assumes that human beings can universally learn via rewards and consequences. If one rewards good behavior, good behavior will ensue and continue. If one “consequences” poor behavior, the poor behavior will stop. If the modification plan fails, then one assumes the reward was not good enough or the consequence not severe enough. An underlying principle is that all behavior is a choice. Behavioral approaches foster the delusion that parents can address every problematic behavior effectively. They also assume that early trauma does not impede the child’s ability to choose good behavior. Finally, behavioral environments are often overly structured, with little time and energy for nurturing relationships.
Brandon’s Family
Bob decided to start summer vacation with a new behavior chart he had created for the emotional support classroom in which students could earn token rewards for each good behavior. Brandon liked playing with building toys, so Bob thought he would be motivated to earn a new set each week for completed chores. Bob proudly hung the chart on the refrigerator. Brandon was excited to earn the fireman set and the first week went well: Brandon got the set. Yet he struggled completing his chores the following week. He was very disappointed that he did not earn another set, but promised he would try harder. By Tuesday of the third week, Brandon was angry and defiant. He declared that Bob gave too many chores. He stopped playing with the building sets and became more interested in physical activities.
Brandon had developed a negative internal working model (N-IWM) from his early trauma. He could transfer his belief system to the external world through the “miracle” of disobedience and have this belief system reinforced through consequences administered as part of the treatment plan. Poor behavior would be identified as “bad,” “evil” and “mean.” A N-IWM causes an inability to effectively make decisions in a positive environment. The child feels a sense of “wrongness” when behaving in the expected way, as it runs counter to the N-IWM. Therefore, this inability to make positive decisions is essentially a “hurt part,” an injury that needs to heal like a broken leg would need to heal before a child can run again. Behavioral approaches assume that the child does not have this “hurt part,” but is instead capable of making good decisions (that is, that the child has a positive internal working model [P-IWM]).
Even after Brandon lost the reward, he preferred to believe, as Bob did, that he had “made the choice” to lose. Instead, the trauma-informed understanding is that Brandon is currently too weak for now to tolerate the fear that comes with success and the challenging of his N-IWM. Most children with early trauma damage will feel more comfortable with the interpretation that they chose the behavior (“I am bad,” instead of “I am too weak to do right.”) The negative consequence feels better to the child (accurately aligns with the child’s belief about self and adults) than the assumption that he or she is weak. But in reality, this child is no more able to make positive choices than a child with a broken leg is able to walk. By trying to implement a strictly behavioral approach, parents fail to account for the trauma damage—namely, the resulting negative internal working model (N-IWM) that will inevitably sabotage the behavior modification plan.
2. Parents Are Capable.
To begin the foster and adoptive process, parents must attend classes, be assessed and be found competent to parent a child. Responding to reference requests, friends and colleagues vouch for their moral integrity and social competence. Their home is inspected and other children in the home are questioned. Successful completion of the evaluation process and granting of the adoption or foster care license convinces parents that they are capable of parenting any child brought their way. Their flourishing birth children further persuade them that “We can do this!”
Corey’s Family
Rebecca felt so confident when Corey arrived. He took his toiletries basket to his room and politely asked about dinner time: “I want to make sure I wash up before we eat,” he said. Rebecca was sure that he was a good fit for their family. He reminded her of her son Andy. A few weeks went by before she noticed food missing from the kitchen. Rebecca searched Corey’s room while he was outside playing. To her dismay she found food and wrappers hidden all over his room. That evening, Danny and Rebecca explained to Corey that he was not allowed to take food without asking. He promised he would never do that again. Unfortunately, the next night Andy’s friend was coming for dinner and Rebecca could not find the dessert she’d made. Rebecca began to question their decision to adopt.
During the integration process, most parents use their familiar parenting skills. It is not until problem behaviors escalate that parents begin to question why their child’s behavior is not improving. Rebecca calmly and clearly outlined for Corey why the behaviors were wrong or not needed. She checked his understanding by having him repeat her explanation, just as parenting classes advise. She provided him with suggestions for alternate behaviors and obtained from him a commitment to do things differently. After all, the parenting manual they had received provided the same techniques that they’d been applying successfully to their birth children. Their intuition told them that Corey really did understand and was contrite about the “oversights.”
But Corey continued to steal and stash food. Rebecca and Danny were faced with either needing to modify their perception of themselves or of Corey: either “I guess we are wrong. We are not good parents, just lucky that our birth children are all right,” or “We are good parents, but Corey is just bad.” And there it was, Corey’s N-IWM invading the here-and-now and infecting the parent-child relationship.
The parents’ belief of themselves as capable and good directly clashes with the child’s belief of the parents as incompetent and hurtful. Successful, capable parents like Danny and Rebecca can be comfortable
