Hearing and feeling a child’s narrative in Integrated Systemic Therapy – a whole systems approach to healing trauma Dan Neale Barbara O’Reilly

KEY OBJECTIVES Starting with a detailed focus on a therapeutic interaction between an iST therapist and a child (a dyad), we will: Hear/experience the intricate nature of the work with the traumatized children by looking through a series of ever-widening lenses: A triad A team A community The whole organisation View the therapeutic approach that contributes to “holding and containment” within the context of the whole systems approach. Show how we can “meet and match the moment of hope” (Winnicott) for each child.

INTENDED OUTCOME Workshop participants will gain: An experience of the application of the Integrated Systemic Therapy (iST) approach. Understanding of how iST encompasses key psychodynamic, psychoanalytic and systemic concepts in the treatment of the fragmented minds of traumatized children.

INTRODUCTION The Institute of iST A 100 year old charity A child psychotherapeutic training and research Institute Unique in our iST approach, developed over 50 years Specialist long-term psychotherapeutic residential and foster care Educate and treat acutely disturbed children and young people Fully immersive clinical training Advise Government about long-term therapeutic care for Looked After Children.  

WORKSHOP PLAN Child’s history Child’s narrative Dyad Triad Small team Community Whole organisation

BRIEF HISTORY OF CHILD Eloise is a 9-year-old girl. Placed at Marigold House, one of our residential Therapeutic Communities, for 10 months. Marigold House takes children aged between 5 & 13. Specialist education provision is attached. Taken into care, aged 6, along with brother, aged 4. Both severely neglected, under-weight, malnourished. The home was in a terrible unhygienic condition. There was little or no food in the home which indicated that the children were not likely to be fed regularly. Eloise’s mother suffered with mental health difficulties including chronic depression, exacerbated by her use of various illegal substances which she described as “self-medicating.” Eloise’s father: frequently absent from family home for reasons unknown. When around, known to have been violent to mother, Eloise repeatedly witnessed the domestic violence. Also possibility that she had directly experienced physical abuse by him.

BRIEF HISTORY OF CHILD On being taken into care, Eloise and brother placed with emergency foster carers for approximately one month. Moved to a “permanent” foster placement together. After 6 months, the foster carers gave notice on Eloise but kept her brother. The reasons cited were defiance, aggression, and some damage to property. Three more foster placements before moving to Marigold House. Similar reasons for the ending of the placement were given each time. As a result of one of these moves, Eloise had to move from her original (mainstream) primary school to a new (mainstream) primary school closer to the new carers. This broke down at the same time as the placement breakdown, as Eloise was assessed as needing specialist education.

DYAD Scene: It is breakfast time on a school morning, all 8 children are awake and Eloise has struggled to make her way into the kitchen. Most of the children (8), and most of the staff on shift (5), are in the large, open-plan kitchen and dining-room. Sally, Eloise’s linkworker, has just made breakfast for a couple of other children. The following interaction then occurs: Narrative to be read

TRIAD Sally has been encouraging her linkchild, Eloise, to have some breakfast. So far, this has been unsuccessful. Narrative to be read

TEAM A few days later, it is the Dynamics meeting for the “Green Team”. This consists of Sally, Terry, Ursula, Veronica and William. Veronica is the Team Leader, and Terry is her deputy. The group is facilitated by Maki, a Group Analyst who is a member of the staff group.

THERAPEUTIC COMMUNITY

ORGANISATION The DYNAMICS THAT REVERBERATE Trustees Monthly Group Dynamics Community and Staff: Therapeutic Milieu Child

SUMMARY iST methodology iST functions at individual, group, home and organisational levels, encompassing both children and adults. Typically, similar emotional and psychological material is encountered and addressed at all levels, thus offering a powerful system for understanding the unconscious processes affecting the children’s functioning, including emotional and psychological wellbeing. iST opens unconscious processes across the community to the possibilities of change, and aims to keep children and adults safe during the children’s journey to emotional and psychological health.