1. Beth Powell, LCSW www.infamilyservices.net
In Conroe, Texas
The Child-in-Family Approach to Helping Hurt Children Heal
Beth Powell, LCSW

2. The Child-in-Family Approach to Treating Children from Hard Places
1. Source-based, not symptoms based
Systems-based; child or teen is not seen alone; even young adults must come
with primary caregiver, support person or mentor
Strong teaching component for client, caregiver, support person or mentor
Recommendations for treatment are comprehensive and sequentially arranged.
Caregivers are trained as co-therapists so interventions continue at home
5. Evaluation is on-going; interventions are continually updated
6. Cost and time effective
7. Strengthens bonds and relationships between caregivers and child
8. Ideal caregivers are:
a. “Hands-on” parents who want to know what to do at home to help their
children be all they can be and who possess the time, the will and the
determination to be able to do so.
Beth Powell, LCSW, 2017

3. A Systems Approach to Intervention
Beth Powell, LCSW, 2015

4. Most Children Who Are Living in Foster/Adoptive Homes
Have Had Disruptions in Various Systems
That Have Caused Them
Emotional and/or Developmental Challenges.
Just Because Kids “Look” Like They Are Doing Okay
Doesn’t Mean That They Are.
Beth Powell, LCSW, 2015

5. Help Kids from Hard Places. Notice What Has the Most Influence.
It Takes More Than Love and a Good Home to
Help Kids from Hard Places.
Notice What Has the Most Influence.
Beth Powell, LCSW, 2015

6. Challenged Mentally, Neurologically, Physically,
Too Many Children Are
Challenged Mentally, Neurologically, Physically,
Spiritually, Socially and Academically
Because of That Previous “Hard Place.”
Beth Powell, LCSW, 2015

7. What Can Cause the Symptoms We See?
Anxiety
Developmental
Age
Nutrition
Insufficient
Oxygen
Boredom
ADHD
Vestibular
Wrong Meds
Perception
Differentiation
Fetal Alcohol
and Drugs
Beth Powell, LCSW, 2015

8. If We Are Going to Address the Problem,
We Have to Identify the Sources of the
Symptoms or Behaviors We See.
Sources don’t have titles like:
ADHD
Reactive Attachment Disorder
Intermittent Explosive
Disorder
Oppositional Defiance
Disorder
Conduct Disorder
Beth Powell, LCSW, 2016

9. Most of the Behavioral Symptoms We See
in Our Population Are Fear-Based and/or
Neuro-Behaviorally-Based.
Sources Such as the Following
Need to Be Addressed:
Sticky Interhemispheric
Switching
Family Dynamics
Immature
Differentiation
Sensory Processing
Issues
High Carb/Sugary Diets
Beth Powell, LCSW, 2016

10. Trauma Can Begin In-Utero
What pregnant mom experiences impacts baby.
What pregnant mom thinks impacts baby.
What pregnant mom feels impacts baby.
Reference: The Secret Life of the Unborn Child. Thomas Verny, M.D. and John Kelly. Dell Publishing (1981)
Beth Powell, LCSW, 2015

11. Trauma Can Be Post-Utero
Experiencing:
Neglect
Abuse
Loss
Disasters
Witnessing:
Violence (even on TV and computer screens)
Note: Pre-birth serious stress/trauma creates more complex brain problems which results in more extreme behavior/academic problems.
Beth Powell, LCSW, 2015

12. How Trauma Impacts the Growing Brain
Experience can change the mature brain…But experience during the critical periods of early childhood organizes brain systems!
The brain develops in a use-dependent manner from bottom of the brain to top of the brain.
It is easier to change the mind than it is to change the brain.
--From Dr. Bruce Perry, Trauma and Brain Development
Beth Powell, LCSW, 2015

13. An Integrated, Systems-Based Trauma-Informed Care Approach
Traumatized children need to be better identified and receive a comprehensive evaluation and treatment plan that is updated every 4-6 weeks: Neuro-behavioral, sensory, behavioral, psychological, nutritional, spiritual, social, physical, educational, etc.
The order of the child’s therapeutic interventions are determined by the systems that must change first so that the child demonstrates visible progress in the areas targeted.
Caregivers must be an integral part of the treatment session.
Foster/adoptive parents are the primary treatment providers; they need to be trained, supported and mentored.
Beth Powell, LCSW, 2015

14. Which Systems Need to Change First?
For Example:
Parent’s Marriage? .
Child’s Brain?
Child’s Mind?
Child’s Diet?
Parent’s Parenting?
Parent’s Perception?
Beth Powell, LCSW, 2015

15. Professional Evaluation Should Determine,
in Order of Importance,
The Systems
That Care Givers
Need to Change First,
So That Improvement
Can Be Seen in the Child.
Beth Powell, LCSW, 2015

16. Are We Identifying the Systems That Are Causing the Behaviors We See?
If a Child Presents with “Bad Behavior,”
Are We Identifying the Systems That Are Causing the Behaviors We See?
Beth Powell, LCSW, 2015

17. Or Attitude (Mind) Issues?
Brain Issues?
Brain
Attitude
Or Attitude (Mind) Issues?
Beth Powell, LCSW, 2015

18. It Takes Longer to Change a Brain Than It Does a Mind. Mr. “Attitude”
Beth Powell, LCSW, 2015

19. When Is It a “Can’t” And When Is It a “Won’t”?
Beth Powell, LCSW, 2015

20. Can’t = Brain/Sensory Challenge Won’t = Attitude Challenge
Beth Powell, LCSW, 2014

21. Beth Powell, LCSW, 2015

22. Safety-Security Comes First with Traumatized Kids and Is Emphasized Again, and Again!
Beth Powell, LCSW, 2015

23. Caregivers Have to Prove Whether the Behavior Is
Over and Over Again
That They Can Keep
These Kids Safe
Whether the Behavior Is
A Can’t or a Won’t.
Beth Powell, LCSW, 2015

24. Caregivers Must Also Be Trained to Recognize
Brain States and Brain State Changes.
They Must Also Learn How to Interpret
What the Child’s Behavior Is Really Saying.
And Then Intervene Appropriately at the
Right Phase of Arousal or Dissociation.
Not When It’s Too Late, and the Brain Is Continuing to Practice
What the Body Already Knows How to Do.
Beth Powell, LCSW, 2017

25. That is why each child needs to have on-going evaluation and updates
to treatment plan.
And caregivers
must have on-going
child-in-family training and mentoring
to meet the
neurobehavioral, behavioral, psychological
and spiritual needs of the child.
Beth Powell, LCSW, 2017

26. Good compensatory interventions are important, but
specifically designed neuro-sequential
brain-changing activities
that are frequently practiced are even better!
Beth Powell, LCSW, 2017

27. The brain develops in a use-dependent manner.
What is practiced becomes perfect.
What problems occur if the above is practiced too much?
Beth Powell, LCSW, 2017

28. The Flight-Freeze Side of Fight-Flight-Freeze
The Fight Side of Fight-Flight-Freeze
Arousal Spectrum Brain States:
Rising Anxiety→ Anxious Vigilance→ Fearful Resistance→
Angry Opposition→ Defensive Aggression→ Angry Meltdown
The Flight-Freeze Side of Fight-Flight-Freeze
Dissociative Spectrum Brain States:
Rising Anxiety→ Compliant Fearfulness→ Frightened Avoidance→ Freaking Out or Dissociation→ Loss of Consciousness
(Information on this page inspired from
Dr. Bruce Perry’s The Boy Who Was Raised As a Dog,
P. 249.)
Beth Powell, LCSW, 2017

29. Beth Powell, LCSW, 2015

30. Sometimes, the Behaviors of Traumatized Kids
Challenge Our Own Sense of Safety-Security.
Do You Get Triggered by the Little Angels
in Your Care?
Beth Powell, LCSW, 2016

31. Build Your Resilience! Strive to:
-- Identify the Sources of the Annoying Behaviors
--Remove the Judgment Regarding the Behaviors
--Remove Your Defeating Thoughts, Beliefs and Feelings
Triggered by the Behaviors
Beth Powell, LCSW, 2016

32. Read a Traumatized Child’s State Changes
Red ears?
Change in breath?
Rocking?
Deer-in-the-headlight look?
Pupil change?
Scanning the horizon for danger?
Nervous when people are too close or behind them?
Prickly?
Got hyper or ultra spacy?
Going (or went) ODD/OCD?
Pulse significantly increased, decreased or is erratic?
Beth Powell, LCSW, 2015

33. The Care-Giving Adult Must Build Trust and Emphasize Protection with the Traumatized Child
Watch Your Affect!
Voice Volume
Facial Expressions
Body Movements Should Not Indicate Threat.
Firm, but Empathic Style of Interaction with Child
Don’t Touch Hyper-Vigilant Kids Unless You Are Ready for Resistance!
Reward Them for Using their Words to Ask For What They Need.
Give Them Two Choices for Behavior: Both You Can Live With
Thank Them Ahead of Time for Doing What You Ask.
Avoid Yes/No Questions with Compliance Issues.
Safety-Security (The Feeling of Protection Develops before the Feeling of Love.)
Caregiver Is the Benevolent Authority Figure: Firm, But Loving.
Caregiver’s Posture Is Important as Well as Height above Child: Must Exude Strength/Protection.
Activity and Noise at Calm Level
Traumatized Children Need to be Situated Where They Can See Others Moving.
Organized, Clutter – Free Environment Important!
Keep to Schedules: These Kids Don’t Transition Well.
Watch for Kids’ State Changes and Be Proactive.
Start off Strict and Loosen Up as Positive Trust Develops.
Beth Powell, LCSW, 2015

34. Bibliography
Awakening the Child Heart. Carla Hannaford, Ph.D. Jamilla Nur Publishing
Behavior Solutions for the Inclusive Classroom. Beth Aune, OTR/L, Beth Burt and Peter Gennaro. Future Horizons
Easy to Love, Difficult to Discipline. Becky Bailey, Ph.D. HarperCollins
More Behavior Solutions in and Beyond the Inclusive Classroom. Beth Aune, OTR/L, Beth Burt, and Peter Gennaro. Future Horizons
On Killing: The Psychological Cost of Learning to Kill in War and Society. Lt. Col. Dave Grossman. Little, Brown and Company
The Body Keeps the Score. Bessel Van Der Kolk, M.D. Penquin Group. 2014
The Boy Who Was Raised as a Dog. Bruce Perry, M.D., Ph.D. and Maia Szalavitz. Basic
Books
The Connected Child. Karyn Purvis, Ph.D., and David Cross, Ph.D., and Wendy Lyons Sunshine. McGraw Hill
The Fabric of Autism. Judith Bluestone. The Handle Institute
The Secret Life of the Unborn Child. Thomas Verny, M.D., with John Kelly. Dell Publishing
Beth Powell, LCSW, 2015