According to NationalAdoptionDay.org, there are
approximately 100,000 children in the United States living in the uncertainty
of foster care while waiting for an adoptive family. With an average wait of 4
years, more than 23,000 children are aging out of the system with no family or
permanent home. Right here in Kansas, as
of 8/31/2015 there
were 6,464 children in foster care in an out of home placement and another
1,025 waiting for a forever family. (www.dcf.ks.gov) That is a large number of children living in
our towns that have relationship-based disturbances stemming from histories of
abuse, neglect and/or trauma. And those
hurts do not disappear overnight when adopted into caring loving families.
In
spite of the fact that these children are adopted into families that have
participated in 30 hours of state-mandated training, attachment problems,
behavior problems, and social problems manifest in these children frequently.
Often causing additional problems and trauma within the members of the adoptive
family. Many times, these children are often labeled with numerous mental
health diagnoses such as oppositional defiant disorder (ODD), reactive
attachment disorder
(RAD), Attention
Deficit Hyperactivity Disorder, (ADHD), as well as many others and then they are known as an alphabet
soup rather than the precious child(ren) they truly are. And in all reality, we must remember the
cause is the adverse childhood trauma.
Being
aware and identifying the fact that our children have experienced trauma is by
no means permission for the behavior.
Quite the opposite is true. In
fact, since we know that these children have been hurt relationally, we must
help them heal in a relational manner as well.
This is where Dr. Karyn Purvis and Dr. David Cross at Texas Christian
University’s Institute of Child Development have made such advances with the
development of Trust-Based Relational Intervention® (TBRI®). TBRI® is a parenting approach for all
children but we are focused on children from hard places. It combines structure and nurture in a way
that teaches respect and compliance while also being loving and playful.
TBRI®
provides parents, as well as other caregivers, teachers, and professionals ways
to connect with, empower and correct the children. What makes this approach so effective is the
fact that it addresses the past relational trauma that adopted kids have
experienced while giving parents the skills needed to help their children heal.
The skills developed during training utilize the most current brain and
behavioral research.
Many
times, when adoptive families reach out for help they are deep in crisis or
sliding there quickly and want to manage behaviors quickly and swiftly. With TBRI® the main focus is really on three
main principles: empowering, connecting, and correcting. Empowering principles
focus on the physiological (internal/physical) and the ecological
(eternal/environmental) needs of the child. Next, the connecting principles
address the attachment and relational needs. Lastly, the correcting principles
will bring about and teach self-regulation, boundaries, and healthy behaviors.
The
first focus is empowering. A child must
learn that they have a voice, and a voice that matters. When we are born into a safe, stable, loving
family we learn this during the first year of life when we hear tens of
thousand “yeses” to our most basic needs being met. However, for the child from the hard place,
we must recreate those developmental needs in current time through felt safety
in safe, structured environments that provide sensory rich activities; proper
nutrition with frequent snacks to maintain stable blood sugar levels; and
adequate sleep and regular physical activity.
Connecting
principles enable both child and parent (or caregiver) to experience personal
and interpersonal activities and behaviors that build trust and secure
attachments. Our same infant born into that safe, stable, loving family learned
through the external regulation of a mother that was attuned to the needs of
the child from food, to diaper changes, to comfort. Now our caregiver must learn to be mindful of
non-verbal cues so that adverse behaviors and basic survival instincts of
fight, flight, freeze can be avoided long before a response happens. Playful
engagement produces trust and warmth between children and their caregivers.
Additionally, it takes about 400 repetitions to learn something new but only
about 12 if you learn it while engaged in play. Who wouldn’t want that
short-cut!
Finally,
are the correcting principles of TBRI®.
As previously mentioned, many parents want to jump to the first,
however, if we meet the basic needs of the child and are connecting, this often
easily fall into place. These strategies
are very proactive and really designed as preventative teaching done through
practicing of life scripts such as: “use your words”, “with respect”, and
“Oops, try again”. During this time, caregivers should
be mindful of using the IDEAL response; the acronym is a simple reminder for
care givers to:
I—Respond immediately to the
behavior (Hester,
Hendrickson, & Gable, 2009) because research proves that
learning is greatest when the response is in swift temporal proximity to the
behavior.
D—Respond directly to the
child through eye contact, giving them undivided attention, and bringing them
nearer to you physically for teaching and guidance (Danforth, 2006) because
research documents significant shifts in brain chemistry and activity during
eye contact and proximity.
E—Respond in an efficient
and measured manner. This is reflected in Levels of Response, in which
caregivers use the least amount of firmness, corrective effort, and verbal
directive that is required to correct the behavior (Hester, Hendrickson, & Gable, 2009).
This strategy also helps children gain trust, knowing adults will not overreact
to their behaviors
A—The response is action-based.
Redirect the child to practice an appropriate behavior alternative. Physically
lead them through a real-life “re-do” when possible. Once the “re-do” is
successful (because they used the appropriate alternative behavior), praise the
child (Heimlich
& Ardoin, 2008; Hohnke & Sur, 1999; Reed, 1996).
L—Level the response at
the behavior, not at the child. Never reject the child as a person,
only
respond to the behavior (Barber & Harmon, 2002; Mills & Rubin,
1998).
It
is vitally important to keep in mind that children with histories of complex
developmental trauma have unique struggles and challenges for caregivers as
they work to meet those needs. TBRI® is
a relationship-based model that can be carried out by nurturing and insightful
caregivers and implemented in nearly every environment. It is very holistic in nature, cost
effective, and has huge potential for creating positive impact for children from
hard places. The most difficult hurdle
to overcome, is that of the caregivers need to learn the skills of mindfulness
and self-reflection of our own emotional triggers and responses we have
developed from our own childhood experiences, parenting and attachment styles.
However, once that is done, you will hopefully be pleasantly surprised by the
“ah-ha” moments and optimism that TBRI® brings.
Barber B. K.,
Harmon E. L. Violating the self: Parental psychological control of children and
adolescents. In: Barber B. K., editor. Intrusive parenting: How psychological
control affects children and adolescents. Washington, DC: American
Psychological Association; 2002.
Danforth J. S. Parent training for families of children with
comorbid ADHD and ODD. International Journal of Behavioral Consultation &
Therapy. 2006;2(1):45–64.
Heimlich J. E., Ardoin N. M. Understanding behavior to
understand behavior change: A literature review. Environmental Education
Research. 2008;14(3):215–237.
Hester P. P.,
Hendrickson J. M., Gable R. A. Forty years later: The value of praise,
ignoring, and rules for preschoolers at risk for behavior disorders. Education
and Treatment of Children. 2009;32(4):513–535.
Hohnke C. D.,
Sur M. Development of the visual pathways: Effects of neural activity. Mental
Retardation and Developmental Disabilities Research Reviews. 1999;5(1):51–59.
Mills R. S.
L., Rubin K. H. Are behavioral and psychological control both differentially
associated with childhood aggression and social withdrawal? Canadian Journal of
Behavioral Science. 1998;30(2):132–136.
Purvis
K.B, Cross D.R., Dansereau D.F., Parris
S.R. Trust-Based Relational Intervention (TBRI): A Systemic Approach to
Complex Developmental Trauma Child Youth Serv. 2013 Oct; 34(4): 360–386.
Reed E. S.
The necessity of experience. New Haven, CT: Yale University Press; 1996.
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