Trauma responsive care model: An Aotearoa New Zealand research informed practice model for residential group homes
DOI:
https://doi.org/10.11157/anzswj-vol33iss1id825Keywords:
Foster care, residential group homes, therapeutic model, trauma-informed practice, trauma responsive care, child-centred practice, attachmentAbstract
INTRODUCTION: This article presents a research-informed model of trauma responsive care for use in residential care practice social work settings with children and young people in Aotearoa New Zealand. The model was developed from a qualitative project which sought to address the research question “Does the quality of relationships with staff members have a positive impact on outcomes for children who reside in group home settings?”
METHODS: Using semi-structured, in-depth interviews, eight children were interviewed regarding their experience of relationships while living within supervised group homes (SGHs). In order to gain multiple perspectives on this topic, six biological parents and two legal guardians of children were interviewed and focus group discussions were held with staff members from three SGHs. Thematic analysis was used to identify key themes identified from the findings.
FINDINGS: Five dominant themes were identified from the children’s and parent’s interviews. The central theme was the importance of relationships; that relationship is the key when working with children who have experienced trauma. Children who have experienced trauma need to feel safe in the context of relationships and benefit from bottom-up interventions in order to heal from their traumatic experiences.
CONCLUSION: A research-informed model of trauma responsive care was constructed from study findings informed by two principal bodies of knowledge: (1) attachment theory; and (2) neuroscience. The resultant trauma responsive care model provides a framework of strategies for anyone working with children in residential care settings who have experienced trauma and/ or attachment difficulties.
References
American Association of Children’s Residential Centers. (2014). Trauma-informed care in residential treatment. Residential Treatment for Children & Youth, 31(2), 97–104. https://doi.org/10.1080/0886571X.2014.918429
Atwool, N. (2010). Children in care. Office of the Children’s Commissioner. https://www.occ.org.nz/home/SearchFor mSearch=Children+in+Care&action_results=+
Atwool, N. (2013). Birth family contact for children in care: How much? How often? Who with? Child Care in Practice, 19(2), 181–198, https://doi.org/10.1080/135752 79.2012.758086
Bailey, J. R., Gross, A. M., & C. R. Cotton. (2011). Challenges associated with establishing a token economy in a residential care facility. Clinical Case Studies, 10(4), 278–290. https://doi. org/10.1177%2F1534650111410969
Bowlby, J. (1988). A secure base: Clinical applications of attachment theory. Routledge.
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77–101.
Briggs, E. C., Greeson, J. K. P., Layne, C. M., Fairbank, J. A., Knoverek, A. M., & Pynoos, R. S. (2012). Trauma exposure, psychosocial functioning, and treatment needs of youth in residential care: preliminary findings from the NCTSN Core Data Set. Journal of Child and Adolescent Trauma, 5, 1–15.
Bryman, A. (2012). Social research methods (4th ed.). Oxford University Press.
Champagne, T. (2006). Creating sensory rooms:Essential enhancements for acute inpatient mental health settings. Mental Health Special Interest Section Quarterly, 29, 1–4.
Champagne, Tina. (2011). The influence of posttraumatic stress disorder, depression, and sensory processing patterns on occupational engagement: A case study. Work, 38(1), 67-75. https://doi.org/10.3233/WOR-2011- 1105
Child Youth and Family. (2010). Key operating policies and procedures manual for supervised group homes (internal document). New Zealand Government.
Children’s Commissioner. (2016). State of Care 2016: What we learnt from monitoring Child, Youth and Family. New Zealand Government. https://www.occ.org.nz/ publications/reports/state-of-care-2016-what-we-learnt- from-monitoring-child-youth-and-family/
Creswell, J. W., & Miller, D. L. (2000). Determining validity in qualitative inquiry. Theory Into Practice, 39(3), 124–130. https://doi.org/10.1207/s15430421tip3903_2
De Bellis, M. D. (2005). The psychobiology of neglect. Child Maltreatment, 10(2), 150–172.
Forbes, H. T. (2012). Help for Billy: A beyond consequences approach to helping challenging children in the classroom. Beyond Consequences Institute.
Geller, S. M., & Porges, S. W. (2014). Therapeutic presence: Neurophysiological mechanisms mediating feeling safe in therapeutic relationships. Journal of Psychotherapy Integration, 24(3), 178–192. https://doi.org/10.1037/ a0037511
Golding, K. S. (2008). Nurturing attachments: Supporting children who are fostered or adopted. Jessica Kingsley Publishers.
Graham, G. (2006). Attachment theory and well-being for the young person in residential care: The provision of a second chance secure base for the child in crisis. Relational Child & Youth Care Practice, 19(1), 23–34.
Hambrick, E. P., Brawner, T. W., & Perry, B. D. (2019). Timing of Early-Life Stress and the Development of Brain-Related Capacities. Frontiers in behavioral neuroscience, 13, 183. https://doi.org/10.3389/ fnbeh.2019.00183
Harder, A.T., Knorth, E. J., & Kalverboer, M. E. (2012). A secure base? The adolescent–staff relationship in secure residential youth care. Child and Family Social Work Journal, 18(3), 305–317.
Herbers, J. E., Cutuli, J. J., Supkoff, L. M., Narayan, A. J., & Masten, A. S. (2014). Parenting and coregulation: Adaptive systems for competence in children experiencing homelessness. The American Journal of Orthopsychiatry, 84(4), 420–430. https://doi.org/10.1037/ h0099843
Howe, D. (2005). Child abuse and neglect: Attachment, development and intervention. Palgrave Macmillan.
Howe, D. (2008). The emotionally intelligent social worker. Palgrave Macmillan.
Hughes, D. A., & Baylin, J. (2012). Brain-based parenting: The neuroscience of caregiving for healthy attachment. W. W. Norton.
Jones, A. S., Rittner, B., & Affronti, M. (2016). Foster parent strategies to support the functional adaptation of foster youth. Journal of Public Child Welfare, 10(3), 255–273. https://doi.org/10.1080/15548732.2016.1148092
Mackinnon, L. (2012). The neurosequential model of therapeutics: An interview with Bruce Perry. The Australian And New Zealand Journal of Family Therapy, 33(3), 210–218. https://doi.org/10.1017/aft.2012.26
McGreevy, S. and Boland, P. (2020), “Sensory-based interventions with adult and adolescent trauma survivors: An integrative review of the occupational therapy literature”, Irish Journal of Occupational Therapy, Vol. 48 No. 1, pp. 31-54. https://doi.org/10.1108/IJOT-10-2019- 0014
Ministry of Social Development. (n.d.). Research access to Ministry of Social Development Information. New Zealand Government. https://www.msd.govt.nz/ about-msd-and-our-work/contact-us/research-access- committee/index.html
Ministry of Social Development. (2015a). Modernising Child, Youth and Family Expert Panel: Interim report. New Zealand Government. https://www.msd.govt. nz/documents/about-msd-and-our-work/publications- resources/evaluation/modernising-cyf/interim-report- expert-panel.pdf
Ministry of Social Development. (2015b). Expert Panel final report: Investing in New Zealand’s children and their families. New Zealand Government. https://www.msd. govt.nz/about-msd-and-our-work/publications-resources/ corporate/expert-panel-cyf/index.html
Mohr, W. K., Olson, J. N., Branca, N., Martin, A., & Pumariega, A. J. (2009). Beyond point and level systems: Moving toward child-centered programming. American Journal of Orthopsychiatry, 79(1), 8–18. https://doi.org/10.1037/a0015375
Munro, E. (2001). Empowering looked-after children. Child & Family Social Work, 6, 129–137. https://doi.org/10.1111/ j.1365-2206.2001.00192.x
New Zealand Legislation. (2019). Oranga Tamariki (National Care Standards and Related Matters) Regulations 2018. New Zealand Legislation. http://www.legislation.govt.nz/ regulation/public/2018/0111/latest/LMS56030.html
Perry, B. D. (1997). Incubated in terror: Neurodevelopmental factors in the “cycle of violence.” In J. D. Osofsky (Ed.), Children in a violent society (p. 124–149). The Guilford Press. https://www.researchgate. net/publication/246456464_Incubated_in_terror_ Neurodevelopmental_factors_in_the_Cycle_of_Violence
Perry, B. D. (2005). Maltreatment and the Developing Child: How Early Childhood Experience Shapes Child and Culture. The Margaret McCain Lecture Series, 1-6. https://www.lfcc.on.ca/mccain/perry.pdf
Perry, B. D. (2006). Applying principles of neurodevelopment to clinical work with maltreated and traumatized children. In N. B. Webb (Ed.), Working with traumatized youth in child welfare (pp.27-52). The Guilford Press.
Perry, B. D. (2011). Keep the cool in school – Self-regulation: The second core strength. Early Childhood Today. https://www.scholastic.com/teachers/articles/teaching- content/keep-cool-school-self-regulation-second-core- strength/
Perry, B. D. (2017). The Child Trauma Academy [PowerPoint slides]. https://www.butler.edu/sites/default/files/coe_ bperry_slides.pdf
Perry, B. D. (2020, 2nd April). 4. Regulate, Relate, Reason (Sequence of Engagement): Neurosequential Network Stress & Trauma Series. https://www.youtube.com/ watch?v=LNuxy7FxEVk
Porges, S. W. (2004, May). Neuroception: A Subconscious System for Detecting Threats and Safety. Zero to three, 19-26. https://static1.squarespace.com/ static/5c1d025fb27e390a78569537/t/5ccdff181905f41db cb689e3/1557004058168/Neuroception.pdf
Powell, M. A. (2011, June). International literature review: Ethical issues in undertaking research with children and young people (Literature review for the Childwatch International Research Network). Southern Cross University, Centre for Children and Young People/ University of Otago, Centre for Research on Children and Families.
Robinson, O. C. (2014). Sampling in interview-based qualitative research: A theoretical and practical guide. Qualitative Research in Psychology, 11(1), 25–41. https://doi.org/10.1080/14780887.2013.801543
Substance Abuse and Mental Health Administration. (2014). SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. U.S. Department of Health and Human Services. https://ncsacw.samhsa.gov/userfiles/files/SAMHSA_Trauma.pdf
Schore, A. N. (2001). Effects of a secure attachment relationships on right brain development, affect regulation, and infant mental health. Infant Mental Health Journal, 22(1–2), 7–66. https://doi.org/10.1002/1097- 0355(200101/04)22:1%3C7::AID-IMHJ2%3E3.0.CO;2-N
Spiegler, M. D., & Guevermont, D. C. (2003). Contemporary behavior therapy (4th ed). Wadsworth Cengage Learning.
Szalavitz, M., & Perry, B. D. (2011). Born for love: Why empathy is essential– and endangered. William Morrow.
Sprinson, J. S., & Berrick, K. (2010). Unconditional care: Relationship-based, behavioural intervention with vulnerable children and families. Oxford University Press.
Streeck-Fischer, A., & Van Der Kolk, B. A. (2000). Down will come baby, cradle and all: Diagnostic and therapeutic implications of chronic trauma on child development. Australian & New Zealand Journal of Psychiatry, 34(6), 903–918. https://doi. org/10.1080%2F000486700265
Van Der Kolk, B. (2002). In terror’s grip: Healing the ravages of trauma. Cerebrum, 4, 34–50. https://www.dana.org/ article/in-terrors-grip/
Van Der Kolk, B. (2014). The body keeps the score: Mind, brain and body in the transformation of trauma. Viking.
Warner, E., Koomar, J., Lary, B., & Cook, A. (2013). Can the body change the score? Application of sensory modulation principles in the treatment of traumatized adolescents in residential settings. Journal of Family Violence, 28(6), 535–634. https://doi.org/10.1007/ s10896-013-9535-8
Wilson, K., & Sinclair, I. (2004). Contact in foster care: Some dilemmas and opportunities. In E. Neil & D. Howe (Eds.), Contact in adoption and permanent foster care. Research, theory and practice. (pp. 165-183). British Association of Adoption and Fostering.
Zelechoski, A. D., Sharma, R., Beserra, K., Miguel, J. L., De Marco, M., & Spinazzola, J. (2013). Traumatized youth in residential treatment settings: Prevalence, clinical presentation, treatment, and policy implications. Journal of Family Violence, 28(7), 639–652. https://doi. org/10.1007/s10896-013-9534-9
Ziegler, D. (1994). A residential care attachment model. In B. James (Ed.), Handbook for treatment of attachment- trauma problems in children (pp.248-255). The Free Press.
Ziegler, D. (2002). Traumatic Experience and The Brain, A Handbook for Understanding and Treating Those Traumatised as Children. Acacia Publishing.
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:
By completing the online submission process, you confirm you accept this agreement. The following is the entire agreement between you and the Aotearoa New Zealand Association of Social Workers (ANZASW) and it may be modified only in writing.
You and any co-authors
If you are completing this agreement on behalf of co-authors, you confirm that you are acting on their behalf with their knowledge.
First publication
By submitting the work you are:
- granting the ANZASW the right of first publication of this work;
- confirming that the work is original; and
- confirming that the work has not been published in any other form.
Once published, you are free to use the final, accepted version in any way, as outlined below under Copyright.
Copyright
You assign copyright in the final, accepted version of your article to the ANZASW. You and any co-authors of the article retain the right to be identified as authors of the work.
The ANZASW will publish the final, accepted manuscript under a Creative Commons Attribution licence (CC BY 4.0). This licence allows anyone – including you – to share, copy, distribute, transmit, adapt and make commercial use of the work without needing additional permission, provided appropriate attribution is made to the original author or source.
A human-readable summary of the licence is available from http://creativecommons.org/licenses/by/4.0, which includes a link to the full licence text.
Under this licence you can use the final, published version of the article freely – such as depositing a copy in your institutional research repository, uploading a copy to your profile on an academic networking site or including it in a different publication, such as a collection of articles on a topic or in conference proceedings – provided that original publication in Aotearoa New Zealand Social Work is acknowledged.
This agreement has no effect on any pre-publication versions or elements, which remain entirely yours, and to which we claim no right.
Reviewers hold copyright in their own comments and should not be further copied in any way without their permission.
The copyright of others
If your article includes the copyright material of others (e.g. graphs, diagrams etc.), you confirm that your use either:
- falls within the limits of fair dealing for the purposes of criticism and review or fair use; OR
- that you have gained permission from the rights holder for publication in an open access journal.
