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HELPING HAND HOME FOR CHILDREN
A Model for Healing - Interventions for Traumatized Children
Who Are We?
Our residential program cares for up to forty-one
children at a time, ages four to thirteen, who have
suffered abuse and neglect.
Our Foster Care and Adoption Program currently cares for fifty-one children
and has 50 families, who are all trained in TBRI.
Residential Care: Foster and Adoption:
Helping Hand Home for Children is a Residential Treatment Center
and Foster Care and Adoption Program.
Our mission: To provide a nurturing and therapeutic home for children
and to restore each child to a healthy family setting.
For information on our Foster Care and Adoption Program: [email protected]
Who Do We Serve?
Our children come from the foster care system in the state of Texas and are
assessed as specialized, intensive, and intense plus, under that system.
We care for the children that many others do not endeavor to due to the intensity of
their behaviors. We know that their behaviors are a manifestation of the
trauma they are experiencing from their abusive and neglectful pasts.
Who Do We Serve?
Common behaviors we help the
children with are high rates of
aggression towards themselves or
others, running away, property
damage, and lengthy crying,
screaming, and yelling episodes
where their bodies are out of
control, also known as tantrums.
Interventions
The types of interventions we use with our children are
determined by the view we have of our children.
Impact of Trauma
Neuroscience shows us that trauma impacts healthy brain development
by causing imbalances in levels and expressions of key
neurotransmitters, chemicals, and hormones in the Central Nervous
System.
These imbalances lead to the aberrant behaviors previously
mentioned that our society labels as mental illness: Conduct Disorder,
Oppositional Defiance Disorder, ADHD, Reactive Attachment Disorder,
etc.
EXCITATORY
Respond to stressor stimuli in the environment and keep the brain focused on survival.
Focused on keeping
the brain and body in a
state of calm, help with
sleep, and determine
mood regulation.
INHIBITORY
Two Types of Neurotransmitters:
Trauma causes an increase, and quite often, a flood of excitatory neurotransmitters. Flooding may
produce a “neurotoxic wash” on the brain, similar to diluted bleach. This wash further suppresses
inhibitory neurotransmitters.
“Neurotransmitter Patterns and
Behavioral Correlates”
What do we know about our children?
Neurochemical impact of abuse & neglect: Living in a perpetual state of fear
Unable to adapt and adjust to their environment.
Low frustration tolerance and impaired communication skills.
Unable to problem solve, build relationships, and exhibit maladaptive behavioral responses.
They have very low self-esteem and minimal sense of self-worth.
They are responsive to and need kindness.
What do we know about their neurochemical
potential?
What do we know about their neurochemical potential?
The human brain can change throughout life given the right stimuli. By exposing
our children to new experiences we facilitate the development of new neural pathways. These pathways aid in self-
regulation, emotional IQ, and appropriate behavioral responses.
Experiential learning followed by effective praise is the key to successful rewiring.
Interventions
Motivation vs Capability to Self-Regulate
Reward/Consequence vs Relationship/Felt Safety/Trust
Behavior = Communication
Anger = Fear/ Loss of Power or Control
We understand that the
behaviors previously
listed are symptoms for
our children of deeper
emotional, psychological,
and physical needs that
were never met or even
damaged.
Interventions
Trust Based Relational Intervention (TBRI)
Empowering, Connecting, & Correcting
Trust Based Relational Interventions
TBRI is designed to meet the basic relationship and developmental needs of children and youth from “hard places”, as well as the needs of the adults who seek
to help them heal learn and grow.
Principles of TBRI
Connecting Principles: Create connections that disarm fear, gain trust, and enhance learning.
Empowering Principles: Empower learning and regulation by meeting physical and environmental needs.
Correcting Principles: Shape beliefs and behaviors, are dramatically effective because kids feel safe, connected, and empowered!
To build trusting relationships that help children feel valued, cared for,
safe, and connected. Disarming fear and building trust greatly increases
the capacity for connection, growth, and learning.
Connecting Principles
Connecting Principles: Mindfulness
What do I bring to this interaction from my
own history?
Be Flexible: adjust interactions based on the child's needs.
Be Aware: of the child's perception of your voice, presence, &
interactions.
Connecting Principles: Giving Voice
Our children are more likely to use aggression, violence, manipulation, & triangulation to deal with adults and other
children. Connecting strategies are dynamic in beginning to teach trust and disarm fear.
Give full attention: A child feels heard and valued when an adult gives full attention and eye contact -even briefly.
Offer Choices: When possible offer choices about activities during the day. This greatly enhances trust.
Offer Compromises: When possible, offer compromises about activities, events, etc. Again this greatly enhances trust, connection, and learning.
Share Power: allowing children to help make some decisions is called sharing power. Sharing power reinforces the adult's authority and at the same time creates connections and trust.
To prepare bodies and brains for success by providing an environment that meets the physical needs of children and youth.
Empowering Principles
Empowering Principles: Physical & Internal
Physiological Strategies:
Have the child's physical needs been met?
Provide hydration: encourage water consumption
Regulate Blood Sugar: healthy food every two hours.
Meet Sensory Needs: physical activity at least every two hours
Model Self-Regulation: teach and practice self-regulation skills, provide physical activities, and provide nurturing interaction throughout the day
Empowering Principles: Environmental & External
Ecological Strategies:
How is the environment affecting this child? How can we impact that?
Schedules & Daily Rituals: daily schedules, morning routine, & evening routine.
Pre-Planned Transitions: minimal abrupt transitions
Awareness of Sensory Input:smell, sight, sound, & touch sensitivities.
Empowering Principle: Self-Regulating
Sample Activities:
Deep Breathing
Magic Moustache
Cooling Your Soup
Chair Sit Ups & Push
Ups
How’s your engine
running?
One of the most important Empowering
Principles is the capacity to teach self-
regulation. These skills can be taught as
part of physical exercises, daily
routines, and/or nurturing activities.
Self-Regulating: Deep Breathing
Because ⅔ of our oxygen
sacks are in the bottom ⅓
of the lung, breathing
deeply will oxygenate
the body and brain,
helping children and
youth think more clearly,
learn more easily, and
make batter behavioral
choices.
Self-Regulating: Magic Moustache
Pressing the
parasympathetic pressure
point just above the center
of the upper lip creates a
calming influence. Most kids
love to make the
“mustache”!
Self-Regulating: Cooling Your Soup
Pretend to hold a bowl
of soup and blow on it
to cool it off. Let
children choose the
type of soup they are
cooling.
Self-Regulating: Chair Sit Ups & Push Ups
These are calming and can be done anytime a child is feeling overwhelmed. An advantage of this activity is that it can be done anytime without creating distractions for other people.
Self-Regulating: How’s Your Engine Running?
This quick
question can
guide a child
quickly back on
track simply by
increasing
awareness.
To help children learn appropriate strategies for getting
their needs met and to learn to navigate successful
interactions day-to-day.
Correcting Principles
Correcting Principles
Proactive Strategies:
Teach Social Skills: teach during calm/alert
times.
Engage Through Play: utilize playful activities
and nurturing games to enhance children’s
awareness of appropriate social, problem-
solving skills, and self regulation strategies.
NOTE: when skills are taught proactively, the need for
responsive strategies is greatly reduced.
Responsive Strategies:
Tools to be used for responding to
challenging behaviors:
IDEAL Response
4 Levels of Response.
Highly effective when adults have
connected and empowered during
calm times.
Capitalize on and create learning
opportunities so that the child sees
you as the “coach” not the
“warden.”
Correcting Principles: IDEAL Response
Immediate: Respond immediately (within seconds when possible)
Direct: Engage directly (with eyes, proximity, and touch when possible)
Efficient: Maximize playfulness when possible and use ONLY the Level
of Response that is essential for addressing the challenge(more on
Levels of Response to follow)
Action-Based: Give the child a chance for a “re-do.” Maximize
learning by creating body memory for “the good stuff!”
Leveled at the Behavior: not the child. Make it clear that you are their
advocate, not their adversary
Correcting Principles: Levels of Response
When a child becomes dysregulated and exhibits behaviors, caregivers should ask themselves these questions:
What is the behavior really saying?
What does this child really need?
How can I teach the child to get their needs met?
How can I teach this skill at a calmer time?
It is helpful to ask a child questions like:
Can you tell me what you need?
How can I help you get what you need?
Helping a child label what they are feeling can help them calm and raise self-awareness, (this is done by asking and not telling them what they are feeling).
Levels of Response
Level I: Playful Engagement
Redirect Child without breaking stride
Give them a chance to correct their behavior without punishing them
E.g., “would you like to try it again with respect?” or “Are you asking or
telling?” in a playful tone
Use consistently – playful engagement reduces misbehavior dramatically
over time because it strengthens the relationship between children and
caregivers
Levels of Response
Level II: Structured Engagement
Pause the situation and use a more regulated voice
Offer two choices – this provides a concrete, quick way to get children back
on track
Ask them to use their words and ask with respect if they are requesting a
compromise
Use behavioral “re-dos” to help children feel more successful. Walking
through the motions of the right behavior is good for motor memory
Levels of Response
Level III: Calming Engagement
Allow children to regulate with adult assistance
Use a time-in and keep children close rather than sending them away (as in
a time-out). This lets them know that they are not alone, that you are there
to offer support and guidance
Work out a predetermined ‘quiet’ or ‘calm’ place adolescents can go when
overwhelmed, (their choice)
Levels of Response
Level IV: Protective Engagement
At HHH we utilize SAMA containments
Reserve use of this level for violence or aggression
The most powerful message an adult can give a dysregulated child is the knowledge that the adult can keep them both safe, and that the adult still knows that the child's behavior is not what defines him or her.
When the child is coherent again, the adult asks them to sit and talk. Looking into the child's eyes, the adult asks, “(child's name) can you tell me what you need?“◼ Based on the belief that an unmet need or fear drives most
aberrations in behavior, this question disarms the child and helps them begin to problem-solve with the adult.
Helping Hand Home for Children: Core Skills
Observing & Describing Behavior
Rationales
Teaching Interaction
Preparing Children for Success
SAMA Assisting Process
Daily Treatment Program Culture
Enrichment Activities – Children
Learn by Doing
Always offer the chance for
experiential learning
Enrichment Activities –
Therapeutic Value vs. Privilege
Shaping beliefs by teaching
rather than taking away
Daily Treatment Program Culture
Language creates perception creates response/behavior/action.
What we say and how we say it, (spoken or written), are equally
important.
The terms we think and speak in have a direct impact on our actions.
What practices do we avoid?
What Practices Do We Avoid?
Any practice that would harm, shame, isolate, or trigger a child.
Time Out
Power Struggles
Shaming or Caustic Language
Elevated Tone of Voice
Reactive Behavior
Physical Isolation