Need a road map to help with troubled kids?…

Ever felt lost for what to do next with a child or young person? Wondering what on earth you can do to make a difference?

Wouldn’t it be great to have map to show you the way?

TRM schematic ©Jonny Matthew & Tricia Skuse

Well now there’s a model which brings together needs, behaviour and interventions. It also takes account of development and suggests the sequence in which interventions should be applied.

Back to the drawing board…

During a period working in a children’s secure unit, I had more than a few moments of panic when it wasn’t clear what to do next to help a young person. I guess this is part of the territory; but it set me thinking… In fact it sent me back to the proverbial drawing board!

A colleague and I set about searching the literature again. We needed a way of joining the dots between child development, attachment theory, high risk behaviour and interventions.

In short, there wasn’t one? Not really.

Photo courtesy of ©iStockphoto/Sashkinw

There was lots of good theory and lots of intervention strategies. But not much that joined the dots between them. Nothing much that could act as a road map for those who do most of the caring – foster carers, residential social workers, kinship carers, family adopters, etc.

If these people – people like you and me – are going to make a meaningful difference to these kids’ lives, we need more than just theory. We need to know what to do.

So we worked on it, over and over, until we arrived at something that made sense, something that helped…

The Trauma Recovery Model…

The result of our work was a new model – you can get it here (p.16).

It has four aspects:

  1. Presenting behaviour
  2. Underlying need, and
  3. Types of intervention
  4. Sequenced intervention
The key underlying principle is this: behaviour in troubled children is developmentally driven, so intervention must be sequenced accordingly.

1. Presenting behaviour…

The kids we deal with have not had the right start in life. They’ve missed the care, safety and consistent parenting that most of us had – and all of us need if we’re to develop normally.

These kinds of experiences lead to ways of behaving that make sense in the bad situation – they are adaptive – butcause no end of problems anywhere else. Dealing with this behaviour is the key to helping these kids lead more stable, productive and contented lives.

Photo courtesy ©123RF/Cole

The TRM does not encourage a focus on behaviour as the goal of intervention. But it does require that we observe, note and manage it. Behaviour is a signpost for development and tells us something about how and to what degree a child has developed normally.

2. Underlying need…

The TRM concentrates its focus on what the behaviour tells us about development. Children growing up in fear, distress, rejection, neglect, will reflect this in the way they present.

A close examination of the developmental journey of each child will yield profound and enlightening information about their needs. These then – as the cause of the behaviour – become the focus of intervention. Behaviour is the symptom; skewed developmental experiences are the cause. To help kids heal we must address the causes.

3. Types of intervention…

Intervention extends beyond the technique or theoretical basis for the work being done to help a child to recover. It applies equally to the setting of the intervention.

The most troubled young people – due to the nature and severity of their problems – tend to be those in the Looked After system and in custody. The stability of such settings can be a real bonus in accelerating the progress. But there is still the question of which kind of intervention might best help them. The TRM seeks to address this.

4. Sequenced intervention…

Because the difficulties faced by children with developmental trauma have skewed their development, the order in TRM diagram - large@2xwhich we address the problems really matters.

For example, if a child is not functioning at a cognitive age commensurate with their chronological age, talking therapies may not work well, if at all. And yet we tend to focus on these almost by default.

In order for a child to benefit optimally from any intervention, we must sequence the timing and type of input to the child’s needs and developmental progress.

Final word…

We would urge anyone working with troubled kids to read the TRM paper. It is not a manualised approach, but it does offer a guide to the main aspects of dealing with these most needy children. It was developed in a secure unit for children, but is applicable – and is currently being tested – in the community.

There is a TRM website where you can read more about the model and join the mailing list for updates.

Please share your own thoughts on addressing developmental trauma in children and young people – leave a comment by scrolling below or just click here.

Related previous posts here & on JonnyMatthew.com:

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© Jonny Matthew 2015

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