Life Story Therapy with Traumatized Children

A Model for Practice

Richard Rose

• Publisher: Jessica Kingsley Publishers
• Year: 2012
• ISBN:
  9780857005748
• Topic: Psicología
• Subtopic: Psicología del desarrollo

Life Story Therapy is an approach designed to enable children to explore, question and understand the past events of their lives. It aims to secure their future through strengthening attachment with their carers and providing the opportunity to develop a healthy sense of self and a feeling of wellbeing.

This comprehensive overview lays out the theory underlying life story therapy, including an accessible explanation of contemporary research in neurobiology and trauma. Featuring tried and tested ideas, with toolsand templates illustrated through instructive case studies, the author identifies how life story therapy can be implemented in practice. Finally, the relationships between life story therapy andtraditional 'talking' therapiesare explored.

Life Story Therapy with Traumatized Children is essential reading for those working with children and adolescents, including social workers, teachers, child psychotherapists, residential care staff, long-term carers, psychologists and other professionals.

Part I

The Roots of Life Story Therapy

Chapter 1

Introducing Life Story Therapy

We are what we were

It is difficult to grow up as a psychologically healthy adult if one is denied access to one’s own history. (Fahlberg 2008)

The phrase ‘life story work’ is commonly used in the social care field, to indicate that an intervention around the history of the child is undertaken. Children placed in the care of a local authority, in permanence or long-term, are entitled to be given information about their past, their birth family, culture and heritage. The UK government has endorsed this view through the Care Matters agenda presented to Parliament in 2007, which itself stems from the Every Child Matters legislation within the Children Act 2004.

It is essential that professionals involved in supporting children and carers have a strong understanding of attachment and of the importance of core practice such as life story work (where a child is helped to make sense of their past experiences) so that they may help an abused, harmed or neglected child to develop a secure emotional base. It is also important that children, carers and professionals have access to appropriate therapeutic interventions that can address the damage that previous experiences have caused to a child’s ability to form attachments. (Care Matters Time for Change 2007)

Life story work, however, is not standardized; therefore a child’s experience of the intervention is wholly dependent on the practitioner’s awareness of the process, the time available to the practitioner and the importance attached to the task, relative to other demands on the individuals involved. I am not in favour of life story work being carried out by students on social work and social care practice placements, although there are wonderful opportunities to engage them in detective roles in the context of creating information banks. Life story requires relationship building and working at the child’s pace, but placements do not afford the time for this to happen, and it is important that anyone engaged in the process is there for the entirety of the work.

The next issue is to decide what form of life story is the most appropriate. A child who has settled well in placement and has developed attachment to her carers may not benefit from an experience of therapeutic life story or life history work. A child who is at risk of placement breakdown, who may feel insecure and confused about her family and her future, may also not benefit from an experience of story work or basic life history work.

Assessment of children is an essential first step; it may be that the adult agenda is to ‘do life story’ but it may be the last thing that the child would want. A detailed assessment will help the practitioner to look behind the presentation, consider the role of the carers, identify the real issues and, if appropriate, support the child to see that the activity would provide a positive outcome for her. Not all children will benefit from the process. For some this may be a permanent issue, for many it is in the timing. The importance, for children, of the opportunity to think about and explore their roots, their growth and their sense of self depends on their willingness to engage.

I have had the opportunity to talk about life story in four continents, and each has a view of the importance of family history, of storytelling through the generations, which enriches and embeds the present with the past. In Seattle, at Day Break Star, a centre for culture and celebration, the organization United Indians of All Tribes provides programmes for all sections of the community. One of these programmes relates to the importance of the relationship between the elder (grandparent or third age) and the child, in which the focus is on the telling of stories past, and how the children themselves become the vessel for the future. There was a particular saying that I was introduced to when delivering life story training in Seattle, USA and on Vancouver Island, Canada to the Indigenous peoples:

We recognize our relationship to the past and to our future because they are the same thing. (Winona LaDuke, Anishinabe, date unknown)

In the UK most residential and foster care providers now include a life story service to children. The approaches are varied: some include a therapeutic element, others introduce a life story ‘box’ to capture the child’s journey whilst in that placement. This seems to have been particularly successful in projects such as the ‘Memory Store’ based in Northumberland and presented by Gillian Shotton (2010) in her article ‘Telling different stories: the experience of foster/adoptive carers in carrying out collaborative memory work with children’. Other organizations use electronic and pro-forma books.

In Sydney, Australia, workers in Metro Intensive Support Services are provided with a life story folder for Indigenous and for non-Indigenous children. This includes prompting sheets, and dividers for personal, family and friends information, and can be tailored to meet the individual child’s needs.

In some forms of life story work, the child’s story is collated. It may then be discussed with the child before a book is produced, which presents a chronological illustration of her life journey.

Sadly, more commonly, ‘life story’ is a collation of ‘known facts’ about a child, contained in a short book which represents so little of the child’s real story and so much of the social work recorded file history.

The experience of some children who are recommended life story work is that work commences, but through no fault of their own the professional moves to a new role and the intervention is delayed, or even dropped – consigned to the unfinished work pile, never to be picked up again.

I am currently involved in providing direct work with children in the UK. These children are from various regions and all have complex needs which affect their placement and their relationship with their carers, and present behaviours which risk the placement stability. I also work with two adoption programmes, one in Argyll and Bute and one in South Gloucestershire, on issues of identity and life story work. The children I work with range from 3 to 16 years of age. The majority are female and have difficult histories which need to be explored and then made sense of, to enable them to separate themselves from their sense of guilt and shame. Most of the children are in placements and have had a myriad of previous interventions which, for whatever reason, have not been successful. Some of these cases have past review recommendations which state that life story work is required or underway, but rarely has such work been carried out, and when it has been done, its effectiveness has often proved limited – often due to the kinds of circumstances described above.

Clearly, ‘life story work’ is a term that means different things to different people, so I’ll now attempt to define the approach advocated within this book. I have observed three types of life story used within the social care field today. Each has a valid application, but each can also cause difficulty for the child who is the subject of the work.

1. Story work

This approach is based on the recollection of the child and her understanding of the events in her life. It is akin to reminiscence work, where the facilitator is interested in hearing the ‘narrative’ of the subject child and not concerned with the stories of others. Often the work is carried out as a one-to-one process, and the facilitator will incorporate ‘date’ evidence for ‘discussion points’; these would include things such as music, photographs and documents, including birth certificates and newspaper cuttings.

Positive applications with this approach include the opportunity for the child to tell her story and to be heard. Children are not confronted by inaccuracies, poor memory recollection or confusion as they are encouraged to consider their perception, which is given value and thereby validated.

This approach is regularly found to occur when facilitators begin life story work from the moment the child is placed in the care system. Of course this is the only approach that can be adopted if the facilitator only has information that begins from the moment that the child arrives in the care placement. (It is not surprising that the facilitator is often the foster carer of the child concerned.)

Case study: Callum

Callum is an 11-year-old child who has experienced acute neglect by his parents from as early as he can remember. He was made subject to care proceedings following a drug search at his family home. The officers who arrived at the scene found the home to be poorly cared for, with drug paraphernalia, including needles and substances, located in the bedroom of Callum and his baby stepsister. Callum had been subject to various child protection enquiries and had been cared for in the past by extended family and through voluntary arrangements under Section 20 of the Children Act 1989.

A life story book was completed for Callum when he was 9; it consisted of 11 pages and 8 photographs. The story basically detailed an incomplete and sadly inaccurate family tree, his brief ‘pen picture’ memory of his mother and stepfather, and his conclusion that he had been placed in care due to his naughty behaviour and because his ‘mum chose her boyfriend over him and his sister’. There was an account of his time with his carers, in which it was stated that he felt happy living with them and that he was there forever.

In this case, Callum was heard and his book did represent his memory; however there was very little detail, meaning or understanding of the reasoning and action of those who had responsibility for him. He was proud of his book, but he had a conviction that he was responsible for being placed in care. When considering Callum’s history as described in the above case study, unanswered questions (Why he was unsafe? Who had hurt him? Why was he placed in care?) are clearly identifiable, but the story work approach that was utilized did not allow such exploration to take place. Callum’s placement did not last ‘forever’ and he has just been placed in his fourth home since the completion of his story work.

The story work approach relies on the child’s memory and perceptions. If these are internalized as the ‘unshakeable truth’ and accepted by the listener as valid, then the child’s willingness to consider a different story, which may be a more truthful account, is far more difficult to achieve. Story work cannot provide the ‘full history’ of the child; it cannot introduce the pre-birth history, the first few years of her life, her internal working model or the essential need for her to consider her past in comparison with her present.

The danger of this approach is that the child can be given assurance and the conviction that all she remembers is accurate, factual and conclusive. The memory may then be adopted as ‘the whole truth and nothing but the truth’, and for some children, therefore, the unshakeable story of their life.

My subsequent work with Callum addressed the need to ‘unpick’ the story contained in his ‘book’, and to provide safety and security for him to reframe his understanding of his own role and the role of others.

Story work can, however, be useful for intervention that does not require a full life story/history approach. I have used the process of story work to assist children to tell their story, as a means to aid thinking and drawing conclusions about selected events or ‘slices’ within their personal history. I have referred to this as ‘spot’ work; the intervention is concentrated on a particular issue, event or crisis, and is particularly effective when working with placement disruption, school disruption and contact difficulties, and working with wishes and feelings.

2. Life history work

Life history work is often referred to as ‘life story work’. However, in most cases the approach does not involve the child in the process. A clear example of this is found in the adoption ‘life story book’ – a book created to enable the child to understand in future years why he or she is subject to an adoption order.

Life history work is a process that gives the child the opportunity to understand her history; it is often provided by a social worker, foster carer or student, and aims to provide a written account of the child’s life journey from her birth to the present date. Life history work has been widely considered as a default service for children who are subject to adoption, and latterly for children who are placed in permanency.

As early as 1981 Aust introduced the notion of life story books as helpful for children in placement, followed by Backhaus (1984), who proposed that life story books could be a tool for working with children in care. Fahlberg (1994) and Ryan and Walker (1993) promoted life story work as a beneficial process for children in foster care and adoption. Terry Philpot and I (Rose and Philpot 2005) introduced life story as a therapeutic tool for recovery work with traumatized children, and Joy Rees (2009) introduced life story techniques for adoption life story books. Life story work has been encouraged as a way of providing children with a narrative which explains life events and the sequence of their journey from before their birth to the current placement in which they find themselves.

In life history work, in order to secure this narrative, the child does not have the opportunity to explore her own understanding of events, or to talk about those who have had significant impact on her life and the role of guilt, shame and responsibility within it. Much life history work consists of collating ‘easy-to-find’ information which is often untested, and taken as truthful. This collated information is placed within a story, loosely based on a chronology, and then presented, often as a completed piece of work, to the child.

Most of us who have been employed in social services will acknowledge in our more relaxed moments that our recording in files, often carried out days after the recorded events, was not as accurate as we would like it to have been. Accounts of these events are often based on opinion and ther...

Table of contents

• Cover
• Title
• Contents
• Foreword
• Acknowledgements
• Preface
• Part I The Roots of Life Story Therapy
• Part II The Stages of Life Story Therapy