Frequently Asked questions by Foster Carers: Behaviours that Challenge

On any given night there are about 18000 children and young people are in foster care in Australia. Most foster carers will be the first to tell you how rewarding it is – but it is also challenging, tiring, and sometimes distressing.

Children and young people in out-of-home care (OOHC) often have early adverse life experiences resulting in trauma-based behaviours. These behaviours may appear alarming, uncontrollable, unpredictable, and even inexplicable to foster carers.


Effects of Trauma on Children

 

Trauma may affect children’s …  

In the following ways

Bodies •       Inability to control physical responses to stress

•       Chronic illness, even into adulthood (heart disease, obesity)

Brains (thinking) •       Difficulty thinking, learning, and concentrating

•       Impaired memory

•       Difficulty switching from one thought or activity to another

Emotions (feeling) •       Low self-esteem

•       Feeling unsafe

•       Inability to regulate emotions

•       Difficulty forming attachments to caregivers

•       Trouble with friendships

•       Trust issues

•       Depression, anxiety

Behaviour •       Lack of impulse control

•       Fighting, aggression, running away

•       Substance abuse

•       Suicide, self-harm

 

Some of my colleagues aptly use the metaphor of falling into a ‘time hole’ that captures children’s sudden mood changes accompanied by extreme behavioural difficulties. These behaviours may be externalised (aggressive/controlling) and/or internalised (dissociative/rejecting).

 

Some stories of confusion that carers have shared with me:

“I bought both children a toy. The next day I found both toys shoved under one boy’s bed. When I asked him about it, he said he wanted to leave and told me to call his worker”.

“He stole the jewellery that my mother left me when she died. When I asked him why, he swore at me and said I deserved it”

“She went into my bedroom and cut up my wedding dress and then denied it”.

“When I was unwell, she became so demanding. Telling me to get up. Asking for special foods to be made. Getting angry”

“There had been no problems. We were getting along really well and that night she sneaked out and was missing for three days”.

 

In the table below I have included some of the signs of trauma in children of different ages. This is not an exhaustive list.


Signs of Trauma in Children of Different Ages

 

Young Children

(Ages 0–5)

School-Age Children

(Ages 6–12)

Teens

(Ages 13–18)

•Irritability, “fussiness”

•Startling easily or being difficult to calm

•Frequent tantrums

•Clinginess, reluctance to explore the world

•Activity levels that are much higher or lower than peers

•Repeating traumatic events over and over in dramatic play or conversation

•Delays in reaching physical, language, or other milestones

•Difficulty paying attention

•Being quiet or withdrawn •Frequent tears or sadness •Talking often about scary feelings and ideas

•Difficulty transitioning from one activity to the next

•Fighting with peers or adults •Changes in school performance

•Wanting to be left alone

•Eating much more or less than peers

•Getting into trouble at home or school

•Frequent headaches or stomach-aches with no apparent cause

•Behaviours common to younger children (thumb sucking, bed wetting, fear of the dark)

•Talking about the trauma constantly, or denying that it happened

•Refusal to follow rules, or talking back frequently

•Being tired all the time, sleeping much more (or less) than peers, nightmares

•Risky behaviours

•Fighting

•Not wanting to spend time with friends

•Using drugs or alcohol, running away from home, or getting into trouble with the law

 

The foster carers I know and have worked with recognise these needs. However, given the complexity of many children’s behaviour, they can feel overwhelmed, unprepared. This is understandable given this is outside the realm of ‘ordinary’ parenting. Thus, fostering can involve high levels of stress, compassion fatigue, secondary traumatic stress, and personal sacrifice.

In my opinion not enough attention has been given to understanding the impact on foster carers of caring for abused and traumatised children. In this series of blogs, I will unpack some key issues that, in my experience, have a very significant impact on foster carers.

 

How do I manage behaviours that challenge?

Our first and most frequently asked question: how do I manage behaviours that challenge? The children in foster care are complex individuals with complex needs and backgrounds. Sometimes, to come to terms with what they’ve been through, children manifest these needs in the form of seemingly antisocial or self-destructive behaviours. Such as violence and tantrums, self-harm and running away from home and getting into trouble with police.

As a child or young person who has experienced trauma attempts to avoid feeling unsafe, a lack of trust or the pain of rejection, the way they communicate is often the opposite of what they really need. For example:


When a child or young person says …

Consider what else this might …
I DON’T NEED COMFORT I must not be vulnerable
I DON’T NEED SUPPORT FROM YOU I can only rely on myself
I DON’T TRUST YOU People aren’t trustworthy. People only break my trust. There is no point trying to trust someone. It hurts too much.
I AM NOT SAD I don’t know what I feel
I AM FINE I must not be vulnerable
I AM FINE I don’t want you to see who I really am
I DON’T TURN TO YOU FOR HAPPINESS OR COMFORT You may abuse me too
I DON’T WANT TO SPEND TIME WITH YOU You make me recognise what I have missed

 

fostercare-blog-part1of2-anger-iceberg-image

 

5 Questions to ask of behaviours that challenge

Consider the following story:

Graham was 10 years old when he was placed with Mrs Brown. When Graham first arrived in their home, it seemed everything was going pretty well, except for sleeping problems. Graham gets under his bed. Graham hardly slept at all which meant Mrs Brown was perpetually exhausted going in and putting Graham back in his bed and quietening him down and telling him he was safe. But as the weeks went on things began to get worse.

Graham was verbally abusive to the other children in his foster home, he used to hurt them. He was very frightened. Unsure what was happening to him. He soiled and smeared faeces. He urinated everywhere. He ripped furniture and bedding. The Browns took Graham away to their holiday house and he tried to set it on fire. He threw food- he wouldn’t eat it. At one point, he pointed a knife at his Mrs Brown.

To help children like Graham deal with what he is going through, and to overcome or manage these behaviours, it’s important to bear in mind the possible reasons behind them.

Try these questions:

  • 1. What happened to Graham? vs. What’s wrong with Graham?

Graham’s child protection worker and your foster care worker should provide you with sufficient information to be able to care for Graham appropriately. That is, you should know enough about his history to assist you to begin to anticipate and meet his needs. The first and most important need is safety. We have historically thought of safety as simply being free from or the absence of physical abuse, sexual abuse, emotional abuse, violence, and neglect. This type of safety is a critical first step on the road to well-being. However, for the children in OOHC we need to broaden our definition of safety to also include the concept of feeling safe; a concept that we call psychological safety. Having a sense of well-being can’t fully happen if we don’t feel safe first.

Graham’s History

Graham’s father was very violent, particularly at night when he returned from the pub. Graham’s mother would wrap him up in a doona and put him under the bed to protect him. Graham would put his fingers in his ears and sing. Graham survived.

Unknowingly, Mrs Brown, through her desire to care for Graham, increased his anxiety, fear and lack of safety. She removed the tools he believed kept him safe.

Seeing through the Graham’s eyes.
Caring for a traumatised child or young person may require a shift from seeing a “bad kid” to seeing a kid who has had bad things happen.

 

  • 2. What does Graham’s behaviour mean?

For Graham safety was being wrapped-up and under his bed blocking out the noise of his father’s violence. Because Graham had left his family home that did not mean his father had left Graham’s system.

  • 3. What is Graham trying to communicate?

I am unsafe and I need to do the things I do until I feel safe, if I ever do. I do not know how to trust or who to trust.

  • 4. What does the behaviour feel like on the inside for Graham?

Terrifying. I might die. I might hear someone else die.

  • 5. How should you react to Graham’s behaviours?

Graham has behaviours that he believes keep him alive. We must respect these and allow him to make use of them until his brain tells him that he does not need them any longer. We can reassure Graham that sleeping in his doona is OK. Safety always comes before trust.

To help Graham we must become and remain curious and help him identify things that instil the feeling of safety and eliminate or minimise things that cause them to feel unsafe.

 

As the caring adults we must try help the child to make sense of his/her behaviour by naming the underlying hidden feeling and responding to them in a calming and safe way; then over time, you are helping to repair his trauma.

 

Are you getting the support you need?

As a foster carer who is caring for a child or young person it is so important to take care of yourself and recognise the risks of compassion fatigue (Blocked Care) and vicarious trauma. In a later blog in this series, we will look at this issue.

As a foster carer you also require emotional and educational support from your agency/government department. Supports specifically relating to understanding and managing the issues that the child(ren) in your care are experiencing. In the next part of this blog series we will explore the issue of support.

 

 

References

  • Baylin, J., & Hughes, D. (2016). The neurobiology of attachment-focused therapy (pp. 1 to 16). New York: W.W. Norton & Company.
  • Sinclair I, Baker C, Wilson K and Gibbs I (2005) Foster Children: Where they go and how they get on, London: Jessica Kingsley.