How to promote resilience and recovery

What can we do to help promote resilience and recovery in children following experiences of abuse and neglect? In this video, clinicians and researchers reflect on key principles that can guide those working with children.

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Key principles

• The brain is a learning organ
• The brain learns through trusting relationships
• Brain adaptations may contribute to behaviour we find challenging
• Stepping back to reflect can create new ways of thinking
• Helping (and well-being) is a team effort
• Behaviour as communication: what does it mean?
• By responding differently we can create a different outcome
• Helping a child make sense of their experience
• Helping ourselves help others

Video transcript

Professor Eamon McCrory

So, what can we do to help promote resilience and recovery? We all know that the answer to this question is not easy – there is no quick fix. But, there are several important principles that both neuroscientists and clinicians agree on. These principles can guide professionals and carers working with children who’ve experienced abuse and neglect. Here we hear from a range of leading clinicians and researchers who each reflect on one of these key principles.

The brain is a learning organ (0:33)

Pasco Fearon, Clinical Psychologist and Professor of Developmental Psychopathology, University College London

The brain is essentially an organ that’s all about learning and adapting to the environment. So environmental inputs, the things that are happening around the child, are absolutely key in the way that the brain develops over time.

When you look at the way the brain develops, it’s the most extraordinary kind of orchestra of biological events. Within the womb it’s already kind of creating itself in a very complex set of interactions between molecules and the environment that the foetus is finding itself within.

The brain is like this plastic organ that is constantly responding to the environmental inputs that it experiences and adapting and building and moulding itself to the social environment.

The brain learns through trusting relationships (1:23)

Peter Fonagy, Psychoanalyst and Clinical Psychologist, Head of the Division of Psychology and Language Sciences at UCL; Chief Executive of the Anna Freud National Centre for Children and Families

When we trust someone, we open our minds to them, open our ability to learn. So when I think about teachers who influenced me, they were teachers who actually took an interest in me as a person. That somehow creates a key, opens a door on a part of my mind where I’m willing to learn new things from that person. We find always the most complicated word to describe the simplest thing. We call this epistemic trust – a trust in knowledge. If I feel understood by you, I’ll open my mind to you, so that you will be able to teach me and I will learn from you about things – mathematics, English, whatever the subject. So, what actually turns out, from decades of research in education, is that children learn best from teachers who have an accurate and individual understanding of them as a person, as a child.

Brain adaptations may contribute to behaviour we find challenging (2:30)

Joanne Jackson, Family Therapist, Anna Freud National Centre for Children and Families

The foster carers are interested and curious anyway. The fact that they want to be foster carers would suggest that there’s a level of interest in wanting to kind of help somebody and also offer a different experience to somebody. So the interest is already there but I think sometimes when the lived experience for them is that, when they actually get a young person with all of these difficulties, it can sometimes close down their curiosity because they’re being faced with such challenging behaviour and the instinct is to react to that challenging behaviour.

So, I think some of the practical ways would be for foster carers to have regular support groups where they can meet with other foster carers to have a regular time of where they can be more reflective in terms of what’s happening. So, to actually look at particular scenarios that happen in their everyday life and to help them to put on, if you like, a reflective cap. So, they’re thinking about not necessarily just the interaction, but what the interaction means because it might mean something completely different to what it looks like on face value.

Stepping back to reflect can create new ways of thinking (3:58)

Roslyn Law, Clinical Psychologist, Anna Freud National Centre for Children and Families

I am a great fan of the importance of pausing – taking a moment when to try and work out what is going on. It can make all the difference in transforming reactions that are usually quite impulsive and not thought through very well into responses that have an idea of our own and other people’s intentions behind them. The swimming coach demonstrated that so well – just taking a moment to try to make sense of something that didn’t quite add up opened up the possibility of a whole new sequence of events that affected at least three different relationships. Crucially, someone else pausing helped the boy in the film to make his way back – he didn’t have to do it on his own. Having a team around us who will help to create opportunities and map the way back from near misses can be transformational in reshaping a child’s opportunities in life.

Behaviour as communication: what does it mean? (5:05)

Tessa Baradon, Child Psychotherapist, Anna Freud National Centre for Children and Families

This young boy who’s showing this really aggressive behaviour or externality can be read with surface level. You can take this as — what an unpleasant child I’ve got to look after now, as a sports teacher with the others. I have to look out for trouble. He’s so sullen and resentful. Really hard to like him. And then perhaps somewhat of a punitive response is aroused in the sports teacher or any adult having to cope with a difficult social situation. But, if you think what that musculature in the face is hiding — those feelings we saw when the boy looked into the mirror: I’m rubbish, I’m nothing, I’m worthless. That’s what gets built into his body. Then it’s much easier to empathise with him and to take that step back.

By responding differently we can create a different outcome (6:13)

Joanne Jackson, Family Therapist, Anna Freud National Centre for Children and Families

One of the things that foster carers have said is that they really value having training and insight into behaviour because they really find it very interesting about thinking about different meanings of behaviour. That’s one of the things that has really enabled them to kind of step back rather than react. So, they’re able to step back and think very differently about a child’s behaviour. When you can really think about someone’s behaviour and the potential meaning behind that behaviour, it really does free you up to then do something differently yourself.

Helping a child make sense of their experience (7:00)

Katherine Mautner, Play Therapist, Anna Freud National Centre for Children and Families

For example in the animation the child who has the difficulty in the swimming pool and reacts to the other boy and then is told to get out of the swimming pool, the teacher finds a way to be able to adjust their response to that child and finds a way to make some repair in the relationship between them and the child. But, there isn’t then an opportunity to wonder, what happened when that boy splashed you? Why did you react the way you did? What do you think the other boy was trying to do? What might you do if that happens again? Is that something that’s particularly difficult for you? Is there a way that we can, everybody can adjust themselves around that kind of situation and be helpful for him, for that child, in that situation. The foster carer has the opportunity — if the teacher passes on that information — to be able to have that conversation. To be able to do some of that working through. That’s quite a fundamental role. Otherwise, the child or young person experiences their social world as quite fragmented.

The making sense process really might help them to adjust the way that they react to things and kind of to be able to take some responsibility for that. Not just necessarily make changes for themselves, but be able to communicate something of their experience, so that other people can help them and give them different experiences in response.

Helping ourselves help others (8:27)

Dickon Bevington, Medical Director, Anna Freud National Centre for Children and Families

How do I keep myself going is, I’ve got to think about who are my friends? Who are my colleagues? Who thinks about me in the way it helps me remember that what I’m doing is hard? That it’s hard to help young people who don’t necessarily make it easy to help them and it’s tiring and it can feel very thankless. Unless there are people around me that recognise the challenge that is going on it’s likely that I’ll get tired or I’ll get lonely. Sometimes it can work that a worker does make a wonderful connection with a young person – I mean genuinely – and that’s great. But, what can happen is they can start to believe and feel: I’m the only one in the world that really understands this kid. That might be sort of partly true, but that’s a really lonely place to be. You can feel overwhelmed by the responsibility. So if you start to feel you’re the only person that understands this young person it’s a reminder to check who’s holding your rope. Check who’s connected to you because you need to be part of a connection of minds to be helpful to a very vulnerable young mind in front of you.

Helping (and well-being) is a team effort (9:52)

Roslyn Law, Clinical Psychologist, Anna Freud National Centre for Children and Families

It is really important to think about our well-being and mental health as a team effort. The basic idea that we see so clearly in the film is that our well-being is socially created – we learn about ourselves and other people through our experiences with the people around us. How we are thought about and felt about, how other people behave towards us shapes the way we go on to think and feel about other people. And just as our sense of ourselves and other people is socially created it can be socially destroyed or at least damaged. This vulnerability isn’t only in the early years of development but continues across our lives with social thinning, losing people, reducing our opportunities for different kinds of experiences and new learning. But just as we might see the problem arising in a social context, so we can find the solution in that social context. The damage that is socially created can also be socially repaired.