Sunday, May 09, 2010


I am in the middle of a six week training of foster parents. The topic is: Trauma Informed Foster Care. The foster parents are teaching me what they need to know in order to stick with these difficult children. The information about trauma and its effects is important; the practical applications are essential.

We were talking about the idea that children are doing the best they can, and how the biological changes they have experienced create real challenges for them. One foster father said to me: "I don’t expect anything different from my foster son as I do from my biological sons. I expect him to do everything they do and if not, have the same consequences they do."

This led me to think about how we readily make accommodations for physical disabilities that we can see. Yet is so much harder to see trauma in the same way. So this led to the creation of the following skit:

I asked two foster care social workers, Jaime and Neftali, to play two brothers. One (Jamie) played the son with a badly broken leg. He had broken it when his friends challenged him to try a jump on his skate board. We wrapped Jaime’s leg with gauze and an ace bandage, and gave him some crutches. The other (Neftali) was fine. But he was angry and resentful that Jaime is getting all the attention and is getting out of doing things.

As the two sons sat in front, I gave volunteer foster parents cards with situations, and asked them how they would handle them. The first was: "Your sons attend the local high school. There are long halls, stairs, and lots of changing classes." The foster father who chose this card, John, said he would go to the school and advocate for his son, ask for a longer time to change classes, a wheelchair, use of the elevators. Immediately both boys began to object. Jaime said that would be embarrassing and he could manage it himself. Neftali said he would NOT be pushing Jaime’s wheelchair. John was sure that he would insist that the accommodations be made even if Jaime objected.

The next scenario was that Jaime’s doctor had recommended PT for his recovery. Jaime did not want to go. PT would hasten his recovery, but it was not life or death. Jaime immediately said it was stupid and he knew he wouldn’t like it and it wouldn’t help. Neftali said he should be forced to go. The foster mom, Rose, who took this card said she would insist that he at least go- he could decide what to do when he got there. Other foster parents disagreed, and said that at least by some unspecified age he should decide for himself once the pros and cons had been explained to him.

The next situation brought us to chores. The boys usually handle the outside, mowing the lawn etc. Naturally Jaime could not do this. This time he was willing to accept his limits and do nothing. Neftali said if he had to do it all he should get Jaime’s allowance. The foster parents all suggested finding other ways Jaime could help such as doing the dishes while sitting in a chair. We had a spirited discussion of allowance, whether it should be used (it is mandated by DCF) and whether it should be contingent. If someone has a physical problem and can’t do the chores should the allowance be withheld?

I thought it would be obvious why I was doing this, but interestingly when I asked the foster parents none of them mentioned the connection between the broken leg and the broken brains our children have. When I pointed this out, the parents wrestled with the implications.

We are used to the idea of being flexible to accommodate visible physical limitations. I wonder if it would help if some how we could see our children’s broken brains?

What are your thoughts? Click on "comment" to respond.


Helga Luest said...

We do "see" our children's distress. Like a broken bone, emotional wounds leave scars... but doctors will note that after a broken bone, we become stronger in those broken places.

To me, even labeling a "broken brain" is not trauma informed. We live through things - then we need to heal. Children lack the emotional maturity and language skills to communicate verbally about trauma, so they do so in their behavior. This, I feel, is what foster parents, parents, teachers and community need to understand. It isn't "what's wrong" with the child (i.e. the "broken brain"), but "what happened" to the child. If we stop with the labels and we stop responding punitively to behavior and take a moment to really ask what the child might be trying to communicate, then we can really begin to provide meaningful support that can lead to a trusting and healing relationship.

Patricia Wilcox, LCSW said...

Great comment, and I appreciate your reaction to the phrase "broken brain". I was making the analogy to "broken leg"- both a result of something that happened to you, both capable of healing.