Misha Fell, Independent Psychologist and Lynn Fordyce Family Therapist presentation at the Supporting Families in Difficult Times Conference held on 18-19th September 2014

1. ‘Supporting Families:
Systemic approaches to early help
and intervention following trauma'
Misha Fell,
Independent Psychologist &
Executive Board Director/Trustee:
Home-Start (Leeds); Solace,
Grandparents' Association,
Lynne Fordyce,
Family Therapist &
Executive Board Director/Trustee, Solace,
Leeds Bereavement Forum
CRUSE

4. Theoretical framework
Our work is underpinned by systemic
perspectives, theory and understanding
integrated into therapy.
Work is carried out within a developmental,
social and cultural context.

5. System’s boundaries

6. Systemic diagram of a family

8. Systemic practice
• Reflects the systemic interconnectedness
of the traumatic experience in the family at
a family, kinship, friendship, community,
cultural and societal level, plus the wider
professional networks and organisations

9. Advantages of a systemic
approach
• allows the complexity of perspectives
when analysing the circumstances in
which trauma has occurred.
• provides understanding of the processes
of impact of adverse events

11. Wider systems matter
• The context of families and individuals through family
history, experiences and relationships is important.
• Families exist in a social, cultural, economic and
environmental context constituting a meaningful system
• Connecting with workers from the health, education,
social services and voluntary services can provide
practical help to families and improve emotional health.
• It is hard to help with feelings if the basic practical needs
of individuals and a family are not met.

12. Extreme poverty and
abandonment

13. Indicators of traumatic events
…trauma occurs when an individual is
exposed to overwhelming events resulting
in helplessness in the face of intolerable
danger, anxiety and instinctual arousal
Eth & Plynoos (1989)

14. Traumatic events
• There are large-scale events like disasters, war,
and terrorism that threaten large numbers of
children and families all at the same time.
• There are events that are particular to a
community or neighbourhood, like crime, school
violence, or traffic accidents.
• And there are events that come from within the
family through domestic violence and child
abuse and loss and bereavement.

15. Family

16. Research on trauma
• Epidemiological research by the World
Health Organization shows that one out of
two people has been, or will be, seriously
traumatised at some time during their life
• One in four will experience at least two
serious traumas.
• Boris Cyrulnik, 2008

17. Traumatised carers
• The psychopathology of a caregiver is
understood to be an important risk factor
for child maltreatment
• Also – maternal depression is associated
with neglect, lack of supervision, an
increased use of corporal punishment and
opportunistic sexual abuse of children

18. Reactions to trauma

20. Suffering or witnessing
traumatic event such as
• Being attacked, kidnapped,
abducted, raped, held
hostage, abandoned
• Witnessing abusive events,
natural disasters, fires, floods
and accidents
• Being abused, victimised
• Being suddenly or
traumatically bereaved by
accident, suicide or murder
of a close person
• Being involved in abusive
incidents, accidents and
natural disasters
• Suffering traumatic loss,
dislocation, fleeing violence

21. Impact of Trauma on children
• Stressful early experiences can drastically
alter important aspects of the brain's
development and function
• Theodore D. Wachs 2003
• Danya Glazer, 2004

22. Feelings immediately after a
traumatic event
• Shock – stunned – dazed – or numb
– cut off from feelings, or from what is going on
around them
• Denial – when in denial, can't accept that it has
happened – behave as though it hasn't.
– Over several hours or days, the feelings of
shock and denial gradually fade, and other
thoughts and feelings take their place.

24. A traumatised child is not alone
A traumatised child is often cared for
by a traumatised carer, family and in a
traumatised community

26. Adult responses to child abuse trauma are
highly significant for a child's recovery

27. ‘Good’ support
• These are the factors immediately post-trauma
that lead to reduced symptom
levels

28. Negative response of adults
• Gradually, most adults believe the child to be
manipulative, “attention seeking” and
controlling
• Then the adults start to behave in ways that
make the child believe “they are losers”
28

29. Basis for intervention
• It is essential for the
development of
appropriate
intervention in the
face of adverse
experience to
recognise:
– the vulnerability
– the resilience factors

30. NICE guidelines
• In the medical context, NICE for the
first intervention suggests:
– closely monitoring a patient without active
treatment of the problem
– in situations where there is an expectation
of self-resolution
• This is described as “Watchful waiting”

31. Intervention needs to be:
• Timely, on an early timescale
• Empathetically informative
• Responsive and interactive
• Client centred
• Context sensitive
• Establishing connections with the
traumatised family or carers
• Leading to informed watchfulness and
identification of needs

32. Traumatised people need:
• a healing environment, offering
support and nurture, consistency and
predictability, limits and expectations,
safety and protection
• to be given a sense of security and
control.

33. We must identify & take into account
the needs expressed by:
• children
• families
• adults
• professionals
• community
• society

34. Basic premise
Children are predisposed by birth and
positive experiences to be resilient.
(Maston et al.)

35. Thank you !

36. Contact
• Lynne Fordyce
• E-mail: oracy@ymail.com
• Misha Fell
• E-mail: strid.uk@gmail.com
• http://mishafell.wix.com/psychologist