Rosie Jefferies spent the first six years of her life in a household of trauma and neglect before being removed from her parents, along with a sister, to the care of a foster family.
No one told the two little girls what had happened to their three younger siblings – a new-born, two-year-old and three-year-old – so they presumed they had died, as there had already been deaths in the family.
"That was a lot of trauma to deal with," Jefferies (27) tells Health + Family from her home in Gloucestershire in the UK. It was six months before they learned their siblings were still alive and in foster care elsewhere.
Sarah Naish and her husband were looking to adopt the younger three when they belatedly heard they had two older sisters. Naish was determined to reunite the five of them and adopt them all.
“There was a lot of fighting about having five siblings all together but she fought for that,” says Jefferies. A year after adopting the first three, Naish manged to complete the adoption of the other two.
A social worker by profession, Naish knew it would be a huge challenge to help these children overcome their early childhood trauma. “Her heart was in the right place, but she had to learn very quickly about therapeutic parenting and how that would work best.”
It’s no wonder Naish has become a leading authority on the practicalities of therapeutic parenting. “We gave her lots and lots of practice,” Jefferies says wryly. “Between us, there were many different behaviours she could practise on.”
Naish has written a range of books on the topic, such as, The A to Z of Therapeutic Parenting, and storybooks for children, including ones that Jefferies collaborated on, and two of which feature "Rosie Rudey".
Therapeutic parenting is a highly nurturing and structured approach needed by children who have severe attachment and developmental problems due to early neglect and trauma. However, it is a process from which all parents could learn. In essence, it’s about trying to understand what is driving a child’s behaviour and responding empathetically, rather than just punishing or rewarding it.
Christine Hennessey of Barnardos Ireland defines it as "a parenting approach that is geared to the needs of the individual child and requires the parent to develop a detailed understanding of how the child's early experiences are impacting even on present behaviour".
Poorly run orphanages
She is project leader of the Barnardos post-adoption service, which works primarily with families of inter-country adopted children. About three-quarters of these children have been adopted from very poorly run orphanages or children’s homes all over the world – but particularly from eastern Europe where children would have had very challenging experiences, says Hennessey.
No small child is a slate that can be wiped clean
Not only adoptive parents but other people in these children’s lives, such as teachers, have to understand the behaviour comes from early trauma. “It’s not coming from their genes,” she says.
No small child is a slate that can be wiped clean; experiences since birth are imprinted on the brain. The first weeks, months and years of life is a period of rapid neurological development for which babies need a loving, responsive primary care-giver.
In 1975, a professor of psychology at the University of Massachusetts, Ed Tronick, devised the famous "still face" experiment, which shows the distress of a baby when confronted with a caregiver who stops responding for two minutes. But for a neglected child that "still face" will last a lot longer.
In this age of smartphone pre-occupation, trying to avoid being a "still face" is something all parents need to be aware of. It is well worth watching Tronick's experiment in action on YouTube as a reminder of just how much babies crave and need a responsive human connection.
Brain scans of children who have been brought up normally and are securely attached show different parts of the brain lit up through nurturing, teaching and parenting, says Jefferies. Whereas a scan of a child who is not securely attached is quite dark, with not many parts of the brain lit up.
However, the one part of their brain that is most lit up is their amygdala, which is their “fight or flight” response. The traumatised child’s brain is preoccupied with survival, to the detriment of the rest of its development.
Jefferies says her adoptive mother learnt very quickly that standard parenting was not the way forward with her and her siblings “and actually made us worse. Strong, nurturing boundaries was the better approach to helping us feel safe.”
For example, they had dinner at 5pm every single day, no matter where they were. “Coming from a place where food may not have been there, if dinner-time was delayed it would send us all into this freefall, we would be so dysregulated.”
It might sound quite odd, she acknowledges, that it couldn’t just be explained to them that dinner was coming later. But early experience of food being withheld was still determining their behavioural responses.
Jefferies and her siblings all had different struggles. “But essentially therapeutic parenting followed us all the way through and helped us all to build a safe base with my mum, so that we could trust adults. Now some of us are a bit more healed than others.”
She works with the Inspire Training Group in the UK for therapeutic parents, is happily married and has a two-year-old son, Arthur, “who is securely attached and thriving”. As a child raised with therapeutic parenting and now a parent herself, Jefferies is in a better position than most to see how all parents could learn from this approach.
“It’s a really strong nurturing way of parenting children, [to] make them feel safe,” she explains. “We always say with a securely attached child it will work first time no problem; sometimes it does take a little longer with children from trauma, but standard parenting will never work for them.”
‘Time in’
For instance, "time out" and the "naughty step" – a corrective technique for bad behaviour that was popularised by "super nanny" Jo Frost – was always a non-runner for therapeutic parenting. And now, Jefferies reckons, it has been discredited as an effective intervention no matter what parenting approach you want to take.
“Time in” is the preferred response. Take the scenario of a boy who starts hitting his brother after some disagreement while playing together. The therapeutic approach would be to remove him from his brother, explains Jefferies, but remain with him rather than putting him in isolation. Give him time to cool down but make him feel supported through it, saying, “You shouldn’t have hit your brother but I still love you and when you have calmed down you can go back”.
Whereas putting children in “time out” would recreate the early neglect, when they may have been left in bedrooms, outdoors or ignored for long periods of time, Jefferies explains. “They just fall back into what we call ‘Room One’ – the neglect stage.” As a result, they may comply perfectly with “time out” but it not only achieves nothing but can be a retrograde step.
With any child, bad behaviour is often about trying to attract the attention of a parent, so even in “standard” parenting, meeting that need is likely to be more effective than doing the direct opposite and shunning them in “time out”.
Rewards charts are not recommended either for therapeutic parenting and Jefferies can see why, but that is one tactic she is happy to use with Arthur, now in the throes of toilet-training.
“Anything like that is all dependent on your child,” she stresses, “and how they respond to stuff like that.”
She remembers her mother trying to use them and how adept she was as a child at manipulating the situation. She knew exactly how to get a green smiley face and then would immediately “be really, really naughty”.
Meanwhile, her brother never got a smiley face “because he was comfortable being shamed, where there was no expectation of him to be any better. He saw himself as a naughty child.”
Hennessey also believes that “without a doubt”, all parents can learn from elements of therapeutic parenting. Modern life has become so busy and many families are becoming a bit detached, she says. The essential skill of being in a still, listening mode with children is so important. Teenagers will push that away, yet it’s a stage of life at which they need their parents, perhaps more than the middle years of childhood, she suggests.
Even children without early trauma can have an emotional age that’s out of step with their cognitive age, she explains. A close bereavement, parental separation or some other trauma may cause that.
“Children’s emotional age tends to freeze with trauma as the system tries to get past what is set in front of them. It’s only when the front brain is in a calm state that we can make progress cognitively. When the lower brain is in a state of agitation for whatever reason, it stops the front brain from maturing.”
As with any toddler, Jefferies finds her son “knows what buttons to push” with his mother and in moments of conflict she often asks herself, “What would my mum do?
I had to remember 'no, you're the grown-up'
“I found myself this morning on my hands and knees begging him to get into the push chair,” she admits, offering him all sorts of bribes to comply. “I had to remember ‘no, you’re the grown-up’; I had to put him in the push chair and he wasn’t happy but ultimately I am the grown up, I am the ‘queen’ – that’s what we say in therapeutic parenting – you’re a steam train going forward, you’re in charge.
“It can seem that you are quite stern from the outside but if you are keeping the child safe, you know who the grown-up is,” she explains. Even with securely attached children, “when the child doesn’t feel the parent is in charge, they can become really anxious and escalate their behaviour”. That’s the child saying, “I don’t feel safe – you’re not in charge”.
Irish Attachment in Action (IAA) was set up by a group of professionals to raise awareness of why attachment matters for individuals, families and societies. Its co-founder Paul Harvey, who works for the Western Health and Social Care Trust in Northern Ireland, says he sees lots of parents struggling and looking for guidance – not just those with fostered or adopted children.
Parents being available to meet a child’s needs from the moment they’re born is so important for them to learn to develop relationships, he adds. We get it wrong at our peril.
Alex’s story
Alex came to Ireland from a children’s home in Russia at age 2½. He had already been moved several times in his short life – from his birth mother into state care in a children’s home and was then transferred to two more children’s homes before his parents adopted him.
“The effect of all that was that he was only beginning to understand what intimate relationships were when he came home to Ireland,” says Christine Hennessey of Barnardos.
The service first saw Alex at age seven, when his parents sought help for his challenging behaviour. He was both very emotionally immature and prematurely independent.
Alex wanted to control his environment and parents because he had nobody to guide his actions for a time in early childhood, explains Hennessey. “He was unable to manage anger, frustration and quick to have meltdowns.”
He was also highly anxious and feared people would break into the house and take him away. Separation anxiety is quite normal, “as the vast majority of adopted children don’t take it for granted that their parents will return when they go away”.
Not surprisingly, Alex was having issues at school and that’s why Barnardos works with teachers to promote understanding of how early attachment issues affect children, not just in primary school but are likely to resurface in teenage years. They may feel under pressure to move away from their parents, as their peers do naturally at that stage, yet these children’s emotional age continues to be out of step with their chronological age.
The work Barnardos did with Alex’s parents included showing them out to play early childhood games such as “peek a boo” and “hide and seek” that he had missed out on.
“You can’t skip these key emotional stages – they must be made up,” says Hennessey. Another issue was that both Alex’s parents were working full-time but emotional availability is key in raising children with early trauma.
“If it is possible for one of the parents to be present for most of the time, the child will make progress much faster – or failing that, a single minder rather than a creche or group situation,” she explains. The child may appear to take to group care, as that is what they are used to, but they won’t make any progress.
Alex’s parents were also advised to reduce the stimulation in his life and not have too many outings to places such as busy playgrounds.
“He found them very stimulating and his behaviour afterwards would escalate.” Instead, routines needed to be increased so he knew what to expect.
Alex’s mother had recalled how she moved the furniture around one day while he was at school and when he returned he had a meltdown. “He needed sameness and predictability.”
While therapeutic parenting helps, it is still very difficult to shift emotional immaturity and there’s “no quick fix”, warns Hennessey. Delaying access to internet-enabled phones as long as possible is advised because they are very vulnerable to bullying, and it’s also recommended that parents are careful to limit screen time.
“Children like Alex get pulled into the fantasy world and they find it very difficult to tell the difference between fantasy and reality.”
They may also dislike team sports – where they could be picked or left out of a team. “For a child who is very vulnerable to rejection, that is quite a challenge, in addition to the high stimulus of the environment.
Swimming or yoga with parents is recommended, while an activity such as adult-led Scouts can be fantastic “It is the ‘just go and play in the playground’ thing that these children really struggle with.”
Interaction with animals is also excellent, such as horse-riding, and ownership of a pet, adds Hennessey.
“It’s like there is something in their hands that is more vulnerable than them and it really helps them understand what love and attachment means and it encourages them to talk about feelings.”
