Working With Traumatised Children

Building an EAGALA Model Evidence-based Practice for Working with Traumatised Children Presented at the EAGALA 1st Pacific Biennial Conference, Paterson, NSW, Australia, December 2012. This paper outlines an evidence-based practice for working with traumatized children using the EAGALA model of Equine Assisted Psychotherapy. This evidence-based approach combines the work of Dr. Bruce Perry who is a world renowned leader in brain development, Arianne Struik who teaches internationally regarding the importance of stabilizing children’s experience before attempting to address trauma and the work of Dr. Deborah Truneckova and Prof. Linda Viney FAPS who have developed a client-centred approach for working with children from the theoretical basis of Personal Construct Psychology. Recent research in brain development has shown the links between a child’s social, emotional and physical environment and brain growth. Children who have experienced trauma through abuse and neglect do not develop the necessary neural connections to concentrate, learn and behave in socially appropriate ways. The work of Bruce Perry has demonstrated that brain plasticity allows the brain to grow new neural pathways when deficits are addressed according to the sequential development of the brain. Bruce Perry is a neuroscientist who is a leader in the field of childhood trauma and its effect on brain development. He advocates that children learn through experience and play and that therapy for children should assist the sequential development of the brain. Struik (2011) recommends that children need to be stabilized before addressing trauma and Truneckova and Viney (2012) have highlighted that when working with children it is best practice not to directly address the trauma if the child does not raise it, but to build resilience and capacity in children so that when they are developmentally ready, they will work through the trauma in their own way. Through a Personal Construct Psychology approach Truneckova and Viney (2012) focus on the child’s meaning making capacity rather than on events that have occurred in their external world. Following this need to build healthy neural pathways in the brain, Perry outlined six core strengths for healthy childhood development. These are attachment, self regulation, affiliation, attunement, tolerance and respect. At Equine Time we use the EAGALA model of equine assisted psychotherapy to address these core strengths through play therapy with the children through activities with the horses. One of the activities we use to build these core strengths is called “The Big Paddock Adventure”. This is a simple activity of leading a horse and can involve siblings, parents and several horses. The aim of the game is to follow the leader. Whilst this sounds simple the horses provide the children with countless opportunities to explore each of Perry’s core strengths for healthy brain development. Attachment. Attachment is the capacity to form and maintain an open and responsive relationship with another person. During the game the child holds the horse’s lead rope and leads the horse where he wants the horse to go. For a horse to follow, the child has to negotiate starting and stopping, walking at an appropriate pace, not letting the horse eat, swapping sides of the horse and swapping hands, making sure the horse doesn’t step on the lead rope or their toes, and negotiate trees, logs, dams, thistles and blackberries. Self Regulation Self regulation is the capacity to notice and control primary urges or pausing for a moment between impulse and action. Self regulation develops from external regulation by caregivers, and in our context it is the horse that becomes the external regulator. There are two ways this can happen such as through questions like”will your horse fit through there?” or if the horse gets stuck then the child is halted, or the horse may stop and we will ask the child why they think the horse has stopped. Affiliation Perry states that humans are biologically designed to live, play, grow, and work in groups. In this game the horses and the therapy team all become part of the child’s group. We also play the game with siblings and parents who lead their own horse. We take turns in being the leader and the followers. We explore taking turns and sticking to roles and we explore how leading and following are different and what role is preferred and why? Attunement Attunement is the awareness to recognise the needs, interests, strengths and values of others. In the game, the child needs to be aware of where the horse is in relation to them, how close, how far away, walking quickly or walking slowly. Questions can be asked about how the horse is feeling, what may have happened to the horse to cause a change in its behaviour or other questions to increase the child’s awareness of the horses. Tolerance Because children affiliate on sameness, they also need to learn to accept difference. While attunement is about awareness of difference, tolerance is about what to do about that difference. Children who learn tolerance are more sensitive to others and can adapt and be flexible. They learn to value what makes each of us special and unique. In “follow the leader”, children become aware of their horse, how its needs are different to their own due to its size and having four legs. Horses have different personal space to children, and can be anxious when too close to another horse. Horses also show a preference for the order in which they follow their leader and the children are invited to explore these differences and work out how to help the horses feel more comfortable. In the game a child may need to adjust the speed of his horse so as to keep in line with the others or by not getting too far ahead of others, or by checking that the followers are OK. Respect Respect is appreciating one’s self worth and the value of others. In Perry’s words “An aware, tolerant child, with good affiliation, attachment and self-regulation gains respect naturally.” As the game is practiced we see children become more sensitive to the needs of their horse and more sensitive to the needs of other siblings or parents in the game. They adapt their strategies according to those other requirements, and they praise their horse for success. Their horse is hugged and stroked gently for doing a good job and learning new things. We have outlined what might seem like a simple activity, however, it provides the opportunity for children to learn important life skills through their interactions with the horses and the therapy team. We have demonstrated how evidence based psychological and neurological theory underpins this work by using Perry’s six core strengths for children’s healthy psychosocial and emotional development. Through this lens, we are able to understand the challenge and the complexity for a child provided by the horses in the game of “follow the leader” otherwise known as our “Big Paddock Adventure.” References: Perry B.D. (2009) Examining Child Maltreatment Through a Neurodevelopmental Lens: Clinical Applications of the Neurosequential Model of Therapeutics, Journal of Loss and Trauma, 14:240-255, Taylor and Francis Group, LLC Perry B. D. Understanding the Effects of Maltreatment on Brain Development (2009) Child Welfare Information Gateway, Children’s Bureau/Administration on Children, Youth and Families, U.S. Department of Health and Human Services, Washington,DC. Perry, B.D (2005) Maltreatment and the Developing Child: How early childhood experience shapes child and culture, The Margaret McCain Lecture Series. Struik A. (2011) Don’t let sleeping dogs lie” Translation of the book Slapende honden? Wakker maken! (2010) Truneckova D., Viney L.L. (2012) Using play to help troubled children in the school setting, InPsych: The bulletin of The Australian Psychological Society Limited, June 2012 34,1.

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