Development supportive dialogue, Timisoara, January 2011
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The document discusses developmentally supportive dialogue with children who have experienced trauma, noting that their "survival brain" is often overactivated while connections between brain regions involved in affect regulation and learning are underdeveloped; it provides guidance on opening disclosure conversations, actively listening, asking open-ended questions, and helping children regulate their affect and become more aware of bodily signals through therapeutic conversations.
Development supportive dialogue, Timisoara, January 2011
- 1. Development supportive dialogue with children Inge Nordhaug & Dag Nordanger Dag Ø. Nordanger RVTS West, Bergen, Norway Norwegian TENTS partner www.tentsproject.eu
- 2. Focus for these days Children in particularly difficult circumstances: Exposed to violence Witnessing violence Sexual abuse Drug abuse in families Orphaned www.rvts.no
- 3. What is developed in these children? Not the ”Learning brain” … Exploration, curiousness, interest Balance between the the safe/known and the new The ”attaching brain” …But the Survival brain” Defensiveness, supsiciousness, identification of danger Mobilisation of resources for protecting onselfskyttelse The ”detaching brain” www.rvts.no
- 4. The ”alarm centre” of the brain is kept a state of constant alert Releases stress hormones which stimulate instinctive reactions and inhibits more higher cognitive processing Underdeveloped connections Inhibited: between limbic system and Affect regulation and ability prefrontal cortex (which runs reasoning, self reflection, to learn and integrate contextualising – cognitive new information control) www.rvts.no
- 5. Different kinds of conversations To explore To understand To disclose To help www.tentsproject.eu
- 6. Disclosure versus therapy Therapy has much to learn from the directness and exposure in disclosure conversations Therapy can be ”anti-therapeutic” if central stressors in children’s lives are not disclosed www.tentsproject.eu
- 7. Some communication theory All behaviour is communication One cannot ”Not communicate” Communication concepts: – Synchronised communication – Counter communication – Uneven power relation between adult and child – Message sent – Message received www.tentsproject.eu
- 8. Centrals aspects in dialogue with children Congruence Position Eye contact Voice tone Body posture and movements Mimics and facial expressions Emphasising sounds www.tentsproject.eu
- 9. Frame factors The adults’ preparation Information about the child Physical arrangements Furniture Tools Presence www.tentsproject.eu
- 10. Facilitating/inhibiting communication Facilitating: Inhibiting: Open questions Closed questions Imperative form Yes/no questions Descriptive form Causal form Wide, general form Non leading Leading Key questions, and Leading questions to references to what has expected answers the child has told Choice questions before Projections www.tentsproject.eu
- 11. What facilitates and what inhibits? Active listening Passive listening Repetition Ignore Confirmation Doubt or deny Sum up Switch of topic Pressure/negotiation Clarification Exploring questions Blurring, making it wage Personal form Interviewing Child language ”You” form Metacommunication/mirroring Adult language Pauses More questions www.tentsproject.eu
- 12. Disclosure conversations www.tentsproject.eu
- 13. General principles of disclosure conversations Show interest, receptivity and neutrality Invite to dialogue based on the child’s own signals Be present, close, and have time Do not push, but make a ”room” for children to talk Remember; It is the child who discloses, not the adult www.tentsproject.eu
- 14. Methodical approach The conversation focuses on the child’s reality The conversation is in the form of dialogue The purpose is to get qualitative and descriptive information through free speech The conversation is a interpersonal interaction The conversation is focused The conversation is non-leading www.tentsproject.eu
- 15. The phase structure Establishing contact Opening procedures Introduction of the topic Free speech In depth exploration Closure www.tentsproject.eu
- 16. When do we need disclosure conversations? When children in different ways signal that they are not ok When these signals make us worry When we want children to tell about concrete events they have experienced www.tentsproject.eu
- 17. Worries can be based signals from: Something the child has said Something the child has shown: – Aggressive behaviour – Withdrawal – Sexualised behaviour www.tentsproject.eu
- 18. Sexualised behaviour Stop it, and ask: - Where did you learn that? - Have you seen someone else do that? - Have someone done such a thing to you? - Who? ...when it happened, how was it like to be you? www.tentsproject.eu
- 19. Why do we not talk to kids about difficult experiences? Our view of children’s credibility Ethical reasons Adults protect themselves We may think we protect children that way Cultural taboos We are afraid that of being wrong Afraid of parents’ reaction Afraid of spoiling possible investigations www.tentsproject.eu
- 20. And why do not children talk about it? Memories about it are unreal and ”split off” Fair of adults’ reactions Fair of consequences and punishment Fair of not being believed, understood and helped Shame, guild and feeling dirty Being threatened to keep quiet Children intuitively understand they must not tell Taboos Nothing happened www.tentsproject.eu
- 21. What does it take for children to tell? An occasion must be created There must be a purpose There must be a thematic connection An inner feeling of “permission” www.tentsproject.eu
- 22. These phrases are the model in a “nutshell”! You look so sad to day... What happened? Tell me …. www.tentsproject.eu
- 23. Drawings and other products Keep them. Comment when they are unusual: What did you draw? Tell me about this drawing… What is this? Who did you draw? What does he/she do? What does he/she think? www.tentsproject.eu
- 24. Opening of disclosure conversation Start with the child’s signals … Generalise: ”I know many children who tell/do/draw just like you, and they have experienced things they do not dare to talk about. I have wondered if there are things in your life you have not dared to tell anybody? Talk to the child about good and bad secrets, and about what typically stops children from telling things. www.tentsproject.eu
- 25. Secrets and frights Talk to kids about good and bad secrets: That children are afraid of to telling bad secrets They fear nobody will believe them They are afraid of threats They are afraid of what will happen if they tell it www.tentsproject.eu
- 26. Practicing disclosure conversations in groups www.tentsproject.eu
- 27. Therapeutic conversations (With emphasis on affect regulation and affect consciousness) www.tentsproject.eu
- 28. The ”alarm centre” of the brain is kept a state of constant alert Releases stress hormones which stimulate instinctive reactions and inhibits more higher cognitive processing Underdeveloped connections Inhibited: between limbic system and Affect regulation and ability prefrontal cortex (which runs reasoning, self reflection, to learn and integrate contextualising – cognitive new information control) www.rvts.no
- 29. Identifies the following key challenges: Help children to regulate affect Help children to become more conscious about their affects and bodily states Help children to make connections between affect and language Group work: Ways to help children with this www.tentsproject.eu
- 30. Some ways we have experience with: Affect consciousness: Being sensitive, intonation: Let the principles of good care and healthy early interaction with infants be the model Comment on signals of affect in the child’s voice tone, body posture, mimic, and other Ask where in the body the child can feel what he or she is telling us www.tentsproject.eu
- 31. Ways we have experience with (continued): Affect control and regulation: Identify the pre-warning signals in the child’s body Discuss alternative ways to cope with those signals (counting techniques, relaxation techniques, and more) Stop destructive behaviour, with own affects controlled Regulate the child’s affect through own affect Use such situation as examples for learning Reward changes www.tentsproject.eu
- 34. Thank you! Hope to see you again soon! www.tentsproject.eu