What becomes of the open-hearted: Supporting resilience in children’s homes staff

Children in care need staff who can connect with them open-heartedly, yet the experience of working in the residential sector is often personally intense and challenging. Staff are commonly at risk of experiencing ‘secondary trauma’ or ‘moral distress’ which will lead to protective responses and blocked care if we do not have well-developed programs of staff support.

As we know, children who can’t live with their families, who may have been abused and neglected, need warm, open-hearted carers, who can form meaningful, loving relationships with them, and stick with them, in order to recover from their trauma and thrive. ‘Relationships are the agents of change and the most powerful therapy is human love.’(Perry, 2006)

In my work on Trauma Informed Care, I propose that children’s homes staff need 3 solid foundations to be effective: 1. Understanding of the impact of early experiences on a child’s interpersonal neurobiological development. 2. Strategies that work for relating and responding to children. 3. A well-developed programme of staff support and self-care. The third leg of the 3-legged stool is often overlooked, but it is vital for a stable and effective staff team.

There are many challenges to remaining emotionally open and warm in this work. Beek and Schofield’s (2004) Caregiving Cycle, shows how feelings lead to thoughts and thoughts lead to behaviours; how staff and children are in a dynamic interrelationship with each other, their behaviours having an impact on each other. This can of course be used to help children to feel safer and become calmer.

However, angry, threatening, rejecting, explosive trauma and survival driven behaviour from young people will impact on how staff feel and think. Children and young people self-harming, drug taking, being missing, having suicidal ideas, or staff care tasks such as tending to self-harm wounds, clearing up damage and destruction, can all lead to intense sensory, emotional and arousal states for staff. Uncomfortable feelings can lead to defensive thoughts and protective behaviours.

We now also know that our physical response to danger cues is instantaneous and automatic. Stephen Porges’s Polyvagal Theory (2011) tells us that information comes into our bodies through the senses, signals travel through the polyvagal nervous system (PVNS) to the brainstem, which sends signals back via the PVNS to trigger automatic responses in the body. We don’t stop to think about whether we need a shot of adrenaline to prepare us for fight or flight, in the face of danger. Our bodies respond super quickly, and later we create a meaning for what we feel in our bodies. It is stressful to have our survival responses triggered frequently – as the young people we care for know all too well.
Frequent stress and stress responses are overwhelming, bad for our physical and emotional health, and can lead to secondary or vicarious trauma for staff. (Cairns, 2002)

There may also be a crossover with staff’s own lives, their own trauma histories and triggers; emotional hot spots might be brought to the surface by being alongside hurt young people.

If these are frequent experiences, they can lead to what Hughes and Baylin (2012) termed ‘blocked care’. Hughes and Baylin explained how caring parental responses are sustained by stimulation of the rewards centre in the brain, from the relationship with the child, as well as other factors, such as beliefs about child-care. Residential care relationships may not stimulate the parenting reward centre of the brain, for a long time, and in fact may be more likely stimulate the danger centre in the brainstem. In this case, staff may be ‘running on empty’ drawing increasingly on intellectual beliefs rather than emotional resources to do their job.

Understandably then, the caring response becomes blocked, leading to rigidity, avoidance, being judgemental, or an over-emotional chaotic response towards children. We might recognise this as burnout, compassion fatigue or work-related stress. As Triesman (2021) points out, an understanding of this is rarely included in people’s training ‘the focus has tended to be on other people’s trauma, rather than one’s own’.

Treisman also writes about how ‘an organisation can itself create trauma for the people who work there …. through adverse organisational experiences’, and how organisations themselves can become ‘trauma soaked and trauma inducing’. This might show up as: fragmentation in an organisation or team, poor communication, inflexibility, ‘leakage’, confusion, being too busy to think, mistrust, idealising/denigrating, warring colleagues, bullying cultures etc.

McMillan’s research (2021) has found that some ethically difficult situations commonly experienced by children’s care workers, can lead to the medically recognised phenomena of ‘moral distress’, again resulting in burnout, absenteeism and staff turnover. Children’s homes staff reported feeling morally compromised by decisions based on resources rather than children’s needs. Decisions which lead to inappropriate placements being made, or placements being ended for financial considerations as opposed to considerations about the child; or needing to work with other staff who are not qualified or competent to do the job, because they are cheaper to employ.

So, staff commonly face pressure from many sides, which can lead to ‘blocked care’ secondary trauma, compassion fatigue, burnout and turnover – all of which negatively impact on the children most in need of consistent, open-hearted, loving care.

Children’s homes leaders need to recognise that for children to receive good quality care, staff need high calibre support. Support to be emotionally intelligent, stay resilient, and to nurture their open compassionate hearts. A fundamental ingredient for a successful children’s home is a thought-out plan for individual staff support, team development, and nurtured interpersonal relationships. Staff also need training to look at their own motivation and triggers, and support to develop good self-care.

We need to invest in the staff we have, grow their capacity and resource them to stick with the children and the home.