Therapeutic Crisis Intervention for Families

A training programme to provide
foster carers with ideas and practical
skills to help a traumatised or
attachment disordered child For over twenty years the Residential Child Care project at Cornell University, New York, has provided training for foster carers. The training, known as Therapeutic Crisis Intervention for Families (TCIF) has evolved over these twenty years as a result of research and evaluation and feedback from carers.

The 2012 edition of the course is based on the latest ideas and research, both at the university, and around the world. The programme is written at the university but includes the latest ideas from America, Canada, Australia, Ireland and Britain. TCIF is widely used in seven countries.

TCIF addresses three questions:

• What ideas and skills do carers need to help children who are traumatised or who have attachment disorders?
• How can we make the training effective?
• How can agencies help carers use these ideas and skills?

• The TCIF programme contains the latest ideas on trauma, attachment, brain research and practical techniques to help children.
• It is designed using the latest ideas on how adults learn and retain information and skills.
• The training is part of a therapeutic system that agencies should adopt to provide the best support to carers.

1. The effects of trauma on children

• How trauma and attachment disorders affect the way the brain develops and influences the way children think, feel and behave.
• How some instinctive child care techniques can be counterproductive and can alienate a traumatised, or attachment disordered child.
• How we need to use more appropriate techniques involving building relationships, listening, showing understanding and being sensitive to the child’s needs.

2. Preventing a crisis by creating a safe and secure environment

• How to create a comfortable, calming environment for the child, controlling potential triggers in the physical environment, activities, routines, relationships and issues specific to the child.

3. The importance of emotional competence

• How we use ourselves when interacting with children.

• The importance of knowing ourselves well, dealing with our own emotions and understanding our own triggers.

1. The stress model of crisis

• Understanding a typical incident as an emotional outburst caused by a child’s inability to control emotions

• Understanding the stages of an incident – triggering, escalation, outburst and recovery

2. Assessing the situation

• How to assess a situation using four questions – What am I feeling? What does the child feel, need and want? How is the environment affecting the situation? What is the best response?

3. Knowing ourselves

• Understanding how our thoughts and perceptions affect how we respond.

• How to keep calm using positive self talk

4. Knowing the child

• The importance of responding to the child’s feelings and needs, not just their behaviour

• Understanding the difference between emotional outbursts and calm, pre-meditated behaviour

5. Managing the environment

• How to organise a calming environment

• How to develop clear and reasonable household rules.

1. Intervention approaches.

• Five different ways to interact with children: as an organiser, an authority figure, a friend, a listener and a teacher

2. Responding to children using the listening approach

• How to use a range of active listening techniques

3. Identifying and responding to feelings

• How to use reflective responses to communicate empathy and help a child understand and deal with feelings

1. Negotiating rules and expectations

• How to use active listening to negotiate with a child to find creative solutions  to problems with household rules

2. Behaviour support techniques

• How to use a range of techniques to calm a child who is becoming agitated

3. Using consequences

• Understanding the harmful effects that punishment can have on a traumatised and attachment disordered child

• How to use consequences for appropriate behaviours to help children learn

• How to discuss positive and negative consequences in advance with a child

1. Assessing what the child feels, needs, or wants

• How to assess the meaning of a child’s behaviour during a crisis

• How to use an assessment tool and choose a strategy based on observation and assessment of behaviours

2. Emotional first aid

• How to calm a child during an emotional outburst so that the child is able to resume an activity

3. The power struggle

• How to avoid getting caught in a destructive confrontation with a child.

1. Nonverbal communication

• Understanding the importance of non-verbal communication in a crisis

2. The elements of a potentially violent situation

• How to de-escalate aggression and violence by reducing stress or motivation, avoiding triggers and removing targets or weapons

3. Crisis co-regulation

• What to think, what to do and what to say when de-escalating extreme behaviour

4. The life space interview (LSI)

• How to talk to a child after an incident using active listening to clarify what happened and help the child develop coping strategies to deal with future emotional outbursts.

1. Crisis intervention

• Practising combining de-escalation techniques and talking to the child after an incident.

2. The shortened LSI

• How to talk to a younger child after an incident to help the child develop coping strategies

3. Developing individual crisis management plans

• How social workers, supervising social workers and any other professional involved can help carers by writing clear, brief guides to what triggers a child, what behaviours to expect, the meaning of the behaviour for the child and which of the TCIF strategies to use when faced with different behaviours.