In their work with young children who have suffered trauma and abuse, one of the greatest challenges for Safe Places carers is helping these youngsters understand healthy childhood behaviours.

From his very first months of life, Jacob's* family struggled to look after him and he lived between many homes from a very young age. By the time Jacob came in the care of Safe Places in 2015 at age nine, he was already displaying a vast range of challenging behaviours. He was diagnosed with post-traumatic stress disorder, ADHD, reactive adjustment disorder, and had symptoms of a dissociative disorder.

Jacob would act like an animal, usually a dinosaur, and completely dissociate from reality to cope with his feelings, not engaging with staff for long periods of time. He would sit in front of the TV or video games for hours and completely ‘zone out’’. There was the usual naughtiness of a child, such as taking extra snacks or unplugging the fridge, but he had no memory of doing so and would yell and hit if staff called him out.

Jacob would hoard food under his bed or eat to the point he would become ill. He would become extremely attached to certain staff, calling them ‘Mum’ and ‘Dad’. He had issues of bedwetting and smearing faeces around his home and in public when he was distressed or angry.

Jacob displayed a lot of sexualised behaviours and was extremely defiant. At school, he required constant supervision, as he did not have a very long attention span and would often be disruptive. It was clear Jacob had no idea how to interact normally with others.

Understanding triggers

For the first six weeks, Jacob’s care team took a very careful approach, as this a very different level of trauma they were witnessing.

Working one-on-one with Jacob, his care team developed a specialised plan where consistency, routine and boundaries were key. They worked closely with Jacob’s psychologist to understand his triggers and how to minimise the risk of an episode.

Throughout this period, Jacob was also disclosing what had happened to him. This was traumatic for him and would often lead to outbursts or dramatic turns in his behaviour. Supporting Jacob meant many sleepless nights and it was very difficult for his carers to hear him speak about his own self-harm and thoughts of suicide.

After each incident, his carer would walk him through a “life space interview” to help Jacob connect with what he did and what he felt, until he gradually started to practice the new strategies and learned how to self-regulate.

Jacob often felt very afraid at night, had frequent nightmares and slept with every light in the house on, so his carers would read to him or help to relax before bed.

They would stay with him until he fell asleep and helped him to understand what therapeutic touch and affection felt like, making him feel safe and cared for.

Childhood regained

In the 18 months that he has been in Safe Places care, Jacob has progressed into a mature, polite and kind-natured boy. He can tell his carers what he’s feeling and let them know if he needs space when he’s upset or frustrated.

He shows very few signs of his dissociative disorder and spends more time outdoors, rather than in front of the TV or playing video games. Rewards such as a new bike and a trampoline gradually enticed him outside and into activity.

Jacob has been able to develop healthy friendships which he never had before. At school, he was previously cut off from other children, because he needed support from an education assistant. These days he loves going to school and hasn’t missed a day in five months. He enjoys unsupervised time in the playground with the other children and receives nothing but positive feedback from teachers.

At home, Jacob can now sleep with the light off and rarely has nightmares. He has not had an incident of bedwetting or soiling in over a year, as he has learned to manage his trauma and anxiety through therapy and talking to his team. He has a very good understanding of appropriate behaviours and will even talk about how inappropriate some things are on TV!

Next steps

After nearly two years with Safe Places, Jacob was now ready to move on to the next stage of his life and transitioned out into a specialised foster placement. At 11-years-old when he transitioned, he was still young and used to one-on-on attention, so there were no other young people in his new home. His carers are also experienced in supporting children with high-level trauma in their past.

Two years on, Jacob has settled in well and is thriving with his foster family. The extent of the abuse and neglect Jacob suffered is still unknown, but his time with Safe Places, where he experienced no judgement and only support, has given him a firm foundation to work through these issues as he matures.

*Name changed to protect privacy