Learning to trust through play

By Jen Willis, Communications Consultant, Berry Street – Take Two  

Learning to talk, walk and play have been bigger achievements for Kassie than for most kids.

When Kassie entered foster care as a toddler, she was severely developmentally delayed and clearly malnourished. She couldn’t walk or talk.  She couldn’t hold eye contact and didn’t know how to play. She vomited 40 to 50 times a day, every single day but for no obvious medical reason.

Kassie is one of dozens of Aboriginal children the Berry Street Take Two program is currently working with.

Like many, she is suffering from the effects of intergenerational trauma. Kassie’s mother experienced abuse herself as a child, but never received any help to recover. She has now had all seven of her children removed from her care because her substance addiction has left her unable to care for them properly.

As a toddler, Kassie was left alone in a public park. She was found by a passer-by some time later and was then formally removed from her mother’s care. It was clear that Kassie had been severely neglected and it was likely she’d been sexually assaulted by men who visited the house where Kassie and her mother had been living.

Kassie was placed into long-term foster care with Andrea and Blake, and their 8-year-old son.

Kassie immediately became excessively clingy towards Andrea. She’d get so worked up when in the same room as Blake that she’d bang her head on the floor. She’d get hysterical if either foster carer tried to bathe her. In her cot at night she would frequently scream for a long time and was unresponsive to attempts to calm her and would eventually go quiet and stare into space. When anyone went to her cot, Kassie’s eyes would be open, but she wouldn’t react to any noises and seemed not to see when someone leaned into her field of vision and talked to her.

When Kassie’s foster carers first met their Berry Street Take Two clinician Catherine, they told her they didn’t think they could keep caring for her – they were really trying, but it was taking a huge toll on them and their son, and they didn’t think they had the skills needed to help her recover.

A thorough clinical assessment of Kassie was undertaken. Catherine quickly observed that Kassie was terrified of men and of water, and that she was unable to engage in age-appropriate play with other children at childcare. She was very developmentally delayed; physically, cognitively and emotionally.

Andrea and Blake started weekly therapy sessions with Catherine to help them understand and respond to Kassie’s behaviours. They discussed ways to devote attention to their son also who was becoming resentful of Kassie.

Catherine also worked with the family using the Child-Parent Psychotherapy model and spent time playing together with Kassie and her carers. The goal of these sessions was to build a relationship of trust between Kassie and the male foster carer Blake, so that Kassie could tolerate his presence without Andrea having to be there.

Catherine started using a therapeutic play narrative during sessions, describing what they were doing and talking to Kassie. Kassie rapidly started learning to talk more, and she became increasingly able to tolerate Blake playing with her. Catherine started asking Andrea to leave the session early, and after several more months, Kassie started coming to the sessions alone with Blake.

During the sessions Kassie would often initiate play that involved feeding a very hungry baby. Catherine would keep playing while reassuring Kassie that “it’s not your fault you were hungry when you were a baby, and Daddy Blake will always make sure you have food.”

Initially Blake would overcompensate for Kassie’s developmental co-ordination difficulties and step in to help her whenever she looked like she needed it. But Kassie didn’t want the help and kept rejecting him which upset Blake. Catherine taught him to wait for Kassie to ask for help, and taught Kassie to ask for it when she needed it.

A year later Kassie is walking on her own, can talk well, and uses words to ask for help. Occasionally Blake still steps in too early, but Catherine can intervene with a “oops, Daddy Blake forgot to wait again” and Kassie will now sometimes say “silly Daddy Blake”.

Blake and Kassie seem to have developed a common and shared quirky sense of humour. Both were previously frightened of the other but are now overcoming that. Catherine has emphasised to Blake that shared, enjoyable activities are central to relationship building, and Blake has been taking Kassie to ride her bike with training wheels and play in the park. As a family, Andrea and Blake have even taken Kassie and their son to the snow, which they all loved.

Catherine has recently ended her work with Kassie. Now in kinder, Kassie has stopped needing her dummy during the day and is playing in a more age-appropriate way with other kids. Blake has proudly told Catherine that Kassie has come to him for comfort a few times, instead of Andrea.

Just over a year ago, Kassie’s foster carers had not thought they could continue looking after her. Now they say they cannot imagine life without her.

Take Two is a Victoria-wide outreach service provided by Berry Street on behalf of the Victorian Department of Health and Human Services. The service is recognised all over the world as a leading model of how best to support children and young people who have experienced complex developmental trauma. 

Take Two can provide specialist clinical consultancy services to other organisations. Contact us for more information.

Note: Names and other identifying details of the children and their families in our case studies have been changed to protect them.

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