Imagine ……… imagine that you are 15-years old. You are intensely aware of how you look, you are not sure who you are, your best friend has just taken your girlfriend, you hate your parents and your life, you are not doing well in school and then you have to have weekly therapy. In therapy you talk about your problems at school as long as you can and then at the end the therapist helps you to reflect on your life story. When you leave you feel more trapped, more anxious than before and you are more angry and aggressive, which gets you into trouble and you are grounded again!
Sometimes after therapy, you meet your friends. They talk about fun stuff and laugh and have a joke, while you are still partly in the last minutes of therapy and you still wanted to ask a question about your birth mum. But somewhere you know that the therapy is working, and you really want to know why you are always in trouble with your parents. And you also really want to understand why you get so angry, why you are always anxious and what really happened when you were little and lived with your birth family. But this is too hard and then you start to cancel therapy sessions. Your parents are more angry than usual, they threaten you and you feel so trapped……..
Or …….imagine being 7 years old and always feeling rubbish. You don’t care any longer and you can’t be bothered with the teachers and your parents always telling you how badly you are behaving. You already know that you are rubbish, you don’t need to hear it again and again. Everything that ever happened to you was rubbish, so why would it ever change? You go for therapy every week and you enjoy the playing, but sometimes the therapist asks hard questions and you do not want to look at your life storybook. You hate your life and don’t like being in therapy any longer.
All of us know that being an adopted child or young person can be very confusing. The adopted child is on one of life’s most difficult journeys trying to make sense of life, of who he/she really is and where he/she belongs. It is all too hard, too overwhelming. To look at yourself and all the complications that early childhood trauma brought with you, can be a
nightmare, especially in a society where the big people around you want you to “behave” or “have better behaviour” or “think before you act”.
Professionals working in adoption support also know from experience that the adopted children displaying multiple emotional and behavioural difficulties is the is the most difficult
group to work with.
In 2006 I started to look at the possibility of shortening the therapeutic process for adoptive parents and children with complex difficulties. Over the past 8 years a form of therapy
evolved which shortens the therapeutic process for adoptive children. As the Intensive Therapy process became more refined over the past 2 – 3 years, we attained more positive outcomes.
James was a young boy of 13 years old when he arrived for his Intensive Therapy with his parents. The main problem on the first day was that the parents had very clear goals – they wanted the aggressive and controlling behaviour of James to stop. The parents were regularly targets of his aggression and violence. James had no goals. His life was bliss – at least most of the time. James was clearly the “boss” of the family and at times reigning with terror! But deep down, James was scared, anxious and he was sad but with his controlling and aggressive demeanour, he was able to mask his emotional pain and fear while the parents became increasingly traumatised and despondent, not knowing whether they could continue to care for their only child. Social workers were involved, James had already been seen by different services and therapists, but the violence and control persisted.
The first task of this intensive therapy was to enable James to align his goals with the goals of his parents. That took many hours of gentle raising of awareness, confrontation, psycho
dramas, writing, explaining and finally James was willing to acknowledge that he also wanted the violence to stop, but he was afraid and felt vulnerable. As we started to process the trauma of James, the parents became increasingly aware of the
fear and terror in James due to early exposure to continuous domestic violence, rejection, abuse and emotional pain. The parents left the room at times, wide eyed and started to change and display more empathy towards their son, more understanding of why James behaved the way he did. They did not expect him to suddenly ‘change’ any longer; they started to focus on their son and not only his behaviour. The parents mastered new ways of talking to James and addressing his control, anger and aggression.
By day 6 of the intensive, James was able to openly seek the affection of his parents and the defiance became less. But difficult days followed as James started to disclose his dissociative defenses and we started to work on these. There were threats to never return again, threats to run away, there was a hole in the one wall; slowly but certainly James started to understand why he always resorted to anger and violence. There were apologies, more anger, tears and extra support for the parents and finally the tenth day of the Intensive Therapy. Everybody was exhausted. James smiled as we ended with celebrating his 13-year old identity, and in his evaluation of the two weeks James explained how he ‘enjoyed’ the journey, although it was ‘extremely hard’.
After a couple of follow up sessions and six months later, the last 5 days of the Intensive Therapy was completed. James appeared more ready and eager to engage. Of course there
were more anger, more threats but finally the hard work. Six months later the family reported that their whole life changed. There were no aggression or violent incidents in the home or
school since the completion of the first Intensive Therapy. The parents reported that they were no longer ‘living on eggshells’; they were no longer ‘stressed’ or ‘anticipating when the next explosion would occur’. They felt that they finally had ‘a normal family life’ and ‘had a future’.
The benefit of the Intensive Therapy is that the child or young person is taken out of their usual environment, does not attend school, or has any contact with their peer group or social media during the active times of Intensive Therapy. It becomes a time ring-fenced for an active process of positive change and restoration of the self and relationships. There is time and space for active reflection and connection. Parents are not at work, but full time involved in this process where they receive the help, support and training that they need. The child or young person is part of an accelerated therapeutic process. He/she starts making sense of why they continue to display difficult behaviours and of their own internal chaos. They also start to explore and understand the different and complex ways they employed strategies as very young babies or toddlers in order to survive inescapable terror. With the help of the therapists the child and parents develop a full understanding how these strategies are causing continuous disruption in the present family.
During the intensive therapy, the parents also receive effective short-term therapeutic input, which provides them with resources and process their secondary trauma. As the therapists
are on standby 24/7 during the active phase of the intensive therapy every question, problem or behaviour can immediately be discussed with the family. Some families said that it felt as
if they were ‘living’ with the therapists. Parents are also able to identify and change their own negative relationship patterns in the family. They are also enabled to change old entrenched
patterns of behaviours in their child.
By the time the family returns home, they have already started to internalise new concepts, new ways of being and new communication strategies. Parents feel much more empowered
to address the behaviours of the child and do not feel isolated in their struggle any longer. Usually they also see a radical change in their child for the better. The amount of therapeutic
support needed after the intensive therapy varies from none to weekly therapy for a period of time.
Intensive Therapy presently appears to be the single most effective tool to bring about a radical change in the adoptive child and family in the shortest possible time. This is especially effective where neither parents nor school is able to cope any longer with the extreme behavioural difficulties at school.
One of the teacher’s recently reported: ‘JP has radically changed since the intensive therapy. He is very calm, is able to concentrate better in the school, does not display the difficult
behavior any longer and is more social with other children’.