Mary Meredith

People might wonder why trauma informed practice is such a passion for me, and why I can’t help but react when it’s dismissed as somehow anti-discipline or dangerous by those who are too entrenched in their behaviourist positions to even find out about it. (I refer here to England’s expert advisor on behaviour & his tribe, given away by their hot takes.)

I could cite lived experience. Like many, I have made poor, impulsive decisions rooted in traumatic stress at times in my life, but they haven’t been life-defining. Compassionate leave (which pupils don’t get), & a chance to decompress & process with loving family & friends got me through.

But it’s not that direct experience of what we need as humans to avoid long term traumatisation which drew me to the field. It was rather the introduction of an Alternative Provision referral panel in my last post as Head of Inclusion in Lincolnshire which focused my mind.

Anyone who sat on that panel will tell you that the reading was grim, jolting. Loss, relational rupture, chronic hardship, parental ill health, domestic violence – these were the chronologies. Middle class children living in secure and comfortable homes were not coming to panel and these are not the pupils who make up the ranks of England’s vast & growing AP sector.

Our behaviour expert regularly mocks the notion of ‘unmet needs’ (only virtue signallers who have not taught in tough schools are sidetracked by these). But visit any AP and you will see how devastating their impact and how urgent the need to fill social and emotional gaps.

One of our APs in Hull begins intervention by asking newly admitted young people to complete ‘My Story’. Staff know that there is always a story, which is not an excuse but a reason. They see the importance of inviting young people to tell it and of empathic listening. Minimising the destructive shame that comes with feeling mad or bad is where the work begins. Many APs do incredible work of this sort, opening young people back up to the possibility of learning in the process.

It’s not easy to regulate so much distress in one place, and I am humbled every day by the emotional labour involved. However, APs, for all of their daily magic, remain segregated settings and a level of stigma is unavoidable. Neither should the pain of ostracism ever be under-estimated. Futher, from the perspective of public purse, the use of AP to contain distress is unsustainable, because distress is spreading and for as long as economic hardship continues to bite, that will remain the case.

APs across the country are full, new ones are opening, but they will fill too…. Unless, unless, policy makers commit to reform underpinned by trauma-informed principles of the kind we are seeing in all three devolved nations.

With behaviourist ideology (do this, get that) deeply embedded here, change will meet with strident resistance and dire warnings of just the kind we heard when England very belatedly banned corporal punishment. However, it is coming.

Nurture rooms, safe spaces to decompress and be heard, these are opening up (though the short supply of support staff is a problem that must be addressed). School leaders are personalising the curriculum when demand is greater than the individual’s capacity to meet it, and before positive stress becomes negative becomes toxic. Stress management is replacing behaviour management in a growing number of settings.

My hope lies in these grass roots and with the growing consensus, which is that we have reached a tipping point. A different demographic – heightened complexity and need from the Early Years and upwards – demands a different way.

Whilst the plight of Ukraine children has inspired a groundswell of compassion and school leaders are absolutely committed to welcoming refugees into the sanctuary of their schools, many are expressing concern about whether they will have the resources required to adequately meet the needs of those traumatised by their experiences. With CAMHS waiting times an issue in many areas, thresholds high, a language barrier in the mix too, this apprehension is understandable.

I wanted to highlight a chapter from Dr. Bruce Perry’s ‘The Boy Who Was Raised as a Dog’ by way of what I hope is a reassuring perspective on this. It describes the experience of twenty-one child survivors of the infamous Waco Seige, which saw most members of a religious cult perish in flames upon the arrest of their leader. There are clear parallels with the refugee crisis: released by negotiators before the catastrophic final raid, the children of the ‘Davidian’ cult had no idea whether family members left behind would live or die; everything that had been familiar was now gone; they had witnessed a deadly assault on their home; their futures were profoundly uncertain.

Originally, Texan child protection services had planned to place the children in foster homes, indiviudally, but these were not available quickly enough so they were instead taken to a children’s home where they were cared for by two rotating live-in couples, the ‘house mothers’ and ‘house fathers’. This proved to be by far the better option: “Keeping them together turned out to be one of the most therapeutic decisions made…these children would need each other.”

Perry observed and then encouraged the development of a therapeutic web of relationships around each child within the home, the impact of which led to a paradigm shift in his thinking about how to heal traumatised children. “At this point in my work, I’d only just started to discover how important relationships are to the healing process.” A mantra well established in the trauma field, that “People, not programs, change people” is in fact a quotation from this chapter.

Throughout Boy Raised, Perry reminds us that we are a deeply social species. Individual humans are incapable of surviving for long in nature without the support of others: a lone human being in the world of our ancestors would soon be a dead one. The presence of people we trust is associated with safety and comfort and there’s a soothing biological reaction to warmly relational experiences; “our heart rates and blood pressure are lower, our stress response systems are quiet.”

However, it is equally true that the major predators of human beings are other human beings, as any refugee will be all too painfully aware. Our survival therefore also depended upon being highly sensitive to the mood, gestures and expressions of others, interpreting threat and working out, albeit mostly at a sub-awareness level, whether we were confronting friend or foe. Hyper-vigilance intensifies and distorts this process such that a harmless nudge might trigger a brainstem reaction.

It is interesting to note how often Perry describes approaching highly traumatised children on his knees in the book, minimising any physical threat represented by the bigger and stronger adult. Whilst this is not a strategy that would translate easily into the average mainstream classroom, staff do need to understand the importance of relational safety cues – a warm tone of voice, welcoming body language, perhaps a playful attitude and certainly smiles.

Perry’s ‘therapy’ for the Davidian children foregrounded the power of proximal relationships to move them out of their frightened hyper-vigilant (or dissociative) survival brain states to psychological safety. He made no use of any kind of formal counselling, which the state did arrange but which proved counter-productive since it only meant the introduction of strangers. The work was child-led:

I thought these children needed the opportunity to process what had happened at their own pace and in their own ways. If they wanted to talk, they could come to a staff member that they felt comfortable with: if not, they could play safely and develop new childhood memories and experiences to begin off-setting their earlier, fearful ones. We wanted to offer structure, but not rigidity; nurturance but not forced affection.

It is not difficult to imagine how a nurturing school community would enable what is known in the trauma field as relational repair of just this kind. Indeed, we can be sure that relational repair is happening daily in our schools, probably in most cases without staff even recognising the brain-changing difference they make through their moments of connection with distressed children. Think Mr. Pigden.

However, whether relationship building is prioritised strategically is another matter. The single most powerful thing a school leader can do, to meet the needs of a refugee or indeed any vulnerable child, is invest in relational practice. The principle of holding on, not referring on, is critical. Workforce development needs to ensure that all staff understand that they have a part to play, regardless of their role, and permission to be human first and teacher second. Therapeutic dosing, the cumulative impact of the kind word and the personal connection, has infinitely more to offer troubled children than any intervention that is confined to Student Support or the ELSA room.

Each night after the children went to bed our team would meet to review the day and discuss each child. This ‘staffing’ process began to reveal patterns that suggested therapeutic experiences were taking place in short, minutes-long interactions. As we charted these contacts, we found that despite having no formal therapy sessions, each child was actually getting hours of intimate, nurturing, therapeutic connections each day. The child controlled when, with whom, and how she interacted with the child-sensitive adults around her. Because our staff had a variety of strengths – some were very touchy-feely and nurturing, others were humorous, still others good listeners or sources of information – the children could seek out what they needed, when they needed it. This created a powerful therapeutic web.

The sense of control that children gain when their access to relational support is not prescribed so much as facilitated through the creation of a relational milieu matters greatly. Trauma is at root the experience of utter powerlessness and victims may well reject formal counselling because it is not respectful of the sometimes acute need for control. There can be a kind of self-defeating independence that dooms any such formalised arrangement to failure, even if it begins.

In a trauma-informed setting, everyday interactions enable healing and staff trust in the process, contributing to it whenever opportunities arise. As Dr. Karen Treisman puts it so well, every interaction is an intervention, or can be.

Reflecting on his experience with the Davidian children, Perry concludes, “The seeds of a new way of working with traumatised children were sown in the ashes of Waco.” We must hope that they take root in every school, regardless of a policy context which does not provide the most fertile soil. When social capital enjoys parity of esteem with cultural capital in the way that education is conceived, the life chances of our most vulnerable children will be greatly enhanced. Many schools are demonstrating that now, and they will be places of belonging and recovery for refugee children.

Expertly and compassionately handled, the managed move can transform the life-chances of vulnerable young people but, as in all things, there is a spectrum of practice and safe transition onto the roll of the new school is far from guaranteed. With every school move, every social and educational disruption, the pupil’s odds of positive outcomes reduce, so it is important that leaders proactively invest in the process, rather than merely opening their doors and reaching a decision at the end of the agreed trial period as to whether or not the required behavioural standard has been met.

In many ways, it is those young people with the least resilience who are required to navigate the most moves. A harmful cycle of failure can result from this, unless it is interrupted. Ella, who agreed to my recording and sharing the interview below, is no exception. She ‘failed’ two placements before finding her educational home at the third, a mainstream school which wrapped support around her for as long as she needed it.

Her reflections on what made the difference form the basis of the five recommendations outlined within this post, alongside findings from the Education Endowment Foundation’s Improving Behaviour in Schools and insights from the trauma-informed practice field.

1. Ask what happened to you?

Without wishing to prompt a futile debate about whether or not all misbehaviour communicates an unmet need, it is reasonable to suggest that chronic behavioural difficulties should always invite professional curiosity. Because of the proven impact of childhood adversity and trauma on the nervous system and subsequently emotional regulation, we need to ask “What happened to you?”

Ella talks about her experiences of relational trauma: the separation of her parents and subsequent loss of ‘my main person at home’, conflict, multiple losses from an early age, moving to a different country and feeling the outsider. With some distance, and now balanced, she recognises how sensitised she was when struggling in school, unable to tolerate mild stressors, such as a teacher’s reprimand. Any one of us who has experienced high levels of stress at certain points in our lives can relate to this. We know from our own experience – even as adults with the frontal lobe fully matured – that judgement is impaired when we are cortisol-flooded.

Knowing ‘What happened to you?’ enables staff to interpret misbehaviour through a trauma-informed lens so that the response can be moderated, which will in turn alleviate the issues. All staff have a vital role to play as stress managers rather than merely behaviour managers, breaking the insidious classroom trauma cycle through their compassionate understanding. Sharing information – a pupil’s trauma history – is therefore important, so far as confidentiality allows.

2. Prioritise relationships

The teacher who spotted Ella standing on her own that cold morning must be given enormous credit for the part she played in changing her life. Offering the sanctuary of her classroom and unstinting kindness, she was the place of safety during those challenging early weeks when Ella would otherwise have felt, once again, the outsider.

The fact that she had no formal responsibility for Ella is worth considering in relation to the critical role of trusted adult: “Mrs. Brown will be your trusted adult and you can find her if you have any problems in R6” is not that. When school leaders invest in and promote social capital, these roles form in an organic way, as authentic human relationships. For a pupil who has experienced relational trauma and therefore struggles to trust, they should be viewed as key interventions.

Ella observes that “they listen to us here” – which tells us everything we need to know about the quality of that nurturing school community. Any pupil undergoing a managed move should be encouraged to talk about their challenges because it is through talking that we habituate stressful experiences which might otherwise overwhelm. This is what is meant in the trauma-field as the ‘social buffer’ against toxic stress.

It is no stretch to suggest that the success of any managed move will depend upon the quality of the relationships that a pupil forms, even if these develop accidentally rather than by design. The EEF recommends a strategic approach: “Is it possible to structure your school such that everyone knows each pupil, their strengths and interests? Can this be managed for some pupils, if not all?

3. Create the conditions for psychological safety

Even for adults, major transitions are stress inducing. That’s because of an unconscious process called neuroception which keeps us safe by constantly scanning the environment for threats. From birth, we categorise incoming sensory data as safe or unsafe, our emotional triggers resulting from subsequent encounters with the latter. In addition to triggers, or evocative cues, novelty is activating in that, as Perry explains, new experiences are classified as potential threats until proven otherwise.

“Anything new will activate our stress response systems. Our default response to novelty is ‘Uh oh. What is this?’ And until the new thing is proven safe and positive, it will be categorised as a potential threat. For most people, the unknown is one of the major causes of feeling anxious and overwhelmed.”

Here we arrive at the key concept of psychological safety. This is enhanced by predictability, so a calm and orderly school climate is essential. In the full version of the interview, Ella explains that she researched the school before she started there, so that it was at least a little familiar. The fact that her initial visit was during lockdown will also have helped; there were fewer new faces to categorise as friend or foe. She was able to focus on getting to know just a handful of key people.

It is worth thinking about how these conditions might be replicated under more normal circumstances; how a carefully phased induction period might allow gradual exposure to novelty such that the nervous system is able to maintain balance.

4. Differentiate the behaviour policy

The crude concept of ‘consistency’ does our most vulnerable learners a grave disservice. Here is the fifth of six key recommendations within the EEF report:

Ella’s previous encounter with an inflexible behaviour policy increased her isolation and loneliness, and with that her risk. Any incidents must be addressed, of course, and boundaries must be maintained, but the ‘how’ matters. Kim Golding’s ‘Connection before Correction’ is the best tool we have for empathic boundary setting and staff will need to avoid any behaviourist short-cuts if psychological safety, which takes time to establish, is not to be compromised. If removal from class is necessary, that should not be to isolation and exclusions can fatally undermine that greatest of all protective factors, a sense of belonging.

Perry is clear about the risk of social thinning, which any pupil undergoing a managed move will experience. A behaviour policy which aggravates that will fail on its own terms, separation from the group being interpreted by the survival brain as a threat to life. Vulnerable pupils need attuned others, access to co-regulating adults – not solitary reflection or undifferentiated consequences. As part of the managed move plan, it is important to agree how setbacks will be managed so that there is learning from them.

5. Aim for intrinsic motivation

There is a risk that the incoming student, not yet one of us, may be held to a higher standard of behaviour than the rest of the school community. There may be closer scrutiny, perhaps a report card measuring progress towards externally imposed targets, such as “Follow all instructions, first time”. We can be reasonably sure that this approach will not work because it will have been tested over a prolonged period in the previous setting already, without success. Any student on a managed move will benefit from not just a fresh start, but a fresh approach – aimed at promoting intrinsic motivation.

Teachers can use tangible techniques such as rewards and sanctions, or less tangible strategies such as praise and criticism, to improve motivation, behaviour, and learning. However, it is intrinsic motivation, or self-motivation, that is crucial to improving resilience, achieving goals, and ultimately is the key determiner to success. Children who are intrinsically motivated achieve better and are less likely to misbehave. (EEF)

Coercive tactics can rarely meet the needs of young people who have experienced trauma. Trauma is very often, after all, the experience of utter powerlessness and the need for control when that is the case is acute. Extrinsic motivators – pressures applied from without to illicit desired behaviours – should therefore be avoided, counter-intuitive as that may feel.

Ella’s initial meeting with the headteacher clearly inspired feelings of intrinsic motivation which got her trial placement (not emphasised as such) off to the best possible start. There was no report card, no monitoring arrangements – at least not that she was made aware of – but instead the offer a prefect’s tie. Conditions were not attached, this was not a bribe; the headteacher merely recognised a need – to be trusted, heard, valued – and found a way of meeting it. The impact of this simple gesture was profound and lasting.

Ella turned out to be a gifted mathematician and secured top grades despite her fractured journey through secondary education. Once she had access to buffering relationships, unconditional positive regard, when she was trusted, heard and valued, she flew. Her story perfectly illustrates Alexander den Heijer’s truth – that “When a flower doesn’t bloom, you fix the environment in which it grows, not the flower.”

The managed move can heal, but equally it can harm, and everything in between. Ella experienced the full spectrum of practice and this for me is what makes her testimony so important. Her transformation was rapid; the young brain is a sponge for learning – highly malleable; shaped and sculpted through interaction with the environment. There is hope in that. We should always be optimistic about the prospect of a managed move to change lives and of course never write young people off.

The short answer to this is with Dr. Bruce Perry’s reversed triangle diagram of the brain, the implications of which need to be understood by all staff, if schools are to meet the greatest challenge of the day: securing the wellbeing of our children. Perry summarises the model in ‘The Boy who was Raised as a Dog’ as follows: 

The human brain develops sequentially in roughly the same order in which its regions evolved. The most primitive, central areas, starting with the brainstem, develop first. As a child grows, each successive brain region (moving out towards the cortex), in turn, undergoes important changes and growth. But in order to develop properly each area requires appropriate timed, patterned, repetitive experiences. The neurosequential approach to helping traumatised and maltreated children first examines which regions and functions are underdeveloped or poorly functioning and then works to provide the missing stimulation to help the brain resume a more normal development.

These interconnected regions of the brain are wired so as to ensure survival. All incoming sensory signals from the outside world and from the body (the inside world) are first processed in the brainstem. This lower region then passes that information up to higher areas for sorting, integration and interpretation. 

If the incoming sensory material is familiar or felt from prior experience to be ‘safe’, the brainstem does not activate a stress response. However, if the incoming information is unfamiliar or previously associated with threat, pain, or fear, a stress response is activated – before the information can reach the higher, thinking part of the brain. This stress response interferes with accurate cortical processing by shutting down certain areas of the cortex, to a greater or lesser extent, depending on the height of arousal. 

Highly sensitised, traumatised children are frequently activated by apparently inconsequential stimuli and this is the root of their manifest difficulties in school.

Eye contact for too long may be perceived as a life-threatening signal. A friendly touch on the shoulder may remind one child of sexual abuse by a stepfather. A well-intentioned gentle tease to one may be a humiliating cut to another, similar to the endless sarcastic and degrading abuse he experiences at home. A request to solve a problem on the board may terrify the girl living in a home where she can never do well enough. A slightly raised voice may feel like a shout to the boy living in a violent home. (Perry, The Boy who was Raised as a Dog)

These children will at times be quite literally unable to consider the potential consequences of their actions because of the arousal state of their brains. The goal then is to ‘get to the cortex’….over time, to widen the window of tolerance (the stressors that can be endured) so that pupils can settle, learn and thrive. Put simply, this involves moving from the bottom of the brain to the top through Perry’s 3 Rs of Regulate, Relate and Reason.

Regulate

(Brainstem and midbrain – the sensory motor brain)

Help the child to regulate and calm their stress responses – fight, flight, freeze. Offer soothing comfort and reassurance. (Perry)

Every adult within school, from site-manager to headteacher, should be ready and willing to ground and regulate a fellow human being in distress. It needn’t be difficult, though it does require the adult to be regulated. Perry is clear that, because of the mirroring neurobiology of our brains, one of the best ways to help another become calm and centred is simply to be present for them, calm and centred ourselves. Emotional contagion means that the reverse is also true of course – dysregulated adults dysregulate children. This is why staff wellbeing is such a high priority within the school that priorities high quality pastoral care.

However, we obviously want children to be able to develop strategies that they will be able to draw upon to regulate themselves, ultimately. Self-soothing techniques, if you like. These need to be introduced and practiced when children are calm, and emotionally intelligent school communities will share the learning with all pupils, not least so that they are in the best possible position to support their struggling peers.

This excellent resource suggests a number of grounding and regulating strategies, from deep breathing exercises to muscle relaxation. Every child is different and will benefit from a different approach, so it’s important to practice a range, possibly as brain breaks within lessons. I find it very helpful to watch demonstrations (never personally having been taught this stuff) and in this regard Dr. Karen Treisman’s relaxation and emotional regulation  videos are invaluable. She stresses the importance of repetition, if lasting and therapeutic change is to occur.

Walking is of course rhythmic, repetitive and grounding and it is worth noting here that the practice of requiring dysregulated children to stop walking and to stand still, perhaps against a wall, only succeeds in escalating the threat and shutting down the cortex. Furthermore, trauma is rooted in the experience of utter powerlessness and power-over adult behaviours are therefore dangerously retraumatizing. Many exclusions would have been avoided were this better understood. The adult who walks alongside, calming and connecting before expecting reason, is the adult we need leading behaviour in our schools, modelling the best practice and not the absolute worst.

Thought needs to be given to the school day itself and whether it is biologically respectful. We are not designed to be still for long periods. There’s a strong case for continuing the Daily Mile activity that many schools have introduced as part of their current childcare offer, this summary of the research.  confirming its benefits, both wellbeing and academic related. 

Not to be confused with discredited ‘brain gym’, stress-reducing classroom brain breaks are also strongly supported by the evidence, as proven here. These could also be utilised as the ten-minute distractor breaks that enable spaced learning, another biologically respectful approach. In addition, sensory circuits are now widely used in primary schools, the motor exercises setting children up for the day, or perhaps for next lesson when they are situated along corridors. 

Relate

(Limbic brain – the emotional relational brain)

Connect with the child through attuned, sensitive relationship. Empathise and validate the child’s feelings so that they feel seen, heard and understood. (Perry)

Articulated quite brilliantly by Kim Golding in this ‘journal paper‘, ‘connection before correction’ is another way of framing the ‘Relate’ stage of the bottom up process. Connection with a distressed child creates relational safety such that reason is possible. Here is psychologist Karen Young’s take on the process:

I know you’re a great human. I know that for certain. That decision you made didn’t end so well, but I imagine there was something that might have felt okay about it at the time. What made it feel like a good idea?’ Then, ‘I get that. I’ve felt that way myself. How do you think it went wrong?’ And finally, ‘What might be a better thing to do next time?’ Or, if needed, ‘Is there anything I can do to make it easier for you to do that?’. Or, ‘Things seem pretty upside down right now. What might you be able to do to put things right?’

Scripts are not difficult to imagine. Their key features are validation of feelings – a child needs to feel seen, heard and understood (“I see you are angry and frustrated and I can understand why”) and empathy (“It must be awful to feel overwhelmed like that.”)

Of course, within inclusive schools, adults understand the importance of making connections with vulnerable and insecure children throughout the day, not just at times of crisis. This is what we mean by ‘therapeutic dosing’. The regulating impact of small doses of kindness should never be under-estimated. As pastoral leaders, how do you know that the young people who need those interactions the most are receiving them?

Relational work needs to be strategic – not left to chance.

We are a deeply social species, our survival having once depended upon group membership. If we don’t relate to children, create within them a sense of belonging and acceptance, then our efforts to reason with them will always be futile because they will feel threatened and activated within a school environment that isn’t psychologically safe.

Reason

(Cortical brain – the great human thinking brain)

Now that the child is calm and connected they are able to fully engage in learning. Heading straight for the reasoning part of the brain CANNOT work if the child is dysregulated and disconnected from others. (Perry)

It is now possible to set limits on behaviour, which clearly we must do for the safety of both school community and child. The question is not whether but how to do this. Perry observes that ‘If we want our children to behave well, we have to treat them well’ (p273) suggesting that radical change is needed to the approach that is traditionally taken:

Troubled children are in some kind of pain – and pain makes people irritable, anxious and aggressive. Only patient, loving, consistent care works: there are no short-term miracle cures. This is as true of the child of three or four as it is for a teenager. Just because a child is older does not mean a punitive approach is more appropriate or effective. Unfortunately, again, the system doesn’t seem to recognise this. It tends to provide ‘quick fixes’ and when those fail, then there are long punishments. We need programs and resources that acknowledge that punishment, deprivation and force merely re-traumatize these children and exacerbate their difficulties. (The Boy who was Raised as a Dog)

This doesn’t mean that rules do not apply, it’s more a matter of how we teach vulnerable children to work within them and how we respond when they slip us, as they surely will. There will inevitably be occasions when it won’t be possible for them to remain in class, for example, and a reliable 3 R respecting plan is needed for such occasions. This would typically involve reporting to a safe base within school where thought is given to repair. For example, When you’re ready, let’s go and pick up your maths book and repair it with some Selloptape. We can then make a small apology card for Sir. Because Sir is trauma-informed, he will accept the apology graciously and ensure that the child knows that there is no rupture to the relationship.

Conclusion

It is important to emphasise that there is nothing suggested within this post that is not achievable if we are creative in our use of all the human and physical resource available within schools. Safe bases don’t need to be spare classrooms; perhaps it’s the clay-room for one  (thinking now about my youngest daughter) or an office for another (mine was always exactly this). 

What is needed if our schools are to rise to the challenges of this pandemic age is not new resources or new services but a new approach, rooted in the science. However, with the current policy focus on traditional behaviour management in mainstream alongside alternative provision for those who flounder, we do not seem to be grasping this. Segregation is not a solution and the evidence is stacked against it, for reasons that Perry explains in biological terms:

Another important implication of our mirrored biology is that concentrating children with aggressive or impulsive tendencies together is a bad idea, as they will tend to reflect and magnify this, rather than calm each other. (The Boy who was Raised as a Dog)

Trailblazing leaders are already proving that their schools are capable of holding, containing and healing distressed children. We must hope that others follow them as they prepare to meet the huge societal challenges of this pandemic age.

To open a can of worms is to attempt to solve a problem only to inadvertently complicate it and create even more trouble. The metaphor refers to fishing – the tendency of live bait to wriggle loose from any open container, creating a messy issue for the angler. The idiom is used to describe uncontrollable breakout, a situation aggravated, and there’s a link with the directive to ‘let sleeping dogs lie’.

Some school leaders (and a good many teachers) worry that trauma-informed practice (TIP) risks opening that can. These are the leaders who also believe that the teacher’s role is purely to ensure that children acquire knowledge; that the ‘change in long term memory’ occurs. Conditions in school must optimise the transmission of knowledge, which means keeping a tight lid on things.

The role of the educator is not to act like some kind of amateur psychologist, asking children about their private lives, their feelings, any experience of trauma. Delving into such places will only create messy breakouts, contributing nothing to the climate for learning, perhaps even causing psychological damage. School is for learning.

Some young people may benefit from access to a counsellor, that is acknowledged even within the most buttoned-up settings; pressure can build up in cans and they can then explode, which is even more messy than lifting the lid. But this kind of talk isn’t to be encouraged or actively promoted across the general school population, otherwise untrustworthy and attention-seeking adolescents, girls especially, will be queuing at the counsellor’s door as an escape from outside PE….regardless of what’s really going on inside them.

These are widely held views that I have heard versions of many times during my teaching career, notably when I introduced a key-worker scheme for distressed young people (the initiative I am most proud of, looking back – more about it later). Such views are regularly tweeted, often with the phrase ‘well intentioned’ to dismiss the case against whilst at the same time evoking wisdom, experience, sage-like perspective. ‘School is for learning’ – it has a seductive simplicity, a purity, a serious sense of mission, that idea.

When I’m confronted by such views now, I feel a mixture of dismay, frustration and ‘where do I start’ befuddlement. There are so many possible replies, including, I’m afraid, FFS (it’s not as if there isn’t readily available information about TIP that people could read before rejecting it) Perhaps I am writing this so that I can get the clearest, most constructive and (and socially appropriate) response straight in my head.

I think there are two essential points to make when we are defending TIP against the can of worms charge. First, that it’s based on a misconception about what the work actually means; people are inclined to hear the word ‘trauma’ and then go on to make erroneous assumptions about the practice (it must mean talking to children about their experience of trauma.)

Second, that when pupils do choose to open up to staff they trust, which is a privilege, then that can do no harm and a great deal of good. In the emotionally healthy school, there is nothing to be frightened of within the can and young people know that they don’t have to carry their burdens alone; they can open the lid and there is the relational capacity within the school to contain whatever comes out.

Point One: What trauma informed practice really means

There are whole tomes written about this. However, we cannot at once complain about misconceptions and then demand that those less invested in the trauma field read entire volumes to educate themselves. So here goes my shot at a summary, beginning with the neurobiological basics:

The infant’s brain develops from the bottom up. The lower parts that mature first are responsible for survival-related functions and responding to stress. The upper parts that develop throughout childhood, but exponentially in the first fifteen months, are responsible for executive functions….emotional regulation, reflection, memory, empathy, cognitive learning and so on.

Development of the upper regions, the cortical brain, depends upon prior development of lower parts. This means that when the stress response is repeatedly activated in the lower part of the brain (typically in the absence of safe, predictable, accessible relationships and through exposure to frightening experiences) then its sequential development is disturbed. Executive functioning in the upper, cortical brain is compromised by a level of stress that has become toxic.

However, the developing brain is highly malleable and with the right stimulus, for example immersion within a safe, relational, stress-reducing school environment, children and young people recover from what is properly called ‘relational and developmental trauma’, sometimes in miraculous ways.

Whilst this sounds very like attachment theory, and certainly the fields are intimately related, trauma-informed practice has a wider reach in that it acknowledges that the biological disturbance created by toxic stress can be rooted in a range of adverse experiences, not just disrupted attachment. These might include exposure to domestic violence, fractious divorce, complicated grief, a caregiver’s mental illness, addiction, violence, racism, bullying, poverty, war – and clearly the list could go on.

These experiences will have increased exponentially as a direct result of the pandemic, meaning that school cohorts will be containing higher levels of stress, on average.

TIP is about mitigating the impact of toxic stress such that children and young people can lower the guard, move out of their hyper-vigilant states, ‘settle to learn’ (Bomber). A key goal is to help those in survival mode expand over time their window of tolerance. A whole pedagogy is developing around this, much of it underpinned by Dr. Bruce Perry’s 3 Rs of Regulate, Relate, Reason.

Whilst there is an inherent challenge to some traditional approaches in all of this (hence perhaps the resistance), the practice does have a strong sense of common sense about it, as well as that biological evidence-base sketched out above. Think about a mistake you made when you were in an activated state; when you were full-up. A long story, but I messed up enormously and lost a job after my mum died. (There’s a reason why we take compassionate leave.)

The practice is emotional regulation, not encouraging children to tell us about their traumatic experiences. It’s about creating nurturing and relational school environments which are good for all children and young people, but essential for our most vulnerable. It’s about social buffering for young people who lack that and who are floundering as a result. It’s about all staff being regulated themselves and offering moments of simple human connection. It’s about understanding and embracing Dr Karen Treisman’s mantra:

It’s about stress reducing and not inducing school climate. It’s about understanding that for children to learn – and yes, school is for learning – we must first ‘get to the cortex’ (Dr. Bruce Perry) which means eliminating threat and creating a sense of belonging. Given the prevalence of childhood adversity, the deep recession we face and the impact that will have on our most marginalised families, it’s about the public duty.

Point two: Opening up is a good and necessary thing

Several safeguarding referrals resulted directly from my key-worker scheme. In that sense, the team did on occasion ‘open up a can of worms’, but thank goodness they did. Encouraging children to build trusting relationships with key staff and to talk is fundamental to keeping them safe. Ofsted inspectors routinely ask pupils if there is a member of staff they trust enough to talk to, for this very reason.

I was immensely proud of my key-worker team, which comprised TAs, a receptionist, the finance officer – my person specification was empathy and attunement, not a certificate in counselling. The provision was cherished by families, including our most marginalised, who had access to a friendly advocate in school; one who knew what was going on at home, who ‘got it’.

Adolescents in crisis had the opportunity to share their experiences and to make sense of them in the process and time was made for this, even if it meant missing some lessons, form-time or assemblies. It was a priority, a biologically respectful priority:

Dr. Perry talks about the human need to habituate difficult experiences by talking about them, by wrapping them up in language. When shaken by something, we pick up the phone, speak to our partners, a friend; we seek connection. The brain knows what it needs to do to prevent the tolerable stress that life inevitably throws up from becoming toxic.

A lot of the most dysregulated behaviour we see in school is driven by blocked grief, young people either not having access to that attuned and empathic other, or not having the self-awareness or perhaps even the language to articulate their distress and thereby reduce its toxicity. These are the young people who make up the numbers in our APs. Ask any PRU leader.

The school climate that discourages this kind of discourse can therefore never be a healing one for vulnerable children and young people who are relationally poor (Perry) and at greatly increased risk of poor outcomes, health and educational, because of that.

I want to finish with a reflection on Kate Clanchy’s wonderful ‘Some kids I taught and what they taught me’. She describes the journey she went on as an educator, from deep suspicion about the teacher as therapist role (not helped by her participation in a traumatising therapeutic writing workshop) to the most profound and moving realisation that her work is in reality deeply therapeutic, and that is the single most important thing about it. I think she charts the journey many teachers make, as simple ideas like ‘school is for learning’ are confounded by contact with complex young people who need something before that, and more than that.

Working with a poetry group comprising ‘disadvantaged but able’ learners, and studiously avoiding any psychological probing because of her firm beliefs about the English teacher’s role, Kate is struck by what her students choose to share. “Each week I show them a ‘real poem’ and they respond with screeds of their own about the hair-raising traumas of their every day lives: boyfriends in comas, deaths, physical and sexual abuse, abandonment. Then they share the results, and cry, buckets. I often cry too. They look forward to it all week, they say. And so do I…..we seem to have happened on a safe place, and a method of holding each other up. I seem to be getting better at this.”

Then the breakthrough comes, after the group has listened to an interview with performance poet Melissa Lee-Houghton, on the subject of poetry and mental health. Writing is not a cure, the poet explains, but it creates distance and control.

Control. This word has somehow never occurred to me before. My students are gaining control over a torrent of experience that has rendered them powerless. And if they dig deep, and find effective images, and make a good poem out of the truths of their lives, then that is not just control, but power. It’s different from being happy; it isn’t a cure for anything, but it is profoundly worth having.

And with confidence that this is helpful, vital, therapeutic – Kate asks her students about their lives, week in, week out, and they reply through the images they create.

So what does it feel like to lose your father to heroin, Amiee? Like being an out of control car, a broken branch on the ground, like rubbish that seagulls are picking, says Aimee. And when, after that, your sister leaves home? Like the moment the cloud goes over the sun and your room is full of shadow. And what does death look like? Like your mum’s addict boyfriend, coming to call with a can of Stella, like the stairwell you were too young to fling him down. And where is your mother, now? In my room. In the sunset. In her scent. In my poem, Miss, safe.

It seems when we worry less about losing control – opening the can of worms – we allow our most marginalised and vulnerable young people to gain it. We give them power over their experiences.

Pulling the two main points of this post together, though, it’s important to reiterate that TIP is not just ‘talking about trauma’. It is about creating the conditions which make such talk possible. Fundamentally, it’s about creating psychological safety within children who feel profoundly unsafe, such that they can learn, grow and thrive.

Many teachers will be feeling apprehensive about their ability to settle classes in September; fretful dreams about losing control will be disturbing sleep, amplified this year because of the unchartered waters that lie ahead. For all of leaders’ planning, and their re-planning following eleventh hour DfE guidance, September is a step into the unknown for staff and pupils alike and there is no doubt that school communities will be fragile during the period of transition.

In stabilizing them, leaders are well advised to reflect on the biology of stress. Levels will need to be deliberately managed, so far as that is possible. We know that tolerable stress is positive – indeed, learning itself requires the experience of some degree of stress – so it is not to be avoided at all costs. But high levels reduce access to the cortical brain, where learning, refection, self-regulation occur, and pupils who experience the return as stress-inducing will therefore be less able to behave appropriately than those whose baseline of stress is lower. 

The same applies to staff, of course, because they are human too. Some will feel profoundly unsafe on return to school, and they too will be operating from the brainstem region when this is the case.

We know that stress is highly contagious. One study of cortisol levels in pupils, taken through saliva samples, showed a direct correlation between the average level in class and that of self-reported teacher-burnout. (Oberle and Schonert-Reichl, 2016) It works the other way too; our calm is contagious. It is through this that we are able to co-regulate highly activated children and young people, just by being attuned and alongside.

As emotional contagion super-carriers, leaders have the power to either induce or reduce stress in staff and subsequently the entire school community: if they succeed in making the adults feels safe, thereby reducing stress, then those adults will be in the best possible place to share their calm rather than their anxiety with pupils, helping them settle back to learning. The importance of their role in this should be made explicit to staff in September because pupils will need that emotional support, but clearly the right conditions must be created first: staff will actually need to feel safe.

Drawing now on the Mobilise staff wellbeing webinars that many Lincolnshire schools accessed during lockdown, it is worth once again flagging Simon Sinek’s work on leadership. He developed a concept called the ‘Circle of Safety’ which he introduces in Leaders Eat Last (2017) thus: “Only when we feel we are in a ‘Circle of Safety’ will we pull together as a unified team, better able to survive and thrive regardless of the conditions outside.”

With the conditions outside school gates so very challenging, the six principles of trauma-informed care from Trauma Informed Oregon will also be of interest to leaders who may wish to consider them as they fine-tune their inset-day presentations. Adapted by the Mobilise team to apply to the current situation, they are as follows and can be read in their unmodified here:

1. Physical Safety

• Communicate all measures taken to ensure all staff are confident; staff feel that their physical safety is a priority
• Highlight management of space and bubble; entry and exit procedures
• Invite feedback and adopt the language staff use for open and honest talk
• Attend to staff unease
• Plan rotas so that staff can have physical (but safe) contact with others

2. Emotional Safety

• Focus on the certainty – the things that you can control
• Demonstrate flexible consistency. Uncertainty is very stressful, so to the extent that an organisation can be consistent and predictable, this will lower stress levels.
• Normalise stressors and pressures
• Share arrangements for regular check-ins, check-ups and check-outs. Staff need to feel supported and safe to speak about vicarious trauma, work related stress, and other emotional considerations
• Make time for regulation; pausing between activities, mindfulness
• Create structure, keep structure. Keep your meetings, honour your staff by being punctual and predictable.

3. Peer support and relationship

• Create buddy networks/1:1s with a trusted colleague(s) for regular check-ins
• Arrange supervision and/or coaching
• Celebrate the wins for the day or week
• Help yourself by helping others. Practising kindness and helping others reinforces feelings of agency and control and creates feelings of empowerment and connection

4. Trust and transparency

• Share regular concise updates of ‘what is known’ with clarity and candour
• Share and be transparent with key policy updates and changes & invite feedback
• Explain the ‘why’ behind protocols and procedures
• Be clear what decisions can be made by individuals
• Convey strength and sensitivity. During a time of crisis, staff look for strength and leadership in the organisation; however, it’s also important to convey compassion and sensitivity; staff need to feel they are cared for; this builds trust
• Examine current expectations; consider how established work practices can be adjusted; be flexibly direct, about what needs to be done today or this week

5. Voice, choice and empowerment

• Share power; for example, what decisions can staff make without approval?
• Provide choice whenever possible. 
• Provide staff with the scripts needed to explain the situation and policies to parents and pupils.

6. Cultural responsivity

• Recognise and build upon the cultural strengths of your community
• Be optimistic about the potential of working with parents
• Talk to parents who are less involved in school life about what support they would find helpful
• Ensure communication is two-way: consulting with parents about how they can be involved is likely to be valuable and increase the effectiveness of home-school relationships
• Use strategies that encourage engagement and minimise mistrust

Guided by these principles, leaders will create a sense of safety, belonging and agency for employees such that they are able to perform, unconstrained by fear or threat. Physical bubbles have dominated thinking and planning, but as headteachers consider their messages for staff when schools reopen next week, the psychological bubble should be held in mind. Ultimately, only this will allow staff and pupils to thrive.

“It wasn’t too bad Miss!”

That’s the kind of feedback we want from our A level students after a terminal exam. It’s a sign they’ve fulfilled their potential, the breadth and depth of which we know intimately by now. Mercifully, it’s also what we hear most of the time, or words to that effect, because we have prepared our students thoroughly and exams are not designed to catch candidates out. 

But things can go wrong. I remember Sophie’s self-reproach. “I completely screwed up the Middlemarch question” she sobbed. “I spent more time retelling the story than I did answering the bloody question …. Idiot!” 

And she was right: I had predicted an A for Sophie, but she was awarded a B. Not the end of the world, but not a true reflection of her ability either.

We do know our students very well, as A level teachers. The teacher-student ratio is lower here than at GCSE, there’s more lesson time normally, as well as more discussion and one-to-one coaching between lessons, for those who want it. 

Many seek out that extra guidance because the stakes are so high; A level results open doors … transform life chances when we are talking about the kid from the impoverished estate who gets into the prestigious university. There can be no greater reward in teaching than to have played a part in such individual triumphs.

But last Thursday, we discovered that transformative outcomes were the very ones that Ofqual took away. The fact that the young people who achieved the most, by overcoming the odds stacked against them, should be cut down to statistically regular size by an unknowing standardisation process is monstrously unfair. They have been punished for being remarkable.

Meanwhile, the same exercise ensured that privately educated candidates were, by and large, ushered through to the next gold-plated step of their educational journeys. Lewis Goodall, policy editor for Newsnight, spent yesterday with university admissions, currently in chaos. He tweeted, “Some places are taken up which would normally be free: by those from private schools who would normally fail to get the grades.” 

Focusing on A grades, here’s how School’s Week illustrated the ‘private school boost’:

Even privately educated candidates can have a bad day. In 2020, however, remarkably few of them did and the regulator was evidently perfectly comfortable with that. If ever there was a manifestation of the social mobility issue that blights this country, where destiny is so often dictated by birth, you can find it in their bland acceptance of this glaring inequality.

There is or course a way to right all of this intolerable injustice – but it’s not through the ‘triple lock.’ Mock exam results? Ministers, please listen to the arguments against. Take note of the rarest of all things that now exists within our sometimes bitterly divided educational community; universal condemnation of a patently unfair and unworkable idea. As for autumn exams – the young people we are concerned about here don’t have access to private tutors – they have had no teaching for a full six months.  

The Scottish and more recently the Northern Irish solution is the fairest available. Teachers have submitted their carefully considered Centre Assessment Grades (CAGs) already, and these must now be used to correct every egregious wrong. Of course, there will always be concern about the shape of the grade distribution curve for those who care more about statistical regularity year on year than they do about justice for individuals – but the individual grades should be trusted. Employers, universities should have confidence in them – because they stand on something real; the sure ground of professional judgement, albeit repeatedly talked down by politicians, punters and even, sadly, from within the profession itself.

There is nothing capricious about the CAGs, unlike the terminal exam. And that is why CAG grades are higher this year than actual results in previous years, not because of the unprofessional ‘inflation’ of grades. Former Gove adviser Sam Freedman understands this, tweeting:

Imagine I’m a maths teacher in a normal year and I have 5 pupils who I know are capable of getting an A. They sit the exam and only 3 get an A, for whatever reason, e.g. a tough question they weren’t prepared for etc. Now this year I have to give an assessed grade for those 5. What do I do – well I know they are all capable of an A so I put them down as an A. That happens across the system so overall now there are far more students predicted an A than in a normal exam year. 

In essence, nobody did a Sophie this year, until Ofqual stepped in, that is. Candidates achieved what they were capable of achieving. No-one experienced a limbic hijack or imploded through exam-based anxiety, suffered a bereavement or watched their mother beaten up the night before the last exam. There was no hay-fever, no missing of the 10 mark question. All students in our imaginary exam hall were able to fulfil their non-imaginary, their very real potential. 

Gavin Williamson, you must now return to them what Ofqual has taken away. The young people of 2020 deserve their CAGs; what they do not deserve, on top of future prospects already ravaged by Covid-19, is this most callous injustice. 

Contents

Foreword

1. What is school-based anxiety?
2. The purpose of this advice
3. Identifying the cohort at risk
4. Guidance for pastoral leads
5. Guidance for parents/carers
6. Guidance for children and young people

Foreword

This guidance draws heavily on comprehensive advice from Babcock EP service which you can read in full here. It doesn’t attempt to cover in any explicit way school-based anxiety that might be rooted in SEND, though many of the strategies suggested will certainly help children and young people who find school more difficult because of SEND. Equally, strategies from the SEND field can help all children cope with anxiety and this comprehensive resource from the National Autistic Society may well support planning.

The guidance assumes that pastoral leaders will prioritise individual needs over systems when the school day in its undifferentiated form is more than a vulnerable pupil can manage. It strongly recommends that personalised, written plans are devised and shared so that there is reassuring clarity for all involved in supporting pupils at risk of school refusal.

1. What is school-based anxiety?

To friends, family and school staff, the reasons for anxiety and avoidance can be baffling and it is not always easy to know how to help. For those who struggle, the experience can be overwhelming: children and young people can become trapped in a cycle of avoidance, feeling like they simply cannot cope with school life.

Anxiety affects different people in different ways. Some may find it harder to sleep, eat or concentrate whilst others may find that they just can’t stop themselves thinking and worrying about the situation they fear, which can then get in the way of everyday life.

It is of course normal to feel anxious – about an exam, a rollercoaster ride, a presentation, a whole range of  situations that people may find stressful  – and there are bodily changes associated with this feeling: an increased heart rate or butterflies in the stomach, for example. This is the body’s ancient way of preparing physically for perceived threat or fear. Anxiety occurs when the level of threat is over-estimated and experienced as pervasive.

2. The purpose of this advice

Within every school, there is a small minority of children and young people who experience high levels of anxiety, some masking it better than others. Whilst this cohort will have experienced lockdown in a range of ways, it is unlikely that the extended period away from school will have ameliorated their difficulties, even though it might have afforded a period of respite. We can anticipate that some will find the return to school very challenging indeed, and anxieties will be increasing as the return date looms closer. Some may return initially, but then attendance may become sporadic whilst other pupils may not return at all, fears associated with the virus only intensifying their anxiety about school.

Sensitive transition planning will of course mitigate some of these risks – the more familiar that all pupils are with the school environment and new arrangements for September 2020, the less worried they will be about it. The more opportunities there are for them to connect with the school community online, to re-establish supportive relationships before they return, to know who to share worries with, the more reassured they will feel. Visual information – faces and places – will of course be especially helpful.

However, there will be some children and young people who will need more support than this to make a successful return to school. Universal transitional arrangements will help, of course, but to overcome any pre-existing school-related anxiety which has escalated during lockdown – or which may have developed since lockdown, perhaps because of the experience of trauma – a personalised plan of support, the PSP or equivalent, will be essential. The pupil and family should be invited into school to co-produce this in advance of the start date, if possible – or it may be necessary to meet at the family home if anxiety is acute.

The purpose of this guide is to define good practice around what helps children and young people overcome school-based anxiety, as a reference for effective PSP planning. To inform the discussion with families and the agreements made, relevant sections should be shared in advance of the initial meeting: there is an invitation to the pupil to practice relaxation activities and to complete a wellbeing plan at home and this could usefully be brought along (Section 6). There are also prompts for parents/carers about how they can reduce school-based anxiety at home (Section 5) and the meeting will provide an opportunity for them to feed back on what has helped.

3. Identifying the cohort at risk

Pastoral leaders will want to identify which pupils are at risk of anxiety-based school avoidance in advance of this becoming a problem they are grappling with reactively; what we can predict, we can prevent. Simple scaling surveys can be shared virtually with pupils or parents/carers for this purpose. For example, on a scale of 1 (extremely anxious) and 10 (extremely confident), how do you feel about your return to school? Please give a reason if your score is low.

Pastoral staff can then use this information as the basis for initial conversations over the telephone or online with pupils and parents/carers. Where concerns are confirmed, then arrangements should be made for the initial PSP planning meeting.

4. Guidance for pastoral leads

Babcock LDP identified “factors associated with the successful inclusion of young people who display anxiety-based school avoidance” through a series of case-studies. Whilst each case was different, there were clear message for pastoral leaders about what enabled pupils to overcome their difficulties, as follows:

a) Key worker/adult support 

Feelings of safety, security and belonging were strong in pupils and all reported that they had developed a good relationship with at least one member of staff who they could rely on for support. Some of the pupils had a ‘key worker’ who would meet them in the morning to discuss any concerns or talk about the day. Adult support promoted feelings of security and there were lots of examples of adults supporting pupils flexibly, including in the classroom or transitioning between lessons.

Outline within the plan:

• an adult the pupil can trust
• arrangements for checking in
• how to find during a crisis, or to prevent one

b) A culture of kindness and flexibility

 Another important factor to note is that the pupils to a large extent felt that all staff were ‘understanding’ and ‘kind’ and this was not isolated to the support staff or those more involved with them. They felt that on the whole, communication was good between all staff and teachers were very understanding of anxiety and responded appropriately, e.g. letting students leave the room when needed.

Outline within the plan:

• how all staff will be made aware of the issues
• how they should support in lessons, e.g. seating arrangements, time out
• reasonable adjustments to mitigate any identified stressors, such as changing for PE

c) Personalised timetables

Another strong factor was the level of personalisation and planning that had gone into developing the pupil’s timetable. There was clear evidence of listening and valuing the pupil’s perspective and prioritising individual need over system processes at times. One important factor raised by pupils, staff and the parents was understanding the need to be realistic and build success slowly over time, rather than setting up a high expectation of reintegration, for example. Each pupil’s timetable was personalised.

Outline within the plan:

• which subject learning will continue virtually, either at home or within the safe base
• how such work will be set and marked
• whether some subjects will be dropped to reduce demand that exceeds personal capacity to cope
• whether there needs to be support for homework, or a reduction in homework (for example, just reading) 

d) Access to a safe base

 Having a safe base within the school was extremely important to the pupils when they talked about their experiences. They talked about the ‘safe’ area as being ‘welcoming’, ‘quiet’ and ‘accepting’ and some pupils reported that without this area, they would not be in school at all. This was partly about the staff in the centre, but also the nature of this area was described as ‘relaxing’ and ‘less pressured’ than other aspects of the school, which allowed pupils to develop their confidence at their own pace.

Outline within the plan:

• where the pupil can go that feels safe
• who will supervise the space
• how it can be accessed at times that are stress-inducing, such as lunchtime

 e) Communication with parents and carers

 All parents involved in the study spoke very strongly of the relationships and communication they had with school staff. For some parents, staff had been a ‘lifeline for both me and [pupil]’ and daily communication with a familiar member of staff was common, which would have been hugely supportive in supporting the pupil.

Outline within the plan:

• who will be the single point of contact for home
• how they will communicate – email, text, phone call
• how often and at what time during the day

5. Guidance for parents/carers

Parents and carers play an essential role in helping their child to manage anxiety and there is research to suggest that the right parental support can have a big positive impact. Although every situation is unique, the following are some key ideas that might help when supporting your anxious child.

a) empathise and encourage

It is important to let your child know that overcoming anxiety is hard, and that you are proud of their efforts.  The message you want to send is, “I know you’re scared, and that’s okay, and I’m here, and I’m going to help you get through this.” Help the child to understand that worry, fear and anxiety are all normal emotions and that they can learn to manage and cope with these normal responses to difficult or scary situations. Every time a fear is confronted, that is a success, and the more successes the child accrues in dealing with their worries the greater their confidence and eventually their resilience will be.

b) don’t avoid everything that causes anxiety

Avoiding things that make your child upset is a natural parental response, but in the long run this only serves to reinforce that anxiety. By taking a child out of a situation that makes them anxious they are learning this as a coping mechanism, and this can become a repeating cycle. An alternative method is to try an exposure ladder. This is a process where the child breaks down their anxiety into manageable steps, and gradually increases these steps to overcome their anxiety. The PSP process will enable school to formulate this exposure ladder with you: ten minutes in reception for the first week might be the best starting point. (Going into school every day is important in relation to establishing a routine).

c) don’t ask leading questions

Whilst it is important to encourage your child to talk about their anxiety, asking leading questions should be avoided as this can reinforce their worry and validate their anxiety. For example, try asking “How are you feeling about the school trip?” rather than “Are you worried about the school trip?”

d) calm parent, calm child

Children model their parents’ behaviours, and so it is important to also consider how your own anxiety might be affecting your child. If you are anxious, your child will pick up on it and experience an increase in their own anxiety. So when you want to reduce your child’s anxiety, you must manage your own anxiety first. Parents can do this by modelling how they successfully manage anxiety; let your child know when you are using a coping skill (e.g. “I’m feeling a little bit nervous about that, I’m going to take a few deep breaths before I respond”). By modelling appropriate behaviour and positive thinking, when you look for the positive in situations, so will your child.

e) reduce the amount of time the child has to anticipate the event

Often the hardest part for children who are anxious is the run up to the anxious event or act. Therefore, parents should attempt to eliminate this anticipatory period, or keep it to a minimum.

f) discuss with your child their reluctance and anxiety about going to school

Try to explore their concerns (often easier said than done) and try to establish if there are specific worries about specific aspects of school. If successful in picking apart the reasons for avoidance, work with the child and the school to find ways of minimising the worries so that the anxiety can be better managed. This might involve reasonable adjustments, such as leaving lessons early, or having a time-out card and access to a safe-base. Consider:

• Are there any friendship issues?
• Could there be any social media related issues or bullying?
• Are they under any extra stress at school? (examples, transition from primary, exams, staff or class changes)
• Could there be any other school related issues? (subject or teacher issues)

Also explore whether experiences outside of school are at the root of the problem:

• How and what does the child benefit from not going to school? (what are they doing at home? xbox, tv, laptop etc – is the home environment too enticing?)
• Have there been any recent stressful or traumatic events?
• Is there a history of worry, anxiety or stress within the family?
• Bereavement or loss in family and/or friends
• Long term Illness in family or friends
• Any traumatic events or loss
• Could the child be reluctant to leave the parent for fear of something happening to the parent whilst they are at school?

g) support your child in confronting fears (where possible)

It is through this that they will learn the coping skills that they will need throughout life. Ensure that you are consistent in encouraging your child to go to (and remain at) school. Avoiding worries and fears is less painful (in the short term) for the child than confronting them. Some children learn how to ‘stay off’ school and they can soon learn the ‘buttons’ to press with parents that will allow them to stay away from school (and avoid their anxieties). This can lead to the habit of avoidance that can be a very tricky habit to break later on. Confront rather than avoid.

h) encourage your child to keep in touch with friends and go to clubs

This will strengthen friendship bonds and could improve their support network within school. This can help them in dealing with their worries.

i) prepare for return and introduce routine

Have the child get everything prepared for school the night before so that there is no added rush (or opportunities for excuses and delays) in the morning. Establish and maintain good routines (eating, sleep and exercise). Sleep patterns are particularly important, sleeping and catching up on sleep during the day must be vigilantly managed. Poor sleep patterns feed anxiety and sleeping during the day will just make it a harder to break a cycle of avoidance.

6. Guidance for pupils

This guidance aims to provide some information about ways that can help you to better manage anxiety. Don’t try and do all of these at the same time, but maybe pick two or three that you think sound helpful for you. Try and do this with someone if possible and let the supporters at your PSP meeting know which ones you have chosen to try.

a) Talk to someone you trust. Talking to someone about how you are feeling can be really important and this could be a family member or someone at school. By doing this, you may realise you are not the only one experiencing these feelings and adults are able to help in different ways when they know how you are feeling.

b) Try out different relaxation techniques by looking at the 30-3-30 approach. Once you have a sense of what’s helpful, complete ‘My Wellbeing Plan’ and consider bringing this to your PSP meeting. There might be opportunities during the school day to use some of the techniques and this can form part of your plan.

c) Try doing something physical. Some people benefit from using stress balls or fiddle toys and they find this can reduce anxiety through distraction (if the mind is occupied, it is distracted from focusing on the anxiety). Exercise is recognised as being particularly beneficial for anxiety and low mood.

d) Keep a diary. Notice and record how you are feeling on a daily basis and identify what triggers the feelings, what helps and how long the feelings last. Remember to record times where you feel good too and record successes and achievements.

e) Distraction techniques. If you notice yourself worrying a lot about something and are finding it hard to stop yourself, try out some distraction techniques, e.g. doing difficult sums in your head, looking around you and thinking in detail about your environment.

f) Understand the feeling won’t last forever. This could involve thinking about times before when you have felt as bad but later felt better. This is about accepting and understanding how you feel but also knowing the feeling will change.

g) Move forward in small manageable steps. Talk to someone about how you could gradually face your fears in small steps and use coping techniques to help you manage, e.g. use the step-ladder approach.

h) Try and eat a healthy and balanced diet.

i) It is very important to have a good sleep routine and to get enough sleep. If you feel you would benefit from more sleep, talk to someone about what could help.

j) Stay away from recreational drugs, alcohol, late nights and excessive screen time. These do not help you.

 

 

School leaders will already be thinking about pupils who may struggle to return, post lockdown, or whose attendance will be a concern. Within some very good guidance to improve school attendance, Milton Keynes psychology service identify common triggers for school refusal as follows:

 

Each category requires a different response, with Thambirajah et al further defining school refusal as the situation which arises when:

Updating SEND support plans

School stress is often rooted in SEND, identified or otherwise. Some autistic children will, for example, be extremely anxious about the prospect of confronting once again the sensory and social challenges of school life, having benefited from the safety of home learning during lockdown. Increased anxiety will need to be matched by increased support, if the risk of school refusal identified above is to be mitigated. This will need to be planned with families, a team approach always fundamentally important.

This comprehensive resource from the National Autistic Society provides examples of transition social stories, visual supports and reasonable adjustments that will assist SENCOs and families in carefully managing the return of children with ASC. It also signposts Full Spectrum Awareness – an excellent toolkit of short videos and activities designed to help secondary school pupils understand autism. ‘Bubbles’ will almost certainly feel safer for autistic pupils if their bubble-peers are educated. Such awareness-raising is also a good way to introduce a buddy system, which can be extremely effective in reducing the anxiety that comes with isolation from the group.

Pacing the return

School refusal may also be rooted in mental health difficulties. Whilst anxiety is a common emotion, the feeling may become long-lasting and intense. Separation anxiety is most often seen in younger children whilst adolescence is a developmentally sensitive period for the onset of social anxiety, the feeling of being closely scrutinised and evaluated by others.

It is important to understand the nature of anxiety and accept that, for those severely impacted, any process of reintegration post-lockdown will require small steps. Patience and time are critical. The pupil needs to have some control of their situation so that the plan moves at a pace they can cope with. It is also important that progress is not expected to be linear – a two steps forward, one step back approach with a focus on the overall trajectory, not temporary setbacks, is essential.

Using surveys

A key task for pastoral leaders and SENCOs as lockdown eases will be to identify this cohort of at-risk pupils in advance, so that proactive, collaborative planning can be undertaken with families. In many cases, pastoral leaders will know who to be worried about from an attendance and wellbeing perspective, but prior knowledge will not identify needs that have escalated during lockdown.

Surveys, though not fail-safe, are therefore a good idea. If these are framed as child-centred offers of support for transition, rather than school-focused attendance concerns, then they will be welcomed by families: the distress caused by school-refusal, or even the prospect of it, should never be under-estimated.

Non-academic virtual learning

For those children whose capacity to engage in cognitive work has been undermined by stress, it will be necessary to reduce or abandon altogether the remote setting of academic tasks, in liaison with families. Otherwise, a detrimental spiral can set in whereby tasks can’t be completed (because of cognitive issues related to stress, such as inability to concentrate), anxiety increases as pupils feel they are falling further behind and will never catch up, and that anxiety builds with every task that lands in the inbox and isn’t completed. I am happy to report that my daughter’s school responded immediately, but I saw this very thing happen; it was for a time hugely stressful.

The political climate around falling behind and the lost generation doesn’t help at all, but those who actually work with children and young people do understand that the hierarchy of needs cannot be safely ignored. Emotionally regulating activities such as walking and talking, gardening, art, sport – these will be more beneficial than the academic curriculum when wellbeing is a concern – and will ultimately improve academic outcomes by reducing stress and increasing access to the cortical brain. School leaders should feel able to give families the mandate to focus on these things, and fortunately most do.

Many schools are also sharing high quality wellbeing resources with families and I wanted to flag here this fantastic resource from learn.4mentalhealth. It introduces 30-3-30 activities, inviting children to try them out and then to complete a downloadable wellbeing plan, as below.

It is easy to see how such a plan might feature within transition planning, so that pupils are actively encouraged to continue to use within schools those regulatory activities that have been practiced at home (and for therapeutic change to occur, they do always need practising). The resource could also be used as the basis for a wellbeing survey mentioned above as it begins with a simple assessment.

Return to school will not be supported simply through access to counsellors, even if an army is deployed; these might help some children who are in a place where cognitive processing is possible, but actually the relational milieu, the therapeutic web of kind human connection, these matter much more. Further, the majority of children who are at risk of school refusal will need regulatory activities (as in fact all humans do if they are to maintain a healthy baseline of stress) consistent with Dr. Bruce Perry’s bottom-up model of therapeutics. The linked resource is a singularly powerful resource in this regard.

Schools factors that help

Every situation is different and complex and a one-size fits all approach to this area of work is doomed to failure. However, research confirms that the following school factors correlate with more successful return, overall:

Learning from lockdown school

The hope is that schools will be better placed to offer personalised support of this kind in the post-lockdown world than they were before it, because flexibility has become the watchword. School leaders will have new problems, for sure, but they will also have new solutions: lower staff-pupil ratios during the recovery phase, a curriculum with wellbeing at its heart, blended learning, an opportunity to pace transition and minimise demand whilst confidence increases,  stronger relational approaches…it should be more possible over the coming months than it was in the past to personalise the deal for the ‘square pegs’ of the system.

This article about a Gloucestershire school emphasises the wellbeing benefits of the flexible lockdown school, its headteacher pledging to make changes after the pandemic, rather than simply returning to business as usual:

The school has ripped up timetables in a way no state school could normally contemplate. “We’ve said, we will be completely flexible to your needs,” says Kerala Cole, assistant headteacher. “We work in partnership with parents to personalise the deal for the students. It can be that they come in for just a couple of hours. And I think we are seeing huge benefits to that.”

One boy who had refused to attend for eight months, has been coming in every day, thanks to this flexibility and the attention he can now be given. Another year 8 child, “who arrived midway through this year and has been struggling … he’s been attending for four weeks now and he’s really benefited”, says Cole. “You can just see how his shoulders have relaxed.”

Clearly, there is something here to build on. Even as more formal structures and curricula are reintroduced, transition planning will be greatly enhanced by retaining some elements of the flexible lockdown school offer – lower demand and enhanced support, planned in partnership with pupils and families, for those who we might otherwise lose from the system altogether.