Chapter 10 - Behaviour Support

Chapter Contents

Introduction

Children and young people who have experienced trauma will have difficulty in stressful situations and can present with a range of challenging behaviours. Wee have a responsibility to:

Respond in a way that promotes a sense of care, self-autonomy, safety and positive change.
Protect children and young people, as well as those working with them.
Support children and young people to be able to express their feelings and manage their behaviour.

Our Goal

Children and young people will enjoy positive relationships with their foster family, be able to interact positively with others and adapt to different situations. They live, grow and develop in environments that are safe, nurturing and supportive, and in a way that assists them in achieving their full potential.

We aim to enable children and young people to get to know who they are and to grow and live in harmony with themselves and others. To achieve this we provide an approach to therapeutic fostering that is specifically designed to improve the psychological and emotional health and wellbeing of children and young people. Therapeutic concepts relating to the effects of trauma, abuse and neglect are used to enable staff and foster parents to view children’s sometimes challenging behaviour as communication of confusion and distress in their internal world alongside, rather than simply as behaviour to be managed.

Support for Foster Families

A network approach

At ISP we are committed to a multi-disciplinary team approach. At all times, you can expect the support of your local ISP team, including the Registered Manager, your Supervising Social Worker and your Fostering Advisor. Our Out-of-Hours service is also available to support you with advice and crisis support when you need it, as well as our local therapists. Building positive relationships, raising children’s self-esteem and resolving problems should be a regular topic at supervision meetings.

PRICE training

Our PRICE programme promotes a therapeutic response to challenging behaviour. This means recognising that all behaviour has a purpose – and that purpose is to get our needs met.

The course helps carers develop skills in:

reflective listening
effective modelling
verbal and non-verbal de-escalation

Using these skills will help young people to learn more socially acceptable ways of getting their needs met. You will also learn about the many factors that affect behaviour, including previous experiences, mood and environmental factors such as noise and temperature.

Complete the mandatory training course: PRICE (Protecting Rights in a Caring Environment

Therapeutic Pathway Training

Our therapeutic training starts from the moment a family applies to foster, and provides ongoing support with the therapeutic fostering task. It is central to our trauma-informed practice.

Find out more about the pathway here.

Understanding Behaviour

The effect of trauma on behaviour

Our young people have often had a painful history that has deeply affected their development. We believe that these children need therapeutic care to reach their emotional, social and educational potential.

Our young people have experienced things as having gone very wrong in their lives and are likely to have been traumatised by this. This often results in behaviour that adults find difficult to manage at home and at school. We aim to contain, understand, empathise and best manage their behaviour as we gradually help them to feel safe and be able to develop within long-term meaningful relationships.

Our therapeutic training pathway helps our foster parents to develop skills to identify and understand the thoughts and feelings that lead to challenging behaviour, and to respond in ways that promote recovery and strengthen relationships. We ask our foster parents to avoid the use of punishment, as this is often not an effective learning tool for children with trauma. Instead, we encourage an approach that acknowledges the child’s feelings, gives them space to pause and restore a sense of calm, and invites them to share in finding solutions to problems.

Find out more about the impact of trauma on children’s behaviour here.

The ABC approach to understanding behaviour

The ABC approach looks at behaviour (B) in terms of its antecedents (A) and consequences (C). This means thinking about what might have led to (or caused) behaviour, and how the consequences of behaviour can influence whether that behaviour continues or not.

Antecedents – the context and causes of behaviour

A large number of personal and environmental factors can influence children’s behaviour. These include:

The culture and ethos of the family or social group
Other people’s attitudes and behaviour
Physical comfort and discomfort
Available activities
Previous experiences and expectations
Medical or disability needs
Rights, rules and responsibilities

These factors determine whether a child’s needs are being met. A child whose needs are being met is more likely to feel safe, comfortable and supported. Their behaviour is more likely to be positively adapted to their environment, and considered appropriate by others. This is our goal.

Some ideas to build relationships and promote positive behaviour:

Welcome children with a smile – let them know you’re pleased to see them.
Set a positive example through your own attitude and behaviour.
Spend time together doing things you both enjoy.
Set clear boundaries, have consistent routines and take the role of a trusted adult.
Give clear and simple instructions.
Work at the pace of the child – small steps can lead to positive change.
Notice when the child is doing well and interact with enthusiasm.
Offer praise and recognition.

Behaviour – the ways in which children respond to different situations

A great many different things influence children’s behaviour. Whilst you can’t control all of these, you can have some control over their environment, and carefully managing this can help to encourage positive behaviour, and prevent behavioural problems from escalating.

Some ideas for early and effective intervention:

Be confident, consistent and fair when dealing with negative behaviour.
Get alongside a child who appears stressed and offer support and reassurance.
Encourage children to let you know if they are feeling stressed or unhappy.
Provide an emotional language for the child, e.g. “you look like you’re feeling angry”.
Employ diversion techniques to calm a stressed child.
Have an ‘exit plan’ for known stressful situations, to allow children to safely withdraw before things escalate.
Give praise and attention to positive behaviour.
Give clear an direct requests to stop unacceptable behaviour.

Consequences – the outcomes of behaviour

This refers to the things that happen as a result of what we do. Consequences can be positive (e.g. receiving praise or a reward, feelings of pride and satisfaction) or negative (feeling guilty, being told off, harm or damage caused).

Behaviourist theory suggests that positive consequences lead to repeated behaviour, whilst negative consequences make us less likely to do it again. These ideas are popular and feature heavily in mainstream parenting advice. However, they are not always effective when working with children who have experienced trauma. In fact, punishment can further weaken a child’s fragile self-esteem.

For this reason, we ask you to consider whether anything in addition to natural consequences are necessary, and to consider any consequences to be restorative in nature. In this way, children learn to take responsibility for their actions and relationships are strengthened.

Encourage and support young people to respect the rights of others, understand the value and safety of boundaries, and help them to make positive choices that increase access to positive life experiences.

Sanctions

As a foster parent, you may be managing some very challenging behaviour, including aggression, violence and destructive outbursts. Through your therapeutic pathway and PRICE training, you will learn to be sensitive to the reasons behind this behaviour and identify ways in which you can help children to manage their feelings of stress and anger.

There will be times when it is necessary to impose a sanction as a consequence for behaviour that is particularly dangerous/unsafe in order to emphasise the seriousness of the situation. Please seek support from your supervising social worker and fostering advisor in managing the incident and identifying appropriate sanctions. We would ask you to avoid the need for police involvement wherever possible. Please only call the police if an emergency requires their immediate involvement to protect the child or others. Please notify ISP immediately if this happens:

Sanctions should always be reasonable and the minimum necessary to achieve the objective. Apply the following principles:

Sanctions should be the exception and not the rule
Sanctions must not be used in retaliation or revenge
Take time to consider the appropriate response – don’t apply sanctions in the heat of the moment
Only impose sanctions for persistent or serious misbehaviour, where reminders and reprimands have already failed, or are likely to fail
Always explain to the child why the behaviour is unacceptable, and why you have decided to apply a sanction.
Sanctions should only last as long as they need to, allowing the child the opportunity to make a fresh start as quickly as possible

Sanctions/punishments may include:

Loss of privileges e.g. loss of staying up late on a special night of the week, or visiting friends.
Going to bed early e.g. in response to disruptive behaviour at bedtime, or coming home late. Do not send them to bed more than an hour before their normal bedtime though.
Paying towards damages. You can ask young people to contribute to the cost of repairing something they have damaged. However, you must never take all their pocket money. Get the agreement of your supervising social worker and the child’s social worker, and always record the repayments in your daily log.
Doing extra jobs e.g. tidying the living room each day for a week if they have been responsible for creating a messy environment for others.
Grounding for a time. Link this to the problem behaviour, e.g. the young person may have damaged trust by not returning home at the agreed time.
No television or treat. This can be difficult if it means that others in the family will also lose out. The sanction is not isolation so do not leave them in another room alone while everyone else enjoys the programme or treat.
Time out. Only use very short periods, particularly if the child is young. Telling them to sit on a chair just outside the room that the foster parent is in for five minutes can be enough. Don’t send a child to their bedroom for ‘time out’, although some will retreat there at times to calm down.
Verbal disapproval. A raised voice, or different tone, can indicate displeasure. Be clear with the child that it is their behaviour you dislike, not the child themselves. Also, avoid reprimanding the child in public if possible.

Non-approved sanctions:

Some sanctions are unacceptable because they humiliate a child. Do not use punishments that the child has experienced in the past and which may bring painful and traumatic memories.

You should never threaten to end a placement as a punishment for the child. They may have previously experienced this threat in their own family, and it can seriously damage their relationship with you.

The following sanctions are not approved, and must never be used:

Corporal punishment; i.e. any intentional application of force as punishment, including slapping, punching, rough handling and throwing missiles;
Sanctions relating to the consumption or deprivation of food or drink;
Restrictions on a child’s contact with his or her parents, relatives or friends; on visits to the child by his or her parents, relatives or friends; on a child’s communications with any of the persons listed below*; or on his or her access to any telephone helpline providing counselling or advice for children. This does not prevent restricting contact in exceptional circumstances, when needed to protect the child or others;
Any requirement that a child wears distinctive or inappropriate clothes;
The use or withholding of medication, or medical or dental treatment;
The withholding of aids or equipment needed by a disabled child;
Intentionally depriving a child of sleep
Bribery or the use of threats;
Anything which may humiliate a child or cause them to be ridiculed;
The imposition of any fine or financial penalty, other than a requirement for the payment of a reasonable sum by way of reparation.
Intimate physical examination of a child;
Measures which involves a child in the imposition of a sanction against another child;
Sanctioning a group of children for the behaviour of an individual child;
Swearing at the child, or the use of foul, demeaning or humiliating language or measures.

*The persons with whom the child may have contact, in relation to the third item above, are:

Officer of the Children and Family Court Advisory and Support Service appointed for the child;
Social worker for the time being assigned to the child by his placing authority;
Any person appointed in respect of any requirement of the procedure specified in the Representations Procedure (Children) Regulations 1991;
Independent Visitor;
Any person authorised by the Regulatory Authority;
Any person authorised by the local authority in whose area the home is situated;
Any person authorised by the Secretary of State under section 80(2) of the 1989 Act to conduct an inspection of the home and the child(ren) there.

Physical intervention

Foster parents should always avoid touching or restraining a child in a way that others could interpret as sexually inappropriate conduct. However, positive touch is recognised as important and necessary and may be used for a variety of reasons:

Self-Care

Giving help with the permission of the child, parent and with the knowledge of the team, and documented in the Placement Plan and/or risk assessment.

Physical Affection

Touching is a powerful means of every day communication by physical means to indicate to a young person approval, affection or sympathy. Touching, such as a pat on the head or shoulder, holding a hand, or an arm around a shoulder are ways a foster parent can convey comfort or reinforce a positive relationship with a young person particularly in a time of stress. However, touching for some young people can be distressing. This should not inhibit a foster parent however from acting to save a young person from a fall, retrieving a young person from deep water or pulling away from dangerous machinery etc. Foster parents should also keep in mind their safe care strategies when using physical touch with young people and be mindful of the physical context of their actions.

Physical Proximity

Controlling a situation using your physical presence involving no actual contact, such as emphasising verbal instructions or sitting closely or temporarily blocking a doorway. You need to do this in a calm manner with explanation and negotiation, and never with aggression or intimidation where a child feels falsely imprisoned.

Touch Control

In general, when dealing with an aggressive child, any form of touch can be inflammatory as the child may perceive it to be an invasion of personal space and as such an aggressive act. However, it can be a great calmer for some children and through reassurance, reduce arousal levels.

The cupping of the hand, placed on the shoulder may support the child and enable you to guide them away from triggers. Only use this technique when you know that the child responds positively to such contact. Always approach defensively as the child may lash out and you will be more able to smother the arm and avoid injury.

Escorting

The method of supporting the movement of a child from a trigger or difficult situation using non -restrictive and/or restrictive physical interventions. In such circumstances, begin with a verbal request; consider a non-restrictive approach (hand on the shoulder/walk and talk technique, creating space, cupping the triceps for support). Remember if the arousal levels of the child are as low as to allow you to escort them there is likely to be little need for any real physical contact.

Breakaway

A foster parent removes himself or herself from the grasp or hold of a child and creates space, moves to a safe position or exits the situation.

Physical Intervention

Physical interventions involve the use of reasonable force to control a person’s behaviour, This can involve using bodily contact, mechanical devices or changes to a person’s environment. PRICE training includes acceptable use of physical interventions.

	Bodily Contact	Mechanical	Environmental Change
Non-restrictive	Manual guidance to assist a person walking.	Use of protective helmet to prevent injury.	Removal of cause of distress e.g. adjusting noise, temperature
Restrictive	Holding a person’s hand to prevent them hitting someone.	Use of arm cuffs or splints to prevent self-injury.	Forcible seclusion or use of locked doors.

DOH/DFES Joint Guidance on the use of restrictive Physical interventions (July 2002) distinguishes between planned and unplanned use of forces and that deployed in an emergency.

Planned Intervention

Children’s risk assessments, and individual Behaviour Support Plans, will detail pre-approved strategies and methods that foster parents can use when needed. The plan will identify specific physical intervention techniques to ensure consistency and safety across the team.

Emergency and Unplanned Interventions

There may be occasions when you need to use an approved physical intervention technique (in which you have been trained) in response to unforeseen events that have not been previously considered.

You should only use physical intervention in exceptional circumstances, where it is the only appropriate way to prevent injury to the child or other people, or serious damage to property. Government guidance says it should be used ‘in a manner consistent with the actions of any good parent’.

Physical intervention should be a last resort to prevent injury to people, or serious damage to property. The intervention should be the least intrusive necessary to protect the child, carer or others. Only use physical intervention if you are confident that you can manage the situation safely, without escalation or injury. You must notify ISP immediately afterwards.

ISP will try to avoid involving the police, who should only be involved in two circumstances:

An emergency requires their immediate involvement to protect the child or others; or
Following discussion with the supervising social worker, Registered Manager, Operations Director, or the out-of-hours service

Notify ISP without delay in the event of a serious incident, or if the police are called. We will inform the child’s social worker and make a full report of the incident and actions taken.

Chapter 10 – Behaviour Support