Most parents and carers have heard of different parenting styles such as attachment, tiger, helicopter, disciplinarian and permissive. Perhaps less well known is a high nurturing approach called therapeutic parenting. So, what is it, who does it help, and how?
First thing’s first, therapeutic parenting ‘does not mean parents are practising psychological therapies on their child,’ says Rosie Jefferies a training co-ordinator at Fostering Attachments. Jefferies is the adopted daughter of Sarah Naish, a leading figure on the subject, and was therapeutically parented by her mother.
Children that ‘have suffered trauma in the first three years of life, usually in the form of neglect when parents can’t provide a child’s needs, are insecurely attached because their basic needs weren’t met,’ explains Jefferies.
These children often go on to have emotional or behavioural difficulties and so need to be parented differently, or therapeutically, so that their specific needs are met.
‘It’s is a high nurturing way of parenting that aims to make a child feel safe again, usually around adults,’ says Jefferies. ‘During the period between 0-3 a child’s brain is still forming so, for example, if a child cried and didn’t get fed, that developmental pathway is turned off so it can’t distinguish if it’s hungry or not.’
‘See it like their brain being in a wheelchair. The child looks normal but functions badly.’
Therapeutic parenting is often regarded as being exclusively for traumatised children who have nearly always been in care, fostered or adopted. But this isn’t always the case.
‘Therapeutic parenting also works for securely attached children; in fact, it often works better,’ says Jefferies. So, even if a child is securely attached [which means born to loving parents] ‘they may have been exposed to trauma at a very young age or in the womb [usually from the second or third month of pregnancy] if the parent has suffered a trauma, were highly stressed, or abused alcohol or drugs.’
‘These children can be born with high cortisol levels and, as a result, are on high alert and often fractious,’ explains Jefferies. ‘It’s doesn’t mean they’ll grow up damaged but they will have a tendency to use their base brain instead of higher thinking.’
If this still doesn’t apply to your child therapeutic parenting techniques can still help parents and children who are struggling with certain issues.
‘Therapeutic parenting is effective for ALL children,’ stresses Jefferies. ‘Not only those who have suffered trauma. It simply works more quickly with securely attached children.’
What is therapeutic parenting?
‘There are many types of therapeutic parenting,’ says Dr Dan Hughes, a US-based clinician specialising in children with emotional and behavioural problems. Hughes developed Dyadic Developmental Psychotherapy (DDP).
Also known as Attachment-Focused Family Therapy, DDP supports the relationship between parents and children with developmental trauma, with the aim of healing past trauma and enabling the child to feel safe.
‘Most are based on principles of building safe, strong relationships that combine affection and comforting along with clear behavioural expectations and routines, ‘ explains Hughes. ‘Therapeutic parenting is especially developed for parenting children who manifest special needs, whether they be based on stressful or traumatic life events or constitutional factors.’
How do parents follow this method?
Therapeutic parenting skills differ from traditional parenting skills in that there’s no time out or any form of corporal punishment. ‘Therapeutic parenting does not shame the child, use reward charts, or expect the child to self-regulate or feel empathy and remorse,’ says Jefferies. ‘Parents need to ‘recognise that behaviour is communication, which is often based in fear, so should respond to the child’s emotional, not chronological, age using empathy and connection to guide behaviour.’
It’s recommended that parents follow PACE, a methodolgy based on how parents interact and bond with very young children. The primary aim of PACE is to make a child feel safe so they can learn to trust. The DDP website describe PACE, which is an acronym, as follows:
Playfulness: creating an environment of lightness and interest when communicating; for example, using a light tone when telling a story and expressing fun and joy over being stern or irritated
Acceptance: showing acceptance of their child’s wishes, feelings, thoughts, urges, motives and perceptions without judging or evaluating
Curiosity: showing that they understand their child’s behaviour. Curiosity also helps parents teach their child how to understand their own behaviour
Empathy: feeling compassion and the emotions of a sad or distressed child and actively showing this so their child feels understood. Parents would offer support, comfort, love and commitment.
Because dealing with troubled children has its own particular set of challenges Hughes recommends that parents or carers don’t go it completely alone, advising that they find ‘a guide, mentor, or counsellor and maybe a parent group’ to learn specific skills and get much-needed support.
Where can parents get support and training?
There are some excellent resources and therapeutic parenting training available, says Jefferies. ‘If you are looking after children who have suffered trauma through early life neglect or abuse, the National Association of Therapeutic Parents (NATP), of which Sarah Naish is founder and CEO, can support you.’ This applies to foster carers, adopters, special guardians, kinship carers, step-parents and biological parents.
How does therapeutic parenting affect children?
Therapeutic parenting offers invaluable advantages to children. By following this method a ‘child is likely to feel safe and supported while being more open to new learning and accepting the guidance and direction of the parents,’ explains Hughes.
Hughes’ words are echoed by Jefferies, who states that therapeutic parenting enables children ‘to self-regulate and develop an understanding of their behaviours and ultimately form secure attachments which will, ultimately, minimise the impact of childhood trauma.’
What are the benefits of therapeutic parenting?
While they can be hard-won, the benefits are hugely valuable to both children with emotional and behavioural difficulties and their parents and carers. With patience, support and work the process can result, says Hughes, in ‘greater open communications and conflicts more easily resolved, leading to more shared interests and values and stronger relationships.’
The goal is that the ‘child can form attachments to others and build trust in adults,’ says Jefferies. What is important to be mindful of is the child’s rocky start and the physiological effect that’s had as well as the psychological. If we remember that cortisol, of which these children have high levels of, is ‘ten times more addictive than cocaine, the child lives with a constant feeling of fight or flight. High cortisol levels in children can be like a smoke alarm constantly going off but with therapeutic parenting this can be quietened or switched off.’
What to read for further information and advice
If you want to find out more there are a number of therapeutic parenting books available. Naish’s books A-Z of Therapeutic Parenting – Strategies and Solutions, and Therapeutic Parenting in a Nutshell: Positives and Pitfalls are go-to publications for parents of children with attachment difficulties or children who have experienced childhood trauma. Both offer practical tips, advice and techniques on therapeutic parenting.
For children, try Sarah Naish and Rosie’s Jefferies storybooks for ages 3-10, which help affected children understand their behaviour.