 I am here at the CYP now mental health conferences in schools today. We have Shehana Knight, who is a specialist in trauma in children. Can you tell us a bit about who you are and what you do today? Yes, I am a director of mental health services. We specialize in helping professional schools, parents, adoption agencies, foster agencies, anyone really who's got contact with children. a chyfnodd yn ychydig yn cael ei ddweud yn ymgyrch yn ymwneud am yr oeddwn i. Ychydig yn chyfnodd yn ymgyrch i'r eich cyfnodd yn cydwylliant. Ac yna'n ddigon nhw'n ddweud o'r dyfodol yn ymgyrch ymwyngau a hwnnw i'r ffordd yn ei ddweud ymgyrch. Yn ymgyrch yn ymgyrch yn ymgyrch. Yn ymgyrch yn ymgyrch yn ymgyrch, yng nghymru yw'n rheiddiwyd, a rwy'n wedi bod y rhai syniad ymlaen i'r osre siwr, felly rhai srytu i'r slinig, y trawr, oedd ti'ch gwybod chi o'ch gwybod i'r srinig? Mae'r cyfnod ymlaen i gwybod chi oes i'r cwmwyng yr holl? Rydyn ni, mae'n siwi oes i ymlaen o rhai syniad i'r srinig i gyd-di-feydd-ynydd ymddai. Mae gyd-di-feydd-onr ymddai ymddai oes i'r cyd-di-gysig. Roedd oedd ysgol yn gweithio gyntafol o'r sorg Mae'n bwysig i ddeithas i ddeithas gyda maesyddol. Mae'n gwneud, mae'n gwneudbyn. Ar ymgwrdd, mae'n cael i dweud. Mae'n ddeithas i ddeithas i ddeithas cyfrannol, mae eraill a chyflwy yna. Mae'n ddeithas i ddeithas iawn. Mae'n ddeithas i gwybod eu wneud a widebwyr o ddeithas yn gwneud'r wneud. Mae'n ddeithas agn涂 o fod yn meddwl gwir. Mae'r hystry yw tro maen. Mae hynny'n deithas, mae hynny'n ddeithas erioed. Can we say history of trauma, what are we talking about? So trauma is things like, there's a massive breath, it can be really low level stuff, like having a new sibling and not being able to deal with the fact that there's more family members, it might be, it might move forward to being things like being involved in a family that has domestic violence, or a family who maybe really love their children but struggle with their own difficult experiences, and that then impacts the child or young person. So for example maybe there's substance abuse there, maybe there are alcoholics, and things like abuse, loss, trauma, maybe they're in care, all of those kind of things we'd be thinking are traumatic, but also the really kind of stuff that we maybe don't think is quite traumatic, like a child who maybe has moved house loads of times, or has people in and out of their lives, those things can be quite traumatic for children as well, and maybe we don't flag them up as much as we maybe could do, or should, even like divorce. So it's about that child's experience really, isn't it, rather than our belief about what should be trauma. Absolutely. So we're looking for those behaviours that you talked about before, and what if we pick up on a child who is displaying these difficult behaviours and not engaging, not flourishing, what can we do? I would definitely flag that up to a service like ours, or an agency or the school, so it depends who you are, if you're a parent you would flag it up to your school, if you were a health professional you maybe would pass that on to either school or an agency, but it's about getting the child the right support I think at the end of the day, and that support would look like therapeutic intervention or therapy. I think a lot of the time there's so many children out there who could do with therapy, and I think they're not getting it, and there's a real hole there. And I think if we just give these children, especially from really early on, some therapy to be able to work through their experiences, and to be able to come to terms with maybe what's happened, and move forward, that's going to have massive impact for the adults of the future really. But back in the real world where loads of kids aren't going to meet the thresholds of therapy for other reasons, what can the non-specialists working with schools each day, what could we do in our normal day-to-day interactions with these kids maybe to provide a bit of input there that might help them feel safe, secure. I mean it's really basic things, a lot of the time, even just practical skills, so the way that we talk to children, really really easy stuff for example, so you could assume that a child of three would need help with their feelings, so you would be saying to a child of three, you know you're feeling really angry because I won't give you the sweet story, you're feeling really upset because you've fallen over, but we need to have that same language with children who are 7, 8, 9, 10, 15, and be saying, giving them that verbal feedback, saying I understand you're really angry, you're really angry because you're feeling anxious or you're feeling nervous, and those kind of verbal feedback, that kind of insight into their feelings and behaviours is really helpful on a really practical basic level. Why is it so helpful? Because actually what happens is, the children or young person, they have never had that verbal feedback, so they don't understand their feelings, they don't know what it is to feel anxious or nervous or scared, what they know is angry, sad, and you know, those are really basic terms, what they need from the adults around them and the professionals around them is to give them that feedback so that they gain that awareness, so by saying to a child or a young person, you are feeling really angry because you're really anxious about this situation, or I can see that you're kicking your hitter things, you're kicking your hitting things because you're feeling really frustrated, not just angry but frustrated, and explaining that, that gives them that self-awareness that they're not getting, so that one day they'll sit back and they'll say, actually I do feel really angry and frustrated and it's because of this, this and this, and then they can change their behaviours. Okay, so you think understanding what's underlying it is the key to them being able to move forward. Absolutely, and that's really basic stuff, there's obviously more that they need to have around them, but that's really helpful for professionals. Yeah, and in terms of, you talked quite a bit in this session earlier about how, you know, it impacts on our brain development when we experience trauma, so does that mean that, you know, if we've got a 15, 16, 17-year-old who is causing huge disruption and getting into fights, and heaven knows what else, really disruptive and difficult behaviour, we give up on them, is there nothing we can do because their brain's been changed by the trauma? Absolutely not, so the brain's ever evolving, although it just gets fixed and locked in at certain ages, so, you know, primary, children who are kind of like younger, their brain's a bit more mushy, so basically, you can kind of change the brain connection, so what happens is, if a child or young person has an experience over and over and over again, it creates a connection in the brain that is then forged, and the more that child experiences that experience, the more they assume everybody else in the world is going to do the same thing, so, for example, if every time they go to their parent with a need of love and affection and they're rejected, they're going to believe that every time they have a need for love or affection, that the people around them are going to reject that, that will become a basic belief. What happens then as they grow older is that basic belief is harder to change, but it's not impossible to change. The brain goes mushy again when they're teenagers and when we're adults, it takes longer, therapy is going to be longer, and do and begin to kind of recreate new changes, but the ideal is that we can get the children and young people when they're still children and young people and really make that difference. So there is a kind of window of opportunity during those difficult teen years where actually the brain is a bit more plastic, and it's a way that if you have those repeated negative experiences you're building those neural pathways, you can do that with positive experiences too. Absolutely, but just more. So what are the kind of positive experiences that a young person who's experienced trauma needs to experience? What are the kind of, what are the pathways we're trying to build there? So they need to know that adults are going to be there to support them and to care for them and to look out for them. So quite often a lot of children who've experienced any type of trauma begin to believe that they have to do it themselves, that they have to protect themselves and they form really negative coping strategies in order to do that. So they reject people around them, they fight and they get into all of these different situations where it isn't really healthy, it's just a form of protection and self-preservation. And actually what we need to be doing is to be able to kind of re-teach them and say look, you can rely on other people for love and support, but it's a process. So that young person then when they're meeting their partner for life for example or they're getting involved with relationships they actually can rely on their partner to love them and protect them and support them. Rather than going back to this belief that actually people who want to care for us are dangerous and aren't going to protect us. So then many of them are in relationships where they reject the person who's trying to care for them or they're quite frustrated and we get volatile when there's a need for love. So it's trying to kind of re-change that brain but it is a process and it takes a while, yeah. Of course. So it's about actually consistency, stability, unconditional care. And what about, so what a lot of people say to me is that they sometimes worry about doing or saying the wrong thing. Yeah. So have you got any advice on the things that you absolutely shouldn't do? I think that's quite complex. I think what advice that I kind of give quite a lot is really simple basic stuff and I don't know if it's going to answer the question. But so like often when we're speaking to children and young people we use the word don't or no or can't quite a lot. So we'll say like we don't do that or you can't do that or that's not what we do or whatever. I think changing our language and maybe taking away some of those words could be quite helpful and maybe I would say don't use those words. Okay. Just because that triggers the brain to shut down so a young person or a child will hear no or don't or can't and they will completely switch off from what you're trying to teach them and they will just then go into this self protection mode where they want to just either get out of the situation or fight you back. So can you give an example? Yeah. So for example in a situation maybe in a school environment where a teacher will say okay we don't hit in this class and you just don't hit in this class but as soon as you say the word don't they're going to completely shut down and they're going to either go into fight-flight-free so they're either going to get really angry and start to say well you're not listening to me you don't think about me you don't understand or they're going to try and get out of the lesson or the session or they're going to freeze and just completely give up on that relationship and that kind of feedback that they need from you they just won't access it anymore. A better way, a healthier way of doing that is to kind of take away those words and keep each other safe. So the child's brain then won't just switch off at the word don't and also gear up for a fight it's going to actually start to listen and learn from the information and that's better, it's even more healthy if you can insert some feelings in there as well so I know you're really angry but in this class we look after each other so I'd really like it if you didn't hit me next time but you did this and then give them kind of put in there give them another way of doing it next time do this and that again teaches them to change their behaviour Presumably even better if you can help them to come up with the next time if Totally, yeah, but if you say to a young person what could you do next time very often they're not going to know really they're going to know the best answer to give you but they're not going to know exactly how to do it so there's a lot of work Presumably there's a bit of reinforcement there as well so if next time they don't hit, they do the other thing we need to actually note that Fantastic, brilliant you know you've done this I can see a massive difference there and everyone else feels those better because of it it's all that verbal feedback So I guess kind of we're going to summarise the discussion then it's about there are going to be lots of young people in our care who have experienced trauma of one kind or another it's not for us to determine what trauma is it's up to the young person and their response if we're seeing a kind of trauma response then we need to be offering unconditional care and support and listening and helping them to try and find some healthier ways of responding And at what point would we say that this is too much this is beyond what we can do safely within school so you absolutely need that further intervention, are there any kind of red flag signs I think yeah I think if the child is extremely volatile that's the easiest to go to sign that the child isn't engaging they're getting quite aggressive with their peers they're getting quite aggressive with the things around them in the room and there's that stage where the school is thinking often they'll say we're not sure if the mainstream environment is right in this child that is when I would be saying okay get an external agency in and let's get some therapy underway here and I think it's really important on that point because this comes up quite a lot where staff really want to keep a child in school and they feel they have a duty of care to that child but I think it's always really important to remember you have a duty of care to every other child too so sometimes we have to make decisions which feel very difficult but at the same time that child we feel they're a bit of a helpless cause but actually from what you're saying they're not that those pathways can be changed and things can get better for that young person with the right input Yeah and I think what's hard is that it's very easy to kind of say okay this setting is not right for this young person or child and then kind of be the mother or put them somewhere else but all that's doing is reinforcing to that child that they aren't worthy of that love or that care and also that yeah actually I am right nobody does care about me nobody gets me if we keep them in school and we give them intervention and help to try and make a change that's sending them so many more positive messages about we're not going to give up on you we believe in you, you are valuable, you are loved and it's hard but it's so much it's much more of a valuable learning message for that child than it is to just think oh we're really struggling there's 30 other kids let's get this child out although it takes more work So we may be trying to pick it up a little bit earlier whilst we're still able to if possible keep that child in school or work to reintegrate them as quickly as possible in a way that they can manage for that peers as well Absolutely and it's about giving guidance to the school as well like I was saying in the seminar you can't just give therapy to the children, I think it's about training the staff as well, training them about their language training them about how to deal with that young person so they're feeling powered because a lot of the time I'll get teachers and they'll say to me well I just did I even choose a like career because it's so difficult and the children are so challenging and I'm not teaching anything and it's like where you are teaching it's just you're teaching them about how to function as a social emotional person so you can do that Thank you so much Can you tell us about it, do you have a website or somewhere So you can tweet us but I don't know my tweet thing All the website is www.tpctherapy.co.uk and you can email me as well can I do emails at tpctherapy.gmail.com for any advice or support Cool and yeah a lot of advice and hopefully the rest of the day is good for you too Thank you so much