Applying polyvagal theory to relationship-based therapeutic care – Practice tool

Download PDF

Jan 2022

Written by Joe Tucci Janise Mitchell

Relationship-based practice is at the core of effective therapeutic care. Key to understanding how to build effective relationships with young people who have experienced trauma is to understand how the consequence of trauma is experienced in their bodies and expressed through their emotions and behaviour. This understanding equips us to be better able to offer relationships that are attuned to their needs. This practice tool uses polyvagal theory as a way of understanding how best to use your relationship with a young person to understand and meet their needs for safety, support and regulation. This tool can be used as a summary for reflection or provided to care team members and those who are also supporting the child or young person. It seeks to summarise the experience of states of social engagement, mobilisation and immobilisation. It outlines how children and young people might present in each state, what might be happening for them and provides a starting point for using you relationship to respond to their needs.

 

 

Audience

This resource can be used with all of those caring for or supporting children and young people in care. Equally, it could also be used as a discussion point with the child or young person to help them to understand these different states, and to perhaps add the unique experiences and responses of that child or young person.

 

What you could do

  • Print and display this tool in your office as a reminder of Polyvagal Theory and its application in practice.
  • Provide this tool to those within a child or young person’s care team or broader relational network to support their understanding of their presentation and some beginning points for responding.
  • Expand the ‘I need you to….’ section for each state with your own ideas of ways of responding that best meet the child or young person’s needs.
  • Discuss the content of this tool with the child or young person and add in additional ideas based on their own unique story.

You may be interested in: Behaviours that challenge Child & youth development

Creating positive social climates and home-like environments in therapeutic care - Practice guide
Creating positive social climates and home-like environments in therapeutic care - Practice guide
This guide has been developed to support the implementation of Essential Element: Physical Environments from the Ten Essential Elements of Therapeutic Care. It explores how to create therapeutic care contexts...
Read more
Making sense of complex and challenging behaviours
Making sense of complex and challenging behaviours
An inability to understand trauma-based behaviours often sees young people 'labelled' in ways that can create a 'spiral of negativity'. A trauma-informed approach orients us to be curious about what...
Read more
Understanding and supporting young people who self-harm in residential care
Understanding and supporting young people who self-harm in residential care
Some of the young people we care for in the ITC programs deal with emotional distress and pain by hurting themselves physically. Young people hurting themselves is distressing to them...
Read more
The role of praise in working with young people
The role of praise in working with young people
We can see each of our daily interactions with each of the young people we care for as bids for connection.  By choosing to turn toward, to turn away, or...
Read more
Preventing self-harm among young people in out-of-home care - Research brief
Preventing self-harm among young people in out-of-home care - Research brief
Many young people in out-of-home care are at an elevated risk of self-harm and suicidality. The reasons range from early exposure to abuse, disconnection from family, instability of their living...
Read more
Exploring the meaning that lies beneath young people’s behaviour and supporting change - Practice tool
Exploring the meaning that lies beneath young people’s behaviour and supporting change - Practice tool
This resource has been developed to support professionals to unpack and plan how to respond to identified behaviours that are concerning, challenging and disruptive for young people in their search...
Read more
What works? Promising practices to support young people who self-harm
What works? Promising practices to support young people who self-harm
Why do young people in out of home care self-harm? What are the best predictors of suicide and self-harm? What really works when supporting young people who self-harm in out-of-home...
Read more
Behaviours that challenge: What has happened to you?
Behaviours that challenge: What has happened to you?
Children and young people living in Therapeutic Residential Care in Australia often present with a range of behaviours that challenge us. The complexity and difficulty in working with these challenging...
Read more
Children, young people and sleep
Children, young people and sleep
Many of those of you who know me, know that I have a big interest in sleep hygiene and the children and young people in out of home care (OOHC)....
Read more
Supporting children in out-of-home care to cope with ambiguous loss
Supporting children in out-of-home care to cope with ambiguous loss
When you think of grief and loss, what comes to your mind? You may think of the immense sorrow one may experience. For some of us, we can seek solace...
Read more
The therapeutic power of laughter
The therapeutic power of laughter
"The human race has only one really effective weapon and that is laughter." Mark Twain We all like to laugh. It makes us feel good. Among humans, laughter begins as...
Read more
Book review: What happened to you? Conversations on trauma, resilience and recovery by Dr Perry and Oprah Winfrey
Book review: What happened to you? Conversations on trauma, resilience and recovery by Dr Perry and Oprah Winfrey
Dr Perry and Oprah Winfrey recently released What Happened to You? Conversations on Trauma, Resilience and Recovery. The book tells the story of how adverse childhood experiences cause deep emotional...
Read more
Creating a balance between empowerment and limit setting in therapeutic care - Practice guide
Creating a balance between empowerment and limit setting in therapeutic care - Practice guide
This guide has been developed to support Therapeutic Care carers and staff to navigate the critical balance between empowering children and young people and setting limits. One of the most...
Read more
Responding to behaviours that challenge - practice guide
Responding to behaviours that challenge - practice guide
Much has been written about understanding and managing the challenging pain-based behaviours of children and young people who have experienced trauma and live in therapeutic or out of home care....
Read more
What Was I Thinking? Handling the Amygdala Hijack
What Was I Thinking? Handling the Amygdala Hijack
Remember that time when you put the child you care for back to bed for the fourth time? Your thoughts suggested a level of desperation and wishful thinking, hoping that...
Read more
12 ways foster and kinship carers can promote compassion and self-compassion in children and young people
12 ways foster and kinship carers can promote compassion and self-compassion in children and young people
What are Compassion and Self-Compassion?Compassion is the ability to feel and connect with the suffering of another human being, self-compassion is the ability to feel and connect with one’s own...
Read more
Fight, flight, freeze, and fibbing: Lying as a trauma-based behaviour
Fight, flight, freeze, and fibbing: Lying as a trauma-based behaviour
In almost every session I have run for foster and kinship carers, someone tells a story about a child or young person in their care who regularly lies. I can feel...
Read more
Why sleep is so important for children with trauma
Why sleep is so important for children with trauma
Many of you who know me know that I have a big interest in sleep hygiene and the children and young people in out-of-home care (OOHC). To this end, I...
Read more
New years' resolutions and other goals for teens in care
New years' resolutions and other goals for teens in care
When I was a teen in care, I found the (well-intentioned) focus on my progress from case workers and other adults exhausting. If I tried hard, I made “progress”, but...
Read more
Living with the Fast and the Furious
Living with the Fast and the Furious
You have opened your homes and your hearts to children who are unable to live with their parents. You want to help them access a better life. To feel safe,...
Read more
Can we provide trauma-informed care for children without changing our beliefs about their behaviour?
Can we provide trauma-informed care for children without changing our beliefs about their behaviour?
This blog article was written by Noel Macnamara, Executive Manager - Research and Policy and Deputy Director, Centre for Excellence in Therapeutic Care, CETC. There is a growing tendency to...
Read more
How are restrictive practices interpreted in therapeutic residential care?
How are restrictive practices interpreted in therapeutic residential care?
This blog article was written by Glenys Bristow,  Senior Specialist, Therapeutic Residential Care, CETC. Restrictive practice in therapeutic care The Royal Commision into Violence, Abuse and Exploitation of People with...
Read more
The role fear plays in the lives of children and young people in out-of-home care
The role fear plays in the lives of children and young people in out-of-home care
Fear is a fundamental human emotion triggered by a perceived threat. It serves as a basic survival mechanism that signals our bodies to respond to danger with a fight, flight,...
Read more
Untangling the challenges of FASD and trauma
Untangling the challenges of FASD and trauma
In honour of FASD Awareness Month this September, the CETC brought together esteemed thought leaders Dr Julia Shekleton, Prue Walker, and Noel Macnamara to delve into the complex intersection between...
Read more
The most difficult thing about residential care work
The most difficult thing about residential care work
The most difficult aspect of working in residential care is not managing the behavioural challenges of the children and young people, the demanding shifts, or the lack of resources. Rather,...
Read more