TST-FC: Helping Children in Foster Care Manage Their Feelings and Behavior

When a child who has expe­ri­enced trau­ma melts down emo­tion­al­ly, kin and fos­ter care­givers can strug­gle to iden­ti­fy trig­gers and help them calm down. The ram­i­fi­ca­tions of this can be devastating.

“One of the top rea­sons that fos­ter par­ents ask for a child to be removed is that they feel ill equipped, incom­pe­tent and unable to help,” says Kel­ly McCauley of KVC Health Sys­tems, Inc. ​“Fos­ter par­ents want new, prac­ti­cal tools that they can use to make the life of a child better.”

McCauley, in con­sul­ta­tion with Dr. Glenn Saxe of NYU Lan­gone Health, is the author of a pow­er­ful new tool called Trau­ma Sys­tems Ther­a­py for Fos­ter Care (TST-FC) that aims to help care­givers meet the needs of kids and teenagers who have expe­ri­enced trau­ma. The Casey-sup­port­ed cur­ricu­lum includes four inter­ac­tive group ses­sions, where facil­i­ta­tors lead care­givers through role play­ing, hands-on exer­cis­es and reflec­tive con­ver­sa­tions to con­nect what has hap­pened in a child’s life to his or her behav­ior. It also offers detailed facil­i­ta­tor guides, train­ing pre­sen­ta­tions, hand­outs and a fos­ter par­ent resource guide.

As part of the train­ing, care­givers devel­op skills to man­age each stage of The Four R’s:

• Reg­u­lat­ing, when a child is calm and engaged in his or her envi­ron­ment. Con­sis­ten­cy in care­giv­ing reduces children’s anx­i­ety and is key to main­tain­ing well-reg­u­lat­ed emo­tions and behavior.
• Revving, when a child is remind­ed of trau­ma and has feel­ings of fear, pan­ic or anger. Care­giv­er calm­ness is one of most effec­tive strate­gies for deal­ing with this state.
• Re-expe­ri­enc­ing, when a child has a ​“fight, flight or freeze” response to a reminder of past dan­ger. The safe­ty of the child and oth­ers in the home is para­mount, and stay­ing ​“neu­tral” — i.e., avoid­ing argu­ment or dis­agree­ment — can help a child calm down.
• Recon­sti­tut­ing, when a child begins to regain con­trol of his or her emo­tions. Because of the risk of esca­lat­ing back into the re-expe­ri­enc­ing state, chil­dren should be com­plete­ly calm before being asked to dis­cuss the inci­dent or receive appro­pri­ate discipline.

A con­struc­tive tech­nique for dis­ci­plin­ing chil­dren who have expe­ri­enced abuse or neglect is a ​“time-in.” Unlike a time-out, which rein­forces iso­la­tion from the fam­i­ly, a time-in involves close super­vi­sion by the care­giv­er and a calm dis­cus­sion with the child about the sit­u­a­tion. ​“Instead of send­ing the child away, we have the child in the room with us in a ​‘let’s think about it spot,’” says McCauley. ​“A time-in says, ​‘Okay, your behav­ior in the gro­cery store was real­ly out of line. I want you to sit here and think about what you can do dif­fer­ent­ly next time.’”

The TST-FC train­ing cur­ricu­lum has been test­ed by child wel­fare agen­cies and eval­u­at­ed by the non­prof­it research cen­ter Child Trends. It is avail­able online, free of charge.

Go to the train­ing curriculum