Let’s Play! Ideas for Relational Direct Work with Children (on a shoestring)
Social workers and practitioners across the helping professions are required to undertake ‘direct work’ with children and their families. I have been asked to offer ideas to help those getting started (or those who are underconfident) to get started. So here are some of my thoughts about what needs to go in an essential resource pack, some suggestions about how to work with children, some thoughts about how to structure a session, and some links to useful resources. Direct work is all about relationships, communication and creating an emotionally containing space where difficult things can be shared safely. The most essential resource then is the practitioner. Their sensitivity, their ability to connect genuinely, their values, their observation and listening skills, their honesty and so on…
In all areas of children and families work communicating with children (hearing their ‘voices’, understanding their wishes and feelings, explaining things clearly and compassionately, undertaking reparative work) is essential. This blog aims to give practitioners some information to assist them in developing skills by sharing some practice tips based on my experience.
Direct work tool kit (on a budget!)
Create a resource bag or box that you use. Take only what you need for the session so the child is not overwhelmed. If I am going to work with a child or family over several visits or sessions I dedicate a bag or box to them. This helps me prepare in a hurry and also offers a sense of consistency and predictability. I have a huge cupboard full of resources built up over years but most has been gathered together for little or nothing.
From the office -(we all have access to these) Paper, pens, post it notes, glue sticks, seloptape, scissors, envelopes.
From your home – plastic containers from take-aways (for storing things in), shoe boxes, ribbons (from presents, clothing, packaging), interesting card/paper (gift wrap and cards), tin foil, cotton balls, string, unwanted gifts (hand creams/nail products/bags/pretty boxes), toys/games (including dice), gifts from crackers, McDonalds toys from children’s meals, buttons, fabric, outgrown toys, homemade dough/kitchen utensils.
From ‘pound shops’ – craft materials (chalks, paint, brushes, felt pens, coloured papers, glittery bits), hats, masks, party products, containers, toys (people, animals etc), doodle/colouring books, bubbles, stickers.
From car boot sales, charity shops and online – second hand small world toys (play people, animals, cars), small dolls house, simple games, children’s books (that tell a social story), tiny organza gift bags, party novelties.
Found items- stones, feathers, pine cones, twigs, shells.
Practice tips:
Prepare carefully if there is time. Have a pre-prepared kit you can use when time is short.
Do adapt your style to meet the child’s developmental stage. Children and young people who have experienced trauma, abuse or neglect need direct work that speaks to their emotional state, which might fluctuate between their chronological and emotional development age.
Children who have experienced early challenges often need to feel in control to feel safe. So offer choices so the child feels a sense of control. However, children need adults who are calmly in charge so limit choices. For example, offering a choice between different size and colour paper or between two possible games.
Think about ‘scripts’ you might use to explain difficult or complex things. The principles of ‘social stories’ (which were developed for people with autism) can be helpful in preparing scripts. These care helpful for children, families and the professional network! Social stories use unambiguous language to break things down into ‘descriptive’ (what is the problem), ‘perspective’ (why is it a problem) and ‘directive’ (how are we going to manage it) (Gray, 1994).
Be flexible and reflexive. Be ready to amend your plans in response to the child’s needs.
Try and build rapport and relationship with the child before embarking on the serious business. Please avoid a ‘hit and run’ approach.
Wherever possible be child-led and actively attentive (avoid distractions/interruptions, comment on the child’s actions (“wow you are thinking so hard/colouring so carefully/being so brave etc”). Look at resources on play therapy and child directed work for some underpinning principles.
Be creative and use multi-sensory approaches wherever you can.
Use relational play activities but use these thoughtfully (for example be wary of any games that use touch). For ideas look at Theraplay games at www.connectedchild.info.
Demonstrate ways you have held the child in mind between sessions. For example “I was eating my tea and I remembered you like fish fingers”.
Create ways of promoting predictability - appointment cards, timing, agreeing a ‘next time’ activity (and remembering to do it!).
Join in! Where possible play with the child and include the parent/carer. Be mindful that parents or carers might have missed out on some early experiences themselves and might need you to emotionally contain them.
Reflect on the session, preferably with peers, supervisors or an observer.
Remember that your intentions are good and any potential harm you might do by making a mistake is outweighed the harm done by not listening to children or explaining things to them. When children are not supported by an empathic adult to express and process their feelings the ‘unbearable’ pain spills out in damaging ways (Sunderland, 2010).
Even if something goes wrong in a session you can repair it. For example by saying “I’m sorry, I think something I just did or said has frightened/upset/annoyed you”, then offer comfort and/or an alternative activity. It might be that you need to address the issue next time you see the child. For example, by saying “Last week x happened, I’ve been thinking about that and…”.
Structuring a session:
A planned session will have a structure, a purpose and be pitched at the child’s developmental level. Ideally, set a routine for your sessions to create a sense of predictability and ‘sandwich’ any potentially emotionally difficult activity between playful or calming ones. For even the most experienced practitioners, or in the best prepared sessions, things can (often suddenly) become overwhelming. So have an activity you know the child enjoys and finds calming ready as a back-up activity in case you need to change your plan.
An example session structure:
The first few minutes should be spent creating a comfortable physical and emotional space for the session and connecting with the child. This might be allowing the child or young person to share their ‘news’, preparing the space where you will do the direct work together, having a drink/snack, engaging with you with the activity/game the child wants to play, or agreeing a plan for the session.
Emotionally contain the session by setting/agreeing a few ‘rules’ so the child knows what to expect and feels safe. Keep these minimal. For example; reminding the child about confidentiality, safety during the session or agreeing how to stop or change an activity if it is too difficult.
Start by using an enjoyable activity for the child. This might be a familiar game, participating in some child–directed play or craft work.
Undertake the piece of work that is your agenda/purpose. Be sensitive to the child and be prepared to amend or stop if necessary. If you do acknowledge this maybe by saying something like “I think this is too difficult/upsetting/frightening to think about right now so we are going to…” Do keep this to a manageable length of time for the child. Very young children, or those who are easily dysregulated, might only manage a few minutes.
Follow on with a playful or calming activity (use the child’s reactions or behaviours to make the judgement which is needed).
Signal that the session will be ending soon. Try and end in the same way with something rewarding for the child (sticker, being read a story, drink/snack, outside play, cuddle with parent/carer).
Useful resources:
Katie Wrench’s Creative Ideas for Assessing Vulnerable Children and Families is an excellent resource. It provides clear instructions and an underpinning rationale for a wide range of activities. I would suggest it’s a must buy for any Social Work students, ASYEs or practitioners who want to widen their repertoire of activities.
A Therapeutic Treasure Box for Working with Children and Adolescents with Developmental Trauma: Creative Techniques and Activities by Karen Triesman is another excellent resource that has photocopiable resources.
For some really great ‘how to’ guidance on making sense of the ‘stories’ children share via their words, play and behaviours and how to create stories that help children understand their situations and begin to heal Using story telling as a therapeutic tool with children by Margot Sunderland is highly recommended. It is readable, inspirational and pragmatic.
Signs of Safety Detailed descriptions of how ‘words and pictures’ and creating ‘safety plans’ are made and the underpinning theoretical constructs can be found in Working with ‘denied’ child abuse: the resolutions approach by Turnell and Essex. Bear in mind that these tools were developed and used by the authors as part of family therapy treatment programme (working alongside safeguarding professionals) in a specific context. The authors make it clear that the approaches and tools can be adapted and developed to fit with different contexts and cases.
We live in a digital age an older children communicate via a wide range of digital platforms. Adapting direct work approaches using digital technology can engage young people. Digital life story work: using technology to help young people make sense of their experiences by Hammond and Cooper offers plenty of ideas. One useful aspect of this book is their descriptions of when things did not go to plan and managing risks. Using digital means requires careful thought so proceed with sensible boundaries and precautions.
Writing and developing social stories: practical interventions in autism, by Caroline Smith provides sample social stories for different ages. Social stories can be really useful for parents/carers, professionals and children because once they have been formulated they provide consistent explanations. There are plenty of resources available online too and you will find plenty of social story ‘script’ examples which use simple, unambiguous language to describe difficult concepts (such as sexual touch).
For some of those really difficult conversations with children (such as explaining abuse) Renee Wolfs Adoption conversations: what, when and how to tell offers some suggested phrasing suitable for different age groups. There are plenty of practice examples of difficult conversations on the website Life Story Works (http://www.lifestoryworks.org/Life_Story_Works/HOME.html)
Direct work: social work with children and young people in care by Luckock and Lefevre is a reader with chapters covering direct work with a wide range of children and situations. Plenty of information about the social work skills required too. A good book to have to dip to have to refer to.
Focussing and calming games for children: mindfulness strategies and activities to help children to relax, concentrate and take control by Deborah Plummer provides a wealth of ideas (with the rationale behind the activity) of games to engage children, calm them and improve their emotional wellbeing. These games can provide the positive ‘sandwich’ activities to a session.
Finally…
Please feel free to print out this blog and use it if you wish. Or you can email me at caroline.aldridgeSW@yahoo.com and I can send an electronic copy. As I find time I shall try and convert some of my tried and tested activities and resources into future blogs. I hope you find this ‘taster’ useful. As always please do give me feedback on how helpful my blogs are. I love hearing how people are using ideas and engaging in dialogue about practice with others! Follow me on Twitter @CarolineAldrid5 to get alerts to new blogs and other ideas/resources. Also look at my other blogs on www.learningsocialworker.com where I share other ideas.
References:
Gray, C., (1994) The new social story book, future Horizons, Arlington
Hammond, S.P., and Cooper, N.J., (2013) Digital lifestory work: using technology to help young people make sense of their experiences, London, British Association of Adoption and Fostering (BAAF)
Luckock, B., and Lefevre, M,. (2010) Direct work: social work with children and young people in care, London, BAAF
Plummer, D.M., (2012) Focussing and calming games for children: mindfulness strategies and activities to help children relax, concentrate and take control, London, Jessica Kingsley Press
Sunderland, M., (2010) Using story telling as a therapeutic tool with children, Milton Keynes, Speechmark
Turnell, A., and Essex, S., (2006) Working with denied child abuse: the resolutions approach, Maidenhead, Open University Press
Triesman, K., (2017) A Therapeutic Treasure Box for Working with Children and Adolescents with Developmental Trauma: Creative Techniques and Activities, London, Jessica Kingsley Press
Wolfs, R., (2008) Adoption conversations: what, when and how to tell, London, BAAF
Wrench, K., (2018) Creative ideas for assessing vulnerable children and families, London, Jessica Kingsley Press
