Although spring officially begins near the end of March, it is often the longer days of April and the transformation of buds into blossoming trees and flowers that make us feel that spring has really arrived. It is fitting that we turn our attention to the prevention of child abuse in the spring, with its annual promise of brighter days ahead. Certainly, we owe the nearly 700,000 children in this country who endure abuse some assurance that their days will be brighter as a result of our determination to do whatever necessary to prevent child abuse.

Realistically, can we prevent child abuse? Perhaps not, but that shouldn’t stop us from putting forth our very best, concerted efforts. Indeed, we are learning and taking seriously the idea that our work must be coordinated and collaborative across all sectors. We know that child abuse occurs in the context of the complex interactions of economic and educational policies, community and culture, and family dynamics. We know that the stresses of poverty, neighborhood and domestic violence, addictions, and mental illness can all contribute to the abuse of children. We also know that, while the presence of any of these may compromise a child’s physical and emotional well-being, they do not necessarily result in abuse or neglect.

We understand that when parents have the support of family, neighbors, schools, churches, physicians, and the larger community, they are in a better position to care for themselves and their children. As our understanding of protective factors deepens, we are better positioned to implement and expand our efforts to offset risk factors.

Effectively addressing child abuse requires that we attend to both the individual and the community. When the young single mother, who is at her wits’ end because she is trying to manage a job, school, and a colicky baby, appears for the regular pediatric visit, it is crucial that the staff take her emotional temperature as a routine part of caring for her infant. It is equally important that there are well-funded community resources that can offer her support at that critical moment and beyond.

Early intervention is good for families and good for the economy. The estimated lifetime cost of a single case of child maltreatment is over $200,000. However, if our young mother has the early support she needs, she has a better chance of keeping her job, finishing school, finding a better job, and enjoying the pleasures of raising a healthy child and achieving personal satisfaction.

Early intervention and support need not be left to pediatricians, mental health practitioners, or agencies. Strong, nurturing neighbors and communities that are supportive of families can get involved and play a role in preventing child abuse and neglect and promoting child and family well-being.

As George Eliot famously observed, “What do we live for, if it not to make life less difficult for each other?”

For parents on the edge and children who have been abused, we no longer need Chicken Little to tell us that the sky is falling, because it already has.  The issue now is how to take care of one another.

By Toni Heineman

For eight years we ran a very successful program in San Francisco for current and former foster teens and young adults. Classes met once a week through the school year to focus on photography and creative writing. At first they met in a community center and moved from classroom to darkroom. When digital photography became affordable and came to dominate the photography world, the classes moved to a computer lab. As the students explored their inner and outer worlds through images, they also read and wrote—stories, poems, and essays. They learned the power of the spoken word as they shared their writing and critiqued their own and each others’ work. Over months of shared experiences the students built strong bonds with each other and with the group.

Everyone agreed that this program was wildly successful. In the process of learning about art the students also learned about themselves, built confidence and self-esteem, and developed important relationships. In that format, we could only reach a few students each year. For years we tried unsuccessfully to figure out how we could replicate it in other communities. Then the Internet came to the rescue! By creating online courses we could make this wonderful program available to anyone with Internet access—not just a handful of foster youth in one city in the country. Of course, there are differences, but the essence of that program—using images and creative writing to promote emotional well-being and build relationships—has been preserved. We have created two new online trainings for our Special Topics Series, xxxx and two new companion decks of Conversation Cards, “Lost and Found” and “Word Power.”

I’m very excited today to release “Using Images for Self-Expression,” created and taught by Amanda Herman, who taught the Fostering Art Program for many years. Amanda is a professional photographer with an MFA in Social Practice. She has taught art to wide range of students, including adults with disabilities, graduate students at California College of the Arts and currently undergraduates at Smith College. The activities suggested in this course reflect Amanda’s acute awareness of the very wide range of resources available to those working in schools, community centers, group homes, and agencies, and other programs serving children and youth.

The companion deck, “Lost and Found,” guides participants on storytelling scavenger hunts. These are great activities that spark really interesting conversations about losing, keeping, searching, finding, etc. Every story is different—depending on the group, the cards they select, the environment, and the images they choose. And—they’re fun!

Keep your eyes open for the launch of the next online training to grow out of Fostering Art, “The Healing Power of Words,” created and taught by Amy Kaufman Burk. Amy holds a Doctorate in Mental Health and, in her first career, saw adolescents and adults in psychotherapy—work she loved. When a move took her family from California to North Carolina, she turned to another passion—writing young adult fiction and teaching writing to high school students. Her first novel, Hollywood High: Achieve the Honorable, explores homophobia among high school students. We are thrilled that she has offered her talents to A Home Within for this wonderful course to help those of us who are not creative writers, learn how we can help children and youth put their ideas and feelings into words in ways that can help them heal from the large and small hurts in life.

“Word Power,” the companion deck of Conversation Cards offers an abundance of ideas for getting children and youth involved in writing creatively about their ideas and feelings. Importantly, the cards give prompts for thinking about how words can help to make hard feelings easier. And, even if what they are writing about isn’t always pleasant, children and youth can learn that the process of writing can be fun—and very satisfying.

We all go through changes. We are both the same and different as we move through life. So it is with Fostering Art. It was wonderful in its first format. Trite though it may be, I think of it as a wonderful caterpillar that lived for a while in San Francisco and is now spreading its butterfly wings throughout the Internet. I do hope that you will use, enjoy, and gain from what we have learned in this transformation.

By Toni Heineman

Among those coming for the festivities will be some whose reason for travel is not for their own pleasure but for the amusement of others. These are the young girls and boys who have been caught in the web of sex trafficking.

Their presence among the fans and partygoers may not be obvious; in fact, they may barely see the light of day. Among the victims will also be Bay Area residents, whose pimps are only too eager to take advantage of the increased sex-for-hire population.

Their purpose is to serve others in the shadows. In this world, they exist only to make money for their pimps. They surrender their bodies for the sexual gratification of those able to pay the right price, and too often they lose their souls as well.

The Super Bowl and other professional sporting events draw large crowds —mostly male — giving organized crime easy access to an audience that might easily be seduced into engaging a prostitute amidst the anonymity, and drug- and alcohol-fueled exuberance, of the occasion. Of course, some travel to these events precisely because they know that sex will be readily available.

According to some experts, the Super Bowl is the largest human trafficking event of any year. Others contend that, for those being exploited, Super Bowl Sunday is just another working day

Regardless of the day, trafficking victims have to turn a certain number of tricks to earn a meal and avoid a beating. Ultimately, it doesn’t really matter if children trapped by sex trafficking have some days when they are required to service fewer perpetrators than others. What matters is that they are enslaved—their bodies and lives are no longer their own.

We know that some groups of children and adolescents are more vulnerable than others to being pulled into the sex trade and that foster children are prime targets for pimps. Children whose parents have been unable to care for them do not have the security that comes from being well loved. When they are repeatedly moved from one foster home to another, their sense of being unloved and unlovable only grows.

It is hardly surprising that the attention and gifts of a pimp easily convince them that they have—at long last—found someone who will love and care for them. This may be especially true if the pimp matches the image of a father figure. There are many misfortunes in the lives of foster children—the fact that physical neglect leaves them vulnerable to sexual exploitation is among the most tragic.

Whether truth or urban legend, the idea that the Super Bowl is among the most lucrative venues for sex trafficking has brought public attention to a problem that too often lurks in the shadows. We remain confounded by sex-for-hire. Too frequently, we blame the victims, forgetting that most have barely crossed the threshold between childhood and adolescence, with some still children by any measure.

If all of the attention generated by the Super Bowl helps to bring attention to the sexual exploitation of children, that is a good thing. If we look away the following Monday and ignore the problem over the coming year, we should hang our heads in collective shame.

By Toni Heineman

For better or worse, holidays highlight the unique dynamics, traditions, and culture of a family.  For many, getting together to prepare or share a meal is the centerpiece of holiday traditions. For others, the holiday wouldn’t be complete without the traditional athletic activity—whether everyone gathers in the outdoor air to play or inside, in front of a screen to watch.

And, whether openly acknowledged or tacitly denied, holiday traditions often include predictable arguments, an annual unpleasant dram
a, and/or the expectable misbehavior of one or more family members. Whether these are relatively serious or benign, they are part of the family tradition and, ironically, part of what holds some families together. All the players know their parts—after all, they play the same roles year-after-year–but  a visitor might feel uncomfortable and confused by the unarticulated history and meaning of a family’s own swirl of dynamics..

For many foster children and youth, holidays often bring feelings of displacement, confusion, and being with a family but not of a family—a visitor rather than a member who truly belongs., This feeling of being on the outside can be as overwhelming for foster children as an abundance of food gracing a holiday table.

Feelings of unease are just one of the ways that holidays can be emotionally loaded for foster youth, particularly for those who enter the system because of neglect, which is the case for 85% of those in care. Many of these children were removed from incredibly chaotic environments where food was often scarce, and actual meals were rare and unpredictable. Parental attention was likely just as scarce and capricious—shifting among anger, despair, or withdrawal–with an occasional unexpected smile or hug also making an appearance, adding to the confusion.  Holiday traditions in these families, if they existed at all, are more typically marked by vague or explicit threat and disappointment.

The move to a family with sufficient food served at regular times, with routines that govern waking and sleeping and almost everything in between, can be a welcome relief, but can also create for children a painful awareness of what has been missing from their lives. Shifting into an environment that is relatively stable emotionally—one in which positive actions or feelings bring smiles or praise and misbehavior elicits appropriate disapproval and/or consequences—can be a surprisingly difficult adjustment for children who have known only chaos and unpredictability.

The holidays often add to this already complicated mix by evoking internal states of excitement, confusion, and vulnerability as a child or teen ventures to hope for a special gift, or nurtures the even more dangerous wish to feel a part of the family, to leave behind the constant struggle of trying to fit in and instead capture some elusive feeling of belonging.

The experience of belonging is our heartfelt holiday wish for all foster youth.

By Toni Heineman

Over two hundred retired generals and admirals have banded together to call attention to the alarming consequences of our failure to care adequately for this nation’s children. Mission: Readiness reports that 75% of the young adults who, in the past, have been the most likely to join the military are “unfit to serve” because of poor education, obesity, or a criminal record. Given the high numbers of foster youth who fail to graduate from high school, spend time in jail, and suffer multiple serious health problems, including obesity, it is sadly safe to assume that they are overrepresented in the group of those who are not eligible for military service.

We should all be concerned about the implications for the individuals who make up this sobering statistic. As taxpayers, we should be alarmed that our failure to invest in our children’s health and education has not only jeopardized these lives, but also our national defense. As citizens, we should be ashamed that the children we have promised to care for when their parents can’t are among those who are unable to serve their country. This is not an argument that our armed services should be staffed by those who grow up in the foster care system. It is an argument that when we step in as surrogate parents we make an implicit promise to give foster children basic health care and education.

We owe them care that prepares them for a full range of adult choices.

Photo Courtesy of “US Army”

When foster youth are unable to serve in the military they are cut off from one avenue of educational opportunities. They also forego the opportunity to benefit from the intangible skills — such as leadership, teamwork, and resource management — that are integral to military life and can translate into success in civilian life. When foster children are unable to serve in the military, they are deprived of one important choice of citizenship — a chance to serve and defend their county.

Over 20,000 youth age out of foster care each year.
If only 5,000 of them can meet the minimum requirements for military service, we have deprived 15,000 citizens of important opportunities and our country of a substantial pool of young adults who might want to pursue the military option. By implication, we have also deprived our country of many other contributions from youth who want to enhance our economy and our culture in significant and satisfying ways but are unequipped to do so.

The retired military leaders who are leading the readiness cause have a long view of what is at stake and what it takes to develop well-prepared armed services. We should heed their wisdom; they have studied war and fought to bring us peace. They tell us that we must not delay in addressing the shortage of military personnel and that we must do this today by meeting the immediate health and educational needs of very young children if we want them to be prepared to serve in the future.

Preparing children for the future begins today.

By Toni Heineman

It’s hard being the new kid at school. You don’t know what to wear or how to find your way to the cafeteria or the restroom. You don’t know which teachers have a reputation for kindness and which for meanness. You don’t know who will be your friend or who will make fun of you.

 Photo credit: cafemama / Foter / CC BY-NC-SA

Foster kids are the new kids and over and over again. Sometimes five or ten or fifteen times before they graduate—or, more likely—drop out. Research coming out of England’s Warwick Medical School found a correlation between frequent school changes and the development of hallucinations and transient psychotic symptoms in adolescence. These findings emerged for adolescents who had switched schools as few as three times.

The author suggests that feeling marginalized creates a vulnerability to the development of emotional problems. Certainly we all prefer the feelings of belonging to those of trying to fit in. Belonging to a group gives us comfort. We know the social rules of the group and count on the members for care and companionship.

Situations in which we feel as if we don’t fit in create anxiety. We expend a lot of energy scanning the relational landscape, trying to understand the implicit rules of social interactions. We may suffer the injuries of rebuffs that come from misreading cues or misunderstanding the group culture.

Many kids attending a new school can find comfort in the familiar routines of family at the end of the day. Even if they are in a new home in a new community, the smells and sounds and tastes of family life will be largely unaltered. Parents and siblings will behave in the same endearing and annoying ways.

In contrast, for foster kids, being the new kid at school usually also means being the new kid at home—whether in a new foster home or a new group home. When home is also new territory they find no respite from the unfamiliar–no calm space in which they can relax into what is known to be safe

 Photo credit: woodleywonderworks / Foter / CC BY

Children and youth in foster care live on the margin, not just in school, but in life. A marginalized life is a stressful life. We know that when stress reaches the level of toxicity it can and does have profoundly negative physical and neurological effects. Human beings are simply not designed to operate at high levels of stress over extended periods of time. We need a break—time for our bodies and minds to recharge.

The instability in foster children’s lives leaves them little opportunity to recharge. They bounce from one new and stressful situation to the next. They are the new kid at school and then, perhaps before their records from the old school have even arrived they are the new kid yet again. It is little wonder that so many stop trying to fit in or hoping that they will ever belong.

By Toni Heineman

Facebook is filling up with photos of kids heading off to the first day of a new school year. Some proudly sport a new uniform indicating that they have moved from lower to upper school or from middle school to high school. Others are beaming in outfits we assume have been chosen for the occasion.

With all those smiling faces and fancy outfits, it’s easy to forget that some of the children taking selfies on the first day of school may also be thinking about whether the judge, or their lawyer, or their foster mom, or their “staff” would want them posting to Facebook. They probably know that the law says that there shouldn’t be any pictures of them online.

Being the new kid can be stressful for any child, but for foster children, simple steps to making new friends – explaining who you are, where you come from, who you live with and why  – can be almost intolerable. Foster children often feel ashamed of their status—even having a “status” sets them apart–not wanting others to know that the adult who brings them to school is their second, third, or fourth caregiver in the last year, or that they have been in more schools than they can remember. If their caregiver is of a different race or ethnicity, other children may innocently inquire. But, the seemingly simple question, “Who’s that lady?” can trigger powerful emotions, and overwhelm a young foster child’s capacity to supply a coherent answer. Depending on the age of the child and the length of time she has been in that foster home, she may actually have very little understanding or knowledge of her caregiver.

While we might forgive young classmates whose natural curiosity inadvertently provokes feelings of shame or embarrassment in a foster child, inappropriate questions from teachers, counselors, coaches or other staff are unfathomable. Children have told me that they’ve been casually asked, in earshot of other children, “So why is your dad in jail?” or “When is your mom getting out of rehab? Do you get to visit her?”

One of the ironies of foster care is that children’s private lives are simultaneously closely guarded and openly displayed. When parents are absent, it sometimes seems as if they belong to no one and everyone. David, who lived in a group home and attended a prestigious private school on scholarship, described an incredibly humiliating incident that occurred near the end of his senior year when he was struggling to figure out whether he would be able to attend college. He said that he had been preoccupied, not sleeping well, and having trouble keeping up his grades. Unexpectedly, he was called to the office from his math class to find his mentor waiting. There, in front of the office staff and anyone who came or went, his mentor berated him for missing baseball practice, ending his angry lecture with “No one can count on you. You just let people down.” Near tears, David said, “I don’t think that would have happened to a regular kid. Parents wouldn’t let that happen. He’s not my relative or guardian or anything. Why does he have a right to come into my school and get me out of class?”

Whether the mentor had a legal right to see David at school is a question separate from the clear sense of entitlement to air a personal grievance with David in the public arena of school. For reasons that were not clear to David, the mentor, who should have been helping him, was allowed to intrude into the school, which until then had provided a safe and supportive environment, as David’s success attests. David is likely correct, that if he hadn’t been in foster care, the mentor probably would have asked them to meet with David at home, and the school would not have allowed him to interrupt David’s school day.

It’s easy to forget how hard it can be for children to manage the complex relationships in the classroom, on the playground, and in the time before and after school. This is even more true for foster children who have good reason to be wary of new relationships and whose social skills often lag behind those of their peers. It’s vital that teachers and school staff recognize that the foster care experience often creates particular vulnerabilities, without making being in foster care the defining feature of a young student’s educational experience. After family, school is every child’s greatest laboratory for learning about relationships. Foster children’s experiences and needs may be unique, but by learning to anticipate and respond to them, we can all help to make sure that school is a place of learning, healing and development, rather than challenge, anxiety, and doubt.

By Toni Heineman

Life cannot be lived without loss. We know that, but many of us don’t have to think about the implications of that truism on a daily basis until circumstances, either within or beyond our control, compel us to attend to it. If, for example, we are fired or choose new employment—whether with anxiety or excitement—we face the loss of familiar routines and co-workers and must find ways of adjusting to our changed condition.

Some losses seem significant in the moment, and then fade or lose meaning with time. Parents may mourn the loss of one phase of childhood as they prepare for their child’s first day of school; there will be only one very first day, but the beginning or end of every subsequent school year means that another phase of childhood is left behind. These, like many losses, will likely shed their noteworthy status and be taken in stride as just one more marker of the passage of time.

This is the opening of the introduction to Relational Treatment of Trauma, released this week by Routledge. I am quite honored to have been given the opportunity to create this volume, which brings together papers and book chapters that I have written over a number of years. Writing is for me, as for so many, an interesting and maddening process. Reviewing years of my own writing was also an interesting, though quite different, process and, happily, not nearly so maddening as approaching a blank sheet of paper or computer screen, waiting to be filled with the words that sometimes easily tumbled from my mind and sometimes could be pried loose only with great difficulty.

This book about loss and hope centers on foster children and those who care for them—a community that knows all too well the painful vagaries of loss. Those in and around foster care also know the power of hope in keeping organizations, as well as individuals from plunging into despair.

Uncertainty virtually defines life in foster care. It interferes dramatically with mourning, yet paradoxically helps to keep hope alive. Uncertain loss permeates every aspect of foster care, and anyone who comes into contact with a foster child or teen—from caseworkers, attorneys, and teachers to judges, therapists and community volunteers—will come to know more than they wish to know about uncertainty and unpredictability. Everyone including the adults responsible for their care and the peers who befriend them will be affected–some more and some less—by the instabilities of life in foster care.

I enjoyed creating this book, both the process of writing the individual pieces and the process of trying to make them come alive as a coherent work.

My personal hope is that in the chapters in this volume you will come to a deeper appreciation of the inexorable connection, despite a tidal wave of failures, between determined, creative thought and the capacity to hope. This volume spans my thinking and writing about loss, anxiety, trauma, and hope. Some of the chapters focus on the therapeutic process—when it works and when it doesn’t, including clinical work with children who have suffered emotional, physical, or sexual abuse yet remained with their family of origin. Other chapters reflect on the psychological meanings and constructs that emerge from life that includes trauma, whether from abuse or the chronic loss that marks life in foster care. Some chapters include clinical material that illustrates the protective nature of functional families, in contrast to the personal and systemic consequences of relationships that harm or fail to protect children.

Thank you for taking the time to read this. If you also take the time to read the book, I would very appreciate hearing your comments. 

By Toni Heineman

Over the course of National Foster Care Month, I’ve written about the impact of trauma on healthy development in infants, toddlers, and school-age children, noting that the effects can occur in any or all domains of physical, cognitive, emotional, and social development.  I’ve also made the point that any caring adult in a child’s life – teacher, coach, tutor, mentor, or volunteer – can be a healer. At A Home Within, we put it simply: relationships matter because relationships heal.

This week I want to focus on adolescence, a developmental period that actually goes on over many years, from the physical and cognitive changes during the early- and middle-teen years, to the neurological consolidation that can take place well into the mid-20s.

Now, whether confronting social pressures from bullying to dating, bearing up under tremendous academic pressure, or simply adapting to a world that now treats them as adults, many youth are navigating the arenas of family, school, and workplace simultaneously, all while their bodies and brains are undergoing the most intense period of rapid developmental change after early childhood. We all know about the physical changes that happen during the teen years, but late adolescence/early adulthood is also a period of cognitive transformation as ongoing neurological development consolidates the pre-frontal cortex to promote complex decision-making, including risk-assessment.  Because the physical changes outpace the cognitive changes during early and middle adolescence, we see many teens engage in risk-taking behaviors without fully considering the consequences of these choices.  For young people with a history of trauma, of course, the risks increase.  Sexually transmitted diseases, early parenting, anxiety, depression, substance abuse, and self-harm all occur more frequently in adolescents whose early lives were marked by trauma.

All adolescents take risks; traumatized adolescents take more negative (i.e., dangerous) risks in more habitual ways.  For example, they might crave more sexual contact because it reassures them emotionally, but abandonment fears have them so insecure about being left that they don’t ask their partners to use protection.  They might have spent years in a kind of numb, dissociated state that leaves them craving physical thrills, so they ride a skateboard without a helmet late at night, weaving through traffic on a busy street.  They might be so distracted at school, where they have trouble concentrating because of anxiety, that they start drinking in the mornings to calm down.  For adolescents, the stakes are high because their behavioral choices can have significant consequences, and  as they approach adulthood, the world around them expects them to assume increasing responsibilities.  As I’ve maintained, though, every adult who comes into regular contact with a traumatized teen has the opportunity to use that relationship develop to promote healing and healthy development.

Shana, a 20 year-old young woman, waited tables at a busy café.  This was her third job in two months; she usually got fired because she showed up late for her shifts.  Shana had a hard time sleeping, and, unsurprisingly, a hard time waking up. When she got a message from Holly, her boss, who said she wanted to talk to Shana about “what’s going on,” Shana was sure she was going to be fired again, so she just didn’t go into work.  On the following Friday, she went to the cafe to pick up her paycheck, Holly asked her to come into her office.  

“Are you quitting?” she asked Shana. 

“I figured you were firing me.”

Holly explained that she had called because she was worried about Shana, not because she was planning on firing her.   

“Shana, you’re a good worker – when you’re here.  I want you to be able to keep this job for as along as you want it, and I want to be able to give you a good reference when it’s time for you to look for a different job.  But if you quit without giving any notice, or if you keep showing up late, I can’t do that.  If you let me know why you’re having trouble getting to work on time, maybe I can help.”

Shana hadn’t ever thought about getting a reference from Holly; she’d never held a job for very long, and she’d certainly never received a reference from a previous employer before.  After Shana admitted to Holly that she’d had insomnia for most of her life, and that the doctor always told her it was because of anxiety, Holly switched her to the afternoon shift, and recommended a book her sister had used to help her relax.   

Six months later, Shana told Holly she was studying for her GED, and said she needed to change back to the morning shift because she wanted to meet with a math tutor who could only see her in the afternoons.  Holly asked about her sleep problems.         

“I know, right?  But I’m doing meditation at night before bed, and that really helps me  fall asleep. I’ve been waking up pretty early, too.  Can I just try it?  If I screw up again, I’ll go back to afternoons and find a different tutor.  Do you think that’s a good plan?”  

Shana was now thinking through her choices, and better able to plan for contingencies. She’d also approached Holly this time, and asked for her opinion.

Because they have trouble trusting, traumatized teens often have trouble asking for help. Adults may have to offer assistance many times over and be willing to be rebuffed many times before their help is accepted. But when the stakes are so high, the difference a trusted relationship makes can be enormous.

By Toni Heineman