Using Trust Based Relational Intervention in Parenting the Adopted Child

By Molly Gratton, LCSW, RPT-S

I am asked regularly if one should parent their adopted child differently than a biological child.

The answer is…YES!  I praise parents when I am asked this as it demonstrates they have something….intuition, forethought, insight…..something that will open their hearts and minds to learn the best way to help their child to achieve success.

Trust Based Relational Intervention (TBRI) is currently the most popular and sought after treatment approach in the adoption world.   I receive daily phone calls from families who are in desperate need of help and guidance for their adopted or foster child.  TBRI was developed by doctors Karyn Purvis and David Cross after over a decade of research and experience working with children, who were later known as “Children from hard places.”  I was blessed in my career to have had the opportunity to train with both Dr. Purvis and Dr. Cross at the Institute of Child Development at Texas Christian University in 2014. The training alone changed the trajectory of my career.  You see, as a clinical social worker and play therapist, I focus my entire career on helping children.  However, helping children from hard places was always the most challenging for me.  As a supervisor of novice therapists, they too struggle the most with these children.  After my training in TBRI, my days became easier, more successful, and I found hope to share with others.  Hopefully, this blog will assist some of you in a way that will provide more success and hope in your days.

Most adopted and foster children have experienced early trauma, often through abuse and/or neglect, in their lives.  Early trauma alters the way the brain is developed. TBRI is guided by the three principles: Empowering, Connecting and Correction.  The relationship with the child is the central focus in TBRI.  Many of these children who come from hard places have experienced so much abuse and neglect.  The behaviors they exhibit are their years of strategies they developed to survive these horrific circumstances.  To ask them to change their behaviors, to fit into our lives and expectations, would be a huge failure and disappointment for everyone.  Why would they give up strategies that kept them alive to try something new for someone they don’t even know?  Relationships are based on trust.  We must work to build this trust through our relationship with them, while gently empowering and correcting, is the key.  The following is a list of key points to remember when parenting children from hard places.

1. Acknowledge your Disappointment. The first thing caregivers must do is acknowledge their disappointment with the circumstances their child survived during their early years.  Acknowledge disappointment that your dreams and expectations you had for an adopted child may be unrealistic for your child.
2. Understand that traditional discipline strategies DO NOT work with children from hard places.  Punishment is counter productive.  Parents who only respond to the behavior, and not to the child, will drive the child deeper into their fear.  Fear is what drive’s their behaviors.  Remember to look past the behavior and into the child’s heart.
3. The Core of TBRI.  Correction of a child’s behavior will happen, but the key is to empower the child while remaining connected to the child.
4. Remember Children from Hard Places Have an Overly Alert Sensory System.  Trauma in the brain will not be healed overnight.  You need to be open to parenting your child like a toddler or infant, no matter what their chronological age is.  Parenting with TBRI is not easy, it is demanding and takes everything you have.  It requires commitment, engagement, and understanding that goes beyond normal parenting.  It goes beyond love.  With these children, love is NOT enough.
5. Start Small and Grow as You Become More Comfortable.  As you learn the principles of TBRI, you will pick up on some things quicker than others.  Know that this is OK!  We all absorb different things at different rates when we learn new skills.  Use the pieces that come more natural and add to it as you become more comfortable with the principles.
6. Explore Yourself First.  As a parent, you must explore your own losses, which can stand in that way of your child’s healing.  You must resolve your own stuff.  When your child reacts to you, your emotional reaction will take over.  Baggage we carry stands between ourselves and the child.  For example, if you cannot take yourself to work on your own grief, you can’t take your child to work on theirs. “You can only take a child as far as you’ve been.” -Dr. Karyn Purvis
7. Create a Support System.  Find people who understand your journey, people who are compassionate and in the trenches with you.  Surround yourself by like minded parents with similar children.
8. Develop Trust with Your Child Through Felt Safety.  This is that the child FEELS safe, which is different from you knowing they are safe.  Create a safe environment with an attachment and sensory rich environment.
9. Meet the Child’s Physical Needs Regularly   Offer regular physical activity, snacks, drinks, rest/sleep. Schedule physical activity for every two hours.  This down regulates the brain chemistry. Balance hand eye coordination.  Create obstacle courses to offer the child the ability to think through their behaviors and their attachment to you.  Playing with them during these moments is deepening your relationship with them.  Often chronic dehydration and malnutrition lead to inability to grow and focus.  This can trigger outbursts.  Regular hydration and snacks improves brain functioning and cognition.
10. Teach Kids to Learn to Recognize their Bodies.  “How does your engine run” helps children begin to recognize how their body is running.  Using the colors red, green and blue (red for too fast or high energy, green for good to go and blue for slow and low energy,) create a sign to hang in your home.  Begin teaching your child to recognize when their body is going too fast (red) or running too slow (blue) or running just right (green).  Offer them strategies for regulating their bodies to get to the green zone.  Maybe they need to hold a pressure point for 10 seconds, do a chair sit up, invite them to use a weighted blanket or a neck pillow, suck on a sucker or chew bubble gum.
11. Be a Detective.  Parents need to learn to recognize the difference between willful behavior or inability to regulate. Gently place a hand on their heart – is their heart racing? Look at the pupils of their eyes – are they dilated? Is their jaw tense? Are they spinning, which indicates seeking a sense of balance.
12. Have Sensory Awareness.  Parents need to learn to recognize sensory behaviors.  What food do they avoid, what activities do they avoid? Touch can be painful to a child from hard places.  Are they struggling with clothing being too tight, too loose, not fitting correctly, or tags and seams bothering them?  Identifying these things early will be helpful to avoid future problems.
13. Never, Never Make Food a Battle.  Too many kids were too hungry for too long.  Parents may know the child won’t starve to death, but the child does not know this.  Offer small snacks to avoid major meltdown while building trust with the child.
14. Make the Day Predictable for the Child.  Transitions and change are difficult for children.  Utilize a warning system.  Offering the child a 10 minute, 5 minute, 3 minute, 1 minute warning.  Use eye contact and have the child acknowledge they hear you at each time warning.
15. Hold the Pause.  When asking children questions, allow the child to process the information going in.   This often takes a longer amount of time than most.  Do not rush them to answer or make a choice when given a choice.
16. Share power.   Sharing power builds trust and empowers a child.  This is the beginning of negotiation.  You will guide the child gently.  Give the child the satisfaction of completing something he enjoys – allow the child to achieve mastery – before ending the activity.  Be sensitive and caring, create structure for the activity.  Parents can share this power, but must still remain in charge.  If you let the kid run the show, it gives them the feeling they are on their own and is counter productive to building trust.
17. Balance Structure with Nurture.  A parent’s job is to be the one in charge, but also provide the nurture.  Families typically go wrong when they drift to one side or the other – either providing too much structure or providing too much nurture.  The best place for kids is to be right in the middle of structure and nurture.  Following the “stick together” rule, TBRI incorporates in their practices,  will assist family in providing appropriate structure and nurturing, while having fun, for the child.

Stay tuned for part two, where we will introduce the Connecting Principles, followed by part three where we explore the Correcting Principles and the IDEAL Response.  If you feel your would benefit from TBRI services for your child, call us at 208-576-6464.