I would like to use this space to reflect on my experiences of working with children as a social worker in a children’s mental health setting. This post will contain academic literature, it will however act as a creflective space. I hope it can act as a space for you to reflect on your experiences, thoughts, and ideas within the comments too.
We as individual learn self-regulation through our parents when we are babies, infants, and children. This is called co-regulation. Co-regulation is the process whereby one nervous system calms another, producing a feedback loop that is soothing for both. It is defined as warm and responsive interactions that provide the support, coaching, and modelling children need to “understand, express, and modulate their thoughts, feelings, and behaviours” (Murray et al. 2015, 14).
Bruce Perry states that ‘without predictable, responsive, nurturing and sensory-enriched caregiving, the infant's potential for normal bonding and attachments will be unrealized. The brain systems responsible for healthy emotional relationships will not develop in an optimal way without the right kind of experiences at the right times in life’ (2013:3).
For example, if a child grows up in a chaotic and busy home environment, their parent may not have the capacity or space to support their child to regulate their emotions. Moreover, some parents may not know how to regulate their own emotions, thus are unable to model these skills to their children.
Therefore, it is unsurprising that Bessel Van der Kolk states that because of the parent’s role in building the foundations of emotional self-regulation in children, the parent child connection is “the most powerful mental health intervention known to mankind”. Unless infants get positive care and affection, they are unlikely to experience normal physical or emotional development.
Resilient children are “made, not born” (Szalvitz & Perry, 2017:38)However, whilst I was working within a children’s mental health setting, the most powerful intervention, as described above, was not used. We as a system would work individually with the child, helping them learn emotional regulation and distress tolerance skills. However, we know that one cannot learn to self-regulate until they have experienced co-regulation. Yet, we continued to fail to work with the parent/carer(s) or the family of the child to help create meaningful change. Senior leaders did not have the capacity to reflect on this professional feedback either, therefore services became a revolving door for children and young people, and their families increasingly distressed.
The system, unsurprisingly, worked primarily alongside the medical model of intervention. Professionals focussed on diagnosing the young person and 'treating' them through medication and short-term interventions.
Under the medical model, the focus on intervention in this setting is on completing dialect behaviour therapy to help children and young people develop a toolbox of ‘distress tolerance’, ‘emotional regulation’ and interpersonal skills. However, these are in 6 sessions, and as briefly mentioned, only completed with the child. Nevertheless, whilst working with children, I would use this as an opportunity to model co-regulation, to help them understand why they struggle to regulate their emotions and to help them find the words to communicate this with their support network.
Many children did benefit from completing skills work, however when reviewing the work in the final session, some children and young people spoke of their parents not supporting them in exercising the skills, not understanding of their need to engage in distress tolerance work or actively mocking them for practicing mindfulness. Or the children and young people would discuss how their home is too chaotic to have the space or time to complete the work. Demonstrating a lack of regulation friendly environments in the home and/or a lack of co-regulation opportunities in the home.
Reflecting on the contrasting experiences children had whilst completing this work, it was apparent that by employing the medical model of supporting children with ill mental health, we worked in silos and did not work closely enough with the parents. They are here because their parent's did not have the self regulation skills to share. However, the service neglected the child’s living environment and the impact of their micro systems.
Whereas, employing a social model of intervention would look to at the causality as well as working with the young person and their family to change the environment. Using the social model, we would work with the young person’s support network to embark on a psychoeducation journey, with developing a holistic understanding of the young person's needs and how they have come to be where they are as the destination.
Parent's should be invited to undertake psychoeducation, and supported to co-regulate and learn the skills to regulate emotions. They need to be invited to reflect on their emotional regulation and how they encourage and support emotional regulation in their own home.
Importantly, schools are developing ways to work with children which encourages regulation and co-regulation instead of punishing emotional dysregulation.
How do you promote co-regulation in your work with children and young people? Comment below!
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