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Psychiatric, paediatric & other therapists for children with a trauma history. Where to start?

Therapists - Dani Lucas - Youtube Chapters

Dani Lucas completed her family through adoption and is a skilled trauma informed specialist. Dani shares with us her insights into finding and arranging therapy for children and in supporting others with complex trauma history, family violence and more. 00:00 - Start 00:46 - Who is Dani? 02:20 - How do you work out which therapist to go see from speech therapists to psychotherapists? 05:10 - Tap into recommendations, use your network/word of mouth and do your online research too 07:06 - Be prepared to tell your child's story over and over again like its a movie reel, sharing facts 09:28 - Setup goals, guidelines and expectations early, including how feedback works 11:40 - You will know if you have the right therapist: read your child's comfort level and consider looking for multi disciplined therapists 13:45 - Don't overload your child: ensure flexibility in appointments to cancel and prioritising goals. Wait for the best therapist you identify, don't just jump in with an alternative 16:00 - Use professional bodies websites as a guide to fees and ideally commit to one or two sessions 18:07 - You may be able to access therapy within school hours 19:58 - Remember to consider alternative modalities and non talking modalities.

Therapists - Dani Lucas - Transcript

This is Sonia Wagner, representing PCA Families in one of our recordings that capture lived experience and best practice research-based learning that assist kinship, permanent and adoptive parents/carers in supporting young people.

PCA Families has a zero tolerance of child abuse. I would like to acknowledge the traditional custodians of the land on which we meet and pay respect to elders past and present and express our intention to move together to a place of justice and partnership.

Today we are discussing therapists with Dani Lucas.

Dani is a program coordinator for Relationships Australia Victoria and was previously the Team Leader of Permanent Care and Adoptive Families. Dani is a skilled trauma informed specialist with a Bachelor of Psychological Science and Post grad qualifications in complex trauma, family violence and therapeutic interventions.  Dani is passionate about the sector and the delivery of services to families and children.

00:46 Welcome Dani. What else do we need to know about you?

Thankyou for having me Sonia. I do have a long-standing passion of working with children, families and individuals that have a history of trauma with a journey that started in child protection in the 1990’s. In a professional capacity I have worked across a range of programs with families, young people and then in a personal experience where I have had to navigate the landscape of finding and accessing therapeutic services along the way. It can be a tricky mindfield to juggle through. I’ve got two children of my own. One who came into our family the biological way and one who came into our family through the intercountry adoption program. For both of them we have had to seek therapists and it can be really daunting and going through the uniqueness of your children’s needs on an ongoing basis can be a challenge but very worthwhile and its really worth it to get the correct services for your family.

02:20 There are so many different types of therapists and specialists.  How do you know whether it’s a speech pathologist or a tutor for example that you might need, or a Sensory specialist (ASD) or psychologist, play therapist or psychotherapist?  How do you work that out? What’s the first step?

I suppose it is complex as you say and the first step is to look at the age of your child and what is the most pressing need.  Our first priority when we have children is to fix all their problems and address their needs. But its really important not to overwhelm the child. Sometimes they can need many interventions across the space of 6, 10 or 15 years. It’s important to work out what is the most important area to focus on first. Also factoring in things like cost.  Assessments are expensive. Therapies are expensive. And you will often find if you write down the things that come to mind the most that your child is struggling with that you feel they need help with and then try and explore that. A good discussion point is with a good paediatrician or a good GP. Or even a more well rounded advocacy program like PCA Families or more family counselling can even point you in a lot of those directions and identify what is a good place to start and what you need target with your child.

When you are looking at psychology, psychotherapy and all those kind of things you need to factor in the age of your child. A lot of people jump to talking therapies but with a younger child starting with play therapies or art therapies or those other things that you may not be thoroughly convinced are going to work.

You may get recommendations to completely “out there” type of things like therapeutic yoga, surfing lessons, mind body type things, but for some children that’s the first step in starting to identify different parts and senses in their body. Firstly look at whats out there, explore options and preferably discuss with a paediatrician or GP.

05:10 Where do you go to find those professionals? Is it about getting online, tapping into recommendations or your network or word of mouth?

It’s about compiling a bit of a list from all three. It will depend on where you live – whether you are more rural or you have accessibility to the city where there may be more options. Certainly looking at some of those key words on online web pages. Following it up with a phone call and really trying to understand if they are more in depth in the trauma space that a lot of our families and children come from. There are a lot of psychologists that work with generalised trauma and if you dig a bit deeper and give them a call and dig a bit deeper you may find they don’t work with families made up from adoption or uniqueness. Coming from the space as an adoptive parent it took me a long time to find those people.  There is a lot of leg work to get to that person. Certainly online groups. I know PCA Families do have a talk session and get other parents together and that can be a great resource. You can get a lot of information. Also don’t be surprised if you get a recommendation that doesn’t work for your child. You may just not click or get the rapport going. That won’t mean your child doesn’t need speech therapy. It just means they may just not click with that particular speech therapist. We had a similar experience with our second speech therapist when we moved states. Sometimes it is unfortunately just a bit of trial and error.

7:06 How do you start the conversation with a therapist?  This is a difficult one for caregivers – knowing what to share whether too much or too little.

It is really hard to tell your child’s story over and over again sometimes to a therapist. But you may have to be that person that does that. I was given a recommendation once from an NDIS provider and you just have to really put yourself as if you are watching a bit of a movie when you tell the story as you need to detach a little bit and tell the facts.  Giving that background and context and content of your child’s story is really important. You will get the feedback even verbally or facially from the therapist if they know where you are coming from.

Sometimes it wont come across as the best person that you pull out of the hat and meet all the goals, Sometimes its just someone that has a similar passion and wants to go down that journey with you.

I think its also really important to set up mutual goals early in the piece. Its not problematic to keep coming back to them. A lot of people are fearful, especially if they have been on a waitlist or something, I don’t want to offend the therapist or I don’t want to do this.  But it’s your child’s journey and you’re not going to get the best out of it if you cant have that kind of relationships with the therapist.

Sometimes you can provide them with added resources around context. They will obviously know their profession but you can be giving them some of the background. It’s really important to establish those guidelines and what your expectations are and if they can meet them before you commit to any longstanding relationship.

09:28 How do you build the relationship? What should you expect as a caregiver in terms of contact with the therapist yourself and being informed about their work with your child?

It’s really important to setup those guidelines and expectations from the very beginning. It’s a mutual process. It will depend on the age of the child and if it’s a psychologist and speech therapist and OT. There will be some of that confidentiality exploration. Especially if the child is in their early teens they may ask the child to consent to share particular information. They will always share safety concerns with you obviously.

Working with speech pathologists and OTs, you would setup what works. Whats the feedback? Am I in session, not in sessions, what works for you. Makes sure that is really clear before you start engagement with the therapist. And then regular checkins and to see how its going. You have to set realistic expectations. We all want our children to get the best and we all want to see some type of change but  some interventions can take months or years.  It’s really important not to get discouraged. That fine line. Pause or take a break if you don’t feel its going somewhere. Reassess the goals with the therapist. I’ve had therapists say  I think we have come to a stumbling point, maybe we should try something else or maybe we should bring in one of my colleagues. I’ts really important to keep that discussion open if you find things are stalling. Or sometimes as children enter their teenage years they might develop that bit more of a relationship with the therapist where they become a bit more friendly and therapeutic and that stepback needs to happen again.

11:40 How do you know if you have found the right therapist?

Often it is reading the child’s comfort.  You will often find that children don’t want to engage with therapy especially if they haven’t been doing it for a while or if their friends and peers aren’t doing it. It’s really good to have a therapist that is quite flexible and open with you and with your child. If you are getting that good rapport and discussion you are probably more than 80% of the way there to getting that good therapeutic relationship. When they can have that, oh he is tired today so we pull back and they adjust things to fit in with your child.  If you are getting a very strict and regimented with reaction, you can often find that doesn’t work well with children that have come from a trauma background. They do need some flexibility in that process.

Depending on the age of the child, its good to engage the child into the process and seek feedback. You will always get oh I don’t want to go or don’t want to do this. When they have a good achievement and come out positive and smiling you generally know that you have got that measure quite right.

I think sometimes it’s good to get a therapist with a multi disciplinary background. I had a young person who said to their Mum Im just going to give this person a call and talk to them. The person they were speaking to was a speech therapist that had a background in psychology as well. He was just really ringing him more as the male that I can interact with sort of thing. You can see that they have that bond that was really lovely to see.

13:45 What are some of the common challenges or pitfalls?

I suppose one of the big ones is that overloading. We commonly fall into that mistake if our child is struggling at school or struggling with anxiety or any kind of things we just want to wrap them around and try and fix the problems all at once. The biggest problem we fall into is we often want multiple interventions and we want a quick fix often which is human nature. We are getting quicker and quicker, and covid has slowed us down. Trying not to overload your child. They may be diagnosed with a couple of different things, so really prioritise what is important.

You will find that children who have had a lot of early childhood trauma are easily fatigued and overloaded. They are even easily overloaded just with school work sometimes and you will get that feedback from school that they are disengaging or they are not concentrating or having meltdowns and shutdowns. Often that is just because they are overloaded. If we add too many layers to that it starts to cause more issues than it does help. 

Similar to making snap choices on providers.  There may be wait lists so you may say Im just going to go with this person, but my heart is really with this person. Sometimes its better to wait. They may not be that right person so then you are going to have to start the journey again anyway and you may have put your child off speech therapy or OT or any of that. Its good not to rush and to take that time. I remember taking a year to find one particular specialist for my son. I just wanted to start. Its good to take the time and do the background work and have your questions ready when you find an opening with someone.

16:00 What fees should you expect to pay, or contracts should you enter into?

They do vary a lot. Most of the professional bodies on the websites will have a guideline of what you should expect to pay. Similarly does the NDIS, they have an approved rate. Of course NDIS has its own issues in that certain things have certainly escalated with NDIS and people have bumped up their charges.

Generally across therapies and providers they will be consistent. They are a good guideline to go with.

Some will do less out of pocket depending on your mental health care plan and your financial circumstances when you engage with them.

I find ones that want to lock you in, to be a little bit wary of unless there is a particular reason. I would say commit to a few sessions and then consider if you are going to lock in. Some will have a 10 sessions to say that they need that to get to a point. With some assessments and things like that it will be the case. But just really do your background and make sure it is happening in that sector rather than a one off.

Depending on what you are wanting out of it. Often you may be seeing a psychologist for multiple reasons such as for educational stuff as well as some complexities. They may say we need at least 5 sessions to give you any kind of ballpark and that’s probably pretty reasonable. At least that initial information gathering of one or two sessions should be all you initially commit to.

Sometimes speech pathologists or occupational therapists,  if they are coming into your school will want a firm commitment. But again I think its wise to do one or two sessions to see if that bond starting to happen.

18:07 How does that work with therapists in the school grounds?

It very much varies. It varies across schools. Some of the schools will have a speech pathologist there particular days and they will generally have a psychologist that comes for specific assessments but they are generally to do with funding through school arrangements. I find most people who are using regular speech intervention will have their own speech pathologist who engages with the school at a reasonable time to come in just because it saves the child having to do something else outside of school. Some schools are really inflexible with that too. Its really good to have that discussion with the assistant principal usually as the best port of call. Sometimes special ed support teachers will really help and write a recommendation if they think the therapist should come into the school. 

It does make life easier when they can come to school. But as they get a bit bigger the kids don’t always like to be taken away from their class and peers. So again having that working relationship where the therapist may engage some peers in activities if they go to the school, because then it becomes special time where they get to play a game like Uno at the end of the session. Again weave it into the class with the teacher and have that open communication then it can work really well.

 19:58 Is there anything else to comment on today?

Just the fact that I would say use your resources like PCAF and other groups like that and getting feedback from them on the more alternative programs. Look at alternative programs like horse (equine therapy) programs, art therapy, play therapy. There will be some rogue ones out there so do your research. You will find with younger children or pre-teens, where they are not really into the talking modalities, that they really do benefit from those non talking modalities, particularly with the horse (equine therapy) programs and music therapy.   

A lot of those school holiday programs that work with traumatised youth and adolescents will use that nature therapy connection quite strongly too.


To anyone making the time to listen to this recording, thank you for giving up your valuable time for the benefit of the young people in your life.

Until next time have an amazing week.