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BUSS® is a relationally based intervention, bringing an appreciation of the role nurture, touch and movement play in the development of bodily regulation in early childhood. Following a neurosequential understanding of development (Perry and Hambrick, 2008), BUSS® works to support foster carers and adoptive parents in understanding both the disruptive impact of trauma on the development of their child's foundation sensorimotor systems and the critical role they can play in ameliorating this disruption. Good bodily regulation offers children a platform upon which relationships, emotional regulation and learning can grow (Lloyd, 2023). LEAPlets is a group for children and their parents and carers, based on the BUSS® Model. It aims to build attachment relationships, supporting parents and carers in understanding and rebuilding their child's foundation sensorimotor systems. This paper brings together two service evaluation projects of LEAPlets carried out by clinical psychologists in training. The first evaluation is of LEAPlets as a school readiness programme for children in foster care in Leeds. The second evaluation is the LEAPlets group in One Adoption West Yorkshire (OAWY) for new adoptive parents and their newly adopted children. While more research is needed, both studies showed improvements for the children in bodily and emotional regulation, communication and relationships, as well as positive changes in skill development, understanding of their child, and relationships for foster carers and adoptive parents. Models like LEAPlets, which address both the relational and sensorimotor consequences of early trauma, may usefully form part of early intervention programmes for care-experienced children. Training to run LEAPlets groups has been developed, and groups are now running in England, Wales and the Republic of Ireland. This will be explored and discussed, with reference to school readiness, impact on foster carers and supporting adoptive families early in their life together. Plain Language Summary: LEAPlets is a group for pre-school children and their foster or adoptive parents. It is based on the BUSS® (Building Underdeveloped Sensorimotor Systems) Model, which understands that when children have had a difficult start in life, this affects them on a bodily as well as an emotional level. We often hear people talking about a child being dysregulated, and by this they usually mean that they're struggling to manage their feelings in that moment. Underpinning good emotional regulation is a foundation of bodily regulation. Without good nurture and care, babies don't get as much loving touch or move around as much as their bodies and brains need for them to develop good bodily regulation. But disruption is different to disorder, and while these children may have difficulties with moving and being overwhelmed by the world around them, it is possible to go back and fill in the gaps in their touch, nurture and movement experiences so that they don't have to use so much energy managing their bodies and things can get easier for them. This means that they're in a better place to play, make friends and relate, and learn. LEAPlets is also a group where foster carers and adopters are supported to understand more about their children's bodily regulation and what they can do to fill in any gaps in their development. The evaluations presented in this article relate to two LEAPlets groups, one for children in foster care and one for children at the beginning of their lives in their adoptive families. The evaluators reviewed research about bodily regulation and children who have had disruption to the earliest parts of their lives. They talked to carers and parents about their experiences in the groups, thinking about what changed for the child, what changed for them and any ideas about how the programme could be improved. [ABSTRACT FROM AUTHOR]

Embedding attachment- and trauma-informed knowledge and skills throughout the services that support children and families who have experienced developmental trauma is vital to meeting the needs of this population. The current pilot study provides provisional data regarding the impact of training delivered by the Gwent Attachment Service to increase awareness and use of attachment- and trauma-informed working across social care teams within Gwent. The training package comprised two-days' training plus six skill development sessions (SDS) delivered to 274 staff within 21 social care teams within Gwent. Staff self-rated their knowledge of, confidence in, and worries about working in an attachment- and trauma-informed way at three time points; pre-training, post-training and post-skill sessions. Statistical analyses revealed significant increases in staff knowledge and confidence pre-post training, plus a significant decrease in worries pre-post training. Whilst a significant decrease in knowledge and confidence, and significant increase in worries was seen between post-training to post-SDS, the final post-SDS ratings remained significantly improved compared to pre-training. Whilst preliminary given the current study limitations, such findings suggest that the current training and SDS programme successfully improved and maintained knowledge, confidence and level of worry regarding attachment- and trauma-informed working. They also demonstrate the feasibility of National Health Service-based teams delivering such training to improve the service offered to children and families affected by developmental trauma, in keeping with the values of prudent healthcare and taking a whole-systems approach to addressing the needs of this population. [ABSTRACT FROM AUTHOR]

Care-experienced youth are more likely than their peers to present with earlier, more severe and more chronic mental health difficulties. This case study presents the development of a Compassion-Focused Therapy (CFT) group for young people who do not live with their birth families due to an early history of abuse and neglect, delivered by psychologists in a social care service. Eight adolescent girls (aged 12–16), who lived in foster, adoptive or kinship care, attended eight face-to-face weekly sessions of a 'Building Your Self-Confidence' group. Most of them attended all sessions, found the group 'enjoyable' and 'interesting', and reported finding it helpful to improve their self-confidence at least to some extent ('a little' or 'yes'). On standardised measures, half of the caregivers reported improvements in their child's mental health but none of the adolescents did themselves. These initial data pave the way to further optimise the application of group CFT for care-experienced youth and inform psychological treatment innovation in youth more generally. Plain Language Summary: Young people who grow up with significant trauma such as abuse and neglect, are often taken into the care of the local authority at some point in their lives when they cannot remain at home. These young people tend to experience high levels of mental health difficulties such as depression, anxiety and post-traumatic stress. Innovative approaches to improve mental health in this population are therefore crucial. In this paper, we describe a therapy group called 'Building Your Self-Confidence', based on a therapy model called Compassion-Focused Therapy (CFT). This group was attended by eight adolescent girls aged between 12 and 16 who lived in foster, adoptive or kinship care. There were eight weekly face-to-face sessions in total, delivered by psychologists within a social care service in the UK. We found that most of the adolescents attended all the sessions and commented that they found the group 'enjoyable' and 'interesting', and that their self-confidence was somehow improved. On questionnaires measuring mental health difficulties, half of the caregivers reported that their adolescents' mental health improved. However, adolescents themselves did not report improvements in mental health in these questionnaires. Overall, this therapeutic group is promising but needs to be refined so that its benefits can be maximised. [ABSTRACT FROM AUTHOR]

BUSS® (Building Underdeveloped Sensorimotor Systems) is an innovative treatment model for children who have experienced developmental trauma. It is based on an understanding that just as a baby needs responsive, attuned and empathic relationships to grow and develop psychologically, attention needs to be given to the impact of the absence of these kinds of relationships on a child's bodily development and regulation. The premise underpinning BUSS® is that these two processes – the need for an attuned caregiver and the progression through predictable stages of motor development – are inextricably linked; one cannot happen without the other. A case study is used to illustrate this innovation in practice, its frame of reference, methods and evaluation. Improvements were seen in physical development, parent–child relationships, cognitive functioning, self-esteem and confidence in parenting capacity. Consideration is given to how this model fits alongside therapies for children who have experienced developmental trauma and their families. This early evidence suggests that BUSS® is a clinically effective and cost-effective intervention that has positive benefits on physical and psychological development for children who have been impacted by early trauma. Further research will be required to establish both the consistency of outcomes and the mechanisms underlying its efficacy, especially in relation to psychological changes. Plain language summary: Babies need predictable, loving care to develop physically and emotionally. They need the grown-ups in their lives to protect them from harm or stress. As newborns, babies are entirely dependent on those adult relationships for their survival – they can't feed themselves and they don't have control of their head or limbs. They need to be held, carried, cared for and played with to grow into their bodies, so that by the end of the first year of life, they're able to move around and are beginning to explore their world and the people in it. Babies in frightening or stressful situations (during pregnancy and once they're born), miss out on these crucial experiences and, as a result, the normal development of their brain and central nervous system is disrupted. This affects how children move and the sense they have of themselves and their bodies – what we call bodily regulation. Good bodily regulation is knowing where our body is without having to think about it, knowing how much pressure or force to use when we're doing something like giving someone a hug or hanging our coat up on a peg. It's knowing that our arms and legs will work together in a helpful way when we're running or climbing. We're much more used to thinking about how early adversity affects a child's emotional or psychological wellbeing, and we haven't paid as much attention to how this affects bodily regulation. BUSS® is designed to bridge that gap – where there has been disruption to these earliest stages of development it's possible to go back and fill in those touch, nurture and movement experiences that have been missed. This paper explores the BUSS® model and hears from a parent about their experience of using the model with their child. [ABSTRACT FROM AUTHOR]

Background : Evidence indicates that the more traditional and behavioural parenting strategies are ineffective when parenting a child who has experienced developmental trauma. Recognising the need to parent with an attachment focus, the current paper evaluates the effectiveness of running the [Enfys] Nurturing Attachments Group, virtually, within the context of the COVID-19 pandemic. Method : A pilot feasibility study evaluated eight bespoke groups. Consenting professionals and co-professionals completed the Brief Parental Self-Efficacy Scale (BFSS), Care Questionnaire (CQ) and the Parental Reflective Functioning Questionnaire (PRFQ). Results : One hundred forty individuals attended the groups, with 51 (36%) completing both pre-and post-measures. The results provide evidence that professionals and co-professionals reported statistically significant positive increases on both the BPSS (d =.55) and CQ (d =.62). For the PRFQ, the results showed a statistically significant decrease on the Pre-mentalising sub scale, a non-significant mid-range score for Certainty about Mental States and a non-significant increase for Parental Interest and Curiosity in Mental States. Conclusion : The study has demonstrated initial viability of effectively facilitating the [Enfys] Nurturing Attachments Group, virtually. Importantly, it has also shown that the group can be run with professionals alongside co-professionals. [ABSTRACT FROM AUTHOR]

Background: Child maltreatment negatively affects the formation of internal schemata of self and other during development, leading to negative adaptations in self-concept and social cognition. Clinical reports suggest the efficacy of psychedelics in treating the psychopathological sequelae of child maltreatment. Altering maladaptive schemata of self and other implicated in negative self-concept and impaired social cognition may be a central mechanism for reducing posttraumatic stress symptoms. Aims: This study aims to assess whether psychedelic use moderates the relationships between child maltreatment and self-concept, social cognition, and posttraumatic stress symptoms. Method: An online survey was completed by 166 participants and included measures of maltreatment exposure and severity, history of intentional therapeutic psychedelic use, posttraumatic stress symptoms, internalized shame, and facial emotion recognition. Results: Child maltreatment significantly correlated with posttraumatic stress symptoms (r =.26 and r =.20, p <.01) and internalized shame (r =.18, p <.05). Of all maltreatment subtypes, emotional abuse and neglect most strongly correlated with complex trauma symptoms (r =.32, p <.001) and internalized shame (r =.31, p <.001). Participants with a history of intentional therapeutic psychedelic use reported significantly lower complex trauma symptoms (d = 0.33, p <.05) and internalized shame (d = 0.35, p <.05) despite similar histories of maltreatment. Differences in complex trauma symptoms (d = 0.66, p <.01) and internalized shame (d = 0.80, p <.001) were largest for participants with a history of more than 5 occasions of intentional therapeutic psychedelic use. A history of more than 5 occasions of intentional therapeutic psychedelic use significantly moderated the relationship between emotional abuse and neglect and complex trauma symptoms (p <.01). No associations were found between maltreatment or psychedelic use and facial emotion recognition. Conclusion: These findings demonstrate that using psychedelic drugs with therapeutic intent is associated with lower levels of complex trauma symptoms and internalized shame in individuals with histories of child maltreatment. Psychedelic use may have therapeutic benefit in treating the posttraumatic sequelae of child maltreatment. [ABSTRACT FROM AUTHOR]

This article highlights the importance of recognizing and working with shame when clinicians are supporting families who have experiences of developmental trauma. This article will help clinicians identify the existence of shame in parents, children, and therapist; differentiate shame from guilt; understand the connection to developmental trauma; and draw information from case examples. This article draws from clinical wisdom and experience, providing possible interventions that may be helpful with this population. Recommendations for future research are also discussed. [ABSTRACT FROM AUTHOR]

This article describes the early life social regulation of the fear circuitry in the brain. In this article, the authors discuss the link between the quality of the caregiving environment and the developmental trajectory of fear regulation systems in the brain. Implications for counseling practices are discussed. [ABSTRACT FROM AUTHOR]

Background: The assessment of children and young people with history of complex developmental trauma presents a significant challenge to services. Traditional diagnostic categories such as post-traumatic stress disorder (PTSD) are argued to be of limited value, and while the proposed 'Developmental Trauma Disorder' definition attempts to address this debate, associated assessment tools have yet to be developed. This review builds on a previous review of assessment measures, undertaken in 2005. Aim: To identify trauma assessment tools developed or evaluated since 2004 and determine which are developmentally appropriate for children or adolescents with histories of complex trauma. Method: A systematic search of electronic databases was conducted with explicit inclusion and exclusion criteria. Results: A total of 35 papers were identified evaluating 29 measures assessing general functioning and mental health (N = 10), PTSD (N = 7) and trauma symptomatology outside, or in addition to, PTSD (N = 11). Studies were evaluated on sample quality, trauma/adversity type, as well as demographic and psychometric data. Distinction was made between measures validated for children (0-12 years) and adolescents (12-18 years). Conclusion: Few instruments could be recommended for immediate use as many required further validation. The Assessment Checklist questionnaires, designed with a developmental and attachment focus, were the most promising tools. [ABSTRACT FROM AUTHOR]

Research into the effectiveness of therapeutic interventions for older children who have experienced multiple forms of trauma within the context of their early development is scant. This article explores the effectiveness of Neuro-Physiological Psychotherapy (NPP): a wrap-around multi-disciplinary, neuro-sequential, attachment-focussed intervention for children and families who present with multiple, clinically significant, emotional and behavioural difficulties. In total, 31 young people and their adoptive parents took part in the study. Baseline measures were repeated and parents and children interviewed. An assessment of the parent/child relationship and child attachment was undertaken but not analysed for this article. Analysis of the repeated measures received statistically significant changes in behavioural regulation, metacognitive executive functioning and externalising and internalising difficulties, alongside an improvement in thought and social problems. An analysis of the parent interviews provided positive results in terms of the children’s engagement in education, an absence of further mental health diagnosis or involvement in the criminal justice system. Further hypotheses are posited regarding the impact of the treatment and further research into the effectiveness of the model outlined. [ABSTRACT FROM AUTHOR]

This article describes the development and validation of a brief screen for developmental trauma appraisals. The 7-item screen was administered to a non-clinical sample of 477 South African adolescents who had experienced interpersonal violence during childhood. In all, 216 participants (45%) met the study criteria for a diagnosis of posttraumatic stress disorder and 41 (9%) met the study criteria for a diagnosis of complex posttraumatic stress disorder. Exploratory factor analysis yielded one factor which had a high level of internal consistency (α = .91) and acceptable levels of construct and concurrent validity for both posttraumatic stress disorder and complex posttraumatic stress disorder outcomes. Mediation analyses indicated that the appraisal screen measures a construct which effectively mediates the relationship between traumatic exposure and the severity of posttraumatic outcomes across a broad range of maltreatment types. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to demonstrate the unique place of understanding and interpreting dreams in the psychoanalytic process while working through developmental trauma. This psychoanalytic process extended over six years and is presented in four phases: establishing the therapeutic alliance, a crisis, working through, and termination. Dreams from each of these four phases of the analysis are presented, and the collaborative work of understanding and interpreting these dreams is highlighted. Evidence is presented that from this analytic work there ensued an amelioration of the impact of developmental trauma and a furtherance of the development of internal psychic structure. [ABSTRACT FROM AUTHOR]

Dyadic Developmental Psychotherapy (DDP) is a relationship-focused therapy characterised by a strong therapeutic alliance, empathy and unconditional positive regard. It seeks to treat the complex psychological problems of looked after and adopted children as they struggle to develop a greater measure of stable functioning in their homes. It was developed by Dan Hughes based on his extensive clinical experience of working with children and families together and is rooted in a close study of relevant theory. DDP can help children who have been hurt and/or neglected within their families in their early years by supporting them to recover from previous trauma and to experience attachment security and emotional connection within their current family.As with any developing therapy, questions have been raised about its clinical relevance and effects. One such critique recently appeared in an article by Mercer (2014) and this will be used to demonstrate how misunderstandings, misinterpretations and the selective use of case studies can lead to misguided views of this important innovation. This article particularly addresses inaccuracies in accounts of the development of DDP as an intervention for looked after and adoptive children and their families, how DDP is practised around the world and how theory underpins the model. Although a lack of evidence derived from robust evaluations is acknowledged, the authors discuss the evidence base that is currently available and plans that are in place to strengthen this. [ABSTRACT FROM AUTHOR]

Despite the evidence linking chronic early trauma with psychological distress, the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) has excluded developmental trauma disorder from its taxonomy. This article considers developmental trauma from an attachment-based perspective and raises some of the difficulties professionals may experience conceptualising the trauma–attachment relationship. It explores the impact of the decision to exclude the diagnosis from DSM-5 on professionals, those who have had traumatic early experiences and their carers. Finally, it presents formulation as an alternative proposition which may better suit those who present to mental health services with attachment- and trauma-linked difficulties. [ABSTRACT FROM PUBLISHER]

The concurrent criterion-related validity of the Structured Interview for Disorders of Extreme Stress (SIDES-SR) was examined in a cross-sectional study of 719 secondary school students attending a high school in Durban, South Africa. For purposes of analysis, exposure to complex developmental trauma was defined as exposure to either chronic (>1 month) and/or multiple incidents (5+ types) of interpersonal victimisation prior to the age of 18 years. A series of discriminant analyses indicated that 12 of the 45 items on the SIDES-SR (27%) did not significantly discriminate individuals who had been exposed to complex developmental trauma from those who had not, with the removal of these 12 items from the scale having no significant impact on estimates of the concurrent validity, sensitivity, or specificity of the SIDES-SR. These findings suggest that the SIDES-SR may be characterised by some degree of construct over-representation when applied to South African samples, with further research being indicated in order to not only replicate the present findings but also address the issue of construct under-representation in the South African context. [ABSTRACT FROM AUTHOR]

Objective: To describe a group programme for the treatment of patients suffering the sequelae of childhood trauma. Conclusions: The programme evolved in response to treatment problems experienced by mental health professionals working with these patients. Patient and therapist experiences are reported and the program content described. [ABSTRACT FROM AUTHOR]