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Before Emma met Sienna*, she’d heard her described as ‘angry and manipulative’, a ‘whirlwind’ and a ‘charmer’.

When Sienna was referred to Take Two, she’d just been moved to a temporary foster home in regional Victoria. Her previous carer had called the foster care agency while she was at school saying Sienna had been very verbally aggressive with him the night before and that she couldn’t keep living with him and his young family. Sienna’s case manager picked up her things, got Sienna from school and took her to a temporary placement that night. It was her 9th foster home in 4 years.

Sienna had been sexually abused by a family member from when she was 9 until she was 11 years old. She’d been removed by Child Protection and the offender had been convicted. She’d gone to live with her estranged father, but tension with his new family meant Sienna’s stepmother told her she had to leave. Sienna had been placed into foster care.

The first time they met

Sienna’s Take Two clinician, Emma, had intended to meet with just Sienna’s temporary carer first, but when she got to the house Sienna was there because she’d been suspended from school earlier in the day.

Sienna fled the kitchen for the backyard with her soccer ball as soon before Emma entered, slamming the door behind her. She started kicking the ball hard against the kitchen wall. Emma asked the carer to explain what she knew about why Sienna was suspended. The ball stopped. Obviously Sienna was now standing against the wall listening.

Apparently, Sienna had fallen over and when another student had gone to help her up, Sienna had screamed at her and pushed her over. She’d then disappeared for over an hour.

When the carer asked Sienna what had happened, all she’d said was that the other student was a ‘dumb bitch’.

Emma said she wished she could hear from Sienna what had happened.

‘I wonder why Sienna was angry,’ Emma said. She put her finger to her lips to indicate the carer to stay quiet. ‘And I wonder where she went for that hour.’

There was grumbling and foot shuffling. ‘Stupid bitch,’ Sienna muttered.

Emma asked Sienna if she could come and sit with her. There was no reply. Emma told Sienna she was coming outside. She didn’t try to make eye contact, and deliberately sat a few metres away, parallel to Sienna rather than facing her. She sat on the edge of the garden bed, low to the ground to avoid physically intimidating Sienna.

After a few moments, Sienna turned and looked down at Emma briefly and saw her top had hearts on it. ‘I hate hearts, they’re soooo lame,’ she said going back to kicking the ball.

After a few minutes, but still not looking at Sienna, Emma started telling her about how she’d seen a story on the TV news about the mouse plague in NSW. She said she’d seen there were thousands of mice everywhere. Emma joked she’d have to move towns if theirs was full of rodents.

Sienna looked at Emma again, saying she loved mice and that when she was little, she’d had a pet mouse. Still kicking the ball, she told Emma about how it escaped and she couldn’t get it back in the cage for 3 days. Then when it died, her mum had tried to flush it down the toilet, but it kept floating back up. Sienna was smiling remembering. She stopped kicking the ball and went to her room, bringing out a photo album. She found a photo of Mr Whiskers to show Emma. After another story about the mouse, Emma asked who the person in the photos on the opposite page was. Sienna’s smile disappeared as she snapped the album closed and put it down on the chair next to her.

‘Mum,’ she said. She stood up and started kicking the ball hard against the house again.

Emma just sat. She could see the kicking was calming for Sienna. The intensity of the kicking gradually reduced.

‘The oval,’ Sienna eventually said. Another long pause and more kicking. ‘That’s where I went. I went to the oval down near the river.’

Second session

Sienna had moved into a more permanent placement when they had their next session a week later. She was on the back deck trying to keep the soccer ball off the ground with her feet when Emma arrived for their next session. The kelpie belonging to her new carer, Jill, was bouncing around her.

Emma had already seen Sienna needed physical activity to regulate her thoughts and assumed she might feel ‘cornered in’ if asked to sit in a small unfamiliar space. Emma had come prepared, wearing her running shoes and suggested they walk down to the oval and kick the ball down there.

While they walked Emma asked Sienna how her week had been. She told her about a couple of funny things that had happened at school that day, how boring maths was, how much she loves PE and how her carer had said she could have Subway (her favourite) for dinner. She also said she really liked having a dog to play with.

When they got to the oval, Sienna told Emma to use the inside of her foot to kick the ball, not her toes. She showed what she meant. After kicking the ball back and forth for a few minutes, Emma asked if Sienna had spoken to the girl she had pushed over. When Sienna didn’t respond, Emma asked if she was still angry. Sienna told her she didn’t want to speak to her ever again. When Emma asked why not, Sienna angrily told her to ‘mind her own fucking business’ and ran off with the ball. Circling back a few minutes later, she'd calmed down and started passing the ball back to Emma again.

‘Because I don’t know what to say,’ Sienna finally said.

Over the last 6 months

By the third session, Sienna was happy to see Emma. After their fourth session, Sienna told Emma she’d spoken to the girl who she pushed over. She said it was ‘awkward AF’, but she’d said she was sorry.

Sienna now catches the bus home after school to drop off her bag and Emma meets her out the front, or comes to the Take Two office, and together they walk to the oval where they kick the ball. The walk is an important part of the session because the exercise is regulating after being at school all day and makes the transition easier for Sienna. Sienna texts Emma to let her know where to meet her. The predictability and having some level of control is also beneficial for Sienna who has had little of either previously.

Gradually Emma started asking about the bad things that happened to Sienna. A couple of times early on she got very angry at Emma and called her terrible things. But time and time again, Emma has kept showing up for Sienna’s sessions, demonstrating she’s not going to abandon her. This rupture and repair of relationships is important for Sienna, who has really struggled with friendships and family relationships since the abuse happened.

Over the last 6 months, Emma has also been working with Jill and Sienna’s school to help them understand how her behaviours are a result of the things that happened to her, and why she reacts to things they wouldn’t expect her to. Her carer and her teachers seem determined to stick by her. She’s still been suspended a few times, but the suspensions have become fewer and shorter. Sienna’s PTSD means she struggles to sit still and concentrate for a whole lesson. Emma worked with the school to get funding for a teaching aide to support her, which has helped Sienna a lot. The aide takes Sienna outside to kick the soccer ball regularly to help her re-regulate and focus. The school staff have increasingly been seeing how kind and caring Sienna can also be. She’s made friends with a couple of others at school, including the girl she pushed over. The assistant principal especially has a strong connection with her.

Emma has also advocated to Child Protection for a targeted care package for Sienna. This is another big assistance, providing more resources for Jill who works full-time to pay fees for the school holiday program and soccer lessons, as well as providing respite care to ensure she gets a break and can keep looking after Sienna. Her Child Protection case manager is doing everything she can to help Sienna get what she needs.

Jill has formed a strong bond with Sienna. She continues to make it clear that while she accepts Sienna as a person, she doesn’t accept all her behaviours. With help from Emma understanding what things are likely to trigger Sienna, they are living harmoniously most of the time. Jill and her kelpie, Chilli, obviously adore her also.

Emma has been consistently pushing Sienna’s tolerance levels to keep talking about and processing what happened to her. There have been lots of hurdles along the way. A couple of times Sienna has found talking about it too overwhelming and has run off during the session. Engaging Sienna in the therapeutic work is a constant balancing act for Emma. When they reached a stable place last year, Emma needed to broach even more difficult topics as part of the therapy, and the relationship ruptured yet again.

As part of the relationship repair process, one day when they were walking back from the oval, Emma asked Sienna if she would like to think about running a soccer training session for her colleagues and her given Sienna’s skills. During the week Sienna texted to say she did want to.

On the day of the training session, Sienna arrived early with a written plan of the training drills and a whistle. She had even asked her carer and Chilli to come and watch. Sienna shone, obviously getting a kick out of the session, particularly getting to tell adults what to do.

‘I can’t remember being around this many adults without losing my shit,’ Sienna told Emma and Jill afterwards.

The mastery of being good at something was an instant self-esteem boost for Sienna. She’s since run a couple more training sessions for the Take Two team, and with Emma’s encouragement is signed up to play both club and inter-school soccer this year. Emma has spoken to her club soccer coach and will provide him with some support to ease Sienna into playing in a team. Together they are hoping next year she might be interested in assisting the younger players with some skills coaching also.

Because of her past experiences, beginning and endings are super tough for Sienna. Emma has already started talking about how one day they are going to end their sessions, so when the time comes in a couple of months Sienna will be better prepared for it.

When asked to reflect on how she has engaged Sienna in the therapeutic work, Emma is realistic.

‘Engagement isn’t something we do just at the start of working with a traumatised child or young person, it’s ongoing. There are ebbs and flows of engagement based on what’s going on for Sienna and the topics I need to broach with her in her sessions. It’s been slow, but I think life is a lot better for her now than it was 6 months ago, and she now has more support to help her get on with her life.’

For more tips on engaging with children who have experienced trauma you can download a free copy of Take Two's practice guide.

*The names of the children and the families we work with have been changed, and models are used in our photographs to protect their identities.

Berry Street’s Take Two program is a therapeutic service helping to address the mental health impacts on children of the trauma they have experienced from abuse, neglect or adverse experiences. At Take Two we see who the child is, not just the behaviour.

We use clinical frameworks, neurobiological research and evidence-informed approaches to repair family relationships and develop networks of caring adults that focus on what the child needs.

Take Two can provide specialist clinical consultancy services, including training to other organisations. Contact us for more information.