Conference handout for a practical session  - Dr. Janice Filer, 20.09.13

Thinking about touch? (Safe handling of children)

 

Containment theory

Containment Theory (Bion, 1962) describes how a caregiver provides containment through responding sensitively to an infant’s cries and distress. The process involves soothing and touch. Children and young people (CYP) may not have received enough experiences of containment and subsequently, this need, including a need for containing touch, can remain high. Steckley asserts that therapeutic containment – literally through the setting of boundaries and metaphorically through understanding CYP’s distress – is the primary task of childcare.

 

The human need for touch

Humans have a need for touch and its contribution to containment, emotional regulation, attachment and managing stress. However, despite the need for touch, there is a culture of fear relating to touching CYP which makes it problematic. Physical restraint “embodies extremes of both touch and containment” (p541).

​

Touch as risky: staff

There is the potential of touch to defuse heightened emotions but people talk more about the risk of escalating the situation through touch. If you use touch it is important to be in public and have a good relationship with the CYP. People are willing to hug or offer comfort to a CYP but they stress the importance of others providing surveillance to make this safe.

​

Touch as aggression: young people

Many CYP speak of touch in a negative way, to indicate aggression or an infringement of rights: “nobody on this earth should be allowed to touch us at all.” (p554) Most discussions on touch related to the physical pain experienced while being restrained, with over half CYP interviewed describing some of their restraints as painful. On the whole, injuries were not seen as intentional but a result of the struggle of the restraint, although a small minority of CYP felt that staff did intentionally inflict pain.

​

Aggressive touch and staff

Physical restraint was also seen by staff in negative terms, with a number describing the distress and guilt they felt. Over two-thirds of the staff spoke about physical injuries they had received in the lead-up or during a restraint. Some of these were unintentional but some were the result of a deliberate assault. Most people understand the issues contributing to the CYP’s behaviour.

​

Physical restraint, touch and catharsis

Many people seek out restraint in order to meet touch-related needs: “Their emotional needs were not being met by anything else and they needed somebody to hold on to them [p554]” This was more common for boys whereas girls were described as more likely to seek out a cuddle.

The trend towards regulation may legitimize physical restraint over other forms of more nurturing touch. For staff to provide therapeutic containment to CYP in their care, they require support for the demanding and complex nature of the work. More reflection on how touch is used is recommended.

 

References

Bion, W. R. (1962), Learning from Experience, London: Karnac.

“Touch, Physical Restraint and Therapeutic Containment in Residential Child Care”, Laura Steckley, British Journal of Social Work, 2012, 42, pp537-555. (Study involved 78 in-depth interviews (37 CYP aged between 10 and 17 and 41 staff) across 20 residential child care establishments.)

​

​

Handout from practical and theoretical seminars workshops/lectures:

​

1. Importance of touch in attachment 

2. A child's rights to safe touch

3. Research presentation: Using Developmental Movement Play in family therapy to address the issues of DVA

​

Friday 20th to Sunday 22nd September 2013

Green Park Training and Conference Centre, Buckinghamshire

​

​

​

 

​