1. THE HOLDING ENVIRONMENT

2. “In some respects the therapy is the
‘order’ of the community and the ego-
functioning and behaviour of the staff.
The milieu, the whole management
structure must reinforce and support this;
if contradicted it will re-enact and echo
earliest environmental failure and
breakdowns.”
John Withwell

3. “A therapeutic milieu must provide the
right emotional climate for its patients so
that they can regain mental health. It will
succeed in doing this to the extent that it
is able to create a human and social
environment which promotes the social
solidarity of staff.”
Bettelheim

4. “Social Care workers dealing with
unintegrated and traumatised children
are frequently at the edge of their
emotional and intellectual capacity.”
Campbell & Draper

5. “Psychological development is based on
the parental capacity to tolerate and
understand a child’s raw emotional states
of distress…. That it is the mother’s job to
make sense of these bewildering
sensations for the baby: to give them
shape, coherence and meaning which
then makes them tolerable.”
Bion

6. “The focus for this is the provision of
primary experiences for each child, in a
dependent attachment with a specific
member of the care team.”
Tomlinson

7. So, questions must be asked….
4.What is it that staff are asked to hold,
or uphold, on a daily basis?
6.How can we create the holding
environment for staff?

8. What is it that staff are asked
to hold, or uphold, on a daily
basis?

9. How can we create the holding
environment for staff?

10. Management’s responsibility:
Continuing source of encouragement,
support, guidance and direction
Democratic approach
Shared sense of responsibility
Foster potential for leadership in others

11. “It is possible to have management without
therapy but not therapy without management.
Management includes safety, boundaries and
all aspects of the organisational structure.
Without these conditions, traumatised children
will not be able to make use of therapeutic
work…in residential and institutional settings
the management structure of the whole
organisation is relevant to the therapeutic
task.”
Menzies Lyth

12. What is it we are asking staff to do
with all this?
To provide a secure base through
the use of themselves as the ‘good
enough’ parent

13. So what can we do?
Provide a safe physical presence to the children
Demonstrate that we are reliable trustworthy grown
ups.
We can try and protect the children from further
harm from others and from themselves (That’s a big
ask)
We can be the recipient of the child’s anger, fear and
confusion (To be the bad object)

14. So what can we do?
We can become emotionally available to the
child, to allow a dependency to develop when
needed
We can meet the child’s primary needs for
physical care (regression may or may not be
involved here)
We can provide clarity and honest answers to
children’s most difficult questions (Why does my
mammy not love me? Why did my brother hurt
me?)

15. So what can we do?
We can be forgiving and non punitive
We can demonstrate an unconditional and non
judgemental attitude at the most difficult times (when
staff have been hurt or lied about)
We can listen, believe, acknowledge, and empathize with
the child around the source of their trauma and suffering.
We can provide new positive experiences which foster
the child’s potential to grow and develop and which
address some of the voids in their lives. (Be they in the
areas of play, education, sensory, or other)

16. So, what can we do?
We can provide the child with the feeling of
been unique and special to someone in their
world. (Special time, individual care and treatment
plan, key worker)
We can strive to manage the child’s anxieties and
return them to the child in such a way that the
child has more control over them.
We can be professional and genuine at all times
and in all our dealings with the children and the
outside world around them.

17. We can provide……
Hope
Joy
Fun