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The emphasis should be on creating a calm and settling atmosphere at these times. It is not a good time for opening up new work about the day’s difficulties, though a child may need matters or concerns he has to be referred to and acknowledged. For example, it could be helpful for a back-up carer to acknowledge the carer’s absence. A child’s carer or back-up carer should be generally tuned into his feelings and the preoccupation provides a context for the visit. The visit provides a focus for and is representative of the relationship between a child and his carer.

A manager keeping an overview of the whole group may often be in this role. We need to think about the type of third person support each focal-carer–child relationship requires and include this in the treatment plan. The catalyst role does not have to be provided by the back-up carer. In this sense, it does not seem so necessary that the back-up carer is always the same person. However, unintegrated children in particular do need a level of care that is consistent and provided by a small number of adults.

Deprived parents or carers can find it difficult to see children eating and enjoying their food. Feelings of envy can be evoked and an anxiety that the child’s need will be overwhelming. As well as thinking about the lack of self-esteem and whatever it is focused on, we can help a child’s self-esteem by paying attention to things he can do well and feel good about. The provision of food and drink for children and adults Providing food for traumatized and deprived children is a demanding task, as it requires a trusting relationship for a child to accept and value the food he is being offered.

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