Child assessment session

Assessment Session Context of the Session: A 45-minute semi-structured session was carried out with Emily Carter, aged 8, in a quiet room at her foster home on 1 November 2024. The session was trauma-focused and aimed to explore Emily’s emotional needs at home and school. The assessment was requested by Social Services, in the context of Emily's experiences as a looked-after child and ongoing emotional and behavioural concerns. Engagement & Presentation: Emily presented as initially withdrawn, but she engaged well with the use of a calming sensory bottle. Her general mood was subdued, and she displayed signs of anxiety, such as fidgeting and avoiding eye contact. She was able to maintain focus for the duration of the session. Exploration of Emotional Needs: * Emily was able to name and identify some of her feelings, such as sadness and anger, but struggled to locate them in her body. * She used a colour-based emotion tool to express her feelings, with the colour blue representing sadness and red representing anger. * Patterns in emotion expression included difficulty regulating anger, often leading to outbursts. * Emily lives with her foster parents, who she described as “kind” and “caring.” * She disclosed feeling scared at night and missing her biological mother. * Protective factors included her love for drawing and her close relationship with her foster mother. * She likes art class at school but dislikes loud noises. * Relationships with adults and peers were described as “okay,” but she struggles to trust new people. * Areas of distress included nightmares and feeling alone. * Support strategies mentioned by Emily included talking to her foster mother and drawing. * She described managing big emotions by taking deep breaths and drawing. * She stated that being in a quiet space helps her calm down, while loud noises and arguments do not. * Her understanding of safety, control, and trust was limited, particularly in relation to new situations. * There were no signs of dissociation, but she displayed control-seeking behaviour, such as wanting to choose the activities. * Her self-identified strengths included her creativity and her ability to draw. * She is proud of her drawings and finds joy in spending time with her foster mother. * She would like adults to know that she needs someone to listen to her and understand her feelings. Clinical Impressions: Emily shows indicators of an insecure attachment style, likely stemming from her early childhood experiences. She demonstrates trauma responses, including anxiety and difficulty regulating emotions. Her emotional regulation capacity is limited, but she shows resilience through her creativity and supportive relationships. Barriers to learning and engagement are linked to her emotional needs, particularly her feelings of insecurity and fear. Recommendations: * Continue with trauma-informed therapy to address her emotional needs. * Provide a safe and consistent environment at home. * Encourage her to express her feelings through art therapy. * School-based recommendations include providing a quiet space for her to regulate her emotions and offering support from the school counsellor. * Care system input should focus on ensuring consistent contact with her foster mother and providing ongoing support to the foster family.