Case Study A - Sam

Sam was one of those children whose social and emotional disadvantage was well established almost from the moment of his conception. Both his young parents had been ‘in care’; both currently faced homelessness, unemployment and a shared history of substance abuse. Only the intervention of his maternal grandmother prevented Sam from being taken ‘into care’ as soon as he was born. However, Sam was still a regular witness to, and a victim of his parent's volatile relationship, as well as the inability of his well-meaning grandmother to protect him.

By the time he started school Sam was already displaying disturbing behaviour consistent with an attachment disorder. Before the age of six Sam had been excluded from school and been through his first period of foster care. This set the pattern for next four years - periods of foster care, some stable and beneficial and some not, various school placements, some disrupted by Sam's difficult and often out of control behaviour and some by yet another placement move. Repeated attempts to re-unite him with his grandmother (as well as one disastrous one with his mother) all failed. Unsurprisingly this left Sam a confused, angry and a hurting nine-year old boy.

And it was at this stage that Sam's Local Authority decided that he needed the stability that a therapeutic placement with special school attached offered. Sam was referred to Marlowe Child & Family Services.

The road to any semblance of recovery was always going to be a long and difficult one. In his play therapy he re-created his memories of the many violent scenes from his childhood. On occasion he acted out the same scenes at his new home, with staff and with other children on the unit as the target of his aggression. He was full of half-understood misogynistic language which streamed out of his mouth almost continually. His mistrust of all adults, especially younger women (at whom much of his anger was directed) was deep and real and dominated his existence. He was also still confused by the mixed messages still being given to him regularly by his mother and grandmother. And Sam's father, although not seen for over two years, remained a powerful and terrifying figure in Sams life.

However, gradually Sam did begin to relate to the other boys around him. They were all around his own age and had all had similar experiences. While none of the boys readily shared their pasts with each other, there was an unspoken understanding between them. This helped Sam feel less self-conscious as he learned, along with the other boys, to play. Crucial for his development, Sam's chaotic and deprived early life had offered few opportunities to play. There were sparse facilities at home and at school his behaviour frightened most of his peers. At Marlowe Child & Family Services however, he began to express himself in an environment that offered him safety.

His aggressive outbursts did diminish, but did not disappear. But he did begin to talk about not liking his anger. This motivation led Sam to refrain from virtually all swearing, except in his worse out-of-control moments. It wasn't only the effect of his changed behaviour was having on others around him, Sam seemed to like his new found politeness and concern for others for its own sake. He was like a small child with a new toy; it was like he enjoyed the sound of ‘please’ and ‘thank you’ as it came out of his mouth.

Within a year of placement Sam begun to ‘catch-up’ educationally and in many other ways. He seemed to enjoy the routine and structure of school, benefiting from significant individual attention he got from his teacher and the teaching assistant in a class (of just three other pupils). Socially he had grown almost as much as he had physically. Sam was 5.5cm taller and 6kg heavier than he was on admission. What's more he was saying vociferously that he was ready for mainstream school.

There were significant anxieties in the team about this - not least the fear that failure could undermine the progress made so far to Sam's still fragile self-esteem. However, it was felt if he was re-integrated into mainstream school, doing so for the final year of primary school was likely to stand the most chance of success. Thanks to the enormous commitment of the village school, unused to children with such complex emotional and behavioural difficulties, and the support of Sam's keyworker, therapist and Unit Manager Sam completed year 6 and moved to year 7 at a local comprehensive school, with the new friends he had made.

Sam's significant sporting prowess helped him fit in quickly. He was soon first choice for the school rugby, football and cross-country teams. His charm and ability to apologise for his occasional outbursts meant he was liked by most of his teachers.

After successfully completing year 7 and moving successfully in year 8 discussions began regarding the possibility of finding a family placement for Sam - one that could meet his still complex needs. It was agreed the most likely chance of this succeeding would be to keep as many areas of his life as stable as possible. This included his school and continuing individual therapy. A specialist family placement was therefore sought within travelling distance of his Gloucestershire Comprehensive School. This took several months to find, during which Sam's understandable increased anxiety spilled over into difficult behaviour. Fortunately he was able to contain this mostly on the unit, rather than at school.

The family, once found, turned out to be ideal. They were down to earth, enormously understanding of Sam and were skilled enough to allow Sam the time he needed to begin to trust them. A period of gradual introduction and integration began. Sam used this to overcome his own fears and the ambivalence of his Mother and Grandmother. Sam was worried about leaving Marlowe Child & Family Services. It had been the only stable placement he had experienced. However, after just 3 years he moved into a new long-term family placement. After two more years it is still going strong. Sam himself is happy and looking forward to County Rugby trials and his GCSE options.

For reasons of confidentiality, and out of respect for the privacy and dignity of the children and young people concerned, names and other incidental details have been changed to obscure their identity. However, in all of the important details, these case studies are an actual summary of what happened. All imagery used has been created purely for artistic effect by Marlowe Child & Family Services and is ©copyrighted by the owner.