Working with the Pain: The Emotional Reality of Therapeutic Work with Children

Working with the pain of childhood trauma is emotionally demanding, both for the children carrying it and the adults supporting them.

For children, feelings of fear, anger and uncertainty can be overwhelming, particularly when they cannot find the words to express what they are experiencing. For adults, it means sitting alongside that distress, managing their own emotional responses and accepting that they cannot always make things better.

Some of the most important work we do at Mulberry Bush is also some of the hardest to see.

It happens when a child pushes an adult away, but that adult continues to show up. When progress feels lost, relationships are tested and the emotional weight of caring can feel particularly heavy.

Working therapeutically means recognising the pain beneath the behaviour, making space for difficult feelings and remaining present, even when it is hard.

Because sometimes, the most important thing we can do is not take the pain away, but help a child feel less alone with it.

‍

‍Working alongside pain, rather than trying to take it away

When we see a child struggling, our instinct is often to want to make things better.

To comfort them, solve the problem or remove whatever is causing distress.

But the reality of therapeutic work is rarely that simple.

We cannot undo a child's past. We cannot erase the experiences that have shaped their understanding of themselves and others. And we cannot expect trust, security or emotional understanding to develop overnight.

What we can do is create relationships and environments in which those difficult feelings can begin to be recognised, expressed and understood.

Sometimes this means listening, giving a child space or remaining emotionally available through anger, rejection or distress, while maintaining the boundaries that keep everyone safe.

And sometimes it means accepting that, despite our best efforts, a child may not be ready to let us in.

Working alongside emotional pain requires patience with the child, with the relationship and with the process itself.

It means recognising that meaningful change cannot always be rushed, and that simply being a reliable, thoughtful presence can matter enormously.

The emotional weight carried by those who care

Supporting children who have experienced trauma can be deeply rewarding. It can also be emotionally demanding.

The adults working directly with children may encounter fear, anger, rejection, sadness and uncertainty as part of everyday life.

There may be days when a carefully built relationship feels fragile. When a child struggles despite weeks or months of support. When an adult is left questioning whether they responded in the right way.

And there are times when the experiences children carry affect the feelings of the people supporting them.

This is an important part of the work that is not always spoken about.

Some days, it can feel as though weeks or months of progress have been undone, leaving adults feeling exhausted, discouraged or unsure of what more they can do.

Reflective supervision provides a space to explore these difficult feelings, make sense of what may be happening beneath a child's behaviour and recognise that setbacks do not erase progress. By supporting the emotional needs of adults, we help them remain emotionally available to the children who need them most.

Why reflection matters in therapeutic childcare

Working with emotional pain is not about always knowing the right thing to say or do.

Sometimes we respond well. Sometimes we get things wrong. Sometimes we do not understand what has happened until we have had an opportunity to think about it with others.

This is why reflective practice is central to the Mulberry Bush approach.

Through reflective supervision and regular check-ins with line managers, staff can discuss challenges, make sense of difficult emotions and identify the support they need.

Reflection allows us to consider not just what a child did, but what they may have been feeling, how we responded and what might help us understand the situation differently.

It also creates space to acknowledge the impact of difficult experiences on the adults involved.

Our psychodynamic approach recognises that past experiences and unconscious feelings can influence how people relate to one another in the present. Reflecting on these interactions can help adults respond more thoughtfully, rather than reacting only to the immediate behaviour.

It depends on teams, relationships and a shared commitment to learning from experience.

When adults are supported to think about and manage difficult feelings, they are better placed to offer the consistency, understanding and emotional security that children need.

Progress doesn't always look the way we expect

When supporting children affected by trauma, progress can be difficult to recognise.

It may not look like a dramatic transformation or a sudden change in behaviour.

Sometimes, progress is a child beginning to trust that an adult will return after a disagreement.

Sometimes, it is a child finding the words to describe a feeling that previously emerged through anger.

It might be asking for help instead of withdrawing. Returning to a relationship after a difficult moment. Or beginning to recognise that feeling overwhelmed does not mean they have to face that feeling alone.

These changes may seem small from the outside.

But for a child whose early experiences have made relationships feel uncertain or unsafe, they can represent important steps towards a different understanding of themselves and others.

Progress is not always straightforward. There may be setbacks, difficult periods and moments when old patterns return.

This does not necessarily mean that the work has failed.

Our focus is not simply on encouraging children to behave differently. It is on helping them gradually develop a greater understanding of their feelings, experiences and relationships.

The pain may still be there. But the way a child understands, expresses and lives alongside it can begin to change.

Working with the pain in action

During a lesson, a child suddenly became overwhelmed, shouting, pushing their work away and throwing their books across the classroom.

The teacher calmly reassured the child and, with support from a colleague, gave them space to settle somewhere safe while the rest of the class continued learning.

Once the child was calm, the teacher gently asked, "Can you tell me what made you so angry?"

"I hate the work."

"What do you think made you feel angry?"

After a pause, the child admitted, "I didn't know how to do the work. Everyone else did."

"I wonder if that made you feel frustrated or worried about getting it wrong?"

The child nodded.

What had initially appeared to be an unprovoked outburst was actually a child struggling with feelings of frustration, embarrassment and fear of failure.

By helping the child recognise what they were feeling and why, the teacher gave them something beyond reassurance: the beginnings of an ability to understand and communicate their emotions.

The teacher gently reassured the child, "I know that felt really frustrating. It's okay to feel angry, but throwing things isn't safe. You did really well telling me what was wrong."

The next time the work felt overwhelming, the child might begin to find the words to ask for help rather than expressing their distress through anger.

Learning to carry what cannot always be changed

There is no simple answer to the emotional pain that some children experience.

No single conversation, intervention or relationship can undo everything that has happened in a child's life.

But relationships can offer something different.

They can help a child experience an adult who listens without judgement. Someone who can acknowledge difficult feelings without becoming overwhelmed by them. Someone who remains interested in understanding the child, even when things become difficult.

Over time, these experiences can help children build trust, recognise their emotions and develop ways of managing feelings that once seemed impossible to contain.

This is not about teaching children to accept what happened to them or suggesting they should simply learn to cope.

It is about acknowledging their experiences while helping them discover that those experiences do not have to determine every relationship, feeling or possibility that follows. And the adults learn, too.

They learn the value of patience, the importance of reflection and how much can be communicated through everyday moments.

They learn that meaningful relationships are not built only during the good days, but also through the difficult ones.

Working with the pain, together

For nearly 80 years, therapeutic relationships have been at the heart of our work at Mulberry Bush.

Across our schools, and through the training, professional development and insight we share with others, we recognise the importance of understanding the emotional experiences behind behaviour.

Our work is not about expecting children to leave their pain at the door.

And it is about recognising the adults who undertake this work, supporting them to reflect, learn and remain emotionally available through experiences that can be challenging for everyone involved.

Because Change from within is not about erasing the past or expecting children to become someone different. It is about creating the relationships, understanding and emotional security that allow meaningful change to develop, at each child's own pace.

Learn more about our therapeutic approach