On working with children and complex trauma: meet member Dr Emma van Daal 

5 July 2022

After 6 years in the College of Counselling Leadership Group, Registered Clinical Counsellor Dr Emma van Daal is stepping down from this voluntary role supporting the profession. It’s an apt moment to ask Emma about what she loves about her practice working with children and families, and how perceptions of the profession have changed. Thank you Emma, for all you have done for PACFA and your fellow therapists! 

Can you describe your practice?  

My practice has changed significantly over the years in response to an unfolding and refolding of the clients I work with, but also in relation to my research. In working with complex trauma, as well as with infants and children, I draw from a range of theories and practices. The neuroscience of trauma and attachment grounds therapy in the body and brain, and the principles of trauma-informed practice AND trauma-informed design largely influences how I think/work/research. 

Healing Centred Engagement brings in values of social justice and anti-oppression that agitate for a more expansive conceptualisation of trauma not tied to the individual and means I also contribute to practices outside the therapeutic setting that seek structural and systematic change as an essential component for trauma healing, but also prevention.  

In the last 5 years, undertaking child psychoanalytic psychotherapy training has provided another lens to pay closer attention to how early life relational experiences and the context of these carry forward in development, personality, and relationships. Subsequently, my practice is a contemporary blend of expressive (arts and play therapy), somatic, and psychoanalytic theories that meets clients where they are at in development, in mind, in body, in relationship, in capacity and offers sensitive, affirming, compassionate being with clients.  

Philosophically, I hold a tension between holding post-positivist values, but still working within (and valuing) the tradition of evidence-based mental health practice. As our understanding of mental health expands beyond the individual and we are turning more towards the more-than-human elements of culture and the physical environment for example, I am a huge proponent of interdisciplinary practice that brings together the arts in all its forms and traditions, health/neuroscience, and architecture, eschewing the boundaries that have traditionally separated them.  

For the benefit of those therapists who only work with adults, what is it like working with children?  

Honestly, working with infants and children is the last place I thought I would end up! But, I love it and I am incredibly passionate about early childhood mental health. Children have taught me so much about myself, about our inherent capacities for change, about relationships, and how to be in the moment. Young children have an incredible capacity for growth and change that adult clients with a lived experiencing of complex trauma strive for.  

We need to find hope in our work and be inspired, so being able to witness healing and recovery helps satisfy this, but this is amplified with infant and child clients. Being able to do this whilst creating, playing and/or being playful offers levity in the between spaces of self, and self + other that are often very needed for healing. Children also demand honesty from you; there is nowhere to hide. Leave your ego at the door! It is very liberating. The wisdom they possess cannot be compared to adults and their capacity to be agents of change is considerable.  

Are there particular modalities that work better than others in therapy with children?  

As with all answers in counselling, it depends. Overall, play is the language of children, so any modality or therapy that includes play or playfulness and is child-centred, are recommended. Drawing from approaches that are developmentally sensitive, neuro-affirming, and promote cultural safety is essential. This includes child psychotherapy, play therapy, and arts therapy as well as other family-based approaches that actively include the child/ren.  

A decent part of my work is helping parents or carers to learn how to play. I prefer infant or child-led approaches (dyadic/triadic and group) that are relational and interactional and allow an infant/child to show their caregiver(s) how they would like them to play with them over parent coaching models that can be paternalistic or too general, making assumptions about a caregiver's cultural and linguistic background. In terms of the client I have worked alongside over the last decade, they are not always the best fit and they are often delivered without the necessary adaptations and individualisation needed to meet the needs of parents/caregivers.  

The research in parent coaching models is strong, but they rely on a trickle-down response and can sometimes be concerned with fidelity over support. I am aware of my criticisms of these programs; however, much of my career has been with families seeking asylum, living in DV/FV refuges, and/or have a history of intergenerational trauma and social adversity. 

In working with traumatised infants, there is an urgent need to respond and support change. Babies cannot afford to wait. Dyadic/triadic approaches that are interactional can focus on promoting a secure attachment whilst attending to the individual and relational trauma by providing a holding therapeutic relationship and building a containing narrative(s).  

I would strongly recommend anyone who is interested in working with infants, children, young people and their families to undertake specialised and accredited training that prepares a therapist with the necessary ethical, theoretical, and practical knowledge required for infant and child mental health, as well as seeking supervision from someone who has particular expertise that matches with the clients one is working with.   

You specialise in working with children and families who have experienced family violence and complex trauma. What do you do as a practitioner to maintain your own mental health and prevent burnout?  

Quite simply, I don't work with clients full time. My work is a fluid blend of clinical practice, consultation, and research which helps me to remain inspired, stay informed, and promotes critical thinking and practice skills as well as challenging and expanding my own ways of being as a therapist/researcher/human which is always evolving. Since completing my doctorate, I now have time to reconnect with my art and I can now take more mini-breaks since the COVD restrictions have eased. I come alive in winter, so indulging in the cold helps me be present and energised!  

For the past 6 years, you have been co-Convenor of the College of Counselling (thank you, Emma!). You’re about to step down from that role. What’s changed within the profession during the past 6 years?  

To begin with, PACFA has grown which reflects an increased valuing of counselling and psychotherapy in Australia. It is encouraging to see the workforce expand and with more degrees on offer too. More recently, there have been significant changes at a government level to include 'us' as mental health professionals, appropriately trained, experienced, and workforce ready. Being able to access NDIS and private health funds was a game changer, and although we are still a little way away from Medicare and being included in relevant legislation that would enable counsellors and psychotherapists a wider choice of employment AND reduce the pressure on the mental health system in Australia, the wheels are in motion.  

There used to be a wider ‘us and them’ divide that was unhealthy and fuelled a sense of elitism and need to exclude, but there is now a more harmonious and inclusive approach with a healthy recognition of the ways we are different and in terms of what mental health professions have to offer. We've had to do a lot of soul-searching re our identity, collectively and individually, which is challenging when locked out. This persistence and demonstration of tenacity has made 'us' stronger and consequently, more united, whilst being able to maintain our uniqueness.   

Is there anything you’d like to say to your fellow PACFA members?  

If you are passionate about advocating for counsellors in Australia and/or have innovative ideas on how to keep moving us ahead, join the College of Counselling Leadership Group! The College of Counselling needs support from its members to be able to continue what we have been doing. I would like to say a huge thanks to everyone I have had the pleasure of working alongside in the role (you know who you are), but a special acknowledgement to Pat (Bradley) who has carried the Convenor torch for the past 6 years with erudite leadership, passion, and grace. I have learned a lot and been proud to have been part of a committee which has achieved so much.