THE INTERNATIONAL CHILD AND YOUTH CARE NETWORK
            Issue 37  •  February 2002

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PRACTICE


Rapport and Relationships:
The Basis of Child Care

Michael Burns

ABSTRACT: The smallest or the most basic aspects of child care are often overlooked or underestimated. The manner in which child care workers can approach each child as a separate and unique human being is a critical aspect of professional and humane practices. In relationships, understanding and rapport are based upon particular styles of perceiving the world. This paper presents to the child care worker a background of information useful in developing basic rapport and solid relations with children. It contains case presentations, highlighting the effective strategies and the common mistakes of care givers.
  

Introduction

Perhaps the most important technique for any care giver to master is the ability to develop a good sense of rapport with the child. Many of the strategies employed by workers in the field of child care are employed unconsciously. This article will attempt to make available, through identification and discussion, those strategies that have been developed and time tested.

Rapport is the name given to the magic that emerges when two people interact to form positive or primarily positive impressions or attitudes toward one another. It is a feeling of sameness and accord threaded with a sense of basic trust. Rapport, that first feeling of trust and respect must be present before even the most basic positive relationship is formed. Once rapport is established, it continues to ebb and flow depending on the way the relationship is interpreted by the people within that relationship. Rapport appears to be the core around which all relationships are formed. The more solid and emotionally healthy the core, the more comfortable and growth producing the relationship.

Preparations

At the very base of the ability to form meaningful relationships lies a great deal of self-awareness on the part of the care giver. A sound knowledge of strengths and weaknesses as well as an awareness of personal patterns and strategies used in relationship building is extremely helpful in avoiding and working through roadblocks that hamper effective rapport building. Attitudes toward helping and the need to help children must be explored to ensure that a healthy focus is maintained in the best interests of the child. Effective care givers maintain an air of genuineness that can only come from a great deal of personal awareness.

As well as having an awareness of yourself, an awareness of children both in groups and as individuals is essential in efficient relationship building. The ability to predict behaviours, understand group process and respond to physical and emotional development in children, makes the task of building trust and comfort into a relationship much easier. So often care givers, in settings where emotionally disturbed children are the normal population, lose track of normal or average growth and development in children. They often overreact or fail to react to the child*s maturational process. Along with this comes the focus on negative areas in the child*s life — the problem list.

This focus can taint or cloud other areas or behaviours that may be normal reactions to stimuli provided by the care giver or the treatment setting. Take the example of a seven-year-old child admitted to a treatment setting. The child has just turned seven and has a number of fears on his problem list. Much effort is put in listing these numerous fears and their possible origins. A study of children done by the Gessel Institute shows that children between the ages of six and seven normally experience a great many fears (hg, Ames, 1955). If this seven-year-old child is a visual learner it may appear that his fears have become more intense over the past year, causing considerable concern for parents and care givers. A further look into the Gessel study will reveal that the fears of a seven-year-old child are predominantly visual in nature while at six they are predominantly auditory (Ilg, Ames, 1955). These circumstances could very well be the reason for the increase in the magnitude of the child*s fear. This new information in turn might convince the care giver to focus treatment on acknowledging the fears and moving toward making this child more comfortable with them. The majority of fears will disappear at or around ages eight and nine (Ilg, Ames, 1955).

In developing rapport and strengthening relationships with children it is most beneficial to have an awareness of the normal growth and development of the cognitive and emotional areas of the child. A general knowledge of these developmental areas of the child can be of much use in understanding and predicting behaviour. Always keep in mind that no one individual child follows perfectly any of the developmental stages presently known to the psychological world (Mussen, Conger, Kagan, 1969). The way the child progresses through stages of development and the way in which he or she expresses the common patterns of behavioural, emotional and cognitive stages vary according to his or her own basic individuality and situation (Ilg, Ames, 1955). When individual differences are considered, however, understanding these levels can serve to assist care givers in drawing closer to the children in their care.

Sensory modalities

An awareness of sensory modalities can also be useful when attempting to keep in step with children. Human beings tend to have a favounte or preferred sensory modality. This preferred modality can be identified in a number of ways and by various techniques (Dilts et al, 1980). Children display characteristics that also make this preferred sensory modality identifiable (Barbe, 1973).

Visual children, that is children who organize their world by means of what they see and what they perceive visually, tend to speak using predominantly visual words (Bandler, Grinder, 1976), e.g., "Look, you can see the sailboats really clear now dad. Notice all the coloured angles near the bow. What a sight!". These children are often more concerned with their appearance. They also tend to do better in mathematics, as opposed to reading and spelling, in school. Visual children often breath more in the upper cavity of their lungs (Dilts et al, 1980). Visual imagery is often more easily attainable for these children and they frequently have vivid and colourful dreams. A visual child often needs to see something before he or she believes it to be true and, therefore, understands best when shown how to accomplish particular tasks. Visual children may tend to look at the person who is speaking more often than others (Barbe, 1973).

Auditory children, on the other hand, will speak using words that predominantly relate to sound (Bandler and Grinder, 1976), e.g., "It sounds to me like she won*t listen to what you*re saying to her. I think she has turned you off*. These children are real "talkers" and tend to speak early in their development. Their voice tone is apt to give indications of their moods. Their tempo when speaking is often very rythmic. An auditory child breaths from the diaphragm and usually at a more even rate (Dilts et al., 1980). Reading and spelling are often favourite subjects in school and auditory children may do poorly in math. Auditory children learn best when given verbal instructions and can often listen very well when they appear to be unattentive (Barbe, 1973).

A kinesthetic child is someone who learns best through his or her sense of touch and emotions. They speak most often in feeling words (Bandler, Grinder 1976). e.g., "I have a feeling that if he does not get in touch with what*s bugging him we are all in for a rough time". These children may be labelled "clingers" or "huggers" due to their strong need for physical contact. They are often considered "sloppy", since they pay more attention to how their clothes feel than how they look. These children often breath deep in their abdomens (Dilts et al., 1980). Their voice pitch is slightly lower than visual and auditory children. A Kinesthetic child is often the child who is labelled "emotional". They use a lot of hand gestures when speaking and often count on their fingers (Barbe, 1973). These children do well in projects that require making things with their hands. Kinesthetic children usually enjoy crafts and body contact sports.

The above profiles of visual, auditory and kinesthetic children are not "fool proof" and, like developmental stages, we must be aware of the child*s individuality. However, children presenting profiles similar to the ones outlined above can be hypothesized as being either visual, auditory or kinesthetic. Awareness of the common and normal developments of children as well as an appreciation for how they interpret their worlds, adds a new dimension, a clearer perspective on the child care worker*s interpretation of the child*s world and how to relate to it.

Common Mistakes and Alternate Strategies

I believe that human beings tend to grow and learn as much, if not more, from their mistakes, as they do from their successes. Listed below are a series of case examples which will act as representations for some of the more common blunders made in attempting to establish rapport.

Case Study #1

Billy, a twelve-year-old child, was admitted to the residential unit of a children*s mental health centre when the parents were unable to handle his behaviour. He was referred to the centre by the courts following three convictions for minor offenses.

Billy was assigned to Don, a child care worker. Don*s first job was to develop some type of rapport with Billy. Billy was acting very aloof with all the staff and tended to interact more with his peers. Don tried everything to establish a positive relationship with Billy, however, he tended to remain "cool" toward Don.

Weeks passed and Billy maintained his casual relationship with Don despite Don*s best efforts, until one Monday night, Don happened to catch Billy trying to sneak out of the cottage. Don confronted Billy on his actions, but Billy refused to speak. Don sensed this as being a good opportunity to win the youngster*s confidence. He told Billy that he would not report him this time and did, in fact, withhold this information in the hope of establishing a higher level of trust.

Following this event, Billy seemed to get closer to Don. He asked for favours, which Don gave in hopes of building a positive relationship. Billy was fond of playing basketball and Don stretched the rules a little to give Billy more time in the gym. Don also found himself defending Billy when the cottage staff found fault with him.

Their relationship progressed, however, Don*s treatment interventions did not. In time, Don felt he had been take advantage of. Billy felt poorly about himself for manipulating Don. Billy*s negative view of himself and his manipulative behaviour was reinforced by Don*s ineffective rapport building strategy.

Analysis
Giving special privileges as a way of establishing rapport can be a very ineffective way to build a relationship. Also, some of Don*s favours were breaking the policy and rules of the agency. It might appear to Billy that Don has little regard for rules and authority. A consistent and honest approach with children is most important. Their need for time and space should be respected. However, they should not be allowed to manipulate and the same rules should apply to all.

 

 

Case Study #2

Sally, an eight-year-old child had been referred for assessment to a hospital out-patient clinic. Jan the psychometrist, met Sally in the playroom and established a base rapport with her by playing house in the waiting room. When they entered the testing room, however, Sally became somewhat withdrawn. Jan assured Sally that everything was okay. Sally responded and began relating positively to Jan again. A short time into the test situation, Sally became resistant to answering Jan*s questions. Jan felt it was crucial that Sally answer. She wanted to break Sally*s manipulative behaviour by not giving in to her and insisted that she answer. Jan felt that she had a solid bond with Sally and believed that she would respond. Sally did not respond to Jan*s questions and refused to speak altogether. Jan tried several times to regain her rapport with Sally but without apparent success.

Analysis
In situations where a child and adult meet for the first time and the child is asked to trust as well as perform, the child needs to have every consideration. The rapport at these initial contacts is very fragile. Children should not be coaxed or tricked into answering questions they are uncomfortable with. Total respect for the child and his or her feelings is most important at these times. In this example, Jan could have put more play activities into the test situation which would have relieved the anxiety around the test. Sometimes completing half a battery of tests with the more sensitive and anxious children is a more productive way to move. Some children do need to be persuaded at times and perhaps Jan*s feelings around being "manipulated" were valid. In that case Jan might have left the question unanswered or returned to it at a different time.

 

 

Case Study #3

Hank, a very aggressive and "street wise" twelve year old was admitted to a group home. He was referred because of truancy and aggressive behaviour. Some of his aggressive outbursts resulted in assaults and property being destroyed. Hank appeared to have a very negative view of the world.

Keith, his assigned worker, implemented a treatment plan designed to change Hank*s negative image of himself, and the people with whom he interacted. Keith decided to model a positive image and to minimize most of Hank*s negative statements and attitudes.

Hank was resistant to this approach and seemed determined to prove Keith wrong by presenting himself as having a negative view of the world. They both ended up in a power struggle which cost Keith whatever rapport he had with Hank.

Analysis
Often children with negative attitudes toward themselves and the world need to be listened to and even encouraged to express such feelings. Aggressive outlets can be introduced to allow the child to express his dislike in an active way. However unsatisfactory such perceptions appear to others, they cannot simply be ignored or invalidated. To approach the problem in this way is to ignore and invalidate the individual. When you discount a negative child on his aggression, chances are you may be discounted in return. Keith*s initial approach with Hank was most acceptable. Once this strategy proved ineffective, Keith might have introduced Hank to his negative side and perhaps this could evolve into a "bitch session". Keith might want to give Hank twenty minutes a day where he can be as negative as he wishes (within obvious safety rules) while providing ample opportunity for the development of alternative and more positive attitudes.

 

 

Case Study #4

Joanne, a very introverted six-year-old child, was referred to a day care program because of peer difficulties and low self-esteem. Connie, her case worker, was very cautious with Joanne and presented herself as a warm and caring person. Joanne responded to Connie*s manner and was making steady progress in their relationship. In the hope of strengthening this relationship, Connie promised Joanne a trip to her apartment which was to include Joanne*s first subway ride. Connie had shared with Joanne that she looked a lot like Joanne when she was her age and promised Joanne a look through her photo album.

The day came for the trip to Connie*s apartment and Joanne was excited. Unfortunately Connie was late picking Joanne up being detained with another child who had an upset. When they finally drove to the apartment Connie had completely forgotten the subway ride. Later, when Connie realized her mistake it did not appear to bother Joanne who was enjoying exploring the apartment. The time went by quickly and soon it was time to take Joanne back. This meant there was no time to look through Connie*s photo album, but again this did not appear to disturb Joanne. Joanne returned to the cottage and seemed a little subdued, but it was interpreted as her being fatigued after the long day. Although it appeared that the day had gone well it was noted that Joanne began to systematically distance herself from Connie following the visit. Overtime, even the positive ingredients of the initial relationship disappeared.

Analysis
Promises made during the initial rapport building stage can be very dangerous unless great care is taken in their fulfillment. One broken promise can trigger a whole series of memories of broken promises from the past, and promises are usually unnecessary in most cases. A relationship needs to be solid before it can withstand a broken promise. Connie might have planned all these excellent rapport building tactics and not told Joanne. The surprise element would have been greater and this may have eliminated many disappointments.

 


Techniques for Establishing Rapport

1. Reflecting

Reflecting is a form of "pacing" (Bandler, Grinder, 1975) or "mirroring" and is literally imitating or miming the child*s behaviour. The phrase "walking in someone else*s shoes" fits comfortably here. This technique is probably the most effective way of establishing quick rapport and is the one, used either consciously or unconsciously, by most care givers and therapists.

A typical strategy for reflecting would proceed as follows:

a. The care giver observes the child being aware of the child*s posture and facial expression.

b. The care giver recreates or imitates the child*s posture and expression.

c. As the child moves changing posture and expression so the care giver follows mirroring the child. As this mirroring is taking place the care giver is aware of any emotions or physical sensations (e.g., feeling of anger, muscle tension) that he experiences while reflecting the child.

d. Having successfully mirrored the child*s posture and expression the care giver begins to use similar word phrases as the child. He or she matches the child*s predicates by responding with visual words when the child uses visual predicates, auditory words when the child uses auditory language and similarly with kinesthetic olfactory and questatory language.

e. When the care giver has successfully mirrored and feels comfortable with mirroring the child*s language he or she observes some of the child*s more subtle behaviours, e.g., breathing depth and rate, gestures and mannerisms, eye and head movements, etc).

f. The care giver then mirrors one or more of these more subtle behaviours.

g. As the child changes these behaviours so the care giver follows by matching them with his or her own behaviours. As in step c. the care giver becomes aware of emotions and physical sensations taking place in his or her body as he or she mirrors the child.

h. Having successfully mirrored the more subtle non-verbal behaviours the care giver now mirrors the more subtle verbal behaviours, e.g., voice tone and tempo, inflections, pronunciations, etc.

i. The care giver*s next step is to respond verbally at an emotional level by feeding back verbally the child*s feelings both those stated by the child and by questioning those implied by his or her verbal and non-verbal communication.

These steps may be repeated several times during an interaction with a child. It*s important not to mimic the child in an obvious way which might make the child feel conscious or agitated. It is a more subtle and unintrusive style that is most effective here.

2. Language

What we say, how we say it, where we say it, when we say it and why we say it can cause a wide variety of responses from whom we say it to.

Incongruent language, when our words do not match what our body is saying, as well as mixed messages, responding inconsistently to behaviour or even (e.g., laughing when a child throws his food one time and scolding the same child when he throws his food on another occasion) cause the children a great deal of confusion and anxiety. When wishing to develop rapport the care giver is best advised to stay away from these two forms of communication. Congruent and clearly understood language is most helpful when communicating with children. Communication patterns that are non-threatening and non-directive will most often produce honest and genuine responses. Speaking positively and optimistically can help to lighten a child*s mood or help him or her to relax and speak more freely. Humour is an excellent technique to help the child to become more relaxed and feel less threatened. Verbal strokes such as praise, encouragement, compliments or calling the child by his or her first name in many cases have a positive effect on the relationship.

Language and its wide variety of uses can assist the care giver to develop rapport in many constructive and interesting ways.

3. Physical Contact

Just as we communicate through language so do we speak with our bodies. Touch or physical contact with someone can be a rewarding and meaningful experience. A hand on the shoulder, a pat on the back or a handshake can all communicate acceptance, approval, comfort or welcome. A hug, a back rub, a kiss, holding hands, or an arm around the shoulder, when done appropriately, communicate positive and caring feelings. Physical contact may possibly be the most meaningful method of communicating feelings of acceptance and caring. Children, with very few exceptions, have almost a hunger to be held or touched in some way. Children under stress, either physical, emotional or both, seem to require more physical contact than they might normally require.

Most children have no objection to being touched; however, some children do not like to be touched initially. In most cases it is advisable to ask permission before you touch a child who seems apprehensive around physical contact. There is an invisible boundary or area around all of us called our personal space. This space is different for all of us and most humans are only comfortable allowing certain people into this space. This space should be respected for children at all times being careful not to invade this space until permission is given. Physical contact should be monitored by the care giver in terms of how the child is reacting to being touched. Also, some cultures, families, groups and individuals enjoy being touched more than others; care must be taken not to over-or understimulate these children in a tactile sense. A good strategy here seems to be to make physical contacts with a child only occasionally at first and by monitoring this contact, it can be increased as the relationship develops. Touch is a very powerful, yet very personal way of building trust.

The therapeutic relationship between the child and the care giver, like the mustard seed, can grow into the largest of trees giving protection and shelter for the birds of the air and the animals afoot.
  

Conclusion
It can be argued that rapport is the most important individual characteristic in assisting children to change and realize their potentials. This skill of developing rapport only comes naturally to those who have had excellent role models, and even then most of these people are not fully aware of what they do to establish rapport. ‘Understanding* in any relationship requires that individuals appreciate and respect the way in which the other person perceives himself and the world in general. Rapport and relationship building skills can be taught and practiced and perfected. It is my hope that the awarenesses, techniques and strategies posed in this paper will motivate you to practice and perfect your rapport building skills to help you reach and motivate the children and young adults in your care.


References

Ames, Louis and Ilg, Francis. The Gesell Institute's Child Behaviour from Birth to Ten. New York: Harper and Row Publishers,
1955.

Bandler, Richard and Grinder, John. The Structure of Magic II. Palo Alto, California: Science and Behaviour Books Inc., 1976.

Barbe, Walter B. What We Know About Modality — A Lecture Given to the 25th Council for Exceptional Children, 1982.

Conger, John, Kagan, Jerome and Mussen, Paul. Child Development and Personality. New York: Harper and Row Publishers, 1969.

Dilts, Robert; Grinder, John; Bandler, Richard; Badler, Leslie; and DeLozier, Judith. Neuro Linguistic Programming, Volume 1. Cupertino, California: Meta Publications, 1980.

 

Acknowledgements: The Journal of Child and Youth Care, Volume 2 Number 2

 

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