Jack* is nine years old. At the age of eight, he was removed from the care of his parents after being exposed to ongoing family violence, substance abuse, verbal, physical and sexual abuse and medical neglect.
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Records show when his mother was pregnant with him she used drugs, exposing him to illicit substances in-utero.
![Principal therapist and manager of Melaleuca Place, Angela Curcio. Picture: Elesa Kurtz Principal therapist and manager of Melaleuca Place, Angela Curcio. Picture: Elesa Kurtz](/images/transform/v1/crop/frm/fdcx/doc76s93sunplsqsxxbe40.jpg/r0_0_3359_2098_w1200_h678_fmax.jpg)
Jack has been referred to Melaleuca Place, a trauma recovery centre for children aged up to 12 years.
Melaleuca Place helps Canberra's most vulnerable children, those who are living in foster care or out of home care. It is at the "pointy end" of support for those who have experienced severe trauma and abuse.
A trampoline and sandpit are two of the most-used tools, manager and principal therapist Angela Curcio said.
Since Melaleuca Place opened in 2014, about 108 children have been through the unassuming little building, the former caretaker's cottage, next to Dickson College. It's not a short-term fix. Those accessing the service visit every week for about two years.
The rooms are cosy and comfortable. There are toys, dolls and a play kitchen in one room that leads out to the fenced backyard. In another room, a bucket of sand and a cupboard of figurines greets the children. The sun streams through the windows, warming the place up. It almost feels like a home.
The trampoline and sandpit are two of our biggest tools... After doing that for five to 10 minutes they get into a pattern where they're much calmer and they're more likely to engage.
- Angela Curcio
Dr Curcio, one of the founding team members of the service, said the bucket of sand is used in a special therapy technique, and within the sandy landscape chaos ensues.
"The sand tray is a therapeutic technique where the child will come and each session, they pick whatever speaks to them from the figurines and they'll play out stories in the sand," Dr Curcio said.
"Often, they'll play out themes of what's happened to them in the past, and it's really interesting to see how over the sessions they progress through the story."
She said initially, the child will dig everything into the sand and cover the whole thing in water.
"It is very chaotic. Over the course of many, many sessions it becomes more organised as they make sense of and make meaning of what's happened to them."
The multi-disciplinary team, which includes an occupational therapist and a speech therapist, use brain mapping techniques as part of a comprehensive assessment to determine how far below average a child is in their behaviour and forming relationships to target the program to the individual.
"We can't just jump in to talk-based therapy, or the kind of trauma therapy people would assume," Dr Curcio said.
"Because the child's brain has been impacted by trauma, that thinking part of the brain isn't online a lot of the time. That's often why they've been referred, because they're getting into trouble or being violent at school, they're having trouble following directions. They're hitting their peers, they're not learning, they're not sleeping.
"There are so many things going on, we need to pinpoint what developmental age this child is at, and how we are going to get them to a point where they can regulate themselves and trust us. Because they've been harmed by adults, they don't trust adults."
![Angela Curcio in the sand play room. Picture: Elesa Kurtz Angela Curcio in the sand play room. Picture: Elesa Kurtz](/images/transform/v1/crop/frm/fdcx/doc76s93qvxx4x13rjt8e40.jpg/r0_0_3861_2433_w1200_h678_fmax.jpg)
A growing body of research has shown the impact of trauma changes the brain's size, structure and the way it organises information, Dr Curcio said. Research has also shown that patterned, repetitive and rhythmic activities can help regulate the brain.
"The trampoline and sandpit are two of our biggest tools," she said.
"We often get them to do activities where they're bouncing up and down, or digging, or kicking a ball back and forth. After doing that for five to 10 minutes they get into a pattern where they're much calmer and they're more likely to engage."
Dr Curcio said the service is aimed at the 0-12 age group because if they could reach children at a young age, there were better outcomes.
"It's really case dependent, but the earlier we can get in in the life of the child and the life of the problem, the more we can do to bring them back to that average trajectory.
"Some children are never going to reach it, but we can get them to a point where they're coping pretty well."
The improvements made over time can be striking.
When Jack was referred by Child and Youth Protective Services to Melaleuca Place, he presented with extremely aggressive outbursts, had inflicted substantial property damage, demonstrated sexually inappropriate and threatening behaviour towards staff, and physical and verbal aggression. He was significantly below his grade level at school, and only able to attend for just one hour each day.
Thankfully, Jack's story has a happy ending.
A comprehensive clinical assessment showed severe dysfunction in multiple areas. The team at Melaleuca Place worked with Jack for two years.
Jack now attends school full time. His violent and sexualised behaviours stopped, and his aggression greatly diminished. Jack joined a rugby team and developed friendships.
Through the support of Melaleuca Place, Jack's carers are now also well equipped to help Jack using the tools they developed working with the therapists.
*Jack's story is based on one child but similar circumstances are seen all too commonly at Melaleuca Place. The de-identified details were provided by the service, giving an insight into the cases it manages.