The Sleeping Dogs method is a treatment to engage chronically traumatized children in trauma treatment. The method provides a framework (the Sleeping Dogs Tool) to make a structured analysis of the possible barriers in the child’s history and circumstances, and develop a customized treatment plan with practical interventions to overcome these barriers so the child can engage and complete trauma processing.
The Sleeping Dogs method is a treatment method to engage chronically traumatized children in trauma treatment. The method is used for children, who initially cannot talk about their traumatic memories or do not want to do that. The Sleeping Dogs method supports them to engage in and complete trauma treatment and prevent dropout. When children don’t talk about their traumatic memories, it is often advised to wait until the child is ready – ‘to let sleeping dogs lie’, out of fear to activate trauma memories and destabilise the child. However, research shows that these unprocessed trauma memories – sleeping dogs – can damage the child’s development in all areas and increase their vulnerability, so it is important to ‘wake up these sleeping dogs’.
The Sleeping Dogs method provides a framework (the Sleeping Dogs Tool) to make a structured analysis of the possible barriers in the child’s history and circumstances, and develop a customized treatment plan with practical interventions to overcome these barriers so the child can engage and complete trauma processing. Then interventions are used to integrate changes and reduce the consequences of developmental trauma.
The Sleeping Dogs method is a collaborative method, in which trauma therapists collaborate with caregivers, residential staff, foster care workers, child protection workers. Therapeutic interventions are conducted by all, to jointly motivate and engage the child to come to trauma therapy. Sessions with the child are reduced to the minimum: “If the child won’t come to therapy, then therapy must come to the child”. Clinicians using the Sleeping Dogs method collaborate not only with the child and caregivers, but also extensively with the child’s network of attachment relationships such as the biological family including the abuser if possible, or previous foster families. Biological parents are not judged nor criticized, but they are invited to assist their children to heal from the trauma they have (unintentionally) caused. The Sleeping Dogs method provides a framework of what needs to be done, in which interventions from other methods can be incorporated, rather than being another comprehensive description of interventions.
The Sleeping Dogs method was first described in the Dutch book Slapende Honden? Wakker maken! (Struik, 2010), which was translated into English in 2014 and now has its second edition: Treating Chronically Traumatized Children (Struik, 2019). This new edition has lots of new materials, practical interventions and metaphors described in detail.
Chronically traumatized children often feel helpless, incompetent, and disconnected from their families. It is no wonder they present as unwilling or unmotivated to engage in trauma-focused therapy, as their basic needs are not met. According to the self-determination theory, these needs must be met to increase motivation. To engage these children, the Sleeping Dogs interventions focus on increasing the child’s feeling of competence by providing psychoeducation and the use of concrete metaphors and illustrations, increasing their autonomy by giving them control over the content of their own therapy, and increasing their feeling of connection by involving the relational environment as major mediator for therapeutic change. Children value their network’s support and opinion much more than the professional’s support.
The Sleeping Dogs method helps children to engage in and complete trauma treatment, which reduces their trauma-related symptoms such as posttraumatic stress, anxiety, anger, depression, attachment difficulties, negative cognitions, and behavioral difficulties. In a pilot-study, 14 children in out of home care, who initially refused or were unable, were treated with the Sleeping Dogs method and completed EMDR therapy, without dropout Struik, Ensink & Lindauer (2017) and Struik (2018).
After more than ten years of implementing the Sleeping Dogs method in five youthcare organisations in the Netherlands, we and the University of Amsterdam want to study the effectiveness of the method on a larger scale. We have started preparations, such as the research protocol and preparation of data collection. Chronically traumatised children in foster and residential care organisations, who are considered ‘stuck cases’, are included in a Sleeping Dogs and EMDR or TF-CBT treatment package to evaluate the children’s willingness and ability to engage in trauma-focused treatment with this treatment. The effect of treatment will be measured on trauma symptoms, caregiver’s stress levels, school attendance, level of care that is needed, and whether positive decisions about the future can be made. Finding a grant to fund this large study is the next step.
