Therapeutic Child Care (TCC)

You may have heard that Burlington Children’s Space provides Therapeutic Child Care. What does this mean?

In 2008, BCS entered into a grant-funded pilot program with the Howard Center to improve mental health support for children and families in the area via a partnership between numerous local childcare centers. After one year, this project received permanent funding, and it is now called the Therapeutic Child Care (TCC) project. There are four additional child care programs in Chittenden County that are implementing this model with the help of the Howard Center. They are: Lund Family Center (Burlington, VT), Trinity Children’s Center (Burlington, VT), King Street Center (Burlington, VT), and Little Ones University (Essex Junction, VT). 

Key characteristics of TCC centers include consistent routines, responsive teachers, self-regulation and coregulation, engagement with families, teacher collaboration, and food security. These features provide children with a predictable and safe environment, and allow them to learn that they can depend on their surroundings for support. TCC environments are designed to be especially responsive to the needs of children who have experienced trauma, but are beneficial to all children. 

Why is being a TCC important to BCS? 

BCS’s mission has always been to embrace, enrich, empower, and educate young children and families in our community. Embodying this mission, the staff at BCS are prepared to accept the uniqueness of each student and meet the needs of diverse learners with a wide range of experiences. This includes addressing the impact of trauma on children’s development, and creating environments where all children feel supported. Responding to challenging behaviors with care rather than punishment is an essential skill teachers are learning, and one they are modeling for students in the classroom. This practice sends the important message that we understand children’s behavior and know how to help everyone learn, even when they are struggling. 

Does the TCC model fit with the mission and vision of BCS? 

In its original mission and vision statement from 1984, BCS outlined the following values: high-quality education and childcare for all children; community; diversity; well-qualified, motivated staff; fiscal soundness; and excellence. Each of these values is consistent with the TCC model of childcare. The Therapeutic Child Care partnership with the Howard Center allows teachers to develop the skills necessary to embrace all students in the classroom, no matter how challenging or atypical their experiences are. The Chittenden County TCC centers have worked collaboratively to establish common practices, develop core training for staff, and implement a team approach to addressing complex issues that arise for children and families, showing a commitment to building community. These systems create unique opportunities for all children and families, and increase our program’s quality. The TCC model fits the mission and vision of BCS as it was when it was founded, and reflects our goals for the future. 

What are the financial implications of Therapeutic Child Care?

By increasing the quality of its program over the years, BCS has also increased opportunities to receive more public and private funds. BCS has the highest quality rating in the Vermont Department for Children and Families STARS system, and receives a higher rate for subsidy payments from Vermont’s Childcare Development Division. BCS also receives a Strengthening Families grant from the State of Vermont due to the quality of services offered to families, especially its therapeutic supports. Each year, BCS applies for and often receives additional grant funds from public and private foundations that allow us to offer a sliding scale for tuition, keep class sizes small, and ensure that staff have the training and support they need to provide high quality care. 

In order to sustain the program and its funds, BCS does considerable work behind the scenes, completing state and national accreditation, making time to meet with parents and any other providers on a child’s team, providing staff with the training they need to implement therapeutic strategies, and ensuring that each staff member experiences professional development. We also create an environment in which teachers not only enjoy their work, but are encouraged to continue working sustainably—teacher turnover is hard on children, families, and programs, and is something we are working to combat through program design.

What does a TCC actually look like? 

Here are several core elements you will see in a Therapeutic Child Care center: 

Engaged Teachers: The most important element in a therapeutic environment is the maintenance of trusting relationships between teachers, students, and families. These relationships thrive when teachers are fully present and involved with students, listening to their words and observing behaviors for clues about what is needed, and are willing to partner with families to further enrich the child. Engaged teachers model the skills they want to see children learn, especially skills around identifying feelings and developing healthy ways to interact with others. They show acceptance for children by withholding judgment when challenging behaviors arise, and instead make observations that help children understand what they might be feeling and how their behavior affects others.  

What we say/doWhat it means
“I’m so happy you’re here!” I want you to be here! I’m ready, and I enjoy being with you.
Sitting at a child’s eye level or on the floorI am with you; we are doing this together.
“I know you like —–, so I put it out.”I see you, and I think about what you like and how you learn.

Supportive Routines: Each classroom at BCS has developed a set of routines and expectations that provides reassurance and guidance to the children and staff alike. These routines help children know what to expect. For children who feel like they don’t have control over their environment, suggesting alternatives that still meet the expectations can be reassuring. These expectations, often developed with the students, provide a framework that shows children how to care for and be taken care of by the community. These routines are often supported by visual schedules showing children what is coming next and what behavior is expected in different situations. Supportive routines also include drop-off and pick-up systems that work for children and do not cause other children anxiety. Shortening the length of the school day and switching pick-up time to a 30-minute window has reduced stress for many children who start to watch the door anxiously as soon as the first student gets picked up and cannot relax until their parent arrives. 

What we say/doWhat it means
“It looks like you feel disappointed by not getting the color you want.” Your feelings are understandable, and we can neutralize them by naming them.
“First, we do —–, then we do ——.”You can count on these routines; we see that doing things in the same order is predictable and comforting.
“Everyone has a right to feel safe. I will hold that block until you can use it without throwing.”I will help you and everyone else feel safe.
“It looks like you are not ready to clean up. Would you like me to set the timer so you can have one more minute to play?”I can be flexible, and I am going to help you meet this expectation.

Self Regulation and Coregulation: A therapeutic environment also helps children build skills necessary for validating and regulating their emotions. In many cases, this means making space for children’s big feelings. Some children can talk through their big feelings, but many need to act them out in some way. This can be one of the most overwhelming aspects of therapeutic care, but it leads to essential skill building. Teachers are trained not to stop children from having big feelings, but to help them work through these feelings in ways that do not harm others. This takes practice! Therapeutic environments include physical space where children can be if they need to act out big feelings, tools to help work through and identify those feelings, and adults who can coregulate (model) the physical behaviors that help calm their bodies—for example, deep breathing, drumming, humming, resistance, or physical affection. 

What we say/doWhat it means
“You are showing me you might be frustrated.”I can help you address this emotion. Let’s identify it first. 
“S. is showing us she doesn’t like your fingers in her mouth, let’s touch her arm gently.”There are lots of ways people show us how they are feeling, even babies. We can work on this together and help our peers feel safe. 
“You seem angry. I am going to sit here next to you to make sure you are safe. We can talk when you feel ready.”It seems like you are experiencing a big emotion, and I see that you may need time to calm down before you are ready to talk. I am a safe adult who is prepared to help you work through this big emotion.
“Do you want to rock in the rocking chair, drum, get a drink of water, have a hug?”I know that rhythmic, repetitive activities help children feel calm and safe. I can do these activities with you, because I know that they are comforting and effective.

Collaboration with Families: The children’s families are essential to therapeutic classrooms’ growth, and the home/school connection should be honored in many ways throughout the classroom. Encouragement, support, and input from families in meeting the needs of children is crucial in creating a successful environment and helping teachers understand what situations are either triggering or reassuring to children. Families also participate in regular discussions about their goals for their children and how they can be met at home and school. Daily reports about children’s eating, sleeping, and home stressors are very helpful to teachers who can use that information to better understand the child’s behavior. Creating relationships with families ensures that the connection between home and school is strong. 

What we say/doWhat it means
Have family photos available in the classroomWe appreciate each child’s family and want them to be a part of our day, even if they aren’t in the room.
“Tell us about what you like to eat/do at home.” We want to know what is important to your families and what they value.
(To a parent): “Help us understand why this is worrying you.”We might have different values, but there is room for us to talk about how we disagree. We will probably understand each other better when this is over.

Teacher Reflection and Collaboration: Providing therapeutic care is extremely rewarding—and hard. Teachers must be aware of and tend to their own emotional states in order to provide modeling and reassurance to children. Sometimes, children’s traumatic experiences trigger trauma responses in teachers, and there must be systems in place to understand and process these experiences. Making time to explore the root causes of children’s behaviors helps teachers respond in productive and supportive ways. BCS has systems in place in which teachers regularly reflect and collaborate with one another, developing strategies to provide the quality care their students need without becoming overwhelmed. 

What we say/doWhat it means
Set aside time for teachers to meet with partner programsWe need to work as a team to do this work well.
Have systems in place for teachers to reflect on their workWe want teachers to learn to tackle complicated challenges and understand how their own experiences impact their teaching.
36 hours of professional development a yearMany teachers do not come to BCS knowing how TCC is implemented. We want to help them learn, and will help them get the training they need to provide the compassionate care we value so much.

Food Security: As a Therapeutic Child Care center, our approach to food is one of generosity, care, and respect. We want all children at BCS to experience mealtime as a relaxing and nourishing time, and to trust there will always be enough to eat. To accomplish this, we focus on making mealtimes calm, conversational, and full of lots of good food. 

We offer a wide variety of foods at lunch, and we encourage children to try foods that are new to them. Looking at, smelling, or tasting—and spitting out—new foods are all steps toward becoming familiar with something new. Children may need time and space before they decide that they like a food, and their preferences can change over time. Our goal is for children to develop healthy eating habits, but we also believe that children should be able to practice autonomy while learning what they like. With this in mind, we use the model of shared responsibility: adults choose when and what children will eat, while children choose if they will eat, and how much. Once children trust that they will have enough to eat, we can teach them to listen to their body’s cues about when they have had enough. Recognizing the sensations of fullness and hunger will help them develop healthy eating habits going forward.

What we say/doWhat it means
“We all really liked the strawberries, and now they are gone. Here are some other things you may want to try.”We all enjoyed eating this specific food, so we ate all of it. But there are more yummy foods available, and you are welcome to try them. 
“Check in with your body and see if you feel full.”Our bodies can tell us whether we need more food or not, and this is something we can pay attention to.
“Let’s save some cheese for our friends who haven’t eaten yet.”We all have a right to enough healthy food. As a community, we have a responsibility to make sure everyone has what they need.