Abused or neglected children need outside intervention. But according to local experts, removing children from their home and the only caregivers they know is not always the best option.

Dr. Liz Kohlstaedt urged Flathead community members involved in child services positions to consider how removing a child from their primary caregiver impacts them psychologically.

“If you have a child who has been traumatized in the home and you take them out of the home, they get worse,” Kohlstaedt said.

“They are terrified to begin with and now they don’t have their primary attachment figure,” she said. “Now they are doubly terrified and they are much more difficult to regulate and calm down. They start to interpret ‘There must be something wrong with me.’”

While Intermountain Clinical Director Kohlstaedt and her colleagues agree a child who is in physical danger must be removed, there are situations in which the mother, or other primary caregiver, can be taught to nurture their child.

Kohlstaedt was joined by Joelle Johnson, an Intermountain trainer and child advocate, during an informational meeting designed to expose community members to research about parent-child relationships in the face of abuse and neglect.

“A lot of times our focus in the child protective system is to really prioritize physical safety, sometimes over other needs. There’s a lot more to what kids need,” Johnson said.

“Physical safety is absolutely paramount. If safety isn’t provided for kids, nothing else matters. But an exclusionary focus leaves out other very important pieces of the equation,” she said.

While neglect and trauma have severe psychological impacts on infants and children, Kohlstaedt warned community members to also consider the impacts of separation.

“If the child continually gets removed and reunited with their attachment figure, the separation can lead to despair, detachment and even death,” she said.

The clinical director said in situations where a social worker can’t decide whether to move a child or not, they are better be off being left with their birth parents if the parents are open and willing to be supported.

Children will bring the trauma they’ve experienced to an adoptive or foster home.

If an infant is removed from their home, the earlier the better, she said, because by 9 months of age the child has “internalized” the mother or made the attachment bond.

“We have to know the removal will be stressful,” Kohlstaedt said.

Going back and forth between two parents, or between foster parents, is not good for young children, especially under the age of 2, the clinician said.

If a child is removed from a parent (or parents) at a very young age, they can be reunited later in their development, she said.

“We can reconnect, maybe not necessarily reunify, when the child is psychologically capable — when they can hold different feelings at the same time and they can see people as both good and bad.”

Johnson works with parents struggling with substance abuse issues. She said many parents would be “good enough” parents if they could stop using. And although parents who are using may not be able to safely care for their children on a day-to-day basis, many times they can still provide their children with nurturing and attachment.

Johnson discussed some barriers parents with substance abuse issues encounter while trying to receive treatment, and more effective means of treatment providers could operate.

Instead of focusing on punishing users for their behavior, treatment providers should foster a more open environment, she said.

“In our own treatment teams we need to look at our expectations realistically about who this person is as an individual and where they are at in the recovery process, and ask how are we responding to the symptoms.”

The community meeting held Nov. 28 was sponsored by Intermountain, a community clinic focused on serving children and their families, and CASA, Court Appointed Special Advocates for Children.

“We are not doing a good job of producing a generation capable of protecting our children and not succumbing to drugs and alcohol, serial relationships, all of those things that don’t work for kids,” Jim FitzGerald, Intermountain Chief Executive Officer.

“Because of the complexity of the issues and the variety of people here, we tend to be in separate silos with a specific lens about how we see the issues, how we see the children, how we see the parents,” he said. “This about trying to turn the lights up on the complexities of decision making regarding protection of children on one hand — and nurturing and caring for their longterm interest on the other.”

Reporter Breeana Laughlin can be reached at 758-4441 or blaughlin@dailyinterlake.com.