School Nursing

The Relentless School Nurse: “Twisting the Lid” for Children in Foster and Kinship Care



Twitter once again connected me to another amazing person working to make this world a kinder, more gentler place for children and families. One of the most hidden, but vital aspects of family constellations are grandfamilies. Grandparents raising grandchildren (grandfamilies) at a time in their lives when they might be retired and slowing down a bit, can find themselves in the throes of crises picking up the pieces of a shattered family. Whether by illness, death, or unforeseen circumstances of life, there are scores of grandfamilies that are left to create safety and security for children to flourish.  

Beth Tyson is a psychotherapist and an author who brings a gentle, but powerful story to life about grandfamilies. Her lovely book – A Grandfamily for Sullivan touched my heart. I reached out to Beth and invited her to share more about her work and this beautiful book that speaks to how we can support children in kinship and foster care in a way that answers their questions with honesty and compassion. These are hard topics, complex and confusing for kids and grandparents or foster parents. A Grandfamily for Sullivan tells the story of one such family and how they managed to navigate the rougher waters after a family separation or transition. Here is my review of the book:

What a gem of a book about a most sensitive and important topic, grandfamilies. The book tackles the upsetting and unsettling feelings that sudden family transitions bring. This book goes straight to the heart of disruptions in family life. It is confusing for kids and they often blame themselves. Given the trauma happening in Australia right now, it is also poignant that Koala bears are the stars of this story. The themes of family dysfunction, childhood adversity, and grandparents raising grandchildren are all compelling reasons to share this story far and wide. I appreciated the author including strategies for handling “big emotions” like using visualization and breathwork. Well done and I highly recommend this very dear story. – Robin Cogan

Beth Tyson

Have you ever tried to remove the lid from a pickle jar that just wouldn’t budge? You twist with all your might, but nothing happens. You hand it to someone else, who turns her hardest, hits it with a butter knife, but still, it doesn’t budge. She gives it to the next person who with one gentle turn, POP! Off comes the lid! I’d like for you to hold this image in your mind as I share with you my perspective as a family therapist for foster and kinship families. 

Right after earning my master’s degree in counseling psychology, I accepted a position as an in-home family therapist for foster and kinship families. My goal was to stabilize families on the verge of having a child/children removed from their home. These families were in crisis. All of the children I worked with were suffering from untreated exposure to early childhood trauma. Often the foster parent was not aware that the behavior problems of the children were stemming from unresolved trauma. It was my job to provide trauma-informed parenting education to the adults aimed at increasing attachment and reducing negative interactions within the family.

Being a new clinician I questioned my capabilities to help these families, but I also felt compelled to try. I sought the guidance of a trusted professor. When I explained how I was feeling about my new job, she replied that I should feel uneasy. She explained that if I thought I “knew it all,” she would be more concerned. The fact that I was self-aware and willing to bring questions to my supervisor meant that I was going to do a great job taking care of my clients. Her advice was the encouragement I needed to move forward.

I traveled across my service territory, building relationships with families who were tired of people knocking on their front door. Therapy with me was not requested by the families, but mandated by the child welfare system. These caregivers didn’t have time to go to the doctor when they were sick, let alone meet with another person like me. They were doing their best to survive each day. But somehow we managed to build a bond. I witnessed frequent positive outcomes in the families I worked with by increasing positive interactions.

Late one winter night while driving home from a day of tough sessions, I started to doubt myself again. I thought that maybe someone else would be more effective in my role. Arriving at my apartment I felt HUNGER wash over me. I had forgotten to eat dinner! I made a sandwich and took the pickle jar from the refrigerator and began twisting the lid. No matter how hard I tried, I could not open the jar! I hit it with a butter knife, ran it under hot water, and still nothing. Then I handed it to my roommate, who popped off the lid with one gentle try. I felt frustrated that he made it happen so effortlessly. I felt the feeling of failure creeping in again. But then I remembered an analogy I once heard about a pickle jar. The analogy explained that it wasn’t my roommates good luck or strong arms that made the pickle jar lid pop off. It was all my failed attempts (PLUS his) that had loosened the lid. I made an impact on the result, even though I never twisted the jar open myself. From that moment on, I knew I had to keep trying to “twist the lid” on the jar of healing for young hearts and minds exposed to trauma and loss.

As I reflected on my work with families, I realized that to make a positive impact I needed to lower my lofty expectations, and adjust my perspective on the outcome. At the very least I could be an example of a healthy adult relationship with each child, which is something they desperately needed. I had to believe the work I was doing now would have a ripple effect on my clients’ lives years from now, even if I never saw the “lid come off.”

I sat at the kitchen table with many foster parents at the end of their ropes. Adults who were overwhelmed by the behaviors of a child. I helped them understand that behaviors are a symptom, not the problem. Behaviors are information letting us know that something deeper is troubling a child. It’s our instinct to punish unwanted behavior, but with children in the foster care we need to be curious about the behaviors instead of judging, concerned instead of punitive, empathetic instead of invalidating, and accepting instead of shaming.

It isn’t going to be just ONE of us who heals these broken hearts. The hurt is too profound. Instead, it will be the combined attempts by all the people in a child’s life to “twist the lid” that will open their hearts to trusting again. Even the failed attempts at “twisting the lid” will create a space, a release of pressure, and an opportunity to shift a child toward love instead of away from it.

While working with, or raising children exposed to trauma and loss, YOU are the hand that is “twisting the lid” every day. Like me, you might also feel the weight of responsibility on you. Take solace knowing that you are not in this alone. Seek help from the resources available to you, such as support groups, education about trauma-responsive care, and raising a child with a history of trauma. Please know that even if you never see the lid come off, you have your hands on the jar, and you are twisting with all of your might. One day, your impact will make a difference.

In my effort to keep “twisting the lid” for children in foster and kinship care, I recently published a children’s book called A Grandfamily for Sullivan. Sullivan’s story is a therapeutic tool for children impacted by family separation, attachment loss and trauma. It opens the door to honest, age-appropriate conversations about family separation and how to cope with BIG emotions. A Grandfamily for Sullivan is available HERE. To learn more about trauma-informed care for foster and kinship families, please visit me at:

Bio: Beth W. Tyson is a psychotherapist and children’s author whose tender-hearted book, A Grandfamily for Sullivan explores the challenges of family separation and kinship care. Sullivan’s story is a therapeutic tool for children impacted by loss and trauma and opens the door to age-appropriate conversations about why a child can’t live with his biological parents. A Grandfamily for Sullivan and additional mental health resources for foster and kinship families are available at

Please visit Beth online:

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