the importance of containment in a complex trauma-soaked system: the team as secure base. belinda...
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The importance The importance of containment of containment
in a complex in a complex trauma-soaked trauma-soaked
system: the system: the team as secure team as secure
base.base.Belinda ThomsonBelinda Thomson
Tanya JacksonTanya Jackson
Structure of EVOLVEStructure of EVOLVE
Objective: To increase mental health, behaviour support and participation in education for children and young people in the care of the Department of Child Safety.
QueenslandHealth
EVOLVETherapeutic &
BehaviourSupportServices
DisabilityServices
Queensland
Educationand the
Arts
Department of
Child Safety
QueenslandHealth
EVOLVETherapeutic &
BehaviourSupportServices
DisabilityServices
Queensland
Educationand the
Arts
Department of
Child Safety
Evolve Sunshine Evolve Sunshine Caost/Cooloola/Burnett/Fraser Coast.Caost/Cooloola/Burnett/Fraser Coast.
Bundaberg (to come)
Fraser Coast
Hervey Bay
South Burnett
Kingaroy
CooloolaGympie
Sunshine Coast
Mooloolaba
Spoke
SpokeSpoke
Spoke
Hub
EVOLVE TEAM MEMBERS:EVOLVE TEAM MEMBERS:• Mooloolaba
– Team Leader (Stephen Bell)– Senior Administration Officer (Meridith Rubins– Service Research & Evaluation Co-ord (Narelle
Raeburn locum; Lucy Coyne on leave)– Professional Development Co-ord (Belinda
Thomson)– 3 Therapists (Fiona Meredith, Tanya Jackson,
Vicky Richardson-Bell)– Consultant Child Psychiartist (Rebecca Wild)– Psychiatry registrar (vacant)
Evolve Team members Evolve Team members Spoke sites:Spoke sites:
• Gympie– 1 therapist (Sabrina Sandy)– Co-located with local CYMHS team
• South Burnett (Kingaroy)– 1 therapist (temp vacant)– Co-located with local CYMHS team
• Fraser Coast (Hervey Bay)– 2 therapists (Kaye Byrnes on leave) (Nicole
Allen locum)– Co-located with local CYMHS
QuoteQuote• “Human beings of all ages are found
to be at their happiest and to be able to deploy their talents to best advantage when they are confident that, standing behind them, there are one or more trusted persons who will come to their aid should difficulties arise.”
• John Bowlby (1973)
Therapeutic Needs of Children in Therapeutic Needs of Children in CareCare
FEELING SAFE PHYSICALLY AND EMOTIONALLY
DEVELOPING RELATIONSHIPS
COMFORT AND CO-REGULATION ELICITING CARE FROM RELATIONSHIPS
EMPATHY AND REFLECTION MANAGING BEHAVIOUR IN RELATION TO OTHERS
RESILIENCE AND RESOURCES
SELF-ESTEEM AND IDENTITY
EXPLORE TRAUMA, MOURN LOSSES
Pyramid of Need
A hierarchy of needs. Assess where child is to guide choice of interventions.
Children move up and down in response to current circumstances.Kim Golding 2007
EVOLVE Collaborative Practice EVOLVE Collaborative Practice ModelModel
Holding the Child in Mind – Creating Therapeutic Networks
Social Care
Health
Child
Families
Communities
Professionals
School
Legal
Voluntary LeisureKim Golding 2007
Child or Young person
Non-GovtAgency
DSQEvolve
BehaviourSupport
Dept. Child Safety
Education
Carers’ Supportagency
Child’s carer
Qld HealthEvolve
TherapueticServices
Stakeholder team
Safe Haven
Secure Basecontainment of overwhelming feelings as bearable and meaningful
Go out to explore, understand clients experience
Return for reassurance, support, advice.
Defences, projection, chaos
Team as container•Empathy
•attunement
•Awareness of defences
•Reflective function
•Development of empathic shift
ContainmentContainment• Being with emotionally,
psychologically, physically.• Resonance with (willingness to feel
something), and• Attunement to (behaviours you do
to communicate your resonance)• The emotional experience of another
(COS)
QuoteQuote“The containment of one team
member may enable others to achieve and provide containment for children in our care.”
Joan Hutten
Safe Haven
Secure Basecontainment of overwhelming feelings as bearable and meaningful
Go out to explore, understand clients experience
Return for reassurance, support, advice.
Defences, projection, chaos
Team as container•Empathy
•attunement
•Awareness of defences
•Reflective function
•Development of empathic shift
QuoteQuote“…adopting a …(curious) stance
through which …(others) can discover a way to work with particular clients which is responsive to their needs rather than to professional differences.”
Joan Hutten (in Psychotherapy with Severely Deprived children)
QuoteQuote“This collaborative team work, including
being the carrier of the child’s cumulative experience, demands exacting commitment from workers if they are to provide the containment which enables children to learn from and integrate experience.”
Joan Hutten
QuoteQuote“We each seek to know that we are
held in the mind and heart of another.”
Fosha