Impact Youth Services

Therapeutic Under 13s Program

In 2011-2012 Impact had an increased number of referrals for males under 13 years of age

Presenting behaviours were more complex, challenging and violent

Recognising the need for more innovative interventions, staff with specific skills and rethink our resources

The story of a young boy named Bill, 9 years old.

Identifying the urgent need for something different

To develop and deliver a Trauma Informed Model of Care for children under the age of 13 who were presenting in the residential OOHC system

To design and deliver a therapeutic program with the aim of assisting children to develop regulation skills in order to sustain a foster care placement

To have the children ready for foster care within 6 months of entering the program

To better understand what was needed to adapt our Model of Care (ARC+C) to better meet the needs of this cohort

Our Goals

Impact had employed Youth Workers who did not want to work with this cohort

We really needed to unpack this issue with staff and the Management

Impact had to consider our recruitment and induction processes

Differing emotional needs meant differing resources – physical restraint

We had to ensure that our staff really understood Safe Attachment

Embedding all of this into therapeutic practice and then training

Organisational Challenges

5

A R C C+

Safety and structure to

stabilise distress

Feelings & regulation of

behaviour

Strengths and life skills

Protective links and sense of

belonging

Impact’s program model

Attachment Regulation Competency Community

6

Building blocks for ATTACHMENT

Carers understand

trauma &

manage their own feelings &

reactions

All carers give

consistent responses

Carers are attuned to the

child:

active listening, noticing triggers

Routines & rituals are predictable,

constant

The most valuable ways that staff contribute to attachment

7

ARC+C building blocks

ATTACHMENT

REGULATION

COMPETENCY

COMMUNITY

Carers understand

trauma

Carers attuned

Consistent responses

Routines and rituals

Recognise feelings & triggers

Expand ‘comfort

zone’

Express feelings safely

Problem solving skills

Positive sense of self

Trauma experience integrated

Belonging

What we came up with

A large eight bedroom house with three lounge rooms, three dining rooms, four bathrooms and a spacious undercover outdoors area

A property on acreage including an in ground pool surrounded by bushland and nature reserves located near the Hawkesbury River

A great therapeutic program focusing on Trauma Recovery and Safe Attachments with the aim of preparing the young people to sustain a foster care placement

Routine - Weekly schedules now more than ever needed to be predictable and consistent

Care team consisting of Residential Manager, House Co-ordinator, Intensive Support Workers, and Clinicians

Highly structured program

A therapeutic model of care for children under 13 (ARC+C)

Use of physical intervention to assist emotional regulation

Focus on education

Rural property providing more relaxed lifestyle and space

Specific criteria for client matching

Focused recruitment and staff training

Critical Elements

Slide show –photos magical moments

What does the data tell us?

Incident Log January 2013 for client within program

What does the data tell us? Reduction in Incidents for client by November 2013

Unavailability of suitable foster care placements High cost of running program due to staffing levels and

property damage Landlord asking us to leave the property due to damage Finding a new property Managing violent behaviours in children Difficulty client matching and the impact on other young

people and the program Operational challenges such as appointments, family

contacts Staff require a high level of support to critically reflect on

their practice and debriefing Expectations of caseworkers and other external parties

Learning and Challenges

Environmental safety plan Risk assessments Age is different- coming up to 13 years No on site senior manager Community involvement – scheduled activities All children engaged in education, external

therapy, community groups The program has a high level of activity and

play Cultural program for children and the care

team

Where we are today

Questions