Many of the children and young people living and learning with us have experienced adverse childhood experiences (ACEs), impacting their development. The concept of a child or young person’s ‘internal working model’ (a cognitive framework of mental representations for understanding the world, self and others) is considered throughout the development of our therapeutic approaches.
Working with a ‘bottom-up’ developmental approach and utilising the principles within the framework of Playfulness, Acceptance, Curiosity and Empathy (PACE), our Therapeutic Parenting approaches initially focuses on developing safety and containment for the child or young person; feeling safe is an essential pre-condition for new relations to be explored, attachments developed and engagement in therapeutic and educational tasks.
Both homes and schools are supported to develop and maintain a safe and secure base for all the children and young people to live and learn. At Outcomes First Group, we recognise that an environment that is predictable, structured, routinised, and has boundaries is integral to the children and young people’s healthy development.
Over time, the experience of safety and containment counters the child or young person’s reliance on primitive defensive/survival behaviours; fight/flight/freeze, and allows them to explore new relationships and alternative ways of viewing themselves, others and the world. Through new attachments and relationships, the child or young person’s ability to self-regulate and process their emotional world will grow; in time, they will begin to access and develop their potential for learning and achieving.
The well-being and clinical teams support home and schools using various approaches such as developing and maintaining a therapeutic culture through the facilitation of reflective practice sessions for the teams when required. These sessions recognise the emotional impact that living and learning with traumatised children and young people can have on the team members’ sense of emotional and physical well-being. Colleagues are supported to express, reflect upon and process their thoughts and feelings about their roles with the children and young people, their colleagues, and of events. Processing enables the team to provide a milieu that can respond to a child or young person’s communications and presenting needs thoughtfully and therapeutically in line with the core practice models.
Multi-disciplinary child and young person focussed meetings provide a space to consider each child or young person individually, review the current therapeutic care plan, analyse data from outcome measures and behaviour trackers, and use tools such as ABAS and Becks Youth Inventories. The outcomes of these meetings inform the development of goals for the children and young people. Progress towards meeting these goals are tracked and recorded.
Children and young people will have access to individual or group therapeutic input, depending on their clinical plan and therapeutic needs. Therapeutic interventions are informed by the child or young person’s clinical assessments and their views.
Therapeutic interventions may include the provision of creative based therapies (Art, Play, Drama, Music) Talking Therapies (Psychodynamic, CBT, Socio-educative) and Forensic models (e.g. The Good Lives model). It is recognised that engaging in ‘formal’ therapy for some children and young people may be difficult, so the team work flexibly and creatively to build a relationship; this engagement work may take place outside of the therapy setting and works at the pace set by the child or young person. The Outcomes First Group Well-being Rainbow enables us to consider therapeutic interventions within all parts of the child or young person’s life and by all disciplines of Outcomes First Group staff across care, education and clinical teams.
The teams work closely with clinical colleagues in our local communities and ensure that our children and young people also access statutory services such as CAMHS as necessary.
Outcomes First Group also has a well-being/clinical support line managed by a senior clinician to ensure everyone involved in a child or young person’s care can swiftly access a wealth of shared resources and expertise when required.