At SureCare we use the fundamental information from all external agencies to begin our work thinking about the young person. During our processing of this information we also include our own standardized assessment details, observations, discussions etc to produce our initial care plan and begin our therapeutic intervention. This process is consistently reviewed and monitored, with relevant alterations happening to meet the ever-changing needs of the young person.
We are a therapeutic community thus we are always working on both behaviours and the underlying psychological needs of the young person i.e. what drives those behaviours. In this way, we consistently monitor their most pressing needs of engaging more appropriately with their world.
A therapeutic approach is about bringing the young person to a place of exploration, clarity and understanding thereby allowing them to reframe ideas, challenge thoughts and actions, and developing more effective ways of working. This is a risky place and cannot be undertaken until the young person feels safe, in a context of containment and able to take time to reflect on very painful experiences. To understand how they think, feel and act the young person will need to identify the life experiences that impacted on their thinking. This sometimes means accessing difficult times in their life, which understandably, they are often reluctant to engage with.
For this reason, when young people join SureCare we do not often feel therapy or any other activity that may create a feeling of anxiety is to be expected immediately. Our immediate target is to make young people feel safe, accepted, contained and we build on that to create trust. We have to take our cue from the young people and the pace is dictated by their journey towards that trust. This is respectful to their previous painful and sad experiences that led them to being in the looked after system. Without trust, the young people will not engage meaningfully and the building of this essential ingredient depends on them entirely. We give them time, this creates calm, a feeling of acceptance and no agenda within which they may fail yet again. Pace is everything in supporting our young people with their therapeutic journey with us.
For the reasons above, we at Surecare have chosen a consultation model to address the initial stages of our young people being in care. Therefore, we input psychology in all stages through our well-trained staff, structures and supervision. This means that, although we still encourage and offer therapy at every moment we can, we do not rely entirely on this as a means of healing, helping and developing our young people. Quite rightly, our therapeutic input is daily, in every interaction, activity, plan, focus, target and that is how we begin the journey. A respectful journey towards a therapeutic understanding is measured and this, alongside therapy when the young person is ready to embrace this riskier endeavour, has already produced much more success in Surecare.
As part of the Placement Planning Meeting an Initial Assessment and Treatment Plan is completed by the Social Worker and passed to the Psychology Department, where clear strengths and areas for development are identified. The areas of development identified help to generate psychological targets that the staff incorporate within keywork sessions and monitor on a daily basis. In addition, once the Young Person has settled into placement a further Assessment and Treatment Plan and Psychological Assessments to measure Coping Strategies and Resiliency are completed and reviewed regularly to identify areas of improvement or deterioration and provides a quantifiable tool for assessing ongoing success for a Young Person.
In addition, Clinical Consultations take place regularly between the Psychology Department to ensure that regular Case Studies regarding the ever-changing needs of the Young People have a regular forum to be discussed.
It is quite normal for young people in the looked after system to find therapy too painful within which to engage. In fact, most adolescents avoid therapy due to their developmental stage i.e. choosing peer approval and support rather than adult help, and this is very normal at this phase and needs to be understood as such. Even if adults feel therapy would be very helpful, it is not generally successful if the young person feels they are not in the right place to make it work, therefore encouragement is good but too much pressure to attend is actually counterproductive.
If young people are forced to attend, they become even less likely to engage, but worse, another opportunity is lost to perhaps positively alter their attitude towards this resource. Most of our young people will have experienced unsuccessful therapy, and we must avoid adding to this list of ineffective psychological interventions.
Once the Young Person has settled upon commencing placement, it is the expectation of SureCare that the Keyworker will initiate conversations around therapy with the Young Person with a further expectation that arrangements will be made for them to be introduced to a professional from the Psychological Department if this is deemed the best intervention. This may be an informal meeting to develop rapport and an opportunity for a plan to engage with therapy, this could be undertaken via a casual coffee, or the young person may begin therapy in a formal manner. At this stage, all options are open and reviewed for the young person. The main message SureCare wish to convey is that therapy is accessible either in the short, medium or long term. As always within effective engagement within therapy, the needs of the young person and success of intervention is consistently reviewed with a view to producing the very best therapeutic programme.
Once a Young Person is happy to meet with a professional from the Psychological Department and begins to engage with therapy, the expectation is that they will generally attend weekly. However, the interim period is dependent upon the needs of each case and, essentially, will be negotiated with regard to best fit for the young person.
As always, the young people are on a therapeutic journey thus all interventions are consistently monitored and reviewed for effectiveness. Individual or family therapy may or may not be part of this journey, but psychological planning, target setting and implementation always forms part of Young Peoples SureCare journey.
At SureCare we are aware of the pivotal role our staff plays in transforming the lives of our young people. We value and respect all the members of our team and want to ensure that they are happy. and content in their role at SureCare.
Being a member of SureCare staff is a deeply rewarding experience but not without its stresses, so we have taken care to create an infrastructure to enable our staff to offload stress and develop personally as well as learn new strategies to cope with the difficulties which they may face.
At SureCare, all staff in general are given ample opportunities to use the resources of the Psychology Department with which to directly address current issues and promote relevant targets, along with ideas about how to approach this work. Thus, therapeutic work is carried out in all of SureCare’s residential homes by staff with specific and focused psychological input, irrespective of whether the young people are in therapy.