Hillcrest Steps - A Journey from Residential child care to a therapeutic community

In Residential Child Care, when discussing with Social Workers and Placement Teams the particular needs of a child about to be placed in a children's home - we often hear the word "Therapeutic" mentioned. When examined more closely however, the term "therapeutic" can cover a wide variety of meanings. There are many types of therapy - depending on the needs of the child. These can range from full blown psychiatric or psychological intervention to work on deep seated mental health or behavioural issues, to less clinical based therapies, such as drama therapy or equine therapy which could help, for example, in boosting a child's low self esteem. In these cases, the understanding of the term "therapeutic" assumes a one on one intervention between the child and a trained person supplying the "therapeutic" intervention.

Perhaps a less well known or less understood approach to therapeutic intervention involving residential childcare, is the use of therapeutic communities - where the whole approach to childcare is based on the principle of the therapeutic community.

Therapeutic Communities (TC's) are settings where the physical environment, the interactions of staff and young people, and the way each day is planned - are considered to be part of the therapeutic process. These three components are essential when working therapeutically  with looked after children - many of whom have had very negative early life experiences - and who require a carefully managed living environment to acquire the social and behavioural skills to help them adjust back to safer and healthier approaches to living.  

The Consortium for Therapeutic Communities (TCTC) is a members association which promotes a values based approach to working with both adults and children. Member Therapeutic Communities  work with either children or adults who can display a range of complex needs including personality disorder, offending behaviour, addictions, learning disabilities and severe mental illness. Therapeutic Communities can be found within health, education, social care and prison settings.

Hillcrest Steps, part of Hillcrest Childrens Services, is a residential children's home for boys and girls aged 6-13yrs. Hillcrest Steps is also a Therapeutic Community, and a member of TCTC. All staff are trained in the principles of Therapeutic Child Care and apply these on a daily basis.

At Hillcrest Steps we believe that relationships and shared responsibility are central to all organisations and that the overall social environment is critical to the effectiveness of any service. We have moved away from a behaviourist model and embraced a more reflective and nurturing space, giving children the chance to consider their actions and learn effectively. We have created a child centred practice and child friendly, homely environment.

An important part of therapeutic care is focusing on why children act in the way they do and what is at the root cause underlying behaviour, as opposed to simply dealing with the behaviour. At Steps there is a focus on each child via a key worker presentation. Staff engage positively and through key worker sessions develop individual relationships further.

There are protocols in place that support the community when new staff or children arrive and similarly we have traditions that are followed every time somebody leaves. Children who have experienced early years trauma may find frequent arriving and departing quite difficult to cope with. So time is taken to explain these processes and support them individually throughout.

Daily community meetings are held at a specific time and place making it part of the routine and an expectation to attend as a member of the community. This encourages peer support and a sense of belonging and gives each child a say in how the community is run.

We also hold monthly group supervisions for the staff team which are externally facilitated. This enables staff teams to discuss any issues that may be reflected in the group of children.

Outcomes for young people are at the forefront of all the work we do at Hillcrest Steps. Since learning how to become a therapeutic community we have seen an increase in the amount of compassion and empathy shown by the children we work with. It has encouraged and improved the abilities of children to share with one another, showed us the power of the group and allowed a real involvement of young people in decision making.  

Since beginning our therapeutic journey some 5 years ago, almost half of young people moving on from Hillcrest Steps have been able to return home or into a suitable foster placement.

For more information about Hillcrest Steps or Hillcrest's other children's homes, please visit www.hillcrestchildrensservices.co.uk or tel 08458 727477.