St Christopher's Fellowship embeds therapeutic approaches in children's care homes

• A range of therapies are provided across different types and sizes of provision

• Placements last longer and break down less often than the average for most residential settings

ACTION

St Christopher's Fellowship supports hundreds of vulnerable children and young people each year through its programme of residential care and fostering services.

The London-based charity, now in its 152nd year, has a track record of providing accommodation and support at sites across the UK and the Isle of Man.

It operates a network of children's homes as well as offering semi-independent accommodation options for young people leaving care.

In addition, its foster carers have placements available in the West Midlands, Essex, Peterborough and London.

The charity says it has adapted its residential provision according to the changing needs of children and young people in its care.

It has also responded to significant levels of trauma and adverse childhood experiences among the young people it works with by using a therapeutic approach to help deliver its services more effectively.

Clare Maude, the charity's wraparound therapeutic manager, says its residential care settings provide a wide range of diverse placement options. Meanwhile, staff aim to find the best ways to meet young people's needs.

“We pride ourselves on being an organisation that listens to the needs of children and young people in our care,” says Maude.

“Our main focus remains to ensure that what we are doing is to the best of our abilities and that the therapeutic element and training aspect for our staff is embedded into all our services.”

The charity is in the process of opening homes in London specifically to work with young men that have gone through the criminal justice system.

Similarly, St Christopher's operates a secure custodial children's home on the Isle of Man which has a youth justice community-based provision attached to it.

This allows staff to work with young people once their custodial period has ended, helping them to rehabilitate and successfully resettle in the community, says Maude.

Another specialised site in London, Safe Steps, provides a home for girls at risk of exploitation.

Referrals to the charity's residential care services are made through local authorities. The exception to this is the Isle of Man where referrals are handled by arm's-length organisation Manx Care.

On average, the charity receives between 600 and 900 referrals a week, with more children and young people being referred from deprived areas.

Most referrals received are for young people aged 14 to 17, with around two-thirds of new cases opened for boys compared to girls.

Using a trauma-informed approach means that all the charity's staff are trained in the areas of brain development, the impacts of developmental trauma and attachment theory, explains Maude.

“We also have additional therapeutic services which are teams consisting of a range of different disciplined therapists and therapeutic specialists,” she says. “What this allows is specific individual therapeutic plans and interventions to be created for all our children and young people.”

Such interventions could range from art or play therapy to more traditional psychotherapy or community-based emotional wellbeing support, she adds.

This approach means that the charity works and complements existing statutory mental health provision for children and young people, often co-working with statutory services.

“For many children and young people that enter care, they've experienced significant adverse childhood experiences,” explains Maude. “We recognise as an organisation that additional therapeutic support is paramount to ensure we can meet the mental health needs of the children and young people that we care for.”

The clinical teams help deliver therapeutic work such as reflective practice and group sessions at the homes as well as individual sessions for staff members.

Maude says the charity is keen to avoid “burnout” among staff members and aims to support and provide appropriate training for them to mitigate the likelihood of it happening.

She describes each residential setting as “unique”, ranging in size from larger children's homes to smaller sites with just a handful of beds.

“We might have a four-bed home but when we've assessed the needs of the children we want to place in that setting, it might not be suitable to have all four beds filled,” she says.

The charity reinforces its therapeutic approach to residential care by involving the children and young people themselves in decisions about how it is delivered.

On the ground this could mean regular meetings at homes with children and young people allowing them to have a voice on aspects of everyday life.

“This might range from what food choices they like or activities they'd like to do. Or even what changes are made in the home,” says Maude.

Participation teams – one based in the UK and one in the Isle of Man – also work specifically around including the ideas of children and young people to help improve service provision, she adds.

IMPACT

Data collected by St Christopher's reveals that its placements for children and young people are more stable, lasting 29 per cent longer than the national average.

The most recent statistic shows young people live in its residential services for 337 days compared with an average of 261 days.

Of these placements, only 18 per cent break down compared with a national average of 48 per cent.

In addition, young people who have been cared for by St Christopher's are less likely to end up not in education, employment or training. Around 25 per cent will avoid this outcome compared with 35 per cent of care leavers nationally.

In terms of homelessness, just seven per cent of young people from St Christopher's settings will experience this problem compared with a national average of 33 per cent.

Maude says further data on the impact of the charity's work is collected through CGAS assessments – children's global assessment scale – as well as clinical outcomes routine evaluation (CORE) assessments.

These show that when a child feels secure in a placement their level of presentation for mental health or behaviour problems decreases. “It also allows us to monitor if there's an increase in presentation – such as depression or anxiety – which means the team in the residential home or the wraparound service can respond if there is a change in a young person's needs,” adds Maude.

Through its trauma-informed ways of working, Maude says staff are better equipped to understand how children and young people present themselves.

“It's not a traditional behaviour model because staff members understand why a child might present in a certain way or they might have a difficulty doing something,” she adds.

“It allows them to be non-judgmental but insightful when responding to children and young people in their care.”

Read more in CYP Now's Therapeutic Care Special Report