Maintaining therapeutic relationships during lockdown


The pandemic lockdown presented significant challenges for providers of children's homes. Here, Rhiannon Thomas, therapeutic manager at St Christopher’s Fellowship, outlines how its specialist therapeutic service helped staff working in the settings to maintain support for children and young people and address anxieties that arose.

I lead the St Christopher’s team providing a therapeutic support programme in England; we aim to help staff to promote positive emotional wellbeing and manage mental health issues for young people living in our children’s homes and semi-independent services. Set up in 2019, the team are trained in art psychotherapy, attachment, system psychotherapy and trauma-informed therapeutic practice. 

St Christopher’s has provided therapeutic support across the Isle of Man for a number of years, so it made sense to learn from the island’s working model when setting up an offer in England. Prior to the coronavirus outbreak the programme was taking shape, with therapists working with on-site staff teams in groups and individually. However, as lockdown was implemented, we needed to adapt.

We felt it was important to find ways to retain a feeling of connection and support our communities, even if we could not be there in person. Anxieties around young people’s safety needed to be balanced with staff’s worries about the health of themselves and their loved ones. Some of this was going to be on a trial and error basis; what might seem a good idea to those of us working remotely may not be what staff and young people in our homes needed.

Support for residential care staff

We continued to provide bi-weekly reflective practice sessions with teams in residential services (children’s homes and semi-independent homes). This was offered by video, meaning that even if staff were in a home together they could join the meeting from different rooms at a safe distance.

Many of the things we do – speaking with other people, thinking together, sharing thoughts and ideas – rely on being physically present. Cues and non-verbal information can be lost on video, so working in this way has been an adjustment for everyone. Concentrating hard on the screen trying not to miss things can be quite tiring and doesn’t always help us connect in the same way. Also, we are dependent on Wi-Fi quality!

On the positive side, remote-working and adapted shift patterns mean we can all be more flexible about timings. In some cases we have increased the frequency of small group sessions to ensure as many team members, including night staff, take part as possible.

Would we want to work like this in the future? Now we’ve all adjusted to video meetings it could help to increase the amount of contact we have with each other without needing to travel as much. Speaking to a face on a screen feels like more connection than a phone call where we can only hear their voice. But it does not feel like it could every replace the value of being in a shared space, including that the importance of silence is lost. On video and phone calls there is more pressure on filling empty space and responding quickly to keep the connection going, whereas relationships are often about the parts in-between and just being with each other.

We offered individual consultations with members of the therapy team (by phone or online) to staff to help them address the pressure of balancing concerns from both home and work. This supported them with worries about personal circumstances and how to adapt their practice with young people whilst social distancing.

As well as support from within St Christopher’s, we circulated information in case individuals felt more comfortable speaking to people outside of the organisation. This included the ‘SAFPAC Frontline Emotional Support’ service being offered by the Southern Association for Psychotherapy and Counselling.

Engaging young people on their terms

A smaller part of our therapeutic service is psychotherapy and counselling directly with young people, including those referred to us through our Trusted Spaces outreach team working with those at risk of exploitation. Our art psychotherapist adapted to video conversations and has meant that some young people have swapped their in-person meetings for a session online. For others this has been more difficult without the structure of the school day, meaning contact has become intermittent.

It’s always hard for practitioners to know if something has “worked” in the short-term but most young people are engaging on their own terms without a parent or teacher to encourage, arrange or facilitate the sessions. This seems to show our support is valued. The hope is that when schools and youth centres re-open we will settle back into a regular offer of support.

We also explored online ‘live’ therapeutic art sessions for staff and young people, using the time to do painting to music or guided drawing. We quickly learned that mornings were not a good time to plan sessions! Another learning point was the anxiety caused by joining an online community where young people did not know who else was going to be taking part. In answer to this the therapy team concentrated on individual homes or young people, inviting them to take part in personal sessions, rather than larger open access meetings.

Alongside all of this, we continuously identify and share resources that can build structure into the day so that we are all still learning, rather than everything stopping. We developed an activity calendar including mindfulness, watching online streams of theatre productions, therapeutic photography, art and online yoga courses. As with everything at St Christopher’s, we listened to activity suggestions from young people to ensure we were meeting their needs. Suggestions included playing Cluedo with everyone dressed up as the characters, doing sponsored activities, car washing, baking and even making lava lamps and guitars at home.

The coronavirus pandemic has provided space for practitioners to examine their own practice and think about how we can adapt to new ways of working. Not all of our initiatives will always be a roaring success, but by giving things a try we know we are exploring everything we can to create brighter future for children and young people.

Rhiannon Thomas is therapeutic manager at St Christopher’s Fellowship

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