Adolescent Therapeutic Residential Services: Enabling Familial Experiences Through Continuum Of Care Presenters Vanessa Smith – Manager Foster Care Melissa Muller- Acting Manager Residential Care

Adolescent Therapeutic Residential Services CatholicCare has delivered therapeutic Intensive Residential Care services since 2005 CatholicCare Broken Bay currently has 6 residential houses across Northern Sydney and the Central Coast of NSW All referrals received are from the Metro Intensive Support Services (ISS) or Family and Community Services (FaCS)

Therapeutic Care What is therapeutic care? CatholicCare’s delivery of therapeutic care  Strengthening CYP’s positive relationships  Supporting CYP in transitioning to less intensive care  Working towards restoration

Delivery of Therapeutic Care CatholicCare bases its service delivery on  Attachment, Self-Regulation and Competency (ARC) principles  Anglin Framework principles  Continuum of care approach

ARC Framework A flexible framework with three core domains: Attachment, Self Regulation and Competency

James Anglin’s Framework

Continuum of Care CatholicCare defines the continuum of care approach as the process of planning and managing the care of a CYP, through the provision of the range of services they require to facilitate their movement through the care system. (Cheers and Mondy, 2009)

Continuum of Care The ability to manage the care of CYP through  Pre-placement  Contact  Admission  Internal placement transitions  Discharge and provisions of aftercare

CatholicCare’s Implementation and Practice Therapeutic care Staff education Staff supports Structural support

Therapeutic Care Responding appropriately to pain and pain based behaviours Application of ARC principals Developing a sense of normality Creating an extra-familial living environment

Staff Education Education and training Professional development Topic-targeted reflection sessions Clinical advice

Staff Supports Regular supervision Clinical support Vicarious Trauma testing Funded self-care packages

Structural Support Client matching Enabling specific Shared Needs residential houses and programs Clinical support Routines and rituals

Program Outcome Achievements Positive culture change within homes Better trauma-educated and informed carer teams Placement continuity for CYP Increased number of CYP engaging in Life Story work CYP restoration to family Self-placed CYP restoration to family with outreach Longevity of care

Program Challenges and Barriers CYP with incomplete narratives of why they are in care Funding changes impacting service delivery Carers learning and becoming adept in the significance of safe attachment

Shared Needs Placement Example First under-12’s house opened in June 2012 Vision for under-12’s house:  Bridge or stepping stone to foster care or possible restoration to family  Target risk minimisation  Assist in stabilising CYP’s placement  Prepare CYP for less intensive model of care

Factors Considered when Establishing Under-12’s House Environment / location Selection of carers Culture and programming

Environment / Location Near beaches and well resourced Carers who live in the area and able to utilise their community networks Large house that provides children with:  Safe, tranquil and personalised individual space  Spacious shared living areas to support relationship- building

Carers Selection Criteria Keen to work with under-12s target group Experienced with younger children and their developmental needs Local knowledge and networks Caring, nurturing and attuned Committed to consistent and structured routines Adept in protective behaviours Supportive of family relationships

Culture and Programming Age-appropriate signage and house agreement Doors locked at dinner time for safety Age-appropriate structured activities, limited TV Education of residents at separate schools Supported in individual hobbies Therapy and Life Story work Carer response to trauma-informed behaviour House mother role

Contacts Melissa Muller CatholicCare Out of Home Care - Residential Vanessa Smith Catholic Care Out of Home Care – Foster Care

References Therapeutic residential care in Australia: Taking stock and looking forward. NCPC Issues No. 35, 2011, Staffed Group Homes for Children and Youth; Constructing a Theoretical Framework for Understanding, James P. Anglin (2002) Cheers, Deirdre and Mondy, Stephen (2009) ‘Enhancing placement stability via a continuum-of-care approach: Reflections from the Australian context’, Vulnerable Children and Youth Studies, 4;2,