1. SHERWOOD HOUSE
A summary of initial outcomes achieved in the first 12 months of implementation of an innovative program to provide therapeutic support in an environment that offers the option for containment

2. Introduction
Sherwood House is a new innovative therapeutic residential program established by the Department of Human Services, Community Services within South West Sydney in February 2009.
This presentation seeks to provide an overview of the context within which the model has been established, key elements of the model and its function, and broadly describe the outcomes achieved in its first 12 months of service.

3. Service Gap
Sherwood House has been specifically founded to meet the needs of a target client group for whom which there is currently limited or no service options.
Client characteristics:
Young people in Out-of-Home Care
Unable to be successfully supported in community settings
Chronic behavioural challenges that pose significant risk to themselves and others
Complex trauma symptoms
Requirements for specialist case management
Placement approved by the Deputy Chief Executive
Placement by Supreme Court order
Managed under Supreme Court case management

4. The needs of this group of young people require
Assess to a suitable (safe) accommodation setting
Setting with capacity for containment
Trained staff with a high level of supervision and access to direction
Staff contingencies that support physical management of high risk behaviours in a safe manner
Intense targeted therapeutic support that is multi-element and consistently delivered over time and across all settings
Complex and intensive case management services
Active engagement of specialist services (inter-departmental as required)
Support that is not time limited but structured around client needs and the outcomes achieved

5. CURRENT SERVICES Restoration Impatient Health Facility Foster Care
Residential care
Intensive Residential Care
Therapeutic Intensive Residential care
Therapeutic Intensive Residential care with Security safety
CURRENT SERVICES
Restoration
Funded Program Options
Funded High Needs Program Option
No Current Options
Sherwood House
Impatient Health Facility

6. Psychiatric Annals 35:5 May 2005. Full version www.tramacenter.org

7. Psychiatric Annals 35:5 May 2005. Full version www.tramacenter.org

8. The Attachment, Self-Regulation and Competency (ARC) model provides a component-based framework that broadly guides the work within Sherwood House.
Psychiatric Annals 35:5 May K.J Kinnibutgh LICSW, M. Blaustein PhD, J. Spinazzola PhD.

9. Sherwood House
Our commitment is to provide a safe, nurturing and therapeutic residential service that enables children and young people to develop to their full potential.

10. Sherwood Entry and Exit
The identification of individual case planning and therapeutic goals is undertaken for each young person entering the program. It is through the revision of these goals that determination of a suitable exit plan and timeline can be shaped.
Generally these include:
Specific health management issues including medication review and appropriate engagement of required specialist and services
Healthy lifestyle habits and routines
Functional and meaningful family contact that is safe and sustainable for the young person
Reduction of anti-social and damaging high risk behaviours
Increase in emotional resilience and capacity to modulate behaviours
Increase in engagement with education and personal development opportunities
Increase in capacity for positive peer engagement (recreational / social)
Permanency planning for future living situation that meets needs
The young person’s beliefs in relation to their readiness to move on

11. Staff Model Parramatta Metro ISS Director ISS Janice Carroll
Manager Client Services Kerri Cronan-Dixon
Admin
Caseworker
Managers 5
Caseworkers 24
Sherwood House
Bradbury
Barbara Hardman
Manager
Residential Care Staff
Partner Agency
Security Staff
Psychological Consulting
Quovus

12. Staff Training
Sherwood House provides a structured in house staff training program that includes :
Policy and procedural review
Induction and buddy shifts
Shift leaders meetings
Team meetings
Formal topic training
Access to manual resources
Team debriefing

13. Therapeutic Support Program
Summary of Sherwood Program Structure
PROACTIVE STRATEGY
INTERACTION GUIDELINES
ROUTINE
REINFORCEMENT PROGRAMS
SUPPORTING FAMILY CONTACT & NETWORKS
ENVIRONMENTAL STRATEGY
RESTRICTIVE ACCESS/ PRACTICES
CARER/ SECURITY
STAFF MODEL
TRAVEL PLAN
COMMUNITY ACCESS
DIRECT TREATMENT
DAILY PLANNING WITH MANAGER
WEEKLY REF PERSON MEETING
SHERWOOD HOUSE THERAPEUTIC SESSIONS
WEEKLY COUNSELLING
REACTIVE STRATEGY
MANAGING AGRESSION
MANAGING SIB
MANAGING PROPERTY DAMAGE
MANAGING ABSCONDING

14. Therapeutic Support Program
Common behavioural support challenges for target young people include;  
High levels of anxiety and withdrawal
Difficulties with emotional regulation
Aggressive and defiant behaviour
Complex family issues
Learning difficulties
Trauma related symptoms
Difficulties with peer relationships
Inability to monitor pitch, inflection and tone of voice
Misreading facial expressions
Misjudging personal space
Mistaking other non-verbal cues

15. Sherwood House: In-house Program
SOCIAL SKILL THERAPEUTIC INTERVENTION PROGRAM (2X WEEKLY)
MUSIC THERAPY (WEEKLY)
MOVEMENT AND DRAMA THERAPY (WEEKLY)

16. The Sherwood Education Program
Classroom to support the young people re-establish their routine participation in formal education programs in the grounds of Sherwood House
A dedicated part-time teacher who provides face to face teaching two days each week
Distance education with the support of staff complete their curriculum requirements.
One of the young people has been able to return to a full time placement in a local school

17. Program Reporting
The reporting requirements of the program are significant and matched to regular scheduled Supreme Court review. Data is tracked and analysed on a monthly basis.
Critical elements of data include:
Case management milestones
Health management goals
Medication management and impacts
Incident profiles
Behavioural scales
Mental health scales
Client wellbeing self reports
Program participation and community access
Reference Person Program
Therapeutic goals and progress

18. Client evidence Based Outcomes (Sample Data Summary)

19. The Step-Down Models
The transition from the Sherwood House model has required the development of a linked program to allow gradual progress and the continuity of program elements
The program has achieved the transition of one young person and is currently preparing for the exit of a second

20. Challenges
Building management and design to ensure a robust safe setting
Staff matching and retention
Family engagement
Establishment of the step-down model

21. Future Planning Ongoing refinement of the therapeutic program
Enhanced projects for community participation for the young people
Creative options to support family engagement
Ongoing investment in service partnerships and collaborative work

22. Questions