1. New Ways of Working across the Children’s Workforce
CWAPH
Wednesday 27th June 2018
Grange Primary School,
Winsford.

2. What does this mean for us ?
One Approach
Integrated Workforce
Shared language
work differently not necessarily more work
Consistent approach building from a position of strength
Challenge all share the same language and practice smarter and differently
Common Approach to Practice

3. Common approach to practice
Continuum of Need
Lens to practice across the continuum from universal plus encompasses all levels.
Common approach to practice

4. New Ways of Working Governance
Children’s Trust
Executive Board
LSCB Executive Board
Sub Group
Work Streams
Communication
Developing the Model
Workforce Development
Comms Strategy
Trauma Informed Practice
Motivational Interviewing
Other models
Group Supervision
Practice Champion
Training Plan

5. Outcomes Holistic & academic development
Reduction in anti social behaviour
Improved school attendance
Increase access to early interventions
Reduction in repeat witnessing & victims of crime
Reduce families’ homelessness
Outcomes
Reduction of statutory interventions for children who are vulnerable or at risk of harm
Increase in confidence, resilience & self worth
Reduction in presentations for mental health & substance misuse at A&E attendance & primary care
Reduction in mental health problems

6. Outcomes of integrated approach to practice
66% reduction in Police repeat incidents
53% reduction in attendance at A&E
(Adult emergencies)
0.15 % reduction in unauthorised absence
42% less children at risk of harm
e.g CP Plans
39% reduction in days spent in care
This approach was implemented at statutory service intervention – whole systems reform to change to develop new framework to practice
Based on Motivational Interviewing
Integrated working and integrated hubs
Change pattern, change practice, change culture, change behaviours, change Practcei outcomes – savings follow.
Example of where a change in collective practice, behaviour and culture improves outcomes, reduces pressure and demand and makes financial savings

7. Model underpinning New ways of Working:
Trauma Informed Practice
Motivational Interviewing
Group Supervision

8. What does Childhood trauma mean ?
Serious injury or accident
Being removed from families or friends
Neglect
Death of beloved pet
Poverty and homelessness
Witnessing the addiction of loved ones
Physical abuse
Witnessing violence or abuse of someone else
Divorce and separation of families
Psychological abuse
Sexual abuse or assault
Serious or life-changing illness
ACE – Adverse Childhood experiencers approx. 90% will experience at least one traumatic event in our life and it is become the experience of trauma is not the rare expectation that society once considered it to be it has become part of our daily living.
over the last 15 years more information ahs bene gained and understood about the impact of trauma.
Trauma – is a term we are familiar with and we are all aware of in different professional capacities.
Trauma is complex and spans a wide spectrum from grief and loss, to serious injury to abuse, exploitation, trafficking and neglect and its impact varies. We need to understand and test out new ways of working across the continuum through a trauma informed model
Following on from the work of Eaton and Benstead – it has made us reflect and consider trauma approaches to practice and how these can support children, young people and theory parents in making and sustaining positive changes.
Influenced by Eaton and Benstead
Experiencing racism or hatred
Witnessing a serious crime or act of terrorism or war
Forced marriage
Being bullied
@jessicae13eaton

9. Adverse Childhood Experiences ACE
10 categories are as follows:
ACE’s: Direct
Sexual abuse by parent / carer
Emotional abuse by parent/ carer
Physical abuse by parent / carer
Emotional neglect by parent / carer
Physical neglect by parent / carer
ACE’s: Indirect
Parent / family member addicted to alcohol / drugs
Witnessed abuse in the home
Family member in prison
Family member with a mental illness
Parent / carer disappeared through divorce or separation.
Attachment and impact and correlation with trauma
65& adult population have experienced one ACE
Research shows that if you have experienced one risk increase to 87% experience two or more ACE

10. Kaiser ACE Study Dr Warren Larkin
64% Adults x 1 ACE
ACEs’ don’t occur in isolation
Experience one ACE there: 87% chance that you will experience two or more.
ACE Score 6 or over: the greater the risk of poor physical and mental health, social isolation, cancer , heart disease and diabetes
20 years less than someone with no ACE Score

12. ACE DVD
Z-A

13. They are also a ‘solution’ to ‘unbearable states of mind’
While it is easy to see these risky & damaging behaviours as ‘problems’ that lead to other problems with health & Life chances, poor parenting …
They are also a ‘solution’ to ‘unbearable states of mind’
Tavistock Clinic FNP, 2017

14. Trauma Informed Practice
Recognise
Respond
Avoid re-traumatisation
Cultural shift in thinking differently, str what we do and how we approach working with children and families – continuum response

15. What could this mean for schools ?

16. Dr Warren Larkin
Blackburn
Trauma Sensitive Schools
Impact:
Fewer exclusions,
less violent episodes
Improved academic outcomes
Improved attendance
Consider: Attachment Friendly Schools,
Leaning mentors & pastoral streams, wider teaching staff

17. Motivational Interviewing

18. Motivational Interviewing
Supports behaviour change
Applied method
Evidenced based approach MI
Focus on empowerment
Difficult conversations
How of hands who is familiar with this approach ?
Applied method: Origins in counselling recent years used in social work practice and as part of CP systems
This is a strengths based approach and is focused on working with families to achieve change rather than seeing the person as the presenting issue.
It focuses on empowerment, support and development and how to have difficult conversations where problematic behaviour is evidenced in families. It enables practitioners to develop skills and confidence to undertake this approach and have access to evidenced based tools. There is a strong evidence base in MI effectiveness in supporting people to change and address problematic behaviours.
Other areas using MI Herts, London boroughs
Skill professionals to enable them to have difficulty conversation to achieve change with families
Resolve ambivalence & support sustained change

19. MI focuses on behaviour change
Technique to work with individuals and families with multiple and complex needs
Considers the cycle of change and working with ambivalence
Servcies who have used MI: Early Help, Schools Children Services, Housing and Health.

20. Group Supervision

21. Complexity & vulnerability collectively assessed and held
Group Supervision
Specialist Support
Chair
Recovery
Worker
Social Worker
Child
Probation
Domestic Abuse Worker
Administration
Complexity & vulnerability collectively assessed and held

22. Next Steps ... Initial Communication briefing
Sub Group (Project Board)
Work streams
Developing the Model – representative Primary Education
Training Programme January 2019

23. Questions ?