Enhanced therapeutic support within children’s residential care

Whilst our Silver package may be limited in assisting your recognition as a Therapeutic Residential provider, we would expect that, alongside your existing trauma-informed/therapeutic knowledge and practice, it would support your aspirations regarding increasingly positive Ofsted and Regulation 44 outcomes. As with any service requisition, the greater the detail and depth of support that can be provided (as well as rigorous implementation), the greater the likely positive outcome. We would hope to support you as much as possible, within the confines of the Silver package, to achieve your anticipated aspirations.

There are a number of reasons why you might opt for our Silver package. Perhaps the obvious one is ‘budget’ – which may not stretch to including ‘everything’ and especially the kitchen sink! It may also be that you are already fairly confident with your therapeutic approach, but would value regular psychologist input to help develop this further.

What does our Silver package include?

The intention is that regular staff support/consultation will contribute to trauma-informed Care Planning and practice, ensuring a therapeutic parenting framework for all aspects of care, including risk and behaviour management. The underpinning therapeutic model to this support is Dyadic Developmental Psychotherapy(DDP)/PACE, and includes concepts and ideas from the Attachment, Self-Regulation and Competency (ARC) model and Non-Violent Resistance (NVR) as applicable. For specific needs such as neurodivergence or other specific mental health needs, appropriate therapeutic approaches will be included.

The structure of the consultations is largely as follows, but flexibly applied as needed:

  • 0.75 hours – general reflection/discussion with managers and/or key staff about current concerns
  • 1.5 hours – detailed consultation with the larger staff group about the young people
  • 0.75 hours – review of any relevant documents/brief input about specific topics/incidents previously identified/time with staff or young person/s as required

Where required, clinical supervision will be provided to managers and debriefs regarding specific significant incidents delivered.

In addition to the 3 hours ‘in the room’ with staff, our clinician would incur 1.5 hours administrative time per consultation. This includes preparation prior to the actual consultation (based on information about the young people provided by the residential manager prior to the consultation – i.e. risk/behaviour management plans, any incidents etc) and a brief summary write-up following the consultation.

This training is core and generally would form the foundation for any further training, consultation and intervention to care home staff and ultimately, albeit indirectly, the young people themselves. This indirect approach is nonetheless crucial therapeutic intervention impacting directly upon the young person.

  • The training is firmly based upon Dyadic Developmental Psychotherapy (DDP)/PACE principles and provides robust understanding of the impact of early trauma and strategies/techniques for managing emotional and behavioural challenges in a trauma-informed way. Ideas and strategies from other theoretical models (e.g. Non-violent Resistance) are incorporated to ensure the training is most helpful for those caring for young people who frequently present with complex needs and high levels of risk.
  • It is anticipated that all staff, including management, would attend this training, to ensure that the trauma-informed/therapeutic approach is embedded within the residential service/s at all levels.
  • The training would ideally be repeated on an annual basis, as an entry point for new staff and as a refresher for existing staff.
  • The training comprises a total of 10 hours input plus 4 hours clinician preparation time, divisible as follows:
  • 2 x 5 hour sessions (plus 4 hours preparation time)

OR

  • as agreed between management and the Gateway Psychology clinician and management.

The content of this training will be informed by initial assessment of the young person/s as well as ongoing review and consultation with managers and staff. In addition to formulation training around the individual young persons’ needs, it is anticipated that the training will address key areas of concern to more fully understand and address the young persons’ needs. This indirect approach should be considered crucial therapeutic intervention impacting directly upon the young person.

The training will have at its core the trauma-informed principles of Dyadic Developmental Psychotherapy (DDP)/PACE), and will incorporate other psychological/therapeutic modalities as appropriate. Topics such as Foetal Alcohol Spectrum Disorder, Self-harm, Eating difficulties, Autism Spectrum Conditions, Blocked Care, therapeutic de-escalation, preverbal trauma, amongst others, may be addressed in the training. Throughout, the young person’s history and the impact of their early trauma will be taken into account in considering these topics. Ideas and strategies for managing the young person’s needs in light of the concerns will form a key part of the training sessions.

The Baseline Psychological Assessment would be considered a routine psychological assessment of new children as they are placed in the home. This assessment will provide a comprehensive psychological understanding of the young person, to inform their Care Plan and consultations for the home, to identify training needs for staff, as well as to provide timeous evidence for any EHCP applications or other agency support, wherever needed. It is anticipated that this trauma-informed assessment will provide an in-depth understanding of the young person’s attachment, behavioural, social and emotional presentation, and will inform and assist in planning appropriate therapeutic intervention for the young person (whether direct or indirect). We anticipate that the assessment will look at the issues identified by the Social Worker and the care home, and may include the following:

  • Early developmental trauma/attachment related issues
  • Emotional presentation
  • Behavioural presentation
  • Cognitive presentation
  • Family/carer and peer (as appropriate) relationships
  • Carer stress/coping

In addition to less structured assessment, we anticipate utilising some of the following measures/tools in assessment, although this can only be clarified once the assessment has begun:

  • Assessment Checklist for Adolescents/Children (ACA/ACC)
  • Family Relations Test
  • Mood/Self-esteem/Resiliency questionnaires
  • Cognitive Assessment tools as appropriate
  • ‘Thinking About Your Child-Revised’ questionnaire
  • Parenting Stress Index
  • Family/Carer Interaction assessment

Before this initial assessment can begin, it will be imperative that the following information is provided by the Local Authority:

  • all relevant background information regarding the young person (e.g. early history, chronology)
  • any previous reports (e.g. medical, psychological, sensory, speech and language etc)
  • chronology of previous placements (including reasons for placement breakdowns)

The assessment will be conducted by a fully qualified and registered Clinical Psychologist/Psychotherapist, with the support of our Assistant Psychologists.

Any direct therapy will be as a result of appropriate assessment of therapeutic need for the individual young person.  Considerations regarding direct therapeutic intervention for a young person will take into account a neuro-sequential approach, ensuring that the young person’s therapeutic needs are most effectively met. The therapy will be contingent upon robust therapeutic/trauma-informed care provided by the staff to the young person on a daily basis.

The most appropriate therapeutic approach and the goals for the intervention will be determined as a result of the initial/baseline assessment or review, and may include, amongst others, the following modalities:

  • Dyadic Developmental Psychotherapy (DDP)
  • Eye Movement Desensitization and Reprocessing (EMDR)
  • Building Underdeveloped Sensorimotor Systems (BUSS Model® Intervention)
  • Theraplay®
  • Safe and Sound Protocol (SSP)
  • Narrative Therapy
  • Trauma-informed Cognitive Behavioural Therapy (TF-CBT)
  • Play Therapy
  • Dramatherapy

Therapy generally takes place on a fortnightly basis and will be provided by a fully qualified Clinical Psychologist/Psychotherapist, with the support of our Assistant Psychologists.

Additional information

In addition to the above information, please note that all Gateway Psychology clinicians are registered with their appropriate regulatory body and have current Enhanced DBS. All our clinicians and other staff undergo regular Safeguarding Training provided by Stoke on Trent and Staffordshire Safeguarding Board and are trained to at least Level 2 in Safeguarding Children, having received this training within the last three years. Gateway Psychology has updated safeguarding policies and procedures which are adhered to in all clinical practice.

Psychological support service costs

  • Our intensive psychological support packages typically range between £35,000–£40,000 per year (over 12 months)
  • The exact cost will reflect the level of input you need, including how often consultations take place and how frequently young people move within your service
  • We’ll also consider the number of homes and young people you support, to ensure the package fits your needs
  • We will always provide you with a full quote, with a breakdown of each service

Working with Gateway Psychology

If you are responsible for a residential care home for children and are exploring options for intensive psychological support, we would welcome the opportunity to speak with you. Our team has extensive experience in supporting children’s residential services to strengthen and embed trauma-informed, therapeutic approaches.

We would be pleased to arrange an initial discussion to better understand your service, consider your goals, and explore how we may be able to provide meaningful and effective support.

Please do not hesitate to contact us to begin the conversation.