Therapeutic Care

Therapeutic Care and Psychological Support Services

The decision to place a child or young person in a children’s home is not undertaken lightly.  It represents a significant and costly intervention in the child’s life and often follows other intervention’s that have not been able to meet the child’s needs, such as the provision of family support, individual therapy, pharmacological interventions, and foster care.  Most of the children placed in children’s homes have complex and multi-faceted needs that cannot be met via any one individual or agency.  Many have refused to engage, or struggled to engage, in individual therapeutic work.  Multi-agency working is the norm in this field of work, requiring effective communication, shared understanding, and a common purpose and goal.  The work carried out in children’s homes is among the most complex, challenging and rewarding in the field of social care.  Keeping children safe, meeting their care needs, and assisting them to address their emotional and behavioural difficulties requires a dedicated team of skilful staff led by trained and experienced managers working to exacting regulatory standards under close scrutiny from external agencies (e.g. Ofsted, commissioning services). 

Positive Pathways is committed to providing high-quality care in home-like environments maintained to the highest standards with maximum opportunity for normalizing experiences and re-integration into the wider community.  Our primary aim is to provide safe, supportive, thoughtfully-created living environments that meet individual developmental and therapeutic needs; promote personal responsibility, autonomy and independence; and safeguard the young person and the community from harm.  We recognise that children struggle to make progress in care environments that are chaotic, disorganised and unkempt.  We aim to create planned psychologically-informed environments (PIE’s) in which the residential teams develop strategic approaches to caring for each young person to achieve identified goals.  This strategy is developed in consultation with our Consultant Psychologist, who guides and helps each team to develop an understanding of individual need.  This therapeutic process is informed particularly by Attachment Theory, Trauma-Informed Care, Social Learning Theory and Positive Parenting.

We view the therapeutic journey as a continuum, with a clearly defined starting point and a destination to work towards.  The starting point is always the same: to establish effective rapport with the young person, to create shared understanding of risk and need, and to develop a working partnership.  Further therapeutic work is built on the foundation of trust and understanding between the young person and the staff team or with specific individuals within the team.  By observing and listening to the young person we aim to develop an understanding of the underlying psychological factors that drive and motivate their behaviour.  We encourage young people to talk about their thoughts, feelings, and difficulties in the belief that problems are best solved when they are shared.  The development of this therapeutic culture is designed to overcome the tendency for troubled young people to resist dealing with underlying psychological issues that result in behavioural problems.          

The aim of therapeutic care is to promote personal change, reflected in changes in thinking, emotional functioning, and behaviour.  Many of the young people are placed with us because they have not responded to conventional therapeutic approaches.  We recognise that a new, creative, flexible, approach is required.  Programmes are built around the specific needs of each young person, with a view to reducing personal distress; promoting recovery from mental health difficulties; improving personal functioning; and acquiring appropriate behavioural self-management and coping skills.

Psychological Consultancy and Support Services

We are committed to providing the best possible quality care and therapeutic intervention to young people with complex needs.  We believe it is vital that our work is informed by relevant psychological knowledge, research, and expertise. This knowledge also helps steer the development of our organisational ethos and staff training programme.   The Director of Psychological Therapies (Dr Kevin Epps) has been working with children and young people in various settings since 1986.  Other suitably qualified and experienced psychologists are sometimes commissioned on a sessional basis.  The management team in each house holds a monthly Clinical Support Meeting (CSM) with the psychologist to discuss each young person.  These meetings are used to formulate observations and clinical material with reference to various theoretical models (e.g. attachment, behavioural, cognitive, systemic, psychodynamic) to develop insight into the young person’s presenting difficulties.  Psychological supervision is also available to individual team members regarding their work with young people.                  

Additional psychological and therapy services can be commissioned on an as-needs basis, including:

  • Individual clinical assessment, including assessment of developmental problems (e.g. intellectual difficulties) and emotional and mental health problems (e.g. depression, psychosis).
  • Individual risk assessment, to self/others, using established risk assessment protocols (e.g. the SAVRY: Structured Assessment of Violence Risk in Youth.)
  • Individual psychological intervention work (e.g. non-directive counselling; CBT; EMDR).
  • Offence-related interventions (e.g. anger management) in collaboration with Youth Offending Services
  • Play therapy
  • Counselling