junctionaustralia.org.au
I would like to acknowledge the traditional owners of the land on which we are gathered and pay
my respects to the elders past and present
junctionaustralia.org.au
• Mel Robison: Team Leader
• Dawn Briggs: Service Manager
• David O’Rafferty: Portfolio Manager
Presentation Team
junctionaustralia.org.au
Therapeutic Support Services
Youth Connections
Nexus Residential Care
Fee for Service FLO
Junction Australia
junctionaustralia.org.au
Therapeutic Residential Care is intensive and time-limited care for a child or young person in statutory care that responds to the complex impacts of abuse, neglect and separation from family. This is achieved through the creation of positive, safe, healing relationships and experiences informed by a sound understanding of trauma, damaged attachment, and developmental needs. [National Therapeutic Residential Care Working Group, Australia]
Therapeutic Care
junctionaustralia.org.au
You should draw a picture
A picture with a twist
A picture with a knife
A picture on your wrist
If you draw it right
A fountain will appear
And in its flowing waters
All your troubles disappear
POEM
junctionaustralia.org.au
• Attachment problems• Eating disorders• Depression• Suicidal behaviour• Anxiety• Alcoholism• Violent behaviour• Mood disorders• Developmental delays
Child trauma
junctionaustralia.org.au
IMPACT ON GROWTH AND DEVELOPMENT
• Chronic state of high stress
• Interpreting neutral cues as threat
• Explosive patterns of fight/flight behaviour
• Extreme patterns of freeze behaviour
• Limited resilience
• Wary of adults in relationships
• Deficits in processing skills
junctionaustralia.org.au
Is the impact of trauma, abuse and neglect during the critical period of early life. This results in the disruption of a child’s growth and development and changes physiology and nervous system responses. Depending on the timing of the trauma will determine the impact on the brain.
Developmental Trauma
junctionaustralia.org.au
Children reflect the world in which they are raised. If that world is characterised by threat, chaos, unpredictability, fear and trauma, the brain will reflect that by altering the development of the neural systems involved in the stress and fear response.
What we have learned
junctionaustralia.org.au
• The brain is capable of change due to it’s plasticity.
• Change in the environment and experiences that are consistent, nurturing, caring and supportive all assist in this change.
Can this change?
junctionaustralia.org.au
• Intervention must begin in the Brain stem
• Intervention must match to trauma history, Understand the meaning behind the behaviour
• Intervention to match developmental stage
• Identification of trauma triggers to ensure you are not creating a re-traumatising situation/environment
• Identify the window of tolerance , safe practice of heightened arousal with co regulation
• Life story work - build narrative memory, healing of pervasive shame and guilt
How we create change
junctionaustralia.org.au
• Seek out the best training and advice available
• Build links with other services and agencies
• Therapeutic Residential Care Network: 5 agencies in SA
• All leadership team doing Graduate Certificate in Developmental Trauma through ACF.
• Houses Supervisors training in Developmental Trauma with AFSS and ACF
• Teams training in Developmental Trauma in team meetings with Clinical Psychologist & TCI refreshers
• Other on going workshops and training
Trauma Informed and Trained
junctionaustralia.org.au
Child Centred Practice ModelTherapeutic Support Services: Practice Model
PORTFOLIO MANAGER
SERVICE MANAGER Team Leaders:
Casework Young People
Line Management of House
Supervisors
Case Conferences
Assist with attending
appointments
House Supervisors:
Manage the House
Maintenance
Rosters
Food & Hygiene
Living Skills checklist connects with Youth Connections
Weekly review
Support Workers:
Build relationship
One On One & Group time
Independent Living skills-
connects with Youth
Connections
Referral from PSU to
Service Manager
Transition &
Care Plan
Referral to
Youth
Connections
Weekly Phone review
Eight- Weekly Case Conference
with all Stakeholders
Transition to Long Term Placement
or Independent Living
3R’s
Respect…:
Self
Others
Environment
Team Leader: Supports Young Person to
access other services
Referral to other services
Mentors:
Independent Living Skills
RAGE
Life Through the Lens
A Life Outdoors
Drumbeat
Rock & Water
Team Meetings
Every two weeks
Clinical Psychologist
once a month
Individual management
Plan
Practice Forum
Incident reviews
TCI review
junctionaustralia.org.au
• Respect yourself
• Respect others
• Respect environment
• Expectations over Rules
The 3 R’s and Expectations
junctionaustralia.org.au
• Reactive Aggression / Planned Aggression
• Strategies: we respond to reactive aggression by assisting the young person to return to baseline and help them learn a new coping strategy
• With planned aggression we negotiate with the young person and then help them to find alternative strategies to achieve their desired outcome without using aggression.
We do not charge young people with property damage
junctionaustralia.org.au
Intake referral checklist
Initial TCP
Referral to Youth
Connections
Weekly reviews
TCP
15+ TCP
Post care
Trauma informed care planning
junctionaustralia.org.au
• Listening and responding with respect
• Communicating a framework for understanding
• Building rapport and relationships
• Establishing structure, routine and expectations
• Inspiring commitment
• Offering emotional and developmental support
• Challenging thinking and action
• Sharing power and decision making
• Respecting personal space and time
• Discovering and uncovering potential
• Providing resources
11 Interactional Dynamics – James Anglin
junctionaustralia.org.au
Rostering – promote healthy work/life balance Regular supervision – structured coaching, training, professional development
Debriefing sessions/On call support –reflective practice, unpacking of incidents, what worked well and how can we do things better next time
External assistance program - for all staff
Vicarious Trauma - Prevention, manage, repair
junctionaustralia.org.au
Leadership and program support
Clinical participation
Supervision and post crisis response
Training and competency standards
Documentation and incident monitoring and feedback
THE TCI SYSTEM 1
junctionaustralia.org.au
• Assist organisations in preventing crisis from occurring, de-escalating potential crises, managing acute physical behaviour, reducing potential and actual injury to young people and staff, teaching young people adaptive coping skills, and developing a learning organisation.
Therapeutic Crisis Intervention
junctionaustralia.org.au
Incident Monitoring
and Feedback
Trainingand
Competency Standards
Supervision and
Post Crisis Response
Clinical Participation
Leadership and Program Support
ICT
junctionaustralia.org.au
Any thing that makes challenging behavior more or less
likely to occur.
For example:
Organizational culture, e.g., control oriented, poor communication
Environment, e.g., hot, crowded
Program related, e.g., routine, staffing, activities
Personal, e.g., illness, medication, trauma
Relationship-based, e.g., excessive controls, “us versus them” culture
CRISIS PREVENTION AND THE THERAPEUTIC MILIEU 2
junctionaustralia.org.au
Being aware of personal goals, values, beliefs
Understanding cultural and ethnic differences and each other’s worldview
Demonstrating self-regulation skills
Knowing personal triggers
THE IMPORTANCE OF EMOTIONAL COMPETENCE 8
junctionaustralia.org.au
A young person’s inability to cope
results in a change in behavior
THE STRESS MODEL OF CRISIS: A TYPICAL CRISIS 9
junctionaustralia.org.au
SUPPORT: environmentally and emotionally to reduce stress and risk
TEACH: children better ways to cope with stress
THE STRESS MODEL OF CRISIS: A TYPICAL CRISIS 10
junctionaustralia.org.au
ASSESSING THE SITUATION 14
1. What am I feeling now?
2. What does this young person feel, need, or want?
3. How is the environment affecting the young person?
4. How do I best respond?
junctionaustralia.org.au
KNOWING OURSELVES 16
Anger can undermine objectivity
Anger is an emotional and physical state
Cognitive abilities are reduced
junctionaustralia.org.au
KNOWING OURSELVES 17
“When we are at our angriest, we are at our stupidest.”
junctionaustralia.org.au
Assessing Behavior
KNOWING THE CHILD 19
All behavior has meaning
Behavior reflects needs
Trauma affects how children behave
junctionaustralia.org.au
KNOWING THE CHILD 20
Impulsive outbursts
Aggression
Running away
Self-injury
Defiance
Inability to regulate emotions
Trauma re-enactment
junctionaustralia.org.au
BEHAVIOR SUPPORT TECHNIQUES 33
Managing the environment
Prompting
Caring gesture
Hurdle help
Redirection and distractions
Proximity
Directive statements
Time away
junctionaustralia.org.au
MANAGING AGGRESSIVE BEHAVIOR 45
REACTIVE PROACTIVE
Safety Safety
Understanding and support Containment and negotiation
Remove or reduce stimulus Engagement and reasoning
junctionaustralia.org.au
THE LIFE SPACE INTERVIEW 66
1. Return the young person to normal functioning
2. Clarify events
3. Repair and restore the relationship
4. Teach new coping skills
5. Reintegrate the young person back into the program
junctionaustralia.org.au
THE LIFE SPACE INTERVIEW 67
I – Isolate the conversation
E – Explore young person’s point of view
S – Summarize the feelings and content
C – Connect feelings to behavior
A – Alternative behaviors discussed
P – Plan developed/Practice new behavior
E – Enter young person back into the routine
Conducted by the care worker
junctionaustralia.org.au
• CTARS+ is innovatively designed to bring together all the paper-based data collection and record keeping that's done on the ground in high needs youth services or services for people with complex needs. CTARS+ combines incident reporting, progress notes, activity logs, behavioural logs, and data logs, along with the range of other critical data systems into one web-based software program.
Client Therapeutic Analysis and Reporting SystemWhat is CTARS?
junctionaustralia.org.au
Youth Connections
Supporting children & young people to become the authors of their future
instead of victims of their past.
junctionaustralia.org.au
Youth Connections is a mentoring program which focuses on building self-esteem, resilience and self-worth in children and young people healing from trauma and neglect.
About Youth Connections
junctionaustralia.org.au
• The mentors operate from a trauma informed practice framework.
• Mentors understand that lack of attachment and exposure to trauma during their early developmental years may affect a young person’s ability to regulate their emotions.
Our Philosophy
junctionaustralia.org.au
MENTOR: “WHAT CAN I DO TO HELP?”
YOUNG PERSON: “Can you just give me some more time……….”
junctionaustralia.org.au
• This program uses a strength's based approach to support each young person to identify their ‘SPARK’ and provide opportunities to embrace and explore possibilities.
• Fostering a young person’s SPARK can give a young person meaning and purpose in their life to improve emotional, psychological and social well-being.
Finding your SPARK
junctionaustralia.org.au
• This is achieved through individualised and group activities, both informal and structured.
• The young people are offered a range of activities and outings to explore their strengths and interests.
• Many of our young people have not had the opportunity to identify what they are good at or what they enjoy doing.
Finding your SPARK cont…
junctionaustralia.org.au
These activities are some of our starting points to engage and explore possibilities with young people for future pathways.
Drives
Photography
Bike riding
Cooking
Art n Crafts
Favourite Activities
junctionaustralia.org.au
• Cooking is an instrumental part of our program. This ensures a healthy lunch and also supports them to develop independent living skills in an informal way.
Cooking
junctionaustralia.org.au
Young people are encouraged to look at things from different perspectives, connect with their school and community through images taken and think about creative ways to display their work.
Through the eyes of Children
junctionaustralia.org.au
Throughout the program young people are supported and encouraged around the ideas of RESPECT, FOCUS and PERSPECTIVE.
Perspective
junctionaustralia.org.au
• The Holyoak Drumbeat program is run over ten weeks and combines the benefits of music to a cognitive approach that develops self-awareness and social learning.
• It was developed to support people who are resistant to traditional ‘talk based’ therapies.
DRUMBEAT
junctionaustralia.org.au
• We use the African DJEMBE drum which acts as a safe form of connection and communication.
• The drumming allows for a therapeutic release of emotion.
African DJEMBE drum
junctionaustralia.org.au
The young people use analogies drawn from the rhythm’s they learn to explore many social and relational issues such as;
• Peer pressure
• Risk taking – safe and unsafe
• Identity
• Emotions and feelings
• Communication & teamwork
Cognitive Approach
junctionaustralia.org.au
Life OutdoorsUsing the natural environment we engage in activities that become gradually more challenging.
Young people achieve success over their physical environment, as well as developing self-confidence and self-awareness.
junctionaustralia.org.au
(Renegotiating Angry and Guilty Emotions) is a six week anger management program that uses a strengths based rather than problem oriented approach.
The program encourages the young person to gain confidence within the group and themselves before they learn to deal with the most misunderstood human emotion – anger.
R.A.G.E.
junctionaustralia.org.au
Managing the Bull is a six week course that aims to build social resilience in teens who feel they are being bullied.
Through fun games, activities and group discussions the program teaches young people how to profile a bully and equips them with useful strategies on how to manage them.
Managing the Bull
junctionaustralia.org.au
When should we stand firm like a rock…
And when do we let ourselves be fluid and responsive like water…..
Rock ‘n Water
junctionaustralia.org.au
Independent Living SkillsThe Independent Living Skills Program aims to support
young people transitioning from our therapeutic houses in to their own homes by developing and sustaining independent living skills.
Specifically the program aims to:
• Improve rates of sustainable successful tenancies through improving living and social skills
• Increase knowledge of and access to local support services to secure and support housing tenancies
• Increase opportunities for young people to develop leadership skills by participating as peer mentors.
junctionaustralia.org.au
Topics Covered:• Job Descriptions
• Resumes
• Mock interviews
• Applying for jobs
Job ready
junctionaustralia.org.au
• Therapeutic crisis intervention training • Part-time permanent staff employed by JA• Trauma informed foundation• Setting a criteria for what is an incident • Structured rostered team meetings with Clinical
Psychologist• Structured supervision and review processes• Client involvement and feedback• Therapeutic environment• CTARS – a data base system • Mentoring program
Factors resulting in reduction of incidents and improved outcomes
junctionaustralia.org.au
2012/13 Prior to TCI 2013/14 TCI Framework 2014/15 TCI Framework
Mulberry 48 51 3
Gulfview 24 18 0
Parkview 61 67 13
4851
3
24
18
0
61
67
13
0
10
20
30
40
50
60
70
80
Axi
s Ti
tle
TSS Incident reports 1st July 2012 - 30th June 2015
junctionaustralia.org.au
2012/13 Prior to TCI 2013/14 TCI Framework 2014/15 TCI Framework
Mulberry 137 270 155
Gulfview 164 84 61
Parkview 254 65 45
137
270
155164
84
61
254
65
45
0
50
100
150
200
250
300
Axi
s Ti
tle
TSS Missing Person Reports 1st July 2012 - 30th June 2015
junctionaustralia.org.au
• Our legacy is for every child or young person who stays with us regardless of the period of time, felt they were treated with respect and dignity.
• That each young person who has stayed with us will remember their stay with Junction Australia as a positive experience.
• Young people are proud to say “l lived there and l was respected and cared for.”
Legacy
junctionaustralia.org.au
• For Therapeutic Crisis Intervention: Therapeutic Welfare Interventions twi.org.au
• Australian Childhood Foundation: childhood.org.au
• Cornell University: rccp.cornell.edu• Professor Dr James Anglin: uvic.ca• Dr Bruce Perry: childtrauma.org• Dr Dan Hughes: danielhughes.org• Dr Dan Siegel: drdansiegel.com• Dr Allan N. Schore: allanschore.com
Contacts