OUR MODEL OF INTERVENTION
We provide a trauma-informed environment to support and enable looked after young people’s journey through their recovery. Whilst this does not involve direct trauma therapy at B.E.S.T Project, our knowledge and understanding of Developmental Trauma allows us to recognise how it affects individuals lives, identify their needs and plan appropriate intervention to support them. If individuals are interested in further reading on Developmental Trauma, we are happy to provide additional information.
DEVELOPMENTAL TRAUMA AND LOOKED AFTER CHILDREN
Young people in care have often been repeatedly exposed to abuse, neglect and/or a repeated cycle of loss, rejection and abandonment; as a result, they can suffer from Developmental Trauma (van der Kolk, 2005). Studies have demonstrated that young people with Developmental Trauma are more likely to engage in harmful behaviour like criminality, violence, substance misuse and early pregnancy. It also contributes to both long-term mental and physical health issues in adulthood, as well as poor social outcomes, such as a lack of education, unemployment and poverty (Hampton, 2019). It is, therefore, imperative to have good knowledge and understanding of the impact of trauma and utilise a trauma-informed approach when supporting young people in care. Recovery from trauma is possible; however, this does not always mean complete freedom from the effects of traumatic experiences, but rather the ability to live in the present without feeling overwhelmed about thoughts and emotions from the past (Manitoba Trauma Information and Education Centre, 2013).
Our model of intervention is predominantly based on The Institute on Trauma and Trauma-Informed Care’s ‘Five Guiding Principles’ (2015) and Skuse and Mathew’s Trauma Recovery Model (2014).
THE FIVE GUIDING PRINCIPLES
The Institute on Trauma and Trauma-Informed Care (2015) identified ‘The Five Guiding Principles’ of trauma-informed care: safety, choice, collaboration, trustworthiness and empowerment. They developed these principles, rather than a set of procedures, so they can be interpreted and applied in ways that are appropriate for different services. We utilise these guiding principles throughout our practice and apply them to our intervention with young people. Definitions are outlined below, together with how these work in practice at B.E.S.T Project.
SAFETY
Providing safety and stability to the young people we support at B.E.S.T Project is fundamental to our practice. Our accommodation is maintained to a high standard, with all the necessary safety precautions in place. We also recognise that whilst physical safety is important, the young people need to feel safe. We specialise in developing trusting and meaningful relationships with young people so they feel valued, protected and secure. Furthermore, part of our intervention with all young people is focused around helping them to identify different risks and supporting them to develop the skills necessary to respond to them appropriately. We are also committed to ensuring that all young people have support for their physical, mental and sexual health needs. We assist young people to register with local healthcare providers and help them to develop the confidence to take responsibility for managing their appointments and medications. We promote healthy living and actively encourage young people to eat well, exercise and maintain good hygiene.
CHOICE
Having choice and a sense of control is critical to self-development. It helps individuals develop autonomy, build initiative, increase self-control, manage self-regulation and improve self-esteem. At B.E.S.T Project, every young person has the right to make decisions and choices about how they live their life. They are central to all decision making about them and are provided with clear and appropriate messages about their rights and responsibilities. We actively listen to what they would like and, where possible, try to meet their needs and requests. We also help young people to deal with consequences, evaluate tasks, develop problem solving strategies, and model how to make meaningful choices; this is achieved through regular mentor sessions, discussions within the home and positive role modelling.
COLLABORATION
Involving individuals in decision making enables equality, inclusivity, control and shares the power. It also encourages participation and promotes transparency. We believe in co-production and collaborating with everyone impacted by the project’s outcomes, including the young people, their families, professionals, statutory and voluntary services and the Council. Young people at B.E.S.T Project are given a significant role in planning and evaluating our service and are able to share their views in several different ways. Providing young people with the chance to share in the decision making at B.E.S.T Project ensures that everyone has a voice and feels heard.
TRUSTWORTHINESS
Positive relationships are vital for individuals to recover from trauma; a key skill needed for this practice is the ability to build strong and trusting relationships with people. All the staff at B.E.S.T Project are highly skilled at developing and maintaining relationships with the most complex and hard to reach young people. We achieve this by utilising B.E.S.T Project core values, as well as being patient, empathetic, consistent, and flexible. We also encourage and support young people to maintain relationships with their family, friends and other professionals.
EMPOWERMENT
This is defined as the process of becoming stronger and more confident as individuals gain control of their circumstances and achieve their own goals. However, at B.E.S.T Project we recognise that it can have different meanings to different people, depending on their experiences, circumstances, hopes and dreams. We support young people to work towards their personal goals identified in their B.E.S.T Plan to maximise the quality of their lives. We provide an environment that allows young people to feel validated and affirmed with every contact at the project. Young people’s success, no matter how great or small, is always recognised and highly praised at B.E.S.T Project.
THE TRAUMA RECOVERY MODEL
Dr Tricia Skuse and Jonny Matthew (2014) developed the Trauma Recovery Model (TRM), illustrated below. It was developed to help professionals support and guide individuals towards their recovery from trauma. The model is sequenced so the right intervention is used at the right time, which is dependent on the individual’s behaviour and psychological needs that underpin it (TRM Academy, 2018).
We have utilised this model to shape our intervention at B.E.S.T Project. Young people who come to the project will be at different stages of the TRM and move through each stage at different times. No one can dictate the length of a person’s recovery and his or her journey may take place over several years. However, we endeavour to support them to achieve as much progression as possible, with the hope that move-on plans will continue to support their development. The diagram to the left demonstrates how B.E.S.T Project support looked after young people at each stage of the TRM.
REFERENCES
Hampton, D. (2019). How Adverse Childhood Experiences Lead to Mental Health Problems in Adults. Available at: https://thebestbrainpossible.com/mental-health-trauma-aces/ (Accessed 28 June 2020). The Institute on Trauma and Trauma-Informed Care (2015). The Five Guiding Principles of Trauma-Informed Care. Available at: http://socialwork.buffalo.edu/social-research/institutes-centers/institute-on-trauma-and-trauma-informed-care/what-is-trauma-informed-care.html (Accessed 25 July 2020). TRM Academy. (2018). Help for trouble children and young people. Available at: https://www.trmacademy.com/#theModel (Accessed 28 June 2020). Manitoba Trauma Information and Education Centre. (2013). Phases of Trauma Recovery. Available at: https://trauma-recovery.ca/recovery/phases-of-trauma-recovery/ (Accessed 28 June 2020).Van Der Kolk B. (2005). Developmental trauma disorder: Toward a rational diagnosis for children with complex trauma histories. Psychiatric Annals. 2005;35:401–408.