Dr. Stuart Hepworth, B.Sc., Clin.Psy.D.,C.Psychol. Our clinical service is overseen by Dr. Hepworth who has worked within child residential care since 2006 and prior to this worked in NHS child learning disability services. Dr. Hepworth has extensive experience in supporting residential homes in understanding the behaviours presented by young people in placement and developing intervention plans to meet assessed needs. Pebbles Care operates from a philosophy of understanding a young person’s individual needs within the context of current research on the impact of early trauma on emotional and behavioural development. It is becoming increasingly recognised that early traumatic experiences impact on all areas of development and that a therapeutic environment in which care staff respond appropriately to established, maladaptive behaviours offers the best opportunity to achieve positive outcomes. By taking a staged approach to intervention, we work on the principle that fundamental aspects of development – emotional regulation, attachment and a sense of safety – need to be in place before more complex work on developing coping skills, formation of a healthy identity and coming to terms with past trauma can be undertaken. Through a process of identifying the stage within this process that a young person is operating within, intervention plans which focus primarily on day-to-day interactions but may also include direct therapy or targeted work conducted by residential staff can be implemented in a way that matches the capacity a young person has to benefit from them. A consultancy model of intervention is seen as the primary mode of achieving positive change. All our homes have access to clinical psychology consultation with the aim of developing a team understanding of the presenting difficulties of the young people they care for. Consultations take a formulation based approach to intervention in which each young person’s background and current circumstances are used to interpret existing patterns of maladaptive behaviour. From this formulation, staff knowledge of why behaviours occur is built, enabling responses to behaviour to become more attuned to the underlying needs of our young people. According to requirements, consultations can be either on a regular, planned timetable, or in response to times of particular need within individual homes.