We have invested in our own Psychological Services, so we can best support young people to achieve positive outcomes. We deem it best practice to have an objective eye over our Psychological Services and thus we have partnered with three Clinical Psychologists to oversee each of our regions:
Dr Marie Renaud for
Dr Adele Parker for Leeds/St Helens
Tim Atkin for Cumbria/
Through our Personal Development Plan (PDP) framework we identified three members of our team to work directly below each Clinical Psychologist, where they will provide Clinical Governance to support the assessments carried out with young people. Each of these key staff members holds an appropriate Psychology Degree and have substantial experience of working with young people within our Residential and Education services.
Assessments carried out include the Assessment Checklist for Adolescents (ACA), which allows us to assess the mental health needs of a young person and highlight whether we need a collaborative approach with external agencies such as CAMHS. We believe this model provides young people with every opportunity to build positive relationships and achieve.
At Pebbles Care we continue to invest within our Psychological Services so we can provide personalised and responsive mental health support for young people and offer an informed strategy to develop resilience for future living. We advocate that young people have experienced significant trauma in their lives, and that their behaviours have developed as a way of coping with their history.
Our assessment model, The Trauma Pathway, which continues to make a difference for so many young people, confronts this trauma and empowers our team to offer a therapeutic solution for those in our care. The Trauma Pathway is an innovative model that insists upon trauma informed practice and offers tangible measurement of each young person’s journey towards achieving positive outcomes.
Created and delivered by Dr Stewart Hepworth, following considerable research and consultation, we wanted to deliver a model that was ‘simple’ to follow but governed and created according to the very highest standards of Clinical Psychology. Following feedback from Local Authority professionals we were also keen to create a model that provided our partners with tracking/measurement in relation to the progress of the young people they were responsible for.
The Trauma Pathway is based upon the ethos that assessment prior to, and upon, admission into placement does not always reflect genuine levels of behaviour or functioning for a young person. In addition, we cannot expect to see immediate progress when therapy begins at the commencement of a placement due to the profound and lasting effects of trauma.
The Trauma Pathway advocates that as development occurs in stages, with certain abilities being unachievable before the foundations of other abilities have been built, a staged assessment approach is essential when treating traumatised young people. For recovery to occur, certain skills need to be mastered at one stage before a young person can move on to the next:
Stage 1: Safety in one’s environment
Stage 2: Skills development in emotional regulation and interpersonal functioning and development of self-esteem
Stage 3: Meaning-making about past traumatic events
Stage 4: Enhancing resiliency and integration into social network
The initial assessment identifies which stage a young person is functioning at, with significant behavioural difficulties indicating that a young person is at stage 1 and does not feel safe. When a young person starts to feel safe, we expect to see behaviours improve and then focus on stage 2 therapies. More complex individual work such as counselling and life story work will be engaged following successful engagement within stage’s 1 and 2.
Each stage is inclusive of intensive psychological input, therapeutic engagement and relationship development which culminates in the Assessment Checklist for Adolescents (ACA), a 105-Item, Caregiver-Report, Psychiatric rating scale that measures behaviours, emotional states, traits, and manners of relating to others, as manifested among young people in Care. Alongside the ACA, which offers an independent measure of progress, we complete further questionnaires specifically designed to inform the Trauma Pathway model of intervention. This is based on the idea that sever behavioural difficulties tell us a young person’s need is to feel safe. Scoring is visually represented in graphical images within the Trauma Pathway report and accompanied by a Statement of Progress and clinical analysis from our Psychologist which offers a unique measurement of progress to parents, carers and professionals associated to each young person.
Our training department provides training modules for each Residential service to ensure a consistent application of the Trauma Pathway therapies and ACA scoring. The Trauma Pathway for each young person is subject to clinical governance and residential staff receive 1:1 time with the Psychologist to discuss the progress of the young person and how this should be best measured and interpreted within the Trauma Pathway report.
Partnership working between professionals, parents and carers is essential to support young people to achieve positive outcomes and reach their target destinations. It is equally important to be able to remove any subjectivity or ambiguity relating to trauma and associated behaviours with so that tangible progress can be measured, and achievable goals accordingly reassessed for each young person. The Trauma Pathway is built on this premise and we want to share our vision in hope an collaborative approach will allow us to reach and engage with even more young people who want to overcome trauma and achieve an independent and dynamic lifetime.