Development of a Framework for Therapeutic Care in NSW

1. Development of a Framework for Therapeutic Care in NSW Simone Czech – FaCS Dr Wendy Foote - ACWA Simon Walsh – Allambi

2. Outline • The project outline and governance structure 2. ACWA’s preliminary survey results 3. Reflections from a service provider

3. Snapshot - OOHC in NSW 481 children and young people were in residential care (2.6%)

4. NSW Snapshot- Residential Care • 481 children and young people in Residential Care: • Ave. age 14 • 10% under 12 • 59% entered OOHC before they were 12 yrs • 7% entered OOHC before their first birthday • Ave. age first placed in OOHC- 9 yrs • 2.6% of all OOHC placements were in residential care • 26.3% cyp CAT score inconsistent with their placement type • Overall 4.2% cyp were in an OOHC placement that did not match their CAT score

5. Project Background • Why Therapeutic Care? • not just about Residential Care • Joint Project • Project Aims • Literature Review • Definition • Program Elements

6. Project Governance • Project Plan • Steering Committee • Working Group

7. NSW Definition NSW A Therapeutic Care for a child or young person in statutory care is a planned approach to the complex impacts of abuse, neglect, separation from families and significant others. This response is achieved through the provision of an evidence based model of care that reflects an environment that provides a positive, safe and healing experience in response to trauma, attachment and developmental needs in partnership. NSW B Therapeutic Care for a child or young person in statutory care is a planned, intensive approach to the complex impacts of abuse, neglect, separation from families and significant others. This response is achieved through the provision of a care environment that is evidence driven and provides a positive, safe and healing experience, in partnership with the family, significant others, utilising the expertise and experience of other services to address the complexities of trauma, attachment and developmental needs.

8. ACWA Residential Care Sector Consultations • April – Aug ACWA consultations with Residential Care House Managers & Direct Care Workers. • 25 ACWA member agencies funded to provide statutory Residential Care OOHC services. • Capturing the diversity of programs across NSW. • ACWA Residential Care Providers Network – used to inform the project.

9. 25 Participating Residential Care Agencies • Marist Youth Care • Entity – Caretakers Cottage • Wundarra • Anglicare Sydney • Premier Youthworks • Barnardos • Stretch-A-Family • Guardian Youth Care • CASPA • Challenge Children’s Services • Delphi Community Services • CareSouth • Allambi • Southern Youth and Family Services • Life Without Barriers • UnitingCare Burnside • St Saviours • Lifestyle Solutions • Mackillip Family Services • William Campbell Foundation • Pathfinders • CatholicCare Diocese of Broken Bay • Stepping Stone House • St Joseph’s Cowper • Impact Youth Services

10. Consultations with ACWA Members The Therapeutic Care Project seeks to develop guiding principles and review current service models for providing therapeutic OOHC services. Residential Care Providers Consultation • All 25 eligible agencies participated. • On line survey: Part I consisted of 34 questions and Part II consisted of 14 questions & a brief case study. NSW Residential Care Workforce Consultation • 110 direct care workers in Residential Care volunteered their thoughts, experiences, and the challenges of working in the Residential Care sector.

11. ModelsCurrently Used in NSW

12. Core elements ranked by overall frequency • Creating a home-like environment - 18/25 • Building rapport & relationships – 15/25 • Congruence in approach by staff – 14/25 • Establishing structure, routine & expectations – 14/25 • Offering emotional & developmental support – 14/25

13. Core elements ranked in order of importance • Nine respondents ranked “Creating a home-like environment” # 1 • Seven respondents ranked “Building rapport and relationships” # 2 • Four respondents ranked “Ongoing training opportunities for staff” # 3 • Five respondents ranked “Clinical supervision available for staff” # 4 • Five respondents ranked “Clinical supervision available for staff” # 5

14. Identified Barriers for Service Providers Breakdown of the 8 identified barriers by overall frequency

15. Research, Training and Sector Development Research • 8/25 respondents identified the development of outcome measures • 5/25 respondents identified the complex nature of trauma • 4/25 respondents identified after care & leaving care supports and funding Training • 11/25 respondents identified training tailored for Residential Care workers • 7/25 respondents identified training around trauma informed care • 6/25 respondents identified training in “Therapeutic Care” Sector Development • 5/25 respondents identified funding limitations for Residential Care • 4/25 identified leaving care options and supports

16. Next Steps • Therapeutic Foster Care • Consultation with cyp who have an experience of Residential Care in NSW

17. Adolescent Family Counselor Therapeutic Residential Programs Clinical & Health Services Allambi Care Therapeutic Foster Care Programs Education, Development and Vocation Services Therapeutic programs for people with Disabilities Joint Support Program Juvenile Justice Youth Hope Mentoring, family support & restoration Going Home Staying Home

18. Individualised Restorative Planning • Child focused • Focus on the child’s ‘here & now’ • Involving all appropriate parties (incl. child, sig others) • Congruency • Model is embedded through policy, practice & planning throughout the agency • State wide consensus of a definition Good Therapeutic Programs Change the Brain for the better • Measurable therapeutic outcomes • Unit costs reflective of needs & outcomes • Access to specialised support services • Clinical Services • Education • Staff/carer training • Therapeutic Care Models • Encompass a range of trauma-informed theories • Draw from one or a variety of models

19. Therapeutic Support provided by AYS Clinical Department

20. Individualised Restorative Planning • Child focused • Focus on the child’s ‘here & now’ • Involving all appropriate parties (incl. child, sig others) • Congruency • Model is embedded through policy, practice & planning throughout the agency • State wide consensus of a definition Good Therapeutic Programs Change the Brain for the better • Measurable therapeutic outcomes • Unit costs reflective of needs & outcomes • Access to specialised support services • Clinical Services • Education • Staff/carer training • Therapeutic Care Models • Encompass a range of trauma-informed theories • Draw from one or a variety of models

21. Facts & Figures Over a three year period: • Average number of clients transferred from IRC to IFC = 11 per annum • Average stay in foster care placement once transitioned = 3 years • Estimated savings in the first year is 2.4 Million • Potential total cumulative saving over 3 years is 14.7 million Clients Year Savings

22. Katie part 1

23. Katie part 2 To everyone at Allambi,Thank you so much for everything and for putting up with all my tantrums and all those long nights at hospital.What you guys have done for me I won’t forget – I love all of you’sso much. I honestly don’t think I’d be alive if I didn’t come here.What all of you do is awesome and I don’t know if you all realize but you do save kids everyday and give them that little bit of hope and love they need.And what makes you all so awesome is that it is pretty much unconditional care. You don’t care where kids come from, or where they are now your still there and are always trying to make each day better than the last. And that’s something only too few people can do. Keep smiling – always – forever