How do we keep to the therapeutic care principles of safety, consistency, predictability, and routine in a world that feels like it has turned upside down overnight? It’s near impossible! If we are feeling this way, imagine how young people may be feeling.

I know you are all working very hard to put plans in place that ensure the safety and well-being of all young people and staff. If your organisation is like ours, this process is consuming a lot of time and energy, including emotional energy. There is so much uncertainty surrounding what we knew our lives to be about – it’s changing in ways we could never have predicted. It’s impossible not to see the parallels of our current realities with the world of a traumatised young person.

Humour is a great way of relieving tension but remember that for many staff and young people it also masks underlying anxiety and fear about COVID-19 that they need our support with.

At these times, the perceived and felt a sense of safety of young people with trauma is easily undermined by the uncertainty brought about with COVID-19. As we know, when young people are feeling unsafe in their world they can have a range of responses that can include escalations in behaviour. We need to remember the drivers of the behaviour are a lack of safety and thus our focus needs to be on building safety in a time of uncertainty.

Here’s a few things to think about in fostering the experience of safety of young people in your care:

1. Be honest and open about the situation, acknowledging that the situation is changing, and we are all having to adapt in the face of it.
2. Keep clear lines of communication open with staff and young people so that any changes can be communicated ahead of time, and where possible allow for the preparation of the young people for change.
3. Acknowledge with young people that it is normal to feel worried or concerned in the face of the uncertainty and that you are feeling it too – even if their bravado suggests they are not worried at all.
4. Encourage young people to share their thoughts and feelings about what is happening so that you can offer reassurance, clarify any misinformation and ensure them that support is available.
5. Where you can, whilst things are still unfolding, keep as much normality as possible in the daily routines and operation of the houses.
6. Set up processes that support young people to be involved as much as possible in decision making about what is going to happen next.
7. Reassure young people that for the vast majority of people the virus is not serious and much like a cold or the flu.
8. Remind them about the things they can do to keep themselves healthy, reinforcing messages about hygiene, social distancing and telling someone asap if they start to feel unwell or have been in contact with someone who is unwell.

There are no easy answers to the unfolding realities for young people in residential care but calm, reasoned and sensitive approaches will always be helpful.

As staffing situations for young people are likely to change due to illness we will need to ensure that staff filling in are aware of the best ways to understand and respond to the needs of the young people.

Now more than ever, Therapeutic Specialists have a role to play in supporting staff so that they can support the young people through this uncertain time.

Janise Mitchell
Director, Centre for Excellence in Therapeutic Care