Over the past two decades, the term therapeutic care has emerged as a new paradigm used to integrate constructs that had traditionally been considered separate – therapeutic processes and the care of young people, many of whom have experienced significant trauma and present with a range of complex needs and challenging behaviours. National and international research has long told the story about how difficult it has been for traditional approaches to residential care to effectively meet the needs of these young people.

The explosion of knowledge about the neurobiology of trauma and development has fuelled a much deeper understanding of what young people in out of home care need, especially in relation to reparative experiences for the direct threat that they have experienced arising from experiences of relational disruption and significant violation. It has confirmed what we have known for a long time. For as much as relationships are the vehicle through which such trauma is deeply embedded in the brains and bodies of young people, relationships are also the resources that help young people to heal.

Therapeutic Care has focused our attention on how relationships come to work for young people in real time. They depend on relationships across the multiple contexts in which they inhabit. The impact of their experiences is so severe that they need multiple relationships to work for them, to help support the healing their brains and bodies are so desperate for. They need relationships to be sensitive to their needs in a consistent way across settings and over time.

This is the context in which the paradigm of Therapeutic Care has surfaced. It is a recognition that traumatised young people benefit from experiencing relationships around them which embrace therapeutic intent and hold therapeutic capacity. It means that for healing to occur, these day to day relationships of care need to be purposeful and oriented to being used as resources in transformation.

The NSW Government has set out a reform to once what referred to as residential care. It has reconceptualised it into an Intensive Therapeutic Care System. The vision for the system is for it to become evidence-informed, trauma responsive and promote stability and positive wellbeing outcomes for young people over the age of 12 with high and complex needs. It has introduced a number of elements which are explained in more detail here: NSW Intensive Therapeutic Care System.

It has also funded Australia’s first Centre for Excellence in Therapeutic Care which is run by the Australian Childhood Foundation in partnership with Southern Cross University. Its purpose is to

• systematically build, synthesise and translate knowledge;
• support the development of a collective understanding and capacity to enact therapeutic care across the ITC system and related sectors; and,
• foster a shared ownership for the achievement of high-quality outcomes for young people.

The Therapeutic Care Blog is an initiative of the Centre in pursuit of its vision. For me, it is a place where practitioners, researchers, cultural experts and service leaders can come together to explore ideas and approaches for the provision of high-quality therapeutic care to young people not only in the NSW ITC system but wherever it is relevant to do so.

The field of Therapeutic Care continues to grow and evolve. This blog is an important place to share emerging ways of thinking as we come to learn more about what is helpful for young people who need our care and support. It’s a great place for you to share your work with colleagues as we generate thinking about the provision of Therapeutic Care in the Australian context.

I look forward to our collaboration in bringing the blog to life.

Janise Mitchell
Director, Centre for Excellence in Therapeutic Care