Client Mix and Client Matching in Therapeutic Care – practice guide

Download PDF

Client mix and the process of client matching is one of the 10 Essential Elements underpinning the Intensive Therapeutic Care (ITC) system in New South Wales. This guide has been developed to support effective decision-making processes around client mix and client matching. The guide identifies and explores seven domains of effective decision making with a focus on therapeutic group or residential care settings including Therapeutic Intent, Participation, Individual Needs, Group Living Context, Staffing, Organisational Capability and System Issues.

 

Key Messages

  • Effective decision making regarding client mix and client matching provides the foundation for safety, therapeutic care and improved outcomes for young people.Client matching is the practice of identifying the individual needs of young people and matching them to an environment that best supports them to recover and heal.
  • Client mix is the practice of understanding the needs of a young person and how that young person could live safely with, benefit from, and positively contribute to the lives of others.
  • The national and international literature is sparse regarding effective client mix and client matching practice.
  • Effective practice regarding client mix and client matching within ITC must take into consideration a range of domains including the individual needs of young people, the group living context, participation of young people, the therapeutic intent of the program, the capacity of the staff team, organisational and systems capability and issues.
  • The interplay of the seven domains will impact the achievement of positive outcomes for young people. Careful assessment of the risks, needs, strengths, and vulnerabilities across each domain, and the consequences of these is critical. Strengths in one or more domains will mitigate the vulnerabilities in another domains.
  • A positive group climate is reliant on the staff to set the relational context within which young people feel safe to share their thoughts and feelings with staff, who are able to set limits, boundaries and expectations that are balanced, negotiated, understood, accepted and calmly applied.
  • Group norms and the expectations young people place on each other and the group itself can play an important role in setting standards for behaviour and maintaining safety.
  • Group dynamics should be carefully monitored and supported in consideration of their ‘readiness’ to accept/ positively tolerate a new young person, supported by a comprehensive understanding of young peoples’ unique strengths, vulnerability and triggers.
  • Positive staff culture and attitudes towards the behaviour of young people are critical to the staff’s ability to interpret the behaviour and needs of young people through a trauma informed lens. Trusting and safe relationships between staff and young people are essential for young people to be supported to de-escalate, co-regulate and learn pro-social behaviours.
  • There is a strong relationship between organisational and system cultures and living group climate in the houses, with staff performing better when there is confidence the organisation shares their vision and commitment to the work.

 

 

You may be interested in: Therapeutic care

An emerging paradigm - Welcome to our new Therapeutic Care Blog
An emerging paradigm - Welcome to our new Therapeutic Care Blog Written by: Janise Mitchell
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...
Read more
Creating positive social climates and home-like environments in therapeutic care- practice guide
Creating positive social climates and home-like environments in therapeutic care- practice guide Written by: Janise Mitchell
This guide has been developed to support the implementation of Essential Element: Physical Environments from the Ten Essential Elements of Therapeutic Care. It explores how to create therapeutic care contexts...
Read more
What is Effective Therapeutic Care? - research brief
What is Effective Therapeutic Care? - research brief Written by: Lynne McPherson Kathomi Gatwiri Nadine Cameron Natalie Parmenter
This research briefing is an introduction to therapeutic care as a preferred response for children and young people who have experienced complex trauma and are unable to live at home....
Read more
The evidence base for therapeutic group  care A systematic scoping review - research brief
The evidence base for therapeutic group care A systematic scoping review - research brief Written by: Lynne McPherson Kathomi Gatwiri Nadine Cameron Natalie Parmenter
The NSW Government has undertaken major reforms over the past two years aimed at improving outcomes for children and young people in out-of-home care. Following a review by Verso Consulting...
Read more
Putting theory into practice
Putting theory into practice Written by: Noel MacNamara
Sometimes you might wonder why you need to learn about theory. I have heard people say: Residential work with young people is often conducted amidst high anxiety, uncertainty and emotion....
Read more
What are the needs of Aboriginal and Torres Strait Islander children and young people in care? - research brief
What are the needs of Aboriginal and Torres Strait Islander children and young people in care? - research brief Written by: Kathomi Gatwiri Lynne McPherson D Rotumah Nadine Cameron Natalie Parmenter
Indigenous children and young people face unique challenges in the child welfare system. The dimensions of this problem are complex and multifaceted. Providing culturally safe and traumainformed therapeutic care to...
Read more
‘Tis the Season to be Jolly’ – but not for everyone
‘Tis the Season to be Jolly’ – but not for everyone Written by: Noel MacNamara
It’s all too easy to get wrapped up in the fun and happiness of Christmas and forget that, for others, the season isn’t necessarily a joyful one. For some the...
Read more
The 10 Essential Elements of Intensive Therapeutic Care NSW - practice guide
The 10 Essential Elements of Intensive Therapeutic Care NSW - practice guide Written by: Janise Mitchell
This guide has been developed to describe the 10 Essential Elements that form the basis for Intensive Therapeutic Care (ITC) service provision in NSW. The 10 Essential Elements have been...
Read more
The Essential Elements of Therapeutic Foster Care - research brief
The Essential Elements of Therapeutic Foster Care - research brief Written by: Janise Mitchell Lynne McPherson Kathomi Gatwiri Nadine Cameron Natalie Parmenter Joe Tucci
As far back as 2002 in the creation of the Catalyst Program, Mitchell developed what was Australia’s first therapeutic foster care program and one of a handful of pioneering programs...
Read more
How to thrive in lock down, lean into what works in therapeutic care
How to thrive in lock down, lean into what works in therapeutic care Written by: Kelly Royds Noel MacNamara
Lockdown means we lose touch with many things: friends, family, freedom. For young people, therapeutic youth workers and other staff in Intensive Therapeutic Care, however, it also offers an opportunity...
Read more
Trauma Informed Care - research brief
Trauma Informed Care - research brief
This research briefing aims to define and clarify what trauma, complex trauma and trauma informed care are. Extensive literature has now surmised that exposure to adverse experiences such as child...
Read more
The strengthen connections and relationships project
The strengthen connections and relationships project Written by: Lynne McPherson Meaghan Vosz
What is this research about? Young people in residential care face major challenges that can prevent them from forming healthy relationships and a strong personal identity, which are critical building...
Read more