Creating a balance between empowerment and limit setting in therapeutic care
Purpose of this guide
This guide has been developed to support Intensive Therapeutic Care (ITC) staff to navigate the critical balance between empowering young people and setting limits.
One of the most challenging tasks for Care Teams, Case Managers, Therapeutic Specialists, Managers and Therapeutic Residential Workers to agree on and implement are limit setting with ‘appropriate consequences or discipline.’
This Practice Guide explores these concepts and considers how to establish the right balance between empowerment and limit setting in ITC for young people with trauma-based behaviours (Morton Clark and Pead 2000).
Key Messages
• Empowerment and limit setting are developmental needs that are significantly disrupted or unmet
in the lives of traumatised young people with complex needs.
• An inability to understand trauma-based behaviours often sees the young person ‘labelled’ and
known by reported negative, ‘high risk’, ‘challenging’ and sometimes unsubstantiated behaviours
until over time the young person feels they must live up to this ‘created identity’.
• A trauma-informed or therapeutic approach orients us to be curious about what is going on for
the young person rather than seeing the behaviour as separate from what has happened to them.
• Setting limits and boundaries is an act of nurturing and care when done in the context of
respectful attuned relationships.
• Be strong enough to help ‘hold/carry’ the agreed line and the young person’s pain. Endure/travel
their journey with patience, advocacy, nurture and caring.
• There needs to be clearly articulated behavioural and social expectations that are understood by
the young people.
• Consistent routines support young people to be clear about expectations of themselves as well
as understand what to expect from staff.
• Setting limits with young people is a constant process of letting go and reeling in, in a safe
environment. Limits and boundaries should be reviewed by staff and the Therapeutic Specialist,
in conjunction with the young person, in recognition of the changing capacities of the young
person to exercise sound judgement and decision making.
• Understand and support the capacity of young people to make good life decisions and avoid
risk-taking and unsafe behaviour. Provide them with opportunities to practice having a voice and
making decisions within their developmental abilities.
• Use a combination of pre-planned consequences developed in consultation with Therapeutic
Specialist and the young person. These need to be developmentally appropriate and link to
behaviour as soon as possible or when it is considered safe for the young person.
• Consequences should be about discipline (i.e. seeking to teach) rather than punishment and must
relate closely to the change required of the young person and address the problem.
• Challenge the young