How to thrive in lock down, lean into what works in therapeutic care

Sep 2021

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 to lean into what we know works in therapeutic care. As we know, you care for an incredibly vulnerable group of young people who experience disadvantage across their developmental trajectories.

When it comes to young people in Intensive Therapeutic Care, and Out of Home Care in general, these issues can be significantly amplified because of:

 

  • their experiences of high degrees of instability and insecurity in their lives
  • the questions that they may have about what might happen to them – ‘Will I catch the virus and die?’; ‘Who will look after me?’; ‘Is my mum or dad or brothers or sisters OK?’
  • the potential for the uncertainty, anxiety and stress associated with the crisis to trigger previous traumatic memories and reactions
  • the impact of the limitations to forms of social contact which require establishing workable boundaries in the house for young people
  • their opportunities to spend time with family members or siblings whom they are not living with being limited

The aims of therapeutic care are to provide reparative experiences that promote healing and recovery. Rather than providing basic care and managing behaviour, therapeutic care emphasises relationships and considers and responds to the young person’s underlying needs. The provision of safe, nurturing relationships, stability and care enables integration of the young person’s experience and promotes healthy development. Positive therapeutic relationships can offer a sense of security, hope and stability in unpredictable and insecure times. These relationships are incredibly important for helping young people regulate their emotional systems. Therapeutic youth workers are ideally situated, at this time, to be among the most influential of healers and helpers.

All the young people in the Intensive Therapeutic Care system need opportunities to practice and learn psychosocial skills in addition to opportunities to engage with caring, emotionally, and culturally competent therapeutic youth workers. The therapeutic milieu of the Intensive Therapeutic Care house needs to offer, without compromise, a structured environment with a consistent plan of care and intervention. For young people who experience emotional and behavioural challenges, there is power in a therapeutic milieu. A therapeutic milieu can be an antidote to the uncertain and insecure times we all face during the COVID-19 pandemic.

Last year, we talked about some of these therapeutic opportunities with Therapeutic Specialist, Vanessa Farell, here and we also shared 8 ways to support young people specifically in residential care during these times.

This year, we reached out to our network of Therapeutic Specialists across New South Wales. The purpose was to find out how they are adapting and leaning in to support the best therapeutic care for young people.

How might this be impacting the young people in our care?

Young people are likely to be experiencing an increased sense of anxiety. Being in lockdown might present real risks to their families and communities.  In particular,  this is either because of family violence, health, unemployment or other concerns.

What therapeutic practices can you lean on?

  • Maintain or build a structured environment
  • A consistent, and engaging therapeutic plan for each young person
  • Continue to facilitate and participate in self-care and reflective practice sessions.. For example:
    •    Morning mindfulness with direct-care workers, foster carers – play guided meditation
    •    Community meetings with workers and young people
    •    Reflective Practice
  • Continue to facilitate young peoples’ engagement in school and offer additional support where appropriate
  • If you are not a direct-care worker, but tasked with supporting young peoples’ therapeutic care from home (e.g., Therapeutic Specialists, Case Managers) conduct welfare checks and check-in with how young people are coping with restrictions

Where might you need to adapt and evolve?

Where might you need to adapt and evolve?

  • Consider how you can maintain family and community contact at this time – you might need to explore a range of different options
  • Review safety planning around leaving the house (harm minimisation)
  • Be conscious that direct care workers may not have the same access to organisational support such as face-to-face contact with Therapeutic Specialists
  • Therapeutic Specialists convening as a group to explore issues
  • Continue to facilitate and participate in self-care and reflective practice sessions. For example:
    •   Music
    •   Art
    •   Technical use of computers etc.
  • Make use of online, click-and-collect services to bring interesting and engaging activities into the home environment. For example:

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