The strengthen connections and relationships project

Mar 2022

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 blocks for their wellbeing and safety. This research aims to understand the practices that help young people living in therapeutic residential care to have a positive self-identity and to form strong, healthy relationships.

Background

Young people living in residential care face complex and persistent challenges in forming and maintaining positive, safe and lasting relationships. Trust is a critical factor given early exposure to unsafe caregiver/child relationships. Whilst in care, young people, often experience high staff turnover and may continue to experience violence and abuse in unsafe residential care settings. Consequently, this impacts their ability to regulate emotions, manage behaviours, and form and maintain relationships with others. As a result, the life trajectory for care-experienced young people remains highly precarious, with care leavers more likely than their non-care-experienced peers to have poor educational outcomes, significant and prolonged mental health and substance abuse problems, risk of unemployment and entrenched criminal justice system involvement. The social capital critical to succeeding in getting and keeping a job, for example, is limited when the capacity to form positive connections is impaired. Similarly, the absence of recognition (in this study, understood as mutual experiences of being cared about, respected and valued) impacts positive identity formation, resulting in poor self-esteem, self-respect and self-confidence, which are also critical for successful transitions from care. Aboriginal and Torres Strait Islander care leavers continue to be significantly over-represented in the out-of-home care system in Australia. Helpful relationships and social connections do not develop in isolation, and for Indigenous children and children from culturally diverse backgrounds, cultural safety is pivotal to their sense of wellbeing.

These outcomes for young people with complex trauma in residential care settings have led to the introduction of a raft of policy and program interventions, including, most recently, ‘therapeutic residential care’ In Australia, ‘therapeutic residential care’ (TRC) (also referred to as ‘intensive therapeutic care’ in NSW) is a relatively new concept, offered in several states and territories, delivered by government and non-government organisations and funded by the relevant state department.

Purported as breaking new ground in responding to vulnerable young people who have experienced trauma, the aim of therapeutic residential care in Australia is to create “positive, safe, healing relationships” and experiences informed by a sound understanding of trauma, damaged attachment and developmental needs”. A growing body of evidence supports such an approach, highlighting that effective, trusting relationships are integral to a felt sense of safety and security.  Such security, along with strong, positive social connections, potentially enhances the likelihood of positive therapeutic outcomes and successful transition from care. However, a critical gap in the current evidence base informing therapeutic residential care is around the actual practices within and beyond the immediate care environment that enable or constrain the development of these relationships.

The Research Team

The research team is led by Associate Professor Lynne McPherson, Director of the CETC, working with colleagues Professor Anne Graham and Dr Meaghan Vosz, along with industry experts from the CETC. In addition, leading researchers from the Australian Catholic University Centre for Child Protection Studies, Charles Sturt University and Trinity College in Dublin complete the team.  It is funded by the Australian Research Council from 2022-2025.

Research Aim and Phases

Building on such evidence, this study aims to examine the interpersonal practices that contribute to positive identity formation in therapeutic residential care contexts, as well as the institutional practices (policies, systems, processes) that enable or constrain the structural conditions necessary for building trust, healthy social connections, cultural safety, positive help-seeking behaviours and opportunities to contribute to the community.

For the first time, this research will ask young people, workers, therapeutic specialists and managers in therapeutic residential care (intensive therapeutic care) about the practices used to support young people to develop trusting relationships, what helps and what gets in the way. This is the first large-scale mixed-methods study in Australia to capture the views and experiences of young people and staff in therapeutic residential care about the practices that enable and constrain positive, trusting relationships and social connections within and beyond the immediate care setting.

The Research Team recently commenced the initial engagement phase, which includes establishing mechanisms to work alongside and consulting with people who have relevant expertise, including lived experience. Concurrent to the engagement phase (which extends across the life of the project), this research will address the research aim and questions in four steps.

Each phase builds on findings in the previous step following an iterative analytical process. The research is founded on a person-centred human rights approach characterised by profound respect for the other throughout each phase. This is also reflected in the peer participatory principles inherent in the study design and implementation, as outlined earlier, and activated with the express intent of improving understanding and practices in therapeutic residential care.

Who are we looking for to help us right now?

We are looking for three kinds of research advisor/co-designers to help us design and conduct research that has purpose, integrity and makes an impact:

  1. Cultural advisors: will help to re(frame) how we see research problems, how we relate and our research practice. We will work with you to ensure the research is informed by cultural knowledge, is inclusive, accessible and responsive to the interests of First Nations young people in therapeutic residential care.
  2. Research advisors: will help to steer the research and outcomes, advising on approaches that will have the greatest impact.
  3. Research co-designers: will get involved with designing research interviews, surveys, and communications to influence how we do the research and the resources we produce.

If you have lived experience in therapeutic residential care in NSW or Victoria, or have worked in ITC or a related policy role, we would like to talk with you about becoming a research advisor/co-designer. If you identify as Aboriginal and/or Torres Strait Islander and have an interest in out-of-home care, then we would like to talk with you about becoming a cultural advisor.

Why is this research important? What difference will it make?

When the research is complete, we will work with advisors to develop resources to improve the practices of therapeutic residential care.  As a result, young people leaving care will have the right support for a solid foundation of personal identity and relationships into the future.

Want to know more?

Contact Research Fellow Meaghan Vosz on meaghan.vosz@scu.edu.au

You may be interested in: Residential care Therapeutic care Youth participation

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 does stability in residential care mean? Part I
What does stability in residential care mean? Part I Written by: Jenna Bolllinger
After four years working in residential care, both on the floor and as a clinician, I wanted to better understand what stability really means for young people in residential care?...
Read more
Stability in Residential Care: Part II
Stability in Residential Care: Part II Written by: Jenna Bolllinger
Sarah is 14 and has been in placement for 18 months. She lives in a residential house with two boys and one girl. The boys display aggressive behaviours and are...
Read more
8 Ways to Support Young People in Residential Care during COVID-19
8 Ways to Support Young People in Residential Care during COVID-19 Written by: Janise Mitchell
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!...
Read more
How do we create excellence in intensive therapeutic residential care practice?
How do we create excellence in intensive therapeutic residential care practice? Written by: Janise Mitchell
What creates high quality therapeutic residential care? This is the question often asked of agencies, of staff, of policy makers and of the young people themselves. There is no simple...
Read more
Cultivating Curiosity in Therapeutic Residential Care
Cultivating Curiosity in Therapeutic Residential Care Written by: Noel MacNamara
Curiosity is something that has excited me my whole life. I am sure a lot of you share my fascination and enthusiasm for curiosity. There seems to be wide support...
Read more
Therapeutic residential workers? Who are we?
Therapeutic residential workers? Who are we? Written by: Glenys Bristow
This blog is to introduce my recent research with therapeutic residential workers. Further blogs and practice guides relating to finding, keeping, acknowledging and celebrating the best person for the job...
Read more
Young peoples' participation is a right, not a privilege
Young peoples' participation is a right, not a privilege Written by: Meaghan Vosz
Under the United Nations Convention on the Rights of the Child (1989), Australian young people should be assured the right to express their views freely in all matters that affect...
Read more
Enabling young people’s participation in residential care decision-making - research brief
Enabling young people’s participation in residential care decision-making - research brief Written by: Meaghan Vosz Lynne McPherson Natalie Parmenter Kathomi Gatwiri
The literature on how young people participate in decision-making in residential care identifies three main aspects of participation: being able to access information to take part in decisions that matter;...
Read more
10 ways to enable young people's participation in therapeutic residential care
10 ways to enable young people's participation in therapeutic residential care Written by: Meaghan Vosz
In this blog, I’m keen to offer practitioners in therapeutic residential care some ideas about how to involve young people in decisions that affect their lives. Many young people in...
Read more
Isaac's story: Having a voice in out-of-home care
Isaac's story: Having a voice in out-of-home care Written by: Isaac Kimberley Lamb Lauren Cooper
Isaac is 15 years old, about 6ft tall, and you know when he is in the room. Isaac lives in his house with one other young person. Isaac experiences the...
Read more
Tahlia’s story: Having a voice in out-of-home care
Tahlia’s story: Having a voice in out-of-home care Written by: Tahlia Lauren Cooper Kimberley Lamb
Tahlia is a 16-year-old young woman who likes to be in complete control of her world at all times. She is as strong, articulate and as sassy as they come....
Read more
The Intensive Therapeutic Care dance
The Intensive Therapeutic Care dance Written by: Noel MacNamara
Therapeutic residential work can be conceptualised as a dance. It works best when therapeutic workers display therapeutic presence, are in sync with the young person, can making meaning of the...
Read more
What does voice and choice mean in Intensive Therapeutic Care?
What does voice and choice mean in Intensive Therapeutic Care? Written by: Kelly Royds
Voice and choice can be an extremely difficult concept in Intensive Therapeutic Care to get right. We know participation is a right, not a privilege, and we also know young people...
Read more
Understanding and supporting young people who self-harm in residential care
Understanding and supporting young people who self-harm in residential care Written by: Noel MacNamara
Some of the young people we care for in the ITC programs deal with emotional distress and pain by hurting themselves physically. Young people hurting themselves is distressing to them...
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
“It wasn't just listening to your ideas, it was following through”
“It wasn't just listening to your ideas, it was following through” Written by: Meaghan Vosz Shelley Keevers Dylan Williams Ben Bonnie
In 2019 and 2020, a group of young people with firsthand experience in out-of-home care joined PhD candidate Meaghan Vosz to research the practices associated with ‘giving due weight’ 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
What makes a good Therapeutic Residential Care Worker? - practice guide
What makes a good Therapeutic Residential Care Worker? - practice guide Written by: Glenys Bristow Janise Mitchell
Trained staff and consistent rostering are essential elements of therapeutic residential care. The purpose of this guide is to consider more broadly what makes an excellent therapeutic residential care worker...
Read more
Q&A with Mohita Kapoor from CREATE Foundation
Q&A with Mohita Kapoor from CREATE Foundation Written by: Kelly Royds
In September 2020 Mohita Kapoor, the NSW State Coordinator for the CREATE Foundation was invited to speak at our Therapeutic Specialist forum for those working within the Intensive Therapeutic Care...
Read more
“Just ask Us”: Insights into working with young people with disability
“Just ask Us”: Insights into working with young people with disability Written by: Laura Moloney
In late 2020, the Advocate for Children Young People (ACYP) shared their first report dedicated exclusively to the unique lived experiences of young people with disability. They asked 370 children...
Read more
How do you prepare for the transitioning of young people into an Intensive Therapeutic Care house? Part 2
How do you prepare for the transitioning of young people into an Intensive Therapeutic Care house? Part 2 Written by: Peter Le Breton
In the first part of the Blog, we explored limit and expectation setting, maintaining a state of occupancy and the planning process for a successful transition. In part two of...
Read more
How do you prepare for the transitioning of young people into an Intensive Therapeutic Care house? Part 1
How do you prepare for the transitioning of young people into an Intensive Therapeutic Care house? Part 1 Written by: Peter Le Breton
This is a two-part blog and will focus on the transition of young people into an Intensive Therapeutic Care house; however, most of the content is transferrable to other placement...
Read more
Changing your practice to being trauma informed in therapeutic residential care
Changing your practice to being trauma informed in therapeutic residential care Written by: Glenys Bristow Noel MacNamara
Whilst the following Arabian proverb takes a bit to get your head around it leads rather nicely into this blog and our brief introduction on the relevance of the conscious...
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 Relationship-Based Recovery Reflection Tool - practice tool
Trauma Informed Relationship-Based Recovery Reflection Tool - practice tool Written by: Noel MacNamara
Children and young people need adults who can co-regulate with them and teach them about feelings and their inner world. This Trauma Informed Relationship-Based Recovery Reflection tool can be used...
Read more
Client Mix and Client Matching in Therapeutic Care - practice guide
Client Mix and Client Matching in Therapeutic Care - practice guide Written by: Janise Mitchell Kelly Royds Noel MacNamara Glenys Bristow
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...
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
Mandatory consent education, a win for all young people
Mandatory consent education, a win for all young people Written by: Kelly Royds Cyra Fernandes
Consent education will be mandatory in Australian schools from 2023, a win for Chanel Contos’ #teachusconsent movement and all young people who have called out a lack of holistic consent and sexuality...
Read more
Q&A with the trainer: Harmful sexual behaviour
Q&A with the trainer: Harmful sexual behaviour Written by: Kelly Royds Cyra Fernandes
Working with young people who engage in harmful sexual behaviour is complex and challenging. Cyra Fernandes and Dan Howell have spent over a 1000 hours in the past year helping carers and professionals...
Read more
Come on it’s Only a Game
Come on it’s Only a Game Written by: Noel MacNamara
Many of you will have experienced something like the following… A residential worker is observing two young people playing table tennis in the rear yard of the residential unit. One...
Read more
Do ‘no touch’ policies in residential care keep workers and children safe? It’s not that simple
Do ‘no touch’ policies in residential care keep workers and children safe? It’s not that simple Written by: Glenys Bristow
Lyn was 16 and had grown up in foster and residential care. Lyn was interviewed about her experience and views about out of home care. She was extremely positive about...
Read more
What Professor Cindy Blackstock can teach us about trusting children and ourselves
What Professor Cindy Blackstock can teach us about trusting children and ourselves Written by: Kelly Royds
First Nations children's rights activist and 2022 International Childhood Trauma Conference speaker Cindy Blackstock recently said that adults need to trust children with the truth. "They can handle it," Blackstock...
Read more