Evaluation of therapeutic approaches to social work in residential child care settings

Following a regional review of residential child care in 2007, the five health and social care trusts in Northern Ireland introduced ‘therapeutic approaches’ in a number of children’s homes with the aim of improving... [ view full abstract ]

Following a regional review of residential child care in 2007, the five health and social care trusts in Northern Ireland introduced ‘therapeutic approaches’ in a number of children’s homes with the aim of improving staff skills and outcomes for young people. This evaluation focused on the five therapeutic approaches developed in response to the recommendations of the Regional Review – Social Pedagogy, Children And Residential Experiences (CARE), Sanctuary, Model of Attachment Practice (MAP) and Attachment, Self-Regulation and Competency (ARC).

Objectives: The evaluation aimed to provide: a description of each approach and the reason for selecting it; details of how each approach works in practice and the resources needed to make it happen; views of different stakeholders (including staff and young people) on how the approach works in practice; early indications of whether the approaches are effective/ ineffective and why; evidence of organisational/contextual factors that help or hinder the successful implementation and evidence of what is needed to continue each approach.

Methods: The study comprised three phases; (i) a scoping review of the five therapeutic approaches; (ii) qualitative research on experience of implementation and (iii) investigation of impact.

Results: Staff reported improvements in their knowledge, skills, competence and confidence. Implementation of the approaches made a difference to how staff felt, to their morale and their practice. Young people reported changes that reflected these claims by staff that life was less confrontational, children were better understood, relationships improved and fewer serious incidents were happening. Factors for effective implementation included the provision of training and supporting materials, and wider systems working in a supportive manner.

Conclusion: There were a number of similarities across the models in terms of core concepts and essential skills. Whilst the study was unable to address whether one model was better suited than others the evidence strongly supports the value of providing staff with a framework and the necessary tools to do their job and an organisational context that allows a positive approach to children and young people.