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Author Archives: Julie Stirpe

  1. What is the value of the TIER System for supporting looked after children in residential care?: Outcome-focused management

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    This mini-article is the latest in a series discussing the TIER system, our bespoke model for the provision of trauma-informed therapeutic residential care and accommodation for children, young people and families. If you have not already read our previous article on the subject, you may find it helpful to do so before reading this one. 

    As mentioned previously, the TIER system is being designed by JSA Psychotherapy as a toolkit with which to pioneer a new paradigm of best practice in the care sector. Today we will be exploring a foundational element of how it functions in practice to instil and continually promote a holistically trauma-informed therapeutic service. This is our system of management overview.  

    At present, every young person in care possesses an individual placement plan to inform staff and home management of their circumstances and, ideally, how best to structure their care as a result. However, we raise that baseline with a full NMT assessment at admission, followed by continued, ongoing assessment with an NMT trained psychotherapist for the remainder of the child’s accommodation. 

    As a result of this, we are able to accumulate regular data which illustrates exactly which areas of cognitive development the child is progressing with and which they are particularly struggling with. We are able to draw important conclusions from these reports to determine how the care plan should be tailored and implemented on a monthly basis to meet the child’s needs as they arise.  

    This is made possible by feeding the information back to home management and the child’s key workers at care planning meetings. In addition to providing clear and informative evidence of a child progressing towards their planned outcomes, perhaps the most valuable impact of this process is that it equips key workers to achieve truly proactive engagement with them.  

    By using the data to predict upcoming challenges before they occur, key workers are able to prepare for their interactions with the children ahead of time each month. Thus, they are better able to achieve the expected care outcomes by meeting the most prevalent needs as they are first presented. In other words, they are able to make the most out of the limited time that the children have in looked after care, rather than being required to simply put out fires after a crisis has already occurred.  

    It’s not hard to see the potential positives of this approach in supporting care staff to feel confident and well-equipped to perform the hard work of supporting the children in their care this way. However, it can also provide agency for the children to be active participants in their own recovery. By inviting the children to understand what challenges are likely to be ahead for them, key workers can work collaboratively with them to decide upon solutions that the children can genuinely feel that they have had a say in.  

    This is a broad summation for two of TIER’s key principles, a child’s Individual Psychotherapy Plan and the Trauma Informed Regulation Response which facilitates it. In the next article, we will be outlining the third, which underpins them both by providing adequate support and oversight to the carer workers who conduct its delivery.  

    Tier System

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  2. What is the value of the TIER System for supporting looked after children in residential care?: An introduction

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    In this article, we will be discussing the TIER system, a new framework that provides a bespoke working model for the care and management of residential provisions for looked after children. It’s designed to be much more effective at meeting their intended outcomes of growth, recovery from complex trauma, and preparation for independent living. 

    TIER stands for Trauma-Informed Emotional Regulation, which is the most basic cornerstone of what we aim to achieve for ourselves and subsequently impart to the children in our care. The TIER system was devised by our Director of Practice Innovation Julie Stirpe, in tandem with expert colleagues working in the industry, as well as our sister company Life Change Care, who have been putting it into active practice for the last few years.  

    Tier System

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    The reasoning behind this project was motivated by the belief that the provision of social care for looked after children in the UK is significantly outdated in its approach to supporting the young people that are dependent upon it, as compared to other parts of the world. This is the case because there is no widespread initiative to accommodate contemporary research into neurobiology as the root of the behavioural & social challenges which affect them. 

    We wanted to pioneer better care for children in the care system using contemporary knowledge of neuroscience. I was compelled to address a clear extant need, which I identified over my career of 30+ years as a psychotherapist and expert witness to the family justice system. Through Life Change Care, we have been able to combine our outside psychotherapeutic expertise and apply neurosequential assessment skills to advance how residential childcare is conducted. 

    As such, we have spent the last few years developing it, putting it into practice, and refining each iteration of the model. At this stage, we are confident in sharing our positive results, in the hopes that it will catch on and drastically improve the lives and prospects of children, young people and families currently involved in social care across the country. 

    It’s already helped us achieve great strides in many of the outcomes that we have identified for the children within our own care, and is enabling us to provide a much greater quality of care by working smarter, not harder. In the coming weeks and months, we will continue to release a series of brief articles which will each focus on a different foundational aspect of the TIER system, how it works, and why it stands to be quite so impactful.