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Carers and children
by Julie Stirpe

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

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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