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Our Model of Care

The care model used at Ty Caredig

All the young people coming into Ty Caredig residential homes are classed as ‘Looked After Children (LAC) by the UK government. This group of young people is likely to have suffered early developmental trauma and/or attachment issues.

As a home, we want to provide a quality service within a settled period of residential care with a therapeutic emphasis that acts as a “healing” process addressing their needs and past traumas. In order to do this, we will work with trained counsellors and therapists to implement a Trauma Recovery Model. 

Trauma recovery model

The Trauma Recover Model is a roadmap to help professional care for and guide troubled children, young people, and vulnerable adults towards recovery. The key underlying principle is that behaviour in troubled children is developmentally driven, so intervention must be sequenced accordingly. 

 

It was developed by Dr. Tricia Skuse and Jonny Matthews in response to highly complex and challenging young people they worked with; children with multiple adverse childhood experiences, extreme welfare needs and a history of serious offences.  

It is a composite model that combines theories of child development, attachment, and neuroscience with hands on practitioner skills. It provides practical guidelines for knowing which interventions to use and when.  This means practitioners can recognise the presenting behaviours of vulnerable people in their care, understand the psychological needs that underpin behaviours and can identify the types of interventions that best address those needs. 

The 4 aspects of the trauma recover model

1. Presenting Behaviour

The young person’s we deal with have not had the right start in life. They’ve missed the care, safety, and consistent parenting that most of us had – and all of us need if we’re to develop normally. These kinds of experiences lead to ways of behaving that make sense in the bad situation – they are adaptive – but cause no end of problems anywhere else. Dealing with this behaviour is the key to helping these young person’s lead more stable, productive, and contented lives.

The TRM does not encourage a focus on behaviour as the goal of intervention. But it does require that we observe, note, and manage it. Behaviour is a signpost for development and tells us something about how and to what degree a child has developed normally.

2. Underlying Needs

The TRM concentrates its focus on what the behaviour tells us about development.  Children growing up in fear, distress, rejection, neglect, will reflect this in the way they present. A close examination of the developmental journey of each child will yield profound and enlightening information about their needs. These then – as the cause of the behaviour – become the focus of intervention. Behaviour is the symptom; skewed developmental experiences are the cause. To help young person’s heal we must address the causes.

3. Types of Intervention

Intervention extends beyond the technique or theoretical basis for the work being done to help a child to recover. It applies equally to the setting of the intervention. The most troubled young people – due to the nature and severity of their problems – tend to be those in the Looked After system and in custody. The stability of such settings can be a real bonus in accelerating the progress. There is still the question of which kind of intervention might best help them. The TRM seeks to address this.

4. Sequenced Intervention

Because the difficulties faced by children with developmental trauma have skewed their development, the order in which we address the problems really matters. For example, if a child is not functioning at a cognitive age commensurate with their chronological age, talking therapies may not work well, if at all. And yet we tend to focus on these almost by default In order for a child to benefit optimally from any intervention, we must sequence the timing and type of input to the child’s needs and developmental progress

 

Working in the TRM way puts relationship building and therapeutic interaction first, mediating the impact of trauma. This paves the way for interventions that are tailored and sequenced in a way that really can make a difference.  It is a tired, tested and evaluated approach that’s being used by practitioners across the UK and beyond. 

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