How we work
Our psychological and psychotherapeutic practitioners draw on a range of theoretical approaches and evidence-based practice. This informs our work and supports the development and practice of integrated trauma-informed services for children, young people, carers and professional systems. Within each service, practitioners are selected to deliver targeted interventions, therapeutic communication and emotional competence, encouraging positive well-being across a wide spectrum of services.
We offer a range of assessments using clinical tools including direct observations, clinical interviews and structured psychometric assessments. Our assessments inform holistic psychological formulations which identify the strengths and requirements of the client and lead to helpful interventions for any unmet need. Specific assessments can be commissioned by local authorities or other agencies, which may include full psychological assessments to plan for therapeutic support, or cognitive assessments to ensure a better understanding of how a client learns and processes information. These assessments can also provide information that can help match young people to suitable carers and to determine the type of treatment package that will support their emotional and psychological needs.
Bespoke assessment process for LAC
When children and young people are placed with Five Rivers Child Care, we complete a series of baseline assessments aimed at telling us more about their emotional health; their strengths, vulnerabilities and their style of attachment. This information helps us to tailor and plan individual support. The assessments we use aim to address more than just emotional and behavioural well-being, by also focusing on areas including trauma symptomology, displays of dissociative behaviour and attachment style. The assessments are reviewed annually within an Integrated Case Management Meeting (ICMM), in which the team around the child gathers to review, share and formulate according to the child’s presenting level of need. During the ICMM, a Therapeutic Needs Profile and Intervention Plan is compiled which share actions, understanding and recommendations as to how to support the child and their carer(s) going forward. The ICMM creates an opportunity for highly individualised care planning that focuses all outcomes on a positive trajectory, embracing all developmental, educational, health, social and emotional needs.
We offer a safe, reflective space to foster carers, residential staff teams and other professionals who may form the team around the child. This assists in providing responsive support to teams or individuals, to review experienced difficulties, set goals and develop positive strategies. As a team we encourage therapeutic care, by considering structures, boundaries, guidance and support via attunement, therapeutic communication and understanding of transference. Our aim is to promote learning and development for those working with young people, so that they can support them to achieve positive outcomes.
We offer group and individual sessions which can focus on different aspects of looking after children who have experienced developmental trauma and disrupted attachments. Topics of consultation may include, but are not exclusive to:
- Developing a psychological formulation of the child/young person’s experiences, needs and strengths which can be used to identify areas of possible intervention
- Understanding the relational and attachment patterns of a child/young person in placement and developing ways to support them to experience safety in relationships
- Processing the emotional impact (including difficulties with compassion fatigue and secondary trauma) of looking after children and young people who have experienced trauma, and how to develop professional, caring resilience.
We aim to ensure that children, carers and staff are supported within their placements to reduce the risk of a placement breaking down, resulting in further disrupted relationships and loss for the child or young person. As a service, we strive to be proactive rather than reactive, aiming to create and grow stability from an early stage.
We try to empower those who are working with children on the front line. We believe that a child’s foster carer, key worker or residential team are the best forms of intervention for the child, providing necessary authoritative parenting, commitment, consistency, sensitivity and attunement.
We offer a range of psychological interventions to children and young people, foster carers and adoptive parents. Our interventions are based on the needs of the client and draw from an eclectic range of psychological approaches including:
- Dyadic Developmental Psychotherapy (DDP)
Treatment based on a theoretical understanding of attachment and intersubjective relationships aimed at supporting children who have experienced substantial developmental trauma.
- Play therapy
A form of therapy in which play is used as a means of helping the client to express and communicate their feelings.
- Attachment Regulation Competency (ARC)
A framework to support children, young people and their families with experiences of prolonged traumatic stress.
- Eye Movement Desensitisation and Reprocessing (EMDR)
Psychotherapeutic treatment designed to alleviate distress associated with traumatic memories.
- Cognitive Behavioural Therapy (CBT)
Talking therapy which encourages the client to manage their difficulties by changing the way they think and subsequently behave.
- Trauma-Focused Cognitive Behavioural Therapy (TF-CBT)
Therapy which aims to address the needs of children and adults suffering from difficulties related to traumatic life events.
- Compassion Focused Therapy (CFT)
A multi-modal approach using compassionate mind training to help the client develop a soothing inner warmth and safety, via compassion and self-compassion.
- Video Interaction Guidance
Therapeutic intervention where the practitioner aims to enhance the client’s communication within relationships, helping them to actively engage in change, ultimately working towards defining values and beliefs around respect and empowerment.
- Mentalisation-based approach
Encouraging the client to think about thinking; helping the client to make sense of how their thoughts, beliefs and feelings are linked to their actions and behaviours.
- Psychodynamic approaches
Approaches emphasising the psychological forces that underlie human behaviour, emotions, feelings and how they might relate to, and be shaped by, early experiences.
The Assessment & Therapy team provides education and training for residential care workers, foster carers and professional teams on best-practice approaches to managing the young people in their care. Children who have experienced trauma are often not amenable to traditional parenting methods; they require a greater level of empathy, nurture and tolerance on the part of the carers and residential staff alike. Our team provides training informed by current research into the impact of developmental trauma on children, and how this manifests in the behavioural Through this training, we can support care staff in their ability to manage challenging behaviour and, in turn, reduce the risk of a placement breaking down.
Education and training programmes aim to provide further support, understanding and stability. Each training package draws on a range of learning and teaching styles, including group discussions, independent and group exercises, and the delivery of additional learning resources and handouts.
We offer tailor-made training on a range of topics, including:
- The impact of relational trauma on children’s development
- Therapeutic parenting and trauma-informed approaches
- Working with self-harm and suicidal behaviours
- Mental health awareness and recovery
- Autism awareness
- Working with sexualised behaviours
- Understanding compassion fatigue
- Importance of self-care.
Training programmes can be developed to cover specific topics and areas on request.
Research and development
At Five Rivers, we are continually seeking to develop our services, providing an evidence-based model of specialist care.
The team has a direct working relationship with respected research partners: the Anna Freud Centre and University College London. We have several ongoing collaborative projects, including:
- Evaluation and analysis of data from within the Five Rivers evaluation framework. This focuses on the profile of young people within our care, reporting changes over time-points within specified domains, and predicting outcomes in the population of children we look after.
- Evaluation, development and adaptation of the Five Rivers assessment process to ensure our baseline measures are thorough and useful in their ability to explore an individual’s emotional health, strengths and vulnerabilities.
- Development of a more coherent framework for interventions, treatments and support systems which will further support the foster carers, residential staff and educational teams who work on the front line with children at Five Rivers.
The Anna Freud Centre has also provided training for our team. We are now able to provide Story Stem Assessment Profiles, and Adolescent Story Stem Assessment Profiles, for the children within our care. These profiles allow for further exploration of attachment style, relationship dynamics, interpersonal themes, internal representations, mentalising and regulation of affect (emotional management).