Five Rivers

Clinical Interventions

We believe that to attain outstanding outcomes for children and young people who may be experiencing psychological distress, there is a core need, to harness the application of psychological knowledge to assist in transforming children and young people’s lives.

This knowledge is harnessed by the practitioners across Five Rivers integrated services to providea shared understanding and language. We use transactional analysis to underpin this framework.A key element across our services is the focus on the relational aspects of the interventionsprovided by the team.

This encompasses the task of therapeutic care (structure, boundaries, guidance, support) and attunement (therapeutic communication e.g. understanding transference and re-enactment etc).

Such work requires consultancy and support to the staff team, and this is provided on a weekly basis by a member of the clinical service team. This support provides a ‘thinking’ space to review the work with each individual child/young person, and ensure that the goals set are being attained.

For this reason we have a team of psychological practitioners (Child and Adolescent Psychotherapists) who provide support and guidance to the staff teams in developing strategies to improve emotional wellbeing.

At Five Rivers we consult with Psychiatry and Psychological (Educational, Forensic and Counselling) specialists to provide support as required.

interventionOur team of practitioners and clinical supervisors have extensive experience in developing and advising on clinical packages of care (family court work), therapeutic programmes which have been implemented by government agencies (Scotland, New Zealand) and seek to guide the advancement of knowledge relating to effective treatment approaches for children and young people (UKCP Children’s Faculty).

These practitioners are highly experienced in working with looked-after children and:

• Use a range of strategies and techniques which are consistent with up to date evidence based practice e.g. NICE Guidance;
• Assist in providing responsive support to our teams as they are consistently available;
• Provide psychotherapeutic interventions following a clear assessment of what are the core needs (Focused Targetted Interventions for the best outcomes);
• Liaise with CAMHS and PCT;
• Use their psychological expertise input into risk assessments, individual crisis management plans, care plans etc

The clinical interventions utilised are based on a range of evidence based therapeutic approaches and interventions. The interventions utilised are based upon both the most appropriate developmentally and focused in terms of need e.g. PTSD can have a range of symptoms.

It is crucial in terms of stabilisation to provide focused targeted interventions for the symptoms of greatest severity to attain stabilisation. It is this detailed assessment which can enable the delivery of ‘Targetted Focused Interventions’.

• Trauma e.g. EMDR and CBT
• Attachment therapy e.g. Dyadic treatments
• Cognitive behavioural therapy e.g. advanced role play for relapse prevention strategies
• Dialectical behaviour therapy
• Play and creative arts
• Drama

Social Enterprise


Five Rivers is a leading independent, Social Enterprise working in partnership with local authorities and ‘Looked after Children’ needing specialist care
throughout the UK and Ireland.

A key area of focus is the increasing of knowledge around effective assessment of need as this underpins the signifi cant changes we support children and young people to make.

Some examples of our development areas are:

• Anna Freud Centre (London) research partnership seeking to validate an attachment measure for children under 10 years and also a new video based interactive assessment for adolescents;

• Knowledge Transfer Partnership (Bournemouth University, Exeter Medical School) is now into its 3rd year to develop the Five Rivers assessment procedure to develop a protocol of effective assessment and measuring of outcomes.