Therapeutic Residential Care Assignment Sample

• Subject Name : Nursing

Looking After Children

This is the case of a young girl who is 12 years old and has been abandoned by her foster mother after the death of her foster father due to heart attack. She feels bad the way her foster mother left her thus is unhappy with her life conditions. She is being reunited with her first mother and special arrangements were made to set up positive relationship between the two. This is the essay on the youth work done for this girl Tess as she is back to her home. This essay aims to address the complex needs of this girl that she might have after being adopted back by her mother. It also defines therapeutic residential care and links it to the case study. The three domains of Looking after children will be selected in this context and these will be supported with the Trauma informed practice theories. These theories will describe the current condition of the girl due to the past traumatic events and will address all the three domains with specific solutions so that she can have a safe and bright future. The relationship with her mother will be addressed along with taking care of her mental health.

The complex needs among the youth people is defined as the circumstances at which young people are burdened by numerous co- ocurring problems. These problems can be related to the health issues, mental health issues, social issues, relationship issues or any other that leads to the need of assistance in different forms (Ungar, Liebenberg and Ikeda 2014). In this case, the complex needs of Tess would be related to her relationship with her mother, security and assistance in feeling protected. She has suffered from traumatic past events due to her father who was involved in violent crime, was in prison and was also involved in illegal drugs. She was found covered in bruises and had a serious head injury. She was not safe at her home and was remover for her protection. This traumatic event in her childhood may have a serious impact on her youth life.

The children who are exposed to domestic violence and violent parents always have security issues and have the complex need of getting security (Van der Kolk 2017). These children are reported to have behavioural problems and are always in the need of psychosocial care. Tess was also abandoned by her foster mother whom she loved when her foster father died due to sudden heart attack. This also was a traumatic event for her because she felt abandoned the way her foster mother left her to residential care after the loss of her father. She was multi- victimized and trauma is pertinent for the children who have suffered multiple forms of maltreatment. There is a growing need of security and the need to be recognized for their identity among children who have been abandoned by their parents (Kinniburgh et al. 2017). They have an emotional need because of not being accepted by the family members and because of being abandoned by the ones whom they love. They have an interactional need and also need a care taker who will not abandon them.

Therapeutic residential care (TRC) is the residential type of care that is therapeutic in nature given to the children and young people (Whittaker et al. 2016). The young people and children are at the centre of the care model and are made to live in an environment that is safe for their well- being. They have the freedom to enjoy their rights and are informed about the decisions of their life. This makes them feel empowered and are given culturally safe care at the TRC. The young people who have experienced psychosocial issues gets this TRC in which they are given an environment that appropriately responds to their complex needs (Martin et al. 2018). TRC aims to provide the comprehensive and coordinated services that meets the complex needs of the young people and children availing these mainstream services. This service is very important for Tess because it aims to restabilise a sense of stability that is very important for the child because she has been through traumatizing events in the past.

The development of therapeutic relationship by the staff members with the young people and children is the core of TRC and they are given individual therapeutic care plan (Coll et al. 2019). The establishment of personal relationships is very important to make them feel safe and protected which is most important for people who have been through trauma especially children. The staff members of TRC provides secure, stable and the consistent base for the recovery of children and young people who are given these services. This have a profound effect on the young people and children because they start trusting their staff members who establishes the therapeutic relationship with them (Duppong et al. 2017). They give the sense of security and this has a positive impact on their emotional health, mental health, social adjustment and the future in different aspects. Thus, giving Tess therapeutic residential care would be a great help for her as it would help her in getting the sense of security and protection.

The Looking After Children (LAC) is a framework that is used for children in out- of- home care (Selwyn, Wood and Newman 2017). This is an outcome focused approach that is used for providing the colloborative good care to the children who have been placed in out- of- home care.

The first LAC domain selected for Tess is emotional and behavioural development. Tess has suffered abandonment and has been left by her parents twice. She needs a nurturing relationship in order to build healthy emotional and behavioural response. The best outcome of this domain is that children learn better to deal with the stressors and they become resilient (Jones and Liddiard 2018). The youth worker aims to provide holistic care to such people who have experienced trauma in past. This domain can be addressed in Tess by a youth worker based on attachment theory. This theory states that there is a direct link between early adversity and the adult psychosocial problems (Holmes 2017). The children who have experienced trauma in past must be given nurturing and consistent experience and interaction with their primary care taker so as to establish the sense of security.

This will have a profounding effect of her emotional and behavioural development. The family dysfunction due to inconsistent parenting pattern have a significant impact on the emotional health of the young people that is reflected in their behavior (Zeifman 2019). Tess has gone back to her mother but the youth worker will apply attachment theory to improve emotional and behavioural response. The youth workers will utilize trauma informed care to give care because early attachment disruption has led to the long- term effect like compromised relational skill and mental disorder in her. Early abusive and neglected relationship with her parents have led her to behave in this manner that she does not feel safe and there is high risk that she might also experience the issue of disorganized attachment pattern (Brazelton and Cramer 2018). The positive and nurturing relationship will be built with her mother also.

The second LAC pattern selected in context with the case study of Tess is identity. The young girl Tess has some identity related issues like who is she and where does she belong because sense of self that comes from the family is lost in her. She was abandoned by the parents who are the most important care taker for each child. Family and community plays a very important role in providing significant element of a child’s identity (Sartor 2018). In her case, the family is the reason that she has lost identity. The traumatic events can have a severe effect as per the degree of trauma on one’s identity and the sense of self. The theory that can be applied here is Erickson’s theory in which fifth stage is identity versus confusion that is appropriate for the children aged 12 to 18 years. This stage is important in developing a sense of personal identity that has a direct impact on the behavior and development of the rest of an individual’s life (Lackovic- Grgin et al. 2018).

The identity at this stage is very important and the people who do not have a sense of self faces a lot of issues in socially interacting with the people. The personal identity is extremely important and the cohesive sense of self endures an individual through life. The sense of self is shaped by the past experiences and interactions with others and this has major impact on the future of an individual. The youth workers have a major role to play in making the children getting back their identity and realizing the sense of self. The youth worker will collaboratively work with other services that will help her in identifying as an individual who had a bad and traumatic past but still can have a bright future (Danieli, Rodley and Weisaeth 2018). The protection of identity is very important and there is a need to establish social identity and personal identity. The youth workers establish personal connection with the young people and children to assist them in establishing a sense of self that is important for their mental and physical growth also.

The third domain of LAC selected is family and social relationships. The young people and children must establish a stable and affectionate relationship with the family members and social relations (Mannay et al. 2017). This girl Tess was when placed at a special school, she was fearful of other children and was socially not very active. she had difficult time in interacting with others at school that reflects her inconvenience in her social life. The youth workers works in collaboration with the social workers to address the clients who have a history of trauma in incorporating the safety, empowerment and trust in them. They help in changing the social relationship dynamics and address the unhealthy relationships. The social baseline theory states that the social relationships are proximal to the human beings in a way that it is it is central for conserving the energy as it keeps us warm (Hillman, Cross and Anderson 2020).

In compliance to this theory, the youth workers assist the clients in seeking proximity to social attachments. This is their main strategy in making their clients cope with adversity and stressful experience. Social relationships assist in managing the adversity and the youth workers use this strategy in assisting the clients (Bryant 2016). This young girl Tess also has issue in social relationships as she faces difficulty in the school. She needs assistance in her social life so that she can be socially active and has good social relationships that will be good for her mental and social health. This also has a direct impact on her mental well- being and also on the social well- being of the client. The social relationships are essential in one’s life and helps in the overall growth of an individual.

The conclusion drawn is that the youth worker will work in association with the social workers to provide a holistic care to this girl Tess. Tess has experienced various traumatic events that had a negative impact on her mental health and has also been abandoned. She had some complex needs and the three domains of LAC needed special attention that are emotional and behavioural development, family and social relationships and identity. She lost her identity and sense of self and was also facing issues in the social relationships because of these traumatic events. Tess required the assistance of a youth worker who would work in compliance with her difficulties and theories that would assist in her normal growth and development. Therapeutic residential care (TRC) is a residential type of care in which the staff members establishes a therapeutic relationship with the client in which they give a sense of security. Tess also requires TRC because of the fact that she feels insecure and has no sense of security and protection. The youth worker will also establish a good relationship with Tess that will help in learning about the condition better and then will facilitate therapeutic strategies for improving her condition. The youth workers and social workers works in this manner to bring about the change in the client’s life.

References for Looking After Children

Brazelton, T.B. and Cramer, B.G., 2018. The earliest relationship: Parents, infants and the drama of early attachment. Routledge.

Bryant, R.A., 2016. Social attachments and traumatic stress. European Journal of Psychotraumatology, 7(1), p.29065.

Coll, K.M., Sawyer, S., Scholl, S. and Hauser, N., 2019. A logic model development for an adolescent based intervention to improve benefits from Therapeutic Residential Care (TRC). Evaluation and Program Planning, 76, p.101678.

Danieli, Y., Rodley, R.S. and Weisaeth, L., 2018. International Responses to Traumatic Stress: Humanitarian, Human Rights, Justice, Peace, and Development Contributions, Collaborative Actions, and Future Initiatives. Routledge.

Duppong Hurley, K., Lambert, M.C., Gross, T.J., Thompson, R.W. and Farmer, E.M., 2017. The role of therapeutic alliance and fidelity in predicting youth outcomes during therapeutic residential care. Journal of Emotional and Behavioral Disorders, 25(1), pp.37-45.

Hillman, S., Cross, R. and Anderson, K.A., 2020. Exploring Attachment and Internal Representations in Looked-After Children. Frontiers in Psychology, 11, p.464.

Holmes, J., 2017. Attachment theory. The Wiley‐Blackwell Encyclopedia of Social Theory, pp.1-3.

Jones, L. and Liddiard, K., 2018. A Diversity of Childhoods: Considering the Looked After Childhood. In The Palgrave Handbook of Disabled Children’s Childhood Studies (pp. 389-408). Palgrave Macmillan, London.

Kinniburgh, K.J., Blaustein, M., Spinazzola, J. and Van der Kolk, B.A., 2017. Attachment, Self-Regulation, and Competency: A comprehensive intervention framework for children with complex trauma. Psychiatric Annals, 35(5), pp.424-430.

Lacković-Grgin, K., Nekić, M. and Ćubela, V., 2018. Age specific quality of integrity from the point of view of Erikson's theory of psychosocial development. Papers on Philosophy, Psychology, Sociology and Pedagogy, 41(18).

Mannay, D., Evans, R., Staples, E., Hallett, S., Roberts, L., Rees, A. and Andrews, D., 2017. The consequences of being labelled ‘looked‐after’: Exploring the educational experiences of looked‐after children and young people in Wales. British Educational Research Journal, 43(4), pp.683-699.

Martín, E., González‐García, C., del Valle, J.F. and Bravo, A., 2018. Therapeutic residential care in Spain. Population treated and therapeutic coverage. Child & Family Social Work, 23(1), pp.1-7.

Sartor, A., 2018. ‘Children in place’: A phenomenography of children’s understandings of place, identity in place and looking after place.

Selwyn, J., Wood, M. and Newman, T., 2017. Looked after children and young people in England: Developing measures of subjective well-being. Child Indicators Research, 10(2), pp.363-380.

Ungar, M., Liebenberg, L. and Ikeda, J., 2014. Young people with complex needs: Designing coordinated interventions to promote resilience across child welfare, juvenile corrections, mental health and education services. British Journal of Social Work, 44(3), pp.675-693.

Van der Kolk, B.A., 2017. Developmental trauma disorder: toward a rational diagnosis for children with complex trauma histories. Psychiatric Annals, 35(5), pp.401-408.

Whittaker, J.K., Holmes, L., del Valle, J.F., Ainsworth, F., Andreassen, T., Anglin, J., Bellonci, C., Berridge, D., Bravo, A., Canali, C. and Courtney, M., 2016. Therapeutic residential care for children and youth: A consensus statement of the international work group on therapeutic residential care. Residential Treatment for Children & Youth, 33(2), pp.89-106.

Zeifman, D.M., 2019. Attachment theory grows up: a developmental approach to pair bonds. Current Opinion in Psychology, 25, pp.139-143.

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