1. Development of a Framework for Therapeutic Care in NSW Simone Czech – FaCS Dr Wendy Foote - ACWA Simon Walsh – Allambi

2. 1.The project outline and governance structure 2. ACWA’s preliminary survey results 3. Reflections from a service provider Outline

3. Snapshot - OOHC in NSW 481 children and young people were in residential care (2.6%)

4. NSW Snapshot- Residential Care 4 481 children and young people in Residential Care: Ave. age 14 10% under 12 59% entered OOHC before they were 12 yrs 7% entered OOHC before their first birthday Ave. age first placed in OOHC- 9 yrs 2.6% of all OOHC placements were in residential care 26.3% cyp CAT score inconsistent with their placement type Overall 4.2% cyp were in an OOHC placement that did not match their CAT score

5. Why Therapeutic Care? –not just about Residential Care Joint Project Project Aims –Literature Review –Definition –Program Elements Project Background 5

6. Project Plan Steering Committee Working Group Project Governance 6

7. NSW A Therapeutic Care for a child or young person in statutory care is a planned approach to the complex impacts of abuse, neglect, separation from families and significant others. This response is achieved through the provision of an evidence based model of care that reflects an environment that provides a positive, safe and healing experience in response to trauma, attachment and developmental needs in partnership. NSW B Therapeutic Care for a child or young person in statutory care is a planned, intensive approach to the complex impacts of abuse, neglect, separation from families and significant others. This response is achieved through the provision of a care environment that is evidence driven and provides a positive, safe and healing experience, in partnership with the family, significant others, utilising the expertise and experience of other services to address the complexities of trauma, attachment and developmental needs. NSW Definition 7

8. ACWA Residential Care Sector Consultations April – Aug ACWA consultations with Residential Care House Managers & Direct Care Workers. 25 ACWA member agencies funded to provide statutory Residential Care OOHC services. Capturing the diversity of programs across NSW. ACWA Residential Care Providers Network – used to inform the project. 8

9. 25 Participating Residential Care Agencies Marist Youth Care Entity – Caretakers Cottage Wundarra Anglicare Sydney Premier Youthworks Barnardos Stretch-A-Family Guardian Youth Care CASPA Challenge Children’s Services Delphi Community Services CareSouth Allambi Southern Youth and Family Services Life Without Barriers UnitingCare Burnside St Saviours Lifestyle Solutions Mackillip Family Services William Campbell Foundation Pathfinders CatholicCare Diocese of Broken Bay Stepping Stone House St Joseph’s Cowper Impact Youth Services 9

10. Consultations with ACWA Members The Therapeutic Care Project seeks to develop guiding principles and review current service models for providing therapeutic OOHC services. Residential Care Providers Consultation All 25 eligible agencies participated. On line survey: Part I consisted of 34 questions and Part II consisted of 14 questions & a brief case study. NSW Residential Care Workforce Consultation 110 direct care workers in Residential Care volunteered their thoughts, experiences, and the challenges of working in the Residential Care sector. 10

11. Models Currently Used in NSW 11

12. Core elements ranked by overall frequency Creating a home-like environment - 18/25 Building rapport & relationships – 15/25 Congruence in approach by staff – 14/25 Establishing structure, routine & expectations – 14/25 Offering emotional & developmental support – 14/25 12

13. Nine respondents ranked “Creating a home-like environment” # 1 Seven respondents ranked “Building rapport and relationships” # 2 Four respondents ranked “Ongoing training opportunities for staff” # 3 Five respondents ranked “Clinical supervision available for staff” # 4 Five respondents ranked “Clinical supervision available for staff” # 5 Core elements ranked in order of importance 13

14. Identified Barriers for Service Providers 14 Breakdown of the 8 identified barriers by overall frequency

15. Research, Training and Sector Development Research 8/25 respondents identified the development of outcome measures 5/25 respondents identified the complex nature of trauma 4/25 respondents identified after care & leaving care supports and funding Training 11/25 respondents identified training tailored for Residential Care workers 7/25 respondents identified training around trauma informed care 6/25 respondents identified training in “Therapeutic Care” Sector Development 5/25 respondents identified funding limitations for Residential Care 4/25 identified leaving care options and supports 15

16. Next Steps Therapeutic Foster Care Consultation with cyp who have an experience of Residential Care in NSW 16

17. Going Home Staying Home Therapeutic Residential Programs Education, Development and Vocation Services Therapeutic Foster Care Programs Therapeutic programs for people with Disabilities Clinical & Health Services Adolescent Family Counselor Youth Hope Mentoring, family support & restoration Allambi Care Joint Support Program Juvenile Justice

18. Good Therapeutic Programs Change the Brain for the better Therapeutic Care Models -Encompass a range of trauma-informed theories -Draw from one or a variety of models Congruency -Model is embedded through policy, practice & planning throughout the agency -State wide consensus of a definition Access to specialised support services -Clinical Services -Education -Staff/carer training Measurable therapeutic outcomes Unit costs reflective of needs & outcomes Individualised Restorative Planning -Child focused -Focus on the child’s ‘here & now’ -Involving all appropriate parties (incl. child, sig others)

19. Therapeutic Support provided by AYS Clinical Department SERVICE REQUIRED BY OOHC C&YP Allambi Care Private SectorCommunity HealthBehaviour Analyst Emergency Services FACS Psychological Assessment    Counselling/Skills Training    Psychiatric Consultation    Psychiatric Management    General Practitioner    Occupational Therapy    Speech therapy    Ecological Observation     FBA     Programming     Therapy (DTT)     Suicide Risk Assessment    Staff Consultation      Staff Training   Case Conference   PRIP Contribution   Restricted Practices   RGP Contribution   Team Meeting  

20. Good Therapeutic Programs Change the Brain for the better Therapeutic Care Models -Encompass a range of trauma-informed theories -Draw from one or a variety of models Congruency -Model is embedded through policy, practice & planning throughout the agency -State wide consensus of a definition Access to specialised support services -Clinical Services -Education -Staff/carer training Measurable therapeutic outcomes Unit costs reflective of needs & outcomes Individualised Restorative Planning -Child focused -Focus on the child’s ‘here & now’ -Involving all appropriate parties (incl. child, sig others)

21. Facts & Figures Over a three year period: Average number of clients transferred from IRC to IFC = 11 per annum Average stay in foster care placement once transitioned = 3 years Estimated savings in the first year is 2.4 Million Potential total cumulative saving over 3 years is 14.7 million YearYear Clients Savings

22. Katie part 1 It’ll all be over soon, that I can highly doubt They all just seem to gaze, not really know what we’re about They say they’re here to help, but they’re here on money demand They say they’re here to listen, yet they never lend a hand. They say they understand, yet their eyes give them away. We all have different fears, to push us through each day. They say they know the feeling, yet they go back to a home. They’ve never tasted real freedom, and they’ve never been alone. They’ve never been unwanted, so how do they compare. Course when they’ve lost on something, someone is always there I say they live the normal life, and use ours as an inside eye To see what the outcome would be, if they’d lived a lie They know we all have problems, They know our families’ are unfair So give me the answer, How do you’s really compare?

23. Katie part 2 To everyone at Allambi, Thank you so much for everything and for putting up with all my tantrums and all those long nights at hospital. What you guys have done for me I won’t forget – I love all of you’s so much. I honestly don’t think I’d be alive if I didn’t come here. What all of you do is awesome and I don’t know if you all realize but you do save kids everyday and give them that little bit of hope and love they need. And what makes you all so awesome is that it is pretty much unconditional care. You don’t care where kids come from, or where they are now your still there and are always trying to make each day better than the last. And that’s something only too few people can do. Keep smiling – always – forever