1. Care Visions Children’s Services Supporting young people leaving our care
Maureen Cassidy- Sanctuary Co-ordinator (Residential Children’s Services)
Lesley-Anne Gemmell, Area Manager (Residential Children's Services)
Jennifer Clark, Care Leaver – Who Cares Scotland

2. Care Visions Children’s Services
Scotland’s largest independent provider of residential care for children. Our first house opened in 1998
One of the country’s leading independent providers of fostering
We specialise in working with some of the most vulnerable children and young people
We help children and young people understand their experiences and help them to ‘recover’.
Committed to professional development and training of staff through the Sanctuary model – caring for children and young people from a trauma perspective.

3. What do we know? The outcomes for young people leaving care are poor

4. Why ? Homelessness/Roofless Prison Unemployment Depression
Domestic violence
Addiction
Abuse
Poverty and destitution
Loneliness

5. National Policy
There has been recognition in national policy of the need to improve support for care leavers in Scotland. More Choices, More Chances (Scottish Executive, 2006), Looked After Children and Young People: We Can and Must Do Better (Scottish Executive, 2007) and These are Our Bairns: a Guide for Community Planning Partnerships on being a good corporate parent (Scottish Government, 2008) are some of the guidance and policy outlines which have stressed the importance of the support we need to give young people in our care and our care leavers.

6. At Care Visions we believe that every young person has the capacity to recover from trauma and adversity and, against the odds, can look forward to a bright and fulfilling future. To help achieve this we use …
The Sanctuary Model

7. Why Sanctuary? It provides a framework for recovery.
It enhances the quality of care.
It helps children, young people, and carers make sense of how present behaviours are informed by past experience.
It teaches children and young people to replace actions with words; self harm with self care strategies.
Framework- Shared Language, Framework for problem solving and a common set of shared values and principles
Quality Care- Recovery model- we view children and young people as being injured and not sick or bad. We ask What has happened to you? And not
‘What’s wrong with you’?
Understand how trauma impacts on the present behaviour- learning about the bio-psycho social effects of trauma. Helps children and carers make sense of experiences.
Focuses on safety and self care and through using the tools and education materials helps children replace feelings with words, self harm with self care strategies.

8. Four Pillars of Sanctuary
Trauma Theory – a foundation for creating a trauma informed environment.
S.E.L.F. – a model which organises the way in which we think about individuals, organisations and recovery.
The Seven Commitments – our value base which guides individual beliefs, practices and policies.
Sanctuary Tools – a range of resources and activities aimed at helping individuals make sense of trauma.
Trauma Theory-

9. The ACE’s Study
The largest study of its kind ever done to examine the health and social effects of adverse childhood experiences over the lifespan (Felitti & Anda)
Adverse Childhood Experiences- Trauma and Loss
The more ACE’s a person is exposed to the greater the risk of chronic disease, premature mortality, substance abuse, chronic depression, poor mental health and victims of violent relationships
Virtually every study shows that ACE’s are strong predictors of homelessness (Burt, 2001)
-Centres of Disease Control commissioned the study 17,000 Health Care workers. Mixed gender and racial backgrounds, ageing 19-over 60.
-ACE- Experiences while growing up that deeply impact a young person and profoundly affect emotional and physical health later in life. These include physical, emotional and sexual abuse. Household dysfunction such as domestic violence, mental health problems, drug and alcohol abuse, loss of significant relationships through death, separation or imprisonment.
67% of participants had experienced one or more ACE’s – showing Adverse Childhood Experiences are very common
Homelessness- poor mental health and substance abuse is more common among homeless people and statistics show non-homeless people with poor mental health and substance abuse ae less likely to hold a job.

10. Trauma Dr S.L. Bloom What is trauma?
“ Trauma is an overwhelming event that causes intense feelings of fear, helplessness and horror.”
Dr S.L. Bloom
“Traumatisation occurs when both internal and external resources are inadequate to cope with threat”
Bessel Van der Kolk 1989

11. What we know about trauma?
Trauma interferes with the integration of left and right hemispheres of the brain. This occurs to such an extent that young people cannot access rational thought in the face of overwhelming emotion and are prone to react with extreme helplessness, confusion, withdrawal or rage.
When we are terrified, language fails us.

12. Fear can look like this!
Fear can look like this!

13. But feel more like this!

14. How do such children and young people present?
Foreshortened and diminished view of future
The world has become a bad place
Inability to trust. No expectation of recourse to justice
Attributing hostile intentions to neutral stimuli (constantly under threat)
Problems with sex and sexuality
Maladaptive coping mechanisms- harming self through
substance abuse, self harm and risk taking behaviours
Re-victimised in adult life or re-create violent relationships
Harming others, re-enacting but putting others in victim role

15. A baby exposed to constant harm and threat will develop into a child/adult in a constant state of alarm and readiness to react to any perceived threat.

16. The S.E.L.F Framework
Safety- No-one can recover or works well without having a sense of safety Safety means physical safety, emotional safety, social safety and moral safety. Safety is where we always start a end. If you are not safe, you cannot recover effectively.
Emotions- Managing emotions is the step that helps us to know what we are feeling and to handle our feelings in a way that doesn’t hurt ourselves or others.
Loss Loss is the step that helps us acknowledge and grieve the painful things that have happened to us, in a safe way. Then we can let go, and move to a healthy future.
Future Future is the step where we look at our choices in creating a better personal future.

17. Seven Commitments
Non violence - 3 components of communication consist of :words 7%; tone of voice; 38%, body language 55%.
Emotional intelligence - managing our feelings so that we don’t hurt ourselves or others.
Social learning - respecting and sharing the ideas of our teams.
Democracy - shared decision making.
Open communication - saying what we mean and not being mean when we say it.
Social responsibility - together we accomplish more. Everyone makes a contribution to the organisational culture.
Growth and change - creating hope for our clients and ourselves.

18. The Sanctuary Toolkit Community Meeting Red Flag Meetings Safety Plans
Self Care Plans
Team Meetings
Care Reviews
Self Education
Toolkit is host of tools and activities which help create routines and ritual within the care settings. This provides safety, predictability and opportunity for children and young people to learn about themselves and others.
SELF Education - Humanistic approach to changing behaviour patterns, values, interpretations and the life outlook for individuals. Teacher/student-working in the lifespace. Use of media, psychoeducation activities.

19. The Sanctuary Model Emphasis on Safety
A platform for understanding experiences of trauma and adversity
Development of positive relationships and forming appropriate attachments.
Helps build self esteem
Enhanced cognitive skills- i.e. problem solving and decision making.
Improved emotional management
Restores hope for the future.

20. Sanctuary is not a sickness model but a social/recovery model
And finally ………
Just when
the caterpillar thought its world was over ….
So to summarise, Sanctuary is a trauma informed model that is about healing and recovery. It’s not a sickness model. It allows us to facilitate recovery and a sense of future for children and young people during their time with us. Sanctuary is about restoring possibilities and creating futures. The allegory of the caterpillar reflects this in our vision for children in care, For ‘Just when the caterpillar thought its world was over’....

21. It became a butterfly -anonymous
It became a butterfly ……… and this is our hope too.