intensive therapeutic service a joint initiative by: berry street victoria & the austin camhs in...
TRANSCRIPT
Intensive Therapeutic Service
A joint initiative by:
Berry Street Victoria & the Austin CAMHS
In partnership with
La Trobe University Faculty of Health Science & Mindful
This target group has been characterised in the report “When Care is Not Enough” (Morton, Clark & Pead 1999) in the following way:
“… there are a number of children and adolescents in care,
who have suffered traumatic early environments, for
whom care is not enough to effectively address the
aftermath. It is argued that these young people need
consistent and high quality care, which offers continuity
of positive relationships. However, they also need
systemic therapeutic interventions, to assist them to
rebuild their lives and address post traumatic states and
developmental disturbance associated with the severe
abuse and neglect they have suffered”.
Service Components
The submission brief required that the ITS deliver four service components:
– Regional Intensive Therapeutic Services (85% budget) – 9 teams
– Training component– Research component– Management component
Service Components…Cont’dThe submission brief also specified that the Target Group will all be:
– Referred by the regional Child Protection Manager– Clients of Child Protection who exhibit, or are at risk
of developing, severe emotional or behavioural disturbance caused by abuse and/or neglect.
– Clients of Child Protection who are subjects of substantiated significant and/or very severe harm because of physical or sexual abuse.
– Aged 0-18– May be living at home, with relatives, or in out of
home care.– Expected to work with 710 clients.
Service ModelThere are 4 key aspects of the Service Model:
– A treatment approach that utilises attachment based, outreach and multi-systemic interventions that have been shown to be particularly effective with the target group
– A commitment to wrap around treatment planning models that emphasise the appropriate use of carers and others in day-to-day contact with the child or young person in order to provide treatment and therapeutic care that supports the healing process
Service Model…..Cont’d– An awareness of key service linkages and
service system issues and a commitment to addressing the needs of target group clients through relevant service system development
– A model that builds on and complements existing Child & Adolescent Mental Health Services (CAMHS) and builds bridges between Child Protection, CAMHS and other relevant service providers, continuing, and further developing, linkages established under the Working Together Strategy
Key Principles The client’s experience of disrupted attachment
will be addressed through a primary one to one relationship between therapist and child or young person
The effects of abuse will be understood within both developmental and systemic frameworks
Interventions will be “whole of person” addressing both the current behaviour and its underlying causes
ITS intervention will never be seen as “stand alone”, but always delivered through the building of collaborative alliances and integrated service planning with other services and professionals that can help the child or young person
Key Principles… Cont’d Given the complexity of understanding required
and the potential complexity of service systems to be accessed, simplicity and consistency will govern the ITS service to any given client
A wrap around approach, including work with school, family, and/or carers, will complement any individual work done with the child or young person
Each client will be taught new social skills to increase their future resourcefulness
Intervention effectiveness needs to be continually evaluated from the perspectives of the client, families and carers and other service providers
4 Clinicians
Senior ClinicianWestern
Senior ClinicianSecure Welfare Services
2 Clinicians
Senior ClinicianGrampians
2 Clinicians
Senior ClinicianBarw on/South West
Area Manager West
Research Assistant
Research Manager(located at
La T robe Uni)
5 Clinicians(inc. Specialist Koori role)
Senior ClinicianNorthern
2 Clinicians
Senior ClinicianLoddon Mallee
2 Clinicians
Senior ClinicianHume
Area ManagerNorthern
Training Manager(located at Mindful)
4 Clinicians
Senior ClinicianEastern
4 Clinicians
Senior ClinicianSouthern
2 Clinicians
Senior ClinicianGippsland
Area ManagerSouth Eastern
Director - TAKE TWO
Chief Executive Officer
BSV Board of Directors
TAKE TWO Structure
Research ComponentThere are 2 research questions:
– What is the service framework and model which delivers effective assessment and therapeutic interventions to at risk children and young people and which effectively engages the elements of the service system to support those interventions and contribute to more positive outcomes for the child or the young person?
– What are the important elements in the effective implementation of the service framework and model?
Research Component… Cont’dThese questions are addressed through:
– The development of the assessment instruments and the provision of information to assist the development of service models.
– The undertaking of process and outcomes evaluations. The process evaluation will identify the processes of the ITS and the factors which impact on the effective implementation of the service. The outcome evaluation will identify if the project meets the ITS aims and the identified outcomes of the service.
Training Component Training Manager based at Mindful. Co-location enables drawing upon their well-established
links and resources. Training calendar developed in two components:
introductory and advanced across a three year training cycle.
Incorporates induction for new staff within TAKE TWO and training for workers from Child Protection, CSOs, Education, CAMHS and Drug and Alcohol Koori workers.
By the third year a training calendar will incorporate university accredited subjects, within existing Graduate Diploma in Mental Health Sciences (Child, Adolescent and Family Mental Health).
Capacity for two junior staff from TAKE TWO per year to access the Developmental Psychiatry Course.
Timelines Minister launched TAKE TWO – 1/5/03 Director commenced on 21/7/03 Area Managers and Training & Research
Managers commence on 11/8/03 Advertised for Senior Clinicians on
2/8/03 Advertise for Clinicians on 16/8/03 Expect to have most staff on board by
early November Fully operational from January 2004
Issues for Discussion
Implementation issues in your region
Key stakeholders and relationships – for consultation and Regional Advisory Group
Location of service