The importance The importance of containment of containment

in a complex in a complex trauma-soaked trauma-soaked

system: the system: the team as secure team as secure

base.base.Belinda ThomsonBelinda Thomson

Tanya JacksonTanya Jackson

Structure of EVOLVEStructure of EVOLVE

Objective: To increase mental health, behaviour support and participation in education for children and young people in the care of the Department of Child Safety.

QueenslandHealth

EVOLVETherapeutic &

BehaviourSupportServices

DisabilityServices

Queensland

Educationand the

Arts

Department of

Child Safety

QueenslandHealth

EVOLVETherapeutic &

BehaviourSupportServices

DisabilityServices

Queensland

Educationand the

Arts

Department of

Child Safety

Evolve Sunshine Evolve Sunshine Caost/Cooloola/Burnett/Fraser Coast.Caost/Cooloola/Burnett/Fraser Coast.

Bundaberg (to come)

Fraser Coast

Hervey Bay

South Burnett

Kingaroy

CooloolaGympie

Sunshine Coast

Mooloolaba

Spoke

SpokeSpoke

Spoke

Hub

EVOLVE TEAM MEMBERS:EVOLVE TEAM MEMBERS:• Mooloolaba

– Team Leader (Stephen Bell)– Senior Administration Officer (Meridith Rubins– Service Research & Evaluation Co-ord (Narelle

Raeburn locum; Lucy Coyne on leave)– Professional Development Co-ord (Belinda

Thomson)– 3 Therapists (Fiona Meredith, Tanya Jackson,

Vicky Richardson-Bell)– Consultant Child Psychiartist (Rebecca Wild)– Psychiatry registrar (vacant)

Evolve Team members Evolve Team members Spoke sites:Spoke sites:

• Gympie– 1 therapist (Sabrina Sandy)– Co-located with local CYMHS team

• South Burnett (Kingaroy)– 1 therapist (temp vacant)– Co-located with local CYMHS team

• Fraser Coast (Hervey Bay)– 2 therapists (Kaye Byrnes on leave) (Nicole

Allen locum)– Co-located with local CYMHS

QuoteQuote• “Human beings of all ages are found

to be at their happiest and to be able to deploy their talents to best advantage when they are confident that, standing behind them, there are one or more trusted persons who will come to their aid should difficulties arise.”

• John Bowlby (1973)

Therapeutic Needs of Children in Therapeutic Needs of Children in CareCare

FEELING SAFE PHYSICALLY AND EMOTIONALLY

DEVELOPING RELATIONSHIPS

COMFORT AND CO-REGULATION ELICITING CARE FROM RELATIONSHIPS

EMPATHY AND REFLECTION MANAGING BEHAVIOUR IN RELATION TO OTHERS

RESILIENCE AND RESOURCES

SELF-ESTEEM AND IDENTITY

EXPLORE TRAUMA, MOURN LOSSES

Pyramid of Need

A hierarchy of needs. Assess where child is to guide choice of interventions.

Children move up and down in response to current circumstances.Kim Golding 2007

EVOLVE Collaborative Practice EVOLVE Collaborative Practice ModelModel

Holding the Child in Mind – Creating Therapeutic Networks

Social Care

Health

Child

Families

Communities

Professionals

School

Legal

Voluntary LeisureKim Golding 2007

Child or Young person

Non-GovtAgency

DSQEvolve

BehaviourSupport

Dept. Child Safety

Education

Carers’ Supportagency

Child’s carer

Qld HealthEvolve

TherapueticServices

Stakeholder team

Safe Haven

Secure Basecontainment of overwhelming feelings as bearable and meaningful

Go out to explore, understand clients experience

Return for reassurance, support, advice.

Defences, projection, chaos

Team as container•Empathy

•attunement

•Awareness of defences

•Reflective function

•Development of empathic shift

ContainmentContainment• Being with emotionally,

psychologically, physically.• Resonance with (willingness to feel

something), and• Attunement to (behaviours you do

to communicate your resonance)• The emotional experience of another

(COS)

QuoteQuote“The containment of one team

member may enable others to achieve and provide containment for children in our care.”

Joan Hutten

Safe Haven

Secure Basecontainment of overwhelming feelings as bearable and meaningful

Go out to explore, understand clients experience

Return for reassurance, support, advice.

Defences, projection, chaos

Team as container•Empathy

•attunement

•Awareness of defences

•Reflective function

•Development of empathic shift

QuoteQuote“…adopting a …(curious) stance

through which …(others) can discover a way to work with particular clients which is responsive to their needs rather than to professional differences.”

Joan Hutten (in Psychotherapy with Severely Deprived children)

QuoteQuote“This collaborative team work, including

being the carrier of the child’s cumulative experience, demands exacting commitment from workers if they are to provide the containment which enables children to learn from and integrate experience.”

Joan Hutten

QuoteQuote“We each seek to know that we are

held in the mind and heart of another.”

Fosha