Therapy and Counselling: An Integrated Service

The young people placed with New Reflexions carry with them the legacy of physical, emotional and sexual abuse. Early toxic experiences have resulted in patterns of behaviour that generate significant levels of concern. Multiple placement breakdown has been a common experience which further compounds early developmental losses. The young people we work with routinely exhibit poor emotional regulation, poor impulse control, poor emotional literacy, poor social skills and a poor empathic response. They are often extremely angry and have fixed and negative views about themselves and what might be expected from relationships. Often a sense of psychological safety is dependent upon an ability to control others.

If we are to intervene successfully in the lives of these very damaged young people it is important that we have a robust framework for doing so. At New Reflexions our approach is largely informed by attachment theory. Using a team based approach we work hard to re-frame the experience of the young people placed in our care. By providing stable, robust and thoughtful environments that are responsive and attuned to the needs of the young person, we hope to establish the sense of security that has so often been lacking. It is only by developing this ‘secure base’ that we can hope to impact on the negative trajectory already set in train. By helping young people to regulate their emotional states, develop a sense of empathy and reflect on the relationship between their experience and subsequent patterns of behaviour, we can go some way towards providing a corrective emotional experience.

At New Reflexions the therapy service has the following functions

· Assessment
· The provision of consultancy to staff teams
· Individual therapy.
· A specific service for young people who display sexually abusive behaviour.

Assessment

At New Reflexions the therapy service is represented both at the initial referral stage and as part of the ongoing assessment process that informs the nature of intervention and calibration of risk. Specific assessment tools augment a rolling programme of rigorous evaluation and demonstrate our commitment to an evidenced based process. Established relationships with Clinical Psychologists and other health professionals further represent our determination to provide an excellent service and add yet another dimension to our assessment capability, should they be required.

Working with the Teams

It is increasingly recognised that effective intervention in the lives of attachment disordered children and adolescents depends on an ability to structure and inform the type of caring relationships they are offered. Members of the therapy service at New Reflexions regularly attend team meetings in order to support and enhance the understanding of those engaged in the day to day care of our young people, and in so doing establish and reinforce a robust theoretical framework that defines task and shapes strategy.

Therapeutic Crisis Intervention (TCI)

Given our commitment to an integrated service and a whole team approach, it will come as no surprise that our method of choice for intervention at times of crisis is founded on principles that are congruent with attachment theory. By providing a robust environment that can support young people in their move towards greater regulation of their emotional states, greater insight in relation to the connection between feelings and action, and greater self reflective capacity within the context of attuned , responsive and thoughtful adults, we are directly impacting on many of the toxic by-products of insecure attachment. TCI provides a tried and tested evidence based system that enables safety and containment at times of crisis and actively encourages the development of insight, self- reflective capacity, emotional literacy and pro- social solutions to long standing problems. For more information see the Therapeutic Crisis Intervention section of the web site.

Individual Therapy

The therapy service at New Reflexions offers, where appropriate, individual sessions to the young people in our care. Once again, the aim is to establish a relationship that can disconfirm the negative template that young people have developed in relation to abusive and traumatic experience. All department members offering therapy have significant experience and receive regular supervision. Rigorous and recognised training allows for particular and specific types of intervention aimed at processing toxic early experience and reframing subsequent maladaptive ‘solutions’ to impossible dilemmas.

Services to Young People who Display Sexually Abusive Behaviour

Sexually abusive behaviour does not usually develop in isolation. It occurs within the context of a whole range of toxic, traumatic and dysfunctional experience. For example we can easily see that the poor impulse control, insufficient empathic response, low self esteem, large amounts of anger and a desire to be both in control and feel powerful, might all be implicated in the genesis of sexually harmful behaviour. It therefore follows that a global and integrated service designed to effectively impact on these by-products of insecure attachment, offers a platform for effective intervention.

However there is also a strong case for a more targeted and specialist service designed to meet the needs of this client group. At New Reflexions experienced practitioners carry out focused assessments in relation to the risks posed by these young people. Robust and validated evaluation frameworks are employed in order to inform care decisions and strategies. Direct work takes full account of contextual issues as well as focusing on offence specific work and the cognitive distortions that so often accompany sexually harmful behaviour.

Once again emphasis is on an holistic approach. Effective work takes place within the context of the more global caring environment. Therapy and focused work on sexually inappropriate behaviour form two specialist but integrated components of the team around the young person.

The Therapy Department

The Therapy Department is headed by Andrew Wood B.A.(Hons), PGDip A.Th., M.Sc., M.St. (Oxon), HPC., UPCA., UKCP.

Andrew is an Art Therapist and Psychodynamic Psychotherapist. He registered with the Health Professions Council and the United Kingdom Council for Psychotherapy, as well as being a full member of the British Association of Art Therapists and the Universities Psychotherapy and Counselling Association. He has Masters Degrees in both Applications of Psychology and Psychodynamic Practice, this last from Oxford University. Attachment theory is an area of particular interest and Andrew has undertaken research exploring the attachment styles of Residential Care Workers. He has been trained in the use of the Attachment Style Interview developed by Professor Bifulco, EMDR and the AIM2 assessment measure in relation to sexually harmful behaviour. Andrew has spent over twenty years working with ‘Looked After Children’.

Dr Stewart B.A. (Hons).,Clin.Psy. D;CPsychol.

A corner stone of our therapy service is the availability of an ‘in house’ Clinical Psychologist. Dr Lorna Stewart has Chartered Status with the British Psychological Society and many years experience of work with ‘looked After Children’. She holds a senior position within a local Child and Adolescent Mental Health Service and is skilled in the delivery of specific interventions and psychological assessment, particularly in the areas of mental health, psychological trauma, intellectual capacity and neuro-developmental disorders. In addition Dr Stewart is a supervising Clinical Tutor for Trainee Clinical Psychologists as well as contributing to the Clinical Psychology Doctoral Training Programme at Keele University.

Antony Quinnell B.A.(Hons), PGDip Sociology of Labour, M.Sc., CQSW, AASW.

Tony is an experienced Social Worker, holding a Master’s Degree in Advanced Social Work. He has particular expertise in the areas of risk assessment, risk management and direct work with children and young people who display inappropriate sexual behaviour. He has delivered training in all aspects of child protection and, for many years, worked as a Children’s Services Manager for the NSPCC. Tony also has an interest in attachment theory, particularly as it relates to sexually harmful behaviour, and has been trained in the Attachment Style Interview.