Abstract
BackgroundThere are 78,150 children in care in England and 12% live in group residential settings. Little empirical research informs our understanding of how these vulnerable children heal from multi-type trauma in residential homes. Evidence-based multisystemic trauma-informed models of care are needed for good quality consistent care.ObjectiveUsing a novel multisystemic trauma-informed model of care with an embedded developmental monitoring index, the Restorative Parenting Recovery Programme, pilot data was collected from young people and care staff from four residential homes over a two-year period. Five key developmental areas of children’s recovery were investigated through monthly monitoring data. Staff were also interviewed to explore their experiences of delivering the intervention to contextualise the findings.MethodsData was gathered from 26 children, aged 6–14 years, over a two-year period. Their developmental wellbeing was measured using the Restorative Parenting Recovery Index and analysed through a comparison of means. To add further context to this preliminary analysis, qualitative interviews were undertaken with 12 Therapeutic Parents to explore their perceptions of how the Restorative Parenting Recovery Programme influenced the children’s development.ResultsYoung people showed significant improvements on indices relating to relationships (p = 0.002, d=0.844). Significant changes are observed during the first half of the programme in self-perception (p = 0.006, d = 0.871) and self-care (p = 0.018, d = 0.484), although limited progress around self-awareness and management of impulses and emotions.ConclusionsThis novel integrative approach to re-parenting and embedded measurement system to track the children’s progress is the first of its kind and has originated from extensive multisystemic clinical practice.
Highlights
There are currently 78,150 children in care in England (Department for Education, 2019), a 4% increase from 2018, with 63% of children entering the care system due to abuse and neglect at home
Vulnerable children and young people who have experienced multiple traumas and relational losses are at risk of further instability and re-traumatisation through a system in need of theoretically robust traumainformed models of care with empirical evidence to support their implementation
It is comprehensively understood that adversities in childhood can impact global development, in relation to psychological sequelae (Cashmore & Shackel, 2014; Gilbert et al, 2009; Varese et al, 2012), highlighting “few associations in the mental health literature are as well established as the relationship between child abuse and neglect and adverse psychological consequences among adults” (Horwitz, Widom, McLaughlin, & White, 2001, p. 184)
Summary
There are currently 78,150 children in care in England (Department for Education, 2019), a 4% increase from 2018, with 63% of children entering the care system due to abuse and neglect at home. Of the 9378 children and young people who enter long-term residential care (e.g. secure units, children’s homes or semi-independent living accommodation), the percentage of children who have experienced multi-type trauma is even higher. These are arguably the most vulnerable group of young people in care and the system they enter is not currently statutorily regulated, with only a proportion of children’s homes regulated and regularly inspected by Ofsted; the Office for Standards in Education, Children’s Services and Skills in England. Objective Using a novel multisystemic trauma-informed model of care with an embedded developmental monitoring index, the Restorative Parenting Recovery Programme, pilot data was collected from young people and care staff from four residential homes over a two-year period. To add further context to this preliminary analysis, qualitative interviews were undertaken with 12 Therapeutic Parents to explore their perceptions of how the Restorative Parenting Recovery Programme influenced the children’s development
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