ECY3001- Working with Young People with Complex Issues

Introduction

It is crucial to understand that some young people have been through very difficult and painful experiences in their lives. They may have experienced things like neglect, physical or sexual abuse, being separated from the people they love, or other types of emotional and mental abuse. These experiences can be quite hurtful to talk about and can make them feel very sad and scared (AIFS, 2023). This essay will provide Youth work professionals working within the Out of Home Care sector (OOHC) with relevant and insightful information on trauma within young people with complex issues. OOHC is referred to as alternative living for young people, and for many children and young people that are vulnerable, there is limited options in terms of living accommodations (Victoria State Government, 2018). It will explore what is trauma-informed care, and how best to support young people with complex issues, and it will apply three Looking after Children (LAC) Domains to a case study and relate relevant Attachment theories that underpin Trauma-informed practice. 

Body

Due to painful childhood experiences, young people might show behaviours that are a way for them to cope with all the hurt they've been through. These behaviours are called "pain-based behaviours." These behaviours can be things like being very angry, feeling really sad, or having difficulty trusting people because they are afraid of getting hurt again. It is essential for adults and caregivers to be understanding and patient with these young people, as they are dealing with a lot of pain and trauma. They might need extra support and help to heal and feel safe again.

Some of the complex needs in the case of Corey are: 

1. Provide emotional support to improve emotional and behavioural development: Corey's Emotional and Behavioural development is complex and is also impacted by a combination of strengths, challenges, and opportunities. Corey is a young, resilient Aboriginal Person who has experienced significant developmental and Inter-generational Trauma within the Early years of his Childhood. It is essential for Corey to receive ongoing support from his psychologist and other professionals to address his emotional and behavioural challenges (The Child Trauma Academy, 2021). Additionally, nurturing and stable relationships, such as those with his present caregivers and siblings, can play a crucial role in his emotional development and may help mitigate some of his challenges over time. Corey displays signs of an Avoidant attachment style and occasionally struggles with emotional regulation. These difficulties manifest in behaviours like running away from home and engaging in physical altercations when confronted or feeling vulnerable. It is essential to recognize that such behaviours can be quite common among young people in care, as they often operate in a constant "fight or flight" mode when they perceive threats or insecurity (AIFS., 2023).
2. Need to provide education and career support: Corey has faced numerous challenges in his educational experiences, including frequently changing schools and placements. As a result of these breakdowns, Corey struggles to form meaningful relationships and connections with his peers. Additionally, Corey has experienced difficulties in accessing and receiving the necessary support for his educational and behavioural needs (The Child Trauma Academy, 2021). Corey's educational Journey has been marked by instability, as being moved to multiple placements and removed from schools, it has made it challenging for Corey to establish and maintain peer connections. The frequent educational change at such a young age, would have a significant impact on the attachment style we see Corey presenting in the behaviours of withdrawing and isolating and have further hindered Corey’s progress in this space (Victoria State Government, 2018).
3. Furthermore, Corey has had several other obstacles in his education, such as schools not being able to adequately provide him with the right classroom environment, behavioural support, emotional support or even peer support. Corey faces challenges in building peer relationships and meeting the high expectations set in an educational environment. 
4. Provide support to manage inattention and impulsivity: Children with ADHD often struggle with inattention, making it challenging to focus on tasks and follow instructions. Impulsivity can result in difficulty to control their behaviour, often leading in impulsive decisions and actions. As mentioned in the case study, when Corey’s foster father tried to talk about his school, he became angry and aggressive and quickly escalated the conversation into an argument. Corey requires behavioural and psychological support, which can help in emerging strategies to manage impulsivity, inattention, and hyperactivity. Corey needs counselling to address emotional and psychological challenges, including self-esteem issues, anxiety, and depression (Victoria State Government, 2018). 

Therapeutic Residential Care (TRC): 

Therapeutic Residential Care is intensive and time-limited care for a child or young person in statutory care that responds to the complex impacts of abuse, neglect, and separation from family (AIFS, 2023). This is achieved through the fostering of positive, safe, healing relationships and experiences informed by understanding trauma, attachment theories and the developmental needs of young people. (Mclean et al., 2011). TRC represents an innovative and comprehensive model designed to empower young people facing complex needs. The primary goal of TRC is to facilitate positive life outcomes and provide a clear sense of direction for young individuals who have experienced abuse, neglect, or trauma, leading them to be placed under the care of the minister (AIFS, 2023). These young people require caregivers who possess a deep understanding of Trauma-Informed care and have been trained in Therapeutic Crisis Intervention (rccp.cornell.edu, n.d.) to ensure their unique needs are not only met but also addressed in a healing and holistic manner (Victoria State Government, 2018).

TRC recognizes that young people who have endured abuse, neglect, or trauma require a different approach to care. It aims to create an environment where these individuals can embark on a journey of healing and recovery. Key to this process is the provision of safety and nurturing, allowing them to rebuild trust, resilience, and a sense of self-worth.

Through Trauma-Informed care, TRC acknowledges the impact of past traumas on the lives of these young people and seeks to provide them with the tools, support, and opportunities needed to heal and thrive. It is a model rooted in empathy, compassion, and the belief that every young person has the potential for positive growth and transformation. In summary, Therapeutic Residential Care (TRC) represents a holistic approach to the care of young people who have experienced significant life challenges. It is a model that recognizes their unique needs and leverages Trauma-Informed care and Therapeutic Crisis Intervention to create a safe and nurturing space where healing can take place, ultimately guiding them toward a brighter future (Corney & Broadbent, 2021).

Why is a TRC approach the preferred intervention?

In the current case study of Corey, the TRC approach is the preferred intervention as it provides a platform for the open and transparent acknowledgement of past atrocities and rights violations, It has been shown that by using TRC and providing young people with holistic, gentle and nurturing approach has a much higher success rate at managing behaviours opposed to a more institutionalized approach. In the case study of Corey, the TRC approach has been used as it provides a highly structured and therapeutic environment staffed by trained professionals who specialize in working with individuals with significant emotional and behavioural changes. The use of TRC can offer many benefits to Corey, which can address his complex emotional and behavioural needs.

By adopting trauma-informed care principles, we can better understand Corey's experiences, acknowledge the impact of past traumas, and work collaboratively to provide the support and assistance he needs to overcome these challenges. It is a compassionate and holistic approach that recognizes resilience within Corey and aims to create a safe and nurturing environment for his growth and healing (Mclean, Price-Robertson, and Robinson, 2011).

As mentioned in the case study, Corey faces difficulties in interacting with his family members. TRC often emphasizes family involvement in the child's treatment by arranging family therapy sessions, visiting schedules, and offering family support programs to help the child and their family heal and rebuild their relationships. TRC facilities can help Corey transition back to his family or into a less intensive care setting when he is ready. This transition planning ensured that the program made during their stay was maintained. 

Three of the LAC domains to respond in the case of Corey include the emotional and mental health domain, the education and skill development domain, and the social and community integration domain. 

1. 1. Emotional and mental health domain: To address the emotional and mental health needs of Corey Bruce Perry, attachment theory can be applied. Attachment theory emphasizes the significance of early relationships in shaping a person's emotional and psychological development (George, 2014). Perry's theory highlights the significant importance of forming healthy emotional attachments in early Childhood. As Corey struggles with impulse control, aggression, and agitation this may be linked to his lack of secure attachments developed from his early years, which is suggested by Perry’s theory (Boris et al.., 2021). According to the attachment theory for people like Corey who have experienced disrupted attachments, a trauma-informed approach should be focussed on securing attachments with caregivers, foster parents, and residential staff. Attachment theory can be implicated in the case of Corey while designing Trauma-informed practice (Boris et al., 2021), like involving peers, caregivers, and mentors in the counselling sessions to reduce the feeling of social isolation and support his social integration (George, 2014). 
   2. Education and skill development domain: Improving educational and skill development is crucial for LACs with ADHD like Corey to help them overcome academic challenges and build up essential life skills to get employment (Zimmerman, 2013). Resiliency theory can be a valuable framework for supporting Corey as this theory majorly focuses on an individual’s capacity to adapt and thrive in the face of adversity and challenges. The implication of resilience theory can enable the development of effective coping skills like strategies to control impulsivity and maintaining emotional regulation (Zimmerman, 2013). Resilience theory can encourage Corey to set realistic goals like set and achieve academic, personal and professional goals, and thus building a sense of accomplishment. Corey needs to be empowered to take responsibility for his own life (Zimmerman, 2013). Resilience theory promotes the empowerment by allowing individuals to become active participants in their own lives. Education can promote the changes of getting better employment and make Corey empowered to make the right decisions and gain a sense of control and wellbeing (Zimmerman, 2013).
   3. Social and community integration domain: As mentioned in the case study, Corey faces difficulties in maintaining relationships. The social and community integration domain is integrated to help Corey to build and maintain healthy social connections. The third theory that can be implicated in the case study of Carey is John Bowlby’s Attachment Theory. This theory provides a psychological framework that emphasizes the importance of early and enduring emotional bonds and attachments between children and their primary caregivers. Meanwhile, not having an attachment figure like a mother or primary caregiver leads to the failure to form attachments, which can lead to emotional and social difficulties later in life. Supporting Corey to develop and maintain family and social relationships is crucial for his overall emotional wellbeing and relational development (Bowlby & Ainsworth, 2013). Providing Corey with placement stability helps minimize any unnecessary changes in his placement and provides Corey with a sense of security and consistency to know that he can count on his carers to be there. Bowley’s theory categorized attachment patterns into secure and insecure types. This theory can help professionals and caregivers understand how these disruptions can affect Corey’s emotional development and his ability to form future relationships (Holmes, 2014).

Conclusion:

In conclusion we have identified what a client with complex needs living in OOHC is, and discussed the challenges these young people face daily. This essay has demonstrated to the readers how vital it is to work with a trauma-informed approach that is strengths-based according to the Looking After Children (LAC) domains, helping our young people feel empowered to achieve their goals. We have discussed the theories that relate to the LAC Domains, and why they help us to understand Therapeutic Residential Care (TRC) and why it is the preferred model to help heal trauma within young people. In this essay we have used facts-based evidence to provide readers with the knowledge to understand Corey, and others with similar experiences and how to support young people with complex trauma to positive relationships and a new path within the OOHC system. Overall, it can be stated that the implication of theories like Bowlby’s Attachment Theory, Bruce Perry attachment theory, and resiliency theory can provide an essential framework for understanding the needs and challenges faced by Corey. These theories underscore the significance of forming secure attachments, the impacts of early experiences on emotional development, and the potential for healing and resilience.

 

Reference list

AIFS. (2023). Therapeutic residential care in Australia: Taking stock and looking forward. https://aifs.gov.au/resources/policy-and-practice-papers/therapeutic-residential-care-australia-taking-stock-and 

AIHW. (2021). Young People in out-of-home Care. https://www.aihw.gov.au/reports/children-youth/young-people 

Boris, N. W., Chesher, T., & Wajda-Johnston, V. A. (2019). 11 Assessment of Attachment in Infancy and Early Childhood. The Oxford Handbook of Infant, Toddler, and Preschool Mental Health Assessment, 267. https://books.google.co.in/books?hl=en&lr=&id=XdG8DwAAQBAJ&oi=fnd&pg=PA267&dq=related:bmk7JmydAdkJ:scholar.google.com/&ots=AyIyLcycuu&sig=qHrqdXWa8n1GxgLcGXIoim8b_LM&redir_esc=y#v=onepage&q&f=false 

Bowlby, J., & Ainsworth, M. (2013). The origins of attachment theory. Attachment theory: Social, Developmental, and Clinical Perspectives, 45(28), 759-775. https://books.google.co.in/books?hl=en&lr=&id=x-Oki9MxalQC&oi=fnd&pg=PA45&dq=John+Bowlby%E2%80%99s+Attachment+Theory.+&ots=raEXJSaawZ&sig=hxj_wFUQzVw1CiqZOMMzV-D-B2I&redir_esc=y#v=onepage&q=John%20Bowlby%E2%80%99s%20Attachment%20Theory.&f=false

Core Strengths for Healthy Child Development. (2022). https://www.buckeyeranch.org/assets/media/documents/Core%20Strengths%20for%20Healthy%20Child%20Development.pdf 

Corney, T., & Broadbent, R. (2021). Professional Youth Work: Principles, Practices and Priorities. https://vuir.vu.edu.au/43005/ 

George, C. (2014). Attachment theory: Implications for young children and their parents. Infant and Early Childhood Mental Health, 97-110. https://www.researchgate.net/publication/261436928_Attachment_theory_Implications_for_young_children_and_their_parents 

Holmes, J. (2014). John Bowlby and attachment theory. Routledge. https://books.google.co.in/books?hl=en&lr=&id=30HFBQAAQBAJ&oi=fnd&pg=PT9&dq=John+Bowlby%E2%80%99s+Attachment+Theory.+&ots=5C9KQCz90k&sig=tkaEsD8G1qIZKp1sl25QEnFFZiA&redir_esc=y#v=onepage&q=John%20Bowlby%E2%80%99s%20Attachment%20Theory.&f=false 

The Child Trauma Academy. (2021). Bonding and attachment in Maltreated Children. https://fosteringandadoption.rip.org.uk/wp-content/uploads/2016/01/bonding-and-attachment-in-maltreated-children.pdf 

Victoria State Government. (2018). Child Protection Manual. https://www.cpmanual.vic.gov.au/

Zimmerman, M. A. (2013). Resiliency theory: A strengths-based approach to research and practice for adolescent health. Health Education & Behavior, 40(4), 381-383. https://doi.org/10.1177%2F1090198113493782