FIFE COUNCIL
Social Work & Health Committee
9 June 2009
Agenda Item No.13
SPRINGFIELD PROJECT
1.0
Introduction
1.1
This report is to inform Members about the Springfield Project. The Project
provides Therapeutic Services for Children and Young People who are
Looked After and Accommodated within Fife Council care placements only
(foster placements / residential houses).
1.2
Springfield Project was set up in September 2006 following multi-agency
discussions about the need for an increased and more co-ordinated provision
of therapeutic services to Looked After and Accommodated Children in Fife.
This is for children who are in local authority accommodation either subject to
a voluntary arrangement, where the child's parents agree to the child being
accommodated or compulsory measures decided by a children's hearing or a
court. Originally funded through the Scottish Executive Changing Children’s
Services Fund, the Project has now been mainstreamed and is funded by the
Social Work Service.
1.3
A multi agency Steering Group comprising Education, Health and Social
Work Service Managers, was set up to oversee the development of the
Project’s Services and continues to provide support and guidance.
1.4
The Project team comprises:
Project Co-ordinator / Social Work Team Leader
Lead Clinician / Child & Adolescent Psychotherapist
Head Occupational Therapy Play Therapist
Child and Adolescent Mental Health Service
Child & Adolescent Psychologist
Art Therapist
Project Secretary
Most staff are part-time and in total, their hours amount to the equivalent of
three full time posts. The nature of the multi agency team enables a variety
of specialist approaches to the provision of services. The team’s location
within Playfield Institute also allows for joint work to be carried out between
the Project and specialist teams within Child and Adolescent Mental Health
Service where appropriate. Children and young people requiring specific
mental health services from other agencies can be quickly identified and
referred on.
2.0
Background
2.1
There are four key components to the service:
2.1.1 Specialist consultation to foster carers, residential care workers, social
workers and other agencies. This service is available without full referral to
the Project and would generally be sought where agencies need specialist
advice in relation to issues such as; making sense of children’s behaviours /
matching children’s needs to carer & placement type / deciding whether
contact with birth families is in the child’s best interests / whether siblings
should be placed together or apart.
2.1.2 Developing and delivering a programme of specialist training to foster
carers and residential workers. Project staff provide a variety of training to
small groups of foster carers with a view to strengthening their relationships
with the children in their care. Carers are helped to understand the impact of
trauma on children’s behaviours and given support to adapt their parenting
approach, where necessary, to meet the needs of the individual child.
Project staff have also provided specialist training to residential care workers
within the five Fife Council mainstream residential houses. This is a three
day course teaching a comprehensive approach to extreme behaviour which
teaches staff ways of managing challenging behaviour when it occurs and
also how to prevent it by tackling it at its source.
Additional training organised and funded by Springfield Project, has been
facilitated by specialists from within the Child & Adolescent Mental Health
Service or external Consultants. The cost of the latter has led to a reduction
in this type of service provision as the Project expands. Also, evaluation has
shown that work with small groups of carers, identified in consultation with the
Social Work Family Placement Service, has been more effective than one off
training events, in achieving positive outcomes for Looked After and
Accommodated Children.
2.1.3 Providing specialist assessment and therapeutic interventions for
children and young people, such as play & art therapy, psychotherapy
and psychology based approaches as detailed in Appendix 1. Both short and
long term interventions are provided. This requires careful monitoring to
maintain Project capacity to take on new referrals and to ensure that direct
Intervention is available to those children who need it most. Children referred
have complex emotional and behavioural difficulties, mainly stemming from
early experiences of abuse and neglect. For children identified as potentially
benefiting from direct work, the intervention provided will depend on the
child’s level of difficulty.
2.1.4 Providing specialist support to foster carers and residential care
workers through individual sessions and small groups (see 2.1 Point 2)
Carers have an opportunity to share the highs and lows of caring for Looked
After and Accommodated Children and are helped to gain insight into
behaviours. Relationship building between carer and child is at the heart of
all of this work, with a view to giving the child the most positive placement
experience possible, thus building their resilience through the remainder of
their childhood and beyond.
2.2
Referral Criteria
2.2.1 Criteria for referral are wide, in order to capture those children who are not
only causing concern through behaviours leading to significant difficulties in
daily life, but those less visible children and young people showing signs of
withdrawal or high anxiety indicating possible concern in relation to their
emotional well being and mental health. Nearly 45% of young people aged
between 5 and 17 years who were looked after by local authorities in
Scotland were assessed as having a mental disorder.
2.2.2 Children can be referred up to and including the age of 18 but must be placed
with local authority carers. Project resources will not allow for a wider remit at
this stage. Looked After and Accommodated Children in private fostering /
residential placements can access therapeutic services through NHS Fife
Child & Adolescent Mental Health Service.
2.2.3 Referrals can be made via the child’s social worker, the foster carer’s link
social worker from the Family Placement Service or residential house
managers. The project works to respond quickly and to support social
workers as well as the child and carers. Once a case is allocated, the Project
organises an Initial Assessment meeting involving the network of people
involved in the child’s care. The decision to accept referrals from Social
Workers alone is in recognition of their key role in the planning and decision
making process. This ensures a dynamic network of people working together
to support both child and placement. In turn, this creates the best possible
environment in which to support the therapeutic process.
2.2.4 Despite the small staff team, currently 75 (25%) of the 300 children and
young people accommodated in Fife’s local authority placements are
receiving a service from the Project, either through direct work or through
work with their carers. In view of the Project’s limited resources, the focus to
date has been on building parenting capacity and confidence through training
and consultation in an effort to create increasingly therapeutic care
environments in which Looked After and Accommodated Children can grow
and develop. The Project is now receiving an increasing number of referrals
for Looked After and Accommodated Children who are likely to need direct
therapeutic intervention to help them to build relationships and be able to
settle in placement. Research shows that the ‘chemistry’ or ‘fit’ between
carer and child is of key importance to the success of placements.
Relationship building will therefore continue to be a crucial part of the
Project’s work.
2.3
Future Plans
2.3.1 A project on Story Telling starting with a one day event for foster carers and
Looked After and Accommodated Children, in conjunction with Fife Council
Library Staff. The purpose being to highlight the importance of reading in
terms of relationship building, the child’s learning and ability to develop
emotional imagination as well as the capacity to think beyond themselves.
2.3.2 The Project’s Lead Clinician has received approval to carry out research
entitled ‘The Preoccupations and Concerns of Foster Carers’. It is hoped that
the findings will provide Project staff and other agencies with increased
insight into the support required by foster carers in their task.
2.3.3 A new group for foster carers, caring temporarily for babies moving on to
adoption. In particular, the group will explore the complexities of caring for
babies post drug withdrawal. Again, carers will be identified in consultation
with the Social Work Family Placement Service.
2.3.4 All Project staff have been trained to provide ‘Story Stem’ attachment
assessments for 4 – 8 yr olds. Additional training in 2009 means that a new
attachment assessment – ‘Child Attachment Interview’ can be offered to 8 –
16 yr olds. These assessments give an insight into the child’s view of the
world and relationships and give helpful indicators to the parenting approach
required to meet their needs.
2.4
Evaluation
2.4.1 The Project is now gathering information from young people, carers and
agencies in relation to their hopes and expectations of Project intervention
and progress will be reviewed throughout the time of the Project’s
involvement. Evaluation feedback is also sought following every training
event.
Regular liaison with the Social Work Family Placement Service helps to
provide the Project with feedback in relation to how well progress has been
sustained within the placement, following Project intervention. Feedback
from agencies and carers to date has been very positive. Carers have
welcomed the level of specialist advice, support and training provided, stating
that it has helped to build their confidence and given insight into children’s
behaviours. Improved relationships between carer and child have frequently
been reported and social workers have spoken of ‘coming to rely on the
services offered’. One young person recently commented ‘I think coming
here has changed me and my carer thinks so too – I can talk about things
and they don’t build up’.
It is hoped that we can build on the positive outcomes to date by identifying
resources to grow the project, enabling more Looked After and
Accommodated Children to access its services.
3.0
Conclusions and Recommendations
3.1
The Committee is asked to note the content of this paper. An Annual Report
will be completed by summer 2009 and will be made available to the
Committee.
Stephen Moore
Executive Director (Social Work)
Social Work Service
Sheila Addison, Project Co-ordinator, Springfield Project (01334 696311)
Playfield House
CUPAR
Fife
KY15 7TW
12 May 2009
Appendix 1
Springfield Project - Therapeutic Interventions
Art Therapy is an intervention that uses art materials as a means of communicating
with the child or young person. Children and Young People referred to the project’s
art therapist do not require any particular skill in art. The art therapist enables the
child / young person to express him/herself through the use of the art materials in a
safe, consistent environment. The art produced helps the art therapist and child /
young person to develop a joint understanding of the child’s inner world and what
sense they may be making of their life experiences. With support from the art
therapist and through the creative process, the child / young person can be helped
to develop positive changes in their lives. Building a trusting relationship between
art therapist and child is of central importance.
Play Therapy Play is often described as the natural means of communication for
children; the way they explore and make sense of their world. Children develop the
capacity to think, imagine and play through the experience of ‘good enough’ early
attachment relationships. Symbolic or imaginary play can allow a child to explore
different aspects of their experiences without necessarily having to talk about things.
Through play children can express their hopes and dreams, their frustrations and
worries. Children can replay new, difficult or upsetting experiences and often, within
the play, come to a resolution or way of understanding their experiences.
Both Play & Art Therapies can be a useful intervention for children with a range of
difficulties. These may include: - loss and bereavement / trauma through neglect
and abuse / difficulties with emotional and social development / low confidence &
self esteem / school worries / emotional & behavioural difficulties or anxieties and
fears.
Child Psychology provides a range of evidence based therapies to children with a
broad range of learning, emotional, behaviour and relationship difficulties including;
Low mood/depression / Overactive/withdrawn behaviour / Attention/hyperactive
difficulties /Anxiety difficulties, including post trauma / Obsessive/compulsive
difficulties and behaviours / Loss or bereavement or Social, Relationship or
Placement difficulties. Support to agencies may include making sense of
neurological conditions caused by injury or trauma, child abuse / neglect, family
breakdown or ‘out of control’ behaviours.
Child Psychotherapy is a specialist child-centred treatment for children and young
people with emotional difficulties, anxiety or depression, and for children and young
people experiencing a wide range of problems where there are underlying emotional
issues. Problems may include difficulties with relationships or social interaction,
aggression, lack of motivation, irrational fears or worries and anxieties that are
expressed in behaviour such as bed wetting, sleep difficulties, soiling or refusal to
eat or drink. Child Psychotherapy is usually considered where problems are severe,
longstanding or complex and are having a significant impact on a child’s everyday
life. It is often considered where other approaches have been tried without success.