14 June 2006



Young people with complex needs often struggle in traditional foster care. Sally Flood looks at the specialist centres that step in and make a difference.

Crisis intervention: A place to call home

Sarah was 14 when she was placed in the crisis intervention centre at Bryn Melyn, north Wales. After a series of violent family arguments, Sarah was taken into foster care, but her heavy drug use caused a series of placements to break down. At Bryn Melyn, Sarah was allocated a team of three practitioners, who helped her consider the reasons why she used drugs. Over the course of six months, Sarah had weekly sessions with a psychologist and regular access to the local youth health team. She also took part in a range of activities, from tenpin bowling to playing team sports. The aim was to help Sarah improve her self-confidence and communication skills, and enable her to return to a traditional foster care placement.

The approach seems to be successful. Since leaving the centre two months ago, Sarah has completed some formal education and is now about to start a part-time job. Sarah attributes the turnaround to her time at Bryn Melyn: "At first, I really resented everyone and wanted to go home," she says. "But the staff at the centre made me want to change my life."

Crisis intervention centres provide a refuge for more than 1,000 young people in the UK who are not able to remain in a foster care or other residential placement. Typically, these are the most damaged and traumatised young people, who display extremely challenging behaviour that requires one-to-one attention from qualified carers. The young people may have been abused, be dependent on alcohol or drugs, or be suffering from conditions such as attention deficient hyperactivity disorder or Asperger's syndrome. Most of the young people in crisis intervention centres are referred by local authorities or social services, and placements are funded by a combination of social services - sometimes via youth services - local health authorities and education authorities. "We're offering something that the local authority itself can't offer," explains Emma Brady, a child practitioner at Five Rivers, which operates a number of crisis intervention centres across the UK.

Brady is currently working with one young person who couldn't successfully be placed in conventional local authority foster or residential care. Katie, 15, has been in care several times before, but those placements broke down and she is now staying at Five Rivers' crisis intervention centre near Weymouth (see box). "I was in foster care when I was 12 but it didn't go to well," explains Katie. "My foster parents accused me of taking drugs when I wasn't, and we got into loads of rows about it." Katie was then placed in a children's home, but returned home after she accused a male member of staff of abusing her. However, things soon deteriorated when Katie's brother began beating her for money to buy drugs. The final straw came when Katie's mother refused to buy her cigarettes: "She'd paid for them before and I was addicted to nicotine, and she suddenly stopped," she says. Katie soon worked out how to pay for her own cigarettes - using a text dating service to pick up men who she slept with for money. "It was just easy to find blokes and sleep with them - my mum knew about it," she recalls. "But it was only when the social services found out that it all kicked off and I got taken into emergency care again."

The aim of crisis intervention centres is to help young people like this to return to something like a normal life, says Jeanette Young, managing partner of Little Islands, which operates a number of residential centres for young people usually aged between 11 and 17. "We're dedicated to helping young people get their lives back on track," she says. "Most centres use a holistic approach, offering a combination of activities, education, therapy and vocational training." Little Islands' facilities tend to be located within urban settings, since the agency believes this is the most effective way to prepare young people for a return to their communities. As they progress, young people are encouraged to attend local colleges and gain additional vocational or academic qualifications; some young people also hold down part-time jobs in local shops, stores and cafes.

Five Rivers' centre near Weymouth is next door to an outdoor education centre and young people staying there frequently make use of the activities on offer. But the emphasis remains on trying to emulate family life by placing young people in solo or dual placements with two key workers in regular family houses. Other centres, such as Bryn Melyn, focus strongly on therapy, providing intensive treatment and support for young people who can't be cared for anywhere else. Because of the challenging nature of some of the young people's conditions, the professionals sometimes have to take a liberal approach to discipline when working with the young people. In the past, this has led to problems with the local community, says Lorraine Giles, director of care at The Ryes School, which specialises in caring for young people who have serious special educational needs and mental or neurological disorders. "There are times when we allow behaviour or language that might not normally be considered acceptable, and observers were extremely critical or nervous of that," she says. "But it's not like there are no boundaries - we do make very clear to young people that there's a world of difference between damage to property and damage to other people." But perhaps the biggest challenge for crisis intervention professionals is being realistic about outcomes, adds Young. "We obviously try to link back to Every Child Matters but, more importantly, we ask if we've taught someone how to live in society," she says. For example, in some cases a young person won't get a GCSE qualification but the centre might have taught them to read and write well enough to open a bank account. Young adds: "That is a successful outcome to me."

Savour every victory
Brady echoes the sentiment that successful outcomes for young people in crisis intervention cannot usually be measured by academic attainment. "Often people come to us in a complete whirlwind so we aim to teach them how to make connections with people, how to communicate their feelings, and perhaps look at their future positively," she says. "We're focusing on teaching young people how to develop and maintain relationships so that, if they have problems in later life, they're able to cope better."

Some names and details have been changed

From the outside, Five Rivers' crisis intervention centre near Weymouth looks just like a regular bungalow. But this centre has provided a safe haven for some of the country's most difficult and traumatised teenagers. Current resident Katie is 15 years old and was taken into care two months ago after her social workers discovered that she had been prostituting herself to pay for cigarettes. When Katie arrived at the centre, she was allocated a team of four carers who have some experience of working with teenage girls with complex needs. During her six-month stay, the aim is to provide Katie with emotional support, but also to give her some sense of structure and boundaries that will help her to be placed in conventional foster care, explains Emma Brady, a childcare practitioner at Five Rivers. Giving young people structure in their lives forms an essential part of the centre's work, so Katie's week is carefully timetabled.

Chance of stability
Staff will wake her in the morning, and the first task is to ensure that Katie makes her bed and tidies her bedroom. After breakfast, one of the staff usually takes Katie to the local school she attends. In the evenings, Katie has a combination of therapy and supervised activities. Since the centre is situated next to an outdoor education centre, Katie has the opportunity to take part in a range of outdoor sports, from quad biking to abseiling and archery. This gives her a chance to experience a feeling of success that may be lacking elsewhere in her life, and helps to provide her with an outlet for some of her energy, explains Brady.

During half term, the rules are relaxed slightly and Katie is allowed to go out on visits with staff members. "Katie gets to choose where she wants to go," explains Brady. "So we've done things like bowling and a day out to Monkey World. They might seem like treats, but it's a way to get her used to being in the community again."

Some names and details have been changed

THE RYES SCHOOL provides therapeutic care for young people aged between seven and 24. The school specialises in working with young people with special educational needs and extreme or challenging behaviour, including autism and attention deficit hyperactivity disorder. www.theryesschool.org.uk

FIVE RIVERS Specialises in providing safe placements for young people who have been abused or are viewed to be in need of specialist care. www.five-rivers.org

LITTLE ISLANDS Specialises in supporting 11- to 17-year-olds with a history of challenging behaviour, substance misuse and mental health-related problems. Www.littleislands.co.uk

BRYN MELYN provides therapeutic care and treatment programmes for young people who are experiencing severe difficulties and disturbances in their lives. www.brynmelyngroup.com

Young People Now
14 June 2006



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