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Give every child in out-of-home care high-quality therapeutic placements

VCOSS recently published its 2016-17 State Budget Submission:Putting people back in the picture. A series of blogs will examine some of the proposals in the submission.

Children and young people in out-of-home care are one of the community’s most vulnerable social groups and are more likely to experience poor physical health and socio-emotional wellbeing and poor cognitive learning ability compared with their peers.[1] Young people in care have often experienced considerable trauma and require safe and supportive environments that meet their individual, and often complex, needs and help improve their health and wellbeing.

Therapeutic care models seek to address the underlying trauma experienced by young people in care, and facilitate healing and recovery from the effects of abuse, neglect and separation from family. Evaluation of therapeutic residential care models show they help improve children’s physical and mental health, education and family connections.[2]  Similarly, an evaluation of the Circle Program, a therapeutic approach to foster care, has shown it helps children form relationships, regulate their emotions and participate in community activities, results in more stable care placements, and increases the likelihood of successful family reunification.[3]

The vast majority of children and young people in out-of-home care are in kinship and foster care placements. Therefore expanding therapeutic foster and kinship care will help strengthen the out-of-home care system’s capacity to create sustainable placements for all children, including those with more complex needs; help children recover from traumatic events, including abuse and neglect; and help keep children and young people out of the residential care system.

Priority should also be given to providing all children and young people in residential care with therapeutic care. In addition to the direct benefits to children, therapeutic residential care models produce savings to government by reducing the demand for crisis services, health, welfare, juvenile justice and other community services. The best outcomes are achieved when key elements of the program are met including integrating therapeutic specialists within each team, training staff in trauma informed therapeutic care, consistent staff rostering, and additional staff to provide more individualised support for children.[4]

In recent years the government has provided funding to increase the number of therapeutic residential care place and introduced targeted care packages to transition children under 12 and Aboriginal children and young people from residential care into alternative living arrangements, with flexible supports to meet their needs. While these initiatives are very welcome, continued investment is needed to ensure all children and young people in out-of-home care can access specialised, therapeutic care. As of June 2015, only 38 of the 163 residential care units use therapeutic models.

The VCOSS State Budget Submission Putting people back in the picture calls on the government to provide all children and young people in out-of-home care with high quality therapeutic placements. This includes upgrading all residential care placements to therapeutic models in line with evidence of best practice, and ensuring that all children transitioned out of residential care are provided with targeted care packages. This should be combined with a staged transition to upgrade all foster and kinship care placements to therapeutic models. This includes training carers in trauma-informed care, as well providing access to therapeutic specialists who can help carers work through issues, discuss strategies and provide advice where required.

In addition to giving every child in out-of-home care high-quality therapeutic placements, the VCOSS 2016 -17 State Budget Submission outlines a number of priorities to support the health and wellbeing of vulnerable children and families including:

  • Improving children’s health and development with better access to Maternal and Child Health Services
  • Helping vulnerable families through intensive early years support
  • Helping vulnerable families and children benefit from playgroups
  • Better supporting all Aboriginal children to thrive
  • Helping foster and kinship carers give children a supportive home environment
  • Supporting young people leaving care to achieve independence.

[1] M Paxman, L Tully, S Burke and J Watson, Pathways of Care: Longitudinal study on children and young people in out-of-home care in New South Wales, AIFS, 2014.

[2] Verso Consultating Pty Ltd, Evaluation of the Therapeutic Residential Care Pilot Programs Final Summary & Technical Report, Department of Human Services, 2011, pp. 6-8.

[3] M Frederico, M Long, P McNamara, L McPherson, R Rose and K Gilbert, The Circle Program: an Evaluation of a therapeutic approach to Foster Care, Centre for Excellence in Child and Family Welfare, Melbourne, 2012.

[4] Verso Consultating Pty Ltd, Evaluation of the Therapeutic Residential Care Pilot Programs Final Summary & Technical Report, Department of Human Services, 2011, pp. 6-8.