Creating Change for Complex Children and their Families : A Multi-Disciplinary Approach to Multi-Family Work

by Holmes, Jo; Oldfield, Amelia; Polichroniadis, Marion; Goodyer, Ian

• ISBN13: 9781843109655
• ISBN10: 1843109654
• Format: Paperback
• Copyright: 2011-07-15
• Publisher: Jessica Kingsley Pub

Summary

The Croft Child and Family Unit is a residential psychiatric unit in Cambridgeshire, UK, that provides intensive assessment and treatment for children with mental health problems and their families. Based on the clinical experiences of this multidisciplinary health, education and social care team, this book describes a model of care that they have found effective, and offers information and guidance to all professionals working with children with complex needs. Using detailed case studies as examples, this book focuses on the needs of children with a range of developmental, emotional and behavioural difficulties, and explores the complicated interactions between these children, their families and their communities. Offering a variety of perspectives from a range of professionals including psychiatrists, teachers, psychologists, nurses and therapists, this book shows that a multi-disciplinary approach is the key to change, and demonstrates how professionals from different disciplines can work together successfully to make a real difference to the lives of children with severe mental health disorders and their families.

Author Biography

Jo Holmes has been the Medical Director of the Croft Child and Family Unit for over ten years. She undertakes specialist assessments of children relating to autism spectrum disorders, attachment disorders and other conditions. She also trains child psychiatrists and other mental health professionals. Amelia Oldfield is a music therapist at the Croft Child and Family Unit and has worked in child and family psychiatry for over 20 years. She is a lecturer in Music Therapy at Anglia Ruskin University. Marion Polichroniadis was a consultant clinical psychologist at the Croft Child and Family Unit. She has over 30 years' experience of working as a child psychologist in a range of settings including education, child development centres and child and adolescent mental health services.

Table of Contents

Foreword	p. 9
Acknowledgements	p. 11
Prologue	p. l3
Background to this book	p. 13
List of contributors	p. 14
The families in the book	p. 15
Artwork in the book	p. 19
Setting the Scene	p. 21
Children with severe and complex mental health needs	p. 23
Intensive family work	p. 25
Multi-family group work	p. 25
Residential family treatment	p. 26
The team	p. 27
The children and their families	p. 27
Summary	p. 28
Therapeutic Engagement	p. 29
Introduction	p. 29
Be prepared	p. 30
Information giving	p. 30
Saying hello and having a cup of tea	p. 31
Supporting the 'meeters and greeters'	p. 33
The first meeting	p. 33
Engaging with the child	p. 34
Talking with parents	p. 34
Beliefs and expectations	p. 35
The therapeutic contract	p. 36
Assessing parenting	p. 36
What about families who say 'no'?	p. 38
Summary	p. 39
Structure and Containment	p. 40
The therapeutic frame	p. 40
The structure	p. 43
Children's timetable	p. 44
The rules, rewards and sanctions	p. 45
Containing aggression	p. 46
The challenge of separation	p. 47
Structure for parents	p. 48
The integrated model of care	p. 49
Multi-modal treatment model	p. 52
The physical environment	p. 54
The evening plan	p. 55
Community living	p. 56
Containing the containers: staff structures	p. 58
Summary	p. 61
A Nurturing Environment	p. 63
Introduction	p. 63
Attachment theory	p. 64
Patterns of attachment	p. 65
A nurturing environment	p. 67
Role of non-clincal staff	p. 68
Enhancing parental nurturing skills	p. 70
Nurturing staff	p. 75
Clinical supervision	p. 75
Summary	p. 83
Multi-Family Work	p. 84
Introduction	p. 84
Multi-family group therapy (MFGT)	p. 85
Community living	p. 85
Managing complex group dynamics	p. 86
Group processes	p. 87
Informal multi-family settings	p. 89
Facilitated therapy groups	p. 93
Summary	p. 103
Accessing Learning	p. 104
Introduction	p. 104
Providing continuity	p. 106
The National Curriculum and achievement levels	p. 107
Links with the children's existing schools	p. 107
The physical environment	p. 108
A varied curriculum	p. 109
Story time	p. 109
Rewarding achievements and building up self-esteem	p. 110
Challenging behaviours	p. 111
Friendships and group dynamics	p. 112
A morning in school	p. 113
Summary	p. 117
Fostering the Child's Social World	p. 118
Introduction	p. 118
Social skills group	p. 121
Art group	p. 124
Music therapy group	p. 125
Yoga group	p. 130
Playtime: outside and inside	p. 132
LEGO club	p. 134
Summary	p. 136
Understanding the Individual	p. 137
Introduction	p. 137
Co-ordinating the assessment	p. 139
Key worker system	p. 140
Feedback to parents	p. 144
Formal assessments	p. 144
Individual therapy at the Croft	p. 156
Summary	p. 166
Understanding the Family	p. 167
Introduction	p. 167
Principles of family therapy that inform the practice at the Croft	p. 168
How family therapy is conducted	p. 172
What happens in family therapy at the Croft?	p. 173
Challenges of family therapy in an intensive residential setting	p. 181
Summary	p. 186
Creating a New Story	p. 187
Mixed feelings	p. 187
The discharge meeting	p. 190
The voice of the child	p. 190
Advocacy with children with complex difficulties	p. 191
Creating a new story	p. 192
The role of a diagnosis or label	p. 195
Inherent developmental problems and care-giving styles	p. 197
How can we continue to promote change?	p. 198
Family therapy	p. 199
Summary	p. 203
Reflection and Evolution	p. 205
Introduction	p. 205
Research and audits	p. 206
National audits and benchmarking	p. 207
Children and parents' feedback	p. 208
Summary	p. 215
Croft Rules	p. 217
Weekly Task	p. 218
Care Plan for Managing Difficult Behavior	p. 219
ChildrenÆs Pictorial Timetable	p. 220
Parent Timetable	p. 221
Assessment of Activities of Daily Living	p. 223
Croft Key Worker Book	p. 225
Global Assessment Care Plan	p. 238
Scoring of Music Therapy Diagnostic Assessment	p. 239
	p. 243
	p. 249
	p. 255
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