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SHERWOOD HOUSE

SHERWOOD HOUSE. A summary of initial outcomes achieved in the first 12 months of implementation of an innovative program to provide therapeutic support in an environment that offers the option for containment. Introduction.

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SHERWOOD HOUSE

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  1. SHERWOOD HOUSE A summary of initial outcomes achieved in the first 12 months of implementation of an innovative program to provide therapeutic support in an environment that offers the option for containment

  2. Introduction • Sherwood House is a new innovative therapeutic residential program established by the Department of Human Services, Community Services within South West Sydney in February 2009. • This presentation seeks to provide an overview of the context within which the model has been established, key elements of the model and its function, and broadly describe the outcomes achieved in its first 12 months of service.

  3. Service Gap Sherwood House has been specifically founded to meet the needs of a target client group for whom which there is currently limited or no service options. Client characteristics: • Young people in Out-of-Home Care • Unable to be successfully supported in community settings • Chronic behavioural challenges that pose significant risk to themselves and others • Complex trauma symptoms • Requirements for specialist case management • Placement approved by the Deputy Chief Executive • Placement by Supreme Court order • Managed under Supreme Court case management

  4. The needs of this group of young people require • Assess to a suitable (safe) accommodation setting • Setting with capacity for containment • Trained staff with a high level of supervision and access to direction • Staff contingencies that support physical management of high risk behaviours in a safe manner • Intense targeted therapeutic support that is multi-element and consistently delivered over time and across all settings • Complex and intensive case management services • Active engagement of specialist services (inter-departmental as required) • Support that is not time limited but structured around client needs and the outcomes achieved

  5. CURRENT SERVICES Restoration Impatient Health Facility

  6. Psychiatric Annals 35:5 May 2005. Full version www.tramacenter.org

  7. Psychiatric Annals 35:5 May 2005. Full version www.tramacenter.org

  8. The Attachment, Self-Regulation and Competency (ARC) model provides a component-based framework that broadly guides the work within Sherwood House. Psychiatric Annals 35:5 May 2005. K.J Kinnibutgh LICSW, M. Blaustein PhD, J. Spinazzola PhD.

  9. Sherwood House Our commitment is to provide a safe, nurturing and therapeutic residential service that enables children and young people to develop to their full potential.

  10. Sherwood Entry and Exit The identification of individual case planning and therapeutic goals is undertaken for each young person entering the program. It is through the revision of these goals that determination of a suitable exit plan and timeline can be shaped. Generally these include: • Specific health management issues including medication review and appropriate engagement of required specialist and services • Healthy lifestyle habits and routines • Functional and meaningful family contact that is safe and sustainable for the young person • Reduction of anti-social and damaging high risk behaviours • Increase in emotional resilience and capacity to modulate behaviours • Increase in engagement with education and personal development opportunities • Increase in capacity for positive peer engagement (recreational / social) • Permanency planning for future living situation that meets needs • The young person’s beliefs in relation to their readiness to move on

  11. Staff Model

  12. Staff Training Sherwood House provides a structured in house staff training program that includes : • Policy and procedural review • Induction and buddy shifts • Shift leaders meetings • Team meetings • Formal topic training • Access to manual resources • Team debriefing

  13. Therapeutic Support Program Summary of Sherwood Program Structure

  14. Therapeutic Support Program Common behavioural support challenges for target young people include;   • High levels of anxiety and withdrawal • Difficulties with emotional regulation • Aggressive and defiant behaviour • Complex family issues • Learning difficulties • Trauma related symptoms • Difficulties with peer relationships • Inability to monitor pitch, inflection and tone of voice • Misreading facial expressions • Misjudging personal space • Mistaking other non-verbal cues

  15. Sherwood House: In-house Program • SOCIAL SKILL THERAPEUTIC INTERVENTION PROGRAM (2X WEEKLY) • MUSIC THERAPY (WEEKLY) • MOVEMENT AND DRAMA THERAPY (WEEKLY)

  16. The Sherwood Education Program • Classroom to support the young people re-establish their routine participation in formal education programs in the grounds of Sherwood House • A dedicated part-time teacher who provides face to face teaching two days each week • Distance education with the support of staff complete their curriculum requirements. • One of the young people has been able to return to a full time placement in a local school

  17. Program Reporting The reporting requirements of the program are significant and matched to regular scheduled Supreme Court review. Data is tracked and analysed on a monthly basis. Critical elements of data include: • Case management milestones • Health management goals • Medication management and impacts • Incident profiles • Behavioural scales • Mental health scales • Client wellbeing self reports • Program participation and community access • Reference Person Program • Therapeutic goals and progress

  18. Client evidence Based Outcomes (Sample Data Summary)

  19. The Step-Down Models • The transition from the Sherwood House model has required the development of a linked program to allow gradual progress and the continuity of program elements • The program has achieved the transition of one young person and is currently preparing for the exit of a second

  20. Challenges • Building management and design to ensure a robust safe setting • Staff matching and retention • Family engagement • Establishment of the step-down model

  21. Future Planning • Ongoing refinement of the therapeutic program • Enhanced projects for community participation for the young people • Creative options to support family engagement • Ongoing investment in service partnerships and collaborative work

  22. Questions

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