How we work
“Being able to feel safe with other people is probably the single most important aspect of mental health; safe connections are fundamental to meaningful and satisfying lives.”
― Bessel A. van der Kolk, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma
Vision acts as a resilient community for the young people we support and the wonderful team that we employ. We use strength-based approaches and practices that integrate therapeutic, relationally reflexive and reflective disciplines.
A strength-based approach means that therapeutic relationships are underpinned by a commitment to young peoples resilience and their relationships with others.
Our support is grounded in theoretical models of systemic practice, personality development, trauma and attachment-aware practices and restorative justice. This evidence-based framework provides placement stability, enabling psychological and emotional safety which support a young person’s successful transition into independent living and beyond.
Systemic
Systemic Family Therapy (also called Family and Systemic Psychotherapy) is one of the major evidence-based therapeutic approaches provided within the NHS. It refers to a range of psychological interventions for individuals, couples and families based on systemic concepts and theory. These are designed to help people make changes in their thinking, behaviour and understandings to relieve distress, improve the quality of their important relationships and make positive changes in their lives.
Systemic practice promotes the belief that families and individuals have the capacity to change. This approach sees problems as existing and being maintained in the relationships between people, rather than being located ‘inside’ any one person. Individuals are part of families who are part of communities, and neither the individual nor the family exists in isolation.
Systemic practice sees all behaviour as a communication to others and seeks to find meaning to behaviour. Patterns of behaviour can often be traced back through generations and these patterns are strongly influential. Change in one part of the system impacts other parts of the system so that problems cannot be seen as lineal and the result of a single cause. A systemic approach helps to make sense of how families work, providing a view of how change happens and gives us tools to assist in the process and context of change. Thinking about change in this way means that expectations of change are more realistic.
A key aspect of the systemic approach is the importance of building relationships and remaining curious. Systemic Practitioners are encouraged to form hypotheses and use circular questioning with the understanding that every situation is unique and there are many different meanings of behaviour. Systemic practice is both reflective and reflexive. A systemic approach also acknowledges the influence of the observer on the system and consequently the relationship between the family and professionals takes on significance and importance.
Psychoanalytical
We have embedded a psychoanalytically informed reflective practice and consultation forum across the organisation. Reflective practice groups are built on the premise that behaviour is determined by experience(s). We are committed to the principle that all behaviours we encounter and experience within the young people and ourselves have meaning and are likely the expression of an internal emotional situation that requires understanding in order for change to take place. The psychoanalytical framework employed underpins our therapeutic framework and supports the development of our capacity to emotionally process the psychological dynamics encountered during our practice. It enables us to: 1, attempt to understand more about a young persons emotional and psychological situation in order to support our support planning, and 2, to consolidate and psychologically digest complex emotional situations, whilst carrying out tasks required by individual young people and the professional networks we may be working with. Using a psychoanalytical perspective in our practice allows us to sustain our ‘capacity to think’, developing the relationship between interpersonal and emotional containment and the resulting transformation into thought and action.
Trauma Informed Practice
Trauma-informed practice is a whole organisational approach using evidence-based interventions and is grounded in the understanding that trauma exposure can impact an individual’s neurological, biological, psychological and social development.
Experiencing trauma, especially during childhood, significantly increases the risk of serious health problems including chronic lung, heart, and liver disease as well as depression, and increases the use of tobacco, alcohol, and illicit drug abuse throughout life. Childhood trauma is also linked to increases in relationship and social difficulties.
Implementing trauma informed approaches organisationally shifts the focus from “What’s wrong with you?” to “What has happened to you?” by:
- Recognising the widespread impact of trauma and understanding potential paths and framework interventions for recovery.
- Recognising the signs and symptoms of trauma in children and young people, families, staff, and organisations.
- Integrating knowledge about trauma into policies, procedures, and practices.
- Seeking to actively resist systematic re-traumatisation through staff training, supervision, and reflection (i.e., avoid creating an environment that inadvertently reminds children and young people of their traumatic experiences and causes them to experience further emotional, biological and toxic stress).
- Empowerment: Using individuals’ strengths to involve them in the development of their support planning and to tell their own story.
- Accommodation: Providing relationally and sensorially rich environments that are personalised with the young person to create a homely, welcoming space to be in.
- Choice: Involving the young person’s aspirations, hopes and goals into their placement planning.
- Collaboration: Working with young people together with their support system including Key stakeholders.
- Safeguarding: The physical, psychological and emotional safety of young people, staff and the organisation are prioritised.
- Cultural consideration: Move past cultural stereotypes and biases based on, for example, gender, sexual orientation, age, religion, disability, geography, race or ethnicity.
Restorative practise is an embedded function of our organisation which assists us in resolving conflict and prevents unnecessary criminalisation, something that is very important to us. All staff working with those with complex needs are Level 2 trained in Restorative Justice and Restorative conference facilitating relating to Official Restorative Practice Consultations, specific cases and organisational discussions around restorative practice.
Referrals are taken from partner organisations, the task of a referral is to begin to identify prospective need, interpret and formulate presenting difficulty and need, associated behaviours, pathology and presenting symptoms. This process informs matching specialist staff, who have the necessary skills to successfully support the young people and young adults, whilst mitigating and managing potential risks from the offset.
- Restorative Practice has a strong international and national evidence base.
- A number of authorities have embedded the approach with several, including Leeds and Rotherham citing it as a key element of their ‘Getting to Good’ journey.
- Authorities that have implemented the approach have achieved the high success rates with “Troubled Families” and have seen a reduction in children subject to both Child in Need and Child Protection plans.
- In Leeds CIN rates have reduced by up to 50%.
- In Leeds embedding Restorative Practice across schools in the city contributed to an overall reduction in exclusions
Restorative
Restorative Practice is a relationship and strength-based approach that embodies a set of core beliefs, principles and a way of being with people that proactively promotes building a sense of community and developing social capital. It is a high support, high challenge model that creates a common language and a common approach to engaging individuals and families.
Equine Assisted Therapy
The organisation that we partner with to deliver this wonderful collaboration between young people and horses is called Equine Pathways UK. They are a Leeds-based charity and are based in a peaceful and tranquil setting on Carr Hall Farm which encapsulates the theory of Biophilia in every way. There is a very special sensory garden which immediately calms the nervous system, providing sensory regulation and a feeling that all is well in the world.
The owner Carole, a skilled and experienced horsewoman and equine behaviourist, has facilitated some truly magical moments with horses and young people that will stay with them for the rest of their lives. https://equinepathways.co.uk/
Scientist, Edward O. Wilson wrote a book in 1990 called Biophilia, which explored the interconnectedness and interdependence of humans and nature, including our relationship with animals. Dr Wilson defined Biophilia as “the urge to affiliate with other forms of life” and hypothesized that humans are innately drawn to nature and other species as an evolutionary adaptation that supports the survival of all species and the natural world. The word biophilia translates as “love of life” and is a subject that is growing in terms of research, focussing on the benefits of human-animal relationships.
Horses have been used for therapeutic purposes going back to ancient Greek times. Hippocrates was a Greek physician known as the “Father of Medicine,” and first documented the use of equine therapy as a treatment for incurable diseases.
The horse-human relationship could contribute to healing and recovery in various ways. When a young person has experienced trauma, it can significantly disrupt how they attach to and bond with other humans. Horse–human relationships may facilitate a safer form of attachment as trauma survivors may trust a therapy animal more readily than a human. The nonjudgmental and unconditional positive regard that therapy animals can offer, provides direct social support to the young people who attend.
It is thought that the development of human-horse attachment can facilitate a transition to feeling more security in human relationships and ultimately facilitate human-human attachment. Trauma-related attachment impairment often includes social isolation and can make it difficult to engage in physical touch with humans. The opportunity for social connection and touch is strictly prohibited in traditional forms of psychotherapy.
Equine-assisted therapy in contrast not only facilitates connection and attachment with another living being but also provides opportunities for physical touch and affection between the young person and equine. It also enhances a sense of control, autonomy, and assertiveness for young people that can occur during this interaction. This intervention often encourages the young person to take on a leadership role, which is not easy due to the size of the animal but with support they can practice appropriate assertiveness in a safe environment, increasing self-esteem and self-worth.
Equine-assisted services studies report enhanced resilience in participants, as well as other outcomes associated with psychological flexibility, including a reduction in depressive and anxiety symptoms, as well as an enhanced quality of life.
Every young person is allocated a Key Worker, who stays with them throughout their journey with Vision, regardless of the setting they are in. The focus of this is to build trust with a key person and use secure attachment interventions to support a positive view of themselves, be secure in their independence and relationships with others beyond our involvement.
The provision of support provided includes psychosocial and pedagogical approaches to supporting a young person to identify potential trigger situations and agree how it can best be managed prior to any intervention.
Vision Management are on-call 24/7/365 days a year; staff and young people can make contact and receive immediate support should any issues arise. Our on-call system is modelled on a systemic model of the ‘reflecting team’. This reflective practice enables us to experience anxiety in manageable amounts so that it can be understood and learned from and risks managed safely. This model is supported by our therapeutic framework and enables staff to ‘carry on’, consolidate and psychologically digest complex emotional situations, allowing us to effectively continue to support young people; thus, preventing a large percentage of incidents from reaching crisis stage.
Vision has a commitment to learning from experience and having a deeper understanding of work, organisations, and the individuals and groups within them. This features an approach that gives attention to the ‘beneath the surface’ emotions and dynamics that impact on individual and organisational functioning and has influenced a self-reflective position that enables us to work better in complex situations. This learning draws on the Tavistock model of understanding organisations which brings together learning from systems theory, psychodynamics and group relations training.
Risk management and safeguarding
We advocate and champion positive and responsive risk-taking to support an individual’s development.
We use a formulation-based risk assessment and safeguarding management plan framework in all our practice. We provide young people with the support necessary for them to proactively take ownership and responsibility of their well-being.
Risk formulation and assessment is carried out with the young person and our partner organisations; using evidence-based practice and national guidelines to effectively minimise serious incidents and determine safe practices.
Risk assessments are person centred, participative, responsive and dynamic. Young people are involved in this process to identify risky behaviours and form a plan which mitigates risk as far as is feasibly possible, without unnecessary constraints or restrictions. This is done in consultation and agreement with all other partners, including the young person primarily, family/carers, and relevant professional networks. Professional networks may involve and include Social Care, Health services such as CAMHS, the police, the safeguarding team, UASC support services, criminal and sexual exploitation specialist organisations and other third sector organisations.