David Steggall Team Leader Intensive Intervention Service Program Toowoomba, Qld. 20/8/2014

1. MERCY COMMUNITY SERVICES THERAPEUTIC DAY PROGRAM USING CRITICAL REFLECTION AND EVIDENCE – BASED PRACTICE FOR MODEL REDESIGN David Steggall Team Leader Intensive Intervention Service Program Toowoomba, Qld. 20/8/2014

2. Overview Mercy Community Services – Family Services Counselling Programs Critical Reflection Evidence – Based Therapeutic Day Program

3. no help for that there is a place in the heart that will never be filled a space and even during the best moments and the greatest times wewill know it we will know it more than ever there is a place in the heart that will never be filled and we will wait and wait in that space. Charles Bukowski

4. Mercy Community Services Mercy Community Services SEQ Limited is a new Catholic Ministry owned by the Brisbane Congregation of the Sisters of Mercy and established to support and empower people who are poor, vulnerable, marginalised or in a position of disadvantage. http://www.mercycs.org.au/

5. Mercy Community Services • At any point in time 700 Mercy Community Services staff work alongside more than 4000 people providing innovative and responsive services in the areas of: • •child protection • •multicultural community support • •family mental health • •community and residential based aged care • •disability support • •employment and training

6. Mercy Community Services • In Toowoomba our Family Services deliver inclusive, responsive and innovative services for children, young people and families in south-east Queensland. The programs in Toowoomba include: • Foster and Kinship Care • Connected Families • Intensive Intervention Placement Service • Family Intervention • Family Contact Facilitation • Supported Independent Living • Unaccompanied Minors • Settlement Grants Program • Community Action for a Multicultural Society • Family Matters Multicultural Program • General Counseling • Sexual Abuse Counseling

7. Mercy Community Services • General Counseling • Sexual Abuse Counseling • IIPS Counseling Individual therapy with children and young people aged between 5 – 18 years who are under a child protection order. These comprised weekly/fortnightly counseling sessions, engagement with carers/parents, schools and Child Safety.

8. Mercy Community Services – Counselling Program in 2012 • Team of six, including four full-time counsellors and two part-time. • Differences in individual’s counselling approaches. • Influence of external factors, e.g. carers and parent’s willingness to make changes. • Structurally there was difficultly organisingcounselling around school times and having parents/carers consistently bring children to their appointments. • Sense of frustration and workers articulating a sense of lack of worth for the work they were trying to do. Risk-staff turnover. • Extended periods of engagement • Further to this and more importantly we didn’t have concrete evidence that the work we were doing was creating meaningful change for vulnerable children.

9. Thinking is the ultimate human resource – Edward De Bono Evidence – Based Research Critical Reflection

10. “Judge a man by his questions rather than by his answers.” ― Voltaire Group supervision Individual supervision Critical Reflection Evidence – Based Research

11. Critically Reflective Practice Critical Reflection is about unsettling individual assumptions to bring about social changes (Fook & Gardner, 2007, p. 16). Fook & Gardner (2007) PractisingCritical Reflection: A Resource Handbook

12. Critically Reflective Practice • Critical Reflection emphasises: • Reflection as a deeper form of thinking. • The process is both a theory and practice. • Understands individuals act in a social context. • Links changed awareness to changed action. Fook & Gardner (2007) PractisingCritical Reflection: A Resource Handbook

13. Critically Reflective Practice The critical reflection framework draws on four traditions: reflective practice, reflexivity, postmodernism/deconstruction and critical social theory: Describe the Incident Reflective Questions Reflexive Questions Postmodern/DeconstructiveQuestions Critical questions Fook & Gardner (2007) PractisingCritical Reflection: A Resource Handbook

14. Critically Reflective Practice – Describing the Incident

15. Critically Reflective Practice Reflective Questions • The reflective approach supplies the framework for understanding the process of critical reflection – searching for the assumptions implicit in practice. • Provides a framework for practice evaluation through examining the contradictions and discrepancies. • Emphasiseshow hidden assumptions effect practice. Thus helps to close the gap between what is implicitly and what is explicitly practiced.

16. Critically Reflective Practice Reflective Questions • Assumption 1: The primary assumption of therapy or counselling is that a person, or more in this case more importantly that a child can change. • Assumption 2:The second related assumption is that a child brain can change with a therapeutic intervention – a counselling skill. .

17. Critically Reflective Practice Reflective Questions • Assumption 1: The primary assumption of therapy or counselling is that a person, or more in this case more importantly that a child can change. • Assumption 2:The second related assumption is that a child’s brain can change with a therapeutic intervention – a counselling skill. . IMPLICIT

18. Critically Reflective Practice Reflective Questions • Assumption 1: The primary assumption of therapy or counselling is that a person, or more in this case more importantly that a child can change. • Assumption 2:The second related assumption is that a child’s brain can change with a therapeutic intervention – a counselling skill. . IMPLICIT EXPLICIT

19. Critically Reflective Practice Reflective Questions • Assumption 1: The primary assumption of therapy or counselling is that a person, or more in this case more importantly that a child can change. • Assumption 2:The second related assumption is that a child’s brain can change with a therapeutic intervention – a counselling skill. . • STRUGGLING TO SEE MEANINGFUL CHANGE • THERAPEUTIC INTEVENTION IN NOT SUFFICENT ON ITS OWN IMPLICIT EXPLICIT

20. Critically Reflective Practice Reflective Questions

21. Critically Reflective Practice • Reflexive Questions • Reflexivity relates to the ability to recognise that all aspects of ourselves and our contexts influence the way we create knowledge, particularly how we create practice knowledge. • Use of self. • It shows us that knowledge is influenced by our physicality and material contexts; social and historical contexts and the tools we use to create knowledge.

22. Critically Reflective Practice • Reflexive Questions

23. Critically Reflective Practice • Reflexive Questions Cooking “The shared meal elevates eating from a mechanical process of fueling the body to a ritual of family and community, from the mere animal biology to an act of culture.” ― Michael Pollan, In Defense of Food: An Eater's Manifesto

24. Critically Reflective Practice • Postmodern/Deconstructive Questions • Postmodernism and deconstruction relate to the understanding that the knowledge we create is connected to power and has powerful functions. • Postmodernism involves questioning that there is only “one truth”; what is believed to be “one truth” (dominant discourse) often masks power and how power is used. • Power is able to function through how we communicate, either in sessions, meeting or emails. Hence it suggests that language plays a role in maintaining dominant discourses through disguising other perspectives (truths), disguising less powerful perspectives and binary ways of categorizing perspectives (either – or decisions).

25. Critically Reflective Practice • Postmodern/Deconstructive Questions Through assuming that any particular knowledge is linear we can unwittingly support a dominant power base and unwittingly preserve power relations through the language we use to speak about our world.

26. Critically Reflective Practice • Postmodern/Deconstructive Questions Children in care have had a very intense experience of power. Their experience has been a language of exclusion.

27. Critically Reflective Practice • Postmodern/Deconstructive Questions Through our own language about change and therapy we support and preserve this language of exclusion. It’s a position of there is a problem that need to be fixed through an exertion of power.

28. Critically Reflective Practice • Postmodern/Deconstructive Questions From therapy being about change to therapy being about development Cognitive, Social, Emotional, Physical, Moral, Spiritual, Cultural Development

29. Critically Reflective Practice • Postmodern/Deconstructive Questions

30. Critically Reflective Practice • Postmodern/Deconstructive Questions

31. Critically Reflective Practice • Critical questions • Critical social theory relates to the connection between personal experience and the broader social context. In particular how these intertwine in the professional context to inform both knowing and doing. • Critical social theory therefore points us to look at our assumptions might function against our interests and therefore how we might need to change them in order to be less restricted.

32. Critically Reflective Practice • Critical questions • Assumption 1: The primary assumption of therapy or counselling is that a person, or more in this case more importantly that a child can change. • Assumption 2:The second related assumption is that a child’s brain can change with a therapeutic intervention – a counselling skill.

33. Critically Reflective Practice • Critical questions • The most powerful therapy is human love, expressed in safe, protective and positive human relationships. • The majority ofdevelopmentalchange occurs outside of formal therapy. therapy.

34. Critically Reflective Practice • Postmodern/Deconstructive Questions “The beginning of love is to let those we love be perfectly themselves and not to twist them to fit our own image.” ― Thomas Merton.

35. Evidence – Based Practice He who loves practice without theory is like the sailor who boards a ship without a rudder and compass and never knows where he may cast. Leonardo daVinci

36. Evidence – Based Practice

37. Evidence – Based Practice – brain development

38. Evidence – Based Practice – brain development

39. Evidence – Based Practice – brain development

40. Evidence – Based Practice – brain development

41. Evidence – Based Practice – brain development

42. Evidence – Based Practice – brain development – activities for development

43. Evidence – Based Practice – Attachment Daniel Hughes

44. Evidence – Based Practice – Attachment The great myth of any family-based, therapeutic work is these breaks are the points of intervention

45. Evidence – Based Practice – Attachment The promise of attachment theory is that children’s capacity to respond to boundaries, to regulate strong emotions and not least move through grief/loss is intimately connected to a secure primary relationship.

46. Evidence – Based Practice – Attachment Attachment and connection are developed through attunementpatterns. Attunement is characterised by the ability of invested adults tuning into, understanding and responding to a child’s emotional, social and physical needs.

47. Therapeutic Day Program • The program seeks to enter into the interplay between the child’s wounds and their resilience, look at them, be with them and know them. • This is so that in understanding, the program may provide a meaning, a meaning provide a language and a language may provide a voice to act as an emotional cue. A voice used to create patterns and habits for healing in a child’s home and school environment.

48. Therapeutic Day Program • The overall purpose of the Therapeutic Program is for children/young people to establish healing patterns for recovery, resilience and growth through positive relationships, therapeutic engagements and developmentally rich activities.

49. Therapeutic Day Program