Therapeutic Fostering - Multi-disciplinary Assessment Treatment & Therapy Service (MATTS)

We know that each child comes into foster care with complex and different needs and we strive to help these vulnerable, traumatised children and young people to grow and develop their individual potential.

A great deal of time and effort is put into finding ways to achieve this.

If you consider the circumstances of the child or young person’s life that led him or her to being placed in care, it is easy to understand any emotional turmoil or difficulties in how the young person understands the world and therefore communicates with it..

Our  local Child and Adolescent Mental Health Services (CAMHS) provide specialist therapeutic assessments and interventions. This is service of great value to young people in care. Unfortunately  due to not enough economic support this has caused  a decline in the availability of resources. The fostering community, specifically the local authorities and independent fostering providers, acknowledge the damage this lack of resources can do to the future of children in care.

The NHS website states that “Parents and carers may also need help and advice to deal with behavioural or other problems their child is experiencing. Parents, carers and young people can receive direct support through CAMHS.”

Capstone Foster Care’s initiative

Capstone Foster Care is proud of its safe, high-quality fostering arrangements. Being aware of the need to open bright futures for the children in our care, we took action. As usual, we chose to be proactive, not reactive.

 What we recognised as a need: an adaptive, timely, responsive clinical service that can respond to the needs of children in our care at any point in their development with our fostering families and beyond. Our solution, our proactive response to this need, is the Multi-disciplinary Assessment Treatment & Therapy Service (MATTS).

Our carers all participate in our Skills to Foster course and now the four days pre-panel therapeutic training is being provided as well. The therapeutic training gives carers and social workers a therapeutic toolkit that is a double benefit to them. They learn the basic principles they need to support and enhance the development of any child or young person in their care. They also learn methods to enhance how they care for themselves.

What MATTS offers

With MATTS, we can provide an extra layer of support that sustains and develops progress for looked after children across all aspects of their development. With an in-house comprehensive therapeutic needs assessment, the team charged with caring for the child and his or her future development receives guidance on the child’s needs. Having a deeper understanding of what additional therapy and or relational principles  will best help the young person thrive in life, our team is better equipped to therapeutically get alongside them and their fostering family. .

The support is dynamic and multi-faceted, and is led by a clinical psychologist or consultant Therapist. The type of Clinical Lead depends on the geographical region.

The service includes therapeutic social workers, child psychotherapists, play therapists, dyadic developmental psychotherapists, speech and language therapists, Occupational Therapists, Psychologists (educational and clinical), therapeutic mentors, mental health nurses to name a few. All of which bring their particular expertise and depending on assessed presenting needs are completely available to our children and young people, carers and social work teams..

Our clinical team are all professionally accredited, highly qualified and skilled with extensive experience working in CAMHS, the NHS, education, and the private sector. In addition, they all have extensive training in Attachment and Trauma and they all have their own regular peer group supervision alongside their professional clinical supervision.

The clinical lead is actively involved in the referral process and works with the registered manager to discuss the suitability of each child or young person’s package of support  as they are accepted into the Therapeutic Fostering Service. There are numerous reasons for recommending therapeutic services for children in care.

These are the most common – complex behaviours due to trauma experience, inability to regulate emotion, barriers to educational engagement, enuresis/encopresis (bedwetting/soiling), tics, inability to socialise, fears, phobias and anxieties, low self-esteem and self-worth, generalised or specific learning difficulties, speech and language difficulties, suicidal ideation and or suicidal intent, self-harming behaviours, vulnerabilities to others eg. child sexual exploitation (CSE) etc , drug and alcohol misuse, eating difficulties, and sexually harmful behaviours. As a service we are keen to notice children and young people who are vulnerable to potential risks mentioned above. So we can support them to form healthier mechanisms to cope/ understand themselves prior to higher risk strategies being formed, and relied on to get their hidden needs met.

The children and young people we support within care have experienced unimaginable adversities including the loss of not being able to remain with their birth families.  With elements of core understanding of the world being built from experiences of fear and sadness, and an understandable hesitation around trusting others it’s important that these children/ young people are able to access additional support- to enable them to develop an understanding of themselves, and find comfort, curiosity and joy in the others and the world around them.  

This is what MATTS is hoping to provide. The service offers a wide range of therapies.

The therapies offered

Because each child and each family situation is different we carefully assess and plan our response to each situation. Take a peek at some of the types of therapy we offer: dyadic developmental psychotherapy (DDP), theraplay, therapeutic life story work,, trauma-focussed CBT, specialist clinical support for the foster carers,, timely comprehensive therapeutic needs assessments, , assessment and intervention of sexually harmful behaviours, , clinical assessments, psychotherapy, forensic assessment, and creative therapies, specialist assessments e.g. Speech and Language, Occupational Therapy and clinical psychology assessments.

The skilled and accredited team has specialised training in trauma and attachment theory and are able to support young people and children with the symptoms that they are experiencing as a result of their trauma symptoms can include, increased stress and anxiety, difficulties accessing relationships due to fear, difficulties in regulating emotions or accessing support from others, hypervigilance to the world/ people around them, Mis-trust, strong protective strategies learned to survive, challenges due to missed development opportunities, difficulty feeling safe with others, difficulties in being able to adhere to boundaries, fabrication as a protective measure, overwhelm, low self- esteem and confidence, a struggle to see themselves and all their beauty.  These challenges unfortunately can if not supported carefully can lead to complex mental health difficulties and leaves them at higher risk for physical illness in adulthood, the Adverse Childhood Experiences study speaks to this impact- its so important we give children and young people a good chance at recovery.   

 Our service prides itself on being able to support children and young people on an individual basis and has a huge breadth of experience with children, young people and adults who have neurodevelopmental diagnoses alongside their adverse experiences.  We also include vital clinical support to their fostering families so that we can support children and young people to be able to connect in key relationships who can support them to begin to experience and understand safe relationships and begin to experience stability. 

What is the MATTS process?

If a child or young person taken into care seems to have problems and there are concerns, a comprehensive assessment is offered.

The assessment is planned according to the needs of the young person or child, if they would like a safe adult to accompany them in these sessions we accommodate this.  The assessment sessions will take place in an environment that the young person or child will feel most able to engage. We are a child led service.

During the assessment phase we will progress at a pace that is acceptable for the young person or child- so to make sure that we communicate a sense of safety and begin to support trust in the assessing Therapist- which we appreciate can be really difficult for some of our children and young people.

Within our assessments we are aiming to gather information that helps us form a clear understanding of the impact early life experience has had on the child or young persons development and interactions with the world around them and then we can formulate a plan to best support.  Within the assessment the clinician will observe the young person, spend time with key people who know the young person/ child, spend time individually with the young person and will use outcome measures to support deeper understanding of the psychological impact of trauma which are used alongside the narrative gained from the broader assessment sessions.  These measure are identified depending on the presenting needs of each young person and child. The recommendations from this inform the plan around the support package in place for the fostering family and child- the options can be:

• No further intervention – The report might state that it isn’t the right timefor further therapeutic intervention. Although the clinical team’s involvement ends at this point, it is available to provide advice and consultation if and when needed.
• Further specialist assessment – If further specialist assessments are recommended, another meeting is scheduled with the child or young person, the assessing clinician, and the network. This meeting will take place within one month of the completion of the assessment.
• Therapeutic intervention recommended – If therapeutic intervention is recommended, a treatment plan is completed. If ongoing therapy is part of the plan, the therapist arranges a Clinical Review Meeting (CRM) at the conclusion of treatment. If the therapy is long-term, there will be regular CRM’s throughout the support period.

At these review meetings, as a support network around the child we review the clinical support alongside a reflective space on the young person/ child’s current presenting needs/ progress.. This allows those involved to present their insights and agree on the way forward. After the meeting, minutes will be shared of the meeting and the Treatment and Therapy plan updated and shared with the network. .  A date will be set for the next Clinical review meeting within the meeting.

Therapeutic interventions take place in the most appropriate place for the young person’s needs. Usually, these happen at schools, colleges, the foster carer’s home, or at a community children’s centre.

What does MATTS do for carers?

When a child is placed with carers, the carers’ receive support from a member of MATTS. This begins in the first week of the placement..  This support provides a space for carers to reflect on their relationships with the children/ young people and ponder their approaches to presenting situations.  Within this space our clinicians support with understanding potential reason’s for children and young peoples presenting communication (bespoke to the particular young person), enable the foster carers to understand their own responses to certain triggers in their relationships with their child or young person, and together with the clinician discuss possible adaptions to their approaches to support the ongoing development on a unique basis to the child/ young person they care for.

A member of the clinical team is available for weekly telephone support to carers this is also reviewed within the Clinical Review meetings. The frequency of support can be adjusted flexibility to respond and adapt according to need..  If our foster carers prefer an in person space to reflect with the supporting clinician this can be arranged. 

How is success measured?

All children and young people placed at Capstone Foster Care have an assessment using an Outcome Tracker every calendar month. The assessment uses a standard of 44 nationally agreed outcomes for all children and young people in care. Their achievements and progress against each outcome are recorded and shared with the placing social worker.

If the child or young person is receiving a MATTS intervention, his or her progress is measured in relation to goal-based outcomes, aspirations of the child or young person, and standardised measures.  For all children accessing the MATTS service we regularly use the ‘Thinking about your child (TAYC)’ measure to think about current needs and progress.

Progress is recorded with reports and are regularly discussed and recorded within the Clinical Review meeting minutes.  Any adaptions to the Treatment and Therapy plan are discussed and updated on the written plan following each Clinical Review meeting.

Our MATTS service is child led and dynamic- as children and young people’s successes, challenges and developmental leaps are all unique, as are the fostering families that care for them, therefore it is essential that we are adaptable and flexible in our responses to them.

From the moment a MATTS arrangement is agreed we remain present and alongside the child/ young person and their fostering family to ensure that we are working together to meet the therapeutic needs of the child/ young person. We have a consistent experienced team of clinicians who keep all the children/ young people in mind to ensure that we are responding appropriately and helpfully to their needs at all times.