Turning Research into Practice to Improve Outcomes for Children and Young People in Care

At Five Rivers, we believe meaningful change is achieved when research and practice work hand in hand. That is why we hold our annual Research into Practice conference to share the latest in therapeutic outcomes for children. This year, we were delighted to bring together so many people who share our commitment to improving outcomes for children and young people.

This year’s theme was Holding complexity: Strengthening care systems through trauma informed connected practice. Throughout the day we explored how trauma-informed, connected practice can help us respond to the increasingly complexity facing children, families and professionals.

The online conference is an opportunity to create a space for reflection and share how research can translate into the everyday experience of children, young people and professionals.

The true strength of the day came from our collective commitment to engaging with and thinking about complexity as a professional community. As pressures across health, social care, and education intensify, creating space for honest, grounded reflection is both necessary and restorative. – Richard Cross Chair, Five Rivers Child Care

Dr Rachel Gibbons opened the conference, exploring suicide and its impact on families and clinicians and the importance of having challenging conversations. She explored the complexity of causation and prevention and what happens afterwards. In the aftermath of suicide, you may feel grief, trauma, and responsibility; it can be overwhelming.

Dr Gibbons highlighted the importance of creating opportunities for professionals and families to understand and process these feelings during compassionate practice, where they can continue to examine what it means to work effectively when circumstances are so complex.

I think if we can move away from the persecution around suicide and this sense of collapsing into blaming, then actually there is something about it that strikes at the heart and asks us questions about what it means to live and be human. – Dr Rachel Gibbons, Vice Chair of the Psychotherapy Faculty at the Royal College of Psychiatrists

Colby Pearce’s session explored inconsistences in the care sector and how they act as a barrier for children. He encouraged us to think carefully about what consistency really means. Colby argues that although trauma is understood in the sector, oftentimes the unpredictability of living in care is overlooked while children continue to present trauma-related behaviour, which undermines their healing.

Colby linked these inconsistences and disruptions to behaviours often linked to fight, flight and freeze responses.

This sensitivity impacts brain development at a time of massive growth, such that prolonged and repeated exposure to emotional distress, both within the infant and in the adult or adults responsible for their primary care, leaving the infant inordinately hyper-aroused and prone to heightened emotion.

As such, in the child protection field, these infants were often referred to as anxious, and children and young people were observed to be prone to anxiety and behaviours associated with the fight, flight, freeze response. – Colby Pearce, Clinical Psychologist

Later, David Cocoran, founder of Beyond Thrive, discussed his experience working in children’s homes and in-patient care, focusing on strengthening care systems and supporting professionals who work with complex crisis and instability.

My theme is around leadership, the importance of leadership, where management
and direct care, how they all coalesce to bring that word, that important word, which is a theme today, which is consistency.

And consistency is key to quality of life. Without consistency, we have a lack of predictability, and if there’s a lack of predictability, it can increase the opportunity or the risk of distress.

With unpredictability children are more likely to develop kind of disorganised attachment styles. Values are at the heart of leadership and they come inwards. Values are central because they’re not just a set of aspirations. They’re not just wishes and hopes. – David Cocoran, Founder of Beyond Thrive

David highlighted the expectations in children’s services to support children with complex needs and why even well-designed support plans can struggle to succeed when organisations lack the conditions needed for consistent, reflective and relational practice.

Drawing on his experience, he talked about how support often breaks down not through lack of care from practitioners and care teams, but because the wider community is not equipped to sustain effective, attuned support for children and young people in care.

Effective practice does not happen in isolation. It depends on relationships between children, carers, practitioners and a service as a whole.

As a Social Enterprise, we are committed to advancing evidence-based practice and continuing to invest in research that improves outcomes for children and young people in care. The final session from the Research into Practice conference covered Attachment and Trauma Informed Care in Fostering (ATIC® F) – a model born from our exploration and findings. It is an evidence-based, clinically led approach that provides structured support and guidance for a set period of time.

Laura Garnett, Clinical Lead (fostering) at Five Rivers, discussed the research highlighting the value of understanding the feelings and experiences that may sit beneath what adults can see. She posed the questions: Why is this behaviour being displayed? What might the child be trying to communicate? And how can our response best support them?

The ATIC ® F model is based around the integration of children’s care, education and clinical services under a single recovery model. So, it’s about bringing these three disciplines together with a common goal and common underlying values and approaches that can really offer a wraparound support to a child’s daily experiences so that we’re all singing from the same hymn sheet, we’re all working towards the same goals together. – Laura Garnett, Clinical Service Lead (Fostering)

ATIC® F is grounded in trauma-informed practice; the model helps strengthen relationships, improve understanding of children’s needs, build confidence and promote stability for everyone working together to better support the child. Closing the day, Caroline Christie, Senior Therapist at Foster Care Associates (FCA) Scotland, shared her findings in Foetal Alcohol Spectrum Disorders (FASD) in fostering, drawing from her experience supporting care experienced children and their Foster Carers as the FSAD lead at FCA.

She highlighted the significant impact of Foetal Alcohol Spectrum Disorder (FASD), explaining that many care-experienced children may have been prenatally exposed to alcohol, often resulting in lifelong challenges that can go unrecognised and unsupported. During her session she explored what this means for fostering families and professionals supporting children in care.

It’s a range of difficulties, both physical and mental, that a person is born with because they have been exposed to alcohol in the womb, and it’s a permanent disability. The leading FASD expert, Professor Mukherjee, talked about this. That actually FASD, alcohol during pregnancy, is like a sledgehammer to the brain as well as to the body. So, the sledgehammer of direct effect is that it destroys areas of the brain. They are missing. They don’t grow back. It is a permanent disability. – Caroline Christie, Senior Therapist, Foster Care Associates, Scotland

It is important to us as a community to connect and share ideas and learning. Research only becomes meaningful when it influences practice and a conference only has lasting value when the ideas discussed continue to shape conversations, decisions and relationships after the event has finished.

It is never the work of one profession or one organisation, it is the work of the many and it is highly dependent on the ability to think, to learn and act together.

That is why we are committed to creating opportunities for learning that connect evidence with the realities of frontline practice. We are grateful to everyone who contributed to this year’s Research into Practice and to everyone who continues to turn that research into action.

We hope you remain curious and continue to strengthen the systems around children and young people, so they can continue to grow, learn and flourish.