Treatment , Training and Program Development for Children Youth and Family Services

 

     Postal address: Box 435

Erindale Centre, 2903

Office@twi.org.au

0415379653

ABN: 5216 7151 162


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Training and Professional Development

 

Custom Designed Training

 

TWI associates are often asked to provide professional development training for organisations.  The content of the days is determined by the needs of the organization. Workshops that have been recently delivered are:

 

·        Autism Spectrum Disorders and challenging behaviours

·        Asperger Syndrome and sexually problematic behaviour

·        Responding to young people with sexually problematic behaviour in out-of-home care

·        Advanced skills for teachers who work with young people with challenging behaviours

·        Conflict in the classroom - how conflict cycles develop and how to avoid them

·        Difficult Conversations with parents, staff and ...

·        The brain and behaviour

·        Collaborative Problem Solving

·        Trauma and disability

 

Other workshops and seminars can be tailored to meet the needs of practitioners in a variety of settings. Over the past four years tailored professional development programs have been provided for schools, treatment programs, juvenile justice facilities, and child welfare services.

 

Internationally Accredited Training

 

The Three Pillars of Transforming Care

 

About the Three Pillars course 

The Three Pillars of Transforming Care course has been developed for Agencies that wish to ensure that their staff and carers are informed about and sensitive to, the developmental impacts of early adversity and trauma. It focuses on the three core traumagenic needs of children and young people in special care and education settings and the priorities for intervention and support.  The three primary traumagenic needs identified are - the need to FEEL SAFE; the need for positive, trust-based CONNECTIONS with caring adults and engagement with community and culture; and the need for support to enable adaptive COPING with external life circumstances as well as turbulent thoughts, emotions and impulses.

The intent of the course is to provide ‘everyday and ordinary’ strategies for care providers to therapeutically meet a child or young person’s traumagenic needs in the other 23 hours.

 

Developed by Drs Howard Bath and Diana Boswell, both with extensive backgrounds as practitioners and researchers in out of home care, the course is now provided across Australia, Europe, Canada and the USA. 

 

Topic areas covered include: 

 

The fundamentals of trauma theory including types of trauma, arousal and stress mechanisms, the impact on brain development, the role of memory and dissociation. It then goes on to look at the common developmental outcomes of exposure to complex forms of trauma followed by the three pillars of intervention and support.

  

Instructional methods include brief presentations, videos, worksheets, group discussions and practice exercises.

 

The recently-published book The Three Pillars of Transforming Care: Trauma and resilience in the other 23 hours (2018, H. Bath & J. Seita, Faculty of Education Publishing, University of Winnipeg) provides a resource and reference guide for course material.

 

The Three Pillars of Transforming Care course is delivered in three formats:

1.    A one-day overview of the key concepts can be provided for interested agencies or groups 

2.    A two-day core training targeting direct care or education practitioners (foster carers, residential workers, teachers, and mentors along with those who supervise and support them) 

3.    A three-day train-the-trainer program that targets more experienced, senior workers who are in a position to provide training for other staff/carers/teachers in their own organisations. This training involves two instructors and up to 25 participants who can be accredited to provide training within their own organisations for a three year period. Periodic one-day Updates are scheduled for trainers to maintain their accreditation.

 

Approximate costs   

One-day overview: Instructional costs are $2,000 (plus GST) plus any required travel and accommodation for one instructor. The host organisation would need to arrange the venue, AV equipment, and any food/refreshments for participants. 

 

Two-day core training: Instructional costs are $4,000 (Plus GST). This includes training materials for each participant including a copy of the

Three Pillars book (but not travel and accommodation for the single instructor, or venue/AV equipment, and food/refreshment costs).

 

Three-day train-the-trainer courses: Costs and other course details are negotiated directly with host organisations. This training is provided by Drs Howard Bath and Diana Boswell.

  

All three course options are provided through Tact Training and Therapeutic Welfare Interventions (www.twi.org.au). Both Howard Bath (0423 617 111) and Diana Boswell (0439 461 999) welcome the opportunity to discuss course content and delivery.



Content of the course  

Module 1: Understanding Trauma 

·       Defining trauma 

·       Trauma and developmental harm 

·       The brain and its development 

·       Brain functioning and integration 

·       The stress response and trauma 

·       Traumatic stress, hyperarousal and dissociation 

·       Traumatic stress and memory 

·       Other impacts on development and behaviour  

Module 2: Safety 

·       The impact of trauma on felt safety 

·       Barriers to creating safety 

·       Why we resort to pain-based behaviours

Module 3: Connections

·       Connections, loss and shame 

·       Connecting with ‘normality’ and caring adults 

·       Five everyday ways of promoting connection

Module 4: Coping 

·       Healthy and unhealthy coping 

·       The place of words in learning to cope 

·       Calming and coping together 

·       Summary and closure

 

The Presenters

 

Dr Howard Bath has been involved in the provision of child, youth and family services for over 40 years. Trained as a clinical psychologist, he has worked as a youth worker, manager, and as the CEO of a child and family services agency.  From 1999 to 2008 he was director of an Institute that provided consultancy and training services for service agencies around Australia and also worked as a clinician running programs for adolescents with difficulties around aggression and sexual behaviour.  Howard is widely published in the areas of family preservation, out of home care, child protection and the impacts of developmental trauma.

 

From 2008 to 2015 Howard was the inaugural Children’s Commissioner of Australia’s Northern Territory where he had a broad responsibility for the wellbeing of vulnerable children in the child protection, youth justice, disability and mental health systems.  In 2010 he took leave from his Commissioner’s role to co-chair a major government Inquiry into Child Protection services in the Northern Territory. Howard currently provides a range of consultancy and training services through Allambi Care for programs around Australia and overseas. He can be contacted at: howardb@Allambi.org

 

 

Dr Diana Boswell initially graduated from the Australian National University then undertook graduate clinical and research degrees in child and adolescent psychology from the University of Toronto. In Canada she worked in the Toronto school system, child and adolescent mental health and a secure forensic unit for adolescents.

 

On returning to Australia Diana worked in a TEACCH program (early intervention for children with autism or communication handicaps). After joining the Marymead Child and Family Centre in 1992 she worked as a clinician, manager and CEO. Later, working as a consultant, Diana has worked with disability, child protection and youth justice services providing program development, assessment, training, research/evaluation and staff supervision. She has developed and taught graduate university courses and was instrumental in developing therapeutic residential care programs and treatment programs for young people with problematic sexual behaviors.

She can be contacted at: dboswell@twi.org.au

 

 

References

 

Bath, H. (2015). The Three Pillars of TraumaWise care: Healing in the Other 23 Hours. Reclaiming Children and Youth23(4), Winter, 2015.

Brendtro, L. & Mitchell, M.L. (2015). Deep Brain Learning: Evidence-based essentials in education, treatment, and youth development (pp. 24-26). Champaign Illinois: Research Press.

Bath, H. (2017). The Three Pillars of Transforming care: Healing in the ‘other 23 hours’

Bath, H.  (2017). The trouble with trauma. Scottish Journal of Residential Child Care, 16 (1).

Bath, H. & Seita, J. (2018).  The Three Pillars of Transforming Care: Trauma and resilience in the other 23 hours. Winnipeg, Manitoba: Faculty of Education Publishing, University of Winnipeg.

Bath, H. (2018). Implementing the Three Pillars Framework.

 

 

 

Research Evidence for the Three Pillars

 

There are three levels of evidence that support the Three Pillars program.

 

1.         The Three Pillars program represents a framing of the large research and clinical literature on the outcomes of trauma exposure and the implications for intervention. Every proposition in the program is supported directly by research evidence or contemporary clinical thinking. The supportive research is detailed in the training manual and some of it is referenced in the accompanying paper describing the program as well as the published papers (Bath 2008, 2015). An extensive reference list is also provided for course participants.  

 

The course itself is not based on new ideas and propositions; its originality lies in the ways existing and widely-accepted knowledge is organised and interpreted for direct care and support providers who are not themselves, specialist therapists. The material on which the course is based is found largely in the work of prominent researchers and theorists such as James Anglin, Sandra Bloom, Bessel van der Kolk, Bruce Perry, Vincent Felitti, John Bowlby, Robert Anda, Larry Brendtro, Stephen Porges, Allan Schore, Daniel Siegel, Louis Cozolino,  Martin Teicher, Michael Rutter, Ann Masten and many others. Many of these authorities have multiple publications and they themselves draw on the work of other researchers and clinicians.  A sample of the publications that directly inform the Three Pillars program is in the attached reference list (the fuller bibliography can be provided). 

 

Where there is not clear research into a particular proposition or strategy, it will only be included if there is strong support in the clinical literature. For example, Henry Maier’s (1992) notion of ‘Rhythmicity’ is included as it has received support in more recent clinical literature (van der Kolk, 2014, p. 84).

 

2.            The phrase ‘trauma-informed’ refers to any program or model that is based on an understanding of the various types of psychological trauma; on how trauma impacts the young brain and other domains of development; and on how this knowledge should shape our approaches to therapeutic intervention and support. The Three Pillars program seeks to apply these understandings in work with vulnerable children and young people.  There are now numerous residential care and foster care programs that seek to be trauma-informed. They draw on the same body of literature (as found in the reference list) and are based around similar propositions although the programs may differ in emphasis, target populations, and specific goals. Research into the efficacy of such programs is at an early stage (as outlined in Whittaker et al., 2015, Section 4), but there are now some promising research outcomes for programs that are trauma-informed.  The Three Pillars program is not intended to be a comprehensive intervention model as it assumes that programs that use it to improve their trauma sensitivity will also seek to address normal developmental needs as well as accepted theory and practice pertaining to all children in special care settings. 

 

In Australia, an independent outcome study of therapeutic, trauma-informed care being implemented in a variety of Victorian services, found that the measured outcomes for young people was superior on all measures studied to the outcomes of young people in standard residential care (Verso Consulting, 2011). 

 

It is difficult to be definitive about outcomes for specific populations because the research to date uses different methodologies and looks at a variety of specific models and target populations. However, research based on outcomes from a number of other trauma-based programs for children in child protection services, including The Sanctuary program and the CARE program out of Cornell University (Holden, 2009), has demonstrated clear positive outcomes.  Bloom and Farragher, 2013, pp. 58-61 list a number of studies that have found encouraging results across a number of dimensions whilst there are also promising results from formal evaluations of the CARE residential program (Izzo et al., in press) in terms of positive adjustment and behavioural data for children and young people.          

 

3.            The third level of evidence comes from outcome evaluation surveys from Three Pillars training programs. The primary goal of the training program is to empower those who provide care for children and young people in their living and learning environments. The train-the-trainer program targets those who train the direct care providers, so the views of these participants about the effectiveness and relevance of the contents are important. In Australia the training program has been provided in four states or territories.