Case (Clinical) Consultancy
An essential element to promoting positive outcomes for vulnerable and troubled young people is the involvement of skilled, experienced, knowledgeable professionals who can stand outside the daily work; in short, case or clinical consultancy. Consultancy provides a safe haven to process experiences, and underpins, adds to, and develops existing elements of good care to transform the lives of troubled children.
Effective case consultancy sustains placements, improves outcomes, promotes satisfactory transitions and develops the organisation’s profile. Within a therapeutic approach to working with troubled children and young people, consultancy is best thought of as a “voluntary, collaborative, non-supervisory approach” (Wagner, Consultation: developing a comprehensive approach to service delivery, 2000, p. 11). It is an interpersonal process involving problem-solving and practice development between caregiving individuals and/or teams, the consultant and the child. Case consultancy builds on, complements and interprets the caregivers’ intimate and detailed knowledge of the child to develop creative possibilities for change by integrating the knowledge bases of caregivers and consultant. Support provided by the consultant for the child is indirect and is delivered to the child through their caregivers. Integrating the intimate knowledge and practice skills of the caregivers with the psychological knowledge, residential practitioner experience, and professional artistry of the consultant, this process can result in new insights, opportunities and possibilities that build feelings of being in control, where none existed before, and promotes optimism and a sense that, although their difficulties are never simple, the child can improve, develop and recover.
Therapeutic case consultancy involves a number of key skills, including:
- Developing a secure base for caregivers
- Mentalizing oneself, the caregivers, their child and other significant people
- Acknowledging and building on existing skills and experience
- Mirroring the therapeutic process with the child in the consultation process with caregivers
- Problem clarification
- Problem management
- Reframing of problems
- Facilitating group decision making
- Skills development
- Feedback and self-reflection
In a therapeutic approach, consultancy will have experiential aspects; that is to say, caregivers should experience the process as inclusive, supportive, empowering, building on strengths, challenging and developing in the same psychologically safe way that they are expected to care for the individual child.
Chris brings a unique range of skills and experience to this process, with nearly twenty-five years’ experience working with vulnerable and traumatized children, he has wide experience, both as a front-line practitioner and manager in therapeutic organizations, contributing to recovery for young people who present a range of problems associated with early attachment difficulties, including high levels of violence, challenging behaviour, self-harming, persistent absconding, withdrawal, mental health difficulties and sexualised behaviour.