Client mix and client matching in therapeutic care – Practice guide

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Client mix and the process of client matching is one of the 10 Essential Elements underpinning the Intensive Therapeutic Care (ITC) system in New South Wales. This guide has been developed to support effective decision-making processes around client mix and client matching. The guide identifies and explores seven domains of effective decision making with a focus on therapeutic group or residential care settings including Therapeutic Intent, Participation, Individual Needs, Group Living Context, Staffing, Organisational Capability and System Issues.

 

Key Messages

  • Effective decision making regarding client mix and client matching provides the foundation for safety, therapeutic care and improved outcomes for young people.Client matching is the practice of identifying the individual needs of young people and matching them to an environment that best supports them to recover and heal.
  • Client mix is the practice of understanding the needs of a young person and how that young person could live safely with, benefit from, and positively contribute to the lives of others.
  • The national and international literature is sparse regarding effective client mix and client matching practice.
  • Effective practice regarding client mix and client matching within ITC must take into consideration a range of domains including the individual needs of young people, the group living context, participation of young people, the therapeutic intent of the program, the capacity of the staff team, organisational and systems capability and issues.
  • The interplay of the seven domains will impact the achievement of positive outcomes for young people. Careful assessment of the risks, needs, strengths, and vulnerabilities across each domain, and the consequences of these is critical. Strengths in one or more domains will mitigate the vulnerabilities in another domains.
  • A positive group climate is reliant on the staff to set the relational context within which young people feel safe to share their thoughts and feelings with staff, who are able to set limits, boundaries and expectations that are balanced, negotiated, understood, accepted and calmly applied.
  • Group norms and the expectations young people place on each other and the group itself can play an important role in setting standards for behaviour and maintaining safety.
  • Group dynamics should be carefully monitored and supported in consideration of their ‘readiness’ to accept/ positively tolerate a new young person, supported by a comprehensive understanding of young peoples’ unique strengths, vulnerability and triggers.
  • Positive staff culture and attitudes towards the behaviour of young people are critical to the staff’s ability to interpret the behaviour and needs of young people through a trauma informed lens. Trusting and safe relationships between staff and young people are essential for young people to be supported to de-escalate, co-regulate and learn pro-social behaviours.
  • There is a strong relationship between organisational and system cultures and living group climate in the houses, with staff performing better when there is confidence the organisation shares their vision and commitment to the work.

 

 

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