As a clinician supporting young people who engage in harmful sexual behaviour, I have the privilege of travelling across the northern region of Victoria and engaging with many residential workers. In the realm of addressing complex trauma in young people residing in residential care, the collaboration between clinicians and residential carers is not just beneficial but necessary.

In my experience, the vital role of residential carers in clinical assessments for young people with complex trauma is frequently overlooked. These carers, who dedicate themselves to providing stability and support to vulnerable youth, possess invaluable firsthand knowledge that enriches the assessment process and ultimately leads to more effective interventions and outcomes.

What we miss when residential carers knowledge is overlooked?

Context is everything in understanding the needs of young people experiencing complex trauma. Residential carers, who spend 24/7 with these individuals, offer unique insights into their daily lives, sensory needs, routines, and challenges. Their perspectives help clinicians interpret pain-based behaviour, engage effectively with the young people, pick up their cues, and support young people to cope during the sometimes intrusive assessment process. Moreover, the recommendations arising from assessments, such as behaviour support plans and safety measures, are more likely to be implemented successfully when they align with what will be accurate and realistic within residential care setting.

Young people who have complex trauma needs will often experience several assessments during their childhood, from neuropsychological assessments, to therapeutic assessments, to behaviour support or functional needs assessments. Rarely will a clinician neglect to interview the parents, foster or kinship carers of the children in order to complete a comprehensive assessment. However, for young people in residential care, it can be rare to take into consideration the multi-faceted perspectives of the people who are responsible for providing stability, care, emotional support and guidance.

Despite their pivotal role, residential carers are often excluded from the assessment process. There may be reluctance to include residential carers who may have limited resources for training, supervision, and therapeutic approaches to use with young people. This can raise anxieties around whose role it is to provide an expert and informed perspective on the child. Yet, by overlooking the perspectives of these caregivers, assessments miss crucial context and risk providing misinformed recommendations.

Towards an inclusive assessment approach

To address this gap, a collaborative approach is essential. Involving a team of carers, rather than a single individual, ensures a comprehensive understanding of a young person’s needs and strengths. Establishing clear communication channels between clinicians and residential carers, including regular meetings and feedback opportunities, fosters alignment in therapeutic goals and enhances the effectiveness of interventions.

Ultimately, consultation with residential carers during clinical assessments is not just about acknowledging their role; it’s about recognising their expertise and integrating it into the assessment process and outcomes. By valuing their insights and experiences, we can create a more empowered and supportive environment for both carers and young people alike. In the complex landscape of addressing complex trauma, collaboration between clinicians and residential carers is indispensable for fostering resilient futures for vulnerable young people.

Written by Jane Harding; Senior Advisor/Team Leader, Harmful Sexual Behaviour Consultation and Support Program