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Practitioner-related Usefulness of Assessment and Intervention Tools in Relation to Looked After Children

Caroline Macrory, Edinburgh Connect Mental Health Team for Looked After and Accommodated Children

Background

There is mounting evidence of the severe difficulties commonly experienced by looked after young people. In particular, several recent studies have demonstrated that young people in the care system have a much higher rate of mental health problems than those in the general population ( e.g. Chetwynd and Robb, 1998; Blower et al. 2004). Despite these findings, there are few tools that have been designed or adapted for looked after children, and no studies have investigated resources for this client group.

Between August 2004 and March 2005, a Resource Bank was established within the Edinburgh Connect Office. (Edinburgh Connect is the mental health team for looked after and accommodated children and young people in Edinburgh.) The Resource Bank takes the form of a cupboard containing a selection of assessment and intervention tools, which are either designed for looked after children or have been recommended by practitioners working with the client group. The resources are for use by the Edinburgh Connect team and may also be loaned out to residential care unit staff and child and adolescent mental health services ( CAMHS) staff. Other practitioners, such as social workers and resource workers, may access but not borrow the materials.

Aims

The research project was designed to monitor and begin to evaluate this new Resource Bank. Focusing on the perspectives of practitioners working with looked after young people, the project aimed to:

• explore the accessibility of the Resource Bank
• assess the perceived usefulness of individual tools with the client group
• identify a selection of materials reported to be useful for approaching issues commonly faced by looked after young people.

Methods

A record was kept of all materials borrowed from the resource bank during the course of the project, and an evaluation questionnaire was given to users whenever a tool was accessed. This questionnaire collected information on:

• how easy the user found it to access the resource bank
• suggestions for improvements to the resource bank
• how useful the user found the particular tool(s) and resource(s) they borrowed
• the issues they wanted to tackle with the young person, using the borrowed resource
• how well the tool worked with the young person.

A set of evaluative criteria was devised to assess the usefulness of the individual resources, on the basis of frequency of use and feedback from users. A resource was classified as useful if it fulfilled one or more of the following criteria:

• An individual renewed the tool, or more than two different users accessed the same resource
• A residential unit or the Edinburgh Connect Team purchased a separate copy of the tool
• The resource was given a high rating on the evaluation form

Clearly, there are limitations to what can be inferred from findings assessed by this set of criteria. However, given the limited time-span of the project, as well as difficulties obtaining feedback from practitioners, a pragmatic approach needed to be taken.

Main findings

Accessibility

The number of loans from the Resource Bank increased each month during the 3-month period (47, 54 and 62 loans in months one, two and three, respectively).

Results suggest that, for all users, familiarity with the materials increased the likelihood that the Bank would be accessed, although additional factors such as staff shortages and time constraints were likely to have affected the use of the resources by residential care unit staff. Use of the Resource Bank was also influenced by the unit's relationship with Edinburgh Connect.

All members of the Edinburgh Connect team and all of the residential care unit staff who completed the evaluation questionnaire reported that the Resource Bank was easy to access.

Usefulness of individual resources

Of the 124 tools in the Resource Bank, 25 met at least one of the evaluative criteria outlined above, and four met all three criteria ( All About Me; The Ungame; My Life and Me; My Life Story).

Conclusions

The findings provide initial indications of the tools that have been found useful for working with looked after children and their carers, and form the basis of a 'Document and Resource List for Looked After and Accommodated Children'. It should be noted, however, that this list is neither conclusive nor exhaustive. A large number (61) of the resources were not accessed at all during the relatively short period of the project. In addition, the individual resources are not comparable - some are for assessment while others are for intervention purposes, and the intervention tools focus on a wide range of different issues.

The limitations of conducting research with this client group include the different working cultures within units, the reluctance of some staff groups to become involved, varying degrees of support from others in the field, and the unpredictable nature of residential care work.

The need for resources that address the particular difficulties faced by looked after children is evident. This project provides a framework which practitioners can use to explore the tools that work best for them within their particular circumstances. As such, it represents the starting point for a process which it is hoped will improve the outlook for looked after young people.

Further details from:

Gita Ingram
Edinburgh Connect Mental Health Team for Looked After and Accommodated Children

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