At Secure Start we offer programs based on the Triple-A Model of Therapeutic Care and the CARE Therapeutic Framework. Both programs were developed by Colby Pearce, are based in psychological science, but are delivered in an accessible way. Both programs inform about what you need to know about the therapeutic care of children and young people who have experienced early adversity, and what you need to do to support their recovery and growth.
Each program includes complementary training for carers and professionals. It is important that carers and professionals are able to communicate with each other effectively, and having complementary training supports this. Communication supports connection, and supporting therapeutic connections is at the heart Triple-A and CARE.
Training for professionals incorporates a practice framework that supports fidelity. Professionals are trained in embodying the model in their practice.
There is a special focus on self-care, in order that participants feel able to realise their aspirations on behalf of children who have had a tough start to life.
Currently, Colby is delivering in Australia and Ireland:
Triple-A is in it’s fourth year of implementation with TUSLA (Child and Family Agency) staff and carers in Donegal, Ireland.
The CARE Therapeutic Framework is in its second year of implementation in the Department for Child Protection’s (DCP) Kinship Care Program in South Australia.
For more information, refer below or click one of the related links on the “My Programs” menu tab.
The Triple-A Model of Therapeutic Care and the CARE Therapeutic Framework represent evidence-informed conceptual frameworks based in psychological science. Both offer a strengths-based approach that focuses on conventional aspects of caregiving and relating that support optimal developmental outcomes and recovery for children who have experienced early adversity, and the evidence-base for them. The CARE Therapeutic Framework is also a practice-framework, whereby it offers a framework for the delivery of accountable support services that promote carer fidelity to the model and optimal outcomes for children.
The Triple-A Model of Therapeutic Care and the CARE Therapeutic Framework do not seek to replace other approaches to trauma-informed, therapeutic re-parenting of children, and support for their carers. Rather, the each program offers a back-to-basics approach that forms a solid foundation to build on. As strengths-based approaches, the Triple-A Model of Therapeutic Care and the CARE Therapeutic Framework complement other strengths-based approaches.
Central to both programs is the development of knowledge and understanding of the reasons why people behave in the manner that they do and competencies that support these reasons being addressed. This is central to addressing one of the main casualties of grossly-inadequate care – namely, the experience of having one’s needs met reliably and predictably that is the foundation for secure dependency and optimal developmental and interpersonal outcomes. Both programs endeavour to promote addressing needs as a fundamental caregiving priority, as opposed to simply addressing behaviour(s) of concern in isolation of needs.
The Triple-A Model of Therapeutic Care and the CARE Therapeutic Framework promote human Connection as a primary task (Kahn, 2005), where the primary task is defined as the one task that we need to get right and upon which the success of all endeavour rests. There is a robust and ever-growing evidence base for the role of connection in supporting optimal emotional and behavioural outcomes for young people and adults alike (Dooley & Fitzgerald, 2015; Ottman et al, 2006; O’Rourke & Souraya, 2017).
The Kinship CARE Project
The Kinship CARE has been implemented successfully with statutory kinship carers in South Australia over the past two years. The Kinship CARE Project is a joint initiative of the Department for Child Protection (DCP) and Secure Start®. At the time of writing, and over the previous 18 months, Kinship CARE Project training has been delivered to 18 groups of kinship carers in 13 metropolitan and 5 regional locations of South Australia. More than 220 kinship carers have attended part or all of the training, with an overall retention rate for attending 4 or 5 sessions (including call-back) of 47%*. This compares favourably with international trends for retention in parenting training (Garvey et al, 2006; Nix et al, 2009).
In the Kinship CARE Project there is a focus on supporting carers to develop an understanding of how to implement a therapeutic re-parenting approach in their own individual circumstances. That is, there is a focus on assisting carers to know what to do, and to develop a tailored therapeutic re-parenting Plan. Psychological theory is presented sparingly and only in support of the rationale (and evidential basis) for recommended approaches. Accessibility of the content is supported through a multi-modal approach to delivery that includes practical activities, demonstrations and audio-visual content in support of verbal content. Regular individual and group reflections also support understanding of the program content. Kinship care support workers regularly attend sessions with carers on their caseload, further supporting caregiver accessibility to the content and shared experience of the program.
In the Kinship CARE Project there is complementary training for
kinship care support workers and psychology staff. The content and delivery is
similar to that which is delivered to kinship carers, except that there is a
focus on the implementation of the CARE Therapeutic Framework in kinship care
support workers’ practice with kinship carers, and psychologists’ practice with
kinship care support workers. That is, there is a layered approach to
implementation, whereby kinship carers experience CARE from their support
workers, and support workers experience CARE from psychologists trained in the
Framework. Implementation is layered in this way to support fidelity to the
framework and embeddedness across the Department for Child Protection’s Kinship
The Triple-A Model of Therapeutic Care
The Triple-A Model of Therapeutic Care was developed for a foster care audience. It was initially implemented as the preferred Model of Care in the Centacare Intensive Family Preservation Foster Care Program in South Australia in 2014/15. Across the past four years the Triple-A Model of Therapeutic Care has been implemented as the preferred Model of Care in the TUSLA (Child and Family Agency) Fostering Service in Donegal, Ireland. In September 2018 twelve local trainers, including 6 members of the TUSLA Fostering Service and 6 local foster carers, were trained as local trainers in the Triple-A Model of Therapeutic Care.
The implementation of the Triple-A
Model of Therapeutic Care in Donegal has been a great success, with successive
reports (2016, 2018) by the independent
statutory inspection authority for health and social care services in Ireland
(HIQA) reporting positively on the Triple-A implementation. A Training Needs
Analysis by the TUSLA Fostering Service in early 2018 reflected that the Triple-A Model of
Therapeutic Care was the most mentioned training when general and relative
foster carers were asked about useful training they had received, including by
a factor of 10:1 over the better-known international approach Therapeutic
Crisis Intervention (TCI).
Pearce, C.M. (2010). An Integration of Theory, Science and Reflective Clinical Practice in the Care and Management of Attachment-Disordered Children – A Triple A Approach. Educational and Child Psychology (Special Issue on Attachment), 27 (3): 73-86
Kahn, W. A. (2005). Holding Fast: The Struggle to Create Resilient Caregiving Organisations. Hove and New York: Brunner-Routledge
Dooley, B & Fitzgerald, A (2015). My World Survey: National Study of Youth Mental Health in Ireland. UCD School of Psychology, Headstrong
Ottman, G, Dickson, J, & Wright, P. (2006). Social Connectedness and Health: A Literature Review. Cornell University GLADNET Collection
O’Rourke, H. M., & Sidani, Souraya. (2017). Definition, Determinants, and Outcomes of Social Connectedness for Older Adults: A Scoping Review. Journal of Gerontological Nursing, 439(7), pp 43-52.
Nix, R.L, Bierman, K.L, & McMahon, R.J. (2009). How attendance and quality of participation affect treatment response to parent management training. Journal of Consulting and Clinical Psychology, 77(3): 429-438
Garvey, C, Julion, W, Fogg, L, Kratovil, A & Gross, D. (2006). Measuring participation in a prevention trial with parents of young children. Research in Nursing and Health, 29:212-222
* Nb Data for groups 1-12 only. Final retention data, including for groups 13-18, to be collated at the end of 2019)
The Kinship CARE Project has been extended to 2020.
The Kinship CARE Project is a joint initiative of the Department for Child Protection (DCP) and Secure Start®. At the time of writing, and over the previous 18 months, Kinship CARE Project training has been delivered to 18 groups of kinship carers in 13 metropolitan and 5 regional locations of South Australia. More than 220 kinship carers have attended part or all of the training, with an overall retention rate for attending 4 or 5 sessions (including call-back) of 47%.
In the Kinship CARE Project (CARE
Therapeutic Framework) there is a focus on relational connection
repairs (relational) harm experienced by
children and young people who are recovering from abuse and neglect;
regulates emotions and behaviour;
supports physical and mental health; and
supports a positive self-concept in children
and young people, which is vital to their confident approach to life and
relationships, and growth.
In the Kinship CARE Project, 75% of participant kinship carers who complete the training and a post-training survey (three months follow-up) agree or strongly agree with the statement that they are experiencing improved relationships with a child or children in their care. The remaining 25% neither agree nor disagree with this statement. It is possible that they were already satisfied with relationships in the home.
The perception that relationships are
improving is likely influenced by, and influences, what carers notice about the
home environment. This is a key outcome of the self-care methodology of The
Project. The self-care methodology is
designed to achieve an outcome where carers see their successes in performing
the role, including what they are already doing that supports recovery from
relational trauma, and evidence that the child(ren) are benefitting from their
caregiving endeavours. This supports carer wellbeing and optimal performance in
the role. Indeed, 84% of respondents on the post-training survey report that
they feel more confident in their role as a kinship carer.
Importantly, an anticipated outcome of
the self-care methodology is that children experience themselves differently,
based on the change in perception by their kinship carers. The self-concept of
children is very much influenced by their experience of how adults in a
caregiving role perceive and interact with them. Children who experience adults
focusing on their problems will see themselves as a problem. Children who
experience adults approaching them with positivity will internalise positive
messages about themselves. This relates to the concept of the
“looking-glass-self”, described by Cooley in 1902 and confirmed via empirical
study since. I discuss this in both of my books.
Children’s thoughts about themselves
influences their feelings, behaviours, and the reaction of others. Negative
attachment representations (negative thoughts about self, other and world) are
reinforced where adults respond to children’s behaviour only, as opposed to the
needs being expressed via the behaviour and/or reasons for the behaviour.
Acknowledging and addressing the reasons for children’s behaviour is a key
aspect of this Project, and a key outcome. Responding with understanding
circumvents unhelpful relational dynamics that perpetuate attachment
insecurity/disorder, where attachment insecurity/disorder is over-represented
among children in out-of-home care. This represents a vital step in supporting
progress towards attachment security for children in kinship care, where attachment
security is widely accepted as optimal for children’s growth and development
and successful approach to life and relationships.
In our Project, participant kinship
carers complete a brief questionnaire about the behaviour of a child in their care
at the beginning of the first training session and at the end of the fourth
training session. Pre- and post-responding to this questionnaire is evaluated
via keyword analysis. What we have found for the first 12 (completed) groups is
a more than two-fold increase in carers acknowledging that the child’s
behaviour relates to a (contemporary or historically unmet) need, from being
mentioned in 26% of carer responses to the pre-questionnaire, to being
mentioned in 58% of the post-questionnaires. There is a corresponding reduction
in mentions that the behaviour is occurring because the child ‘wants’
something. This outcome appears to reflect that carers get better at looking
beyond the behaviour, which is also an important outcome of the Project and
necessary to support kinship children’s progress towards secure attachment,
optimal arousal for wellbeing and performance in life tasks, and new learning
about the accessibility and sensitive responsiveness of adults in a caregiving
In helping kinship carers focus more
on needs that drive the behaviours of children recovering from relational
trauma, the Kinship CARE Project supports the imperative to nurture secure
attachment, the importance of which is enshrined in the new child protection
legislation in effect in South Australia.
For more information about the Kinship CARE Project, including forthcoming implementation sessions, follow the link to the Project page on the Secure Start site.
Following the success of the resources for trauma-informed practice in early learning centres, I am pleased to advise of my new training workshop: Addressing Trauma in the Early Learning Setting: The CARE approach.
The training workshop covers:
What is ‘trauma’?
The effect of trauma on the developing child
Signs that a child has or may have experienced trauma
What a therapeutic care environment looks like
Implementing a Therapeutic Care Plan
What recovery looks like for the child who has experienced trauma
Supporting our best endeavours – implementing a Self-Care Plan
The training was recently rolled out to a community early learning centre, with all staff who attended indicating that they would recommend the training to other early childhood educators.
The all-inclusive* cost of a one-day training workshop is AUD$2,000. This covers presenter costs and all handouts, including proformas for developing Therapeutic CARE Plans and Self-Care Plans.
Contact Secure Start to discuss an implementation:
The Kinship CARE Project is a dedicated endeavour to support kinship carers in South Australia who are looking after children for whom the Department for Child Protection has an authority to place. The Kinship CARE Project has been implementing for the past 18 months, to 18 carer groups in 13 metropolitan and five regional locations.
The Kinship CARE Project offers training in therapeutic care of children recovering from a tough start to life. It is specifically tailored to Kinship Carers. Interactive and informative, the training demonstrates how to enrich relational connection with children in kinship care and support their recovery from a tough start to life. Participants develop a therapeutic care plan for their home that fits with their circumstances and the individual characteristics of each child in their care. The Kinship CARE Project training is strengths based and offers a practical approach to self-care, in support of participant wellbeing and success in performing the caregiving role.
For a limited time, I am offering organisations that support kinship carers access to the Kinship CARE Project Carer Handbook via PDF download. It is anticipated that access to the Carer Handbook will support consideration and decision-making with respect to engaging me for an implementation project with kinship carers. The price of this inspection copy of the Kinship CARE Project handbook will be deducted from the price of an implementation project.
The Handbook can be purchased via the link below. For more information about the Kinship CARE Project, click here.
Kinship CARE Project Carer Handbook
Buy it now and I will email your personalised copy of the Carer Handbook (Please allow up to 2 business days for us to respond to your payment).
Disclaimer: I reserve the right to refuse a purchase and refund the purchase price in instances where I consider that the Handbook may be used without appropriate acknowledgement of authorship or otherwise used to the detriment of my capacity to carry out my usual professional activities.
In addition, I offer training for early learning educators in the CARE Therapeutic Framework. This training can be offered in a series or as a whole day. For more information contact me at email@example.com
Yesterday I posted about the vital role that foster and kinship carers play in any child protection endeavour. You can view my post here. Foster and kinship carers play an essential role in providing a safe and loving home that supports children’s recovery from abuse and neglect.
Though it is a vital role that they play, and foster and kinship carers speak of the satisfaction they experience in performing the role, it is not always easy and plain sailing. When times get tough, foster and kinship carers rely on family and friends to help them through the tough times. They also rely on skilled and dedicated professionals whose vocation is to support foster and kinship carers and, in turn, the children in the care of foster and kinship carers.
So, in this follow-up to my post yesterday, I would like to acknowledge the care and support offered to foster and kinship carers by family, friends and professionals who work in the area. Your endeavours are also vital in supporting the recovery of children and young people from a tough start to life.
The 8th to the 15th of September is Foster and Kinship Care week, a time when we pay homage to the vital role performed by foster and kinship carers in Australia.
In my opinion, foster and kinship carers are crucial to any endeavour to care for and protect children who cannot safely be cared for by their parents. Foster and kinship carers offer these children the best chance to recover and thrive after early adverse experiences.
Put simply, our society simply cannot intervene to protect children and support them to achieve to their potential without foster and kinship carers. We owe them a lot!
I have worked directly with foster and kinship carers since 1995. My work with foster and kinship carers has enriched my career, just as they enrich the lives of children who enter their homes and their care. Borrowing heavily from insights and experiences gained through interactions with foster and kinship carers, I have had the opportunity to develop ideas and programs in support of their endeavours to facilitate better outcomes for children recovering from a tough start to life.
In South Australia, and with the support of my wife, Rebecca, our colleague, Georgina Johnson, and my children, we deliver the Kinship CARE Project, an endeavour to provide statutory kinship carers with information and guidance about how best to support the children in their care, and themselves. The Project arose in response to the Royal Commission into Child Protection Systems, is funded by the Department for Child Protection (DCP), and has been under implementation for 18 months. In that time we have delivered the CARE Therapeutic Framework to 18 kinship carer groups in 12 metropolitan and 6 regional locations. We have reached more than 220 kinship carers and (indirectly, via the training) over 290 kinship children. We have been further supported in this endeavour by the Department for Child Protection’s Kinship Care Program, whose staff have also been trained in The Framework and regularly transport and participate in carer training sessions in support of the kinship carers they work with.
Through our practice, Secure Start®, we continue to provide therapy to children in foster and kinship care and parenting support to their caregivers. We also support the work of the TUSLA (Child and Family Agency) foster care service in Donegal, Ireland, via the implementation of the Triple-A Model of Therapeutic Care to General and Relative Foster Carers. The Triple-A Model of Therapeutic Care is my other training program and has been under implementation in Donegal for four years . It is currently being rolled-out by members of my team of 12 local trainers (including 6 TUSLA staff and 6 foster carers), who were trained by me in September 2018. The implementation has been a great success and favourably mentioned in reports of the independent statutory inspection authority for health and social services in Ireland (HIQA) in 2016 and 2018.
Though our various endeavours we hope to maintain our relationship with foster and kinship carers for many years to come. In the meantime, we wish you well in your endeavours and pay recognition to the vital role that you perform.
The CARE Therapeutic Framework is a back-to-basics, strengths-based program that supports enrichment of therapeutic care environments for children who are recovering from relational trauma and other forms of early adversity, and their caregivers.
Relational connection, wellbeing, and new learning (growth) are key outcomes, as is the promotion of competencies among carers and professionals in the delivery of therapeutic care.
A back-to-basics approach supports consistency of care and reparative relational experiences, where consistency is optimal for a child’s new learning about the accessibility and responsiveness of adults in a care and supporting role, wellbeing, and positive beliefs about self, other and world (attachment representations). A back-to-basics approach reflects the fact that our care needs are very similar across the lifespan, notwithstanding that they are expressed and met in different ways at different ages.
A strengths-based approach is necessary as people focus too much on problems to solve than on what is going well. Problem-solving can be stressful and carries a number of inherent risks associated with our tendency to selectively attend to aspects of the world around us that are consistent with our thoughts, and overlook aspects that are not in our thoughts; including the things that are already occurring that support positive outcomes for children and carers. Problem-solving can become overwhelming. People need to be reminded to ‘see’ the positives. A strengths-based approach supports wellbeing and successful endeavour. For children, it supports a positive self-concept and confident approach to life and relationships.
The CARE Therapeutic Framework supports positive relational connections. As is known, positive relational connections:
repair the relational harm experienced by children and young people who are recovering from abuse and neglect;
support physical and mental health; and
support a positive self-concept in children and young people, which is vital to their confident approach to life and relationships.
Evaluation data is continuously collected as part of the CARE Therapeutic Framework. We are happy to share information about how The CARE Therapeutic Framework is achieving desired outcomes as part of a conversation about an implementation project with your organisation or group.
Raising children who have high and/or complex needs, such as those who have developmental and medical conditions, a disability, and those who are recovering from family trauma, presents a set of stressors that can be poorly understood by others, including other family members, and leave you feeling overwhelmed and unsupported.
This is often compounded by feelings of guilt and shame about those times and situations when you don’t feel at your best and perform at your best in the caregiving role.
Raising children who have high and/or complex needs is a tough gig. It can leave you feeling like a failure. It can distort your perception of yourself and the child in your care.
It is important to consider the role and importance of wellbeing when caring for children with high and/or complex needs. In a state of wellbeing we:
think at our best
feel at our best
perform at our best.
This is illustrated in the diagram below, representing Yerkes-Dodson’s Law (1908), which also shows that in a state of distress – that is, when our nervous system is too highly activated – we are incapable of performing at our best in any task or role that we undertake; including caregiving. The consequence of not performing at our best is further shame and distress, which compounds the problem.
Achieving and maintaining a state of wellbeing when raising a child with high and/or complex needs is vital. There are many suggestions and methods about how this might be achieved, but my concern is that they often involve activities that the already overwhelmed parent or caregiver finds hard to implement. If it is hard to implement, it will not get done!
In my programs, including the Triple-A Model of Therapeutic Care and the CARE Therapeutic Framework, I favour a less demanding approach to achieving and maintaining wellbeing that is based in what we know from science about how our thinking works.
In life, we are only consciously aware of a proportion of the information that our brain registers via our sensory inputs. That is, we selectively attend to certain aspects of our experience and environment, and miss other (equally obvious) aspects of our experience and environment. This is well-demonstrated in the video below, which represents the work of Simons and Chabris (1999) on selective attention:
There is a filter at work. The filter is our thoughts. We selectively notice those aspects of our experience and environment that are consistent with our thoughts, and overlook those aspects that are not. For another example of what I am referring to, think about what happens when you buy a new car, or a coat in a certain style, or have your hair cut a certain way. You see a lot of the same car, coat or hair style; right? You also don’t notice (that is, pay attention to) cars of a different make and model, other types of coat, or other hair styles.
So, if our thoughts influence what we notice about our experience and environment, it is important to consider the following. Have a look at the image and think about what stands out for you.
When I show this to various audiences they almost always respond that the simple arithmetic equation in the bottom left hand corner is wrong. 4+4 does not equal 9. They do not comment that nine out of ten equations are right. That is, our brains appear to look for problems to solve and overlook what is right.
This is not unique to you who are caring for a child with high and/or complex needs. We all have a tendency to do this.
However, if you put this in a parenting context, where you are raising a child with high and/or complex needs you are vulnerable to noticing a lot of problems and missing the things that are going right; both in terms of your performance of the role and the gains the child is making.
This selective focus on problems to solve is unhelpful and self-defeating when raising a child with high and/or complex needs. It can leave you overwhelmed with problems to solve, thereby undermining your wellbeing and capacity to solve them. Even worse, it can also impact on how the child sees themself.
It is important to get better at noticing the things you already do that help the child with high and/or complex needs, and the signs that they are benefitting from your endeavours on their behalf. In doing so, I anticipate that you will experience feelings of wellbeing that sustain you through tough times and support your best endeavours on behalf of the child in your care with high and/or complex needs.