Steven was 14 years old when he came to Meadows Care. His family had been involved with children’s social care for a long time due to concerns that Steven’s physical and emotional needs were not being met at home. Further, there was a lack of supervision within the family home and indicators that Steven may have experienced sexual abuse.

Meadows Care was Steven’s first experience of care. He came as an emergency placement following a recent allegation of physical abuse perpetrated by his stepfather. It was clearly a confusing time for Steven and he was filled with anxiety and uncertainty about the future. The residential staff team were keen to develop positive relationships with Steven and help him settle into the home. They spent time learning about his likes and dislikes, which meant lots of trips to the local trampoline park and the staff supporting Steven to decorate his bedroom in his favourite football teams’ colours. It was an unusual experience for Steven and he expressed feeling undeserving of this, but the team’s consistency meant that Steven slowly began to trust them.

As Steven began to settle in the placement, he began to build positive relationships with the residential care team. He was also supported to maintain those relationships that were important to him, like with his brothers and his Headteacher at school. At this point, it felt appropriate for Steven to meet with his allocated therapist, who spent time getting to know him through activities that he enjoyed (McDonalds was a particular favourite!) Over time, a trusting therapeutic relationship was established which formed the foundations for completing therapeutic work together.

Meadows therapy recognise the importance of a comprehensive, collaborative, and holistic psychological assessment, capturing the young person’s presenting difficulties. As such, Steven, professionals involved in his care, and his family played an active role in contributing to the psychological assessment through a variety of methods including interviews, questionnaires and observation. Information was collated to develop an understanding of Steven’s difficulties, specifically his attachment style, his coping style and his beliefs about himself, and how his early life experiences had impacted upon each of these. This understanding was shared with the team and formed the basis of the therapeutic care plan, which guided all interventions to support Steven. Interventions included pieces of work for the residential staff to complete with Steven around his relationships and emotions, as well as specific training for the team. Importantly, the formulation was also shared with Steven himself which he found validating in helping him to understand that his difficulties were not his fault.

Another important intervention for Steven was the development of a trusting therapeutic relationship through weekly individual therapy at a consistent time; to begin to heal his relational trauma, it became evident that he needed a relational repair. An exploratory approach was used, led by Steven, where he was given the opportunity to explore painful emotions within a safe and validating relationship. The key intervention was offering Steven emotional containment rather than the rejection he had experienced in his early life. In doing so, he began to learn that his emotions were valid, they were tolerable and as such, he began to develop a positive sense of self. At times, Steven’s emotions and traumatic material were clearly overwhelming for him, as he disclosed thoughts of wanting to hurt himself. It was crucial for a clear robust safety plan to be developed in collaboration with Steven, where important session content could be shared with the team so that they could support him following a session.

Over time, Steven built positive relationships with all of the residential team, therapist and manager, engaging in education and positive social activities. It was felt by all professionals involved that Steven would flourish in a foster placement and so this was sought. Steven was involved in the process of searching for a placement, creating a poster of his hopes and dreams for a foster family and it was not long before a family was found. Under the supervision of the therapist, the team worked hard to give Steven an experience of a good ending to a relationship, developing a memory book, engaging in positive activities and creating a self-soothe box for Steven to take with him. Within therapy, confusing feelings of anger and loss were also explored and it was positive that Steven could connect with these. It felt important that a solid therapy transition plan was put in place to ensure that Steven’s amazing progress was maintained. Indeed, Steven requested to see his therapist for sessions once he had left Meadows Care to help him settle and contain any anxiety. Positively, Steven’s wishes were honoured by all professionals involved, and currently Steven’s therapist visits fortnightly. He remains positive about his future and aspires to be a professional car valet.

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