Category Archive: On and Off the Ward Ideas

The Secure Base Model

A secure base is at the heart of any successful caregiving environment – whether within the birth family, in foster care, residential care or adoption. A secure base is provided through a relationship with one or more caregivers who offer a reliable base from which to explore and a safe haven for reassurance when there are difficulties. Thus a secure base promotes security, confidence, competence and resilience.

 

 

The Secure Base Model has been developed through a range of research and practice dissemination projects led by Gillian Schofield and Mary Beek in the Centre for Research on Children and Families at the University of East Anglia.

The Secure Base Model is drawn from attachment theory, and adapted to include an additional element, that of family membership, for children who are separated from their birth families. The model proposes five dimensions of caregiving, each of which is associated with a corresponding developmental benefit for the child. The dimensions overlap and combine with each other to create a secure base for the child, as represented below:

 

 

From: https://www.uea.ac.uk/providingasecurebase/home

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“Some parents and carers wanted more of a dialogue with units throughout a young person’s stay, because of the worry created by not knowing what is happening. Where this information was given, it was greatly appreciated, and went some way to allaying the anxiety parents/carers felt.” (See YoungMinds’ Where Next 2)

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Visits from friends and family are very important. We have daily visiting times focused around the therapeutic programme but we can be flexible with these times if needed.

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Some young people are particularly shy and find group settings difficult. In which case, staff facilitate some activities on a one-to-one basis until they feel more confident.

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Based on the ward our Assessment and Adolescent Outreach Team is available to carry out crisis interventions, help prevent unnecessary admissions and assist the discharge planning process. If young people experience difficulty during the transition from inpatient to community care we can provide outreach without the need for them to return to hospital.

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Strong links with community agencies and in particular with Tier 3 – an outward looking treatment ethos – need to be worked on. Similarly, in-patient staff need to be encouraged to think about what they can offer to help improve support to young people on discharge. (See YoungMinds’ Where Next)

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We place great importance on partnerships with each young person and their family, referrers and other professionals. Working together, we set out clear aims and objectives for each young person, allowing us to identify when a young person may be ready for discharge to the care of community services.

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“I think it’s about working in partnership, in true partnership, not just saying it, and working with families in communities, it’s not about providing services in localities, in GP surgeries or in a clinic, it’s about empowering and working with the community in a multi-agency way.” Unit staff (See YoungMinds’ Where Next 2)

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Young people need the help and advice of a wide variety of sources at times of crisis. There are voluntary, statutory agencies as well as relatives or friends who they find easier to approach than parents. So we can sign post them to these sources when preparing discharge.

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Clear information about sources of help, and mental health problems is needed for young people and families to give them more opportunity to help themselves. (See YoungMinds’ Where Next)

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