“Understanding my story”: young person involvement in formulation

Abstract

Purpose The SECURE STAIRS framework has promoted young person involvement as a key feature of innovative service provision. In the North East of England, Secure Children’s Homes (SCHs) have pioneered young person involvement in team formulation. Young people have also led on the development of formulation materials through a young person involvement project. Young people’s attendance at team formulation meetings has become embedded. These service developments have also begun to expand across broader SCHs, Secure Training Centres (STCs) and Young Offender Institutions (YOIs) and reflect the national impact of such pioneering developments. There is a notable lack of research examining the impact of young person involvement in formulation. The purpose of this study is to elucidate this area. Design/methodology/approach Between April and August 2019, there were 86 staff attendances at formulation meetings where young people were present across two SCHs in the North East of England. Findings Paired samples t-tests indicated staff-reported significant post-formulation improvements across all domains measured including knowledge [t(85) = 11.38, p < 0.001]; confidence working with the young person [t(85) = 5.87, p < 0.001]; motivation [t(85) = 3.58, p < 0.001]; understanding [t(85) = 9.03, p < 0.001]; and satisfaction with the treatment plan [t(85) = 8.63, p < 0.001]. Research limitations/implications Implications of findings are discussed and further developments outlined. Practical implications Young people attending team formulation is a new and evolving area, and to the best of the authors’ knowledge, there is no existing research evaluating this area. The current findings suggest that staff knowledge, motivation, confidence and satisfaction with the treatment plan is improved following attendance at team formulation where the young person is present and actively participating. Young people’s participation and involvement is central to planning, developing and progressing meaningful provision within children and young people secure provision. Social implications Involving children and young people in decision-making, service development and evaluation are also key components of ensuring the voice of young people is central in our minds. It also supports empowering the young people we work with. Young people and their journey should always be at the heart of what we do. Originality/value Young people attending team formulation is a new and evolving area, and to the best of the authors’ knowledge, there is no existing research evaluating this area. This is the first study of its type evaluating formulation directions within the SECURE STAIRS framework.

The SECURE STAIRS framework: preliminary evaluation of the impact on therapeutic climate in a secure children’s home (SCH)

“…Previous research has indicated that the formulation-led approach promoted by the SECURE STAIRS framework can enhance staff confidence and knowledge regarding the young people that they are working with, particularly when the young person is present. McKeown et al (2020) found that staff attending young person formulations within a SCH where the young person was present expressed significant improvements in their knowledge, motivation and confidence with supporting the young person, as well as enhanced satisfaction with the treatment plan. The increase in EssenCES scores after the depletion during the pandemic may also have been impacted by the enhanced formulation-led support that was provided during this time, following principles of the SECURE STAIRS framework to enable containment and therapeutic relationships during a time of uncertainty.…”

Reduction in incidents during COVID-19 in a Secure Children’s Home: an opportunity for learning

“…The current findings indicated significantly more psychological formulation and formulation attendees after lockdown; the number of incidents were also significantly negatively associated with the number of formulation meetings. Being a part of team formulation enables staff to recognise and understand potential relational and developmental processes that could be underlying certain behaviours and supports staff teams to develop psychological understanding and strategies to work with the young person (Kustner, 2019; McKeown et al , 2020). Team formulations also provide a reflective space where incidents and challenging behaviour can be explored; developing a shared understanding provides the young person with a consistent approach (Christofides et al , 2012).…”

“…For example, increased case formulation meetings were provided and further reflective practice opportunities were offered to staff. Previous research within the setting has identified that formulation meetings significantly increase staff knowledge, confidence, motivation and understanding of young people (McKeown et al , 2020). Resources promoting mindfulness, sleep hygiene and coping strategies to manage any anxiety originating from the pandemic were distributed for young people within the setting. Technological developments.…”

“…The SECURE STAIRS framework is a whole system approach to integrated care, which is based upon trauma-informed care (Saxe et al , 2007), the Sanctuary Model (Esaki et al , 2013), Enabling Environments initiatives (Haigh et al , 2012) and Psychologically Informed Planned Environments (National Offender Management Service, 2013). The approach also promotes psychological formulation (McKeown et al , 2020; Taylor et al , 2018), which is a multi-disciplinary process where a shared understanding of a person’s journey and difficulties is developed (Division of Clinical Psychology (DCP), 2011). This is underpinned by psychological theory and can help inform intervention and treatment pathways (DCP, 2011).…”

The SECURE STAIRS framework: preliminary evaluation of formulation developments in the Children and Young People’s Secure Estate

“…There is limited research in the domain of young person involvement in formulation. Of limited research that exists, there are indications that young person involvement in the process is helpful (McKeown et al , 2020; Milson and Phillips, 2015). In terms of evaluation of formulation directions, young people involvement in this process is also an important consideration.…”