Psychological formulation is at the heart of our therapeutic care. In taking a developmental perspective, we will analyse key historical, biological, psychological, social and cultural factors that have most likely shaped and continue to maintain a young person’s difficult behaviour, including protective factors relevant to a young person and their social context. Our comprehensive formulations are developed in collaboration with the young person, their families and colleagues across Health, Education and Care. By the end of their stay, we provide each young person with a ‘therapeutic letter’, which encompasses their formulation and outlines recommendations for therapeutic support on their move back into the community.
When young people first arrive with us, working formulations are prepared by CAMHS specifically for the staff team, which are based on referral information and initial observations and conversations with the young person. This document helps the staff team begin to understand the behaviours a young person presents with and the subsequent best ways of meeting their needs to help them make positive steps forward.
In addition, CAMHS facilitates a weekly Team Formulation Meeting for our Residential Support Workers (RSWs) to explore, in-depth, why a young person may be presenting as they are and how their life story can help us to understand their on-going needs. It is an opportunity for reflective conversations about how we impact on the young people, how they impact on us and how we can remain open and attuned to their emotional world.
CAMHS also provides clinical supervision to individual workers, often the key-worker, to support their therapeutic interactions with their key-child. Where clinically indicated, the CAMHS team will engage in their own direct therapeutic work with young people, although the emphasis remains on the joint development of psychological understanding of a young person’s needs across the whole staff group.