A tkinson Secure Children ’ s Home in Devon supports young people accommodated under section 25 of the Children Act ( 1989 ). It ’ s aimed at young people with a history or likelihood of absconding , who are likely to suffer significant harm , or who present a risk to themselves or others .

These young people have frequently experienced trauma . The Royal College of Paediatrics and Child Health ’ s ‘ Healthcare standards for children and young people in secure settings ’ recognise that the children and young people cared for in the secure estate are often some of our society ’ s most vulnerable .

These are young people with high levels of complex needs , who become completely dependent on the system and those professionals working within it ( RCPCH 2019 ).

The standards also highlight the importance of supporting staff to be emotionally resilient and remain child-centred when facing behaviour that challenges . An important way of supporting staff is making relevant training available to staff across the setting .

The Just Right State programme

The effects of early trauma and deprivation on sensory processing and emotional regulation are well documented and can lead to children having difficulties with engagement with others , the formation of secure ( or more secure ) attachments , knowing how to play and interact with others and an inability to differentiate between threatening and non-threatening sensations , resulting in hypervigilance and persistent fear .

Adults supporting these adolescents are at a high risk of experiencing vicarious trauma , with Baginsky ( 2013 ) and the Health and Safety Executive ( 2014 ) stating that those involved in direct work with children and families are at a high risk of work-related stress and burnout , which impacts on incidence of sickness and retention of staff .

The Just Right State ( JRS ) programme was developed by Éadaoin Bhreathnach , an expert occupational therapist based in Northern Ireland . It is based on sensory , attachment and emotional regulation theories , designed to support the use of strategies to support self-regulation and coregulation .

Its core aim is to enable individuals to regulate their emotional states and facilitate reflective functioning . It enables this by embedding regulation strategies into daily occupations , recognising that food , daily care routines , our homes and choice of leisure pursuits all deeply impact on our emotional

Trained staff reported a greater awareness of their own self-regulation needs , while it also enabled them to be more aware of the impact of these sensory processing patterns on the young people in their care .”

states and behaviour . Regulation in turn facilitates reflective functioning .

The neurosequential nature of the programme supports the ability to engage in higher level thinking and the processing of trauma experiences . In the programme the focus is on :

• Regulation of arousal states and its impact on functioning and activities of daily living .

• Providing practical advice and tools .

• Empowering individuals to self-regulate .

• Increasing the ability to process trauma .

• Enriched environment provision that supports regulation and greater engagement in everyday activities ( West 2020 ).

Additional resources to support the protocol include a pack for professionals that provides a step-by-step guide to preparing children for narrative work and emotional regulation .

We implemented the programme in the secure children ’ s home to support staff in exploring and using regulating strategies to further develop resilience , support self-regulation and co-regulation for themselves and the young people .

It was hoped this would help staff to remain emotionally available to the young people at the home , and to buffer the effects and potential for blocked care and secondary trauma , which are significant risk factors for those working with children and young people who have experienced complex developmental trauma .

By embedding regulation into daily activities , including the use of sensory environments , food and sensory activities , it introduces additional ways to support the young people in managing emotional dysregulation and distress through a sensory regulation-based lens .

Implementation

We profiled each individual team member , to support greater understanding of their own selfregulation and enriched environment needs , as well

May 2023 OTnews 43

OTnews May 2023 | Page 43

Children ' s services

Trained staff reported a greater awareness of their own self-regulation needs , while it also enabled them to be more aware of the impact of these sensory processing patterns on the young people in their care .”

Children ' s services

A tkinson Secure Children ’ s Home in Devon supports young people accommodated under section 25 of the Children Act ( 1989 ). It ’ s aimed at young people with a history or likelihood of absconding , who are likely to suffer significant harm , or who present a risk to themselves or others .

Trained staff reported a greater awareness of their own self-regulation needs , while it also enabled them to be more aware of the impact of these sensory processing patterns on the young people in their care .”