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Here at the Emotional Health and Wellbeing Team we use AMBIT (Adaptive Mentalization Based Integrated Treatment) in order work through cases that are determined to be at 'acute risk'.

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We can provide one off informal advice or signpost you to another service that may support the child/young person/families needs. Please contact the Emotional Health and Wellbeing Team should you require this support.

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We would welcome any feedback that you can provide about your experience when working with the Emotional Health and Wellbeing Team.
Thank you.

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The THRIVE Framework conceptualises the mental health and wellbeing needs of children, young people and families into five needs based groupings. Here at the Emotional Health and Wellbeing Team, we use these five groupings in order align our service delivery with that of the framework.

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The THRIVE Framework for system change conceptualises the mental health and wellbeing needs of children, young people and families into five needs based groupings:

Find out more detail about each of the needs based groupings by exploring the different pages in the side bar.
The THRIVE Framework Animation
We invite you to watch the THRIVE Framework for system change animation that was co-produced with children, young people, parents and carers. It is a helpful starting point to understanding the different needs based groupings. Watch the animation by clicking on the image below:

7 Minute Briefings
Another helpful resource to support understanding about the needs based groupings are the 7 Minute Briefings:

To access direct support from the programme team to assist with the implementation of the THRIVE Framework locally, please contact the team at ithriveinfo@tavi-port.nhs.uk.
←Back to About i-THRIVE

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The THRIVE Framework for system change conceptualises the mental health and wellbeing needs of children, young people and families into five needs based

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THRIVE Framework for system change (Wolpert et al., 2019) Animation

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The EHWB team would like social workers to provide the SDQ score of a child/young person on the consult request form where possible. This helps us to assess what intervention is required at the right time whilst considering the young person's emotional needs.

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Overview

The Strengths and Difficulties Questionnaire (SDQ) is a brief emotional and behavioural screening questionnaire for children and young people. The tool can capture the perspective of children and young people, their parents and teachers.

There are currently three versions of the SDQ: a short form, a longer form with an impact supplement (which assesses the impact of difficulties on the child's life) and a follow-up form. The 25 items in the SDQ comprise 5 scales of 5 items each. The scales include:

1) Emotional symptoms subscale

2) Conduct problems subscale

3) Hyperactivity/inattention subscale

4) Peer relationships problem subscale

5) Prosocial behaviour subscale

The SDQ can be used for various purposes, including clinical assessment, evaluation of outcomes, research and screening.

Terms of use

If you are planning to use this measure for the delivery and improvement of health and/or social care, a license to incorporate it into electronic systems can be obtained from NHS Digital. Please note that licenses obtained via this route may be restricted to particular territory (e.g. England, UK). If planning to use the measure outside of England, you may wish to contact NHS Digital to clarify the geographical scope of the licence.

Scales/Subscales

The questionnaire can be completed on paper or online and can all be found on the Youth In Mind website.

Suitability

The SDQ can be completed by children and young people aged 11-17 years old, and a separate version can be completed by those aged 18 and over. The parent and teacher SDQ can be completed by the parent or teacher of CYP aged between 2 and 17 years old.

Clinical experience indicates that the SDQ may be appropriate to use with CYP with mild learning difficulties, but not with more severe learning difficulties (Law & Wolpert, 2014).

Administration

The questionnaire takes between five and ten minutes to complete. All versions of the questionnaire can be given to the appropriate respondent to complete themselves.

Alternatively, in order to ensure that each item is understood by the respondent, or to gain additional information about each response, the questionnaires can be administered directly by the clinician who can ask follow-up questions.

Working remotely with SDQ

Paper versions may be downloaded and subsequently photocopied without charge by individuals or non-profit organisations provided they are not making any charge to families. Users are not permitted to create or distribute electronic versions for any purpose without prior authorisation from youthinmind. If you are interested in making translations or creating electronic versions youMUSTfirst contactyouthinmind@gmail.com.

SDQplusassessments ( https://sdqscore.org/sdqplus/) can reduce physical contact and allow those working remotely to continue providing mental health assessment, monitoring and analysis. The closely related web browser application SDQblockchainallows usingSDQplusfor cohorts of individuals (e.g., groups, class of students, client or patient list). The new self-entered assessments of SDQplus each cost US$1.00. They are email-able and provide reports (PDF included) and software tools in the fee.

Scoring

Assisted Scoring: If CYP, parents or teachers fill out the SDQ online, the Youth in Mind website produces a technical and readable report with a description of the scores for a small cost.

Manual Scoring: Paper versions of the SDQ can be scored by following the instructions found on the SDQ website.

Interpretation

Assisted: After entering paper versions of the SDQ on the SDQ website, a report designed for professionals will then be generated.

If CYP, parents or teachers fill out the SDQ online, the Youth in Mind website produces instant feedback reports including a technical report designed for professionals as well as a readable report with a description of the scores, the level of concern, an overall impression as well as suggestions about what to do if the child or young person, their parent/teacher still has concerns.

Manual: Instructions for scoring the SDQ manually can be found on the SDQ scoring website and instructions for interpreting the SDQ when scored by hand can be found . Instructions in other languages are also available .

Psychometric properties

Internal consistency
The degree to which similar items within a scale correlate with each other.

Research on the reliability of the SDQ has produced mixed results. Some articles say the SDQ exhibits strong internal consistency (Yao et al., 2009), some say the SDQ shows satisfactory internal consistency (Goodman, 2001) and others say there are concerns regarding the reliability of the subscales, with most subscales showing low internal consistency. It has been suggested that the SDQ total difficulties score should just be used for screening purposes (Mieloo et al., 2012).

Test-retest reliability
Degree to which the same respondents have the same score after period of time when trait shouldn't have changed.

SDQ showed moderate test-retest reliability (Yao et al., 2009).

Concurrent validity

Correlation of the measure with others measuring same concept.

SDQ shows good concurrent validity (Muris, Meesters & van den Berg, 2003).

Discriminant validity
Lack of correlation with opposite concepts.

SDQ showed good discriminant validity (Lundh, Wangby-Lundh & Bjarehed, 2008).

Translation

The SDQ is one of the most widely and internationally used measure of child mental health and has been translated into more than 80 languages. The English and translated versions are available here. Information on normative SDQ data from the United Kingdom, Australia, Denmark, Finland, Italy, Germany, Japan, Spain, Sweden and the United States can be

Useful resources

More information on the SDQ can be found online, together with downloadable questionnaires and scoring instructions.

References

Goodman. R. (2001). Psychometric properties of the strengths and difficulties questionnaire. Journal of the American Academy of Child and Adolescent Psychiatry, 40 (11), 1337-1345.

Law, D., & Wolpert, M. (2014). Guide to using outcomes and feedback tools with children, young people and families. UK: Press CAMHS.

Lundh, L.G., Wangby-Lundh, M., & Bjarehed, J. (2008). Self reported emotional and behavioral problems in Swedish 14 to 15-year-old adolescents: A study with the self-report version of the Strengths and Difficulties Questionnaire. Scandinavian Journal of Psychology, 49, 523-532.

Mieloo, C., Raat, H., van Oort, F., Bevaart, F., Vogel, I., Donker, M., & Jansen, W. (2012). Validity and reliability of the strengths and difficulties questionnaire in 5-6 year olds: Differences by gender or parental education. PLoS One, 7 (5), 1-8.

Muris, P., Meesters, C., & van den Berg, F. (2003). The Strengths and Difficulties Questionnaire (SDQ): Further evidence for its reliability and validity in a community sample of Dutch children and adolescents. European Child and Adolescent Psychiatry, 12 (1), 1-8.

Yao, S., Zhang, C., Zhu, X., Jing, X., McWhinnie, C. M., & Abela, J. R. Z. (2009). Measuring Adolescent Psychopathology: Psychometric Properties of the Self-Report Strengths and Difficulties Questionnaire in a sample of Chinese adolescents. Journal of Adolescent Health, 45, 55-62.

Hall, C., Guo, B., Valentine, A., Groom, M., Daley, D., Sayal, K., Hollis, C. (2019). The validity of the Strengths and Difficulties Questionnaire (SDQ) for children with ADHD symptoms. US National Library of MedicineNational Institutes of Health

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Strengths and Difficulties Questionnaire (SDQ)

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The Strengths and Difficulties Questionnaire (SDQ) is a brief emotional and behavioural screening questionnaire for children and young people.

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This video encompasses and underpins the ethos of the work of our team. The EHWB practitioners strive to bridge the gap between the impact of attachment, trauma and relational health

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Childhood Trauma and the Brain | UK Trauma Council

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Learn from the experts at our free webinar Childhood Trauma, War and Conflict taking place 4th December. Register now!

More than one in three children and young people are exposed to at least one potentially traumatic event by age 18.¹ The right support can make a substantial difference to the extent that traumatic events impact on their lives.

The UK Trauma Council (UKTC) creates evidence-based resources to improve professionals and carers' understanding of the nature and impact of trauma. We aim to better equip all those supporting children and young people exposed to trauma.

¹Reference: Lewis, S. J., Arseneault, L., Caspi, A., Fisher, H. L., Matthews, T., Moffitt, T. E., Odgers, C. L., Stahl, D., Teng, J. Y., & Danese, A. (2019). The epidemiology of trauma and post-traumatic stress disorder in a representative cohort of young people in England and Wales. The Lancet Psychiatry, 6(3), 247-256.

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Creating a world that nurtures and protects children and young people following trauma

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The UK Trauma Council's mission is to radically improve the help children and young people receive across the UK following traumatic events and experiences.

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UKTC-ComplexTrauma-Principles.pdf

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Immediate help for child sexual abuse

If you have noticed signs, or are worried that a child may have, or is currently being sexually abused, then it's important to take action.

Here are organisations you can contact who can help protect the child, so you can be reassured that you are doing the right thing.

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If you have noticed signs, or are worried that a child may have, or is currently being sexually abused, then it's important to take action. Here are organisations you can contact who can help protect the child, so you can be reassured that you are doing the right thing.

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charity bereavement child death grief loss baby stillbirth miscarriage suicide young people parents

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We help children, young people, parents, and families to rebuild their lives when a child grieves or when a child dies.

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Cumberland:
Barbara Turnbull (Practitioner)
Jude Forster (Practitioner)
Talia McMillan (Practitioner)
Wendy Evans (Practitioner)
ehwbnorth@cumbria.gov.uk

Westmorland & Furness
Jenny Lofthouse (Practitioner)
Laura Hopkins (Practitioner)
Zoe Heathcock (Practitioner)
ehwbsouth@cumbria.gov.uk

Team Manager
Sean Twomey
sean.twomey@cumbria.gov.uk
ehwb@cumbria.gov.uk

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Welcome to Beacon House

Beacon House is a specialist, innovative and creative therapeutic service for young people, families and adults. With a special interest in working with individuals of all ages who have experienced trauma and loss, we are passionate about offering safe and effective therapies in a way that enables people to re-build their lives following stress and adversity. We also take pride in supporting individuals and teams to develop their trauma informed practice through training, supervision and consultation.

Our Cuckfield Clinic periodically closes to new child and adult referrals to prevent long waiting times. Please do get in touch with us to find out if we have spaces currently.

We have some specific capacity for child and family referrals at our Chichester Clinic. Please do get in touch with us to find out if we are able to allocate your referral at this time.

Find out more about us

Our Services

How can Beacon House help you?

Educational Psychology

Get In Touch

Get in touch today to find out more.

We have clinics in Cuckfield and in Chichester.

Please note: We are not able to accept any walk-ins. All meetings are by appointment only. Office hours are: Monday to Friday 9am to 5pm.

To ask any questions, please contact us on admin@beaconhouse.org.uk

We use cookies to help improve your experience of this website. By using this website, you agree to accept cookies from this site.

Accept

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Beacon House | Chartered Clinical Psychologist Trauma Specialist

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Home - Therapeutic Life Story Work International (TLSWi)

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Anna Freud National Centre for Children and Families

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Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust

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Child and Adolescent Mental Health Service (CAMHS) West Cumbria - CNTW254

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CAMHS help children and young people who are finding it hard to cope with everyday life because of difficult feelings, thoughts, behaviour or relationships. The Child and Adolescent Mental Health Service (CAMHS) and Barnardo's My Time Service provides services to all children and young people aged 0-18 years living in North Cumbria who are experiencing [...]

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ABOUT CTA

With a long history of working with high-risk children through education, research and the dissemination of innovation, CTA's insight remains online as a shared resource.

​

During its long tenure, a major activity of the CTA was to translate emerging findings about the human brain and child development into practical implications for the ways we nurture, protect, enrich, educate and heal children. The "translational neuroscience" work of the CTA resulted in a range of innovative programs in therapeutic, child protection and educational systems.

Etienne Wenger, a leading social learning theorist, defines communities of practice as groups of people who share a concern or a passion for something they do and learn how to do it better as they interact regularly. This model has been discussed as optimal for promoting social change in our current complex world. The CTA worked to create these collaborative working relationships between organizations and individuals to most effectively promote positive change for children.

​

The CTA started as a typical center of excellence in an academic setting, initially at The University of Chicago and later at Baylor College of Medicine. Over time however, it was clear that the problems of abuse and neglect in children were much more complex and multi-dimensional in ways that our medical model was unable to address.

​

A medical school centered work group investigating and solving physiological problems in humans makes sense. Solving problems which involve parenting, education, the law, child protection systems, mental health, law enforcement and a host of related systems across every professional discipline is more challenging. In response to this challenge we created this collaborative, interdisciplinary virtual Center of Excellence, The ChildTrauma Academy.​

THE HISTORY OF OUR MISSION & STRATEGY

The ChildTrauma Academy set out to help improve the lives of traumatized and maltreated children - by improving the systems that educate, nurture, protect and enrich these children. We focused our efforts on education, program consultation, research and disseminating innovations in the field.

Essential to this process was the collaboration of all sectors of society. As such, we engaged in a continuous process of identifying key partners, drawn from academia, the corporate world, private organizations and public sector systems. While each partnership had a distinct focus- identifying best practices in child protection, evaluating the latest research in child development, defining optimal ways to provide resources to parents or creating a novel therapeutic approach with traumatized children- all engaged in the continuous process of testing, refining and distributing innovations that can improve children's lives.

OUR EVOLUTION

In late 2018, the Neurosequential Network was formed to develop a whole host of online trainings for front-line professionals working in education, mental health, coaching, early childhood and research. The new entity continues to serve professionals from around the world at www.neurosequential.com.

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ABOUT CTA With a long history of working with high-risk children through education, research and the dissemination of innovation, CTA's insight remains online as a shared resource. ​ During its long tenure, a major activity of the CTA was to translate emerging findings about the human brain and child development into practical implications for the ways we nurture, protect, enrich, educate and heal children.

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The adoption support fund ( ASF) provides funds to local authorities and regional adoption agencies ( RAAs) to pay for essential therapeutic services for eligible adoptive and special guardianship order ( SGO) families.

The ASF will continue to offer support to adoptive and eligible special guardianship families up to March 2025.

The ASF model is based on the existing statutory framework for the assessment of adoption support or SGO support needs and the provision of support services.

This guide is for local authorities and RAAs so they can apply for ASF funding.

For more information on support available to families, visit:

Apply to the adoption support fund

Contact the ASF fund manager or your adoption support service adviser if you:

need a new account

need to register someone new on the system

want to inform the ASF of any new staff or other changes

Funding eligibility

To be eligible for funding, local authorities and RAAs must apply to the ASF within 3 months of assessing a family's support needs.

The ASF is available for children and young people up to and including the age of 21, or 25 with an education, health and care plan, who:

are living (placed) with a family in England while waiting for adoption

were adopted from local authority care in England, Wales, Scotland or Northern Ireland and live in England

were adopted from abroad and live in England with a recognised adoption status

were in care before an SGO was made

left care under a special guardianship order that was subsequently changed to an adoption order, or vice versa

are under a residency order or child arrangement order (CAO) and were previously looked after

were previously looked after but where the adoption, special guardianship, residency or CAO placement has broken down, irrespective of any reconciliation plans

You should make a funding application before therapy starts. We will only consider retrospective applications in exceptional circumstances. This includes:

the need for an urgent intervention due to the family situation

an unexpected absence of approving local authority staff when the funding is commissioned

We will not consider administrative and clerical errors, or delays caused by organisational restructuring as exceptional.

Further guidance for local authorities about the different care orders is available.

Maximum funding allocations for each child

Until the end of March 2025, the ASF will have 2 fair access limits:

£2,500 per child per year for specialist assessment

£5,000 per child per year for therapy

The majority of applications to the fund fall within these limits. In exceptional cases, where there is an urgent need for higher cost support, local authorities or RAAs are asked to match-fund applications.

Criteria for match-funding:

a high risk of adoption breakdown without high cost support

local authorities and RAAs dealing with an unusually high number of complex cases that they cannot afford to fund without additional support from the ASF

additional funding would help to progress hard to place adoptions

a lack of available, affordable therapeutic support means higher cost provision is required

The ASF can fund up to 50% of the amount above the fair access limits, up to a maximum of £30,000 per child including the fair access limits.

How families access ASF support

The local authority or RAA that places a child with a family is responsible for assessing that family's support needs for 3 years after the order is made. After 3 years, the responsibility lies with the local authority or RAA where the family lives, if they have moved.

Families apply to the relevant local authority or RAA, which will assess their needs.

Local authorities and RAAs will:

assess the family and consider if therapeutic support is needed

decide on the type required and if it is eligible for payments from the ASF

apply directly to the ASF

purchase the support from their own list of approved suppliers when the ASF approves funding

Complaints

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Local authorities and regional adoption agencies (RAAs) can apply for therapeutic funding for eligible adoptive and special guardianship order families.

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Mental Health advice, support, information

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Mental Health advice, support, information

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Bing Videos

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Center on the Developing Child at Harvard University

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How Early Childhood Experiences Affect Lifelong Health and Learning

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The Repair of Early Trauma: A Bottom Up Approach

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The Shield of Shame: what is it & how can we help? (learningandwellbeing.org)

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For children who experience sensitive, responsive caregiving, shame is a feeling that is experienced at a young age. These feelings might be triggered when the child is told off and through this, they help teach children about behaviours that are deemed acceptable and unacceptable.

As children get older, through the support of their caregiver, their understanding develops and feelings of shame evolve into feelings of guilt. In contrast to shame, guilt can be motivating to repair a situation where distress has been caused to others. Through feelings of guilt, confidence and self-esteem can be developed based on the realisation that the child can successfully correct their mistakes.

But what if a child hasn't experienced sensitive, responsive caregiving?

In these cases, children can be stuck in a state of shame. Through their early experiences, they may have developed an inherently negative self-concept, believing that they are bad and unlovable. Feelings of shame can be very painful to experience and so children may utilise certain behaviour strategies in order to protect themselves from these feelings.

Deny - lying is a strategy for denying any behaviours that might reflect the 'badness' of the child. Lying can also create conflict which might maintain emotional distance between the child and their caregivers.

Blame - by blaming others, attention is deflected away from the child. This might reduce feelings of anxiety that are experienced if the child believes others are evaluating them and might the expose their 'badness'.

Minimise - similar to lying, minimising their role in a behaviour can reduce feelings of shame. Equally, avoiding apologising can also minimise a child's role in relation to a behaviour or situation.

Rage - a child experiencing shame might display heightened anger or aggression. For them, these emotions may be considered far less painful than experiencing shame and are therefore preferable.

How do we respond to a child who experiences shame?

Firstly, it is important to recognise that 'traditional' behavioural approaches will not work and may further feed into an ongoing cycle of shame.

DON'T repeatedly ask whether they did something - this will increase their use of their 'shield of shame' responses.

DON'T become angry yourself - they are likely to mirror this emotion.

DON'T tell them they are 'bad' or 'naughty' - this will reinforce their self-concept of being inherently bad.

Instead, respond to situations with curiosity, acceptance and empathy.

DO prioritise connection before correction - rather than immediately reprimanding the child, demonstrate compassion and empathy in order to connect with the child.

DO implement meaningful consequences - help the child learn ways of rectifying the situation.

DO express unconditional positive regard - provide reassurance to the child that you continue to like them (although you may not like the way they have behaved in this situation).

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The Shield of Shame: what is it & how can we help?

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For children who experience sensitive, responsive caregiving, shame is a feeling that is experienced at a young age. These feelings might be triggered when the child is told off and through this, they help teach children about behaviours that are deemed acceptable and unacceptable.

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Richard Rose (Therapeutic Life Story Work) - Serve and Return demonstration - Bing video

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Zoe Heathcock (EHWB Practitioner) attending the AIM study group in London - April 2023.

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MacKillop Family Services South Melbourne

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For a description of one of the techniques used in the AMBIT support sessions (RMCS) please watch the video attached. This is called 'thinking together'.

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Ambit - "Thinking Together" - Description

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Cumberland Annual Public Health Report 2024

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Cumberland Annual Public Health Report 2024

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The Boy who was Raised as a Dog by Dr. Bruce Perry

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“The research has shown us that TLSW strengthens the attachment of a child to a primary care giver, which then supports improvement in peer relationships, education outcomes, reduction in trauma symptoms experienced, reduction of high - risk behaviours, improves mental health and wellbeing and overall, a greater sense of identity”

Dr James Lucas (2022)

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What Happened to You? By Dr. Bruce Perry and Oprah Winfrey

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Life Story Therapy with Traumatized Children. A Model for Practice. By Richard Rose

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PACE - A Therapeutic Approach - Help Children Live Better

The EHWB team use PACE to underpin direct work being completed with a child or young person (i.e. therapeutic life story work or attachment and trauma work). Please see link for more information.

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North Cumbria Mental Health Support Team (padlet.com)

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If you are concerned about a child please seek appropriate support from the Local Safeguarding Team, the child's GP or local A&E department. Other support is also available below:

Cumbria Safeguarding Hub: For your local Safeguarding Team please contact the Safeguarding Hub
Tel: 0333 240 1727
www.cumbriasafeguardingchildren.co.uk

Children & Adolescent Mental Health Service (CAMHS)
01900 705800

CAMHS Crisis for imminent concerns regarding a child's risk to self
0300 9015 123

PAPYRUS HOPELINEUK: (prevention of young suicide)
Tel: 0800 068 4141 Text 07786209697
https://papyrus-uk.org/hopelineuk/

Childline:
Tel: 0800 1111
www.childline.org.uk

Samaritans:
Tel: 116 123
www.samaritans.org

If you have immediate concerns about a child or young person being at risk of significant harm, then dial 999

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Therapeutic Crisis Intervention (TCI)

Trauma Informed Practice

Attachment and Trauma Informed Care

Neuro-Sequential Model of Therapeutics (NMT)

Secure Base Model

Emotion Coaching

Adaptive Mentalization Based Integrative Treatment (AMBIT)

Trauma Informed Supervision

Narrative Practice Workshops

Direct Work Practice Clinics

SDQ Workshops

Therapeutic Life Story Work Group Supervision

Padlet Workshops

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An introduction to the Secure Base model - Groups and Centres (uea.ac.uk)

The EHWB use the SBM model (alongside many others) and this will often to be referred to during our involvement.

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Emotional Health and Wellbeing Team Training Calendar 07092023

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Words and pictures is used to explain what has happened or what is going to happen to a child or young person that we are supporting. The EHWB Team often request that this has been completed prior to moving on to the next step ('getting help') i.e. a consultation

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Words and Pictures Practice Guidance (1)

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Words and Pictures Commonly asked Questions

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Bank of Questions for Words and Pictures

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Sean Twomey (EHWB Team Manager) representing the Emotional Health and Wellbeing Team at the AMBIT International Study Group in Dublin - September 2024

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When using AMBIT we use the emotional thermometer to help keep us in the green zone to remain curious, flexible and reflective when mentalizing the child and their network. It can be helpful to check in how we are feeling before and at the end of the session

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This has been referred to as the "Egg and Triangle"

It is a simple "back-of-an-envelope tool":

Important practice points in using this tool, which simplifies and adapts Maslow's HierarchyOfNeed, are as follows:

A worker may develop and present their "first efforts" either in real time, during a session or between sessions, but crucially the point is to present these to the client:

"what I have heard and understood from you, about what you need and want..." but also

"...what you should know about what the wider system expects of me."

i.e. The system expects proper Governance and Managing Risk by all workers

Which is particularly focused on ensuring basic safety.

For the worker to get quickly to the point where they are able to share this "first effort" with their client

When sharing a first effort to articulate one's clients story and one's aims and goals, use

Tentativeness

Hesitancy

Self-deprecating humour

Invitations to "Help me get this much more accurate than I can on my own, please!"

Understand that this exercise is all about Broadcasting Intentions!

If these do not agree with those of your client, see below.

Go to this link to download this in PDF format, or just use the back of an envelope!

There are frequently Individual Differences and Disagreements that separate the worker's intentions and plans and those of the client. Workers come with some pre-ordained priorities, and they are inevitably (and quite properly) part of a system that is larger than them, and to which they are answerable.

The foundation of any work from the professional's point of view is safety - without which any further, more elaborate building work would be liable to crumble. In Broadcasting Intentions about our work and our ideas about Aims and Goals for the work ahead, it is helpful for our clients to hear this stated in simple terms:

"Above all, it's worth saying that everything I do is first of all about helping things to be safer... that is my job, and its worth understanding that this is absolutely at the centre of how I must work. I guess the reason is that if we can get things safe enough then you and/or the people around you don't need to spend so much time worrying, and can start to spend more time being imaginative, and planning, and experimenting with new ways to work things out..."

From the client's point of view Safety may be a shared foundation priority, but they may have other "Needs" aside from this that they would feel need to be the starting point (that if their worker did not show them they had recognised would leave them feeling misunderstood, or ignored.

"It's also important for you to know that I DON'T KNOW exactly what YOU see as the things that you really need right away - but I really want to get these things straight in my own head, as I am pretty sure that if you think I haven't got a clue about what YOU feel you really need right now, then I'm not going to seem very helpful to you!"

Thereafter (once basic safety is assured with the implementation of a reasonable/defensible safety plan) the worker may be focused on developing shared ideas about what "Recovery" would look like for the client(s), and devising the means by which to get there. Likewise, the client may have particular "Wants" that may or may not overlap with the intentions of the worker.

Finally (at the top of the triangles in the "hierarchy") the"Why?" marks "the point of all this effort". Now, this kind of discovery-focused work (as opposed to recovery-focused work) may be seen as the "icing on the cake" for a worker, but in developing and working towards Agreeing Waymarks with a young person, it may be much easier to find common ground in the more distant wondering about longer term Aims than it is to agree on more specific Goals, or detailed plans.

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Active Planning Map: AMBIT - CORE CONTENT of the AMBIT manualfrom the Anna Freud National Centre for Children and Families

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This has been referred to as the "Egg and Triangle" It is a simple "back-of-an-envelope tool": Important practice points in using this tool, which simplifies and adapts Maslow's HierarchyOfNeed, are as follows: A worker may develop and present their "first efforts" either in real time, during a session or between sessions, but crucially the point is to present these to the client: "what I have heard and understood from you, about what you need and want..."

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Please see this SDQ padlet for more information (i.e. what an SDQ is, the importance of SDQ and how to complete the questionnaire).