For children with complex trauma, the out-of-home care sector is more often reactive rather than proactive or preventative. Not many programs exist to provide significant early intervention support, as opposed to waiting for a crisis or placement breakdown to occur.

Placement breakdowns are, unfortunately, common for children and young people who exhibit behaviours that challenge. As the CETC’s recent Submission to the NSW Advocate for Children and Young People outlines, children who experience multiple placements are more likely to experience further emotional, behavioural, physical, and mental health challenges, which increase the likelihood of future placement breakdowns.

Therapeutic Residential Care reforms have been developed to help address this issue for children over 12, but no system to address the complex needs of younger children. Unfortunately, these children under 12 can find themselves in prolonged stays in Alternative Care Arrangements (ACAs), such as in hotels, motels, or Airbnb spaces, often in the care of labour hire agencies.

Recent evaluations of two programs, LINKS and OurSPACE, show that pre-emptive trauma-informed intervention can have an enormous positive impact on children and their carers, preventing crises and placement breakdowns. And that’s not all – these interventions are more cost-effective for the system than reacting to crisis.

At the recent FACSIAR Lunch and Learn event, researchers from LINKS and OurSPACE shared the findings of their evaluation reports, showcasing remarkable improvements in trauma symptoms and relational stability for participating children.

Placement breakdowns are often thought of as being caused by children’s trauma. However, as Dr Joe Tucci speaking for the OurSPACE program observed, this problematically implies that it is on children to “get better”, or to recover from trauma, to avoid placement breakdowns.

Prevention is better than the cure!

What the independent reports for LINKS and OurSPACE show is that prevention and early intervention in out-of-home care placements is crucial to delay or prevent the crisis of further breakdowns of the relationships that should be supporting children. These services were both found to drastically improve outcomes for participating children and young people, including greater relationship permanence and placement stability.

While it might seem expensive to implement such robust therapeutic and relational support to children and young people before they are in a crisis that “proves” they need it, these findings also show that the cost of these programs is far less than the cost of reacting to crisis.

The FACSIAR Economics team estimates the average weighted cost for each placement breakdown is $14,682 per child or young person, and $6,080 for each ROSH report made to Child Protection Helpline (Department of Communities and Justice, 2019). This figure does not include the cost of treating displaced children’s exacerbated emotional, behavioural, and psychological health difficulties, or the ultimate cost to society that children who have faced such disadvantage continue to accumulate once they grow into adults. It also does not include, of course, the emotional cost to everyone involved in the child’s life.

Proactively investing in strengthening children’s support networks to understand and respond therapeutically to trauma benefits everyone. The need for ineffective and costly crisis responses, such as Alternative Care Arrangements, is preventable. It is imperative that the out-of-home care system adopt a child-centred and evidence-based therapeutic care approach to uphold the rights of children and, in turn, benefit from their strengthened connection to their communities.

Resources

• Video: The full captioned recording of FACSIAR’s Lunch and Learn available online – NSW Department of Communities and Justice
• Report: Evaluation Report on the LINKS Trauma Healing Service – Parenting Research Centre
• Report: Evaluation Report on the OurSPACE NSW Specialist Outreach Trauma Therapeutic Support Program – Australian Childhood Foundation
• Policy Submission: Submission to the NSW Advocate for Children and Young People: Special Inquiry: Children and Young People in Alternative Care Arrangements (ACAs) – Centre for Excellence in Therapeutic Care

References

Department of Communities and Justice. (2019). Benefit per person per lifetime calculation for a reduction in out-of-home care entry and report of risk of significant harm. FACSIAR, NSW Department of Communities and Justice.