“You need to know [their] soul, what makes them tick”: residential support workers’ perceptions of their role in a therapeutic setting

As part of a Professional Doctorate in Clinical Psychology, the author of this thesis was particularly interested in exploring the experiences of support workers working in residential children’s care-homes. Paper 1 presents a literature review of nine published studies that investigate the outcomes for residential children’s home staff after being trained in trauma-informed care (TIC). The studies were critically appraised using the Crowe Critical Appraisal Tool (CCAT) and a narrative synthesis was undertaken of the findings. The findings indicate that there are some trends in the effectiveness of training, including improved, attitudes towards TIC, TIC knowledge, understanding of children’s behaviours and emotions, self-reflection skills, and understanding of relationships. Barriers to implementation of training into practice were identified including availability of resources. There is need for more research on the outcomes for staff after TIC training. Paper 2 is an empirical study which used Reflexive Thematic Analysis (RTA) to explore residential children’s home support workers’ perceptions of their role in a therapeutic setting. Findings suggest that these support workers are skilled in their therapeutic work but may benefit from ongoing support from Clinical Psychologists to maintain their confidence and skills in this area. Difficulties with guarding their emotions in their work, and systemic conflicts were identified. These are protected by support from management, with shared debrief and reflection in teams. Suggestions are made for supporting these teams using the clinical consultation already offered by Clinical Psychologists. Future research should look at the understanding of what ‘therapeutic work’ means in care-homes. Paper 3 is an executive summary written as an accessible account of the research for the participants who took part in this research, but can also be used to disseminate findings to those interested in the experiences of residential children’s home support workers and their perceptions of their role in a therapeutic setting, including professionals working with these teams and developing these services.