Lighthouse Model of Care
A therapeutic approach to caring for kids who have experienced trauma
Young people with histories of trauma often struggle with emotional and social difficulties, and complex mental health needs. Traumatic experiences can have a profoundly negative effect on psychosocial, cognitive and physiological development. Many traumatised young people develop a sense of the world as being unsafe, unjust, untrustworthy and unpredictable. This can lead to problems in forming healthy, trusting relationships and having core human needs met. Lighthouse's Therapuetic Model of Care (LMC) is a treatment approach that sees, recognises and responds to these complex features in young people.
The LMC is a holistic therapeutic treatment program which draws on over 60 years of empirical research into human development across the fields of psychology, psychiatry, trauma and neurobiology. The LMC integrates trauma-informed practice, attachment theory and contemporary psychoanalytic principles to create a holistic therapeutic treatment environment in which the mental health, wellbeing and social and emotional capacities of young people in Lighthouse homes are developed and enriched. More broadly, the LMC also informs and guides decision making throughout the organisation. For example, trauma informed practice does not mean simply applying these principles to our young people in isolation, but building and maintaining an organisational culture that promotes psychological safety and wellness of all its members.
Lighthouse also places significant importance on the role of organisational structure as a source of containment for staff and young people. Line management structures operate to hold and contain staff and young people by providing clear levels of responsibility both, operationally and clinically.
Trauma informed practice: Trauma informed practice in supporting young people heal from past traumatic experiences. Developmental trauma describes the effect of neglect, chronic abuse, or other harsh adversity during the early years of a child’s life affecting the child’s neurological, psychological and emotional development and attachment. A failure to form secure attachments early in life can have long-lasting and negative relational and behavioural impacts. Recognising these impacts, Lighthouse places an emphasis on re-establishing a young person’s physical and emotional safety, and on the restoration of the young person’s capacity for intentionality, agency, and hope. The LMC places particular importance on the provision of a caring network of respectful and emotionally skilled and reflective professionals, who are able to empathically feel their way into the young person’s shoes, and views reflective practice as a core element of what it means to be “trauma informed”.
Attatchment theory: The LMC is informed by attachment theory and the significant body of research into the social, emotional and cognitive consequences related to repeated experiences of attachment disruption. Asecure and supportive reflective practice at each level of the young person’s Lighthouse community forms a cornerstone of the LMC and is an organisational wide commitment from the top down. This multi-tiered approach to facilitating reflective function and attachment security ensures that each young person is surrounded by a network of primary attachment figures, attuned carers and therapeutic specialists who themselves are held in a secure and safe relational environment.
Established and contemporary psychoanalystic theories of emotional development: Contemporary psychoanalytic principles are a central feature of our approach. For example, while acknowledging the neurobiological impacts of trauma on the developing mind, trauma may also be understood as a severe psychic wound – a breakdown of mental structures that leaves the young person vulnerable to intense and overwhelming anxieties. Through the failure of ‘good objects’ to provide protection when it was most required, primitive fears impulses and anxieties – including fear of annihilation – may be unconsciously activated in the present, often in response to ‘seemingly’ benign stimuli. The process may be understood in part as the young person transforming and transposing a past extraordinary rupture onto something, or someone, familiar and recognisable. Psychoanalytic thinking pays attention to this unconscious process (often expressed through behaviour) and helps bring some of these processes into the conscious mind where they can be processed
Our LMC's four key domains
The home is the heart of all of our programs. Each home is staffed 24/7 by therapeutic Carers who play a critical role in supporting the young parent and their baby to develop and grow healthily. Lighthouse homes are designed to be safe, warm and nurturing. Lighthouse aims to replicate a family home environment, providing the young person with a sense of permanence and stability, and a place they feel they belong. Each of our homes are thoughtfully designed for our children and young people - encouraging growth, development, and a means of balancing the need for support with privacy. Privacy is of the utmost importance in ensuring that both the young parent and Carers feel comfortable and safe in their home. Bedrooms do not have locks on their doors, replicating a typical family home rather than an institutional facility. This enables the young person to build trust with Carers and other parents in the home.
Child development and infant mental health principles also inform interior design choices, furnishings, and the layout of our homes. Lighthouse encourages young people and Carers to personalise their home with decorative items, photos and furnishings. Having personal pictures, photos, trophies and the like can greatly facilitate a sense of belonging. Each home also has a communal dining area so meals can be eaten at the table together, as other families would.
Young people's interventions:
Lighthouse programs use many interventions to improve the overall wellbeing of each young person. These interventions are key to creating a space for young people to achieve their goals, wishes and desires, as well as enhance their overall wellbeing. Central to this process is the IDP. The IDP is a therapeutic tool designed to create a thoughtful treatment program. As part of this process, the young person is supported by their Senior Carer to reflect on and assess their own needs and desires. They then create goals with their Senior Carer in response to these and review them monthly. Treatment programs developed through the IDP process are holistic in that they support each young person to develop goals across five elements of treatment:
1. Attachment, Relational and Emotional Wellbeing
2. Life Skills
3. Physical Wellness
4. Cultural and Spiritual Belongingness
5. Education, Training and Hobbies.
The IDP guides the young person’s journey incorporating universal interventions and subjective goals. Interventions occur on a daily, weekly and monthly basis. For example, universal interventions such as ‘reflections’ occur every evening; ‘family meetings’ are weekly; and ‘community events’ are monthly. Each young person is also encouraged to engage in regular psychotherapy with their allocated Clinical Services Team clinician, who oversees their treatment journey at Lighthouse. This clinician also provides supervision and reflective practice to each young person's Care Team. It is common that when a Young person is in an environment where they start to feel safe, embodied cognitive and emotional memories of past traumatic experiences may begin to surface. When this manifests, individual psychotherapy can be beneficial as it provides a confidential and contained space for the young person to begin to process their trauma.
Providing effective support to traumatised young people requires a high degree of personal insight and awareness, a strong understanding of the developmental impacts of trauma and its expression, and a toolkit of responses. It also requires staff to be reliable and predictable, safe and containing. Through a range of staff interventions Lighthouse support, train, and immerse staff in a reflective-rich environment designed to strengthen their capacity to support young people.
Family meetings provide a space for young people to express themselves, to listen to others and to respect the rights of others. Family Meetings are a space for the young person to share what is happening in their life, including celebrating achievements, and working through and conflicts in the home.
All members of the Care Team also have direct access to support through Lighthouse’s Youth Resource and Administration Centre and participate in both operational meetings and suite of reflective practice groups depending on their role (see, Reflective Practice Spaces, Right). As staff may work in isolation from other staff, it is critical that staff are deeply connected to a team and use the reflective practice spaces. Reflective practice describes the process of thoughtfully learning from experience, considering the feelings and thoughts elicited, and improving practice through a process of open and supported self-reflection. Lighthouse acknowledges that staff can experience vicarious trauma directly and indirectly through the organisation’s exposure to traumatised young people. Vicarious trauma can prevent staff from working effectively with traumatised young people. Therefore, the aim of all reflective practice is to provide staff at all levels of the organisation with the emotional resources to remain thoughtful and self-aware, and thus capable of responding to, rather than reacting to, the young person’s expression of trauma.
Connecting a young person to community creates spaces to develop a sense of belonging. For many young people, this may be the first time they have ‘belonged’ to a safe and supportive community. Lighthouse creates numerous spaces to foster community connection, including connection to culture. Each Lighthouse home hosts a community event every three months (which equates to one to two community events every month across the Lighthouse community). Young people contribute to organising these events to share their culture and interests with the lighthouse community.
Each Lighthouse home is connected to a volunteer community committee. These committee members support the young people in various ways according to their interests and skills such as organising working bees to landscape the home, or supporting the young person with resume writing. Each home’s committee act in some ways as an extended family who help connect the young person to the outside world through building a wider network base.
Once a year, Lighthouse organises a camp for all young people to attend. Camp provides an opportunity for the entire community to come together. Lighthouse also has a holiday home where young people are offered the experience to enjoy some holiday time away with those close to them.
Lighthouse’s Youth Resource Centre also offers young people a place drop in to, to meet others, to connect and to build and maintain relationships with other young people outside of their home. The Youth Resource Centre is also the site for a range of community events such as art shows, fundraisers, award nights and an end of year celebration. Lighthouse also works to maintain and strengthen any safe and healthy attachments the young person may have before coming to Lighthouse
How our LMC benefits the community
SROI Independent Evaluation:
In 2012 Social Ventures Australia (SVA) was commissioned to complete an analysis of Lighthouse Foundation’s Social Return on Investment (SROI). The SROI is an internationally recognised methodology that measures the value created for stakeholders. SROI is a framework for identifying, measuring and accounting for the value an activity creates from the perspective of each stakeholder. Findings included the following insights: The intensive support model leads to a holistic transformation of young people’s lives; The changes experienced by young people are sustainable and result in permanent exit from homelessness for 8 out of 10 young people that complete the program; Investment into LHF generates significant social returns for all stakeholders. For every dollar invested into LHF programs, more than $12 in social value is created; The Government is a large beneficiary of the work done by LHF which decreases the future burden of chronic homelessness and creates direct benefit to Treasury in the form of decreased welfare and increased taxes.
A story featuring our LMC
Click play to watch Lighthouse's therapeutic Model of Care through powerful animations: