An insight into the role of a Clinician within Nexus Fostering

An insight into the role of a Clinician within Nexus Fostering

At Nexus Fostering, we are immensely proud to retain our Ofsted Outstanding rating since 2011. This is hugely down to the support we provide as a close-knit team. Each local office has a lead therapeutic supervising social worker and in-house clinician.  It is recognised how children benefit from our commitment to and investment in high-quality training and support, meaning foster carers receive expert specialist care. Foster carers also receive targeted training and support to offer trauma-informed care to children, providing an excellent understanding of the impact trauma has on children’s lives. Fostering is ultimately rewarding but can be a challenge at times. We have various placements available depending on the needs of the child. Care + and Nexus 360 placements receive a therapeutic approach to fostering with a bespoke package of care and the professional support the carer and child needs.

We spoke to Barbara, a Clinician from our North Midlands office to explain her role within Nexus Fostering.

What was your background prior to working at Nexus Fostering?

I have a varied background – senior management in fashion retail for several years, Local Government roles – establishing and managing the national Troubled Families programme within Shropshire. I have been successful in my various roles through my effective management of people, listening, and communicating with others. I studied for a Master's in Counselling and then set up my private practice. I found the job role for Nexus via my professional organisation BACP website.

Describe your job role and what support you offer our carers.

I see my job role as supporting our carers to support our children and young people. I do this through regular clinics with our carers with young people on supported packages, offering insight into children’s behaviours, helping carers understand their own reactions, and then discussing different responses if appropriate. I listen to carers, and at times am simply a support where they can offload their frustration and their own emotions. I also offer support within the Team – holding reflective sessions and discussing individual carers or young people when necessary. I attend TATC or Professionals meetings for young people and write and update Therapeutic Care Plans for each young person on a Supported Package. Occasionally I will attend other meetings e.g., CLA reviews or PEP’s to support a carer, but this is not generally my role.

Can you describe your typical day at Nexus Fostering as a clinician?

Typically, I will hold 2-3 clinics a day (for 1 hour). This requires preparation (reading CHARMS reports on the young person, the carers, etc.), and then writing up the notes from the clinic and putting them on CHARMS. I also plan my time to update and prepare Care Plans (every 3 months for 360 young people) and prepare and attend TATCs. I also follow up with SSWs or the Therapeutic Lead if necessary, after a clinic/meeting.

What is the format of the clinician sessions?

The clinics are fortnightly, generally at the same time and day but this often changes with school holidays. They are largely online (I support carers in several different areas). The sessions are usually for 1 hour, but if carers have 2 young people on a Supported Placement, the clinics are 1.5 hours to allow time to discuss both young people. My clinics tend to have the same format, a review of the past 2 weeks, planning ahead for any foreseen issues e.g. contact, school events, TATCs, and checking how the carers are. As the clinician for the carers, my focus is on supporting them, so generally I do not see/meet the young people.

Can you explain the therapeutic support you offer?

The therapeutic support is very much about supporting the carers to understand and implement appropriate parenting models for our young people, e.g., PACE, Circle of Security. Through discussions with carers, I can help them understand a child’s behaviour, where the child may be on the circle, and help the carer recognise how using PACE effectively may support them to connect with a young person. Therapeutic support is often about listening and letting the carers know they have been heard.

How do you help our foster carers overcome hurdles or challenges?

I can offer carers an understanding of a young person’s behaviour and through greater understanding, carers can often recognise they need to try different approaches. Typical challenges are when young people need to control a situation and can be very oppositional. By understanding what the behaviour is communicating, i.e. they want control, not that they are being difficult, the carer can give choices instead of a demand. E.g. instead of asking a young person to go and have a bath, the carer can ask if the young person wants the blue bubble bath or the pink bubble bath. The choice allows the young person to have control and can therefore avoid a confrontation.

Do you have a positive outcome or memory that sticks with you? 

Helping a carer re-connect with a young person. The young person had stayed out all night and then feared rejection from the carers so was trying to reject the carers first by demanding she move placement. I helped the carers understand what the young person's behaviour was possibly communicating, so they not only verbally communicated to the young person that they wanted her home, but also made it clear that they had the young person in mind. The young person was staying with a friend and had asked for some of her electronics. The carers took over what she had asked for, but also took over her favourite sauce from the cupboard that she loved to add to all her food. When they gave this to her, the young person burst into tears, knowing they had thought of her personally. The young person returned to the placement the following day.

Another particular memory is supporting a carer to understand that the young person she had cared for, for over 6 years, needed more support than she could now offer. His behaviour was escalating (through no fault of anyone’s) and he was becoming a danger to himself and others. Through listening to her description of everyday life, and relaying it back to her, she understood, and accepted, that it would be in the young person’s best interest if he received greater therapeutic care in a different setting.

What do you most enjoy about your role?

I most enjoy seeing our young people and children feeling safe and secure. I love it when carers describe their young people and children not just surviving, but thriving, as all children have a right to do.