One moment you're covered in blood and next it's what’s for tea? An interpretative phenomenological analysis of residential care staff's experiences of managing self-harm with looked after children

Young people in care have been found to have a higher incidence of self-harming behaviours. However, despite research findings that managing self-harm can be stressful for carers, there has been a dearth of literature which has specifically examined residential carers' experiences of this. Therefore, the current study used an interpretative phenomenological approach to explore the experiences of residential carers in relation to self-harm. Three superordinate themes emerged from the study, each with a number of subordinate themes. 'Surviving' illustrated how managing self-harm can be a difficult experience for residential carers and therefore they need a number of coping strategies to draw upon to manage. 'We're out here alone' represented participants' feelings around being held individually responsible for managing acts of self-harm and also feeling as though outside agencies were inadequate or slow to respond to the young people’s needs. 'Losing control' reflected when coping strategies failed, and participants were left feeling uncontained. It also demonstrated the potential negative consequences on their life outside of work. Recommendations are discussed for future practice, including regular staff supervision, team consultation, training and shared risk planning

Caregivers’ experiences of therapeutic support for children exposed to developmental trauma

Purpose: Exposure to trauma in childhood can have lasting impacts upon development and psychological well-being. Services can be sought to help young people heal from their experiences; however, literature suggests that their care may not always be trauma-informed. This paper aims to generate a theory to explain caregivers’ experiences of accessing mental health and therapeutic services for young people exposed to developmental trauma. Design/methodology/approach: A constructivist grounded theory approach was used, using an iterative process of data collection and analysis. Nine individuals including foster carers, adoptive parents and a special guardian were interviewed following purposive and theoretical sampling. Techniques of initial, focused and theoretical coding, alongside constant comparative analysis were used to develop the end theory. Findings: The theory demonstrates that multiple factors can impact upon caregivers’ experiences when accessing support for young people exposed to trauma. Six themes emerged documenting caregivers’ journeys from the decision to seek support to the ending of service involvement. Barriers, challenges and positive experiences are described. Results are contextualised through consideration of wider organisations and systems. Originality/value: The theory highlights challenges caregivers face when accessing mental health and therapeutic support for young people exposed to developmental trauma. It provides new insights into what caregivers consider to be trauma-informed experiences of care in these settings. Tentative recommendations are provided in the hope of improving future care.</p