Islington CAMHS Children Looked After (CLA)

What will being seen by this team involve?

The CAMHS CLA team includes a range of professionals who work together to provide support and assessment directly for young people; consultation for their professional network and carers, and relevant training. Children who are ‘looked after’, or in care, and care experienced young people are at the core of all our work. The overall aim of the team is to support the mental health and emotional wellbeing of these young people, their social workers, foster carers and birth families.

What is assessment?

An assessment with a clinician from the CLA CAMHS team would involve a young person or some people from their support network meeting to discuss what is going on for this particular young person, what their presenting needs are, what factors from their past may be impacting them now, what is currently helpful and unhelpful, and how our team can work together to best support their individual needs.

What do we mean by therapy or direct support?

Therapy is an opportunity for the young person to discuss concerns they want to bring with a professional who can help them set goals, and work on those goals by using various strategies, discussing and exploring the concerns they currently have, and problem solve together. These could be issues to do with how they might be coping day to day with their mental health and emotional well-being, friendships and relationships, school and college work.

Who will I work with?

• Child & Adolescent Psychotherapists

• Clinical Psychologists
• Systemic Family Psychotherapists
• Trainee Clinical Psychologists / Psychology Students / Assistant Psychologists

How do these professionals work?

Clinicians in the CAMHS CLA team will use their professional experience, training and expertise to best support each young person. They may draw from training in different types of psychotherapies, or ways of exploring and making sense of our thoughts, concerns and identify needs and make helpful changes. They will be trained in trauma-focused supports which means they will always consider the impact of difficult circumstances or incidents that may have happened in the young person’s past. They will be sensitive to these difficulties and support the young person to move at their own pace and explore difficulties when they are ready. They might draw on cognitive therapies or models which will involve tips, strategies and provide a framework to help the young person make sense of their thoughts, feelings and behaviour. They will also help the young person manage the big feelings, numbness or upset that have led the young person to request support. The young person will be provided with a safe space where it’s ok to bring concerns. The young person will be supported to set goals and start meeting them.

Referral information

There are two referral routes:

1. Through your local CLA social worker. If a care experienced young person or current looked after child is experiencing difficulties with any aspect of their mental health or emotional wellbeing, support should be sought through this young person’s social worker. The social worker will contact their link clinician and have a conversation. Once it is agreed, there will be a form to fill out and you will be assigned a CAMHS CLA clinician.
2. Refer directly through the Islington CAMHS SEMH team. Again, If a care experienced young person or current looked after child is experiencing difficulties with any aspect of their mental health or emotional wellbeing the below form can be completed by your carer, GP or school and returned to Islington CAMHS specifying that you want support from the CAMHS CLA team. The form can be accessed on the Islington Council website, or you can call 020 7527 3355 to speak to the duty clinician.

Service description

The CAMHS team for Children Looked After (CLA) is a multi-disciplinary team providing a range of consultation, training and direct clinical work for young people looked after by Islington, their carers and professional networks. The work of the team aims to promote the mental health and emotional wellbeing of young people and to offer specialist support to social workers and foster carers in their care and management of the needs of CLA.

What will being seen by this team involve?

CAMHS CLA clinicians are largely based at Elwood Street and are integrated into the CLA Social Work teams based there. Advice and consultation are available to social workers through the allocation of a named Clinician (CAMHS link) to the CLA, Independent Futures and Fostering and Permanence teams.

There are a range of ways that CAMHS CLA might support carers of children who are looked after, including:  

• Consultations: CLA staff can speak to CAMHS CLA clinicians about their work with children, young people, carers and family members. This might be to think about concerns around mental health, trauma or how they can best support a child or young person, and/or those around them. We call these ‘consultations’.  Consultations can be one-off meetings but sometimes we might several times (e.g. offering support through a change).
• Training: CAMHS CLA clinicians join social workers in delivering training to foster carers. Trainings include Nurturing Attachments (8 week group) and Introduction to PACE (2 day workshop).  
• Trauma Formulation Meetings: When a young person first enters care or shortly afterwards, we meet with the team around the young person. In this meeting we try to understand what the young person has experienced and how this affects them now. Foster carers and/or kinship carers are invited to these meetings with their supervising social worker so that they feel well prepared for caring for the young person.
• Direct clinical intervention: Foster Carers employed by Islington Council can access assessment and direct therapeutic interventions to support them in their role as foster carers. Foster carers who have participated in CAMHS assessments for young people in their care, may also be offered direct support from CAMHS CLA but this will be specifically related to the named child.

Referral information

The services available to foster carers will depend on a range of criteria including:

• What type of Care Order is in place?
  • We can only offer direct assessment and intervention to children who ‘looked after by the local authority’. We are unable to offer direct intervention to children who are care for under a Special Guardianship Order. This must be accessed via the Community CAMHS Teams.
• Who is the carer is employed by?
  • We can offer direct therapeutic support for foster carers who are employed by Islington Council. This support does not need to be directly related to a child in their care but rather it can be to promote the emotional wellbeing of the carer to support them in their role.

There are two referral routes:

1. Through your local CLA social worker (SW) or supervising social worker (SSW). The SW/SSW will discuss the referral with the CAMHS link. Once it is determined that the young person requires support there will be a request for consultation.
2. Refer directly through the Islington CAMHS SEMH team. Again, If a care experienced young person or current looked after child is experiencing difficulties with any aspect of their mental health or emotional wellbeing the below form can be completed by the carer, GP or school and returned to Islington CAMHS specifying that support from the CAMHS CLA team is required. The form can be accessed on the Islington Council website, or you can call 020 7527 3355 to speak to the duty clinician.

Recommended resources for foster and kinship carers:

• Kinship Compass

• Fostering Islington

Team description

The CAMHS team for Children Looked After (CLA) is a multi-disciplinary team providing a range of consultation, training and direct clinical work for children and young people looked after by Islington, their carers and professional networks. The work of the team aims to promote the mental health and emotional wellbeing of children and young people and to offer specialist support to social workers and foster carers in their care and management of the needs of children and young people.

What will being seen by this team involve?

CAMHS CLA clinicians are based at Elwood Street and are integrated into the CLA Social Work teams based there. Advice and consultation is available to social workers through the allocation of a named Clinician (CAMHS link) to the Social Work and Fostering teams.

CAMHS CLA clinicians offer a range of interventions to the CLA under 16s service, Independent Futures, Fostering, Permanence, UASC and the House Project teams. These include group supervision, consultations, trauma formulation meetings, and for children with placements in Islington, direct clinical support is also offered when appropriate.

Group Supervision

Clinicians are allocated to teams/clusters and attend group supervision, fortnightly or weekly. The clinician contributes a mental health/therapeutic perspective to case discussion in group supervision. Clinicians also are available to offer support to Practice Managers in their task of facilitating and embedding the group supervision model.

Case Consultation

Clinicians offer consultation, at the request of social workers, in their respective social work clusters. Requests for consultation may result in a one-off discussion or a series of discussions. Social workers seek ‘consultation’ about a broad range of issues. Consultation requests include: concern/questions about a child’s mental health/ emotional wellbeing, behaviour or development; placement disruption; concerns about a child’s relationship with foster carer or birth family or may focus on a foster carers role /wellbeing. Some requests seek a referral or advice re: accessing a mental health or therapeutic service for a child. Alternatively, a consultation may be sought by social workers seeking advice about work they are doing with a child/carer or to reflect on the emotional impact of a particular task or case.

Consultations are offered to social workers individually or jointly with Practice Managers or Supervising Social Workers, depending on the nature of the request and what is agreed will be most useful.

Initial Trauma Formulation Meetings

This is a meeting of the key social workers (CiN, CLA and SSW) and foster carer or keyworkers during the initial phase (first 3 months) of a child becoming looked after, and is facilitated by a CLA Clinician. The task of the meeting is for the new ‘parenting team’ to have an opportunity to consider the links between a child’s experience of trauma and how they behave, manage relationships and communicate their needs, including the meaning behind any challenging behaviour. It is anticipated that this will support the parenting team to be better prepared to understand and attune to a child’s experience and trauma - and less liable to become overwhelmed by the child’s behaviours and emotional communications.

Prior to the trauma formulation meeting, a pre-formulation consultation will be offered to the parenting team. After the trauma formulation meeting, the CLA clinician will create a report based on the discussion and this will be shared with those in attendance.

PACE for your Practice (Jo McNeal leading)

A series of consultation meetings (initially 6 and review) offered jointly to the SW and SSW informed by the Dyadic Developmental Practice model/ theory.

This consultation is targeted at in-house Foster Placements and aims to enhance the direct work the SW and SSW are offering to a foster carer and child, to support the placement where there is particular complexity. It provides social workers access to a DDP informed clinical consultation and it is hoped will contribute to social workers developing practice, skills and confidence.

Referrals/requests are made by social workers via their CAMHs link. Clinicians may also suggest this input in consultation or referral discussions.

Clinical Assessment and Intervention

Clinicians hold a small clinical caseload offering clinical assessment and intervention to children and young people in placement in Islington, alongside the range of other input offered.

Unaccompanied Asylum Seeking Children (UASC)

Dr Katherine Parra Castaneda offers specialist CAMHS input three days per week. The role aims to identify emotional health and wellbeing needs of UASC entering the CLA service early and provide rapid and accessible emotional wellbeing support provided to UASC via direct work. All newly arrived unaccompanied asylum-seeking children and young people under the care of Islington Local Authority are offered an initial mental health screen when they attend for their statutory initial health assessment. The role also involves providing consultation to social care and CAMHS colleagues as well as delivering training to foster carers and social care staff.

Return Home Project

A Systemic and Family Psychotherapist is linked to the Local Authorities “Return Home” project. This a pilot project focussed on systemic planning of family reunification following a period of care. The Systemic and Family Psychotherapist supports the risk assessment and planning processes and contributes to the development of the professional network. Families are supported through this role to access and collaborate with professionals and make changes to ensure sustainable safety and stability for their children.

Referral information

There are 2 referral routes:

1. Through your local CLA social worker (SW). The SW will discuss the referral with the CAMHS link. Once it is determined that the young person requires support there will be a request for consultation.
2. Refer directly through the Islington CAMHS SEMH team. Again, If a care experienced young person or current looked after child is experiencing difficulties with any aspect of their mental health or emotional wellbeing the below form can be completed by the carer, GP or school and returned to Islington CAMHS specifying that support from the CAMHS CLA team is required. The form can be accessed on the Islington Council website, or you can call 020 7527 3355 to speak to the duty clinician.

• Child & Adolescent Psychotherapists

• Clinical Psychologists

• Systemic Family Psychotherapists

• Trainee Clinical Psychologists / Psychology Students / Assistant Psychologists