In Perth and Kincross, there has been a different approach to youth justice as exemplified by the Resilient, Engaged, Achieving, Confident, Healthy (REACH) team. As an edge of care multidisciplinary team, REACH provides intensive support to families with young people experiencing multiple complex needs. In most cases, there is a high chance of the young person – usually between the age of 12 and 18 years – becoming accommodated away from home or in care. Young people aged 12-16 who are referred for sexual, violent or persistent offending and require a specialist risk assessment and/or focused intensive support can be referred to REACH as well.
The establishment and principles of REACH are predicated on the shared aims of the Scottish government’s current Whole System Approach (WSA) as well as its ‘Getting it Right for Children and Young People’ youth justice strategy. Such aims include better information sharing, supporting work on school inclusion, strengthening positive relationships, improving health and well-being, and promoting opportunities.
To achieve these aims, REACH provides evidence-based assessments and interventions to support complex needs families and young people. The assessments and interventions are designed to:
- Develop resilience;
- Develop problem-solving skills;
- Reduce risk to self and others;
- Improve overall family functioning;
- Empower families; and
- Reduce re-offending
They also help practitioners to:
- Better coordinate information;
- Better understand complex needs; and
- Have better access to specialist advice with regards to complex needs like language therapy etc.
Best practice in relation to working with families and young people referred is discussed at the weekly Services for Young people allocation meetings. Referrals come from a variety of agencies such as Police Scotland. The meeting is attended by representatives from Police Scotland, the REACH Team Leader and the Youth Work Team Leader.
The referrals taken on by the REACH team are discussed at the weekly REACH screening group, which features representatives of the multiple disciplines within REACH: social work, clinical psychology, education, speech and language therapy (SLT), and performance and evaluation.
To show how the different specialties that make up the REACH team contribute to young people’s treatment, this case study highlights SLT.
Speech and Language Therapy (SLT)
The inclusion of the SLT discipline is an evidence-based inclusion. Major studies show that up to 70% of young males in Scotland have significant difficulties with language function. However, there has been a services gap for these young people as there is little statutory provisions for Speech, Language and Communication Needs (SLCN). The REACH team attempts to alleviate this problem by incorporating SLT into the services it provides.
SLCN refer to difficulties or conditions affecting aspects of communication. For some, these difficulties may be mild and limited to particular situations, but for many these difficulties are persistent, pervasive and complex.
SLT attends the REACH screening groups to gather general information about the young person. This information helps them to determine whether the young person has any SLCN with which they can help. Every REACH referral is screened by SLT. This screening out rather than screening in approach means no SLCN symptom remains unidentified.
If a young person is identified to have a SLCN then, using their expertise, the SLT will introduce a range of inputs and approaches with the aim of reducing the impact of the SLCN on the young person. These include:
- Input into a Young Person’s Plan (including expected outcomes and strategies to be put in place);
- Development of inclusive communication environments;
- Training to parents and carers of the young person;
- Development of a one-page profile to share the most appropriate communication strategies unique to that individual;
- Direct therapy unit;
- Further assessment; and
- Provision of resources to promote effective communication.
The SLT team also help REACH by being available for general advice, phone support and help with confidence in working with young people with SLCN.
The SLT inclusion in the REACH team has already produced some significant results such as:
- Improved inclusion of the young person in their intervention: the SLT team provides young people with SLCN accessible versions of their SLT reports. This helps to include the young person in their intervention and improve their participation.
- SLT helps some parents with their own communication and cognitive needs. The REACH SLT team can help the parents by addressing the issues they may have with communication. Further, they produce accessible reports for parents.
- Diagnosis of Development Language Disorder (DLD): The SLT team has trained the rest of the REACH team to better diagnose and recognise DLD that may be hard to identify, particularly with young people that have good verbal skills.
Whilst SLT is only one part of the multi-dimensional REACH team, its workings and evidence-based, tangible contribution show the basis on which the REACH team operates. It is designed to significantly address the many service gaps for young people with complex needs and their families.
This case-study was compiled by Michael Farinu in 2019