“I’d lost trust and having to tell everyone the same story again and again and again…”: Bottlenecks and barriers to the application of therapeutic approaches within care services’ ecological systems

Children in out-of-home care (OOHC) who have been exposed to significant adversities such as neglect, abuse, family dysfunction, acute family stress, and/or revolving placements are at risk of experiencing poor outcomes. Each of these experiences can result in complex traumas for children, which creates cognitive and emotional difficulties. Although social care has the responsibility for supporting such children, there are certain pressures when it assumes responsibility for other statutory services, such as Public Health. These tensions can lead to missed opportunities in the effective support of children and young people with, for example, a focus on behavioural management rather than therapeutic approaches, with the latter being believed to be more effective in dealing with the underlying trauma. When partnerships are formed effectively, this creates space for innovative practices such as the approach examined in this paper.