Dr Heather Price: Conversations across roles and hierarchies (Mulberry Bush therapeutic community)

Hello, I'm Dr Heather Price and I'm a lecturer and staff tutor in the School of Psychology and Counselling and I'm really pleased to be able to introduce members of the Mulberry Bush organisation today. The Mulberry Bush is a charity, it's based in rural Oxfordshire and a main part of the charity's work is a school which is a residential child care home and specialist school for children who've been impacted by trauma, primary age children and the children are placed in partnership with their families and with the local authority. The Mulberry Bush also has a learning and research centre that supports trauma-informed training and practice throughout southern England and internationally and it's got a new venture, Mulberry Bush Third Space, which is a residential training site in Gloucestershire with a big archive for the Planned Environment Therapy Trust and for the National Children's Library and containing records from therapeutic communities for children including the Mulberry Bush's own records going back to its founding in 1948. So I'll hand over now to John Turberville who's the Chief Operating Officer at the Mulberry Bush. My name is John Turberville, I'm the Chief Operating Officer for the Mulberry Bush charity and I was the Director of the school for about 10 years. So the Mulberry Bush started back in 1948 on the current site in Stand Lake and it was started by Mrs Dr Drysdale and her husband Stephen and their family and they moved to a large farmhouse on the site there and what they started to do was to look after evacuees who'd been displaced by the war and over time what they started to see were certain sort of behaviours, certain things going on for the children and they wanted to understand more about that and so Mrs Dr Drysdale had monthly meetings with Donald Winnicott at the time and they both really started to grapple with what was going on for the and how best to help them and I suppose in many ways that's work that continues today so that sort of mutual process of learning and in many ways I suppose the research getting others perspectives started at that time and I suppose that that idea of really being open to others perspectives is very important because that means that we can feel more confident about the practice that's going on day to day in all of our services so that sort of self-reflection and using others perspectives to tailor and hone our services has been very important to us and in many ways it is exactly what we ask the children to do every day as well which is to really to grapple with their own situations and what's been going on for them. Over the last 10 years I suppose 10 or 12 years what we've done is increased our focus on research and action research so we've started our own research department and we started our own outreach team. I suppose what all of this does is try to ensure that we're a progressive sort of charity so we're really interested in ensuring that that we're ambitious for the quality of all our services and that we remain interested in everybody else's perspectives and in what we're doing and what we're hoping I suppose is that that focus and that ambition really ensures that the outcomes for the children and the families and all those that we now help which includes adults and families and their communities is the best it can possibly be. What we do now have is a quite extensive ex-pupils network and we have an ex-pupils advisory group so we bring together a group of ex-pupils who attended the Marlborough school across the decades so from the 1950s all the way up to present day although we remain with sort of post-18 those that are 18 and over and what we do is we bring them together and talk to them about what we're doing in terms of our services how we can do better with the services that we currently offer but we're also interested in their thoughts about how we can develop new services that may well help pupils like them when they've left somewhere like the Mulberry Bush but I suppose more generally all those who have suffered early life trauma. I'm Dr Karen Onions and I'm the head of research and development at the Mulberry Bush. I have been at the school for nearly 16 years and I've had this research role for the past three years. Before that I've got a social work and child psychotherapy background so very much on the ground clinically. Clinically I'm working with children and families for most of my career and it's only latterly that I did my own piece of research at the University of Exeter and my particular interest was thinking about the experience of parents and carers who have children who are also who are looked after by somebody else and what's that experience like for them and so I left the clinical role and I've moved sideways over into a research role. We have a lot of work, well one of my roles is to try and think you know what actually do we want to find out at the school? What is it that people are interested in about us as an organisation and one of the things that we keep coming up against is about actually what is it that makes an organisation therapeutic? That seems to be something that we have in common with a lot of other residential settings and child care settings not only in the United Kingdom but also internationally so it's quite a topical issue now at the moment as well so we have really got things that I think through our research that we can share with other organisations and really get a research conversation going because I think within the field of child care in its broadest sense residential therapeutic care has had very little attention in terms of you know good quality real in-depth research and helping practitioners understand what it means to be therapeutic and that sort of takes me right back to what John mentioned earlier on about the Dockert Drysdale's link with Winnicott and really grappling through some of these issues and she wrote extensively at the time and I think what we're doing now is really looking at so where is what's practice look like now in 2021 sort of 70 years later really and what what's the research telling us about about our practice and we have developed some good links with Oxford Brookes University where we're doing some work particularly thinking about what what life's like in the classroom and what does what does it we're particularly working on a piece of research at the moment about what does emotional security for a child look like in in a classroom and sort of thinking broadly broadly about you know what does therapy what does a therapeutic classroom look like how do you teach traumatised children in a therapeutic way those are massive questions really for the practitioners for the teaching staff so that's that's an interesting collaboration we have undertaken two really big pieces of research that we've collaborated on with other organisations so we initially did a quantitative piece of research with the Institute of Education at UCL in London and that was really looking at a variety of outcomes for the children academic social and emotional a full and their behave and sort of behavioural outcomes so a full range of quantitative outcomes for the children and that was then complemented by a qualitative piece of research that was undertaken by the University of East London where we had a team of researchers who came in and did observations of the staff and the children in situ over a long period of time and this they also did interviews with staff they did interviews with stakeholders parents and carers and they were really able to sort of drill down into what what does it look like what does therapeutic practice look like at the Mulberry Bush yeah Karen I just wanted to come in actually and and just make a couple of points about the findings from the two big pieces of research that you commissioned at the Mulberry Bush the UCL quantitative project that reported in 2018 I think you know it was great that they found really good outcomes for the children educationally and socially and emotionally when when they finish at the Mulberry Bush School but there were some really interesting findings weren't there about how the children's attachment patterns changed over the course of their placements at the school not just straightforwardly from insecure attachment to secure but a more complicated nuanced picture emerging so you know children moving away from the anxious avoidance style of relating but not all becoming more secure which I guess we might expect and I just wanted to say a word about the qualitative project that I was involved in actually at the University of East London I think what we found really interesting about the practitioner work in the organisation was the fact that staff didn't just squash or suppress or repress disturbed behaviour or troubling behaviour in the setting so they didn't come in and use heavy behavioural modification methods or sanctions or exclusion there was a real effort to think with the children about what their behaviour meant and what was going on for them and to talk with other staff members and with other children about about what was happening and that was quite a risky strategy some that some people might see is quite permissive and perhaps going against the grain of a more zero tolerance type approach but it requires very fine judgment and a lot of skill to do that successfully and keep everyone safe and we thought it was a very interesting balance that staff will hold in there. My name is Dawn Davidson I'm the charity learning and development lead and I've been at the Mulberry Bush my second incarnation I was there once before as a practitioner and but I rejoined the Mulberry Bush just at the point that the FDA was just starting and it was around the time that the government were beginning to introduce an expectation for workers within health and social care to have a qualification for working in this field and historically the qualifications and the requirements of people working in this field have been very low so an NVQ level three was introduced for staff in this particular sector and it was a real struggle within the organisation to get people to engage with it and I think one of the issues that people were really struggling with was the fact that it was incredibly generic it was a qualification that spanned the entire field of working with children and young people and the work that we do is is very unique in terms of working therapeutically with primary age children within a residential setting so it was very different to the kind of things that were being covered in the NVQ and so in consultation with Ofsted it was agreed that perhaps we could develop our own qualification that might be more bespoke might be better fitted to the needs of the children and young people that we were working with and I think what has come out of of working with the FDA has been a sharing of understanding and a sharing of language and a sharing of the the therapeutic the academic underpinnings of the work that we do I think that Mulberry Bush has always been very underpinned by theory and and we've talked earlier about the fact that Barbara Docker-Drysdale who wrote extensively in the school was underpinned by her work and then her work with Donald Winnicott and so we were informed by his work as well but actually sort of bringing a shared understanding and expectation of all of our staff to to be able to make sense of the theory and how they relate it to practice was really important and and I think one of the things that we've realized is that often in organizations the the knowledge and particularly academic knowledge is held and in higher parts of the organization but actually through introducing the FDA and having everybody having a really clear understanding of the theory that underpins the work that we do actually allows conversations to happen far more vertically within the organization so there's it's not held in one place and I think that the way that people think about things and the way that people are able to have those discussions at various different levels within the organization have really been facilitated by making sure that everybody has a similar knowledge and understanding of the theory that underpins the work. My name is Elsa Bouillard and I am a therapeutic child care practitioner in the residential part of the school which means that I work in the houses I work in the 52-week provision yeah so it's it's basically like a children's home I work in during the holidays where children who cannot who don't don't have any foster placement or adoptive parents or anywhere to go to come to us so there's currently six children in the whole school who comes there during the holidays and in term time I work in me and my team work in the other houses which is morning and after school kind of house duties really being a student in the FDA and and a practitioner working and studying traumatized children in residential care care is definitely intense and it's it's a challenge it's a little bit like being an anthropologist in the field in a way because you have your you're able to observe the the theories that you read about on a daily basis but at the same time it's a unique opportunity to be able to read you know and study theories like attachment theory or or other psychodynamic concepts and then apply them it is quite it's quite enriching because it allows you to take to have a deeper insight on the trauma of the children you work with but also on the group dynamics that there are between the children between the adults as well the practitioners and and between both groups the children and adults it's it's also an opportunity to stop and think and be at a distance and then reapply what you've read and studied and thought about and use that to help support the children and your own responses as well because two intense situations at work when it comes to I mean the opportunity to publish and to have a journal that allows you to publish some of your work is a great opportunity for people to also know about a practitioner a practitioner's view of of the work so it's quite it's quite rewarding really there's there's there's also another thing that we we we have a reading group in the in the school that actually Dawn presides over or Karen or is it both of you or and and it's once a month where we have the opportunity to read an article and on a specific topic linked to to to the work which is also usually it's an academic article but it doesn't have to be and it provides an opportunity for whoever wants to attend once a month and to kind of discuss and that provides a different way of of seeing you know this theory because you don't you don't discuss with your fellow students you discuss with people who are in completely different parts of the organization and it's in a way it's applied differently you think about it differently because you don't have an assignment to write you don't have to to think about your own practice in the same way so it's kind of there's kind of two different ways of seeing theory and using it one more thing about the benefits really of of applying theory to research is just understanding you know understanding your children the trauma the trauma the children went through and understanding behaviors you know I remember there was a case of a child who he yeah it was like a really intense intense experience for me it's a child who had kind of like he was leaving the school and he was regressing really to being like a toddler and I had to spoon feed him and dress him and and I didn't understand his behavior and how it affected me until a year later I studied like a specific like a concept that applied to to his behavior and that that freed me I didn't realize that for a year it had it had stayed with me and because I hadn't processed it I hadn't understood and just understood it so that's also really really liberating. My name is Michelle Bassett I am a senior teaching assistant and nurture group practitioner I've been with the Marbury Bush organization for four years so I graduated from the FDA two years ago I think when I first started at the Marbury Bush I think there was a six month period before I started the FDA and I think in that time I'm consumed I was consumed by experiences so experiences of the children experiences of their behavior experiences of how other practitioners experienced practitioners spoke to the children and the way that they talked around the children and about the children in such a thoughtful way and I think that's you know you go some days you get hurt but to be able to sit and think about what that behavior was whilst also feeling quite hurt yourself can be quite difficult so I think for me starting the FDA it kind of opened my eyes to looking at the theory about about you know Winnicott, Barbara Drucker-Dyesdale looking at Freud and going back Melanie Klein people like that I'm just thinking about all of the all of that quite historic stuff that's been brought forward and worked upon and developed further in more recent years and I guess for me I was able to look at the children with a different pair of eyes and understand what was going on for them so so making those links it also the FDA teaches you you're kind of forced into these reflective situations that are quite uncomfortable with with people you didn't choose to sit and and share those feelings with so it also puts I think the children are pushed together they don't choose to be here we push them in together into these houses into these classrooms and for me that was an experience similar to what they were experiencing I guess in coming in and being put in these groups and being asked to reflect and and to learn about ourselves as well as about the work that we're doing so there's lots of learning going on on a sort of emotional and personal level for me but also on that practical level working directly with the children. I think something came up earlier about why theory is important why do we need to know and if these children are deeply traumatized children and on the face of their behavior you know they could go through life and not unless you I think unless you understand what you've got in front of you are just our children misbehaving in a classroom without that deep knowledge of what you know what's where they've come from why all of the trauma they've had how that impacts their behavior and what their behavior is telling you I don't think these unless there's that somebody there to understand that and to support the children with it I don't I don't I it feels a bit hopeless so for me I think the the theory is important because we need to understand what's going on for these children um for our children um but also it that it informs everything we do I always look back at you know my reflective journal and all of those the different things that I've used for the FDA the even some of my essays that I've written I still go back and re-look at them because they helped me with my work um as much as all of the books that I know that we've had our Moby Bush 70th anniversary book that you know I do dip into and read chapters by different people at points because it really does help me focus me um on my work yeah I'm Stuart Harrigan and I'm a senior family networks practitioner and also the deputy head of the therapist networks team um and yeah while I in my role I'm not child facing um I suppose it's important that that we are often the people who are explaining the work and and helping other people understand the work of the school parents carers and and the people who are paying for the children to be here um so it's important for us to still have a good understanding of um of of that research and the the theories behind the work that we do and the work that the school does um and to interpret them into and in ways that other people can understand how how birth families how social workers how people who don't have a background in this type of work um can understand why we might not tell children off in a way that they might think we should be telling children off how we might not punish them in the way that we might and and I suppose how the school can often be seen as a permissive environment when that's not what it is at all and while our foster carers are part of other fostering agencies they are in a slightly different position in that their children are away from them for most of the time um and that the reason their children are away from them for a lot of the time is because of their more extreme behaviours that they can they can present and they were telling us as well that they they didn't feel they were always understood by their agencies and by other carers so we have started a foster carers group which originally was only once a term because of distances that people had to travel but during covid we've extended that and increased that to twice a term because they're being done virtually now and um that is it's a really valued space by the parents again it's it's while it's not a reflective space um it has elements of that and it's un um unagendered and they are very much the experts and the people who will help and support each other um we've also extended that now to adoptive families and special guardians which similarly has had a very positive response we have a member of our our team who is doing currently doing the fda she's coming to the end of her course and her final project is looking at the effectiveness and the value of the um of these groups one large project that has been ongoing now for quite a few years is we're developing or we have developed a social and emotional tool or a measure sort of a paper questionnaire on paper questionnaire um because there aren't assessing the how well children are socially and emotionally has been quite a difficult thing to measure not just for us but sort of internationally and so there are what there are for example there's something called the strengths and difficulties questionnaire the sdq which is used all over the world and and in the united kingdom it's particularly used in cams so in a mental health setting for working out lots of different lots of different things um and it we in the organization we've looked at that tool and other tools but they don't really take into account the struggles and the difficulties and the the sort of the traumatic nature of the children's experiences and what they're like to be be alongside in the classroom and in group group living so we felt that we didn't really want to use those kinds of scales because they weren't terribly helpful for us in terms of of our work so together we worked out so what actually is it that we think how would we know if a child was improving or their social and emotional development was on the right on the right pathway how would we know that what is it that we do so we put together a load of questions and ideas we got staff in different areas of the organization to contribute and so we came up with lots of ideas about what we think and we gave this to or we we might we found collaborators at the university of sussex particularly um professor robin banerjee and we've had a phd student and a student and an undergraduate student who have worked on all of this together with us and come up with this 25 item questionnaire and we've got a website for the c scale and we're now hopefully just fun where we are fundraising for a phd student to take all of that learning and to answer some more questions about the c scale so it's a bit of a long a long answer to say um we've come up with a homegrown questionnaire that we think will be useful for children who have really experienced the kind of trauma early years trauma that our children have experienced sea social and emotional adjustment sea um and it's it's it's quite timely because the department of education and the national children's bureau and somebody else now who's now gone out of my mind in 2018 and 2020 in national reports about our population of children all said that we need measurements and tools which really take into account the complexity of the needs of the children and so we feel that the tool that we've come up with the c scale goes some way to fillings this gap so that's that's quite an important and exciting um development for us really we are collaborating with the recenter at the department of education at oxford university and we're in the process of planning and designing a longitudinal retrospective sort of historical look at um the outcomes for our ex-pupils so we have ex-pupils who were at the school in the 50s right the way through to 80s 90s 2000s and we're hoping to use their archive the archive data as well as following up with um sort of structured semi-structured interviews with people who are interested these ex-pupils who are still who are interested in in researching with us to think about their experience over the years and what is it maybe when they look back on their childhood at the mulberry bush is there something that's mulberry what is the mulberry bushness that they've all experienced really and how that stayed with them over the years has it stayed with them if it has what have they learned from it you know we're particularly interested or i'm particularly interested in is there an intergenerational impact that that's had that these children were at the school between say the age of you know in their primary junior age and now as they've gone on to have their own families or not what have they learned about themselves as parents or maybe not as being parents that they might attribute to something that they learned when they were very young at the mulberry bush we're also thinking that something about our particular way of doing life story work might link in with that so that's going to be maybe a new development in thinking about the life story work in our particular way about helping children create a narrative for themselves that might have a longitudinal impact those are quite big links to make i realize that and in terms of actual research that's quite tricky really to to prove or to try and say something about but we're working with the recent to try and do something about that really the recent is a part of the department of education at the at oxford university and they are looking at outcomes for children in residential care for children in adoptive placements and for children in foster settings and they are a very good collaborator for us they are you know they're a nice they give us kudos really as an organization so it's it's very nice we want to be linked to them and actually they want to be linked to us because we have this pool of ex-pupils and also you know a nice pool of current pupils so we can we can we help we can help each other yeah so i'd just like to say thank you very much to everybody again for all your contributions you know to karen and to john and michelle and elsa and and and john again and dawn of course it's been a very rich discussion and and much food for thought thank you everyone