Training Systems and
Psychological Services
Managing Behaviour of Concern
Assessments
The Studio 3 team conduct a broad range of clinically based assessments. These range from two to five days depending on the nature of the request.
There are several distinctive types of assessments that our team can conduct.
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Psychological and physical health assessments
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Assessments for suitability for therapy
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Parental competency based assessments
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Risk assessments (both for individuals and for organisations)
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Conduct assessments for services and organisations
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Service specifications for individuals who require support in the community
Below outlines a the general pathway for assessments and diagnoses. Please note that there are distinct pathways for adults and children/young people. For more information on the diagnostic pathway for both adults and children, please see the documents below. Further enquiries should be sent to admin@studio3.org.
Written reports (subject to confidentiality) are provided when required and a detailed report can be provided at three monthly intervals for any involved professionals.
A Studio III Story
Joanna is 14 years old and refuses to go to school, sleeping during the day and often awake at night playing computer games. After assessing her, we found that she was highly stressed and her cortisol levels (the stress hormone) were very high at night and too low in the day. This meant that biologically she struggled to sleep. Our intervention focused on stabilising her cortisol levels by increasing cardiac exercise and attempting a trial of melatonin. She is now less stressed and going to school on a sessional basis.
Helping to Transform Care:
Studio III 360° Assessments
In response to the Winterbourne View documentary and investigation in 2011, the Transforming Care initiative was developed with the aim to close specialist placements in the U.K. (both private and NHS provision) and provide more community based provision. This has had mixed results with some individuals experiencing the “revolving door” phenomenon often fuelled by placement breakdowns and the challenge of developing specialist community packages in a timely manner.
In the Irish Republic, similar issues do exist and there has been increasing awareness since the RTE undercover documentary about the abuse of people with intellectual disabilities at Aras Attracta. The Studio 3 organisation has developed this pathway to help commissioners of services, provider organisations and families support people in community based settings.
The Studio 3 philosophy is to create restriction free lives for people with empowerment, choice and independence. To enable people to thrive within successful services in the community with the appropriate supports. We strongly believe that there is a gap between commissioning and services especially for people who are at high risk of being admitted to inpatient services and restrictive environments where they are excluded from their local communities.
In our view, to do this effectively local NHS commissioners and local authorities require a clear plan to create community based supports. However developing these plans often requires provider organisations to produce this sometimes without the technical skills and knowledge or sufficient time to do this. We also are aware that community based teams with behaviour support specialists are under increasing time and resource pressures.
Alternatively reports are requested from people who work in inpatient care to identify care and accommodation needs for people transitioning into their community. There can be a large experiential gap with this as people are basing their knowledge, risk and future needs based on their expertise within inpatient settings rather than community based settings. To support the people we work with, a pathway assessment is done in collaboration (co-production) with the person and significant others if this is what the person wants. A pathway assessment can take four forms; an assessment of the person’s needs and profile, the development of a service specification for that individual, the identification and application of additional specialist supports for that person during transitions, prevention of placement breakdown.
The assessment pathway is highly individualised in nature and involves sensitive issues. We advise people to arrange a call with a member of our clinical team by contacting us at info@studio3.org or calling 01225334111.
The Assessment Pathway
1. An assessment of the person's needs and risk profile
This involves interviews with the individual, key stakeholders and time spent shadowing the person in their current environment. Our assessments will normally include an opinion about the current risks the person presents and suggested strategies for risk reduction. It will normally include an opinion about community-based risk taking. These assessments are usually 3 days in duration (2 days information gathering, 1 day report writing). The turn-around period to complete the report is estimated to be between 4-6 weeks.
2. The development of a service specification for that individual
This is often an extension of the risk profile assessment or equivalent. In these circumstances there may be a preferred provider organisation who have been identified as developing a community-based service. Alternatively, the assessment may take place without a preferred provider to provide a road map for that individual. These reports will also include how the transition should be managed, a community focused risk profile, training and support needs of front line staff and additional specialist behaviour support or psychological inputs if required.
Information will be gathered from the person and key stakeholders, with observations in community based settings. These assessments are usually 5 days in duration (2 days information gathering, 2 days observation and 1 day report writing). The turn-around period to complete the report is estimated to be between 4-6 weeks and will be tailored to the individual.
3. The identification and application of additional specialist supports for that person during transitions.
Many individuals do require additional specialist inputs especially in the first 6-12 months of any new scheme. We believe that many placement breakdowns can be successfully avoided if those additional inputs are in place. These inputs can take the form of staff training in the management of challenging behaviour, additional staff supervision, reviews of risk profiles and support plans, debriefing and other trauma informed behaviour supports. The Studio 3 organisation will consider either providing such supports or helping commissioner and preferred provider organisations develop these supports further.
3. Prevention of placement breakdown
Studio 3 are also very aware that due to the challenging nature of our work that staff teams may “burnout”. Most concerning is when individuals in community placements attract the use of restrictive physical interventions. The Studio 3 team can be requested to provide opinions on how to prevent a placement breaking down. This will usually involve a 5 day audit of practice and a 360 degree review of the service. Guidance is provided on whether the placement is still viable and what steps are needed to maintain the placement.