Engaging Young People with Complex Needs

Introduction

There are different approaches to engaging young people in services and treatment. Before we delve into some of them, it is essential that we, as clinicians, understand that young people come into contact with services with challenges, histories, and experiences associated with their presentation. These are unique to the young person we work with.

At the ACT Group, many young people are referred to us for difficulties relating to their emotional and behavioural challenges, often compounded by their disabilities, trauma, complex (or emerging) mental health needs, and the associated comorbid conditions. Young people with multidimensional and complex (interrelated) needs are often, but not always, most challenging to engage.

It is highly fulfilling to engage young people by exploring and providing different ways to the engagement process that they are typically accustomed to. With the capacity to conduct outreach work, clinicians at the ACT Group are in a privileged position to engage young people in flexible ways, which often extend beyond closed doors in a clinic.

Why Do Young People Disengage from Service?

Before discussing the approaches to engaging youth with complex needs, it is essential to understand why young people might not be willing to engage with services and clinicians.

The presentation of young people with complex needs is often perplexed by the stage of adolescence, a period of significant change for a young person. This period usually represents a shift in young people’s presentation as they increase their need to identify with peers and seek experiences of novelty and autonomy.

The decision for young people with intricate needs to engage with services is often made by the team around the young person, and at times, with little input from the young person him or herself. When young people are expected to engage with an extensive list of services without the collaboration to streamline their care, their capacity to engage and manage the appointments will be significantly hindered.

The systemic complexity of accessing services and pathways to care includes long waiting lists, inconsistent delivery of care, costs and funding-related challenges. All these factors can influence a young person’s engagement. The list of barriers is extensive, including but not limited to stigma, AOD misuse, trauma, practical challenges related to finances, housing, transport, etc. Engagement needs to be tailored to a young person by understanding these barriers.

This is where clinicians take a collateral approach by obtaining information from various sources, including the clinician’s observations.

Our Approach

Promoting engagement with young people with complex needs is a process that requires ongoing attention as the needs attached to the young people are dynamic. Clinicians must reflect on their expectations of the young person and whether they are realistic in the current situation. Clinicians can adapt their approach by understanding the barriers to engagement for each young person.

Child-Centered Approach

This approach incorporates the young person’s voice and takes a curious stance on their positive and negative experiences, acknowledging them without judgment. The information will give new clinicians insight into successful planning.

Multidisciplinary Team Approach

Sometimes, a young person might not engage despite our best efforts. When this happens, clinicians should use the experience around them and discuss the best next steps. When continued attempts to engage the young person become counterproductive, the clinician should take a team-based approach to discuss the risks and benefits of continuing proactive engagement.

Clinicians must know that they don’t need to carry the decision’s load or weight alone.

Relational Approach

Young people with complex needs can find it extremely hard to trust adults due to their childhood experiences and attachment style. They may have learned to rely on themselves for most things in life.

In some cases, young people may have developed a negative internal working model and core belief that relationships are unreliable or dangerous. It is essential to provide a different experience to their pre-existing notions of relationship and attachment by demonstrating that relationships can be safe, positive, and nurturing.

7 Tips to Create a Positive Client-Clinician Relationship

  1. Adopt the P.A.C.E Model: Be open and transparent about appointment expectations.
  2. Offer Choices: Give young people choices around their appointment times, where possible.
  3. Empower Young People: Equip them with what they need to participate in the shared decision-making process.
  4. Be Predictable and Consistent: Maintain a consistent approach and responses.
  5. Embrace Unconditional Positive Regard: Show acceptance and support.
  6. Stay in Control: Manage your own emotions in stressful times.

Link to P.A.C.E Model