Kisimul’s
Therapeutic Services
We are a multidisciplinary team of more than 20 people who work together to support the young people and adults within our services to become more independent and enjoy a lifestyle that supports health and wellbeing. We support individuals to work towards reaching their full potential and promote their capacity for self-determination and self-efficacy in a safe and supported way.
Introduction
Our Therapeutic Services team provides a range of support, both direct and indirect, to ensure that a person’s admission, time within the service, and any transitions, are supported by considering each person’s individual needs within the ethos of positive behaviour support.
Our team works collaboratively with the wider multidisciplinary team, individuals’ families, other professionals and stakeholders to promote the wellbeing and best interests of the people who use our services. We work as part of an integrated team, alongside education and care colleagues, to develop and extend individuals’ knowledge, skills and experiences. Another key role of the team is to support our staff to understand and meet the needs of the people we support. We provide training to our residential and education teams on a wide range of topics including Autism, Effective Communication and Makaton. Our team is also readily accessible to the wider multidisciplinary team to provide advice and resources to support their work with individuals within our services.
What support is provided?
We strive to ensure that every individual has the support they need within their daily lives in their home and educational environments at Kisimul. We call this ‘Universal Support’ and this is achieved by providing the following:
- Written guidelines focusing on an individual’s needs and how to support them effectively
- Advice on any equipment or resources that may be needed to support individual needs
- Training for our staff teams to ensure they are confident in how to meet the needs of the people they are supporting
- Attendance at regular multidisciplinary meetings to review progress and ensure effective ongoing support is available
Once a person is settled at at Kisimul, and the universal support they need is in place, we will assess what further input they may need that can be offered by our team. This could include group or 1:1 therapeutic input. Our ultimate aim is for individuals to maintain and generalise their knowledge and skills throughout their daily life. We want progress to be meaningful for each individual to increase their independence and confidence in line with their goals and aspirations.
Occupational Therapy
Occupational Therapy supports individuals’ health and well-being by encouraging and supporting engagement in occupation. We refer to occupations as the everyday activities that people do as individuals, in families and with communities to bring meaning and purpose to life. Occupations include things people need to, want to and are expected to do (World Federation of Occupational Therapists, 2012).
The people who live and/or attend educational placements at Kisimul may have complex patterns of behaviours, sensory differences, communication and social interaction difficulties that prevent them from engaging in occupations that are meaningful. We work with individuals to support their engagement in everyday activities to promote a meaningful and purposeful life. This may involve modifying the occupation or environment for an individual to motivate and facilitate their engagement. We also work with individuals’ families and staff teams to help maintain and generalise the person’s skills through all aspects of their life. The people we support may not have had the opportunities to develop a routine or range of occupations in their lives that enables them to feel fulfilled. We work in a person centred and holistic way to enable individuals in our services to realise their potential for independence and well-being.
Our team will assess a person’s individual needs by completing observations and we may also use formal standardised and/or non-standardised assessments to evaluate the person’s strengths, skills and functioning. We will then identify areas where specific interventions or programmes may benefit the person’s development and consider this within the context of their interests, wishes and aspirations. We will also gather information through talking to individuals, staff members, and families.
We support individuals to develop their functional skills and independence across a range of daily activities and pursuits, these may include:
- Personal care tasks such as washing, dressing and eating
- Domestic tasks such as cooking and cleaning
- Accessing the community e.g. using transport and going shopping
- Accessing leisure activities e.g. physical activity/sport and developing roles within the local and wider community
- Accessing educational environments and the curriculum
- Helping with the development of skills such as handwriting
We support the development of these occupations through:
- Development of fine and gross motor skills
- Supporting people with their eating and drinking skills
- Helping people with their sensory and emotional regulation
- We may also assess an individual’s sensory processing skills, how their environment impacts on this and what other techniques to use to enable improvement in self-regulation skills. One of our Occupational Therapists has postgraduate qualifications in sensory integration and may implement a programme using a sensory integration-based approach
- Recommending particular equipment/environmental adaptations in specific settings
- Contributing to risk assessments
- Writing and regularly reviewing person centred programmes that are implemented by support staff in the homes and classrooms.
- Providing group or 1:1 therapy sessions
- Contributing to EHCP reviews
- Coaching and training staff
- Consultation with staff and families
Through this support, we aim to increase a person’s motivation and engagement in occupation and improve their ability to communicate and interact to reach their occupation goals. We want individuals to gain confidence with their daily functional skills and enjoy access to a wide variety of pursuits with as much independence as possible.
Psychology
We provide specialist educational and clinical psychology services to individuals in our schools, children’s homes and adult services. Our support can be delivered directly to the people we support, or through advice/training and collaboration with the multi-disciplinary team at Kisimul.
We are able to complete a variety of psychological assessments which help us to understand the people we support as well as guide our formulation as to the best way to help staff to support them. We evaluate and make decisions about interventions, taking into account theoretical and therapeutic models and factors concerning historical and developmental processes, which have shaped the individual and their support network.
The Clinical and Educational Psychologists are supported by Assistant Psychologists who receive regular supervision from the Psychologists.
We support individuals with the following:
- Exploring their self-identity
- Promoting emotional regulation through both self and co-regulation strategies
- Promoting social, emotional, and mental health
- Developing executive function – the ability to use cognitive abilities to plan and organise
- Developing functional and independence skills
- Learning more effective and safer ways to manage their emotions and behaviour
- Learning more effective ways to express how they are feeling and seek the support that they need
- Achieve educational success commensurate with their abilities and learning potential
- Raising their self-esteem and self-confidence
We support the development of these areas through:
- Assessing a person’s psychological needs through standardised/non-standardised assessments and/or observations
- Identify learning and cognitive difficulties
- Helping people with their emotional regulation e.g. through recommending approaches such as emotion coaching or through direct session work with individuals
- Contributing to risk assessments
- Writing and regularly reviewing person centred intervention plans
- Providing group or 1:1 interventions
- Recommending approaches or strategies that are implemented by support staff in the homes and classrooms.
- Contributing to EHCP reviews
- Attending multidisciplinary meetings
- Liaising with external agencies such as CAMHS
- Coaching and training for staff e.g. on topics such as Attachment
- Consultation with staff and families
- Contributing to person centred support plans
- Analysing behaviour using evidence-based approaches
We aim to help the people we support to develop as much independence as possible in respect of achieving their learning goals, regulating their emotions and taking care of their physical and mental wellbeing. We want the people who use our services to enjoy a good quality of life and achieve as much success in their life as possible. Our team strives to help individuals achieve this through the range of direct and indirect support offered by our service.
Speech and Language Therapy
Each Kisimul school has its own team of Speech and Language Therapists and SLT Assistants. The Kisimul SLT teams promote and support a Total Communication environment throughout care and education settings, finding and using the right combination of communication methods for each pupil. This approach helps an individual to form connections, ensures successful interactions and supports information exchanges and conversations.
Our goal is to embed communication strategies within the pupils’ daily environments consistently in order to facilitate communication at all times. This universal approach ensures communication is supported from the first day a student attends our setting. Our approaches include using a range of alternative and augmentative communication methods such as:
Makaton
Objects of Reference
PECS (Picture Exchange Communication System)
Communication boards and books
High tech devices such as iPads
Various therapeutic approaches such as Intensive Interaction, Attention Autism, Social Stories, and Comic Strip conversations support students to develop their language and social interaction skills.
A full assessment of each pupils’ needs is made and, where direct support is required, a therapy plan is put into place to support individual target development. Individual and/or group sessions may be offered with SLTs or SLTAs (under supervision from the SLTs). Where appropriate, plans are written collaboratively with other therapists to ensure the best outcomes for each pupil. Joint therapy sessions ensure enjoyable and accessible interactions for all pupils.
Indirect support is also an essential part of the therapy process and the SLT teams invest time in a wide programme of staff training and supporting pupils in the classroom and care settings, as well as during off site activities. Regular multidisciplinary team meetings ensure all members of the team are working together effectively. The SLT team also contribute to the annual review of EHCPs.
At Kisimul, we believe that a crucial part of our role is giving our pupils a voice. This includes making Mental Capacity Assessments to establish each person’s ability to process information and contribute to the decision making regarding their care where possible. The team uses creative approaches to support this process including tailoring information to their level of understanding, using visual supports such as photos, symbols, Talking Mats and Social Stories.
Music Therapy
Kisimul employs the services of Music Therapists who work across the schools on a sessional basis. It is an established psychological clinical intervention which is delivered by HCPC registered Music Therapists in which music and sound are used therapeutically to support and encourage emotional, social and physical wellbeing in children and young people who have behavioural and learning difficulties.
Central to the therapy is the relationship that is established and developed between the therapist and pupil through engagement in live musical interaction and play. A wide range of musical styles and instruments can be used, including the voice. For pupils who do not communicate verbally, or who have very limited verbal ability, it can offer an alternative language through which they can express themselves, release their emotions and frustrations and through which the therapist can establish a common connection. Within this, the therapist uses free-flowing improvised (not composed) music and the children and young people can express themselves by using a variety of instruments such as drums, guitars, keyboards, wind-chimes, blowing and ethnic instruments. As the therapist listens and responds to their sounds, new ways of relating can emerge, leading to development and change.
Such musical dialogues involve many of the fundamental elements of social interaction, such as self-awareness and “self in relation to another”. Because of this, the musical aspects of interpersonal timing, attuned reciprocity in shared play, turn-taking and listening and responding to another person can be augmented in music therapy very effectively with people with autism. This is because it accommodates and addresses their frequently idiosyncratic and avoidant style of communication.
Additionally, the individualistic approach of music therapy, in which the therapist actively endeavours to ascertain and work with the type of sound that a particular individual prefers, is one of the strengths of its application to people with autism as it offers them an opportunity to feel confident when expressing themselves. Music therapy also offers the opportunity to experience a wider range of emotions and to develop reciprocal communication.
Art Therapy
Like any psychotherapy, the aim of art therapy is to work with children and young people to increase self-awareness, self-esteem, improve upon relationships with self and others, engage with the school environment in a more positive affect and can help process and manage difficult feelings and behaviours and has the ability to provide a relational container for the child or young person to understand more about themselves.
