ORIGIN AND DEVELOPMENT
The CRRES model's origins lay in the early 1990s, in a context sharing some similarities with today, when rates of mental health need and permanent exclusion from schools in England were soaring, and Child and Adolescent Mental Health Services (CAMHS) were suffering chronic shortages of staff. In the mid 1990s there was much focus on local education authorities challenging and supporting schools in tackling emotional and behavioural needs, such that EP services were able to be involved in additionally funded projects aimed towards turning around the concerning trends.
As part of a pilot behaviour support team in my LEA, I was allocated protected time to offer play and creative arts therapy to primary school pupils seen as risk of exclusion. I had trained in integrative arts psychotherapy, part time, whilst in my first main grade EP post, hence I offered sessions in the manner specified by the United Kingdom Council for Psychotherapy for the provision of therapy, including the need for regular sessions at a set time and place, appropriate environment, clear contract of confidentiality, and clinical supervision.
The capacity for this work to facilitate creative symbolic expression of complex emotions proved remarkable. Of particular note was how much information was revealed by children and young people, often from the first session. It seemed clear from the point of view of EP practice, that had this been gathered in an assessment context, and shared with staff and parents/carers immediately after, their support in the change process could have been harnessed much more efficiently than the therapy contract allowed.
For my generic EP work within a cluster of schools, the additional understanding from integrative arts psychotherapy certainly assisted in the formulation of factors impinging on problem situations, and influenced consultation and advice, but in the time allocated it was not possible to offer multiple sessions of direct work for children for whom the school raised concerns. So the development of a therapeutic assessment approach which could combine the merits of EP assessment and creative arts psychotherapy began.
Using a practice-based evidence approach (Dunsmuir and Hardy, 2016), and still with the benefit of clinical supervision, carefully chosen activities from integrative arts psychotherapy were adapted and introduced into SEMH assessments for the full school age range, to see what might be achieved in a single session format, whilst ensuring a safe, boundaried, enabling experience for the child. The results were overwhelmingly positive, from the perspective of child, school, parents/carers, EP and LA, in terms of the detail of information gathered, and its usefulness in assisting the wider system in formulating ongoing intervention to promote children’s well-being. Incrementally the number of activities was built up, until a comprehensive array was arrived upon, which was practical, portable and flexible according to age and nature of presenting SEMH need. The CRRES Model of therapeutic assessment was born!