Therapeutic care: Evidence brief

Published: April 16, 2021

This evidence brief presents a comprehensive narrative review of the therapeutic care literature.

Background

The purpose of this evidence brief is to provide a description of ‘therapeutic care’ and outline essential aspects of the therapeutic care environment. Therapeutic care incorporates a range of interventions, or ‘ways of working’, usually stemming from a variety of therapeutic techniques or theories presented and employed in different ways.

This evidence brief does not attempt to gather all the available evidence on therapeutic interventions to assess their effectiveness. Rather, it starts with a fundamental question: what is common to good practice therapeutic care? This evidence brief should provide an adequate overview and depth of coverage to inform discussion and decision-making.

Key findings

  • While there are distinctions between aspects of therapeutic care, what is common among definitions at different levels is the focus on healing and safe relationships with caregivers and workers at the centre of therapeutic care practice.
  • Relationships are one among several ‘common factors’.
  • Māori models of health and wellbeing are a way of conceptualising therapeutic focus. The foundations of Māori healing practices are based on interconnected relationships. The health and wellbeing of tamariki Māori is inseparable from that of their whānau.
  • Research on therapeutic care interventions, including in residential care settings, demonstrates effectiveness if they are responsive to children’s needs.
  • Most of the therapeutic interventions used in Aotearoa New Zealand originate in part or entirely from overseas. They do not adequately address Aotearoa New Zealand’s unique cultural context, specifically for Māori, and for other ethnic groups.
  • The importance of cultural identity is found in the literature on good practice therapeutic approaches involving Indigenous populations, along with considerations of spirituality, understanding family dynamics, and crucial links to the surrounding environment.
  • Similar themes, including a strong cultural identity for tamariki Māori and adults, are found in the Aotearoa New Zealand literature.
  • Collaborative approaches are the best way to pursue change and develop a suitable therapeutic care framework.