The role of emotions in therapeutic care

May 2019

Written by Noel Macnamara

The role of emotions within human service work may at first glance appear to be intuitively obvious and incontestable. Indeed, Howe (2008) described the day of a human service worker as ‘suffused with emotional content’. The role of emotions is at the core of literature regarding relationship-based practice and the separation of feelings from professionalism can be seen as anathema in an interpersonal profession (Hennessey, 2011). Intensive Therapeutic Care has been described as:

Providing quality care environments that support positive, safe and healing relationships and experiences, to address individual and complex needs and work towards addressing the trauma experienced…The children and young people will receive the appropriate level of care, ‘in the right way, at the right time

FACS, 2016

Staff who work in such an environment require leadership that is emotionally intelligent responsive, authentic, open and honest and compassionate.
This blog will explore how the development of two habits that can help increase your Emotional Intelligence (EQ or EI). Emotional Intelligence is a term created by two researchers Salavoy & Mayer (1990) and popularised by Dan Goleman in his 1995 book of the same name.

Ingram (2013) highlights the role of emotional intelligence as a trait and skill that can help human service leaders manage the emotional complexities of practice. Emotional intelligence can be briefly defined as the ability of an individual to: be aware of their own emotions; be able to understand and manage these effectively within relationships; be motivated to similarly understand the emotions of others; and to communicate this within relationships (Salovey and Mayer, 1990; Morrison, 2007). Such leadership capacities are crucial for relationship-based practice, as they underline the existence and importance of emotions within residential care practice.

In practical terms, this means being aware that emotions can drive our behaviour and impact people (positively and negatively), and learning how to manage those emotions – both our own and others – especially when we are under pressure; a common condition in residential services work.

According to Goleman (1995), there are five key elements to it:

  • Self-awareness.
  • Self-regulation.
  • Motivation.
  • Empathy.
  • Social skills.

The more that you, as a leader, manage each of these areas, the higher your emotional intelligence. Good leaders know that there is power in emotions. They work smarter, not harder and use their insights to cultivate conditions that tend to motivate others. Research studies, such as that done by the Harvard Business School determined that EQ counts twice as much as IQ and technical skills combined in determining who will be successful. It has also found that people with high EQ experience vast benefits including better mental health, job performance, and leadership skills.

Below are two powerful habits that can help you to continue cultivating your leadership skills related to emotional intelligence. Emotionally intelligent leaders:

1. Focus on the AFFECTIVE before the EFFECTIVE

This approach helps us build and nurture positive relationships. The rule means that affective considerations (how people feel) are vitally important, and often pave the way for effective results (what people achieve).

“Culture eats strategy for breakfast” is a famous quote from legendary management consultant and writer Peter Drucker. To be clear he didn’t mean that strategy was unimportant – rather, that a powerful and empowering culture was a surer route to organisational success.

How people within a program, agency or organisation FEEL. The affective part- is crucial to an organisations/programs’ long term culture and success. What research has told us is that the results – the effective part- flows because of the presence of happy, challenged, empowered people within the organisation.

Emotionally intelligent leaders know that one of the most artful, yet trustworthy, ways to take the “temperature” of their organisation and forecast positive outcomes is to gauge how people FEEL. Do your staff feel…. Happy. Valued. Challenged. Excited. Safe. Inspired. Appreciated. Resourced. Hopeful? This is one antidote to high staff turnover.

When leaders have a single focus on outcomes or processes without accounting for affective elements, they may be susceptible and eventually contribute to not only creating the conditions for burnout of their staff but also themselves.

Emotionally intelligent leaders proactively invest time, resources and sometimes make explicit mention that they care about their staff and service users

Emotionally intelligent leaders proactively invest time, resources and sometimes make explicit mention that they care about their staff and service users (the Affective part). Emotionally intelligent leaders know that: everyday acts of care and recognition are more important than formal standards and procedural requirements. Without this kind of human interaction, there are no relationships. Without relationships, there is not trust. And without trust staff feel unsafe, like no one has their back, and this results in them spending more energy on self-preservation and leads to low innovation and lack of agility and responsiveness to complex and challenging situations, the essence of therapeutic residential care.

To be clear. Everyone agrees that outcomes (Effective considerations) are vitally important. No doubt. One of the exciting consequences of the “Affective before Effective” rule is that not only does everyone end up feeling better (Affective), they often also end up producing better outcomes (Effective) for the organisation. Effective relationships are central to successful outcomes.

There are compelling philosophical, policy and practice reasons to put relationships at the heart of our leadership practice. In short: Be affective to be even more effective.

2. The Power of WHY

The second habit of emotionally intelligent leaders is understanding the power of Why. This reminds leaders to drop the ego of “I” and speak from the vision of WHY (connect to the larger purpose or vision).

With significant demands in their roles, very often leaders will think and speak from an “I” perspective (which is totally understandable). They’ll make statements that begin with phrases like “I need you to….” or “I want to make sure that the results are….”. These statements are productive and necessary – at times. However, and here is the caveat- sometimes it’s important to focus on the WHY first and intermittently throughout the grind of the day or week.
Importantly, “Why before I” leaders periodically and explicitly talk about the “why” to frame the discussion. They increasingly use WHY statements. Why statements state the WHY first (the larger purpose) and then lead into stating a goal or making a request. There is a difference between ‘supplying’ information about what, where, how and when things will happen and deeply ‘engaging’ with people, actively listening, supporting capacity development and authentically connecting people to find shared opportunities. Purpose should permeate everything you do. “Every decision should be looked at in terms of purpose.

For example, at the ACF, we are committed to making sure that every child and young person feels safe and is relationally supported (the WHY) and that is why we

privilege relationship before all other forms of therapeutic intervention

Relationships are central to the healing process for children and young people who have experienced multiple adverse childhood experiences. The quality of life, happiness, their ability to cope when things get tough for a child are all directly related to the degree that they feel connected to a healthy adult who they can rely on for support.

Another example: At our organisation, we believe in the power of collaboration and dreaming big to change the experience children and young people in the OOHC system (the WHY) and that is why we form partnerships with organisations around Australia to de-silo and create join-up approaches to care for these children.

Connecting to the why can help us tap into our emotional power. When we are drained, or frustrated in our roles, the question we commonly ask ourselves is “why am I doing this”. A person’s WHY can be motivating and help people persist amid challenges. Our neocortex can process the what and the how, our emotional limbic brain is motivated by the why. That is why services and leaders only feel right when there is a why behind what they do. Why is all about your raison d’etre, cause and beliefs.

“I statements” can appear self-serving even when they are not. A leader may be thinking about the WHY (larger purpose or vision) while delivering an I message, but staff are not mind readers. In these scenarios, the message heard is about the leader (the I). The connection with the larger purpose or vision can get lost.

You are a leader for many good reasons. You also often connect to your WHY at times without saying it out loud. The power of WHY invites you to refer to and say your WHY periodically so that it transforms from latent potential to practical inspiration.

Noel MacNamara
Senior Advisor, Centre for Excellence in Therapeutic Care

References

Goleman, D. (1995). Emotional intelligence. New York: Bantam.
Howe, D. (2008) The Emotionally Intelligent Social Worker, Basingstoke: Palgrave. (p. 13)
Hennessey, R. (2011). Relationship Skills in Social Work, London: Sage.
Ingram R (2013) Locating emotional intelligence at the heart of social work practice. British Journal of Social Work, 43, 5, 987-1004
Morrison T (2007) Emotional intelligence, emotion and social work: context, characteristics, complications and contribution. The British Journal of Social Work, 37, 245-263
Salovey P and Mayer J (1990) Emotional intelligence. Imagination, Cognition and Personality, 9, 185-211

You may be interested in: Supervision Trauma-informed care

An emerging paradigm - Welcome to our new therapeutic care blog
An emerging paradigm - Welcome to our new therapeutic care blog
Over the past two decades, the term therapeutic care has emerged as a new paradigm used to integrate constructs that had traditionally been considered separate – therapeutic processes and the...
Read more
Coaching and mentoring - The art of giving feedback - Practice guide
Coaching and mentoring - The art of giving feedback - Practice guide
This guide has been developed to support Therapeutic Specialists and Supervisors in Intensive Therapeutic Care in NSW in their development and support of staff. It is a companion to the...
Read more
A model for coaching staff in Intensive Therapeutic Care: A guide for therapeutic specialists and supervisors - Practice guide
A model for coaching staff in Intensive Therapeutic Care: A guide for therapeutic specialists and supervisors - Practice guide
This guide has been developed for use by Therapeutic Specialists and Supervisors who have a role in supporting and developing the practice of staff. It covers the critical elements of...
Read more
What is effective therapeutic care? Research brief
What is effective therapeutic care? Research brief
This research briefing is an introduction to therapeutic care as a preferred response for children and young people who have experienced complex trauma and are unable to live at home....
Read more
The evidence base for therapeutic group  care:  A systematic scoping review - Research brief
The evidence base for therapeutic group care: A systematic scoping review - Research brief
The NSW Government has undertaken major reforms over the past two years aimed at improving outcomes for children and young people in out-of-home care. Following a review by Verso Consulting...
Read more
The needs of LGBTIQ young people in out-of-home care - Research brief
The needs of LGBTIQ young people in out-of-home care - Research brief
Young people who are same sex attracted, trans or gender diverse – a population who will be referred to in this document as LGBTIQ (lesbian, gay, bisexual, transgender, intersex and...
Read more
Safety from the outside to the inside
Safety from the outside to the inside
At the recent Therapeutic Specialist’s forum, there was lots of discussion about the concept of physical and relational safety in Intensive Therapeutic Care (ITC). We all agreed that it is...
Read more
Therapeutic residential workers? Who are we?
Therapeutic residential workers? Who are we?
This blog is to introduce my recent research with therapeutic residential workers. Further blogs and practice guides relating to finding, keeping, acknowledging and celebrating the best person for the job...
Read more
The role of supervision in the trauma-informed journey
The role of supervision in the trauma-informed journey
The intention of trauma-informed practice and care is an increased understanding of how present behaviours and difficulties can be understood in the context of past trauma. The approach offers a...
Read more
Understanding and supporting young people who self-harm in residential care
Understanding and supporting young people who self-harm in residential care
Some of the young people we care for in the ITC programs deal with emotional distress and pain by hurting themselves physically. Young people hurting themselves is distressing to them...
Read more
The role of praise in working with young people
The role of praise in working with young people
We can see each of our daily interactions with each of the young people we care for as bids for connection.  By choosing to turn toward, to turn away, or...
Read more
The healing power of friendship
The healing power of friendship
Can the friendships and connections that can develop in Intensive Residential Care be nurtured and grown rather than feared? I would like you to take a moment to think back...
Read more
Preventing self-harm among young people in out-of-home care - Research brief
Preventing self-harm among young people in out-of-home care - Research brief
Many young people in out-of-home care are at an elevated risk of self-harm and suicidality. The reasons range from early exposure to abuse, disconnection from family, instability of their living...
Read more
The 10 essential elements of Intensive Therapeutic Care NSW - Practice guide
The 10 essential elements of Intensive Therapeutic Care NSW - Practice guide
This guide has been developed to describe the 10 Essential Elements that form the basis for Intensive Therapeutic Care (ITC) service provision in NSW. The 10 Essential Elements have been...
Read more
Vicarious trauma and secondary stress in therapeutic residential care - Research brief
Vicarious trauma and secondary stress in therapeutic residential care - Research brief
It is generally accepted that child welfare professionals are at high risk of experiencing vicarious trauma: the manifestation of traumatic symptoms resulting from working with individuals who, themselves, have encountered...
Read more
What works? Promising practices to support young people who self-harm
What works? Promising practices to support young people who self-harm
Why do young people in out of home care self-harm? What are the best predictors of suicide and self-harm? What really works when supporting young people who self-harm in out-of-home...
Read more
Q&A with Cate Keady from the Elver Program
Q&A with Cate Keady from the Elver Program
Since 2018, Cate Keady has worked within the Department of Communities and Justice to establish and manage the Intensive Support Services Elver Program - in partnership with South Western Sydney...
Read more
What makes a good therapeutic residential care worker? Practice guide
What makes a good therapeutic residential care worker? Practice guide
Trained staff and consistent rostering are essential elements of therapeutic residential care. The purpose of this guide is to consider more broadly what makes an excellent therapeutic residential care worker...
Read more
Achieving effective supervision – Games that supervisors play
Achieving effective supervision – Games that supervisors play
In the previous blog, we discussed how easy it is for the supervisor/supervisee relationship to be consciously or sub-consciously ambushed by power/defensive game play. Kadushin (1968) described games as repetitive...
Read more
A story you may recognise
A story you may recognise
Peta had worked in residential care for 18 months. She took the position because she had had a difficult childhood and she felt that she had a lot to offer...
Read more
How do you prepare for the transitioning of young people into an Intensive Therapeutic Care house? Part 2
How do you prepare for the transitioning of young people into an Intensive Therapeutic Care house? Part 2
In the first part of the Blog, we explored limit and expectation setting, maintaining a state of occupancy and the planning process for a successful transition. In part two of...
Read more
How do you prepare for the transitioning of young people into an Intensive Therapeutic Care house? Part 1
How do you prepare for the transitioning of young people into an Intensive Therapeutic Care house? Part 1
This is a two-part blog and will focus on the transition of young people into an Intensive Therapeutic Care house; however, most of the content is transferrable to other placement...
Read more
Changing your practice to being trauma informed in therapeutic residential care
Changing your practice to being trauma informed in therapeutic residential care
Whilst the following Arabian proverb takes a bit to get your head around it leads rather nicely into this blog and our brief introduction on the relevance of the conscious...
Read more
Supporting children in out-of-home care to cope with ambiguous loss
Supporting children in out-of-home care to cope with ambiguous loss
When you think of grief and loss, what comes to your mind? You may think of the immense sorrow one may experience. For some of us, we can seek solace...
Read more
Trauma-informed care - Research brief
Trauma-informed care - Research brief
This research briefing aims to define and clarify what trauma, complex trauma and trauma informed care are. Extensive literature has now surmised that exposure to adverse experiences such as child...
Read more
Trauma-informed relationship based recovery reflection tool
Trauma-informed relationship based recovery reflection tool
“Childhood trauma has the potential to interrupt the normal physical, physiological, emotional, mental and intellectual development, of children and can have wide-ranging, and often life-long implications for their health and...
Read more
Secondary traumatic stress and staff well-being: understanding compassion fatigue, vicarious trauma and burnout in therapeutic care - Practice guide
Secondary traumatic stress and staff well-being: understanding compassion fatigue, vicarious trauma and burnout in therapeutic care - Practice guide
This guide has been developed to support organisational congruence and in the provision of trauma informed therapeutic care and the critical need for a well-supported, capable, and stable staff group...
Read more
Frequently asked questions by foster carers: Behaviours that challenge
Frequently asked questions by foster carers: Behaviours that challenge
In Australia, there are about 18 thousand children and young people in foster care. Most foster carers will be the first to tell you how rewarding it is – but...
Read more
12 ways foster and kinship carers can promote compassion and self-compassion in children and young people
12 ways foster and kinship carers can promote compassion and self-compassion in children and young people
What are Compassion and Self-Compassion?Compassion is the ability to feel and connect with the suffering of another human being, self-compassion is the ability to feel and connect with one’s own...
Read more
Trauma-sensitive family time is about connection and repair
Trauma-sensitive family time is about connection and repair
Relationships with family come with good times and challenges for everyone, but for children and young people in care, this birthright of family connection can often be deprioritised for the...
Read more
Trauma-informed care connects to children’s needs; trauma-informed carer training should connect to carers’ needs
Trauma-informed care connects to children’s needs; trauma-informed carer training should connect to carers’ needs
The CETC is thrilled to announce our new online course “Caring for Children and Young People with Trauma” is now live and free for all South Australian kinship and foster...
Read more
Can we provide trauma-informed care for children without changing our beliefs about their behaviour?
Can we provide trauma-informed care for children without changing our beliefs about their behaviour?
This blog article was written by Noel Macnamara, Executive Manager - Research and Policy and Deputy Director, Centre for Excellence in Therapeutic Care, CETC. There is a growing tendency to...
Read more
The role fear plays in the lives of children and young people in out-of-home care
The role fear plays in the lives of children and young people in out-of-home care
Fear is a fundamental human emotion triggered by a perceived threat. It serves as a basic survival mechanism that signals our bodies to respond to danger with a fight, flight,...
Read more
The effective and efficient approach to preventing placement breakdowns
The effective and efficient approach to preventing placement breakdowns
For children with complex trauma, the out-of-home care sector is more often reactive rather than proactive or preventative. Not many programs exist to provide significant early intervention support, as opposed...
Read more
Q&A with the trainer: Trauma-informed supervision
Q&A with the trainer: Trauma-informed supervision
Over the recent decades, we have seen leaps in research and practice promoting the importance of taking a holistic trauma-informed approach to caring for children and young people with trauma....
Read more
Q&A with the trainer: Behaviours that challenge
Q&A with the trainer: Behaviours that challenge
One of our most frequent requests at the CETC is for more training on how to respond to the behaviours of young people in out-of-home care that caregivers can find...
Read more