Baobab Centre: Assessing change and understanding impact

The Baobab Centre works with young asylum seekers who have with complex and chronic symptoms related to trauma, grief and developmental difficulties. It seeks to achieve positive outcomes for its young community members in the short, medium and long term and in particular tries to increase resiliencies and well-being. After a series of violent experiences in their home countries and during flight, young people need help over a long period of time to achieve a steady sense of well-being and peace of mind.

There are clear, measurable positive subjective and objective changes that are the consequence of psychotherapeutic individual and group work and other therapeutic activities. There are also persistent observable difficulties. Progress after massive trauma is a slow process that sometimes involves moving two paces forward and one backwards.

Psychological and Developmental Outcomes:

The outcomes towards which we are working for each young person who attends the Baobab are:

Regulating Affect:

  • Managing strong feelings (rage, fear, sadness, shame, guilt)

  • Reducing symptoms of depression, anxiety and lack of motivation

  • Feeling in control of mind and body

Relationships:

  • Developing a relationship with self (caring for oneself and self-awareness)

  • Developing the capacity for relationships with others (both formal and informal peer and intergenerational relationships) and to develop bonds of attachment

  • Developing the ability to study and work and participate in social and community life

Developing resilience:

  • Enabling the development of secure and stable identity

  • Accessing old resiliencies that have been lost due to traumatic experiences and development of new resiliencies through the exploration of both nourishing and destructive past experiences

  • A developmental shift from a sense of isolation and a feeling that they are expendable, to holding a sense of agency and entitlement, self-confidence.

Evaluation of Psychological and Developmental Outcomes:

Subjective Measures

Psychotherapists work with young people and regularly discuss the outcomes of psychotherapeutic work in terms of regression, ‘stuckness’ and forward moves. Young people attending the Baobab Centre generally wish for both internal and external outcomes. For example, their internal goals may include development of an ability to focus and concentrate, to be in control of their lives and feel balanced, to sustain or increase self-esteem, to reduce stress, and to be able to improve relationships with others; while external goals include feeling a part of various groups (school, college, work) in the community and not on the margins.  We work on these outcomes through the process of skilled psychotherapeutic work which includes the developing relationship between therapist and young person in combination with our holistic therapeutic approach wherein the Baobab Centre acts as a transitional community between their experiences of their home country and of the local social environment in the UK. 

Objective Measures

In addition to the ongoing assessment of the subjective measures that take place between the psychotherapist and the young people, we also institute objective measures of outcomes through our formal evaluation process. We aim to be a reflective organisation. We hope that our model of work helps young people by offering a context that holds and contains their difficult feelings and memories and their current problems. Our evaluation process aims to explore the consequences of our work in some detail in order to enable us to think about and improve our interventions.

This objective evaluation of the psychological and developmental outcomes for our young people is carried out annually using a bespoke evaluation tool developed by the Baobab Centre and the Anna Freud Centre. This evaluation tool integrates the Child and Adolescent Mental Health Services Outcome Research Consortium model (CORC) with various other measures relevant to our work. It makes use of a semi-structured interview that includes five standardised questionnaires of emotional well-being, psychopathology and resilience. It examines behaviour, depression, anxiety, affect regulation, resilience and sense of belonging. This enables us to measure changes in a young person’s functioning in various dimensions (for example the ability to mourn losses and the quality of relationships). Each year approximately half of those who attend the centre regularly take part in the evaluation. The external evaluation reports can be accessed here:

Monitoring and Evaluation Report 2016
Monitoring and Evaluation Report 2015
Monitoring and Evaluation Report 2013-2014

Additional measures:

In addition to the annual formal evaluation, evaluations of specific project activities are carried out as they take place (for example, after workshops and therapeutic retreats). Our clinical staff have weekly supervision sessions with the Clinical Director or one of our clinical supervisors to discuss the individual young people whom they have in treatment. We hold fortnightly clinical casework discussions at which case studies or difficulties with individual community members are discussed. These meetings provide an opportunity for the team to think collectively, to learn about what is working well, identify specific challenges and discuss how problems can be tackled. We also run a weekly attendance log so that we can follow up on missed appointments in a timely fashion.

The outcomes that we aim for in our casework are as follows:

  • Greater understanding of the experiences and psychological impact of human rights abuses in assessment and decision-making in asylum cases.

  • Greater protection and safeguarding of children and young people’s rights and needs

  • Reduction and avoidance of destitution through financial advocacy and limited funding in critical cases

  • Better access to healthcare

  • Better access to suitable housing

  • Better access to education

Evaluation of Casework/Practical Outcomes:

The annual evaluation tool includes a section about the young people’s access to services outside the Centre and gathers their perspectives of the casework support they have received. In addition to this, all interventions made by the Senior Social Worker are logged in the casework database/files and progress (for example access to and regular attendance at college, financial support secured, outcome of pathway planning) is reviewed on an ongoing basis during weekly supervision sessions. A quarterly analysis of the beneficiaries with whom the social worker has been working, the areas of intervention and the outcomes is also produced.

Finally, we also carry out ad hoc evaluations of our services amongst those who make referrals to the centre. The last evaluation conducted was published in March 2015 and can be accessed here.

Conclusion

The Baobab Centre is committed to effective, inclusive and transparent work with young people. It believes that its work must be based on sound principles and the evaluation methods set out above should enable the Centre and others to assess the extent to which it is meetings its goals.

Further Information

For further information about our work, please see our Booklet, ‘Wishes, Hopes and Dreams’ in which some of the young people who attend reflect on their values, hopes, coping strategies and what Baobab means to them. With contributions from Sheila Melzak, the Centre’s Director and other staff, the publication gives a sense of Baobab’s holistic, integrated approach and the remarkable young people at its centre. (Download Wishes, Hopes and Dreams)