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Royal Commission into Victoria’s Mental Health System

Case study:

Coral Tree Family Service

Coral Tree Family Service

Coral Tree Family Service offers a four‑night intensive family residential program to assist the families of children with mental health, behavioural, emotional and relationship difficulties. The entire family (everyone living in the same household as the referred child) attends the program. It has been operating in its current form for 20 years, providing a service to families across New South Wales.

Cathryn McElroy, Service Manager at Coral Tree, said it is a unique model that focuses on elements of family therapy, parent management training and attachment‑informed interventions.

It is the only organisation of its kind in Australia to offer a residential service—the most unique part about spending a week at Coral Tree is the chance to have in‑the‑moment observation and coaching. Staff are present at community activities, mealtimes, points of transition and family fun time, to both observe and provide assistance.

Ms McElroy added that children and families admitted to the service have already had significant outpatient family, parenting and psychiatric input, and that four nights in the program can effect change.

We find a one‑week admission to be long enough to make some changes, with a significant burst of intensive input, and short enough to maintain the focus of family and staff, and not get too ahead of the ‘reality’ of the need to return home to put things into practice.

Dr Matthew Symond, Clinical Lead at Coral Tree, said the program makes no assumptions or determinations of who is in a child’s family, which can include parents, carers, grandparents and siblings.

They define the family—but we request that parents or carers and/or other members attend for the treatment. If the parents are separated, they access the service separately. The key to the success of the program is the continuity of people involved in the treatment.

Treatment is provided by a multidisciplinary team that includes a child and adolescent psychiatrist, nurses, psychologists, social workers and peer family workers. Staff support parents as situations are occurring by checking in, offering thoughts about what strategies could be used, and assisting parents when managing any risks. According to Tamar Karkour, Clinical Psychologist at Coral Tree, this coaching can be as little or as much as the parents like, as staff are guided by the parents’ preferences.

Clinical staff actively coach parents in moments that present a challenge for them in their daily life. For example, a child refuses to take medications, getting dressed for school or any other stressors in the day. How to outlast an escalation, support a parent to enforce strategies such as time out, and praise them healthily, are all aspects of coaching for the parent that this model offers.

The Lawson family spent five days in the program to support their 10‑year‑old son Adrian and said the help they were given was invaluable.

This is our second visit to Coral Tree … If you had told us six months ago that life could begin to be almost normal, we would not have believed it. Adrian has behaviour problems, which escalate to violent outbursts and end with someone getting hurt … We have been given so much help, advice and encouragement here. We learnt that [my partner] and I also had many things that needed to change, to help Adrian and bring us together as a family. It is very hard to change ten years of ‘life’, but we are doing it. Step by step. [We] now feel that we are able to be ‘parents’.

Source: RCVMHS meeting with Coral Tree Family Service, March 2020; Peter Krabman and others, Intensive inpatient family work with families of children with emotional and behavioural difficulties: an Australian experience.

Photo credit: Cathryn McElroy