This week I want to celebrate one of the most exciting projects underway at Plymouth Institute of Education: the SAFE Project.
SAFE is an intervention for families of a child/children with a diagnosis of autism developed by Professor Rudi Dallos and Dr Rebecca McKenzie (Stancer) in collaboration with families of children with a diagnosis of autism.
Becky Stancer (formerly McKenzie) writes:
“Systemic Autism-related Family Enabling (SAFE) is a manualised systemic intervention for families of children with a diagnosis of autism spectrum disorder. SAFE draws on evidence based principles of Family Therapy and what is known about the strengths and preferences of people with autism. SAFE is delivered by trained therapists and is a flexible toolkit of activities that can be used with families depending on their needs. The purpose of SAFE is to support families to build on their strengths and enhance their problem solving and coping strategies to deal with everyday challenges.
The University of Plymouth and the Plymouth Autism Network supported the development of SAFE. See our news item here
We carried out a randomised controlled trial, funded by the National Institute for Health Research (NIHR), to assess the feasibility of SAFE. The results of the trial were very positive. A copy of the trial protocol paper can be found here.
Autistica funded a research project which focused on the experience of families receiving SAFE. You can read more about our research on the Autistica website here. The outcomes of the project showed that families receiving the intervention found it helpful in the following key areas:
Therapist as helping reflection
The therapists were seen as helping families to focus and encouraging reflective processes in the family which included a sense of helping them to slow down, pause and think and support the development of new solutions to their problems.
This featured changes in understanding of each other, the autism and of family dynamics. This also included a sense that they understood each other better – increased empathy.
Feeling closer to each other and as a family
This contained a sense of the family members feeling less conflictual and blaming of each other. The focus on positive events and cycles assisted with this related to families generally feeling more hopeful, able to cope and to assist each other.
Feeling more confident to cope with problems
There was an overall sense that the sessions helped them to feel more able to cope with problems and important in this was a belief that they could better understand and manage the meltdowns in the future.
More able to reflect and problem solve
This included the families feeling more able to stand back, reflect and think about their dynamics and develop new ways to manage problems. This connected with the sense of being more able to solve problems but specifically contained the view that this was because they could reflect more clearly and constructively.
This contained the ideas that the session helped people to be able to communicate their thoughts and feelings and that the various activities helped with this. Especially for the children being able to express things visually helped them to communicate what would be difficult for them in words
Feeling less alone and isolated
Particularly from the Multi Family Therapy sessions families expressed an important benefit and change in feeling less alone and isolated and a sense of sharing their difficulties with other families. This contained a powerful theme of feeling validated and not to blame for problems, especially with regard to meltdowns which they could experience as humiliating in public.”
What do families say about SAFE?
“The best part of the sessions was hearing positive things. You rarely hear positive things about your parenting and how you are doing well as a family” (Father)
“learning about supporting the family as a whole. Wanting the family to find solutions together. Sitting with husband going through things. Understanding every family is different with ranges of approaches to situations” (Mother)
“talking about our family challenges and listening to your suggestions. Feeling understood, listened to…feeling supported” (Mother)
“the part when we made playdoh figures and what we were like. I told my mum lots more about me” (Autistic child)
“looking at what went well and what didn’t. Because we got to see what can lead to/prevent a meltdown” (Sister)
SAFE for Schools
Families receiving SAFE commonly report interactions with schools as being problematic and their children are often subject to informal exclusions. Discussions with teachers also identified concerns about how to manage difficult behaviour among children with autism and to collaborate effectively with families. These findings led to the development of SAFE for Schools (SfS).
Tara Vassallo is the lead investigator for SAFE for Schools and is conducting a research project on SfS as part of her Doctoral Studies. SfS uses the same principles and adapted activities from SAFE to provide an intervention which facilitates people around the child with autism working together, sharing strengths and resources to support each other and the child by:
- Developing a secure base- talking to each other and coming to a mutual appreciation of the problems faced and the challenges, successes and beliefs associated with the child with autism. Developing plans for working together
- Understanding the challenges- exploring the nature of key difficulties around meltdowns, anxiety and relationships. Furthering understanding by discussing neurological information, attachment theories and models of intervention
- Developing solutions- using techniques such as tracking, sculpting and thinking about the interests of the child to develop ideas for change
- Moving towards trying out and adapting solutions- trying techniques and discussing successes and challenges and how things may change in the future
We are currently running a whole school pilot study for SAFE for Schools at Beechwood Primary Academy in Plymouth. If you would like to know more about SAFE for Schools or our pilot study contact us through firstname.lastname@example.org
Key Team Members on the SAFE project are:
Rebecca McKenzie (Stancer) is a Developmental Psychologist specialising in Autism Spectrum Disorder. Rebecca is an Associate Professor in Early Childhood Studies within The Institute of Education at The University of Plymouth.
Contact Rebecca McKenzie for information about SAFE research email@example.com
Rudi Dallos is an Emeritus Professor of Clinical Psychology at The University of Plymouth. Rudi is an experienced Family Therapist and developed Attachment Narrative Therapy, a well-used systemic approach.
Contact Rudi Dallos for information about the intervention and training in SAFE firstname.lastname@example.org
Tara Vassallo is the SAFE Family Consultation Group representative and is the Lead Investigator for SAFE for Schools
Contact Tara Vassallo for information about SAFE for Schools email@example.com
Our Partners and collaborators
Peninsula Clinical Trials Unit
Autism Spectrum Disorder Assessment Team
Plymouth Child Development Centre