The Spiral RADIAL™
Any therapeutic model seeks to improve the lives and prospects of children across a variety of domains. It is important to continually monitor whether the model is achieving this. Over the past 10 years we have used a number of indicators of progress, such as stability in placement, number of incidents, or goal achievement.
However, capturing progress over time, in a clearly demonstrable way, has been difficult. We were not satisfied with standardised measures such as R-CADS or YP-Core, because some children report no issues with anxiety or mood, despite major functional issues, while others scored very highly on those measures, while significant changes to their functioning, such as starting a college course, were not reflected in the measure.
We therefore decided to create our own measure: the SPIRAL Radial. This tracks a child’s progress on the 6 SPIRAL domains: Safety, Positive Relationships, Independence, Resilience, Aspirations and Life Skills.
In developing the SPIRAL Radial we wanted to achieve several things:
• A measure to support practice
• A measure to foster optimism and celebrate success
• A measure to evidence effectiveness
Supporting Practice
The SPIRAL Radial is scored every 2-3 months and the score in each domain is arrived at collaboratively with young people and staff, supported by qualitative, illustrative paragraphs in each domain.
Young people and staff are able to use the measure readily, and enjoy seeing changes displayed graphically.
The measure is sensitive to change and has good ecological validity. The discussions we have while arriving at a score shape a conversation about each domain. These conversations lead to reinforcement of progress and a problem solving lens in areas where the child continues to struggle.
Celebrating Success
In our experience of consultation, staff can be very problem-focused, concerned about incidents and risks. It can be hard to give much time to successes and achievements. This bias towards ‘what’s wrong’ and not ‘what’s going well’ is also often seen in the young people themselves. A benefit of the measure has been that staff, and children alike are able to recognise gains made over time, despite on-going issues. For example, in the sample measure shown below a child is in crisis because of a distressing contact, and so the Safety Domain shows a regression to risk taking behaviours. However, they also have more positive relationships with staff and are therefore more willing to share how they are feeling; their interpersonal effectiveness skills have improved so they are able to better communicate what went wrong on contact, and they are more resilient, so the crisis can be more rapidly resolved than in previous crisis episodes.
The ability to recognise gains made across domains, even in the middle of a crisis episode, has helped staff and young people to remain positive, despite setbacks, and guards against a ‘back to square 1’ mentality.
Evidencing Effectiveness
At present we are able to evidence changes over time, in areas likely to be meaningful. We are currently researching the psychometric properties of the SPIRAL Radial, as part of a doctoral dissertation, so that it can be used as a reliable and valid metric of meaningful change.
