Practical Alternatives to Custody (PAC)

Providing 1:1 therapeutic provision for vulnerable young people

Based in Carlisle, but serving all of Cumbria, PAC is a lifeline for teenagers with severe emotional and behavioural difficulties which prevent them from accessing mainstream statutory provision. FCSCT funding has been used to support Gilly Brown, PAC’s Art Therapist, for the past four years with the story below just one example of her invaluable work.


“J”, aged 15, was referred because of serious aggression and volatile anti-social behaviour at home and in the community, serious self-harm and attempted suicide. J had been taken from the family home and placed in foster care. J refused to attend mental health provision elsewhere or to discuss alleged sexual abuse. J returned home but the situation remained volatile due to emotions and differing opinions within the family over the abuse and experience of domestic abuse when younger. J then assaulted a sibling and had to move out of the family home again under court order.


J began weekly sessions of art therapy in September 08, attending after a full school day in West Cumbria. J engaged well and developed a good relationship with the art therapist, often stating how much they were benefiting from the service.

The referrer hoped the art therapy would explore the alleged abuse nonverbally to help the volatile nature of J. Feelings around this were discussed in the first weeks but it was consistently more relevant to deal with feelings, emotions and practical issues around coping on a weekly basis. J felt vulnerable, homeless, rejected and angry with high levels of anxiety about the unstable situation.

The art work throughout the sessions reflected the progress of J in building self-esteem and confidence. Notably a ‘heart with wings’ was created. This was begun early in therapy, and returned to over the weeks on occasions until it was filled with colour, built up and completed. A visual depiction of the strength developing with J.

J received extended art therapy provision of 30 sessions to provide consistent support when everything else in life has been unstable and stressful. J felt overwhelmed with involvement from too many different agencies and the art therapist acted as an advocate at meetings.

Outcomes from art therapy

The first outcome was the successful engagement of J onto art therapy as J had previously refused all support. J developed a positive therapeutic adult relationship which helped to encourage involvement with other services beyond just art therapy.

J began to show improved coping skills and was better able to deal with difficult situations. J stated feeling calmer, less anxious, more in control of life with a stronger sense of self and increased confidence. J received continuous support from the art therapy project until completing GCSE’s at school.

On completion of art therapy, J was referred onto one of PAC’s longer term projects: Building Pathways. This will continue weekly emotional support using counselling skills and based on Cognitive Behavioural Therapy. This will support J with future living circumstances which are still unsatisfactory and unstable. J will also receive help with future education, training and employment on this project.

Case Studies

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