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Writer's pictureUna O'Brien

Who are Youth Untroubled & What is ISTAC?


A family including parents and children lying together smiling
ISTAC; Keeping families together

Youth Untroubled are an established team of experts in family therapy, child behaviour and development, risk assessment in complex family situations, and young people’s mental health. We have worked for many years helping to keep families together, and children thriving and safe from harm. 


Where did we come from?

Youth Untroubled Ltd was founded in 2023 by Natasha Gold, but our directors aren’t new to this field of work. Natasha, along with Una O’Brien and Carly MacDonald worked together for more than 7 years at the Brandon Centre, providing pioneering intensive systemic therapy, commissioned for hundreds of families across London, by local authorities and mental health trusts, including Forensic-CAMHS. 


In 2017, whilst working at the Brandon Centre, the Youth Untroubled team developed our therapeutic treatment model, ISTAC (read more about this further down). While Natasha led on development and later manualising the model, Una and Carly were the clinical leads for the systemic teams at the Brandon Centre. The team’s skills, expertise and passion for helping the most complex families to overcome significant challenges and truly thrive, and their shared desire to develop the model further and facilitate a national rollout of the various adaptations, is what drives Youth Untroubled.


What exactly is ISTAC and why is it needed?

Intensive Systemic Therapy Around the Child (ISTAC) is a clinical model and adaptation of MST, a type of therapy that is facilitated in the family home and predominantly involves sessions with parents, carers and professionals such as social workers or teachers who are involved in the child’s life, rather than 1:1 therapy with the child or young person. The reason for this is that, often, the child isn’t motivated to meet with a therapist and start talking about it. So, instead of putting the expectation on the child, MST, and ISTAC focuses on helping those closest to them change how they react or respond to the child. When everyone around the child is working together this is when we see real changes in the child’s behaviour and ultimately their mental health and wellbeing. 


There are notable differences between MST and ISTAC, including that ISTAC is a 12-14 month intervention (as compared to 3-5 months), with a stepped-back phase at the end, where therapists are a little more ‘in the wings’ to support the family and network if any new issues arise or things come off track. Highly skilled and qualified therapists provide ISTAC with extensive experience; as a result, therapists can address even the most complex of underlying causes of every family's struggles, including parental mental health, domestic violence, trauma and attachment difficulties, amongst others.   


In 2023 the UK government launched its Social Care Reform Strategy; ‘Stable Homes, Built on Love’. The ISTAC approach encapsulates the very heart of this proposal; creating stability at home and within the systems around these young people, which really is the key to happy and well-adjusted young adults who will go on to thrive in the world.


The ISTAC therapist takes the clinical lead role within the professional network and coordinates the care plan. They provide a comprehensive understanding of the behaviour, creating bespoke treatment plans that include detailed scripts, ideas and plans to change the problematic behaviour and improve the child’s mental health and overall well-being. The approach is often very pragmatic and solution-focused as this tends to allow change to happen quickly. But treatment is bespoke and tailored to the needs, strengths and struggles of each and every family and family member The frequency of the family sessions is also important. We work with families for up to a year, sometimes seeing families and being with them in their homes (where the action usually happens!) three times a week and more if necessary, including a 24/7 on-call provision. We really step inside the shoes of the family so that we get the best possible understanding of how and where to help them.


Why is ISTAC needed?

Currently, the UK is facing a growing epidemic of children and young people being placed in out-of-home placements such as foster care and psychiatric in-patient units, when this could be avoided if families and networks were provided with a safe, viable alternative. What’s worse, the outcomes for many of these vulnerable young people who are placed away from their families are devastating; statistics show that young people in care are six times more likely to go to prison and four times more likely to end up with a criminal conviction, one in three are not in education, employment, or training and have poorer physical and mental health than children who stay at home with their families. Research has also indicated that children who are admitted to psychiatric inpatient units experience difficulties with relationships including family relationships, disruption to their education and real difficulty adjusting to ‘normal’ life.  


There are currently 82,000 young people in care and this figure is predicted to grow to at least 100,000 by 2030. There are more than 350 in psychiatric inpatient units and at least 450 in custody at any one time. We believe that these numbers can and should be significantly reduced. Often, local authorities and health trusts have no other option but to place children in out-of-home placements because there is no alternative on offer. This needs to change…


We aim for ALL children on the edge of care, or facing custody or inpatient admission, and their families, to be able to access our intensive, community-based, therapeutic intervention that actually works. And for those currently placed outside of the home unnecessarily? We want to get them home, safely, with the right support to ensure they can remain at home with their families, where they belong. We believe it’s time to give ALL families the skills and opportunity to create loving, stable, and safe environments where children can thrive.


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