The Thrive Compass: A Systems Methodology for Complex Care

Introduction

Across mental health wards, schools, children’s homes, and social care, there remains a troubling reliance on two responses to distress: medication and restrictive practices. When systems are under pressure, behaviour that communicates distress is too often managed through control rather than understanding.

The result is traumatising for those at the centre — cycles of escalation, over medication, exclusion, and long-term harm. For staff, it fosters burnout and helplessness. For leaders and commissioners, it drives rising costs, systemic instability, and reputational risk.

The evidence is clear: approaches such as trauma-informed care, neurodiversity-affirming practice, relational approaches, skills-based teaching, Acceptance and Commitment Therapy (ACT), and the Capable Environments Framework all contribute to better outcomes (Lerner, Mazefsky, & Gotham, 2023; Sternberg, Powell, & McDonnell, 2024; Tyrer, Shankar, & North, 2019; Veltro, Vendittelli, & Nieri, 2024). The challenge is not in knowing what works, but in embedding these practices consistently and sustainably across systems (Fixsen, Naoom, Blase, Friedman, & Wallace, 2005).

The Thrive Compass was developed to address this implementation gap. It is not a single intervention but a systems methodology that integrates established evidence bases into a coherent framework. At its core are five outcomes that reduce distress, trauma, and restriction — replacing them with safety, dignity, and thriving.

“The challenge is not discovering what works, but embedding what works, consistently and sustainably.”

The Five Thrive Outcomes

1. Distress as Communication

In too many settings, behaviour is still framed as “non-compliance” or “challenging.” The Thrive Compass reframes behaviour as communication: signals of unmet need, distress, or barriers in the environment. Neuroaffirming and function-based approaches support staff to ask, “What is this person telling us?” rather than “How do we stop it?” This aligns with research showing that behaviour is best understood through its function and context, rather than through deficit-based models (Lerner et al., 2023).

2. Safety and Trust

Psychological safety is not optional — it is the foundation of recovery and inclusion. Trauma-informed care demonstrates significant reductions in the use of restraint and seclusion when services embed predictable, safe environments (Sternberg et al., 2024). The Thrive Compass integrates relational practice, trauma-informed care, and the Capable Environments Framework to create predictability, belonging, and dignity (Tyrer et al., 2019). A child, young person, or adult who feels safe and valued is far less likely to enter a cycle of confrontation, while staff working in environments that prioritise safety experience lower burnout (Brandsen, Pestoff, & Verschuere, 2024).

3. Consistency Across the System

Good practice too often collapses when staff rotate, pressures rise, or projects end. Implementation Science research confirms that without system-level supports, fidelity to interventions deteriorates quickly (Fixsen et al., 2005). The Thrive Compass embeds consistency through Implementation Science and Organisational Behaviour Management (OBM), which ensure that practice is reinforced, monitored, and aligned across leadership, workforce development, and organisational systems (Brandsen et al., 2024). Consistency is not simply a matter of training; it is the product of systems designed to sustain practice over time.

4. Alternatives to Medication

For too long, staff have been left with a narrow toolkit: medicate or restrain. The Thrive Compass expands therapeutic options by integrating ACT, function-based teaching, trauma-informed care, and relational approaches. Evidence shows that ACT builds psychological flexibility and improves recovery outcomes in psychiatric residential facilities, offering alternatives to medication and coercion (Veltro et al., 2024). These values-driven approaches empower both staff and service users, replacing sedation with opportunities for regulation, communication, and autonomy.

“Preventing one out-of-area placement pays for the Compass across an entire service.”

5. Outcomes That Matter

Traditional metrics — such as incident counts or bed occupancy — fail to capture what really matters. The Thrive Compass prioritises quality of life, wellbeing, belonging, and recovery as the primary outcomes of support. Research shows that belonging and meaningful activity are directly linked to wellbeing and resilience (Brandsen et al., 2024). By making lived experience central to evaluation, the Compass shifts the definition of success from “fewer problems” to “better lives.”

The Thrive Compass Methodology

The Thrive Compass is a systematic framework that can be applied across all levels of intervention — from individual assessments to organisational development. At its core, it provides a consistent lens through which complex needs are understood.

Universal Application

The Compass can be used in short assessments or in longer-term service development. Whatever the scale, it consistently examines:

• Communication: What is this distress telling us about unmet needs?

• Safety and Trust: Where do relational breakdowns occur and how can they be restored?

• System Consistency: What contradictions exist in current approaches and responses?

• Alternatives to Medication: What evidence-based options exist beyond restrictive practices?

• Meaningful Outcomes: What matters most to this person and their network of support?

Scalable Implementation

The methodology scales across levels:

• Individual: assessments, care planning, family support.

• Team: training, supervision, fidelity monitoring.

• Organisation: policy alignment, culture change, outcomes measurement.

• System: commissioner guidance, pathway development, quality assurance.

This ensures that foundations are in place at every level, preventing reliance on crisis-driven responses and aligning with evidence that systemic supports are essential for long-term change (Fixsen et al., 2005).

Why It Matters — Human & Economic Impact

Lives improve. Costs reduce.

Preventing even one out-of-area placement can more than offset initial investment, as placements cost an average of £172,000 per person annually (Social Care Online study cited in national commissioning reviews). Reductions in crisis admissions, lower staff turnover, and fewer restrictive interventions translate to both financial savings and improved quality of life.

This isn’t theoretical: psychoeducational interventions in psychiatric facilities have been shown to improve functioning and recovery while reducing reliance on restrictive responses (Veltro et al., 2024). Neurodiversity-affirming approaches similarly improve quality of life and agency, countering the harms of deficit-based models (Lerner et al., 2023).

Conclusion & Call to Action

The Thrive Compass replaces reactive, crisis-driven responses with proactive supports grounded in values. It’s about transforming systems so that people feel safe, understood, and able to live full lives.

If you lead or work in a service, education, health, or care organisation: shift from merely solving problems to aligning values, outcomes, and consistent practice.

Interested to find out more? Contact Beyond Thrive for a conversation — let’s explore how your organisation can start the journey toward safer, stronger care.

“When systems are aligned around person-centred values, people do more than survive — they thrive.”

References

• Brandsen, T., Pestoff, V., & Verschuere, B. (2024). Co-production and public services: Emerging research and practice for systemic change. Routledge.

• Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M., & Wallace, F. (2005). Implementation research: A synthesis of the literature. University of South Florida, National Implementation Research Network.

• Lerner, M. D., Mazefsky, C. A., & Gotham, K. (2023). Moving toward neurodiversity-affirming care: Clinical and systems perspectives in autism services. Journal of Autism and Developmental Disorders, 53(5), 1987–2002. https://doi.org/10.1007/s10803-022-05895-3

• Sternberg, K., Powell, B., & McDonnell, A. (2024). Trauma-informed care in practice: Reducing restrictive practices in inpatient settings. British Journal of Psychiatry, 225(3), 421–430. https://doi.org/10.1192/bjp.2024.45

• Tyrer, P., Shankar, R., & North, B. (2019). The Capable Environments framework: Improving environments to reduce behavioural disturbance. Journal of Psychiatric Intensive Care, 15(1), 23–34. https://doi.org/10.20299/jpic.2019.004

• Veltro, F., Vendittelli, N., & Nieri, A. (2024). Psychoeducational and ACT-informed interventions in psychiatric residential facilities: Outcomes for recovery and social functioning. Psychiatric Services, 75(4), 327–336. https://doi.org/10.1176/appi.ps.20230321