Understanding and working with complex needs

Updates to this guidance

This page replaces the 'Responding to complex needs' page in the previous Practice Centre.

Supporting practice

Our practice is supported by our practice standards, practice framework, practice models, tools and resources.

Understanding complex needs for tamariki and rangatahi

In Oranga Tamariki we understand complex needs as multiple interrelated or interconnected needs that impact across different parts of the life of te tamaiti or rangatahi. These needs often emerge when te tamaiti or rangatahi has had to adapt to prolonged stress, disrupted relationships, or engage with systems that may not respond to their way of being in the world.

Complex needs can become more intense and acute at times of disconnection, distress, and if emotional, relational, cultural, or developmental needs are unmet. Changes such as moving between homes, starting a new school, school exams, moving between care arrangements, traumatic events happening around them and dislocation from their cultural identity and community can all impact on their complex needs or the way te tamaiti or rangatahi responds to the change.  

Complex needs can relate to a range of interconnected areas, including:  

• physical health 
• mental and emotional wellbeing 
• social and relational connections  
• ways of thinking, learning, or processing (cognitive development) 
• disability or neurodivergence 
• trauma and complex trauma (exposure to a traumatic event or multiple events). 

When complex needs are not fully understood or met, tamariki and rangatahi may struggle to feel safe, seen, or supported. This can affect their oranga including their: 

• ability to feel secure within relationships; at home, in out of home placements, or in the community 
• ability to engage with learning, routines, or healing 
• sense of identity, belonging, and self-worth 
• ways of responding to stress, which may be seen in how they behave  
• capacity to take in language, directions, or expectations from adults. Particularly when in a stressed or overwhelmed state. This can sometimes be misread as defiance or disrespect rather than a reflection of the needs of te tamaiti or rangatahi and the way that they are feeling. 

Evidence Brief: Complex Needs (PDF) | Oranga Tamariki

Trauma-informed theory

Specialist topics

Working with tamariki and rangatahi with complex needs

The way te tamaiti or rangatahi responds to different situations can sometimes become a focal point and detract from the underlying needs. Rather than focusing only on behaviours or symptoms, we aim to build understanding of the needs, what lies beneath including what te tamaiti or rangatahi may be trying to express, protect, or restore in themselves.   

Working with, and responding to, tamariki and rangatahi with complex needs requires a multi-disciplinary approach, widespread consultation and collaborative planning. A collaborative approach will ensure that tamariki and rangatahi are receiving the right response from the right people within the best possible timeframe. We work with te tamaiti, rangatahi and their whānau or families and others, including other professionals and agencies to: 

• build our understanding of the needs and underlying factors 
• plan how we work together to restore oranga and support rangatiratanga for whānau and families 
• connect tamariki, rangatahi and their whānau and families to service, supports and entitlements.

Practice considerations

• We use the practice framework and Organising my Practice to plan and organise our mahi and how we work with te tamaiti or rangatahi, their whānau and family and others to build and deepen our understanding of the complex needs.
• We use Tiaki Oranga to understand and plan for current safety, harm and risk for te tamaiti or rangatahi in the context of their whānau or family. We can use this same tool over time to continue to build a picture of safety for te tamaiti or rangatahi and understand how complex needs may be impacting on their oranga, including safety. 
• We recognise that needs can change. We use the assessment report to record our understanding of complex needs in relation to harm, safety and protection for te tamaiti or rangatahi, or their offending behaviour at a particular point in time and communicate what should happen next at different points in time.  
• We ensure that complex needs and strategies to address these, including how we work with te tamaiti or rangatahi, are identified in their All About Me plan, and in caregiver support plans and care support plans in residences. 
• We advocate strongly for te tamaiti, rangatahi and whānau or family to access services, supports and entitlements.  
• We work with te tamaiti or rangatahi in a way that is mana enhancing and recognises complex needs. 
• We support whānau or families to adopt strategies and strengthen whanaungatanga networks that support oranga for te tamaiti or rangatahi within their whānau or family.  
• We take a multi-disciplinary approach and good planning, widespread consultation, and a willingness to think creatively about how the needs can best be met within the community of te tamaiti or rangatahi. 
• We work with the te tamaiti or rangatahi with complex needs, and their whānau or family and Oranga Tamariki High and Complex Needs Unit if an out of home placement is needed.
  High and Complex Needs Unit | Te Pae