A Brief Introduction To The Children & Young Peoples IAPT Project – Including feedback from a young person’s perspective Helen Nash – Senior Systemic Practitioner Michealla Lincoln – Safe Care Lead / Senior Cognitive Behaviour Therapist 16/1/18

By the end of the workshop participants will: Increase their knowledge and understanding of the IAPT Agenda / Transformation of Services. Follow a Young Person’s experience of their journey through the CYP-IAPT programme within Sunderland Community CAMHS (CCAMHS) Gain an insight into the journey of CCAMHS practitioners through the CYP-IAPT agenda

We Invite you use the rating scales to score your current knowledge of the CYP-IAPT transformation agenda

Research on CAMHS service Policy/Research

The Children and Young People's Improving Access to Psychological Therapies Project (CYP-IAPT) is an exciting programme…. Which aims are to: Work with existing Child and Adolescent Mental Health Services (CAMHS) to improve access to CAMHS. Improve the partnership working with children, young people, families, professionals and agencies Build capability and capacity to deliver positive and measurable outcomes for children, young people and families Increase choice of evidence based treatments available.

This will be achieved as follows Working in partnership with children and young people Developing a culture of reflexivity and accountability Improve access to treatments based on best evidence and training staff to deliver Evidence Based Practice Make effective use of Routine Outcome Measures (ROM) to improve clients, therapist and supervisory experience

CYP IAPT evidenced based therapies (within CCAMHS) Cognitive Behaviour therapy for depression and anxiety disorders. Incredible Years Parenting Programme for children aged 3-10 presenting with conduct disorder Systemic work with families (including self harm / depression and conduct disorder) Interpersonal psychotherapy for adolescent depression (IPTA) Enhanced Evidence Based Programme (EEBP) Supervision Leadership Evidence based programmes commencing in 2018: Counselling for Depression Psychological Well Being Practitioners (PWP’s)

Sunderland CCAMHS Practitioners qualified in Evidence Based Interventions ROMS/PROMS Interpersonal Psychotherapy For Adolescents (IPTA) CBT Supervision Leadership IYG Parenting Enhanced Evidence Based Practice (EEBP) Systemic Practice

An Example of a Young Person’s Journey Through CCAMHS Introduction to the young person and his family We will refer to the young person as ‘Jay’ to ensure confidentiality however permission has been given to share this today Jay was referred by his GP for anger issues which was having a negative affect in school and in his relationships We will now show you the young person’s presentation to highlight his experience of his journey through Community CAMHS

Jays presentation: School and CAMHS working together CAMHS has been working with our school to Help children with worries and feelings.

HELP This place can help you in so many ways such as: Thinking Talking Showing Problem solving Feelings Worries

Bridges One of the ways I learnt was bridges This means that you can build imaginary bridges! Its your choice if they are weak or strong Its mostly about finding about feelings and how to deal with them.

Trapping Anger This is about finding ways to stop anger getting out. Think of happy memories and positive feelings. Think of Imaginary cages and dropping anger in to it. I would recommend family help and speaking to family.

How it changed anger Because of the ways you have just learnt you should understand it can change you The people around you Your emotions

Listening and pretending It was a joyful way to learn about solutions. You get interviewed as adult members and emotions . You notice and learn from their perspective.

Thank you Power point highlights: Approach: Counselling for 10 sessions/ Family Therapy 12 Method: Family sessions in CCAMHS/ Reflecting Team/ Work in school/ Jays presentation within school Techniques: systemic questions, ROMS: SCORE 15, interviewing internalised other, externalising language…….

What’s your reflections so far? In the spirit of IAPT: How are we meeting your hopes/aims within the workshop?

CCAMHS Practitioner’s experience of CYP-IAPT: positive perspective…. Stimulating, thought provoking, challenging and affirming. Great to meet and be with other CCAMHS practitioner ‘s and services. I gained training in a new therapeutic modality and can now offer children and young people NICE approved treatment. I have learned different theories and skills which was supported within supervision. I have gained positive feedback from patients about the intervention being helpful as it help to facilitated positive change. An opportunity to develop my practice amongst like minded people. Incredible Year’s Group availability has risen and waiting list has reduced due to extra staff being trained through CYP-IAPT CYP-IAPT has promoted talking therapies More CBT, IYP Groups, IPTA-A and Systemic appointments available following CYP-IAPT

And more….. CYP-IAPT gave me the opportunity to enhance my knowledge and clinical skills CYP-IAPT the opportunity reflect on my practice by reviewing recording within supervision. Improved my understanding of Outcome measures and the benefits of these. It was helpful to keep abreast of current policy and good practice. Enjoyed networking with University and different professionals as well as trusts. Well resourced and learned a great deal as I am now well equipped to deliver the approach. Gained new ideas which helped me in my practice especially from Systemic Approach Wider range of choice and therapeutic provision which can enable practitioners to tailor treatments according to need and service.

CCAMHS Practitioner/ Challenges of CYP-IAPT Young people were not fully involved within the transformation agenda. Some frustration when applying knowledge and skills within the constraints of service and organisational culture. Lack of co-ordination within the running of CYP-IAPT. Course is very intense and felt rushed at times with the amount to learn and skills to consolidate. Additional time was not given to complete training which was very demanding! The hardest course that I have ever done! Course not long enough to enable me to consolidate my practice… cram packed and sharp learning trajectory……. Impact on my caseload as I was not on CYP-IAPT training.

CCAMHS Practitioners consideration post CYP- IAPT and future…. How to continue to involve the children and young people in shaping CCAMHS. Concerned about the sustainability as CYP-IAPT is possibly ending 2018… How can we sustain Evidence Based Treatments in our practice? I would like to gain opportunity in Video Interaction Guidelines (VIG) in my Early Years role. How can CCAMHS maintain links with University in the development of our service and within our roles a practitioners, supervisors…

CCAMHS/ UNN collaboration within CYP-IAPT Created the opportunity for CCAMHS Practitioners to have input within CYP-IAPT training: CBT Parenting Systemic Supervision EBP PWP

Transformation in CCAMHS continues…. PWP’s Parenting: Early Years Specialist Practitioner Review of Systemic Practice/ Family Therapy Accreditation Robust Supervision structures Recognition with Commissioners of CYP-IAPT agenda

Questions

We Invite you use the rating scales to score your current knowledge of the CYP-IAPT transformation agenda

Helpful references: C. L. Hall, M. Moldavsky, J. Taylor, K. Sayal, M. Marriott, M. J. Batty, S. Pass, C. Hollis, Implementation of routine outcome measurement in child and adolescent mental health services in the United Kingdom: a critical perspective, European Child & Adolescent Psychiatry, 2013, Wolpert, M., Fugard, A. J.B., Deighton, J. and Görzig, A. (2012), Routine outcomes monitoring as part of children and young people's Improving Access to Psychological Therapies (CYP IAPT) – improving care or unhelpful burden?. Child and Adolescent Mental Health, 17: 129–130. doi: 10.1111/j.1475-3588.2012.00676.x http://www.corc.uk.net/wp-content/uploads/2013/10/Guide-to-Using-Outcomes-and- Feedback-Tools.pdf#page=85