Mental Health Champions: November 2017 Agenda: 9.00 – 09.30 - Settle and updates 09.30 – 10.30 - Therapeutic Relationships 10.30 – 10.45 - Information from Barnardos – LGBT issues (Nicky Hartley) 10.45 – 11.00 – Break 11.00 – 12.00 – Supervision 12.00 – 12.30 - Networking

Updates LLTTF/ We Eat Elephants – licences and evaluation tool Website – profile instructions Assemblies Resources for young people – Youth mental health mixtape Suicide prevention toolkit Data collection sheet – feedback?

Developing therapeutic relationships A group training model for Bradford Mental Health Champions Magdalen Maguire and Vicki Morris Bradford Educational Psychology Team November 2017 Department of Children’s Services

What are the most important factors in effective therapeutic interventions? Why do we need to know this….? Our interventions need to be based on evidence-based practice Department of Children’s Services

Gold Standard Research Findings Gold standard research using randomised controlled trials (RCTs) and meta-analysis (pooling together of similar studies)

4 Main Factors What do you think are the 4 main factors leading to success with therapeutic interventions? Discuss

Research results - Four Main Success Factors A positive therapeutic relationship (the therapeutic alliance) Shared goals Client resources Therapist resources

Developing therapeutic alliance What does this mean? Definition of alliance: ‘A union or association formed for mutual benefit’ (Oxford Dictionaries) ‘A merging of efforts or interests by persons, families, states or organisations’ Mutual benefit is interesting….idea of Vygotsky’s ‘equal communication partners’

Key features of good therapeutic alliance Bordin (1979) identified liking, trust and respect as key features of a positive therapeutic relationship. How do we develop these?

Activity – In pairs/groups of 3 Think about someone in your life who you always feel at ease talking to. What qualities do they have? What is it about them or how they make you feel that makes it easy to talk to them? How do you feel after talking to them?

But isn’t the approach the most important thing? The best approach in the world wont be effective if the client doesn’t feel heard… Whose goals are we talking about anyway? School? Parents? Ours?

Example of Evidence Based Approach without therapeutic alliance Reported young people’s negative experiences of CBT: ‘..but I didn’t like the therapist’ ‘I didn’t agree with what she was telling me’ ‘I felt inauthentic’ ‘It didn’t work’ CBT has best evidence base….helped by the fact that 80% of research on effective therapeutic approaches has focussed on CBT…now somewhat discredited….see handout…

Using Attuned Principles Being Attentive – ensuring the child or young person has space and time (in your mind and in the ‘space between’ you both) Encouraging Initiatives – Waiting, listening Receiving Initiatives – Showing you have heard

Developing therapeutic relationship using attuned principles Receiving initiatives – listening, showing you have heard

Activity – use attuned principles sheet Listener, speaker, observer Speaker– talk about something that you have been concerned about. Listener – use the attuned principles to actively listen and show you have heard. Observer – tell the listener what you noticed. Speaker – tell the listener how you felt.

Skills Practice - Establishing shared goals Listener….support speaker to establish the following: Which actions does s/he feel confident about doing at present? Pick one or two that s/he would like to develop Use example questions on next slide if you wish (three minutes)

Ideas for questions to help establish shared goals ‘So is that something you would like us to work on together?’ ‘Shall we set some goals so we can be sure we are working on what is important for you? How will you know when you have achieved that goal? What will you be doing? What would [someone who knows you well] notice? What small step could you take in the next few days to start on this journey of [summarise goal]

4. Speaker - What went well? Look at attuned principles How attuned was the practitioner? What do you notice her/him doing? Give positive and specific feedback Swap roles (if time)

Scaffolding We are attuned! We receive initiatives, the client is leading, we are so in tune… How do we make a difference? Scaffolding and Deepening Discussion

Deepening Discussion Example Questions Circular questions…finding out different perspectives What does x think about that? Would your brother agree or do you think he has a different view? Who in your family is the most/least likely to [worry/get upset/be late/argue] How do you understand that? Loved ones ‘what advice would your grandmother give you if she was here now?’

Deepening discussion questions Time perspectives to establish difference Was there a time when this problem was smaller/larger? Are there times/days of the week when you feel better? Looking ahead can you think how you would ideally like things to be? What would you like to be doing in five years time?

Checking out Never assume (makes an ass out of u and me) Checking is so easy…. ‘Tell me more about…’ ‘What do you mean by…?’ [word/phrase], e.g. having a go ‘Is that the right word, what would be your word for that…’ ‘have I understood this right, you are telling me’ ‘Is this what you want to be talking about today?’

Activity in pairs – practising summarising Speaker – talk about something at work you are proud of (two minutes) Listener Reflect back what the other is saying Use slightly different words (more impact) Speaker – feed back – how did you feel?

Today’s topic …in summary We have talked about the importance of the therapeutic alliance How to build therapeutic alliance Being attuned, active listening, letting client lead…. Establishing shared goals Checking out

Thank you for participating today We hope you found it useful…..