Or Some Techniques for ‘Doing’ Recovery Oriented Practice Siri Wooster & Steve Kingsbury: East Herts. CAMHS

…the Choice and Partnership Approach  a clinical system that evolved in Richmond CAMHS from 2000  developed and implemented wholesale in East Herts. CAMHS 2005 and  now being used in many CAMH teams across the world  UK  NZ, Australia, Belgium  And adult mental health (NZ)

3500 staff and around 400 teams

It is about  Doing the right things = on the right goals  With the right people = with the right skills  At the right time = with no waits

 Users are at the heart of the process  “Led by them and guided by us”  Shift in clinician stance to  Facilitator with expertise rather than expert with power

There are 4 ideas that separate CAPA from more “traditional” models. These are Choice 2. Core and Specific work 3. Selecting clinician to Partnership 4. Team Job Planning

 Individual uniqueness  Real Choices  Attitude and Rights  Dignity and Respect  Respectful Partnerships Lets look at the links between these and CAPA…

 Recovery recognises that  Whole life matters  Outcomes are personal and  Empowers individuals  CAPA has  The Choice appointment and approach  A Collaborative model

 Recovery recognises that:  People need to make their own choices  Supports individuals to take responsibility  We need to encourage individuals to take positive risks  CAPA:  Choice is the central stance in CAPA  Strengths based model  The best risk management is to work actively with the individual

 Recovery ask that we…  listen to and act upon communications from people  promote and protects rights  Support people to maintain activities which enhance mental wellbeing.  CAPA  Choice framework

 Recovery suggests that we should be…  courteous, respectful and honest  sensitive and respectful of each individual’s own values and culture.  CAPA  promotes a non-hierarchical interaction with young people  Cultural and personal values are a given in CAPA

 Recovery states…  that each person is an expert on their own life  work in positive and realistic ways with individuals to help towards their hopes, goals and aspirations.  CAPA  CAPA uses own expertise to facilitate their choices  Partnership work is a collaborative focused on their choices with continual review of the chosen goals

These techniques only make sense if Recovery Principles or CAPA principles are embedded in the team culture.

Language Used in CAPA  Redefines the relationship between service user and their family and clinician  Impacts on moment-to-moment interactions in sessions

 What are they worried about?  What’s going on?  How shall we understand it together?  What shall we do about it?  Do they want to come back?

 Work togethervs Treat  Help you choosevs Tell you  Share our thoughtsvs Give an opinion  Decide togethervs Assess

 Peer group supervision and Post-Choice discussions  (in addition to individual supervision and whole team clinical discussions)  Small groups  Weekly  Keeps focus on realistic goals  Helps with ‘letting go’