Clinical Guideline 1 December 2002 Developed by the National Collaborating Centre for Mental Health Schizophrenia Core interventions in the treatment and management of schizophrenia in primary and secondary care Psychological treatments – CBT Family work

Clinical Guideline 22 December 2004 Developed by the National Collaborating Centre for Mental Health Anxiety Management of anxiety (panic disorder, with or without agoraphobia, and generalised anxiety disorder) in adults in primary, secondary and community care Panic disorder – CBT Self-help based on CBT Generalised anxiety – CBT Self-help based on CBT

Clinical Guideline 23 December 2004 Developed by the National Collaborating Centre for Mental Health Depression Management of depression in primary and secondary care Mild – Self-help based on CBT Problem solving therapy Brief CBT/counselling Moderate to severe – CBT Interpersonal therapy Antidepressants Treatment resistant, recurrent, atypical – Combined CBT/antidepressants

Post-traumatic stress disorder (PTSD) The management of PTSD in adults and children in primary and secondary care Clinical Guideline 26 March 2005 Developed by the National Collaborating Centre for Mental Health PTSD – Trauma focused CBT Eye Movement Desensitisation & Reprocessing (EMDR) Antidepressant – NOT as first line

Clinical Guideline 31 November 2005 Developed by the National Collaborating Centre for Mental Health Obsessive-compulsive disorder Obsessive-compulsive disorder: core interventions in the treatment of obsessive-compulsive disorder and body dysmorphic disorder OCD & BDD – CBT – individual or group

RATIONALES FOR SaFF TARGETSSaFF TARGETS 2006/2007 Why bother? Trusts are beginning to be audited in terms of compliance with NICE guidelines and will face financial penalties for failing to comply SaFF targets Who will carry out all these “psychological” interventions?

Journal of Advanced Nursing Volume 27 Page February 1998 doi: /j xVolume 27 Issue 2 The clinical skills of community psychiatric nurses working with patients who have severe and enduring mental health problems: an empirical analysis Sheila M. Devane DClin Psychol, Gillian Haddock PhD, Stuart Lancashire MSc, Ian Baguley RMN, Tony Butterworth PhD, Nicholas Tarrier PhD, Abigail James BSc & Phillip Molyneux MSc Abstract This study describes the use of reliable scales to rate the clinical skills of mental health nurses when working with individuals and families with severe mental health problems. The Cognitive Therapy Scale and the Schizophrenia Family Work Scale were adapted for the study and were shown to have good inter-rater reliability when assessing audio-taped interviews carried out by mental health nurses during their usual course of work with patients with severe mental health problems and their families. The sample of mental health nurses studied were shown to have significantly better general therapy skills than specific cognitive therapy technical skills. The implications for training are discussed. Significant difference between general and technical skills Good on understanding, empathy and professional manner Moderate on questioning Poor on specific cognitive behavioural skills –pacing and use of time –collaboration –guided discovery –agenda setting Very poor on –feedback –conceptualising problem –setting goals –implementing goals –negotiating homework Do nurses have the skills?