1. Guided Self Help in NHS Dumfries & Galloway
Dr Rosaleen Isles- Cognitive Behaviour Therapist
Ian Hancock – Director Psychological Services
Dumfries & Galloway

2. Dumfries & Galloway Guided Self Help Service - summary
Ist Tier short term, face to face individualised intervention for Mild/moderate Psychosocial problems
Service delivered to all GP practices
Between 1000 and 1200 referrals annually

3. Dumfries & Galloway Guided Self Help Service - Milestones
2001 – One GSHW covering two GP practices (Waiting Times initiative)
2003 – Four GSHW covering half D&G (Local Health Partnership funded)
2004 – Eight GSHW covering whole D&G (Doing Well By People with Depression)
2006 – Recurring Funding by NHS D&G

4. Dumfries & Galloway Guided Self Help Service – Service/Costs
Budget = £203K. Includes:-
Service Lead (CBT/Manager) 0.8 wte
Senior SHW wte
SHW x wte
Secretary wte

5. Dumfries & Galloway Guided Self Help Service
Psycho-social problems of life:-
- validate
- normalise
- promote personal responsibility
- resilience
Maximum 3 sessions
Tight referral criteria
Lay workers

6. Selection of Self Help Workers
Experience of life-
different work environments/ people
No formal mental health qualifications
Varied interests
Personal qualities-
kindness/ humour/ trust/ creative/ adaptable.

7. Training of Self Help Workers
Background reading of all self help materials
Five sessions Cognitive Behavioural Model
Experiential- role play/ self awareness
One week in sessions with experienced SHW

8. Supervision of Self Help Workers
Weekly- with CB therapist lead
Plus individual for 6 months for new workers
Regular review of recorded sessions
3 monthly workshops
Social

9. Aim of supervision Skills development Adherence to service remit
Self Awareness
Mutual support
Confidence building

10. Monitoring service Contact time – within 1 week of referral
Waiting times - 3 weeks max
Operational Policy-
Details of the whole service
Suitable/ unsuitable referrals
Referral on
Risk
Administration
Cross cover – exceeding wait time/ sick leave

11. Monitoring service Outcome measures:- Demographic Survey HADS
Work & Social Adjustment Scale
( WSAS)
Client Satisfaction Questionnaire

12. Context of Service Delivery
SHW based, where possible in GP practices
Close contact with referrers
Regular updating of community/ voluntary provision in all areas
Managed within Psychology

13. Why the service is managed within Psychology
Psychological model of care
CBT based model
Facilitates a stepped care approach

14. Based on 2880 clients Of which: 2061 females (72%) 819 males (28%)
DWPD Evaluation
Based on 2880 clients
Of which:
2061 females (72%)
819 males (28%) 1

15. Referrer 1

16. Appointment Response Times Mean = 11.76 days Range = 0 – 85 days
From date of initial contact to date of first appointment with Self Help Worker
Mean = days Range = 0 – 85 days
46% of referrals
21%
16% 9% 4% 1% 1%
0.5%
0.3%
0.4%
Dumfries & Galloway
Self Help Project 1

17. Nature of Problem From available data from those referred:
Dumfries & Galloway
Self Help Project 1

18. GP Choices
Alternative Interventions GPs Would Have Chosen If Self Help Service Was Not Available: 1

19. Client Satisfaction Questionnaire Outcomes
Summary of Total Scores
Mean = Points (Maximum score on CSQ-8 = 32)
Range = Points
90% of those discharged 9% 1%
Dumfries & Galloway
Self Help Project 1

20. Work & Social Adjustment Scale – Total Score
Dumfries & Galloway
Self Help Project

21. HADS Depression Hospital Anxiety & Depression Scale - provides a measure of anxiety and a measure of depression for each client. It is completed prior to Self Help intervention and immediately following the final contact with a Self Help Worker
N = 2387
N = 1053
N = 539
Dumfries & Galloway
Self Help Project

22. HADS Anxiety Hospital Anxiety & Depression Scale - provides a measure of anxiety and a measure of depression for each client. It is completed prior to Self Help intervention and immediately following the final contact with a Self Help Worker
N = 2387
N = 1053
N = 539
Dumfries & Galloway
Self Help Project

23. Alternative or additional to medication?
Final Thoughts
Alternative or additional to medication?