Children and Young People’s Project

Children and Young People’s Improving Access to Psychological Therapies
Newsletter - June 2012

For more information please see: http://www.iapt.nhs.uk/cyp-iapt/

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Children and Young People’s Project
Welcome and Introduction
Welcome to the first Children and Young People’s IAPT newsletter. We hope that this and subsequent editions will not only inform you about how the project is progressing, but also help you feel more involved. As many of you will know, Children andYoung People’s IAPT is a service transformation project for Child andAdolescent Mental Health Services (CAMHS) working in targeted and specialist services (Tiers 2 and 3), in the statutory and voluntary sectors. It focuses on embedding evidence-based practice across services, making sure that everyone involved in the services, not just those who are being directly trained by the project, use intensive (session-bysession) outcome monitoring and work to incorporate the views of children and young people in service design and delivery.

Professor Peter Fonagy National Clinical Lead for Children and Young People’s IAPT

We aim to ensure that children and young people have improved access to the best possible psychological therapies in a way that they find acceptable and relevant. As acutely as ever we face the challenge of working with limited resources to meet the needs of a society increasingly aware of mental health issues and appropriately insisting that care is provided to children and young people. A common misconception is that Children and Young People’s IAPT and Adult IAPT are the same. Although we sit within the overall IAPT programme, and have learnt from the adult experience, we are working to improve existing systems and services rather than creating new standalone services. The obligation to deliver value in child mental health has never been greater. Delivering therapies to the standards of RCTs may seem like a big challenge, but children deserve nothing less than the best if we can provide it - which it seems we can. The first year of the project is coming to an end and during this time everybody involved has worked unbelievably hard to ensure success at each stage of its development and implementation. The collaborative spirit, support and selfless commitment that we have received in the first year from those involved has been humbling and a source of immense gratification for me. In 35 years of professional work I have not experienced anything that comes close. With a limited budget and a tight timescale we have delivered national curricula, working with 18 partnerships of NHS services, commissioners and voluntary services committed to transformation to outcome-focused, evidence-based, child-oriented clinical work. You can read updates from the year one learning collaboratives on pages 7-9. We have been lucky enough to secure up to £22 million additional funding from the Government to extend the project over the next 3 years. More details about plans for year two onwards can be found on page 2. Ensuring that the voices of children and young people are heard clearly by all of us involved in providing mental health services for them is a crucial aspect of our project. They have been involved
For more information please see: http://www.iapt.nhs.uk/cyp-iapt/
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at both a national level, helping to steer the project, and at a local level, where sites have been listening to their wishes and preferences.You can read more about participation activities on page 5. I would like to thank you all for your extraordinary contributions and I hope that the upcoming years of the project, as we bring new modalities into Children and Young People’s IAPT, are characterised by as much enthusiasm and hard work. On the 16th July 2012 UCL will be hosting the first annual Children and Young People’s IAPT conference where Paul Burstow, the Minister for Care Services, will join us in celebrating our achievements and help us plan the future. More details about the conference can be found on page 10.

Children and Young People’s Project

Professor Peter Fonagy National Clinical Lead for Children and Young People’s IAPT

Year One and Year Two Therapies
In its first year the Children and Young People’s IAPT project chose two therapies, CBT and Parent Training, as the core treatments behind a range of psychological interventions in CAMHS. Not only are these therapies the ones with the clearest recommendations from the National Institute of Health and Clinical Excellence for a range of disorders, but they are also ones where other aspects of the step change, i.e. outcomes monitoring and evidence-based case management, can be most easily integrated with the intervention. The service transformation rests on the development of collaborative care and an increased opportunity to integrate children and young people’s voices into decisions about their care. The quality of training in these therapies, alongside the focus on Kathryn Pugh Children and Young People’s supervision and service improvement, is beginning to make itself felt across services throughout the three existing collaboratives. IAPT Project Manager A comprehensive CAMHS offers a range of therapies and choices to its service users and their families. Next year we will be adding training in two more therapies commonly practiced in CAMHS, Interpersonal Psychotherapy and Systemic Family Therapy. The curricula for these interventions will be developed over the coming months.
For more information please see: http://www.iapt.nhs.uk/cyp-iapt/
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Children and Young People’s Project
Project Awarded Additional Funding
On the 29th February 2012, the Deputy Prime Minister, Nick Clegg, and the Minister for Care Services, Paul Burstow, announced that our project will receive an extra investment of up to £22 million over the next three years. This is in addition to the £8 million per year for four years (2011/12 to 2014/15) that has already been secured. The additional funding will be used to: extend the range of evidence-based therapies to include Systemic Family Therapy and Interpersonal Psychotherapy; extend the geographical reach of the project; and develop exciting interactive e-learning programmes for staff working in universal settings and the NHS and counsellors working with children and young people.

“Too many young people suffer in silence with mental health problems. This is vital investment that will give children the very best tailored treatment to restore them to good health.” Nick Clegg
Deputy Prime Minister

“We broke new ground last year investing in children’s mental health. This additional funding will help deliver services specific to young people. We’re working with young people and staff to start to change the way mental health is delivered by the NHS.” Paul Burstow
Minister for Care Services

For more information please see: http://www.iapt.nhs.uk/cyp-iapt/

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Children and Young People’s Project
Year One Learning Collaboratives
Children and Young People’s IAPT is made up of learning collaboratives. These consist of Higher Education Institutions (HEIs) and local CAMHS Partnerships (mental health services, voluntary sector services and commissioners) and provide the training and mutual support for the service managers, supervisors and trainees who will put the service transformation into action. Three learning collaboratives have been funded for year one of our project.

Reading Collaborative
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London Collaborative
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Salford Collaborative
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Ox and Bucks Wilts, Bath and NE Somerset Gloucs Swindon Bournemouth, Dorset and Poole

Lambeth & Southwark Herts Sussex Westminster Haringey Cambridge Wandsworth Greenwich

Derby Manchester and Salford Pennine North Pennine South Barnsley

Year one learning collaboratives

Year Two Learning Collaboratives
In year two, the Children and Young People’s IAPT project will cover a greater area in England. It will achieve this increased geographical reach in two ways:
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New CAMHS partnerships have been offered the opportunity to join one of our existing three collaboratives. Two new collaboratives in areas of the country that are not in easy reach of the existing collaboratives are being recruited.

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New partnerships and collaboratives are being interviewed and the decisions are due to be announced shortly.
For more information please see: http://www.iapt.nhs.uk/cyp-iapt/
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Children and Young People’s Project
Young People’s Participation
To ensure that children and young people’s voices are heard we have been working with them in a range of innovative ways. For example, Catherine, Shanise and Sarah from the Getaway Girls, a young women’s charity in Leeds, have been helping to interview new collaboratives. The girls grilled each potential team and fed back their thoughts to the board of professionals, who were carrying out interviews at the same time. In addition, all three collaboratives have asked children and young people to help them interview prospective partnerships. Young people have also been working with a production company to make a film on what the project means to them. Earlier in the month, groups from Oxford/Reading Partnerships spent a day coming up with ideas and inspiration. Some of the same groups have also developed and delivered a training session for service leads on the importance of listening to young people when designing and delivering services.

The Getaway Girls from Leeds helped interview potential new collaboratives

Young representatives are working with a production company

Involving Users when Creating Services
Between the ages of 8 and 15 I suffered from Obsessive Compulsive Disorder (OCD). I am now in control of my OCD, largely thanks to the CBT I received between the ages of 12 and 14. Some things were good about my experiences of this treatment and some were not. This year Reading University and the Charlie Waller Institute have given me a chance to share those experiences with Children and Young People’s IAPT trainees. For example, one thing that hugely motivated me to engage with CBT was the way in which it was presented to me as something that I could undergo methodically. I hope that whilst clinicians develop newer models, they are still able to present them to young people in a way that is easy to understand.

Joe Wells Children and Young People’s IAPT Participation Tutor

Service users have always had opinions on the systems they are going through, or have been through. For the past six years I have been involved with OCD-UK, a charity run ‘by sufferers for sufferers’. At every step of my involvement with OCD-UK I have encountered fascinating insights from sufferers of all walks of life, as well as their friends and families. I have heard therapy described as ‘a meeting of two experts: the clinician and the service user’, therefore it is vital that both are involved in training. In the future I hope to see the insights and opinions of service users being heard by clinicians everywhere.
For more information please see: http://www.iapt.nhs.uk/cyp-iapt/
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Children and Young People’s Project
Outcomes Monitoring
Central to our project is the vision of using routine patient-reported outcome measures to improve the quality and experience of services. Session-by-session monitoring is being implemented as part of collaborative practice with clients. It is intended to underpin best practice as well as helping inform understanding of the outcomes achieved by CAMHS. Practitioners have already started using a combination of both standardised measures (e.g. RCADS) and bespoke measures (e.g. progress towards agreed goals) in their work, along with feedback about how children and families experience the help they receive.The sessional data allow children and young people to map their progress, and enable their therapist to consider patterns of change and refine their interventions accordingly. The measures are designed to offer clients and professionals options to suit need and practice.

Dr Miranda Wolpert, Children and Young People’s IAPT Informatics Advisor

Having robust outcome data also helps us to review the effects of the work and to ensure the project is good value for money.The outcomes monitoring is now being rolled out across services involved in the project. We have been very excited to see the first data coming in from sites, and the second data upload will be next month. This is an extraordinary achievement and is the result of hard work by therapists and data managers in all sites.

“The sense of ownership and empowerment created by being at the centre of this participatory process supports children and young people to explore their feelings and issues at their own pace.”
CBT trainee, Oxford Health

“It’s really good to look back on the progress I have made through graphs and being able to question how things have improved and what has worked.”
15 year old, Oxford Health

For more information please see: http://www.iapt.nhs.uk/cyp-iapt/

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Children and Young People’s Project
Update from Reading
It’s exciting times for the trailblazing Children and Young People’s IAPT Project. A collaboration between Oxford Health NHS Foundation Trust, the University of Reading and two other NHS Trusts, 2gether (Gloucester) and Dorset Healthcare University NHS Foundation Trust (Bournemouth, Poole and Dorset), is teaching 25 therapists new skills meaning more children and young people are able to get the help they need. Ten supervisors started their training in November 2011. By January 2012, they were ready to supervise the 19 trainees studying CBT (which they’ll eventually use for one-to-one sessions with young people) and the six studying Parent Training (these skills will be used with groups of parents as well as individually for those who require help and support with their children).

Students on their first day of training

Our Leadership Training Programme began in February 2012. There are eight managers and 11 clinical leads participating.As part of the programme, they are working together on projects around self-referral, implementation of routine outcome measures across a whole service, and young people’s participation. It’s always been important that young people are involved in this project.Young service users have been on board from the start, interviewing, training managers, and designing invitations for our launch. As well as being involved in the future development of self-referral, some young people are currently making a short film to raise awareness of what Children and Young People’s IAPT is and promote its use. All in all, it’s been a busy few months!

Reading University held a regional launch of the Children and Young People’s IAPT project on 24th April 2012. Amy (front right), a young person’s representative, gave a talk to the audience.

For more information please see: http://www.iapt.nhs.uk/cyp-iapt/

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Children and Young People’s Project
Update from London
University College London and King’s College London are currently delivering training to nine managers, 13 supervisors and 37 therapists. The programme has benefitted from significant contributions from other organisations involved in child and adolescent mental health work, notably the Institute of Psychiatry, the Tavistock Clinic and the Anna Freud Centre. The Higher Education Institutions and partnerships been attending London CBT trainees quarterly steering group meetings, chaired by Sarah Brennan, the Chief Executive of YoungMinds, to ensure that the Children and Young People’s IAPT initiative is successfully implemented across the whole collaborative. Since the launch in November 2011, the managers’, supervisors’ and therapists’ courses have progressed well. Course London Parent Training trainees member feedback, collected at the end of training sessions and through the Student Staff Consultative Committee (SSCC), has been a valuable steer for teaching across all three courses. Four student therapists have volunteered to attend SSCC meetings and bring with them student feedback as agenda points. Following a suggestion from one of the representatives, we distributed an anonymous questionnaire to all course members at the end of the Basic Skills module. Survey responses produced some positive feedback and highlighted some worthwhile challenges for the course next year. For example, a large proportion of the students were pleased with the content and quality of teaching on offer. However, it was noted that the pace of teaching was sometimes felt to be too slow or too fast depending on the existing knowledge of course participants. Many course members recognised the lack of preparation time prior to the course to establish appropriate IT support for practice tutor groups. Despite the fact that many felt that the use of video would have benefitted practice tutor groups, many students still found practice tutor groups a valuable chance to develop their skills as evidence-based practitioners. Some course members found balancing training alongside existing work commitments stressful and many therapists have found producing written assignments challenging. However, most assignments for the Basic Skills module have since been fully completed and passed.
For more information please see: http://www.iapt.nhs.uk/cyp-iapt/
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Children and Young People’s Project
Update from Salford
The project is well underway here in Salford. We are delighted to report that all of our partnerships have robust participation plans, which are crucial and central to the successful implementation of Children and Young People’s IAPT. The 28 trainees at Salford Cognitive Therapy Training Centre (20 CBT and 8 Parent Training), at Greater Manchester West NHS Foundation Trust, have now passed the half way mark and have started their specialist modules. The feedback so far from the trainees has been excellent; they are enjoying the programme but finding it tough in terms of new learning, the amount of clinical work, and academic and clinical assignments. The supervisor training is also nearly complete and has been well received.

“It’s hard going but worth every minute, I’m a different clinician now – much more effective.”
Parent Training trainee Salford Parent Training trainees

The service transformation training, led by Barry Nixon and Gill Walker, is almost finished, with 8 out of 10 training days completed to date. The course covers a diversity of topics from workforce planning, value-based practice, finance and economics to participation.The service leads are working hard on their individual service projects with support from Barry and Gill, who have been offering 5 whole-day site visits per service lead to offer bespoke support. They report that most of this has been around the implementation of outcome measures throughout the service. Feedback from the service leads has been excellent and they have been particularly appreciative of the site visits. In terms of project governance, a steering group was set up and commenced in March 2012 and meets monthly. Both YoungMinds and Barnardo’s have been involved in teaching on all of the training programmes and the interview process. Barnardo’s will be assisting with the phase two partnership interviews on the 22nd June and have been working with us to develop this.

“The video supervision is intensive, but I can’t believe how much I’ve learnt from it.”
CBT trainee Salford CBT Trainees

For more information please see: http://www.iapt.nhs.uk/cyp-iapt/

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Children and Young People’s Project
First Annual CYP IAPT Conference
University College London is hosting the first Children and Young People’s Improving Access to Psychological Therapies Conference on Monday 16th July 2012. This conference is aimed at colleagues working in Children and Young People’s sites, both current and future, and will be of interest to colleagues from the Higher Education Institutions and CAMHS partnerships within the project, including service managers, therapists, supervisors and commissioners. This event will give you an opportunity to hear about and discuss the important lessons that have been learnt so far, the project’s achievements, and the challenges faced by those involved. With extra funding secured and new partnerships and collaboratives due to be announced shortly, it will also be a chance to discuss plans for the future. Speakers include: l Paul Burstow, Minister for Care Services l Children and Young People from Article 12, Oxford Health NHS Foundation Trust l Professor Peter Fonagy, Children and Young People’s IAPT National Clinical Adviser l Dr Miranda Wolpert, Children and Young People’s IAPT Informatics Adviser l Dr Ann York, Chair of Children and Young People’s IAPT Service Development Group l Dr Duncan Law, Editor of A Practical Guide to Using Service User Feedback & Outcome Tools to Inform Clinical Practice in Child & Adolescent Mental Health l Dr Raphael Kelvin, CAMHS Professional Adviser , Department of Health l Professor Mick Cooper, Interim Children and Young People’s IAPT Counselling Adviser l Representatives from Year One Collaboratives The Department of Health is offering some free places to each partnership. We hope you will join us to celebrate our first year and look forward to welcoming new colleagues to join the project. To register your interest please contact Sabina Hussain (sabina.hussain@ucl.ac.uk)

If you have any questions about the newsletter or suggestions for future issues please contact Rose Palmer: rose.palmer@ucl.ac.uk For more information please see: http://www.iapt.nhs.uk/cyp-iapt/
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