ro rossiter , duncan law, isobel fleming

© Duncan Law

Making Feedback and Outcomes work for Children and Young People with Learning Disabilities,

& their Families & Networks:A Workshop

Ro Rossiter, Duncan Law, Isobel Fleming

© Duncan Law

Setting the Context:CYP-IAPT and all that……….

Duncan LawClinical Lead for the

London and South East CYP-IAPT Learning Collaborative

CAMHS Issues

ACCESS: % With anxiety or diagnosable depression not in contact with mental health services

Source: Ford et al. (2005) Child & Adol Ment Health, 10:2-9

Dean et al., (2004) DoH; McCrone et al., (2008) King’s Fund

80%

70%

60%

50%

40%

30%

20%

Adults withdepression

5-15 year olds

Percent

unknown

to any

service

35%

76%

Funding

• Only 6% of Mental Health funding goes to services aimed at children (Kennedy 2010)

• Spending on child mental health continues to be cut – by up to 95% in some local authorities (YoungMinds 2014)

• Savings in MH is 1.8% per annum, compared to 1.5% in physical health (DH 2014)

What is the problem – in summary?

• CAMHS is under-resourced and yet investment in CAMHS can save money across the whole health economy and, more importantly, save years of distress

CAMHS Opportunity?

Opportunities:• CAMHS Select Committee inquiry• Children's Task Force• General Election

Threats:• Lack of good Data

(c) Duncan Law & Alex Goforth - London & SE CYP-IAPT Learning Collabortive

What is CYP-IAPT?(a reminder?)

Template for appropriate CYP services: key components

Improving access & engagementAccess

Improving access & engagementAccess

AwarenessIncreasing MH

awareness & decreasing

stigmatisation

Template for appropriate CYP services: key components

Improving access & engagementAccess

AwarenessIncreasing MH

awareness & decreasing

stigmatisationParticipation

Enhancing youth, carer and community participation

Template for appropriate CYP services: key components

Improving access & engagementAccess

AwarenessIncreasing MH

awareness & decreasing

stigmatisationParticipation

EBPDelivery of evidence-based practices

Template for appropriate CYP services: key components

Enhancing youth, carer and community participation

Improving access & engagementAccess

AwarenessIncreasing MH

awareness & decreasing

stigmatisationParticipation

EBPDelivery of evidence-based practices

Accountability

Improving outcomes

accountability

Template for appropriate CYP services: key components

Enhancing youth, carer and community participation

CYP-IAPT

CYP-IAPT is a set of principles for Whole Service ‘Transformation’

The CYP-IAPT principles:1. Better Evidence Based Practice2. Better Collaborative practice - Clinically

Meaningful use of feedback tools 3. Authentic participation of families and Young

People who use the service4. Rigorous outcomes monitoring Leading to effective and efficient use of resources

(c) Duncan Law & Alex Goforth - London & SE CYP-IAPT Learning Collabortive

© Duncan Law

Feedback & Outcomes Monitoring

Feedback & Outcomes Forms

Why bother using them?

© Duncan Law

Values behind outcomes and feedback

1. Demonstrate/celebrate/prove: effectiveness of interventions and service

2. Enhance collaborative practice:– Better service user voice in therapy (&

supervision)– Facilitates good clinical practice

© Duncan Law

Feedback & Outcomes Monitoring

Demonstrating success

© Duncan Law

Demonstrating effectiveness• 90% target

• at least two time points with repeated, normed measure

• plus, at least one report of Education Employment and Training (EET)

• plus, consent

http://www.iapt.nhs.uk/silo/files/90.pdf

© Duncan Law

It’s not (just) about measurement, it’s about a culture of collaboration

© Duncan Law

Feedback & Outcomes Monitoring

Enhancing Collaborative Practice

Evidence Based TransformationShared Formulation &

Agreed Intervention Goals

Research evidenceYP/Family’s goals preferences, values, and unique context

Clinician expertise

+ +

Frueh et al (2012) Evidence-Based Practice in Adult Mental Health. Handbook of Evidence-Based Practice in Clinical Psychology. Published online.

Adapted and used with thanks to Peter Fonagy

Hertfordshire PartnershipNHS Foundation Trust

Goals Based Outcome Tool:

What does it look like?

© Duncan Law, London & SE CYP-IAPT Collaborative Outreach

© Duncan Law, London & SE CYP-IAPT Collaborative Outreach

Session Rating Scale (SRS)

26

Resources and Other Information

(c) Duncan Law & Alex Goforth - London & SE CYP-IAPT Learning Collabortive

© Duncan Law, Stephen Butler, & Alex Goforth

For more information on outcomes and feedback

http://www.corc.uk.net/resources/additional-information-about-the-measures/

© Duncan Law

Other Resources• www.cypiapt.org • www.corc.uk.net • www.myapt.org.uk • www.vimeo.com/tag:cyp+iapt • www.MindEd.org

Contacts

Duncan LawClinical Lead

London & South East CYP-IAPT Learning Collaborative

Duncan.law@annafreud.org

(c) Duncan Law - London & SE CYP-IAPT Learning Collaborative

Scene setting: feedback and outcomes, principles and

practice - CYP-LD, their families and networks

Ro RossiterConsultant Clinical Psychologist/Research Fellow

Member CYP-IAPT Outcomes and Evaluation Group

Drivers 1:

• Improve collaboration, focus, evaluation and demonstration of effectiveness

• Desire to collate practice experience for guidance (clinical psychology and multidisciplinary)

• LD Clinical Psychology Faculty had done similar project (adult focused, some themes in common)

Drivers 2

• CYP IAPT begins

• Health inequalities and CYP-LD (access &recognition- eg Simonoff et al. (2006) only 15% IQ < 70 had a statement of special educational needs, yrs 8-9; Emerson & Baines (2010) lack of recognition of LD in mental health, care, education and criminal justice settings, therefore CYP-LD needs not met -contributes to health inequalities; prevalence of children with Complex Learning Difficulties and Disabilities increasing (Blackburn et al., 2010; DCFS, 2010; Carpenter et al., 2010). “Atypical” development &/or neurodevelopmental disorders- part of broader diversity/equalities agenda (race and culture, socioeconomic status etc.).

• Equalities legislation

• Passionate practitioners

Journey so far:

Journey so far 1:

• 2012- Paper for Children , Young People and their Families Clinical Psychology Faculty Review

• 2013 :CYP-IAPT LD ROMS Management Project (Swindon-

Julie Pill and colleagues)CYP-IAPT Outcomes & Evaluation Group membershipChapter for ACAMH LD & Challenging Behaviour

Briefing

Journey so far 2: • 2014 Evaluation & Outcome tools survey (Phillips &

Sopena)CYP-LD & families chapter in CYP-IAPT Guide to using

outcomes and feedback tools chapterToday’s workshop

What next? • Share experience, plan actions (local,

collaboratives, national levels- CYP-IAPT, Child Health eg CHUMS project?)

© Duncan Law

We hope you found this presentation useful

Feel free to use all are parts of it to help train other staff in your organisation & to

further implement CYP-IAPT

If you do use slides please reference the authors appropriately

These slides must not be used in training for commercial gain