nhs iapt children and young people's project newsletter june 2012

7/31/2019 NHS IAPT Children and Young People's Project Newsletter June 2012

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Children and Young Peoples Project

1For more information please see: http://www.iapt.nhs.uk/cyp-iapt/

Welcome to the rst Children and Young Peoples IAPT newsletter. Wehope 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 Peoples IAPT is a service trans-formation project for Child and Adolescent Mental Health Services (CAMHS)working in targeted and specialist services (Tiers 2 and 3), in the statutoryand voluntary sectors. It focuses on embedding evidence-based practice

across services, making sure that everyone involved in the services, not justthose who are being directly trained by the project, use intensive (session-by-session) outcome monitoring and work to incorporate the views of chil-dren and young people in service design and delivery.

We aim to ensure that children and young people have improved access to the best possible psy-

chological therapies in a way that they nd acceptable and relevant. As acutely as ever we face thechallenge of working with limited resources to meet the needs of a society increasingly aware ofmental health issues and appropriately insisting that care is provided to children and young people.

A common misconception is that Children and Young Peoples 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 standaloneservices. The obligation to deliver value in child mental health has never been greater. Deliveringtherapies to the standards of RCTs may seem like a big challenge, but children deserve nothing lessthan the best if we can provide it - which it seems we can.

The rst year of the project is coming to an end and during this time everybody involved hasworked unbelievably hard to ensure success at each stage of its development and implementation.

The collaborative spirit, support and seless commitment that we have received in the rst yearfrom those involved has been humbling and a source of immense gratication for me. In 35 yearsof 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 NHSservices, commissioners and voluntary services committed to transformation to outcome-focused,evidence-based, child-oriented clinical work. You can read updates from the year one learningcollaboratives on pages 7-9.

We have been lucky enough to secure up to 22 million additional funding from the Governmentto 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 pro-viding mental health services for them is a crucial aspect of our project. They have been involved

Welcome and Introduction

Professor Peter Fonagy

National Clinical Lead for

Children and Young

Peoples IAPT


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at both a national level, helping to steer the project, and at a local level, where sites have been lis-tening 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 upcomingyears of the project, as we bring new modalities into Children and Young Peoples IAPT, are char-

acterised by as much enthusiasm and hard work. On the 16th July 2012 UCL will be hosting therst annual Children and Young Peoples IAPT conference where Paul Burstow, the Minister forCare Services, will join us in celebrating our achievements and help us plan the future. More detailsabout the conference can be found on page 10.

Professor Peter Fonagy

National Clinical Lead for Children and Young Peoples IAPT

Year One and Year Two Therapies

In its rst year the Children and Young Peoples IAPT project chose two

therapies, CBT and Parent Training, as the core treatments behind a rangeof psychological interventions in CAMHS. Not only are these therapiesthe ones with the clearest recommendations from the National Insti-tute of Health and Clinical Excellence for a range of disorders, but they

are also ones where other aspects of the step change, i.e. outcomesmonitoring and evidence-based case management, can be most eas-

ily integrated with the intervention. The service transformation rests onthe development of collaborative care and an increased opportunity tointegrate children and young peoples voices into decisions about theircare. The quality of training in these therapies, alongside the focus on

supervision and service improvement, is beginning to make itself felt acrossservices throughout the three existing collaboratives.

A comprehensive CAMHS offers a range of therapies and choices to its service users and theirfamilies. 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 interventionswill be developed over the coming months.

Kathryn Pugh

Children and Young Peoples

IAPT Project Manager


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On the 29th February 2012, the Deputy Prime Minister, Nick Clegg, and the Minister for CareServices, Paul Burstow, announced that our project will receive an extra investment of up to22 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 includeSystemic Family Therapy and Interpersonal Psychotherapy; extend the geographical reach of theproject; and develop exciting interactive e-learning programmes for staff working in universal set-tings and the NHS and counsellors working with children and young people.

Project Awarded Additional Funding

Too many young people suffer

in silence with mental health

problems. This is vital investment

that will give children the very besttailored treatment to restore them

to good health. Nick CleggDeputy Prime Minister

We broke new ground last yearinvesting in childrens mental health.

This additional funding will help deliver

services specifc to young people. Were

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


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l Derby

l Manchester and Salford

l Pennine North

l Pennine South

l Barnsley

Year One Learning Collaboratives

Children and Young Peoples IAPT is made up of learning collaboratives. These consist of HigherEducation Institutions (HEIs) and local CAMHS Partnerships (mental health services, voluntarysector 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. Threelearning collaboratives have been funded for year one of our project.

Year Two Learning CollaborativesIn year two, the Children and Young Peoples IAPT project will cover a greater area in England.It will achieve this increased geographical reach in two ways:

l New CAMHS partnerships have been offered the opportunity to join one of our existing threecollaboratives.

l Two new collaboratives in areas of the country that are not in easy reach of the existingcollaboratives are being recruited.

New partnerships and collaboratives are being interviewed and the decisions are due to beannounced shortly.

Reading Collaborative

l Ox and Bucks

l Wilts, Bath and NESomerset

l Gloucs

l Swindon

l Bournemouth, Dorsetand Poole

Salford Collaborative

l Lambeth & Southwark

l Herts

l Sussex

l Westminster

l Haringey

l Cambridgel Wandsworth

l Greenwich

London Collaborative

Year one learning collaboratives


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Between the ages of 8 and 15 I suffered from Obsessive Compulsive Dis-order (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 somewere not. This year Reading University and the Charlie Waller Institute have

given me a chance to share those experiences with Children and Young Peo-ples 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 somethingthat I could undergo methodically. I hope that whilst clinicians develop newermodels, they are still able to present them to young people in a way that iseasy to understand.

Service users have always had opinions on the systems they are going through, or have beenthrough. For the past six years I have been involved with OCD-UK, a charity run by sufferers forsufferers. At every step of my involvement with OCD-UK I have encountered fascinating insightsfrom sufferers of all walks of life, as well as their friends and families. I have heard therapy describedas 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 beingheard by clinicians everywhere.

Young Peoples Participation

Joe Wells

Children and Young

Peoples IAPT

Participation Tutor

Involving Users when Creating Services

To ensure that children and young peoples voices are heardwe have been working with them in a range of innovative ways.

For example, Catherine, Shanise and Sarah from the GetawayGirls, a young womens charity in Leeds, have been helping to

interview new collaboratives. The girls grilled each potentialteam and fed back their thoughts to the board of profession-als, who were carrying out interviews at the same time. Inaddition, all three collaboratives have asked children and youngpeople to help them interview prospective partnerships.

Young people have also been working with a productioncompany to make a lm on what the project means to them.Earlier in the month, groups from Oxford/Reading Partner-ships spent a day coming up with ideas and inspiration. Some

of the same groups have also developed and delivered a train-

ing session for service leads on the importance of listening toyoung people when designing and delivering services.

The Getaway Girls from Leeds helped

interview potential new collaboratives

Young representatives are working with a

production company


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Central to our project is the vision of using routine patient-reportedoutcome measures to improve the quality and experience of services.

Session-by-session monitoring is being implemented as part of collabora-tive 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 bothstandardised measures (e.g. RCADS) and bespoke measures (e.g. progresstowards agreed goals) in their work, along with feedback about howchildren and families experience the help they receive. The sessional data

allow children and young people to map their progress, and enable theirtherapist to consider patterns of change and rene their interventionsaccordingly. The measures are designed to offer clients and professionalsoptions to suit need and practice.

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 servicesinvolved in the project. We have been very excited to see the rst data coming in from sites, andthe second data upload will be next month. This is an extraordinary achievement and is the resultof hard work by therapists and data managers in all sites.

Outcomes Monitoring

Dr Miranda Wolpert,

Children and Young

Peoples IAPT

Informatics Advisor

The sense of ownership andempowerment created by being at the

centre of this participatory process

supports children and young people toexplore their feelings

and issues at their own pace.

CBT trainee, Oxford Health

Its really good to look back on the

progress I have made through graphs

and being able to question how thingshave improved and what has worked.

15 year old, Oxford Health


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Its exciting times for the trailblazing Children and Young Peoples IAPT Project. A collabora -

tion between Oxford Health NHS Foundation Trust, the University of Reading and two otherNHS Trusts, 2gether (Gloucester) and Dorset Healthcare University NHS Foundation Trust(Bournemouth, Poole and Dorset), is teaching 25 therapists new skills meaning more children andyoung people are able to get the help they need.

Ten supervisors started their training in November 2011. By January 2012, they were ready tosupervise the 19 trainees studying CBT (which theyll eventually use for one-to-one sessions withyoung people) and the six studying Parent Training (these skills will be used with groups of parentsas well as individually for those who require help and support with their children).

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 aroundself-referral, implementation of routine outcome measures across a whole service, and youngpeoples participation.

Its 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 arecurrently making a short lm to raise awareness of what Children and Young Peoples IAPT is andpromote its use. All in all, its been a busy few months!

Update from Reading

Students on their rst day of training

Reading University held a regional launch of the

Children and Young Peoples IAPT project on 24th

April 2012. Amy (front right), a young persons

representative, gave a talk to the audience.


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University College London and KingsCollege London are currently deliveringtraining to nine managers, 13 supervi-sors and 37 therapists. The programmehas benetted from signicant contribu-

tions from other organisations involvedin child and adolescent mental healthwork, notably the Institute of Psychiatry,the Tavistock Clinic and the Anna FreudCentre. The Higher Education Institu-tions and partnerships been attending

quarterly steering group meetings, chairedby Sarah Brennan, the Chief Executive ofYoungMinds, to ensure that the Chil-dren and Young Peoples IAPT initiative issuccessfully implemented across the

whole collaborative.

Since the launch in November 2011, themanagers, supervisors and therapistscourses have progressed well. Course

member feedback, collected at the end oftraining sessions and through the Student Staff Consultative Committee (SSCC), has been a valu-

able steer for teaching across all three courses. Four student therapists have volunteered to attendSSCC meetings and bring with them student feedback as agenda points. Following a suggestionfrom one of the representatives, we distributed an anonymous questionnaire to all course mem-

bers at the end of the Basic Skills module.

Survey responses produced some positive feedback and highlighted some worthwhile challengesfor the course next year. For example, a large proportion of the students were pleased with thecontent and quality of teaching on offer. However, it was noted that the pace of teaching was some-times 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 establishappropriate IT support for practice tutor groups. Despite the fact that many felt that the use ofvideo would have benetted practice tutor groups, many students still found practice tutor groups

a valuable chance to develop their skills as evidence-based practitioners. Some course membersfound balancing training alongside existing work commitments stressful and many therapists havefound producing written assignments challenging. However, most assignments for the Basic Skillsmodule have since been fully completed and passed.

Update from London

London CBT trainees

London Parent Training trainees


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The project is well underway here in Salford. We are delighted to report that all of our partner-ships have robust participation plans, which are crucial and central to the successful implementa-tion of Children and Young Peoples IAPT. The 28 trainees at Salford Cognitive Therapy TrainingCentre (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 fromthe trainees has been excellent; they are enjoying the programme but nding it tough in terms ofnew learning, the amount of clinical work, and academic and clinical assignments. The supervisortraining is also nearly complete and has been well received.

The service transformation training, led by Barry Nixon and Gill Walker, is almost nished, with 8

out of 10 training days completed to date. The course covers a diversity of topics from workforceplanning, value-based practice, nance and economics to participation. The service leads are work-ing hard on their individual service projects with support from Barry and Gill, who have been offer-ing 5 whole-day site visits per service lead to offer bespoke support. They report that most of thishas 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 andmeets monthly. Both YoungMinds and Barnardos have been involved in teaching on all of thetraining programmes and the interview process. Barnardos will be assisting with the phase two

partnership interviews on the 22nd June and have been working with us to develop this.

Update from Salford

Its hard going but worth every

minute, Im a different clinician now

much more effective.

Parent Training trainee

Salford Parent Training trainees

The video supervision is intensive,but I cant believe how much Ive

learnt from it.

CBT trainee

Salford CBT Trainees


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University College London is hosting the rst Childrenand Young Peoples Improving Access to PsychologicalTherapies Conference on Monday 16th July 2012.

This conference is aimed at colleagues working in

Children and Young Peoples sites, both current andfuture, and will be of interest to colleagues from theHigher Education Institutions and CAMHS partnershipswithin the project, including service managers,therapists, supervisors and commissioners. This eventwill give you an opportunity to hear about and discuss

the important lessons that have been learnt so far, the projects achievements, and the challengesfaced by those involved. With extra funding secured and new partnerships and collaboratives dueto 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 Trustl Professor Peter Fonagy, Children and Young Peoples IAPT National Clinical Adviser

l Dr Miranda Wolpert, Children and Young Peoples IAPT Informatics Adviser

l Dr Ann York, Chair of Children and Young Peoples IAPT Service Development Group

l Dr Duncan Law, Editor of A Practical Guide to Using Service User Feedback & Outcome Toolsto 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 Peoples IAPT Counselling Adviser

l Representatives from Year One Collaboratives

The Department of Health is offering some free places to each partnership. Wehope you will join us to celebrate our rst year and look forward to welcoming newcolleagues to join the project.

To register your interest please contact Sabina Hussain ([email protected])

First Annual CYP IAPT Conference

If you have any questions about the newsletteror suggestions for future issues please contactRose Palmer: [email protected]

nhs iapt children and young people's project newsletter june 2012

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