Working with CYP and Families with Complex Mental Health Needs: Therapeutic Skills and Interventions to Improve Psychological Wellbeing
| Module title | Working with CYP and Families with Complex Mental Health Needs: Therapeutic Skills and Interventions to Improve Psychological Wellbeing |
|---|---|
| Module code | PYCM119 |
| Academic year | 2021/2 |
| Credits | 20 |
| Module staff |
| Duration: Term | 1 | 2 | 3 |
|---|---|---|---|
| Duration: Weeks | 10 | 10 |
| Number students taking module (anticipated) | 31 |
|---|
Module description
This module will equip you as a YIPP with a good understanding of and the ability to contribute to the process, under supervision, of therapeutic support and the management of individual young people (and parents / carers) experiencing severe and complex mental health difficulties in inpatient and community settings. As a YIPP you will support the process of a whole team and whole system approach to risk management, developing the ability to assess and manage a range of risk factors and presentations in this context. You will develop an understanding of the application of positive / therapeutic risk management and harm minimizations and be able to identify appropriate actions following risk assessment. You will develop the ability to establish and maintain therapeutic alliances with young people 8 and their parents / carers in this context and interpersonal boundaries that will support therapeutic risk management. You will understand and develop the ability to implement strategies, under supervision, to support active risk management including supporting young people with daily skills and self-care. As a YIPP you will deliver appropriate skills and interventions to improve psychological wellbeing, anxiety and low mood in young people and their parents / carers in this context. You will actively contribute to whole team formulations, behaviour change models and strategies to support emotion regulation and distress tolerance.
Module aims - intentions of the module
1. To equip you with the skills to support psychological intervention under close supervision.
2. To deliver appropriate skills to stabilize and improve psychological wellbeing.
3. To learn brief interventions, which can be delivered (under supervision) from community to inpatient and back.
Intended Learning Outcomes (ILOs)
ILO: Module-specific skills
On successfully completing the module you will be able to...
- 1. Understand the use of relevant code of practice guidelines for children and young people and the least restrictive practice (Refer to Practitioners Handbook for crisis and Inpatient CAMHS).
- 2. Provide interventions within the least restrictive environment and using least restrictive practice.
- 3. Recognise the interaction between psychological states and physical risk and implement a framework to reduce use of physical intervention
- 4. Assess and contribute to MDT risk management plans to mitigate risks such as neglect, self-harm, suicidal intent/acts, absconsion/running away, substance misuse, physical aggression, restricted eating/binge/purge, offending behaviour.
- 5. Demonstrate and understanding and skills in risk assessment and positive / therapeutic risk management/harm minimization.
- 6. Involve the parents and family or carer effectively in supporting the young person and in risk management, recognising them as a helpful resource and partner where appropriate.
- 7. Demonstrate an understanding of the impact of secondary trauma.
- 8. Understand and contribute to the management of difficult/highly expressed emotions.
- 9. Use a holistic risk assessment within an agreed framework to develop a risk management plan.
- 10. Establish and maintain therapeutic alliances and set and manage clear interpersonal boundaries
- 11. Develop skills in supporting social skills, communication, sleep self-care, daily living skills, self-soothing, relaxation, play, distraction, physical exercise, acceptance, interests.
- 12. Explore motivation to change and negotiate safe ways of managing risk behaviours. associated with the child/young persons mental disorder and ensure that early changes provide steps for further change and re-evaluation of treatment targets.
- 13. Explore and manage risk associated with the use of social media and mobile phones. Social systems, groups, team working.
ILO: Discipline-specific skills
On successfully completing the module you will be able to...
- 14. Summarise basic and essential factual and conceptual knowledge of the subject, and demonstrate a critical understanding of this knowledge
- 15. Review and evaluate established work and identify some of the strengths and weaknesses of this workReview and evaluate established work and identify some of the strengths and weaknesses of this work
ILO: Personal and key skills
On successfully completing the module you will be able to...
- 16. Record accurately interviews and questionnaire assessments using paper and electronic record-keeping systems
- 17. Evaluate your strengths and weaknesses, challenge received opinion and develop your own criteria and judgement, and seek and make use of feedback
Syllabus plan
The module content, module-specific learning objectives, style of delivery and assessment for this module are informed by the National Curriculum for Youth Intensive Psychological Practitioners –Teaching content will include:
- Therapeutic risk assessment and risk management
- Working systemically with risk in families and systems
- Practice skills to support psychological interventions
- Overview and introduction to brief interventions, which can be delivered (under supervision) from community to inpatient and back
- Working with the least restrictive practice
- Understanding high expression emotion, de-escalation and physical interventions
- Legal/professional issues
- Reflective practice, secondary trauma, managing boundaries and de-briefing
- Assessing motivation to change and motivational interviewing
- Understanding specific risks associated with adolescence i.e. use of social media, mobiles, sexual exploitation.
The curriculum for YIPP in Specialist CYP Mental Health settings is organised into three components. Components can be organised according to local module structure requirements by training providers to comply with their academic timetable and tailored to suit local needs. The curriculum is based on three components delivered over 45 days in total. This number of days is essential to meet the learning objectives specified within the curriculum. Although each component has a specific set of foci and learning outcomes, the clinical competencies build on each other and courses are expected to focus the majority of their teaching activity on clinical competence development through clinical simulation/role play. Assessment focuses primarily on trainees’ practical demonstration of competencies. Skills based competency assessments are independent of academic level and must be passed. The curriculum will form the basis of any future course accreditation.
Supervised and Assessed Practice: The training programme requires trainees to learn from observation and skills practice under supervision while working in fully functioning young people community mental health and / or inpatient settings, as well as through the theoretical teaching, skills practice and practice-based learning directed by the Higher Education Institute. Trainees should complete a minimum of 80 clinical contact hours with young people and their families including within an CYP community mental health service for severe and complex mental health needs and within a CYP inpatient setting as a requirement of their training (of which 40 hours should be specifically delivering intervention / wellbeing support in line with Module 3 ILOs). Trainees either need to evidence working with cases in both the inpatient and community settings or a case or cases move between the two settings. The clinical practice should encompass three areas: 1) Working with a YP/ Family in the Community, 2) Working with a YP/ Family in Inpatient setting, and 3) Working with a YP/ Family at risk of unnecessary Inpatient Admission (to include crisis). Trainees should undertake a minimum of 40 hours of clinical supervision of which at least 20 hours should be case management supervision and at least 20 hours should be clinical skills supervision. Clinical Supervision should be provided weekly by an HCPC registered Clinical Psychologist who will hold clinical responsibility for the cases. There should also be fortnightly individual case management supervision (where the entire caseload is reviewed and actions agreed if there is current high risk, an increase in risk or a regular monthly review of the care plan is due). Case management supervision can be provided by a suitably qualified member of the multi-disciplinary team with competence in the interventions the MHWPs will offer, and who have undertaken training on MHWP supervision. Supervisors should be individuals of a sufficiently senior status within the service with capacity to oversee both case management and how this interacts with the system. Supervision may reduce in regularity as the training proceeds. In addition, there may be a need for particular clinical tasks where specialist supervision will be needed. This will need to be considered within the context of the particular service setting. Supervisors will need to attend the supervisors training / orientation days at the relevant training provider.
The assessment of academic and clinical skills is detailed below. All clinical skills should be assessed by practical tests of clinical competence either via live tapes of simulated clinical scenarios. Because of the critical nature of clinical competence, there can be no compensation/condonement for a failed clinical 11 competence assessment. While the assessment strategies for assessing practical clinical skills are set out for each component, the methods of assessing academic skills and knowledge may be varied locally to cover the academic content of all three components. A service-based portfolio should all cover clinical work in modules 1-3. The portfolio should include details of number of contacts and ‘intervention’ sessions for each and supervision sessions. Supervisor observation and evaluation / sign off is considered a critical part of the portfolio evaluation process.
Learning activities and teaching methods (given in hours of study time)
| Scheduled Learning and Teaching Activities | Guided independent study | Placement / study abroad |
|---|---|---|
| 60 | 120 | 20 |
Details of learning activities and teaching methods
| Category | Hours of study time | Description |
|---|---|---|
| Scheduled Learning and Teaching | 25 | Practical classes these will be used to develop clinical competencies through tutor supervised small group role-play |
| Scheduled Learning and Teaching | 7 | Lectures |
| Scheduled Learning and Teaching | 10 | Seminars these will be led by the tutor and address a range of important topics covered in the module |
| Scheduled Learning and Teaching | 8 | Tutorials these will take the form of small group sessions led by the tutor |
| Guided Independent study | 50 | Reading and preparation for seminars and/or flipped classroom delivery model |
| Guided Independent study | 50 | Self-practice and self-reflection on role plays of assessments with fellow students undertaken outside of teaching sessions |
| Guided Independent study | 20 | Develop an understanding of service-related clinical protocols, policies and procedures to inform practice, and develop knowledge of role. |
| Scheduled Learning and Teaching | 10 | Within the workplace, Supervision will be provided by a HCPC registered Clinical Psychologist or a suitably qualified MDT member with competence in the YIPP interventions with young people with severe mental health problems. Trainees should undertake a minimum of 40 hours of clinical supervision of which at least 20 hours should be weekly 1:1 case management supervision and at least 20 hours should be clinical skills supervision, either individual or group-based, on a fortnightly basis. |
| Placement | 20 | Programme members will be employed by their Trusts as trainee YIPPs where they will work 3 - 5 days a week over the year. In this time they will accumulate a minimum of 80 contact hours with service users within an young persons community mental health / inpatient |
Formative assessment
| Form of assessment | Size of the assessment (eg length / duration) | ILOs assessed | Feedback method |
|---|---|---|---|
| A video recording or clinical competency simulation 1 demonstrating skills in planning and implementing brief interventions to support psychological wellbeing in this context. | 30 mins | 2 8, 12 17, 20, 21 | Written and verbal |
Summative assessment (% of credit)
| Coursework | Written exams | Practical exams |
|---|---|---|
| 50 | 0 | 50 |
Details of summative assessment
| Form of assessment | % of credit | Size of the assessment (eg length / duration) | ILOs assessed | Feedback method |
|---|---|---|---|---|
| A video recording or clinical competency simulation Demonstrating skills in planning and implementing brief interventions to support psychological wellbeing in this context. | 50 | 30 mins | 2 8, 12 17, 20, 21 | Written and oral |
| Clinical Portfolio including Supervision report (see supervision and practice requirements above) Pass/fail. | 0 | n/a | 1-19 | Written |
| Practice Outcome document : Trainees will be required to demonstrate competence in the clinical practice outcomes related to working effectively in teams, supporting transitions, working with systems. The supervisor will sign off this summative POD once they are satisfied the trainee has demonstrated competence in all areas. Different sources of evidence can be used to demonstrate completion of each POD competency (direct observation by clinical supervisor, discussion and questioning by the clinical supervisor in supervision, testimony from other colleagues, written case records, use of video recordings of clinical encounters and feedback from your clinical supervisor on these, reflective accounts of how the outcome(s) was achieved, drawing upon the research evidence base and feedback volunteered by YP and families). | 50 | n/a | 1-19 | Written and oral |
Details of re-assessment (where required by referral or deferral)
| Original form of assessment | Form of re-assessment | ILOs re-assessed | Timescale for re-assessment |
|---|---|---|---|
| A video recording or clinical competency simulation demonstrating skills in planning and implementing brief interventions to support psychological wellbeing in this context. | A video recording or clinical competency simulation demonstrating skills in planning and implementing brief interventions to support psychological wellbeing in this context. | 2 8, 12 - 17 | Four weeks from the date feedback was provided |
| Clinical Portfolio including Supervision Report III | Clinical Portfolio including Supervision Report III | 1-19 | Four weeks from the date feedback was provided |
| Practice Outcome document | Practice Outcome document | 1-19 | Four weeks from the date feedback was provided |
Re-assessment notes
Three assessments are required for this module. In all cases re-assessment will be the same as the original assessment, although it may be appropriate for there to be an individual reassessment of elements of the group presentation. Where you have been referred/deferred for any form of assessment detailed above you will have the opportunity to retake within four weeks from the date that feedback was provided.
If you pass re-assessments taken as a result of deferral, your re-assessment will be treated as it would be if it were your first attempt at the assessment and the overall module mark will not be capped.
If you pass re-assessments taken as a result of referral (i.e., following initial failure in the assessment), the overall module mark will be capped at 50%.
If you fail re-assessments taken as a result of referral (i.e., following initial failure in the assessment), you will be failed in the module and the programme
Indicative learning resources - Basic reading
General:
Carr, A. (2000). What works with children and adolescents? A critical review of psychological interventions with children, adolescents and their families.Routledge.
Grant, A., Townend, M., Mulhern, R., & Short, N. (2010). Cognitive behavioural therapy in mental health care. (2nd Edition). Sage Publications.
Greenberger, D., & Padesky, C. A. (1995). Mind over mood: A cognitive therapy treatment manual for clients. New York: Guildford Press.
Howard, C., Burton, M., & Levermore, D. (2019). Children’s mental health and emotional well-being in primary schools. Learning Matters.
Kedar, N. D., & Harper, P. B. (2004). Promoting the emotional well-being of children and adolescents and preventing their mental ill health. Jessica Kingsley Publishing
Reynolds, S., & Pass, L. (2021). Brief behavioural activation for adolescent depression: A clinician’s manual and step by step guide. Jessica Kingsley Publishers.
Ritschel, L. A., Ramirez, C. A., Jones, M., & Craighead, W. E. (2011). Behavioral activation for depressed teens: A pilot study. Cognitive and Behavioral Practice, 18, 281–299
Roth, A., & Fonagy, P. (2006). What works for whom? (2nd edition). Guildford Press.
Webster-Stratton, C. (2004). How to promote children’s social and emotional competence (7th edition). Sage Publications.
Williams, C. (2012). Overcoming anxiety: A five areas approach. Arnold.
‘Working with families and systems’
- Fonagy, P. and Target, M. (2005). What works for whom: a critical review for children and adolescents. London: Routledge
- Dallos, R. and Draper, R. (2010) An introduction to family therapy and systemic practice. Buckingham: OUP.
- Day, R. (2010) Introduction to family processes. New York: Routledge.
- Rivett, M. and Street, E. (2009) Family therapy: 100 key ideas and techniques. London: Routledge.
- Rivett, M and Street, E. (2003) Family therapy in focus. London: Sage.
- Smith-Acuna, S. (2011) Systemic theory in action. New Jersey: Wiley and Sons.
- Sprenkle, D. and Piercy, F. (2005) Research methods in family therapy. New York: Guilford.
- Gehart, D. (2010) Mastering competencies in family therapy. Belmont CA; Brooks/Cole, Cengage Learning.
- Patterson, J.; Williams, L.; Edwards, T.; Chamow, L and Grauf-Grounds, C. (2009) Essential skills in family therapy. New York: Guilford.
- Pilling, S.; Roth, A. and Stratton, P. (2010) The competencies required to deliver effective systemic therapies http://www.ucl.ac.uk/clinical-psychology/CORE/systemic_framework.htm
- Stanton, M. and Welsh, R. (2011) Speciality competencies in couple and family psychology. New York: Oxford University Press
- Williams, L.; Edwards, T.; Patterson, J. and Chamow, L. (2011) Essential assessment skills for couple and family therapy. New York; Guilford
Working with eating disorders’
- Eisler I, Lock J and Le Grange D (2010) Family-based treatments for adolescent anorexia nervosa. In Grilo C and Mitchell J (Eds) The Treatment of Eating Disorders New York, Guilford Press
- Simic M and Eisler I (2012) Family and Multifamily Therapy. In Fox J and Goss K (eds) Eating and its Disorders. Oxford, Willey-Blackwell
- Eisler, Simic and colleagues (2012) Maudsley Child and Adolescents Eating Disorders Service model and treatment manual for single and multi-family therapy for adolescent anorexia nervosa. Unpublished treatment manual. South London and Maudsley NHS Foundation Trust
- NICE (2004) Eating Disorders: Core Interventions in the Treatment and Management of Anorexia Nervosa, Bulimia Nervosa and Related Eating Disorders. A National Clinical Practice Guideline. London: National Institute for Clinical Excellence
‘Working with conduct disorder, self-harm and adolescent depression’
- Henggeler, S.; Schoenwald, S.; Borduin, C.; Rowland, M. and Cuningham, P. (2009) Multisystemic therapy for antisocial behaviour in children and adolescents. New York: Guilford.
- Sexton, T. (2011) Functional family therapy in clinical practice. New York: Routledge.
‘Diversity’
- Beck, A., Naz, S., Brooks, M., & Jankowska, M., (2019). IAPT BAME Service User Positive Practice Guide, Retrieved from BABCP website: https://www.babcp.com/files/About/BAME/IAPT-BAME-PPG-2019.pdf
- Bernal, G. and Domenech Rodriguez, M. (2015). Cultural Adaptations. Washington: American Psychological Association.
- Beck, A. (2016). Transcultural Cognitive Behavioural Therapy for Anxiety and Depression: A Practical Guide. London: Routledge/Taylor & Francis Group.
- Thornicroft, G. (2006). Shunned: Discrimination Against People with Mental Illness. Oxford: Oxford University Press.
Indicative learning resources - Web based and electronic resources
pntal health by the deadline. ectronic copy et on the timetable and write your name in the comments to mark your attendance. MindEd sessions
Reach Out – Low Intensity Manual
National Programme Student Materials to Support the Delivery of Training for Psychological Wellbeing Practitioners Delivering Low Intensity Interventions
Low Intensity Workbooks
Behavioural experiments workbook with children and young people: https://swcypiapt.com/resources/publications/
PWP workbooks
https://cedar.exeter.ac.uk/iapt/iaptinterventions/
NICE Guidelines
CG113
National Institute for Health and Clinical Excellence (2011). Generalised anxiety disorder and panic disorder in adults: management https://www.nice.org.uk/guidance/cg113
NG134
National Institute for Health and Clinical Excellence. (2005). Depression in children and young people: Identification and management https://www.nice.org.uk/guidance/ng134
CG31
National Institute for Health and Clinical Excellence. (2005). Obsessive-compulsive disorder and body dysmorphic disorder: treatment https://www.nice.org.uk/guidance/cg31
TA102
National Institute for Health and Clinical Excellence. (2006). Parent-training/education programmes in the management of children with conduct disorders.
https://www.nice.org.uk/sharedlearning/solihull-approach-parenting-group
PH20
National Institute for Health and Clinical Excellence. (2009). Social and emotional wellbeing in secondary education https://www.nice.org.uk/guidance/ph20
Websites
http://www.cypiapt.org/children-and-young-peoples-project.php?accesscheck=%2Findex.php
No Health without Mental Health:
Roth & Pilling (2007) & Roth, Calder & Pilling (NHS Education for Scotland Competence Framework for Workers in CAMHS Settings, 2011):
http://www.ucl.ac.uk/clinical-psychology/CORE/competence_frameworks.htm
Indicative learning resources - Other resources
Referencing: Please follow APA guidelines for referencing (7th Edition). For more information, see: https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/general_format.html
| Credit value | 20 |
|---|---|
| Module ECTS | 10 |
| Module pre-requisites | PYCM117 Children & Young People’s Mental Health Settings: Context and Values PYCM118 Working with Young people and their Families with severe and complex mental health needs: Assessment, Engagement and Formulation |
| Module co-requisites | None |
| NQF level (module) | 7 |
| Available as distance learning? | No |
| Origin date | 21/02/2022 |
| Last revision date | 24/05/2022 |
