Working with CYP and Families with complex mental health needs: Assessment, Engagement and Formulation

Module title	Working with CYP and Families with complex mental health needs: Assessment, Engagement and Formulation
Module code	PYCM118
Academic year	2023/4
Credits	20
Module staff	Mr Bob Williams (Convenor)

Duration: Term	1	2	3
Duration: Weeks	0	10	10

Number students taking module (anticipated)	31

Module description

As a Youth Intensive Psychological Practitioner (YIPP) you will support the assessment of children, young people and families with a range of severe and complex mental health needs in inpatient and community settings as part of a multi-disciplinary team. This assessment must reflect the young person and their family’s perspective and must be conducted with the young person’s and family’s needs paramount. The assessment should reflect a shared understanding of the young person’s current difficulties and inform how decisions are made with the family about the best next steps for the young person and the family.

As a YIPP you must be able to undertake a child-centred interview which identifies the child’s/ young person’s current difficulties, their goals and those of their family/parents, their strengths and resources and any risk to self or others. You will need to understand the young person in the context of their family, culture, wider social environment, developmental stage and temperament. You need to engage the young person and their carer(s) and other family members and to establish and maintain therapeutic alliances. You will need to gather appropriate information from different sources, be able to make sense of this and with the family develop and communicate a shared understanding, and contribute to formulation where appropriate. They also need to understand how the child’s difficulties fit within a diagnostic framework, recognize other physical, developmental or psychological difficulties (e.g. epilepsy, autistic spectrum disorders, and attachment history) and know what evidence-based intervention or approaches are likely to be appropriate within the inpatient and community settings.

This module will therefore equip you with a good understanding of the incidence, prevalence and presentation of severe and complex mental health problems experienced by young people in these settings and evidenced-based intervention choices. Skills teaching will develop core competences in active listening, engagement, alliance building, patient-centred information gathering, information giving and shared decision-making. The module will develop your competency in assessments including identifying areas of difficulty (including risk) and establish main areas for change, establish and maintain a working therapeutic alliance and engaging the young person/family to support them in recovery, identify and differentiate between common mental health problems in CYP, navigate and use routine outcome measures and standardised assessment tools effectively as part of the assessment and engagement process.

Module aims - intentions of the module

To equip you with an understanding of the general developmental needs of YP
To equip you with broad overview of typical mental health presentations, and the aggravating or mitigating circumstances that impact on an admission to an inpatient unit and/or need for crisis care/intensive community support
To equip you with a basic understanding of the risks and benefits of an inpatient admission
To equip you with a broad understanding of the family as a system, and the impact of MH difficulties and service use recursively on the family and the YP
To develop an understanding of how to assess, formulate and review needs of the YP and their family in this context
To develop your understanding of the relational needs of young people and families in these contexts and develop basic skills of engagement and the ability to manage the therapeutic relationship
To support you with an understanding of the importance and active engagement and working in partnership of participation for the YP and family

Intended Learning Outcomes (ILOs)

ILO: Module-specific skills

On successfully completing the module you will be able to...

1. Demonstrate knowledge of childhood and adolescence as developmental stages; the nature, functions thereof and how mental health difficulties might develop in childhood and adolescence. This should include demonstrating knowledge of attachment, attachment disruption and how this can manifest
2. Demonstrate knowledge of common mental health difficulties that might be seen in this context (including self-harm, depression, anxiety, eating disorders)
3. Demonstrate an understanding of developmental needs (cognitive, neurodevelopmental etc) and how these might impact on young people and their families in the context of crisis services
4. Demonstrate knowledge of PTSD and complex trauma and how these can manifest and impact on young people and family systems
5. Demonstrate understanding of the nature of inpatient admissions including the risks and benefits
6. Demonstrate understanding of the nature and role of family systems and how they might experience crisis pathways and inpatient admissions
7. Demonstrate skills in building engagement and communication, in developing and maintaining therapeutic relationships with young people and the systems (including families) around them
8. Demonstrate an understanding of risk assessment and management and safeguarding in this context

ILO: Discipline-specific skills

On successfully completing the module you will be able to...

9. Demonstrate skills in assessment in this context (including semi structured interviews, indirect assessment, self-report questionnaires)
10. Develop and demonstrate an understanding of the nature, functions, and complexities of formulation as a process, models of formulation and their application in this setting

ILO: Personal and key skills

On successfully completing the module you will be able to...

11. Make a contribution to models of formulation and their application; demonstrating skills in aiding assessment, interpreting of information, and information sharing formulation in this context
12. Demonstrate the ability to work in partnership with CYP and their parents / carers, drawing on and applying knowledge of co-production and shared decision making in this context

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:

CYP developmental stages and an overview of attachment theory
Aetiology and prevalence of common mental health difficulties in CYP
General overview of PTSD and complex trauma both in CYP and families
Risks and benefits of an inpatient admission
Impact of admission on a family system
Developing and maintaining multiple therapeutic relationships
Understanding risk, risk assessment and safeguarding
Formulation theory and team formulation skills
Diversity and Culture, social inclusion
Working with families and communicating within systems
Collaborative practice/working, participation and co-production
Reflective practice

Knowledge will be learnt through a combination of lectures, seminars, discussion groups, guided reading, and independent study.

Skills based competencies will be learnt through a combination of clinical simulation in small groups working intensively under close supervision with peer and tutor feedback and supervised practice through supervised direct contact with service users in the workplace.

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.

Learning activities and teaching methods (given in hours of study time)

Scheduled Learning and Teaching Activities	Guided independent study	Placement / study abroad
90	110	0

Details of learning activities and teaching methods

Category	Hours of study time	Description
Scheduled learning and teaching	80	Practical classes these will be used to develop clinical competencies through tutor supervised small group role-play, lectures and seminars
Scheduled learning and teaching	10	Tutorials these will take the form of small group sessions led by the tutor
Guided independent study	40	Reading and preparation for seminars and/or flipped classroom delivery model
Guided independent study	40	Self-practice and self-reflection on role plays of assessments with fellow students undertaken outside of teaching sessions
Guided independent study	30	Develop an understanding of service-related clinical protocols, policies and procedures to inform practice, and develop knowledge of role

Formative assessment

Form of assessment	Size of the assessment (eg length / duration)	ILOs assessed	Feedback method
Supervisor report 2	N/A	1-12	Written
Discussion of a 360 review from the team and young people through a team survey and feedback / outcome measures. This would be done half way through training which would allow the team to raise strengths and weaknesses for the trainees to work on	Conducted in clinical context	1-12	Written and verbal

Summative assessment (% of credit)

Coursework	Written exams	Practical exams
100	0	0

Details of summative assessment

Form of assessment	% of credit	Size of the assessment (eg length / duration)	ILOs assessed	Feedback method
Podcast: Trainees record a 10/15-minute case presentation and critical analysis of a model or theory	50	10/15 minute presentation	1,3,4,6,7,8,9,12	Written
Practice outcome document 2: Trainees will be required to demonstrate competence in the clinical practice outcomes related to 1) working effectively in teams, supporting transitions, working with systems and 2) working with young people and their families with severe and complex mental health needs	0	n/a	1-12	Written and verbal
Formulation document: Trainees will be required to demonstrate an ability to collaboratively assess and formulate. Attention must be paid to the young persons life experiences, developmental stage, their family context, current mental health context as well as demonstrating knowledge of common mental health problems	50	2000 words	1-12	Written
	0
	0

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
Podcast (50%) /15 minute presentation	Podcast	1,3,4,6,7,8,9,12	Four weeks from the date feedback was provided
Practice outcome document 2 (0% pass/fail)	Practice outcome document 2:	1-12	Four weeks from the date feedback was provided
Formulation document (50%)	Formulation document	1-12	Four weeks from the date feedback was provided

Re-assessment notes

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:

Addis, M., Martell, C.R. (2004). Overcoming depression one step at a time. New Harbinger
Bennett-Levy, J., Richards, D., Farrand, P., Christensen, H., Griffiths, K., Kavanagh, D. J., Klein, B., Lau. M. A., Proudfoot, J., Ritterband, L., White, J., & Williams, C. (2010). Oxford guide to low intensity CBT interventions. Oxford University Press
Bennett-Levy, J., Butler, G., Fennell, M., Hackmann, A., Mueller, M., & Westbrook, D. (2004). Oxford guide to behavioural experiments in cognitive therapy. Oxford University Press
Burton, M., Pavard, E., & Williams, B. (2014). An introduction to child and adolescent mental health. Sage
Carr, A. (2000). What works with children and adolescents? A critical review of psychological interventions with children, adolescents and their families. Routledge
Cartwright-Hatton, S., Laskey, B., Rust, S., & McNally, D. (2010). From timid to tiger. A treatment manual for parenting the anxious Child. Wiley
Cooper, M., Hooper, C., & Thompson, M. (2005). Child and adolescent mental health. Theory and practice. Hodder Arnold
Dogra, N., Parkin. A., Gale, F., & Frake, C. (2002). Child and adolescent mental health for front-line professionals. Jessica Kingsley Publishing
Friedberg, R. D., & McClure, J. M. (2002). Clinical practice of cognitive therapy with children and adolescents: The nuts and bolts. Guilford Press
Fuggle, P., Dunsmuir, S., & Curry,V. (2013). CBT with children, young people and families. Sage
Gellety, J., Bower, P., Hennessy, S. Richards, D., Gilbody, S., & Lovell, K. (2007). What makes self –help interventions effective in the management of depressive symptoms? Meta-analysis and meta-regression. Psychological Medicine, 37, 1217-1228
Graham, P. (2013). Cognitive behaviour therapy for children and families. (3^rd edition). Cambridge University press
Grant, A., Townend, M., Mulhern, R., & Short, N. (2010). Cognitive behavioural therapy in mental health care. (2^nd 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
Kendall, P. C., Beidas, R. S., & Mauro, C. M. (2013). Brief coping cat: The 8 session coping cat workbook. Workbook publishing
Kendall, P. C., Crawley, S. A., Benjamin, C. L., & Mauro, C. F. (2013). Brief coping cat: Therapist manual for the 8 session coping cat workbook. Workbook publishing
Kendall, P. C., & Hedtke, K. A. (2006). The coping cat workbook (2^nd Edition). Workbook Publishing
Kendall, P. C., & Hedtke, K.A. (2006). Cognitive behavioural therapy for anxious children: Therapist manual. Workbook Publishing
Kennerley, H., Kirk, J., & Westbrook, D. (2016). An introduction to cognitive behaviour therapy: Skills and applications. Sage
Kinsella, P., & Garland, A. (2008). Cognitive behavioural therapy for mental health workers – A beginner’s guide. Routledge
Lejuez, C. W., Hopko, D. R., & Hopko, S. D. (2001). A brief behavioral activation treatment for depression: Treatment manual. Behavior Modification, 25, 255-286
March, J. S., & Mulle, K. (1998). OCD in children and adolescents: A cognitive-behavioural treatment manual. Guilford Press
Martel, C. R., Addis, M. E., & Jacobson N. S. (2001). Depression in context: Strategies for guided action. W W Norton and co
Martell, C. R., Dimidjian, S., & Herman-Dunn, R. (2010). Behavioral activation for depression: A clinician’s guide. New York
Myles, P., & Rushforth, D. (2007). A complete guide to primary care mental health. Robinson
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? (2^nd edition). Guildford Press
Stallard, P. (2002). Think good, feel good: A cognitive behaviour therapy workbook for children and young people. John Wiley & Sons
Stallard, P. (2002). A clinicians guide to think good, feel good: Using CBT with children and young people. John Wiley & Sons
Stallard, P. (2009) Anxiety – Cognitive behaviour therapy with children and young people. Routledge
Verduyn, C., Rogers, J., & Wood, A. (2009). Depression: Cognitive behaviour therapy with children and young people. Routledge
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

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

https://cedar.exeter.ac.uk/media/universityofexeter/schoolofpsychology/cedar/documents/Reach_Out_3rd_edition.pdf

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.camhsnetwork.co.uk

http://www.cypiapt.org/children-and-young-peoples-project.php?accesscheck=%2Findex.php

https://swcypiapt.com/about/

https://www.minded.org.uk

http://www.ucl.ac.uk/CORE

No Health without Mental Health:

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_123766

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 (7^th Edition). For more information, see: https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/general_format.html

Key words search

Youth Intensive Psychological Practitioners, YIPP, Low Intensity, Young People Common Mental Health Problems, Inpatient, Evidence Based Psychological Therapies, Clinical Competency

Credit value	20
Module ECTS	10
Module pre-requisites	Children & young people’s mental health settings: context and values
Module co-requisites	Therapeutic skills and interventions to Improve psychological wellbeing
NQF level (module)	7
Available as distance learning?	Yes
Origin date	21/02/2022
Last revision date	21/04/2023