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 | 2021/2 |
| Credits | 20 |
| Module staff |
| Duration: Term | 1 | 2 | 3 |
|---|---|---|---|
| Duration: Weeks | 10 | 10 |
| Number students taking module (anticipated) | 31 |
|---|
Module description
As a 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.
A YIPP must be able to undertake a child-centered 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. They 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 ) and know what 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 your core competences in active listening, engagement, alliance building, patient-centered information gathering, information giving and shared decision-making. The module will develop your competency in assessments and identify 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.
Module aims - intentions of the module
1) To equip you with an understanding of the general developmental needs of YP.
2) 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.
3) To equip you with a basic understanding of the risks and benefits of an inpatient admission.
4) 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.
5) To develop an understanding of how to assess, formulate and review needs of the YP and their family in this context.
6) To develop your understanding 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.
7) 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
- 2. Demonstrate knowledge of attachment, attachment disruption and how this can manifest
- 3. Demonstrate knowledge of common mental health difficulties that might be seen in this context (including self-harm, depression, anxiety, eating disorders)
- 4. 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
- 5. Demonstrate knowledge of PTSD and complex trauma and how these can manifest and impact on young people and family systems
- 6. Demonstrate understanding of the nature of inpatient admissions and the risks and benefits
- 7. Demonstrate understanding of the nature and role of family systems and how they might experience crisis pathways and inpatient admissions
- 8. Demonstrate skills in building engagement and communication, in developing and maintaining therapeutic relationships with young people and the systems (including families) around them
- 9. Demonstrate an understanding of risks assessment and management and safeguarding in this context
ILO: Discipline-specific skills
On successfully completing the module you will be able to...
- 10. Demonstrate skills in assessment in this context (including semi structured interviews, indirect assessment, self-report questionnaires)
- 11. 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...
- 12. 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
- 13. 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 safe guarding
- 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.
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 MHWP 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 |
|---|---|---|---|
| Supervisor report 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. 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 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 w | Contingent on practice | 1 - 15 | 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 as a formative assessment, which would allow the team to raise strengths and weaknesses for the trainees to work on. | 1 - 15 | 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 |
|---|---|---|---|---|
| Podcast: to demonstrate engagement / therapeutic alliance and include engagement with family. This can include clips from sessions if appropriate. Trainees record a 10/15-minute case presentation and critical analysis of a model or theory | 50 | 1015 minute presentation | 1,2,3,4,5, 9, 10, 11 - 15 | Verbal |
| Practice Outcome document: 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. 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 | Contingent on case outcomes | 1 - 15 | 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 |
|---|---|---|---|
| Podcast | Podcast | 1,2,3,4,5, 9, 10, 11 - 15 | Four weeks from the date feedback was provided |
| Practice Outcome document | Practice Outcome document | 1 - 15 | 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:
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.
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.
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.
‘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 |
| Module co-requisites | PYCM119 Therapeutic Skills and Interventions to Improve Psychological Wellbeing |
| NQF level (module) | 7 |
| Available as distance learning? | No |
| Origin date | 21/02/2022 |
| Last revision date | 24/05/2022 |
