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Engagement and assessment with people with severe mental health problems

Module description

This component introduces MHWPs to severe mental health problems and teaches you how to engage and form collaborative alliances with service users, carers and families. It teaches how to assess, manage risk, and arrive at a collaborative, simple formulation which can guide the planning of care.

Module aims - intentions of the module

The aim of this module is to develop your core ‘common factors’ competencies in communication skills and collaborative working and, along with a good understanding of severe mental health problems and evidence-based treatment choices, enabling you to apply these skills to engage service users, carers and families. Through collaborative alliances you will undertake an effective low intensity CBT-based assessment, including management of risk, develop a shared understanding of the problems using simple formulations and plan a collaborative treatment programme.

Intended Learning Outcomes (ILOs)

ILO: Module-specific skills

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

• 1. Develop a collaborative alliance through warmth and empathy and demonstrate engagement skills using active listening and enquiry
• 2. Demonstrate knowledge of and ability to be with someone in distress, managing affect by listening and validating
• 3. Demonstrate knowledge of, and ability to operate within, professional and ethical guidelines
• 4. Demonstrate understanding of cultural competence and anti-discriminatory practice, addressing inequities of access and outcome
• 5. Demonstrate respect for and the value of individual differences in age, sexuality, disability, gender, spirituality, race and culture
• 6. Demonstrate knowledge of and competence in responding to peoples’ needs sensitively with regard to all aspects of diversity, including working with older people, the use of interpretation services and taking into account any physical and sensory difficulties service users may experience in accessing services.
• 7. Demonstrate understanding of CHIME factors – Connectedness, Hope, Identity, Meaning and Empowerment and their link with wellbeing and recovery, assessing where there is a need and ensuring these needs are addressed
• 8. Demonstrate knowledge of and competence in accurate risk assessment and safety management plans
• 9. Demonstrate knowledge of, and ability to work with, confidentiality, consent, and the appropriate involvement of families and carers
• 10. Demonstrate knowledge, understanding and critical awareness of the experience and core features of psychosis, bipolar disorder, personality disorder and eating disorders, and associated difficulties (including anxiety and depression) and autism
• 11. Demonstrate knowledge and understanding of the relationship between adversity and presentations of severe mental health problems
• 12. Demonstrate knowledge of, and ability to work with, Trauma Informed Care principles in practice
• 13. Demonstrate knowledge of and competence in collaborative assessment and formulation within the 5 Ps framework of Presenting problem, Predisposing factors, Precipitating factors, Perpetuating factors and Protective factors
• 14. Demonstrate knowledge of and competence in collaborative construction of a 5-areas formulation to inform shared decision making for low intensity psychological interventions

ILO: Discipline-specific skills

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

• 15. Summarise basic and essential factual and conceptual knowledge of the subject, and demonstrate a critical understanding of this knowledge
• 16. Review 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...

• 17. Record accurately interviews and questionnaire assessments using paper and electronic record-keeping systems
• 18. 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 Mental Health and Wellbeing Practitioners – Specialist Adult Mental Health for the training of Mental Health and Wellbeing Practitioners to support the delivery of low intensity CBT. Teaching content will include:

Knowledge Concerning Core Competencies, Assessment of Severe Mental Health Problems

• Engagement and developing a collaborative alliance
• Being with someone in distress and managing affect
• Professional and ethical practice - codes of conduct in relation to practice as a Mental Health & Wellbeing Practitioner
• Cultural competence and anti-discriminatory practice
• Respect for and the value of individual differences in age, sexuality, disability, gender, spirituality, race and culture.
• Responding to peoples’ needs sensitively with regard to all aspects of diversity, including working with older people, the use of interpretation services and taking into account any physical and sensory difficulties service users may experience in accessing services.
• CHIME factors – Connectedness, Hope, Identity, Meaning and Empowerment: understanding their link with wellbeing and recovery;
• Risk assessment and safety management plans
• Confidentiality, consent, and the appropriate involvement of families and carers
• Recognition of patterns of symptoms and relate these to diagnostic categories of mental health difficulties, particularly the experience and core features of psychosis, bipolar disorder, ‘personality disorder’ and eating disorders, and associated difficulties (including anxiety and depression) and autism
• Understanding the relationship between adversity and presentations of severe mental health problems
• Trauma Informed Care principles in practice
• Collaborative assessment and formulation within the ‘5 Ps’ framework of Presenting problem, Predisposing factors, Precipitating factors, Perpetuating factors and Protective factors
• Collaborative construction of a 5-areas formulation to inform shared decision making for low intensity psychological interventions
• Standardised symptom assessment tools and psychometric instruments

Intensive Skills Practice

• Use of ‘common factors’ communication skills to effectively engage clients and develop and maintain an effective therapeutic alliance and engagement with the CBT self-help intervention process
• Patient-centred information gathering; deriving a collaborative definition of the service user’s main mental health difficulties and impact on daily living
• Recognising risk, assessing risk and safety management plans
• Use of standardised symptom assessment tools and psychometric instruments
• Managing the emotional content of sessions
• Appreciation and understanding of the service user’s perspective or world view

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

Details of learning activities and teaching methods

Formative assessment

Summative assessment (% of credit)

Details of summative assessment

Details of re-assessment (where required by referral or deferral)

Re-assessment notes

Three assessments are required for this module. In all cases re-assessment will be the same as the original assessment. 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 40%.

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 as a consequence you will be failed in the programme and your registration as a student of the University will be terminated.

Indicative learning resources - Basic reading

Core reading:

• Bennett-Levy, J., Richards, D., Farrand, P. et al (2010). Oxford Guide to Low Intensity CBT Interventions. Oxford: Oxford University Press.
• Bennett-Levy, J., Thwaites, R., Haarhoff, B. & Perry, H. (2015). Experiencing CBT from the Inside Out: A Self-Practice/Self-Reflection Workbook for Therapists. Guilford, New York.
• Farrand, P. (2020). Low-Intensity CBT Skills and Interventions. London: SAGE.
• Silverman, J., Kurtz, S. and Draper, J. (2005). Skills for Communicating with Patients . Oxford: Radcliffe.
• Leamy M, Bird V, Le Boutillier C, Williams J, Slade M. (2011). Conceptual framework for personal recovery in mental health: Systematic review and narrative synthesis. Br J Psychiatry, 199: 445–52. doi: 10.1192/bjp.bp.110.083733

Wider reading:

• American Psychiatric Association. (2013). Desk reference to the diagnostic criteria from DSM-5. Washington, DC: American Psychiatric Publishing.
• Bazire, S. (2018). Psychotropic Drug Directory 2018: The Professionals Pocket Handbook and Aide Memoire. Salisbury: Fivepin Publishing.
• Goldberg, D. and Huxley, P. (1992). Common Mental Health Disorders: A Biosocial Model. London: Routledge.
• Layard, R., & Clark, D. M. (2014). Thrive: The power of evidence-based psychological therapies . London: Penguin Group.
• Michie, S., van Stralen M.M., & West, R. (2011). The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implementation Science , 6, 42
• Myles, P. and Rushforth, D. (2007). A Complete Guide to Primary Care Mental Health . London: Robinson.

Indicative learning resources - Web based and electronic resources

• ELE – https://vle.exeter.ac.uk/

Indicative learning resources - Other resources

Other resources:

• Leamy, M., Bird, V., Le Boutillier, C., Williams, J., & Slade, M. (2011). Conceptual framework for personal recovery in mental health: Systematic review and narrative synthesis. British Journal of Psychiatry, 199(6), 445–452
• The British Psychological Society (2021) Family interventions in psychosis: Guidelines for psychologists and practitioners supporting families and social networks
• Worthington, A., Rooney, P., & Hannan, R. (2013). The triangle of care: Carers included: A guide to best practice in mental health Care in England. Carers Trust.
• NHS England. Reducing health inequalities resources:
  • LGBT Health
  • Advanced Mental Health Equality
  • NHS Resources
• Sweeney, A. & Taggart, D. (2018) (Mis)understanding trauma-informed approaches in mental health, Journal of Mental Health

Key words search

Mental Health Wellbeing Practitioners, MHWP, low intensity, cognitive behavioural therapy, common mental health problems, secondary care, evidence based psychological therapies, clinical competency