New Developments in CYP IAPT Dr Raphael Kelvin Consultant & Associate Lecturer in Child & Adolescent Psychiatry Cambridgeshire & Peterborough NHS FT & University of Cambridge National Professional Advisor, Children and Young People s Mental Health, Dept of Health, England
Thank you! Barry Karen Nixon Gowler To Jessica Colin Startup Deighton Natalie Margaret Bryant Murphy Sabina Margaret Hussain Oates Everyone Kate Martin David Miranda Deb Derek Stephen Pam Paul Karen Andy Duncan Richard Shirley Kathryn Ann Raph Roz McNally Burstow Fugard Clark Turner Wolpert Spence Yvonne Myles Bolton Shafran Kelvin Law Butler Layard Scott Reynolds Peter Fuggle Taylor Pugh Sheila Ann York Shribman Peter Fonagy
Outline The vision Expansion of training capacity New Additions to Therapies Skills Training Offer E-Portal Links to PBR development in CYP MH services
The Vision: CYP IAPT Strategy
The Translation Gap Best Evidence Clinical Practice
6 Bridging the Gap System level organizational drivers (systems interventions, facilitative administration, decision support data systems) Best Evidence individual clinical level competency drivers (selection, supervision, coaching Clinical Practice
Evidence based practice + + Research evidence = Patient preferences and values Quantifiable results Utility for clinicians Acceptable to recipients Clinician observations Frueh et al (2012) Evidence-Based Practice in Adult Mental Health. Handbook of Evidence-Based Practice in Clinical Psychology. Published online.
Measurement for a purpose: Guiding treatment to better outcomes 3 2.5 TAU EBP EBP+Outcomes Monitoring Number of diagnoses Pre 2 1.5 15% 33% 1 0.5 0 Usual care Care Manualized Standard therapy Modular Therapy delivered on without Condition outcomes basis of intensive monitoring outcomes monitoring Weisz et al. (2012). Testing standard and modular designs for psychotherapy treating depression, anxiety, and conduct problems in youth: a randomized effectiveness trial. Archives of General Psychiatry, 69(3), 274-282.
What about cases that don t easily fit High need and high complexity cases don t always fit a single evidence base Good psychosocial care facilitates best practice CYP IAPT is developing a core or basic skills curriculum (similar to specialist clinical care in IMPACT RCT)
Participation Specifying the CYP IAPT model Interviewing potential collaboratives Making a film on CYP IAPT Presenting at conferences Teaching CYP IAPT courses
1 Tuning in to the interpersonal channel You ll just Not make like this! things worse
1 Tuning in to the interpersonal channel When Trust there opens is no up trust, the social the mind communication is blocked and superhighway, it is impossible enabling to us move to learn forward and change
1 Tuning in to the interpersonal channel Win the Trust other opens person s up the trust social by showing communication them that you are and they will tune to you! superhighway, listening to them enabling and thinking us to learn about and what s change going on in their mind
CYP-IAPT model leading to more effective and efficient outcomes
Milestones -Project team created Partnership 1 NHS CAMHS VS Commissioners 2011 jan Partnership 3 NHS CAMHS VS Commissioners H E I Assure quality Organise training Deliver content Partnership 2 NHS CAMHS VS Commissioners
Milestones -Supervisors and service managers begin training - CORC-Meganexus appointed to provide national data collection 2011 nov
Milestones -Application process for 2012-13 announced -Accreditation Steering Group convened -New resources announced 2012 feb
Salford Collaborative HEI - Manchester University CAMHS Partnerships Derby Manchester & Salford Pennine North Pennine South Barnsley Phase 1 Sites Reading Collaborative HEI Reading University CAMHS Partnerships Ox and Bucks Wilts, Bath & NE Somerset Gloucs Swindon Bournemouth, Do rset & Poole London Collaborative HEI UCL/KCL CAMHS Partnerships Lambeth & Southwark Herts Sussex Westminster Haringey Cambridge Wandsworth Greenwich
Increased Training Capacity
Salford Collaborative HEI Manchester University CAMHS Partnerships Central Lancashire North Lancashire Bolton South-West Collaborative HEI - Exeter University CAMHS Partnerships Devon Torbay Plymouth Phase 2 Sites Reading Collaborative HEI Reading University CAMHS Partnerships Berkshire Bedfordshire Luton Kensington & Chelsea Northumbria Collaborative HEI Northumbria University CAMHS Partnerships Tees Durham North Yorkshire Darlington Rotherham Doncaster London Collaborative HEI UCL/KCL CAMHS Partnerships Tower Hamlets Hackney Camden Islington Waltham Forest Richmond Bromley Croydon
Additional Therapies
New Therapies for CYP Systemic Family Therapy Interpersonal Psychotherapy Next Steps: Define curriculums IAPT Training periods and entry criteria Numbers of trainees per year Establish process and appoint trainees for Partnerships and HEIs Redefine existing training packages in light of new therapies eg introductory term
E-Portal for CYP MH E-learning for CYP MH Kite-marked CYP IAPT Quality standards
Target Audiences Anyone working with CYP In any settings Universal services; police, youth groups, clergy, charities, local authority Universal services in healthcare; GPs, Nurses Counsellors linked with schools, colleges, HEIs Targeted and Specialist health and social care services; Paediatricians, MH staff, social workers
The Vision: An Evolving Ambition! To provide a lovely experience One click away Accessible formats: tablet, phone, desktop Appropriate to context of professional accessing section
E-learning for CYP MH portal linked to CPD and accreditation processes Become the go to site Save organisations from continually reinventing websites
Sections of E-Portal
Sections of E-Portal Detecting problems: promoting wellbeing Assessment tools links Sources of help: what to do next Outcomes Monitoring: why, how, what, when, meaning, utility Context sensitivity
Sections of E-Portal e-learning: CPD and linked to Healthy Child Programme e-enabled CYP IAPT Therapies curriculums CBT, Parenting, Systemic Family Therapy, Interpersonal Psychotherapy
Scoping of E-enabled Therapies Comprehensive scoping: National Collaborating Centre for Mental Health within E-Portal Consortium Effectiveness, cost, utility Consider role in future developments of E-Portal
PBR for CYP MH CYP IAPT sites provide a great opportunity to Test preliminary clusters Test validity Map cost and outcomes characteristics In transformed quality enhanced services PBR metrics then based on best evidence based practice and outcomes
Summary CYP IAPT is gathering momentum Contact Raphael.kelvin@dh.gsi.gov.uk Raphael.kelvin@cpft.nhs.uk