ro rossiter , duncan law, isobel fleming

© Duncan Law

Making Feedback and Outcomes work for Children and Young People with Learning Disabilities,

& their Families & Networks:A Workshop

Ro Rossiter, Duncan Law, Isobel Fleming

Duncan Law

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© Duncan Law

Setting the Context:CYP-IAPT and all that……….

Duncan LawClinical Lead for the

London and South East CYP-IAPT Learning Collaborative

Duncan Law

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CAMHS Issues

ACCESS: % With anxiety or diagnosable depression not in contact with mental health services

Source: Ford et al. (2005) Child & Adol Ment Health, 10:2-9

Dean et al., (2004) DoH; McCrone et al., (2008) King’s Fund

80%

70%

60%

50%

40%

30%

20%

Adults withdepression

5-15 year olds

Percent

unknown

to any

service

35%

76%

Funding

• Only 6% of Mental Health funding goes to services aimed at children (Kennedy 2010)

• Spending on child mental health continues to be cut – by up to 95% in some local authorities (YoungMinds 2014)

• Savings in MH is 1.8% per annum, compared to 1.5% in physical health (DH 2014)

What is the problem – in summary?

• CAMHS is under-resourced and yet investment in CAMHS can save money across the whole health economy and, more importantly, save years of distress

CAMHS Opportunity?

Opportunities:• CAMHS Select Committee inquiry• Children's Task Force• General Election

Threats:• Lack of good Data

(c) Duncan Law & Alex Goforth - London & SE CYP-IAPT Learning Collabortive

What is CYP-IAPT?(a reminder?)

Template for appropriate CYP services: key components

Improving access & engagementAccess


AwarenessIncreasing MH

awareness & decreasing

stigmatisation





stigmatisationParticipation

Enhancing youth, carer and community participation






EBPDelivery of evidence-based practices







EBPDelivery of evidence-based practices

Accountability

Improving outcomes

accountability



CYP-IAPT

CYP-IAPT is a set of principles for Whole Service ‘Transformation’

The CYP-IAPT principles:1. Better Evidence Based Practice2. Better Collaborative practice - Clinically

Meaningful use of feedback tools 3. Authentic participation of families and Young

People who use the service4. Rigorous outcomes monitoring Leading to effective and efficient use of resources


© Duncan Law

Feedback & Outcomes Monitoring

Feedback & Outcomes Forms

Why bother using them?

© Duncan Law

Values behind outcomes and feedback

1. Demonstrate/celebrate/prove: effectiveness of interventions and service

2. Enhance collaborative practice:– Better service user voice in therapy (&

supervision)– Facilitates good clinical practice

© Duncan Law


Demonstrating success

© Duncan Law

Demonstrating effectiveness• 90% target

• at least two time points with repeated, normed measure

• plus, at least one report of Education Employment and Training (EET)

• plus, consent

http://www.iapt.nhs.uk/silo/files/90.pdf




© Duncan Law

It’s not (just) about measurement, it’s about a culture of collaboration

© Duncan Law


Enhancing Collaborative Practice

Evidence Based TransformationShared Formulation &

Agreed Intervention Goals

Research evidenceYP/Family’s goals preferences, values, and unique context

Clinician expertise

+ +

Frueh et al (2012) Evidence-Based Practice in Adult Mental Health. Handbook of Evidence-Based Practice in Clinical Psychology. Published online.

Adapted and used with thanks to Peter Fonagy

Hertfordshire PartnershipNHS Foundation Trust

Goals Based Outcome Tool:

What does it look like?

Resources and Other Information


© Duncan Law, Stephen Butler, & Alex Goforth

For more information on outcomes and feedback

http://www.corc.uk.net/resources/additional-information-about-the-measures/




© Duncan Law

Other Resources• www.cypiapt.org • www.corc.uk.net • www.myapt.org.uk • www.vimeo.com/tag:cyp+iapt • www.MindEd.org

http://www.corc.uk.net/

http://www.corc.uk.net/

http://www.myapt.org.uk/

http://www.vimeo.com/tag:cyp+iapt

http://www.MindEd.org/

Contacts

Duncan LawClinical Lead

London & South East CYP-IAPT Learning Collaborative

[email protected]

(c) Duncan Law - London & SE CYP-IAPT Learning Collaborative

mailto:[email protected]

Scene setting: feedback and outcomes, principles and

practice - CYP-LD, their families and networks

Ro RossiterConsultant Clinical Psychologist/Research Fellow

Member CYP-IAPT Outcomes and Evaluation Group

Drivers 1:

• Improve collaboration, focus, evaluation and demonstration of effectiveness

• Desire to collate practice experience for guidance (clinical psychology and multidisciplinary)

• LD Clinical Psychology Faculty had done similar project (adult focused, some themes in common)

Drivers 2

• CYP IAPT begins

• Health inequalities and CYP-LD (access &recognition- eg Simonoff et al. (2006) only 15% IQ < 70 had a statement of special educational needs, yrs 8-9; Emerson & Baines (2010) lack of recognition of LD in mental health, care, education and criminal justice settings, therefore CYP-LD needs not met -contributes to health inequalities; prevalence of children with Complex Learning Difficulties and Disabilities increasing (Blackburn et al., 2010; DCFS, 2010; Carpenter et al., 2010). “Atypical” development &/or neurodevelopmental disorders- part of broader diversity/equalities agenda (race and culture, socioeconomic status etc.).

• Equalities legislation

• Passionate practitioners

Journey so far:

Journey so far 1:

• 2012- Paper for Children , Young People and their Families Clinical Psychology Faculty Review

• 2013 :CYP-IAPT LD ROMS Management Project (Swindon-

Julie Pill and colleagues)CYP-IAPT Outcomes & Evaluation Group membershipChapter for ACAMH LD & Challenging Behaviour

Briefing

Journey so far 2: • 2014 Evaluation & Outcome tools survey (Phillips &

Sopena)CYP-LD & families chapter in CYP-IAPT Guide to using

outcomes and feedback tools chapterToday’s workshop

What next? • Share experience, plan actions (local,

collaboratives, national levels- CYP-IAPT, Child Health eg CHUMS project?)

© Duncan Law

We hope you found this presentation useful

Feel free to use all are parts of it to help train other staff in your organisation & to

further implement CYP-IAPT

If you do use slides please reference the authors appropriately

These slides must not be used in training for commercial gain

ro rossiter , duncan law, isobel fleming

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