Or

Some Techniques for ‘Doing’ Recovery Oriented Practice

Siri Wooster & Steve Kingsbury: East Herts. CAMHS

…the Choice and Partnership Approach

a clinical system that evolved in Richmond CAMHS from 2000

developed and implemented wholesale in East Herts. CAMHS 2005 and

now being used in many CAMH teams across the world UK NZ, Australia, Belgium And adult mental health (NZ)

3500 staff and around 400 teams

It is about Doing the right things

= on the right goals With the right people

= with the right skills At the right time

= with no waits

Users are at the heart of the process

“Led by them and guided by us”

Shift in clinician stance to Facilitator with expertise rather than expert

with power

There are 4 ideas that separate CAPA from more “traditional” models. These are...

1. Choice

2. Core and Specific work

3. Selecting clinician to Partnership

4. Team Job Planning

Individual uniquenessReal ChoicesAttitude and RightsDignity and RespectRespectful Partnerships

Lets look at the links between these and CAPA…

Recovery recognises that Whole life matters Outcomes are personal and Empowers individuals

CAPA has The Choice appointment and approach A Collaborative model

Recovery recognises that: People need to make their own choices Supports individuals to take responsibility We need to encourage individuals to take

positive risks CAPA:

Choice is the central stance in CAPA Strengths based model The best risk management is to work

actively with the individual

Recovery ask that we… listen to and act upon communications

from people promote and protects rights Support people to maintain activities

which enhance mental wellbeing.CAPA

Choice framework

Recovery suggests that we should be… courteous, respectful and honest sensitive and respectful of each

individual’s own values and culture. CAPA

promotes a non-hierarchical interaction with young people

Cultural and personal values are a given in CAPA

Recovery states… that each person is an expert on their own

life work in positive and realistic ways with

individuals to help towards their hopes, goals and aspirations.

CAPA CAPA uses own expertise to facilitate their

choices Partnership work is a collaborative focused

on their choices with continual review of the chosen goals

These techniques only make sense if Recovery Principles or CAPA principles are embedded in the team culture.

Language Used in CAPA

Redefines the relationship between service user and their family and clinician

Impacts on moment-to-moment interactions in sessions

What are they worried about?What’s going on?How shall we understand it together?What shall we do about it?Do they want to come back?

Work together vs Treat

Help you choose vs Tell you

Share our thoughts vs Give an opinion

Decide together vs Assess

Peer group supervision and Post-Choice discussions (in addition to individual supervision and

whole team clinical discussions)Small groupsWeeklyKeeps focus on realistic goalsHelps with ‘letting go’