Solihull Approach in Kent A Ke nt- wide multi- age nc y tr aining - - PowerPoint PPT Presentation

Solihull Approach in Kent

A Ke nt- wide multi- age nc y tr aining initiative

Dr Alex Hassett Senior Consultant (CAMHS) Manager CAMHS Practice Improvement Programme

Outline for the Presentation

• Background

– Programme – Solihull Approach in Kent

• What is happening currently – structure

and process

• Research
• New developments
• Results from survey
• Challenges and learning

POLICY CONTEXT: SERVICES FOR CHILDREN AND YOUNG PEOPLE

Every Child Matters: Change for Children The National Service Framework for Children, Young People and Maternity Services The National Healthy Schools Standard on emotional health and well-being Promoting Children's Mental Health Within Early Years and School Settings Childcare Bill and National Childcare Strategy Youth Matters

Policy Context

New policy developments and guidance in education, health and social services emphasise:

• Mental health promotion
• Primary prevention programmes
• Early identification and intervention
• Beginning this process as young as possible
• Impact parenting has on the emotional well-

being and development of children and young people.

To meet the mental health needs of children and young people the policy calls for the development of multi-agency comprehensive child and adolescent mental health (CAMH) services that are delivered in a seamless manner and that are appropriate to the service users needs. Thus supporting young people’s mental health is not just the responsibility of Specialist CAMHS, it is the responsibility of all those working with children and young people. Need for all staff working directly with children, young people and their families, to have sufficient knowledge, training support to promote psychological well-being and to identify early indicators of difficulty

The definition of comprehensive CAMHS emphasises the need for a balance and range of services that should be available to children and their families, in order that all levels of mental health need are met. This includes ensuring that professionals and workers at tier 1, in daily contact with children, have sufficient knowledge of children’s mental health need in order to:

• 1. identify those who need help
• 2. offer support and advice to those with mild or minor

problems

• 3. to have sufficient knowledge of services to be able to

refer on when appropriate

CAMHS Training and Development Project 2003 – 2006

• The Child and Adolescent Mental Health (CAMH)

Training and Development Project was a Kent based multi-agency training and development project focusing on service providers working with children and young people in both the statutory and voluntary sectors.

• The Project was focused on addressing the

education, training and development needs of these workers to enable them to work more effectively with issues relating to the mental health and emotional well-being of the young people with whom they work.

Aim: to put in place processes and structures that support and develop the children and young people’s workforce’s capability to take responsibility in terms of caring for children and adolescents’ emotional well-being and to do so in an optimal and relevant way, appropriate to their level and role. Kent wide programme which covers all statutory services for children and young people and will attempt, where possible, to engage with the voluntary and private sector. Focus: Improving the provision of comprehensive mental health services for children and young people.

CAMHS Practice Improvement Programme 2007 - 2010

This is done in various ways:

• The primary focus of the programme for the

improvement of CAMH services is through the training and development of the children and young people’s workforce. This will continue and extend the work of the CAMHS Training and Development Project.

• The programme supports agencies in training

and developing their workforce’s skills, competencies and capabilities to enable the workforce to provide effective and safe responses to promoting emotional well-being and mental health, identifying mental health difficulties and offer effective, evidence based interventions across a spectrum of need.

This is done in various ways:

• Through enhancing and supporting

commissioning and practice through research, policy and practice guidance.

• The programme sits between

commissioning and delivery, providing an advisory and consultancy function in an attempt to improve both commissioning and provision of multi-agency comprehensive CAMHS provision.

Programme has various projects focusing on different levels of training, development and support

• Looking both at formal and informal training
• Links with Higher Education Institutions as well as other

training providers e.g. MSc in Mental Health Studies (CAMHS) at Kent University Adolescent Mental Health (module at level 2 and 3 at Canterbury Christ Church University)

Programme has various projects

• Child Observation Training
• Support between specialist & primary care staff
• Linking Youth Offending Service and CAMHS
• ADHD Protocol Training
• Member of:

– CAMHS Strategy Steering Group – Parenting Support Strategy Steering Group – Children and Young People’s Workforce Strategy Steering Group – Young Carer Strategy Group

CHALLENGE: How do we ensure that Tier 1 Universal Services Frontline workers have sufficient knowledge of children’s mental health need in order to:

• 1. identify those who need help
• 2. offer support and advice to those with mild or minor

problems

• 3. to have sufficient knowledge of services to be able to

refer on when appropriate But not make them into counsellors or therapists and Value what they are already doing

Mental Health Awareness Training and The Solihull Approach

How has the Solihull Approach rolled out in Kent? Background

Background

• School Nurse Lead and Primary Mental

Health Worker – East Kent

• £2000 from PCT
• Education match funded
• Ran 2 courses with PMHW and Ed Psychs

• Train the trainer
• Cascade approach
• Delivered by multi-agency trainers to

multi-agency groups

• Offer locality based training and

practice development sessions

Background

Background

• Children's Consortia Steering group
• Educational Psychology signed up to

become trainers

• PMHW and Tier 2 services - trainers
• Accepted as the Kent-wide approach in

principle

• Consortia Performance Reward Grant

money

Funding

Kent County Council and the NHS in Kent. Over the first 2 years funding came from:

• Consortia (10 out of 12)
• PCTs (8 out of 9)
• Surestart
• Family Liaison Officer Service

and various other pots of money

Where we are now

Solihull Approach in Kent

A Ke nt- wide multi- age nc y tr aining initiative

Funding

Currently

• £65 000 from the Children’s Services

Grant (2007/8 and 2008/9)

• Additional funding from extended schools

e.g. conference and support for trainers forums

• Local pots of money

Funding

• Funding for roll out across the county until

March 2009 (resource packs, venues, refreshments)

• Administration support (.5 wte)
• Research Assistant (.5 wte)

Training Offered

• 2 days of training in the foundation course

– Certificate

• 6 Practice Development Sessions

– Certificate

Practice Development Sessions

• It is expected that if a person attends the 2

days training they will also attend a minimum of 6 practice development sessions to embed the approach in their practice.

• These sessions will be run locally by members
• f the Solihull Approach Trainers Group.
• Participants will get a certificate of attendance

for the 2 days training and will then get another

• ne to confirm their attendance of the 6

practice development sessions

• Six is the minimum number of sessions -

additional sessions may be available

Practice Development Sessions

• During these sessions additional training needs

may be identified and these will be fed back to managers through the trainers forums. Where possible local need will be met locally.

• Practice development sessions of the Solihull

Approach does not replace organisational

• supervision. It is important that agencies think

about the support needs of their staff internally.

• It is important that managers understand that the

practice development sessions:

– are essential to the practice of the approach – are not clinical supervision but rather to enable practitioners to put the approach into practice with the cases they are working with

Structure of the

Solihull Approach in Kent

A Ke nt- wide multi- age nc y tr aining initiative

KENT CHILDREN’S TRUST CAMHS Strategy Steering Group CAMHS Practice Improvement Programme East Kent Trainers Forum West Kent Trainers Forum County-wide Solihull Approach Steering Group

Link with children and young people’s workforce development plan

• Solihull Approach is seen as part of the

core training for universal children and young people’s services

• It is integrated into the plan along with

mental health awareness training

• Plan under review – mental health still

seen as a key element underpinning 5 ECM outcomes

Steering Group

• CAMHS PIP Manager (chair)
• Head of Child Clinical Psychology,

Lead for Primary Mental Health, CAMHS

• Head of West Kent Children's Services
• Acting Assistant Principal Educational

Psychologist

• Senior Educational Psychologist
• Senior Practitioner

Steering Group – Terms of Reference

• To provide strategic direction and guidance for the

training in and support of the Solihull Approach across Kent

• To ensure consistency in the roll out of Solihull

Approach Training across both East and West Kent

• To ensure that the Solihull Approach is embedded in

broader strategic and practice based developments (e.g. within the Parenting Support Strategy, the Children and Young People’s Workforce Development Strategy, Common Assessment Framework and Lead Professional)

• To plan, monitor, and account for the use of funds

and resources allocated to the county-wide roll out of Solihull Approach Training

Steering Group – Terms of Reference

• To provide direction and guidance in terms of

evaluation of the training and its impact both across Kent

• To plan and co-ordinate the annual county-wide

Solihull Approach conference

• Play a role in developing the Solihull Approach

in Kent webpage as part of the www.camhs.org website

• To ensure distinctive branding of the multi-

agency nature of the approach across the whole

• f the county

Steering Group – Terms of Reference

In order to do this effectively the group will:

• Meet every three months and have regular contact via

email

• Set up sub-groups to action the areas above
• Have multi-agency representation from both the East

and West Kent Trainers forums Accountability:

• This group will have representation from the CAMHS

Practice Improvement Programme, East and West Kent Solihull Approach trainers’ forums

• The steering group will feedback and consult with the

East and West Kent Solihull Approach trainers’ forums

• Through the CAMHS PIP feedback with be made to

the county-wide CAMHS Strategy Steering Group.

The Trainers Forums

East Kent Trainers’ Forum

• 20 trainers

– 6 PMHW – 11 Educational Psychologists – 3 Health Visitors

West Kent Trainers’ Forum

• 28 trainers

– 6 Tier 2 CAMHS workers – 4 Educational Psychologists – 5 Health Visitors – 5 Specialist Teachers – 4 Social Workers – 2 School Nurses – 1 Tier 3 CAMHS worker – 1 Voluntary Sector

The Trainers Forums – Terms of Reference

• To provide strategic direction and guidance for the training

in and support of the Solihull Approach across East Kent

• To provide an East Kent wide view on the roll out of

Solihull Approach Training

• Ensure effective delivery of Solihull Approach to frontline

practitioners in East Kent Area (Swale/Dover/ Deal/ Thanet/Canterbury/Ashford/Shepway) according to local priorities.

• To support and monitor the setting up of local practice

development session for frontline staff trained in the approach

• To provide support for the East Kent Solihull Approach

trainers

• To support the development of a training and practice

development plan for each District in East Kent

• To encourage the evaluation of the training and its impact

both across east Kent and locally.

In order to do this effectively the group

• Develop and consolidate trainers skills to ensure good quality

training

• Attempt to have a sustainable pool of trainers (multidisciplinary).
• Have regular trainers group meetings
• Review trainers role in relation to new developments linked with

Solihull Approach.

• Provide support / facilitation for local groups following training.
• Ensure the effective application of the Approach by case

discussing, consultation and / or supervision in appropriate form.

• Develop effective methods of communication with all

stakeholders.

• Report to CAMHS Local Implementation Group on current status

within District.

• Providing information sessions for Managers.
• Link with other training organisations within East Kent area.
• Look at ways to evaluate the impact and outcomes of Solihull

Approach

CRITERIA FOR TRAIN THE TRAINERS: The following criteria have been used in selecting people as trainers: (these criteria are used as a guideline)

• The capacity to offer training needs to be built into this

person’s present role e.g. PMHW, Practice Educators and Educational psychologists have a training element as part

• f their remit.
• Time to do training and practice development sessions
• Group facilitation skills and confidence
• A background in working with children and young people
• Have done the training and been practicing for 6 months
• r more

Training and development of the trainers

• Train the trainer courses
• Observation
• Co-training

Training and development of the trainers

East Kent

• Termly forums and local meetings
• CPD Sessions

West Kent

• Quarterly forums and local meetings
• CPD Sessions

Practice development sessions

Challenge

• Attendance
• Manager’s views
• Many notions of supervision
• Capacity

Criteria for Practice Development Facilitator

• Have done the 2 day training in the Solihull

Approach and attended 6 practice development sessions.

• Have been using the approach for six months or

more in their own practice.

• Have experience in facilitating group

discussions.

• Capacity within their current role to offer 6 x 1 ½

hour practice development sessions (or more a year) and has manager’s approval to undertake this additional activity.

• Have a background in working with children and

young people.

Participants

• Over 700 trained
• Multi-agency
• Target Groups

– Youth Offending Teams – Family Liaison Officers and Parent Support Advisors – Connexions Health and Intensive Personal Advisors

Participants

Certain rules

• If a Family Liaison Officer then a SENCO
• Youth Offending Service senior first

Participants

New focus:

• Social Workers
• LAC workers

Managers Awareness Sessions

• Information Sessions
• Experiential

Half Day Experiential Sessions

• Pilot
• Managers
• Specialist CAMHS

Solihull Approach in Kent Conference

October 2007

• 100 delegates who had been trained
• Hazel Douglas and Jill De Laney
• Workshops from local trainers
• Parenting Strategy / Parenting

Commissioner November 2008

LAC Seminar

September 2007

• 50 LAC Practitioners
• Taster of the Adoption and Fostering

Resource Pack Looking at how this is rolled out to all LAC staff

SOLIHULL APPROACH ASSESSMENT AND THE COMMON ASSESSMENT FRAMEWORK The Solihull Approach is linked to the Common Assessment in two ways:

• 1. The Solihull Approach provides a coherent

assessment framework for frontline practitioners to work from and this information or content needs to be meaningfully linked into a CAF if it is done.

• 2. The Solihull Approach provides a very useful

framework and set of skills for any worker who is going to do a CAF to enhance their assessment skills

Research

• This study is looking at the outcomes for

young people between 7 and 15 years of age who have been seen by a practitioner who has been trained in the Solihull Approach.

• School years study
• Multi-agency

Research

The outcomes are being measured via Young person:

• 11-15 years – Strengths and Difficulties

Questionnaire (SDQ)

• 7-11 years – 7 item analogue scale

Parents:

• SDQ Parent Version
• Becks Anxiety Scale

Teachers:

• SDQ Teacher Version

Research

The young person and their parents and teachers will be asked to complete questionnaires:

• Before the practitioner sees them,
• After the practitioner has completed

their intervention (or after five visits) and

• Again three months later.

Research

Participants

• Family Liaison Officers

– Solihull Trained 22 Control 11

• School Nurses

– Solihull Trained 25 Control 1

Issue around comparison group

Research

Analysis

• Statistical analyses will be used to

compare the responses of parents, teachers and young people who have received an intervention from a practitioner not trained in the Solihull Approach (Standard Care Group, N=100) with responses of those who have received a Solihull Approach intervention (Solihull Treatment Group, N=100).

Ed Psych Research Students

Family Liaison Officers perceptions of the Solihull Approach – link to Personal Construct Theory Young people’s views on what helped when seen by a Solihull Approach trained school nurse. Comparison between those who take up the approach and those who don’t – issues around psychological processes and its impact on INSET

Parenting Programme

• Link to parenting strategy
• Co-ordinating function

DVD

• Information
• Training and development

Adolescence

• Adolescent Brain Development
• Making materials more older adolescent

friendly

• Linked to Adolescent Mental Health

Module – Canterbury Christ Church University – Level 2 and 3

Accreditation

• Kite marking
• Module – Level 2 and 3
• Skills Training Escalator

Child and Adolescent Education and Training Escalator

PhD MSc PG Cert/dip – Phase 1 Graduate Diploma

Specialist CAMHS Skills Pathway – Phase II

CAMHS Workers Foundation Degree Course

Generic skills, knowledge and capabilities for all CAMHS workers Specialist Skills Phase III

NVQ Curriculum

NVQ 1 /2, Parents, Carers, young people – Foster care, child care etc…

National Service Framework FE Validation HEI Validation

Solihull Approach / Mental Health Awareness Training

Survey

Of the 500 questionnaire 140 questionnaires were completed (28% response rate)

• 45% Education
• 38% Health
• 6% Social Services,
• 4% Voluntary sector
• 7% work in other fields

Survey

A total of 96% rated the training good to extremely informative. The vast majority (94%) have now used skills which they learned in the training Issue around those that took the time to respond to the survey were probably positive

Survey

How the skills learned have been used

21% 30% 45% 57% 79% 41% 44% 59% Working with nursery/school staff Generally focus less on providing behaviour management strategies Generally more focus on listening to the school staff/parent/young person Understanding of reciprocity has improved understanding

• f cases

Working with parents Working with young people Generally less focus on "providing solutions" More containment of teacher/parent's/young person's' worries

Survey

• 89% reported feeling more confident as a

practitioner following the SA training.

• 92% report having referred to the resource

pack since attending the training.

– They particularly liked the parent handouts and assessment tools.

Survey

Most valuable aspects of the training

19% 28% 17% 20% 13% 3% Theoretical background Specific topic information Assessment Tool Practical application Developmental charts Other

reciprocity and containment

Survey

“It has been interesting to identify that although I was containing and noticing dance of reciprocity. I can now recognise it, it now has a name and the reason how it helps to support families explained”.

Survey

60% percent report that they have attended the practice development sessions offered after the Solihull Approach training

Survey

What was found useful about the practice development/supervision/support sessions offered after the SA training?

25% 15% 26% 26% 8% Able to discuss cases Guidance from experienced practitioner Networking with staff Reflective time Other

Survey

Barriers to not attending the practice development/supervision/support sessions

4% 53% 5% 2% 36% Inconvenient Lack of time Not useful Personal reasons Other

Survey

BARRIERS

• Had not been offered supervision sessions since

the training

• Some said that the appointments were being

delayed.

• Some people had only just been informed of

new dates and already had other commitments when sessions were taking place.

• Having to travel quite a distance for supervision

which was a problem due to their heavy case- load.

Survey

• Thirty four percent of participants reported

that there have been barriers to them implementing the Solihull Approach.

• Barriers included:

– time constraints – the lack of other trained staff – level of clients’ needs

Survey

• “Working with vulnerable and disruptive teenagers in

schools, it has given further insight on the importance of early developmental stages in a child’s life and how attachment difficulties early on can attribute to a young persons well being later in life”.

• “I find it really beneficial when meeting with parents and

looking at the whole picture from birth to present day. It really gives me an insight into where problems may have started from and the resources give me the handouts to support parents and give me ideas when a little flummoxed myself”.

Survey

• “This training was very interesting and informative and

has made me think about how I interact with others both in a professional capacity, and within my home life. I have recommended that other colleagues attend the training”.

• “I have found it invaluable although initially I was

sceptical but it has given me enormous job satisfaction and really turned families around. Thank you”.

• “Since implementing the approach I have found it very

helpful and have referred to the leaflets for confirmation

• n behaviour strategies especially toilet training. I have

also found it easier to practice as my confidence in using it has developed”.

Survey

• “I have used the Approach with families in my

work for over a year and a half. I have become part of the training team for my cluster and have recently undertaken the Solihull Parenting group facilitators course. I have found the Solihull Approach training and resource packs to be the most valuable pieces of training I have undertaken during the 14 years of working in education and 10 years working with families and children and have applied this to my work with families”.

Challenges/Learning

• Running before we could walk
• Setting up structures but keeping

practitioner enthusiasm

• Multi-agency buy-in (concerns about

another intervention)

• County-wide acceptance
• Linking training with strategy and service

development

Challenges/Learning

• Funding
• Multi-agency working
• Administration
• Quality assurance
• Practice development

– Attendance – Understanding purpose

• Equity

Challenges/Learning

• Need for criteria for trainers and PDFs
• Need for manager awareness
• Vital role of practice development
• Ensuring difference between practice dev

and supervision is clear

• Lack of supervision for frontline staff
• Engagement of Specialist CAMHS

Contact details

Alex Hassett alex.hassett@canterbury.ac.uk 01892507687