Your FON can be downloaded from www.ucl.ac.uk/clinical-psychology/EBPU
ISSUE No. 6
Free Occasional Newsletter Project News |CAMHS Press | Update from the director | CORC Corner |
CORC launched a new website
In 2012 do not miss the final year of EBPU Masterclasses starting with a London event on 12 November
The challenges and opportunities in establishing a new network Interview with Dr Miranda Wlopert
Evaluating Kidstime Workshops Kidstime workshops are monthly events for parents and children where one or both parents have mental health problems. The workshops’ main aim is to explore and discuss mental health issues in a simple and non-stigmatising way. CAMHS EBPU was asked to evaluate the effectiveness of these workshops and was involved with trying to help others who wish to set up similar workshops in their own area.
he Evidence Based Practice Unit (EBPU) is leading through the difficult times for all involved in mental health services. Winning three nationally important projects means a great responsibility and several months in Payment by Results, BOND and Children & Young People’s IAPT have shown us the importance of communication and networks. In this issue Dr Miranda Wolpert, EBPU and CORC Director, talks to Selina Fox from the Health Foundation.
e are pleased that the EBPU has successfully completed yet another year of providing training through national master classes for clinicians. Classes covered the topics of how to drive quality improvement and service user participation and embed evidence-based practice in their service. In order to continue the good work in facilitating helpful discussions between researchers, data analysis experts, clinicians, and advocates of service users in CAMHS we are planning further work on these topics through our upcoming events.
As part of this the EBPU organised two workshops which examined the results of the evaluation, included feedback from two service users and discussed some of the practicalities of setting up and running such workshops. Attendees were also given a free copy of the new Kidstime Manual which sets out the details of running the workshops. (We still have some free copies of the manual available on request.) Over 100 people attended the workshops and feedback has been very positive, with 95% rating the workshops as either good or excellent. There has also been a lot of interest in the Kidstime RCT with just over 40 people signing up for more information.
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PROJECT NEWS CPRU- Child Health Policy Research Unit - Policy Research Unit for Children, Young People and Families (2011- 2016) Commissioned by Department of Health and launched in January 2011, this is one of seven units funded by the DH to help provide research based advice to inform policy funding for up to five years. The EBPU leads the mental health strand of work within this unit. Current projects include modelling repeated outcome data over time and focussing particularly on trajectories of change for children with severe behavioural problems. Increasing Access to Psychological Therapies IAPT (2011-) – Outcomes and evaluation The EBPU is part of the expert reference group for the IAPT initiative and lead the group looking at the best means of evaluation and data collection. Data is collected by the independent collaborator MegaNexus through their Commit System.
such problems. CAMHS EBPU is one of the partner agencies (along with the Tavistock and South London and Maudsley Trust) to provide a project team to develop ideas as to the best way to take forward PbR in CAMHS. PbR involves developing systems for categorising CAMHS processes and outcomes to aid the development of payment systems. BOND – Better Outcomes New Delivery This is a two year collaborative project led by YoungMinds. The aim of this project is to build up the capacity of Voluntary and Community Sector Organisations (VCSOs) to deliver early intervention mental health support for children and young people. CAMHS Network is a short term funding from the Health Foundation to help further develop capacities to share knowledge and information building and securing your set of connections. Closing the Gap: Shared Decision Making in CAMHS (2010-2012) Commissioned by The Health Foundation this project seeks to empower children, young people and their families to make informed choices and become active partners in their treatment. Informed Choice (2011-14)
CAMHS Payment by Results (PbR) This project is looking at how children with emotional, behavioural and wider difficulties are being supported and how much these kinds of support might cost so that the right amount of funding is provided for children with July 2012
Funded by the Department of Health, this project is a collaboration between EBPU and YoungMinds. The project builds on our Think-Thank and will allow children and young people to exercise informed choice and control about their mental health care through innovative use of high quality information. The project will ensure children and young people have access to the most up-to-date information to allow them to make meaningful choices and decide on the right option for them with their care providers. Promoting SDM in CAMHS(2012-15) Funded by the Department of Health, this project will develop and disseminate a range of free resources
and training to child mental health professionals to help them adopt ‘Shared Decision Making’ (SDM). These resources will be developed with central input from service users. Resources will include a training manual, skills-based training events and other information materials. The main beneficiaries will be the young people and their families accessing services. MSc Training in Evaluation of Clinical Interventions Andrew Fugard is Module Coordinator for the ‘Evaluating Clinical Practice’ module. The module aims to introduce students to the importance of evaluating therapeutic practice and to introduce them to the different types of evaluation that are possible and their relative strengths and weaknesses. Through attending the course, the aim is for students to have met all the “core” CAMHS competencies in relation to evidence-based practice. Masterclasses (2010-2013) CAMHS EBPU has funding from the Department of Health to run a series of Masterclasses aimed at developing the skills of practitioners and managers in terms of undertaking meaningful local evaluation, outcomes informed and evidence based practice and ensuring appropriate user participation. We have just finished our 6th set of Masterclass which covered the latest developments in evidence based and outcomes informed practice in CAMHS. Classes took place in Birmingham, London (twice) and Manchester. Over 180 people expressed an interest in the class with 108 attending the four classes. The CORC Data Assistants, Harriet and Charlotte, who attended the Manchester Masterclass, summarised some of the key points as follows: “The focus of the day was on using outcome measures as part of collaborative and reflective practice. There was recognition that change is important for service development and
that outcomes informed and evidence based practice could be key to driving this change in the right direction. Moreover, it was emphasised that change can be on an individual basis and does not have to be incorporated into an entire team or unit immediately. However, it was also acknowledged that change can be hard. “ “It was made clear that the evidence base and outcome data should be used as clinical tools, in collaboration with clients, to make sure that treatment is as effective as possible. Neither should be used or followed blindly, without reference to a clinician’s clinical judgement and understanding of a particular measure. Both also provide useful data for reflecting on cases and highlighting the strengths and weaknesses of clinicians allowing for improvement in individuals’ practice. “Attendees were also given an oversight of the work of CAMHS EBPU and CORC and updates on Children and Young People’s IAPT (Improving Access to Psychological Therapies), Closing the Gap: Shared Decision Making in CAMHS and CAMHS Payment by Results. The free new CODE Database was also introduced and more detailed information was provided on some individual measures.” The presentation from the final Masterclass in London is now available on our website at: http://www.ucl. ac.uk/clinical-psychology/EBPU/ presentations/presentations.php. Hearing Voices Hearing Voices is a project evaluating the London Voice Collective, a service which provides advice, support and workshops/groups for young people who hear voices. The aim of the evaluation is to try to work out what aspects of the service are working well, and how we can improve it. RECENTLY COMPLETED PROJECTS: CODE – Child Outcomes Data Explained (2009-2012) Commissioned by the Department of Health, this project was being undertaken by CAMHS EBPU in consultation with CORC and aimed to create nationally accessible web and paper based tools that will help practitioners, commissioners, children and young people to make real use of a
range of outcome data in a meaningful way. We now have a CODE database available to all the CAMHS in UK. Currency Development (2011) This was a successful pilot for the Payment By Results project, evaluating tools developed for currency allocation within London pilot sites. It was performed in collaboration with the Institute of Psychiatry. TAMHS – Targeted Mental Health in Schools (2008-11) This project was commissioned by the Department for Children, Schools and Families (now Department for Education) to investigate the impact of a government initiative to improve mental health in schools and to examine the ways schools try to help children when they feel sad, worried and troubled. The project has now finished and the final report is available online at: https://www.education.gov. uk/publications/standard/publicationDetail/Page1/DFE-RR177 CYP Think- Tank The EBPU Children’s Think Tank was a consultation group of young people who help us to ensure that our materials, research, and general approach are accessible and young people-friendly. It is a fun, interactive way of hearing young people’s opinions about the work we do at the AFC, and it was also a great opportunity for young people to get involved in research and participation themselves. The Think Tank had four two-hour meetings held over the course of a year and led by a few members of the EBPU team. During these meetings the young people took part in a selection of games, activities and discussions, focusing on a few projects we were doing here at the centre. The final meeting took place on Saturday 16th June with Dion and Thurza from the EBPU team leading it. Over the course of several meetings Dion, Emily, Sam and Thursa dedicated their time and expertise in devising exciting and useful activities. We would like to take this opportunity to thank Ann, Abinaya, Omodele, Georgia and Alessia for their contribution and for taking time to participate in EBPU Think-Tanks for 2011-12.
EBPU CYP Think Tank 2011-12 feedback from the young participants: “It is better to listen to young people to know new ideas from them. They can give you a clear view of what they are going through.” Georgia “I have found think tank useful and I believe that it is important to ask people in the same age range for advice. The experience as a whole has been fun and interesting” Abinaya “I have found the think tank to be an interesting experience. Through the T.T I have been able to understand what the purpose of the Think Tank and CORC is. I have also learnt much more about children and young people. Thanks!” Ann “I think that the Think Tank is a helpful and interesting way to find out more about young people. Also bringing children to the building to help out was a good idea. Including food in this has really helped me to come back.” Omodele “I’ve found out that Think Tank is really fun and good to socialise with other people. It is good that you’re asking the opinions of kids as it is kids you’re helping. I think you have asked us all the obvious questions which is a good thing! But maybe you could have asked more questions that really dug in because most of this was just about the outside, so yeah, you could have gone a bit further.” Alessia
you Thank ele, Omod , a y a Abin a Ann, Alessi d n a ia Georg
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THE UPDATE FROM THE DIRECTOR The challenges and opportunities in establishing a new network Dr Miranda Wolpert is a Director of the Child and Adolescent Mental Health Services (CAMHS) Evidence Based practice Unit (EBPU) and CAMHS Outcomes Research Consortium (CORC). She is a clinical psychologist by background and worked for many years in the NHS and in school settings before founding EBPU in 2006.
The interview with Miranda was conducted by Susannah Randall of the Health Foundation. The interview took place on June 2012. Miranda talks about the challenges and opportunities in establishing a new network.
The network Miranda is working on with The Health Foundation is in its first stages of development. However, she has experience in bringing together communities of people with shared interests as Chair of the CAMHS Outcome Research Consortium (CORC), a collaboration of over half of all child and adolescent mental health services in England committed to using routine outcome evaluation to inform practice and service development. About the network We are looking at how to formalise the collaboration between those involved in child mental health services. Our particular interest is on those who are innovating: frontline practitioners, commissioners, services managers. Through the training we run (at CAMHS EBPU) there is already an informal community in loose contact out there. The question is how can we get people to see themselves as a collaborative network? What are the shared values or views that could bring them together? This is a group of people that are feeling particularly battered and ground down at the moment. We want to link them up with other like-minded souls.
and a central group, or individual, committed to running the network. Without that it just doesn’t work. You have to be able to meet face to face at some intervals, and you’ll need to demonstrate some evidence of progress to both the network members and externally. A delicate tightrope to walk is finding the balance between top down and bottom up. It’s no good having one person dictating and others doing the bidding. Neither does it work to have everyone debating by committee and no decisions made. That almost needs negotiating on a daily basis but when it works I find it very exciting. If the balance is right then there is a real energy and creative buzz to it. It you allow people the space to come up with the answers to problems they do. And where it can go pear-shaped
This much I know about running a successful network
It doesn’t work to try to be all things to all people; that’s why we’re spending time working out the particular niche and direction for this new network.
You need a strong common purpose
You have to be rigorous about
You need a strong common purpose and a central group, or individual, committed to running the network. Without that it just doesn’t work. not allowing people with their own agendas to take over and there has to be a small team with some resource at the core. This means that you need a champion with validity for your network members. They don’t have to be full time but, for example, if your network is for clinicians they will want to know that there is someone who
has ‘walked it themselves’ involved. Forget the need for administrative support at your peril because if you don’t have it, it doesn’t happen. There needs to be someone to answer emails, check the website and database is up to date and facilitate events. Long term that can’t be the champion, they will burn themselves out. Our work with The Health Foundation We have found the bespoke support from Faculty members very useful in helping to clarify our purpose. We’re still debating the most appropriate common focus for this network. Is it shared decision-making or collaborative practice? I don’t want to reinvent it if someone else is already doing it. They have encouraged us to have a tight audience focus – so looking at those innovators who lie at the far left of the adoption curve. And we’re spending time exploring the different platforms available for us to communicate with – Facebook, Linked In – some guidance around how to use those and we’ve already got testing underway. The tailored help from the Faculty works; it is totally relevant for our context. Some tips on setting up a network: • You’re going to go down a lot of blind alleys and that’s OK. It’s good to model failure and to show that it’s not a big deal
Academic Papers Staff at EBPU and CORC have had a paper published and one accepted for publication. The Journal of Mental Health has published a paper by Miranda, Andy, Jess and colleagues entitled ‘Patient-reported outcomes in child and adolescent mental health services: Use of idiographic and standardized measures.’ The paper looks at emerging findings from standardized and idiographic child-, parent- and clinician- rated outcomes in CAMHS and considers their correlations. For those interested in reading this, the full reference is: Wolpert, M., Ford, T., Law, D., Trustam, E., Deighton, J., Flannery, H., & Fugard, A. J. B. (2012). Patient reported outcomes in child and adolescent mental health services (CAMHS): Use of idiographic and standardized measures. Journal of Mental Health, 21, 165–173.
Child and Adolescent Mental Health have accepted an editorial commentary by Miranda, Andy, Jess and Anke on ‘Routine outcomes monitoring as part of Children and Young People’s Improving Access to Psychological Therapies (CYP IAPT) – improving care or unhelpful burden?’ This is a short commentary which considers the implications of intensive outcome monitoring and should be published soon. Neus Abrines, Project Coordinator, has published two articles as a first author:
Attachment & Human Development has published ‘ADHD-like symptoms and attachment in internationally adopted children’ , you can find it on http://www.tandfonline.com/doi/abs/1 0.1080/14616734.2012.691656 Child and Youth Service Review has published her paper: Comparing ADHD symptom levels in children adopted from Eastern Europe and from other regions: Discussing possible factors involved and you can find it on the following address: http://dx.doi.org/10.1016/j. childyouth.2012.05.025 Dr Anke Gorzig, CPRU Research Fellow, is one of the authors of the newly published book by Policy Press:
Children, Risk and Safety on the internet: Research and policy challenges in comparative perspective, edited by Sonia Livingstone, Leslie Haddon and Anke Görzig. Based on an impressive in-depth survey of 25,000 children carried out by the EU Kids Online network, it offers wholly new findings that extend previous research and counter both the optimistic and the pessimistic hype. It argues that, in the main, children are gaining the digital skills, coping strategies and social support they need to navigate this fast-changing terrain.
• Resist being over-ambitious. Be very clear about what is needed from your network • It’s the people that matter, not the perfect website so don’t put too much faith in technology • Communicate, communicate, communicate. People will come in and out of the network, their attention will peak and wane, they will forget things. You cannot communicate enough.
Illustration by Clive Goodyer
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STAFF and other NEWS
Follow us on Twitter CAMHS EBPU (@camhs_ebpu) has an account on twitter and has 99 followers including individuals and larger groups and organisations. Although we have tweeted only 16 times, we have great plans to use this form of communication more often with our latest news. CORC has also joined twitter (@CORCcentral) In addition, they were busy with launching the new website! Please go to: www.corc.uk.net. The CORC website has been completely redesigned. It is more user friendly and easily navigable.
New EBPU Team Members The EBPU now assembled a CAMHS Payment by Results Project team, led by Dr Melanie Jones, who is our Clinical Research Fellow and include Dr Ruth Sweeting who is working as a Clinical Associate for the unit, Rebecca Kyrke-Smith, Research Assistant and Katherine Hopkins , Pilot Site Coordinator.
Neus Abrines, Project Coordinator, submitted her PhD thesis ‘Inattention and hyperactivity in children adopted from Eastern Europe’ to the Departament de psicologia clínica i de la salut Facultat de Psicologia Universitat Autònoma de Barcelona. Praveetha Patalay, PhD student at EBPU, did her Research Methods: Statistics exam with highest marks and she finished all her required credits. The working title of Praveetha’s PhD is’ Child and Adolescent Mental Health in the school context: measurement, pupil and school level effects’. Jenna Bradley, CORC Senior Research Officer, successfully completed the first year of her MSc
Andy Fugard had a quick chat with Slavoj Žižek at the cafe OTO
in Developmental and Educational Psychology, at the IOE. We are pleased to announce that Jessica Deighton, Research Lead and Deputy Director gave birth to her twins Tilly and Rosie in March. Samantha Murphy, Research Officer for CORC, gave birth to a baby girl named Olive in June. Thomas Booker, EBPU Administrator, and his wife Janine spent their honeymoon in Las Vegas and used the opportunity to visit Grand Canyon. At the same time Andy Fugard, CORC Research Lead, met Slavoj Žižek, a Slovenian philosopher and cultural critic, at cafe OTO, a 24-hour event to launch Less Than Nothing Seminar and talk on Hegelian legacy. We wish Thurza Honey a good time at the nursery where she will work full time from September.
The CAMHS Outcomes Research Consortium (CORC) is a collaboration between child and adolescent mental health services (CAMHS) staff across the UK with the aim of instituting a common model of routine outcome evaluation and analysing the data derived. Over half of all CAMHS staff in England are now members, with members also in Scotland, Wales, Norway and Sweden. There are now over 70 collaborating services within the consortium. CORC Recent Events The last Implementer’s Meeting was held in February and was well attended with positive feedback from attendees. The last Member’s Forum took place on Wednesday 25th April 2012 with the theme of “User Participation and Commissioning.” Around 50 people joined the central team for the day and feedback for the day as a whole was largely positive. Related to the theme of the day presentations were given on: an update from the CORC central team; involving young people in the implementation of CORC in Devon CAMHS; Routine Outcome Monitoring use in CAMHS and diabetic settings from the point of view of young people; the latest research findings from CORC; and the experiences of introducing outcome measures to the commissioning approach in Camden CAMHS. The day also included training sessions on the CODE and COMMIT databases. The next CORC Member’s Forum is 21st November in London.
Dion Terrelonge, CORC Research Officer, will be starting at the Tavistock and Portman NHS Trust on a 3 year professional Doctorate in Child, Community and Educational Psychology training course which will allow her to practice as an Child/ Educational Psychologist. Emily Stapley, CORC Research Assistant, will be starting a PhD and working on the IMPACT-ME Study at the Anna Freud Centre and UCL. Her PhD will mainly focus on a parents’ experiences of living with a son or daughter with depression and their experiences of their child’s treatment for depression. Charlotte Wray, CORC Data Assistant for the last year will be moving to the position of a Research Assistant on the Surrey Communication and Language in Education Study (SCALES) at the Royal Holloway, University of London.
The CORC community is happy to welcome 4 new member groupings: NHS Blackpool, Worcestershire Health and Care Trust, Calderdale and Huddersfield NHS Foundation Trust and The Childhood Bereavement Network. 28 CORC member groupings Harriet Hockaday, CORC Data Assistant, have submitted data since January this secured a Research Assistant post in year and CORC has produced 18 reports Glasgow where she will join her fiancé. and 2 Consultation reports. 10 more reports are on the way next month. The New CORC Team Members CORC team has been on three visits this We would like to welcome Rachel year where they had the opportunity to Argent and Ruth Plackett are starting present to over 50 members. as CORC Data Assistants in July and September respectfully. Feedback on the quality of the website www.Choosing.org.uk We have feedbacks from eight visitors to the UK site: • 3 young person over 11 Have found the website helpful and suggest: more comprehensive list of illnesses and treatments • 3 adults Have been positive about the website overall • 2 service providers One of the Service Providers found the website helpful while the other
one is extremely critical: * Information on Choosing is already old and simplified * In reality interventions are multidisciplinary * Irritated by use of the word ‘scientists’ describing varied professional groupings involved in this study * The Choosing web address is unhelpful - choosing what? • 4 of the visitors came through electronic mailing 3 through word of mouth 1 through a search engine
Prepared and designed by Slavi Savic; assisted by Thomas Booker; If you want to comment or to give feedback please email Slavica.Savic@annafreud.org; If you would like to be on the mailing list please email email@example.com; All other information can be found on our website: www.ucl.ac.uk/clinical-psychology/EBPU/
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CAMHS Press CAMHS PRESS is the publishing arm of CAMHS EBPU and is responsible for publishing booklets aimed at children, young people, and parents, as well as information and resources for professionals. Our two most recent publications (“How to Get up and Go when you’re feeling low” and “I gotta feeling: Top Tips for Feeling Good”) were developed as part of the Help4Pupils project and are designed to help children when they are feeling sad, worried or troubled. Both “I gotta feeling’ and ‘How to Get up and Go’ have proven popular. So far we’ve sent out almost 2100 copies of ‘I Gotta Feeling’ to some 70 schools and related organisations, whilst ‘How to Get up and Go’ has proven even more popular with over 2400 copies sent out to over 80 schools and related organisations. 2500 copies of each booklet are available for free with a maximum of 30 per organisation. We have almost reached this threshold so if you want to get hold of some free copies for your organisation get your orders in quickly. Booklets for Children:
I Gotta Feeling, Top tips For Feeling Good, 2011 (Aimed at primary school children). This booklet has been designed by Help4Pupils to help children when they are feeling sad, worried or troubled. It is full of fun simple tips on what to do to improve their mood and maintain emotional wellbeing. We have 2500 copies available free of charge (maximum of 30 per school/organisation).
Booklets for Professionals:
Choosing What’s Best For You, What Scientists have found helps children and young people who are sad, worried or troubled, 2007 A booklet that explains the latest research in this area to children and families to help them make treatment choices. More than 25,000 copies have so far been distributed across the UK and beyond. The booklet is currently being translated into Swedish For more than 5 copies, orders must be in multiples of 50 (i.e. 50,100,150 etc.).
A Mental Health Care Pathway for children and young people with learning disabilities. A resource pack for service planners and practitioners 2007 A resource pack for services to help them become more accessible to children with learning disabilities.
Knowing Where to Look How to find the evidence you need. Psychological health, emotional wellbeing and mental health in children and young people, 2008 A booklet to help you find, analyse and use information to develop and deliver services to support the emotional, psychological and mental health needs of children and young people. Authored by Paula Lavis and published in partnership with YoungMinds and the Department for Children, Schools & Families.
Drawing on the Evidence. Advice for mental health professionals working with children and adolescents, 2002 A booklet that explains the latest research in this area to busy practitioners to help them make appropriate treatment choices. 10,000 copies have now been distributed across the UK and beyond.
The Kidstime Workshops, 2012 A Multi- Family Social Intervention for the Effects of Parental Mental Illness. This booklet provides information on what is needed to set up and run Kidstime Workshops. The ‘Kidstime’ is an approach, developed over the past 12 years, for helping the children of parents with mental illness.
How to order:
How to Get Up and Go when you’re feeling low, Top tips for feeling good 2011 (Aimed at secondary school pupils) This booklet has been designed by Help4Pupils to help children when they are feeling sad, worried or troubled. It is full of fun simple tips on what to do to improve their mood and maintain emotional wellbeing. We have 2500 copies available free of charge (maximum of 30 per school/organisation).
All of our booklets are freely available as PDFs on our website. Alternatively, booklets can be ordered directly by sending an email to ebpu@annafreud. org. You must include the following details when ordering: • Title of the booklet • Number of copies (see the details about suggested quantities) • Name and address of person to invoice (only if the booklets are not free) • Name and address to send the booklets to