IAPT Organisation & Admin Advice Pack to go with the training on our Youtube channel by Jason Hassan

NOTE:

ORGANISATION AND ADMIN

The following is for informational and guidance only. Please refer to your services protocols and policies regarding admin, templates, and system management.

Jason Hassan

WORKSHOP PACK

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Interactive Exercise 1: Diary Time 09:00

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09:30

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10:00

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11:00 11:30

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Checklists Initial Assessment checklists: Note: Check with service protocol to ensure nothing else is missed. ☐ Complete Clinical contact. ☐ Complete Assessment Tab. ☐ Add Problem Descriptor. ☐ Add medication if any. ☐ Flag and bring to supervision. ☐ Select appropriate care pathway. ☐ Edit and add any necessary info for patient registration. ☐ Contact any relevant professionals if necessary. IE: Safeguarding ☐ Update client via email or phone. ☐ Write assessment outcome letter. ☐ Send outcome letter to GP. ☐ Send letter to patient and any useful documents. IE: Self-help materials

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Blank Checklist ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐

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Interactive exercise 2: Spreadsheets: Initials/ Number

IA DATE 22/07/2021 Click or tap to enter a date.

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Referral labels Choose an item.

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Assessment tab Choose an item.

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Medication/ problem descriptor Choose an item.

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Clinical contact Choose an item.

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Outcome letter Choose an item.

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Supervision Choose an item.

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Care pathway Choose an item.

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Unallocated

Follow-up Notes

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Mind Map:

PWP Work

Specialism Service user involvement Arrange feedback forum

Assessment Drugs and alcohol

Put up availability slots for month

Adhoc

cCBT

GSH Put up new slots

Workshops

Booked

Training

Line Manager

Questions to ask

Buddy

Case Manager

Duty

Risk from IA Ask about health anxiety questions

Write-up supervision notes

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Kanban Boards: Assessment Appointment

Referral Labels

Assessment Tab

Medication/Problem Descriptor

Clinical Contact

Draft Outcome letter

Supervision booked

Follow-up

Outcome letter

Move on care pathway IA 1

IA 6 IA 3 IA 2 IA 4

IA 5

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To Do

Doing

IA XXXX To take to supervision Book group welcome calls

Done Discharge letter for XXX

Awaiting response XXXX Response by xx/xx/xx

IA XXXX Call for follow-up Health anxiety Write IA notes Write case management notes

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Interactive exercise 3: ABCE: Interrupting in a session Situation:

Cognitions:

Behaviour:

Autonomy:

Emotions:

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Experiment: Situation:

Prediction:

What do I think will happen?

How much do you believe it will, 0-100?

How would you know if it had?

What I am testing: Focus on what happens rather than your feelings & let go of Safety behaviours

Outcome:

What I learned:

Was the prediction correct?

How likely is it that your predictions will happen in the future? (0-100%)

What actually happened?

Is there a more balanced view?

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Optional exercise: Decisional Balance (Pros and Cons) Pros of change

Cons of change

Pros of not changing

Cons of not changing

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Interactive exercise 4: Responsibility Pie Charts 1- We can sometimes overestimate or underestimate how responsible we are for an event, feeling that ‘it’s my fault’ or even ‘It’s all somebody else’s fault’. Identify a negative situation that has troubled you.

Situation: My client did not complete their homework task.

2- Now list all those people, or factors that played a part, no matter how small, in the situation. List people, circumstances, organisation

INSERT TEXT HERE:

3- Now divide the Responsibility Pie into slices, giving each person, circumstance, or organisation a percentage or slice. Give bigger slices to those with more responsibility. Put yourself last.

Responsibility Percentage 22% 33%

44% Client forgot

Client didn't understand

Client had sick children

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4- How does this responsibility pie chart affect your feeling of guilt and shame?

What action can you take to make the situation better?

INSERT TEXT HERE:

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Perfectionism vs Good Enough Assessment Example 1: Demographics Living Situation: Lives with partner Referral Source: self referral from suggestion/advise of GP Employment: Full time No benefits or SSP Long-term conditions: Asked and none reported.

Medication: Not prescribed Reports that they used to take medication seven years ago, when asked they reported that it was to help with sleep, but they were unsure of the name. After exploring it further it appears that they use to take CALMS which they purchased in the pharmacy and in fact did not take any prescription medication.

British armed forces – No But reports he used to be part of boy scouts.

Barriers to treatment (language, general or learning disabilities): They reported that a few years ago they had sciatica, but this is no longer an issue. Sometimes they have allergies.

Any other current psychological support: Asked and none reported.

Past: Client reports not having formal therapy but used to go to the GP weekly for a brief chat and advice.

QUESTIONNAIRE Client agreed MDS is reflective of symptoms of severe Depression and mild Anxiety.

TRIGGERS: Patient stated there are several triggers reporting “too many to say, it’s just constant and I can never catch a break. It all started seven years ago when he had an argument with his parents followed by a break-up with his partner and losing his job. He said that it’s worse when alone, usually because there is nothing to distract them from their thoughts. They also found this to be worse at night.

THOUGHTS: WHAT: Reports the main issue is feeling low, depression and feeling lethargic.

WHO: client reported with everyone, makes no difference who and is in fact better around people.

WHEN: client reported it is at most times but worse at night WHERE: Everywhere but seems to be worse at home this is because he is often alone when at home.

FEELING: sad, morose, depressed, scared, nervous, anxious, down, unhappy, despondent, miserable, disheartened, worried, uneasy BEHAVIOURS: Ruminating more often about the difficulties in life and how they are miserable, worrying about their future and forever being alone, stopped engaging with things they enjoy like football or seeing friends

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PHYSICAL: client reported noticing tension, uneasiness in stomach, feeing drained, having no energy, headaches from tension WSAS: Work 7 – Lost job and now feels the pressure to find another job but is struggling to find the energy to do so.

Home: Reports that he has not been able to tidy up the house and is eating a lot more takeaways Social: He reports that he is not seeing his friends and is ignoring text messages and phone calls alongside going out to see them.

Private: He reports that he does not have the energy to do the things he enjoys anymore like playing football.

Family and relationships: He reports that he is not interacting with his friends and family as much and that he is worried about losing them.

ONSET: Started 7 years ago when his relationship broke down and this was made worse after he lost his job.

Risk They have passive thoughts of not wanting to be here but no plans or intent to end their life or selfharm in any way. They reported that their family are their protective factors and agreed to a safety plan that included talking to their parents. Additionally, they were advised to visit their local A&E or call the Urgent Advice Line on (NUMBER), if at risk of harming themselves or others. They were also advised to contact their GP or call the Samaritans on 116 123 if not at immediate risk but if would like support and advice. There was no reported history of previous attempts to end their life or to selfharm and no concerns about risk of harm to or from others.

Suicide (current): He has had thoughts of being better off not here but has no plans or intentions to act on these thoughts.

Suicide (past): He has never attempted to end his life.

Self-harm (current): No thoughts of wanting to self-harm whatsoever.

Self-harm (past): Has never attempted to self-harm.

Harm to others (current): No thoughts of wanting to harm others.

Harm to others (past): No previous attempts of harming others Harm from others: He reports he is not at risk from anyone.

Self-care: He reports he struggles to shower, and his appetite has reduced somewhat.

Protective Factors: His family and friends, his pet bird – Tweety.

Dependents/Under18s (Full Name, DOB): He has no children under the age of 18 Safeguarding concerns: He has no children therefore not applicable.

Drugs/Alcohol: He reports that he drinks on average one pint of beer a week, but it has never gone over the 14-unit limit.

RMP Discussed: Agreed to Safety plan/social support: 24-hour services: reported they would visit their GP or ring 111/Samaritans or call crisis number: NUMBER OR Personal Support Network: mother and father 14 Created by Jason Hassan

Patient Expectation: Client reports that he would like to feel better in himself so that he can have the time and energy to do the things he enjoys and see his friends again alongside applying for jobs.

Treatment Options: : GSH Tele

Supervision: Assessor Suggestion PRESENTING PROBLEM + PLAN (with rationale): Depressive episode GSH Tele We discussed various options such as counselling and step 2 LICBT, he reports he would like to focus on developing techniques to manage his mood. We also discussed referring him onwards to the employment support service.

Barriers (disabilities/language): none

Risk Category - Low He reports that he has passive thoughts only but no plans or intentions and he can keep himself safe by contacting his GP and other emergency services.

Previous episodes summaries (if any): Has never had formal therapy previously but used to see his GP weekly for a check-in.

Call-back (if needed): “anytime”

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Assessment example 2 Demographics Living Situation: Lives on own

Referral Source: self referral from suggestion/advise of GP Employment – Full time No benefits or SSP Long-term conditions: Asked and none reported Medication: No medication British armed forces – No Barriers to treatment (language, general or learning disabilities): None

Any other current psychological support: Asked and none reported Past: None QUESTIONNAIRE Client agreed MDS is reflective of symptoms of severe Depression and mild Anxiety

TRIGGERS: - Separation from partner 7 years ago - Loss of job THOUGHTS: Will it get better? What’s the point? I have no energy, I need a job, my friends must be fed up of me.

WHO: Feels better around people.

WHEN: Worse at night due to having more time to think WHERE: Worse at home where he is alone.

FEELING: sad, morose, depressed, scared, nervous, anxious BEHAVIOURS: Ruminates, worries, avoids others and doing things he enjoys.

PHYSICAL: Tension, headaches, lethargic WSAS: Work: Loss job, struggles to motivate self to find another job Home: Struggling to tidy house Social: Not seeing anyone, ignoring phone calls Private: Avoids doing hobbies like play football Family and relationships: Has not spoken to friends in a while.

ONSET: Started 7 years ago but things were made worse after losing his job.

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Risk Suicide (current): No thoughts Suicide (past): None Self-harm (current): No thoughts Self-harm (past): None Harm to others (current): No Harm to others (past): No Harm from others: No Self-care: Struggling to shower and sleep and eat Protective Factors: Family Dependents/Under18s(Full Name, DOB): No children under 18 Safeguarding concerns: N/A Drugs/Alcohol: No concerns RMP Discussed: Agreed to Safety plan/social support: 24 hour services: reported they would visit their GP or ring 111/Samaritans or call Oxleas crisis number: 0800 330 8590 OR Personal Support Network: Speak to parents

Patient Expectation: To build up motivation to see friends, apply for jobs and play football Treatment Options: GSH Tele Discussed counselling and Step 2 LICBT, client opted for GSH telephone

Supervision: Assessor Suggestion PRESENTING PROBLEM + PLAN (with rationale): Depressive episode GSH Tele Main issue is depression, wants to build up motivation again.

Barriers (disabilities/language): none

Risk Category - Low Previous episodes summaries (if any): None

Call-back (if needed): “anytime”

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Question 1: What are your thoughts when reading both assessments.

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Question 2: List two things you like and dislike about the first assessment.

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Question 3: List two things you like and dislike about the second assessment.

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Question 4: What will you consider when writing notes for your own assessments?

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Guided Self-help Template Session number: Treatment protocol: Choose an item.

Demographics – (age, sex, relationship status, employment status, any children, any disabilities or long-term conditions) Risk – (thoughts, plans or intent to end life or self-harm, risk to or from others, risk to children, risk to dependents, self-neglect, medication, substance use, risk management plan) MDS: PHQ9 – GAD7 – Engagement - (homework review, changes in MDS, attendance, engagement in session) Progress so far: Additional considerations: 5-areas - (First session only) Situation: Thoughts: Emotions: Physical: Behaviours: Problem statement - (First session only) My main problem is feeling: This is worse when/this is triggered by: During these times I think: Emotionally I feel: Physically I feel: My behaviour changes by: Goals: Homework: Plan for next session:

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