UPDATE REPORT
NHS EDUCATION FOR SCOTLAND MENTAL HEALTH
STAKEHOLDER STEERING GROUP
September 2012
Contents
Page
Children and Young People Projects update
3
Education to support values based and recovery
focussed practice
4
Dementia
5
Increasing access to psychological therapies update
6
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1.
CHILDREN AND YOUNG PEOPLES’ MENTAL HEALTH PROJECTS
UPDATE
1.1
Children and Young Peoples’ Mental Health- Competencies
Framework Project
The CAMHS competence framework is now complete and can be
accessed on
http://www.ucl.ac.uk/clinical-psychology/CORE/child-adolescentcompetences/CAMHS%20Competences%20Framework_V1%20(2).pdf
It is also available at http://www.knowledge.scot.nhs.uk/camhs where it
has been linked to ksf.
The map contains documents on different competence areas relevant
to Child and Adolescent Mental Health Services. The competence
framework also has an accompanying guide for Young People and
Parents Carers – see:
http://www.ucl.ac.uk/clinical-psychology/CORE/child-adolescentcompetences/CAMHS%20Framework%20service%20user.pdf
The framework was launched at the CAMHS Open Meeting on 16th
November 2011 at Murrayfield Stadium.
1.2
‘Essential CAMHS’ Learning Materials
The Essential CAMHS learning resource has been produced on disc
initially, with it eventually being made available on line. It contains 5
core modules: child and adolescent development, child and adolescent
mental health, engagement, assessment, and intervention. The
learning resource has been designed to encourage reflective practice,
and the learner is encouraged to discuss reflective practice activities
with their supervisor or group mentor, as well as recording reflections
in a learning portfolio.
The implementation of Essential CAMHS has begun in Ayrshire and
Arran with 3 groups of staff. Glasgow has also received presentations
about the resource and aim to implement and evaluate it with two
teams. A number of other Scottish sites have also been identified for
early implementation. A full evaluation of the experiences of both new
staff and supervisors will be carried out.
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2.
EDUCATION TO SUPPORT VALUES BASED AND RECOVERY
FOCUSSED PRACTICE
Scottish Recovery Indicator
An updated version of the tool SRI-21 was launched by the Minister for
Public Health on the 31st of October 2011.
The tool enables mental health services to assess and develop
practice and is focussed on ensuring the recovery of the people who
use their services. In doing so it highlights issues in relation to
inclusion, rights, service user and carer involvement and equalities and
diversity. A further commitment concerning SRI implementation is very
likely to be included in the new Mental Health Strategy for Scotland,
and the consultation document for the strategy specifically asks – ‘what
support needs to be in place to support SRI -2 implementation’ ?
NES and SRN will continue to work together in 2012/13 to support 2
further types of learning networks, one for Advanced recovery
Practitioners and anther SRI-2 learning network.
The Leading Better Care Delivery group have also agreed that SRI-2
should be a Clinical Quality Indicator for Senior Charge Nurses in
mental health and this will provide further impetus in taking forward
SRI-2 usage.
10 Essential Shared Capabilities ESCs) Learning Materials
An additional generic 10 ESCs resource has been produced based on
the 2011 Mental Health resource but widening applicability to all staff.
The resource is similar in style and content with one significant
development being the re writing of the Module on Socially Inclusive
practice into a new module on Inclusion, Assets and Outcomes
focussed practice. The resource is now available as an interactive PDF
on the NES ‘Little Things Make a Big Difference’ web site at
http://www.knowledge.scot.nhs.uk/making-a-difference/resources.aspx
Another 10 ESCs resource specific to application of the ESCs to the
care and support of children and young people is currently under
development.
.
10 Top Tips for Mental Health Staff Supporting Carers
NES has worked with Support in Mind Scotland to develop tip cards on
10 Top Tips for Mental Health Staff Supporting Carers. The tips are
based on the findings of Support in Minds’ carers’ surveys and also
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http://www.sri2.net/
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further consultation with carers. They provide mental health staff with
information about steps they can take to significantly improve carers’
experiences and involvement. The cards were launched in June
alongside
Support
in
Mind’s
Carers
pack
see
http://www.supportinmindscotland.org.uk/files/Support%20in%20Mind
%20Scotland%20-%20Summer%202012%20newsletter.pdf
.
To order copies of the tip cards email mental.health@nes.scot.nhs.uk
3.
DEMENTIA
The NES/SSSC Promoting Excellence’- A framework for working with
people with dementia, their families was launched alongside the
Standards of Care for People with dementia in Scotland on the 6th of
June 2011.
See http://www.scotland.gov.uk/Publications/2011/05/31085332/0
Phase 2 of this work programme is underway and involves undertaking
a range of activities to implement the strategic Workforce Development
Plan. This work is overseen by a NES/SSSC Dementia Programme
Board and update papers form the Board are available to Stakeholder
group members on request or can be downloaded from
http://www.nes.scot.nhs.uk/media/1427018/dpb_update_aug12_final_
web.doc
4.
PRE REGISTRATION MENTAL HEALTH NURSING PREPARATION
NES continues to work, on behalf of SG with Higher Education
Institutions to support implementation of the National Framework. We
have also, on behalf of the CNO Directorate – SGHD, updated the
framework in light of the NMC review of pre-registration nursing and
the new NMC standards that were published in September 2010. The
2012 version of the framework is available on the NES web site at
http://www.nes.scot.nhs.uk/education-and-training/by-themeinitiative/mental-health-and-learning-disabilities/publications-andresources/publications-repository/national-framework-for-preregistration-mental-health-nursing-field-programmes.aspx
4.
PSYCHOLOGICAL THERAPIES
The importance that the Government places on rapid and equitable
access to effective Psychological Interventions within NHS Scotland is
demonstrated by the introduction of the current HEAT Access Target
Deliver faster access to Mental Health Services by delivering 18 weeks
referral to treatment for psychological Therapies from December 2014.
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NES is working to support NHS Boards to deliver on the HEAT target
through teaching and training.
4.1
Competencies/Stepped-Care
The competence frameworks for CBT, Psychodynamic Psychotherapy,
Humanistic Therapy, Systemic Therapy and PTs Supervision have
been produced in partnership with Skills for Health. The CBT
framework lays out the competencies necessary to deliver CBT at both
the ‘low intensity’ and High Intensity’ levels of stepped care. This
framework is being used to inform the restructuring of CBT training in
Scotland.
Website:
http://www.ucl.ac.uk/clinicalpsychology/CORE/competence_frameworks.htm
The next stage of the work-the production of National Occupational
Standards for the various therapeutic modalities-is now complete.
In addition to the work on PTs competences in Adult Mental Health,
NES has commissioned a competence framework for CAMHS
services, which is available at:
http://www.ucl.ac.uk/clinical-psychology/CORE/child-adolescentcompetences/CAMHS%20Competences%20Framework_V1%20(2).pd
f
4.2
Increasing Capacity for Delivering Mindfulness-Based Cognitive
Therapy (‘Mindfulness’) for Depression in Scotland
The scoping, planning, and delivery of training for a rollout of
Mindfulness Based Cognitive Therapy has been completed. A draft
competence map, adapted from the CBT competence framework, has
been developed for Mindfulness for depression, and a trainers network
has been established. Both ‘basic level’ and ‘advanced level’ training
were delivered in a number of Board areas in order to ensure the
sustainability of high quality training provision in the longer term.
Ongoing supervision of trainees is being provided to consolidate the
skills learned during the initial training
4.3
Supervision
The competence framework for supervision of psychological therapies
has been produced in partnership with Skills for Health. NES has
developed a curriculum for generic psychological therapies supervision
training based on this framework and this was piloted at the end of
March 2009. The course was very favourably received by practitioners
from a range of therapeutic backgrounds, and we have now developed
and piloted a ‘training for trainers’ package which will enable NHS
Boards to provide their own supervision training. The ‘training for
trainers’ course was delivered in March and October 2010, and in
March 2012. The staff who took part in these courses have begun to
roll out the generic psychological therapies supervision training in local
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areas. So far more than 370 psychological therapies staff have been
trained to deliver PTs supervision through the roll-out.
4.4
Guidance for NHS Boards
In partnership with the SGHD Mental Health Division and the
Psychological Therapies steering group, NES has updated guidance
for NHS Boards on the local delivery of evidence-based psychological
therapies. The document‘The Matrix: A Guide to evidence-based Psychological Therapies in
Scotland’ has been designed to help NHS Boards:


Deliver the range, volume and quality of Psychological Therapy
required to achieve the HEAT Psychological Therapies Access
Target, and to meet ICP accreditation standards;
Provide evidence-based psychological interventions in other key
government priority areas.
The new version of ‘The Matrix’ can be found at:
http://www.nes.scot.nhs.uk/media/425354/psychology_matrix_2011s.p
df
The summary evidence tables in the document cover



Key areas within Adult and Older People’s Mental Health
services
Key areas within services for children, young people and
families
Some aspects of Long Term Conditions management and
physical health care.
The current version includes new or revised tables summarising the
evidence base for the application of Psychological Interventions






With Older People
With Children and Adolescents
With people with Learning Disabilities
With Forensic populations
For Trauma and PTSD
For Depression
The intention is to continue to extend the evidence tables over time to
give more comprehensive coverage, and to update the
recommendations as new evidence becomes available. An evidence
table for self-harm, and an update of the table on alcohol misuse are
underway. There are plans to develop sections on ‘Psychological
Interventions in Physical Health’ and on neuropsychology.
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4.5
Psychodynamic Psychotherapy
A package of ‘training for trainers’ in mentalisation-based therapy was
completed, and the new trainers are cascading the training in local
areas.
4.6
Other modalities
NES has supported training in a number of other areas including



Behavioural Family Therapy (BFT), which can benefit individuals
experiencing complex and enduring mental health problems and their
families
Inter-Personal Therapy (IPT), which is recommended for Depression,
Social Anxiety and Eating Disorders
Mindfulness-based Cognitive Therapy, which can help reduce the risk
of relapse in Depression.
4.7
CAMHS
We have deployed government resources to commission training in
Child Psychodynamic Psychotherapy from the Scottish Institute for
Human Relations, We are also delivering training, and creating the
necessary supervision infrastructure, in Systemic and Family Therapy,
CBT for Children and Adolescents and Parenting programmes.
4.8
Other Activities
Psychological Therapies Training Co-ordinators
NES is working with Boards to deploy resources to support the
sustainable delivery of training. We now have service level agreements
in place with all territorial Health Boards. In many Board areas this
resource has been used to fund sessions for a Psychological
Therapies Training Co-ordinator (PTTC) to provide extra capacity to
assist with the identification of training and supervision needs, and to
organise and deliver training and supervision where appropriate.
Psychological Interventions Team
The Psychological Intervention Team has completed the training
programme for 2011 – 12. Over 40 different training events have been
delivered across Scotland to a total of 1136 staff. The programme
includes highly specialist (8%), high intensity (17%) and low intensity
(75%) training options to ensure capacity is built in multi-disciplinary
groups working in primary, secondary and specialist clinical settings.
The training has been provided through high quality education
delivered by experts in their field. Each initiative was developed in
consultation with SGHD Mental Health Directorate Psychological
Therapy sub-groups ('Alcohol', 'Older People', 'Forensic', 'Trauma and
PTSD' and 'CBT Alternative Delivery Mechanisms') and NHS Board
Psychological Therapy Strategy groups.
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Following consultation with local boards and the Psychological Therapy
sub-groups, the Psychological Intervention Training Programme for
2012 – 13 is being developed. Many of the training events that were
organised by the Psychological Intervention team last year were
oversubscribed and are being offered again in 2012 – 13. All planned
events are advertised on the Psychological Intervention Team web
pages:
Date
Course Title
Venue
Target Audience
Going beyond the tip of
the iceberg: Creating a
NES Central
low intensity, multi-level,
13th
Offices, 2
multi-purpose service in
Sept 12
Central Quay,
primary care and the
Glasgow
community for older
people
Applicable to those with remit for
service development and design,
including Mental Health Strategy
Leads, Service Managers within
Older Adult Mental Health
Services and Primary Care,
PTTCs and Senior Clinical Staff
Training the Trainers:
18th &
Foundations of
The Lister, Hill
19th
Education for
Sq, Edinburgh
Sept 12 Facilitators of Training in
Psychological Therapies
Experienced practitioners who
have participated in the NES
Alcohol and Other Drug Training
Events (MI, CRA or C-BIT) or
comparable training, and have a
high level of confidence in the
delivery of the core CBT skills in
working with substance misuse
problems
FOLLOW UP FOR
LEARNING
COLLABORATIVES:
Trauma focussed
25 Sept cognitive behavioural
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therapy (CBT) for post
traumatic stress
disorder (PTSD) and
related conditions
(North)
Delegates that attended the 2 day
Suttie Centre,
trauma focussed CBT for PTSD
University of
training and the 3 month follow up
Aberdeen
day
10 Oct
12
FOLLOW UP FOR
LEARNING
COLLABORATIVES;
Trauma focussed
cognitive behavioural
therapy (CBT) for post
traumatic stress
disorder (PTSD) and
related conditions
(South)
Medical
Education
Training
Centre,
Kirklands
Hospital
Delegates that attended the 2 day
trauma focussed CBT for PTSD
training and the 3 month follow up
day
19th
Oct &
2nd
Nov 12
An Introduction to
Cognitive Behavioural
Therapy for Anxiety
Disorders (North)
Royal Cornhill
Hospital,
Aberdeen
Registered Mental Health staff
with experience of working with
people with anxiety problems but
do not have a qualification in CBT
29th &
30th
Training the Trainers in
Behavioural Activation
Stirling
Management
Participants will be registered
mental health staff with expertise
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Nov 12
for Depression
1st &
8th Feb
12
An Introduction to
Cognitive Behavioural
Therapy
Conference
Centre
and experience in using &
delivering Behavioural Therapy
with people who have depression
PG Medical
Registered Mental Health staff
Centre,
with experience of working with
Garnavel
people with anxiety problems but
Royal Hospital do not have a qualification in CBT
Further information is available at: http://www.nes.scot.nhs.uk/education-andtraining/by-discipline/psychology/multiprofessional-psychology/psychologicalinterventions-team-(pit).aspx
For further information on the Psychological Intervention Team, please email:
Anne.Joice@nes.scot.nhs.uk
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