Big Idea 3 - Selecting Clinician for Partnership
A key part of CAPA is matching the young person and family’s choice of goals to a clinician with the right extended core skills to help them with these. This means choosing a Core Partnership clinician at the end of the Choice appointment for the young person and family to work with in Partnership.
So why select clinician?
Selecting clinician ensures that the person with the right skills will do the Partnership work. The traditional CAMHS model of service delivery means that there is a rather hit and miss process whereby the clinician that the family first sees is the one they continue with. They usually work with the family in the way they feel comfortable and most familiar with. The allocation might be random or on guesswork based on the referral letter. In CAPA you select the clinician to work in Core Partnership at the point the family have been seen in Choice. This allows the Choice clinician to choose the right person for the family in terms of skills and, to some extent, personal style. Plus, if it seems complex, two staff can be allocated in Partnership. There are other gains too…
Curiosity
The Choice clinician can be more curious. Thinking about how they will help this family does not distract them. They are freed from worrying about whether they have the skills. The focus is on engaging the family in helping themselves, working out what is needed and starting the change process going.
Informed Choice
Setting up the Choice appointment as a one-off session right from the start facilitates the family’s ability to make an informed choice. It makes the purpose of coming clear. The pros and cons of all options can be discussed without assuming that continued input from CAMHS is necessarily required. This allows a clear plan of action to be made by the end of Choice (the Choice Point).
Closure
As clinicians, we know that if we can meet with the family again, the easiest thing is to offer another appointment. Then we don’t need to start to formulate the issues with the family nor explain processes in the way that perhaps we should. It can then be easy to drift into continued contact that is not truly informed or agreed and with no, or only a vague, care plan. Without a clear goal it can be much harder to stop (see Letting go of Families).
Choice Point
Knowing that a colleague is going to take on the ongoing work in Partnership with the family puts the onus on the Choice clinician to ensure a Choice Point is reached.
Openness
We also know from audit that families and young people feel more open in what they can say if they know that this initial session is a one-off with the clinician. (See Evaluation). AND…
Capacity Management
Selecting clinician facilitates capacity management. Separating Choice and Partnership allows the team to plan the first contact/Choice activity based on the referral volume, as it doesn’t include the unpredictable amount of follow-up activity.