Letting Go of Families

CAPA is all about empowering young people and families and helping them access their own resources - and those in their communities - to move their lives forward. Part of this is not to assume they need CAMHS and if they do, to focus on the time that they, once again, will not need to come to see us. This ability to ‘Let Go’ is important in helping families regain control of their lives - and for us to smooth flow through the service. In our survey of 100 CAMHS teams in 2005 we found that in the 7 HELPFUL Habits of Effective CAMHS, Letting Go of Families was one of the areas most teams felt they struggled with.

There are two parts to this – 1) how you ‘discharge’ people but also 2) how you actively plan to work with those who have chronic difficulties. It is with this last group that we often feel stuck; worried that we cannot stop seeing them for fear they will not cope, or knowing that they have a problem that will not go away (e.g. living with autism).

Outcomes in CAMHS often seem grey. There is always more we could ‘do’. As children grow and develop, and families reach different stages and transitions, problems change and new issues arise. Some families may do best with bursts of crisis contact, or planned infrequent ‘booster’ sessions.

It is important for those families with multiple, complex health and social care needs that we work effectively with other agencies and extended family and communities. Support can come from a range of places and it does not necessarily need to be us. The big changes in CAMHS in England, with the focus on extending skills and services in universal services can help families be supported in a way that is most helpful, rather than sitting chronically with CAMHS.

We tend to have well thought through processes for opening cases but less robust processes for closing, except perhaps for admin processes. We also know that many families just stop coming - rather than having a planned ending. Are they telling us something? Have they had enough, we just didn’t realise it?

Thought moment - how often is your last contact with a family a ‘DNA’?

Letting Go of Families is so important that it is a HELPFUL Habit – see the 7 HELPFUL Habits section of the book. There are three items in this Habit:

2. Care Planning

Using Care Plans helps you and the family be clear about what you are all aiming at.

We find these things help: