Peter Fuggle, Dickon Bevington, Fiona Duffy and Liz Cracknell
MBIT is a manualised mentalization-based approach to working with hard to reach young people at risk of a wide range of life adversities including severe mental illness, substance…
Abstract
Purpose
MBIT is a manualised mentalization-based approach to working with hard to reach young people at risk of a wide range of life adversities including severe mental illness, substance misuse, family breakdown, school exclusion, offending and homelessness. The on-line manual (www.tiddlymanuals.com) describes how Adolescent Mentalization-Based Integrative Therapy (AMBIT) is a systemic intervention requiring attention to four different domains of intervention simultaneously; much emphasis is placed on the support systems for workers to maintain this balance in what are often chaotic working conditions. The purpose of this paper is to illustrate how these four main components of the AMBIT approach link together in actual clinical practice.
Design/methodology/approach
The authors illustrate the core techniques of the AMBIT approach, namely, “working with your client”, “working with your team”, “ working with your network” and “learning as a team” with a series of case vignettes, demonstrating the inter-relationship of these components rather than seeing them as separate strands.
Findings
A range of mentalization-based techniques such as “thinking together”, mentalized formulation, “disintegration grids” and web-based manualising are described and illustrated in relation to a series of case vignettes in order to address barriers to effective practice. The vignettes emphasise how these components must be linked together and held in balance, and how easily they become disconnected in working with young people’s ambivalent or even hostile relationships to help.
Practical implications
First, developing a shared, mentalized formulation of a young person’s difficulties is an important aspect of working with highly troubled young people. Second, mentalizing is a relational process and is easily disrupted, for both workers and young people, by raised anxiety and affect, a common feature of working with this client group. AMBIT provides specific methods, for example, “thinking together” for supporting the mentalizing of individual workers in their team in an explicit way. Third, workers from different agencies may often find it difficult to make sense of each other’s behaviour and decision making. AMBIT proposes the use of a mentalizing approach to this difficulty using a technique called a disintegration grid. Finally, AMBIT proposes a new practitioner focused approach to manualising as a method by which a team can become more explicit about its methods of working in order to support systematic practice and evaluate outcomes.
Originality/value
The innovative AMBIT approach proposes that clinicians need to attend to team and network relationships at least as much as their relationship with the client, in addition to adopting a stance of learning as a team from their casework. A high level of clinical skill is needed to support a team to achieve this balanced approach to casework. This work is of interest to all multi-disciplinary teams working with hard to reach young people.
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Not many weeks back, according to newspaper reports, three members of the library staff of the School of Slavonic and East European Studies in London were dismissed. All had…
Abstract
Not many weeks back, according to newspaper reports, three members of the library staff of the School of Slavonic and East European Studies in London were dismissed. All had refused to carry out issue desk duty. All, according to the newspaper account, were members of ASTMS. None, according to the Library Association yearbook, was a member of the appropriate professional organisation for librarians in Great Britain.
This chapter brings the book to a close by summarising the overall argument and looking to the future of commodified lifestyle sports and post-industrial cities under an ailing…
Abstract
This chapter brings the book to a close by summarising the overall argument and looking to the future of commodified lifestyle sports and post-industrial cities under an ailing capitalist economy. Most importantly, it calls upon academics to abandon concepts of resistance and social scientific approaches rooted in symbolic interactionism and discursive meanings in order to return to a critical analysis of the real generative mechanisms of political economy. This chapter closes with a brief epilogue that returns to the traceurs and the parkour community in this study one year after the ethnographic fieldwork ended.
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Kerry A. Thomas, Annelise M. Schroder and Debra J. Rickwood
Timely access to effective treatment is a primary goal for mental health services; however, when demand exceeds available resources, services may place clients on a waitlist or…
Abstract
Purpose
Timely access to effective treatment is a primary goal for mental health services; however, when demand exceeds available resources, services may place clients on a waitlist or restrict services. This paper aims to identify approaches used by mental health services to manage service demand and waitlists.
Design/methodology/approach
A review of research literature between 2009 and 2019 was conducted using the Medline, PsycINFO, CINAHL, Embase and Cochrane databases. Articles were screened and assessed against inclusion criteria and the methodological quality of included studies was assessed using the Mixed Methods Appraisal Tool.
Findings
In total, 20 articles were located that met the inclusion criteria. Five demand management approaches were identified, namely, walk-in models, triage processes, multi-disciplinary care, patient-led approaches and service delivery changes.
Research limitations/implications
This review identifies effective approaches that services can consider adapting to their local setting; however, further research is needed to demonstrate the clinical effectiveness of services provided under these models.
Originality/value
This review makes a valuable contribution to mental health care service delivery by detailing the strategies that services have adopted to manage demand and, where available, comparative outcomes with traditional service delivery models.
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Claire Maxwell, Peter Aggleton, Ian Warwick, Ekua Yankah, Vivian Hill and Dina Mehmedbegović
This paper aims to inform the development of policies and programmes to support children and young people's emotional wellbeing and mental health. It seeks to bring together…
Abstract
Purpose
This paper aims to inform the development of policies and programmes to support children and young people's emotional wellbeing and mental health. It seeks to bring together findings both from recent systematic reviews, and from individual evaluation studies which have adopted a relatively rigorous methodology but whose findings have not to date been included in such analyses. Research undertaken in England is to be prioritised, to complement an existing evidence base comprised largely of findings from US‐based research.
Design/methodology/approach
Using five key search strategies, studies were categorised into three main categories – “demonstrably effective approaches”, “promising approaches” and “approaches for which there is little or no supporting evidence” – according to robustness of evidence. Overall, 171 potentially relevant studies were identified, with 20 of these being robust enough for inclusion in the final review.
Findings
In schools, sustained broad‐based mental health promotion programmes combined with more targeted behavioural and cognitive‐behavioural therapy (CBT) for those children with identifiable emotional wellbeing and mental health needs, offer evidence of a demonstrably effective approach. Early and brief intervention programmes which reduce waiting times for services appear promising approaches and seem to reduce the number of sessions a family require. There is a reasonably strong evidence base to support targeted work with both parents and children.
Practical implications
By providing a detailed description of the successful initiatives reviewed, this paper should help policy‐makers and practitioners to develop their work.
Originality/value
By complementing the relatively narrow evidence base offered by systematic reviews, this more broadly based review offers policy‐makers and practitioners in England an up‐to‐date, context‐relevant guide for programme development within this field.
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Gabriela Uribe, Ferdinand Mukumbang, Corey Moore, Tabitha Jones, Susan Woolfenden, Katarina Ostojic, Paul Haber, John Eastwood, James Gillespie and Carmen Huckel Schneider
Integrated health and social care initiatives are increasing and health and social care systems are aiming to improve health and social outcomes in disadvantaged groups. There is…
Abstract
Purpose
Integrated health and social care initiatives are increasing and health and social care systems are aiming to improve health and social outcomes in disadvantaged groups. There is a global dialogue surrounding improving services by shifting to an integrated health and social care approach. There is consensus of what is “health care”; however, the “social care” definition remains less explored. The authors describe the state of “social care” within the current integrated care literature and identify the depth of integration in current health and social care initiatives.
Design/methodology/approach
A narrative literature review, searching Medline, PsychINFO, CINAHL, PubMed, Scopus and Cochrane databases and grey literature (from 2016 to 2021), employing a search strategy, was conducted.
Findings
In total. 276 studies were eligible for full-text review, and 33 studies were included and categorised in types: “social care as community outreach dialogues”, “social care as addressing an ageing population”, “social care as targeting multimorbidity and corresponding social risks factors” and “social care as initiatives addressing the fragmentation of services”. Most initiatives were implemented in the United Kingdom. In total, 21 studies reported expanding integrated governance and partnerships; 27 studies reported having health and social care staff with clear integrated governance; 17 had dedicated funding and 11 used data-sharing and the integration of systems’ records.
Originality/value
The authors' demonstrate that social care approaches are expanding beyond the elderly, and these models have been used to respond to multimorbidity [including coronavirus disease 2019 (COVID-19)], targeting priority groups and individuals with complex presentations.
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The purpose of this paper is to report a work‐based learning innovation developed in response to the skills agenda affecting post‐registration continuing professional development…
Abstract
Purpose
The purpose of this paper is to report a work‐based learning innovation developed in response to the skills agenda affecting post‐registration continuing professional development for nurses.
Design/methodology/approach
The experience of learners, mentors and assessors using the “Skills Bank” are illustrated as part of an ongoing evaluation of work‐based learning. This was captured by semi‐structured interviews and the observations of the author as innovation was implemented and to the quality issues for academic rigour were addressed. The study is set in the context of the debate about skills and competence.
Findings
The study finds that learners responded well to the innovation because they were motivated and self‐directed. The experience exceeded their expectations of continuing professional education. Some did not engage with the database of skills and learner‐generated skill design was consequently of poor quality. The assessment strategy is well‐defined and rewards excellence in practice with the use of a grading tool.
Practical implications
Content of skills templates reflect current evidence‐based practice, which can be mapped to Skills for Health workforce competences. Maintaining the Skills Bank in terms of currency and authenticity is challenging.
Originality/value
This paper will be of interest to education and training providers keen to address the preparation of health care staff fit for purpose and practice. It attempts to articulate skills as a notion of competence.
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Alison Hurst, Anna Price, Rebecca Walesby, Moira Doolan, Wendy Lanham and Tamsin Ford
Despite an increasing policy focus, routine outcome monitoring (ROM) is not common practice in UK children's services. This paper aims to examine whether it is feasible and valid…
Abstract
Purpose
Despite an increasing policy focus, routine outcome monitoring (ROM) is not common practice in UK children's services. This paper aims to examine whether it is feasible and valid to use measures from ROM of evidence-based parenting programmes (EBPPs) to assess the impact of services and to drive service improvements through feedback mechanisms.
Design/methodology/approach
This is a secondary analysis of ROM measures collected from a London clinic offering EBPPs over five years. Demographic information from referrals was compared for attendees and non-attendees. Changes in parent reported child behaviour were measured using the Strengths and Difficulties Questionnaire (SDQ), and a Visual Analogue Scale (VAS).
Findings
No significant differences were found in socio-demographic characteristics of attendees and non-attendees. Statistically significant differences were found between pre- and post-scores on parent reported SDQ scores and VAS concerns, as well as the SDQ Added Value Score. The data collected did not allow for investigation of a dose-response relationship between the level of attendance and any improvement made.
Originality/value
This study illustrates that ROM can provide useful information about the impact of EBPPs in a particular clinical context. Demographic data could support service managers to evaluate reach and uptake while evidence of improvements can be communicated back to parents and support future funding bids. Incomplete data limited the inferences that could be drawn, and collaborations between research centres and clinics may be a way to optimise the use of ROM to drive service improvement and innovation.