July 2019

Families First News

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Dispelling the uncertainties regarding the Children’s Wellbeing Team

The Children’s Wellbeing team focuses on Psychological support for Children and Young People experiencing Mild – Moderate Anxiety and Low Mood. We are part of the CAMHS transformation however as the Hertfordshire CWP’s sit within Children’s Services Families First organisation we are more accessible in our approach to therapeutic intervention.

The CWP service is based on Improving Access to Psychological Therapy (IAPT). The Guided Self-Help model utilises cognitive behaviour therapy in its approach. The focus is on symptom management not symptom recovery, we are a non-diagnostic service. The team consists of Qualified and Trainee practitioners; however, all trainees are undergraduates at commencement of training.

Our aim is to deliver an early help mental health service and consequently we do not work with challenging behaviour that has emerged due to environmental factors and this is supported by clinical rationale.

  1. Our intervention is brief, generally affording eight sessions, which can include face to face and telephone sessions. The brief therapy is not clinic based so it helps to break down barriers to accessing mental health support, evoking confidence and dispel some stigma’s relating to mental health challenges for the individual through normalising symptoms. 
  2. Our intervention requires we build a trusting working relationship with the people we work with. As practitioners we work in complete alliance with the Child, Young Person, Parent or Carer affording the respect and autonomy of choice. It is consensual, and we do not encourage the Child or Young Person to be persuaded into accessing CWP intervention.

The relationship-based approach gives validation to the person’s thoughts and feelings and guided self-help is crucial to contribute to the advancement and maintenance of progress. Often with the strength, enabling based approach, and the intervention we can rebuild confidence and their sense of self and support the person to independent self-management of their symptoms.

If a Child/Young Person has presenting emerging needs they should initially be supported by universal provision such as Protective Behaviour work, School Nursing teams or in school Counselling where appropriate.

Generally, it is recommended that no further therapeutic support is introduced during or for three months after intervention unless the intervention has not shown signs of improvement for the Child or Young Person and there is an escalation regarding more significant symptoms. In addition, if it is considered that the child’s mental health requires more specialist support then it is likely our service is not appropriate and a referral for the right service should be requested through Single Point of Access or via GP support.

In order to access the CWP service Children and Young People need to be:

Between the ages of 5-18 years,

Presenting with Anxiety, Low Mood or Co-Morbid Anxiety and Low Mood,

On school role (unless the anxiety is not based around the school environment),

NOT affected by the following:

  • Current Domestic Abuse in the family home within the last 3 months and/or where the perpetrator of the abuse resides in the family home
  • Current Substance Misuse (Parent/Carer/YP) or use within the last 3 months
  • Parental Conflict which has not been resolved
  • Obsessive Compulsive Disorder (These CYP’s should be directed to CAMHS)
  • Eating Disorder (These CYP’s should be directed to CAMHS)
  • Active Suicidal Intent or Attempt within the last 6 months (These CYP’s should be directed to CAMHS)

We cannot work with Children and Young People who are currently accessing or have accessed:

  • Child and Adolescent Mental Health Service (CAMHS) within the last 12 months
  • Step 2 (Within the last 12 months)
  • Counselling, Art, Play or Drama Therapy (Within the last 3 months)
  • Protective Behaviours (Within the last 3 months)

Children and Young People with a developmental diagnosis:

Children and Young People who have a diagnosis, or awaiting assessment, of ADHD or ASD cannot be offered appropriate support from the service with regards to the presenting associated behaviours. Children and Young People who have a formal diagnosis of ADHD or ASD we may be able to offer support in relation to managing low mood and/or anxiety. However, IAPT approach does not always provide positive change for people who are symptomatic of ASD/ADHD and therefore any referral will be considered on the CYP’s capacity and in consultation with Parents/Carers.

If the below are historical (over 3 months) issues for parents:

  • Parents/carers with mental health difficulties MUST be receptive to CWP advice and this will be informed through the Initial assessment.
  • Parents/Carers with substance misuse issues MUST be receptive to CWP advice and this will be informed through the Initial assessment.

How do we offer support?

The team receive both internal (HCC) and external referrals, including self-referrals.

Children and Young People whose mental health needs are considered appropriate for the CWP’s intervention will be offered Guided Self Help through:

  • 1-1 Interventions with young people (secondary school age) and Parent/Carers
  • School based Group work (6 weeks – Years 9 &10)
  • Parent Training Group work for Child Anxiety/mild low mood (6 sessions – Children under 11)
  • Anxiety workshops to year six groups can be offered to Primary schools on request of school.

For more information and to access referral documents please go to the CWP Families First Portal

Author: Vicky Stewart, Qualified CWP

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