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Some Techniques for ‘Doing’ Recovery Oriented Practice
Siri Wooster & Steve Kingsbury: East Herts. CAMHS
…the Choice and Partnership Approach
a clinical system that evolved in Richmond CAMHS from 2000
developed and implemented wholesale in East Herts. CAMHS 2005 and
now being used in many CAMH teams across the world UK NZ, Australia, Belgium And adult mental health (NZ)
3500 staff and around 400 teams
It is about Doing the right things
= on the right goals With the right people
= with the right skills At the right time
= with no waits
Users are at the heart of the process
“Led by them and guided by us”
Shift in clinician stance to Facilitator with expertise rather than expert
with power
There are 4 ideas that separate CAPA from more “traditional” models. These are...
1. Choice
2. Core and Specific work
3. Selecting clinician to Partnership
4. Team Job Planning
Individual uniquenessReal ChoicesAttitude and RightsDignity and RespectRespectful Partnerships
Lets look at the links between these and CAPA…
Recovery recognises that Whole life matters Outcomes are personal and Empowers individuals
CAPA has The Choice appointment and approach A Collaborative model
Recovery recognises that: People need to make their own choices Supports individuals to take responsibility We need to encourage individuals to take
positive risks CAPA:
Choice is the central stance in CAPA Strengths based model The best risk management is to work
actively with the individual
Recovery ask that we… listen to and act upon communications
from people promote and protects rights Support people to maintain activities
which enhance mental wellbeing.CAPA
Choice framework
Recovery suggests that we should be… courteous, respectful and honest sensitive and respectful of each
individual’s own values and culture. CAPA
promotes a non-hierarchical interaction with young people
Cultural and personal values are a given in CAPA
Recovery states… that each person is an expert on their own
life work in positive and realistic ways with
individuals to help towards their hopes, goals and aspirations.
CAPA CAPA uses own expertise to facilitate their
choices Partnership work is a collaborative focused
on their choices with continual review of the chosen goals
These techniques only make sense if Recovery Principles or CAPA principles are embedded in the team culture.
Language Used in CAPA
Redefines the relationship between service user and their family and clinician
Impacts on moment-to-moment interactions in sessions
What are they worried about?What’s going on?How shall we understand it together?What shall we do about it?Do they want to come back?
Work together vs Treat
Help you choose vs Tell you
Share our thoughts vs Give an opinion
Decide together vs Assess
Peer group supervision and Post-Choice discussions (in addition to individual supervision and
whole team clinical discussions)Small groupsWeeklyKeeps focus on realistic goalsHelps with ‘letting go’