Setting

This audit is useful to those who work in a child and adolescent mental health service (CAMHS) where the Choice and Partnership Approach (CAPA) is used.

Background

The CAPA is a clinical system that is widely used in CAMHS throughout the UK, Australia and New Zealand. It is a system that helps the team do the right thing with the right people and at the right time (York & Kingsbury, 2009).

There are three main components in CAPA and they are choice, partnership, and core and specialist work. The last is the ‘bread and butter’ and the more specialist and therapeutic work in CAMHS, but the concept of choice and partnership is unique to CAPA.

ᐅ Choice. Children and families make informed choices about what services and interventions may be useful to them. There is a focus on engagement and clinicians need to help the families and young person reach a ‘choice point’ at the end of the initial appointment (when a partnership appointment is booked with a clinician with the best skills to help).

ᐅ Partnership. Partnership work represents the bulk of the intervention and can be done by most CAMHS clinicians with generic skills, together with extended skills that can give the partnership appointments a specific ‘flavour’. All ‘partnership’ clinicians need five core treatment skills (assessment, behavioural, cognitive, dynamic and systemic) and ‘choice’ clinicians need to consider the spread of these skills when offering the family or young person a partnership appointment.

ᐅ The change of clinician from ‘choice’ to ‘partnership’ is an integral part of the CAPA process and an important theme.

Standards

The recommendations by the founders of CAPA (York & Kingsbury, 2009) regarding the choice appointment for the family or young person who is progressing to partnership are as follows:

ᐅ Children and families make an informed choice about what services and interventions will be useful to them, giving them autonomy.

ᐅ The focus is on engagement with change, not the clinician.

ᐅ Clinicians should facilitate this using their ‘expertise’.

ᐅ A ‘choice point’ is reached at end of the choice appointment.

ᐅ The choice clinician is changed for the partnership clinician.

Method

Data collection

A questionnaire was created and given to all choice clinicians. The questionnaire was completed if the young person or family were progressing to partnership.