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Enhancing Family-Centered Practices in CAMHS: A Collaborative Approach

This project, led by Dr. Paul Denborough from Alfred CAMHS, aimed to transform the experience of families attending child and adolescent mental health services (CAMHS) by fostering collaboration and prioritizing therapeutic relationships. The initiative sought to shift from a rigid, one-dimensional treatment model to one that aligns with clients' goals and beliefs. Key changes included introducing flexible assessment modalities, enhancing documentation, increasing carer involvement, and promoting client satisfaction. Ongoing evaluation indicates significant improvements in individual service plans and overall client satisfaction.

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Enhancing Family-Centered Practices in CAMHS: A Collaborative Approach

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  1. Making Family Sensitive Practice RoutinePresenter: Dr Paul DenboroughHospital: Alfred CAMHSKey contact person for this project: Dr Paul Denborough, Phone: 8552 0555email: p.denborough@alfred.org.au 15 February 2008 - Melbourne

  2. KEY PROBLEM • Alfred CAMHS and child psychiatry in general arose out of psychoanalytic traditions and the medical model where patients are treated for problems and diagnoses and the clinicians are seen as experts • Treatment at CAMHS was somewhat one dimensional with rigid assessment procedures and typically the intervention was one of parent therapy and individual therapy

  3. AIM OF THIS PROJECT • The aim of this project was to make the experience of attending CAMHS more collaborative for families, with more focus on the therapeutic relationship and attempt to organise treatment around the clients goals and beliefs. • We also wanted clinicians to become more outcome driven and flexible in strategies provided. • There was no defined time period and this project is ongoing and relates very much to culture change.

  4. KEY CHANGES IMPLEMENTED • Managing demand - Clarifying CAMHS role as Tier 3 service - Consolidating workload management system - Introducing flexible assessment modalities • Developing more appropriate documentation (written for clients) - ie ISP’s - Discharge summary • Ensuring continuity of care

  5. KEY CHANGES IMPLEMENTED • Developing appropriate information brochures - Eg working together brochure • Increasing carer involvement - Staff presentations - Consumer advisory group - Carer consultant • Writing assessment summaries / therapeutic letters for clients • Introducing session by session ratings of alliance and client rating scales

  6. OUTCOMES SO FAR • Individual service plans • Since change in form 35% clients have ISP • 95% have parental signature • Prior to new form approx 60% had ISP • 5% had parental signature • Client satisfaction survey (2007) • 90% clients satisfied with help received • 3% clients dissatisfied with help received • 75% of clients very satisfied with staff attitude • 16% of clients satisfied with staff attitude • 2% of clients dissatisfied with staff attitude

  7. PROJECT EVALUATION • Project about culture change which is ongoing but very worthwhile • Need multi-model strategy – relentless persistence • Start with getting the basics right ie clear organisational lines of accountability, workload management, supervision structures and then build to more aspirational goals.

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