Choice in CAPA is:
- A stance/philosophy
- A process of always offering alternatives.
Choice is about giving our clients as much choice as we can to engage them in their change and in our working together on issues that matter to them. The key philosophy of CAPA is to have the service user’s viewpoint and wishes at the centre of what we do. Our aim is to do this through a stance of ‘facilitator with expertise’ in all contacts. Thus their choices lead to enhanced task alliance and so effective partnership goals and care plans.
We aim to make all our contacts with people feel collaborative, accessible, useful and facilitative. This means using ordinary everyday language, working to understand their view of their world and problems. We reach a shared understanding and agree goals to work on. We try to avoid making the experience of coming to our service one of expectantly visiting an expert who asks questions and delivers a verdict to a rather passive recipient.
We make sure we always focus on:
- 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?
This applies as much to the 50th session or the first.
This is our term for the first contact the client has with the service. The aims of the Choice appointment are to build the therapeutic alliance by:
- Clarifying their hopes for change
- Exploring whether your service or another or multiple agencies are best placed to help
- Considering risk, including safeguarding/child protection
- Allowing the client to make an informed choice about what they need and want and what services they may need
- Identifying what they can do for themselves
- Providing written information about the problems they are struggling with and solutions and other sources of help, such as other agencies and websites.
The Choice appointment experience should thus be one that builds a therapeutic and task alliance. We do this by developing a joint understanding of the problem with choices made as to future actions – reaching a Choice Point. This appointment can take as short or as long as it needs to reach a Choice Point. In fact, further Choice appointments need to be offered if the clinician and service user cannot reach a Choice Point – perhaps because a key person wasn’t there.
This whole stance we call working in a Choice framework and it is one of the 11 Key Components of CAPA.