Partnership work is all the work done following the initial Choice appointment and any Choice Plus. This is all follow-up work whether in a Core or Specific pathway. Core Partnership is where the majority of intervention work occurs and can be done by most clinicians who have extended clinical skills alongside their advanced ones. Assessment and reformulation continues through- out contact with the client, in the normal way.
Some people will need additional Specific Partnership work, alongside the Core work. An example could be individual psychodynamic psycho- therapy in conjunction with Core family work, or additional Specific assessment e.g. psychometry or ASD assessment.
Partnership work can be as many or as few appointments as are needed, as long as this is regularly reviewed against clear goals. We know that most clients in CAMHS seem to receive an average of 7 Core Partnership appointments. But the range may be wide! They are not limited to 7!
The Choice process ended with a Choice Point (the joint understanding of the problem and a decision as to future actions).
Tasks of Partnership
So the aim of the first Core Partnership appointment is to:
- Revisit the goals developed in the Choice Point. Have these changed?
- Look at how the Pre-Partnership work went – what happened, what worked?
- Use the Core level skills that were identified in Choice as useful to the desired change
- Explore important areas that may now arise
- Build on the person’s hope for change
- Continued consideration of risk, including safeguarding
- Engage other agencies as needed and link with those already involved
- Continue to provide written information about mental health issues and solutions and other sources of help, such as other agencies and websites
- Let them go promptly!
The first Partnership appointment should not be just a repeat of the Choice appointment. That would be a waste of time for the service user and the clinician. If the Partnership clinician is not the same person that saw them in Choice then the challenge for the clinician is to be continually aware that this is the first contact for them, but the second (or third) for the client. We’ve heard it described as like getting on a moving bus. This means that the Partnership clinician needs to read and reflect on the information gathered in Choice and continue to be very curious as to how the person views things.
A range of Choices continue to be available throughout Partnership…
Choice as in:
- To engage or not in the service
- Whether to change or not
- Who in the family/network comes
- Venue (if you have several sites)
- The formulation e.g. to label/medicalise the problem or not and
- The type of interventions
- Booking preferences for times and days
- Subsequent appointments.
When someone is re-referred to the service they always have an initial Choice appointment before moving into Partnership, even if recently discharged. All people need a review of current issues and discussion of what they want.