The philosophy of Choice continues throughout Core and Specific Partnership.
- Curious: being curious and following their concerns. Really learning their views, understandings and hopes
- Honest Opinion: this is us presenting our advice or opinion (so far) to discuss with the client
- Joint Formulation: to gradually form an understanding with the person as to roughly what is going on
- Discuss alternatives that might help
Which leads to…
- an agreement over the service user’s goals which then form the…
- Choice point: to use the evolved joint understanding and discussion of alternatives to help them make an informed choice about the next step
- Engagement: engage them in their own change by considering how they think they can help with their concerns perhaps discussing any ‘homework’ they might do.
The biggest challenge can be how to continue to be honest with our opinion, especially if this differs from that of the Choice clinician. In practice this does not seem to happen as often as you may think. Lots of opportunity for peer case discussion helps.
You will be using your extended clinical skills to help them work towards their goals. In this sense Core Partnership is the familiar clinical work that we all do. The addition, for some, may be the more explicit use of goals and measuring out- comes towards those goals. The goals may have changed from Choice (this is not uncommon as a result of the Pre-Partnership work).
The discussion with the person and their family continues to be about what they would like to be different and the ways they could achieve those changes. This uses a range of skills and techniques, which is why extended clinical skills are needed. Linking with school, other agencies and co-ordinating care is part of Core work. The Core worker takes on the role of Key Worker.
A Care Plan is developed with the client and this is reviewed at regular intervals.
Specific Partnership work
This may need to be added to the Core work e.g. individual psychodynamic psychotherapy. This should not involve going on to a waiting list but by the clinician involved joining the Core worker.
Segmented Pathways or “Clinics”
Some problems are predictable in their durations and skills needed e.g. anorexia nervosa. Full booking to a segmented Specific Partnership pathway that aligns the right mix of skills at the right level plus has balanced capacity for the demand may be helpful.