Most work in CAPA teams is Core Partnership …
It is average duration work that uses a range of integrated or single modality core skills, involving liaison with the system and other psychosocial interventions. It requires clinicians to have ex- tended clinical skills in key areas, at a core level of competence.
On average, Core Partnership work in CAMHS lasts 7-8 appointments (though the range may be wide). See the Job Planning chapter for more about this. If you are working in another type of service then Core Partnership work takes whatever is the average for your setting (for example, the average in a learning disability service may
be greater than 7; that in a primary mental health service may be less).
Clinicians working in Core Partnership are using extended clinical skills. These are basic ‘core’ competencies in what we call the Alphabet skills. The ABCD’S!
- Dynamic and
As Core Partnership work forms the majority of the work of the service it is important that clinicians have the flexible skills to deploy according to the preferences and needs of the client. This work should be privileged as the clinical domain where good, widely skilled clinicians work.
The principles of Core Partnership are
- to work with the joint formulation agreed with the client
- in an outcome focused way to jointly agreed goals
- which are reviewed frequently
- with a focus on strengths
- to enhance their internal locus of control
- and is developmentally and culturally appropriate
Core partnership work has two functions:
1. Key worker responsibility
Co-ordinating work around a person, with the sys- tem and their relatives, ensuring the paperwork gets done and reviews happen. Rather like the care co-ordinator / key worker role.
2. Delivering further assessment and interventions
This could be in an integrative way or average du- ration, specific therapeutic modality work to help the client move forward with their goals. Continuing to enhance the therapeutic and task alliance and working collaboratively. They are developing and agreeing goals with the client, reformulating, facilitating shared decision making, and monitoring goals frequently with the client. If things are not changing, regular review of the formulation, outcomes and choices ensures different interventions or styles of therapy can be offered by the Core Partnership worker in a seamless way.
For example, CBT delivered in Core Partnership is likely to involve explaining the model, structuring sessions, devising and reviewing homework. Many people will improve with this level of help. And it will take an average of 7 appointments, maybe less, maybe more, depending on how much key working and social intervention is needed.
For other clients, a systemic approach in Core Partnership will work on the person’s goals by focusing on relationships and interactions, again combining with key worker functions. However, you will not be delivering the systemic work with a group of colleagues as a reflecting team. This type of work will consume more than 7 hours of work across all the clinicians and the use of higher level of technical skill.