This work stream is when we use particular skills, often at higher intensity or the duration or amount of work is not of average duration .
So this could be when we use a particular advanced technique, assessment or skill, to target specific symptoms/problems as a complement to Core work, or to extend or intensify it. It may be of short duration e.g. psychometric assessment, or longer term, more intensive work e.g. attachment work or dialectical behaviour therapy. We may have done additional, higher-level training and could supervise someone in that skill. It may occur at a particular time and place. The level of competence is higher than extended core skills – we call it an advanced level skill. Examples could be psychodynamic psychotherapy, schema based CBT, Eye Movement Desensitisation and Reprogramming (EMDR), multi-family groups, autism assessment, psychometric assessment and pre- scribing of medication.
A client accesses these advanced skills by the Core Partnership worker asking someone to add in a particular assessment or therapy skill. It is an adjunct to the Core work, but at this point the Core Partnership work often reduces to the key working function only. This continuing key worker role may, although not always, push the number of appointments for that service user above the average of 7. However a large percentage of the service users seen have treatment volumes above 7 sessions and ARE STILL in the average distribution of 7.
Initially, in a team that is new to these concepts, there may be some debate about seeming to reduce “specialist” roles. Some can feel that to be a ‘professional’ they need to be doing lots of “specialist” work. Our view is that the Core Partnership work needs Specific Partnership work to support it. Defining clinicians’ Specific time promotes and preserves it. The shift is that this should come about through transparent team job planning (the 4th Big Idea!) rather than decided by individuals or professional line management.