What makes a good transfer?

When the East Herts CAMHS team started CAPA in 2005 they found that at every team away day for the first 18 months they wanted to talk about the Choice – Partnership Transfer! It often seems one of the most contentious issues and although, from one point of view, completely common sense, from another it’s one of the most radical things about CAPA. For a while, to review this process, the team used audit forms for the receiving Partnership clinician to review how well the transfer went. Below is a summary of what the team felt helped the transfer process, based on their experiences.

Informed Choice

The first and most important factor was that the family have made an informed choice about what they were coming for. This meant clarifying goals as clearly as possible, some idea about the type of intervention they will be engaged in and that they had had some discussion about possible alternatives.

Initial Joint formulation

The important precursor to an informed choice is a clear and joint initial formulation made with the family. As stated before in the Choice components, this requires the use of our honest opinion and getting their honest opinion as to whether our ideas make any sense at all.

CAUTION: an enthusiastic clinician may inadvertently promote their favourite therapy for a particular problem, by saying that it would be ‘really helpful’. This is especially true if they are not very familiar with other approaches, or have never de- livered them. Clients are polite and may conceal their lack of enthusiasm for such an intervention. There is rarely one way of approaching things and it can end up being your choice not theirs.

Skills

It obviously helps if the receiving Partnership clinician has right skills! This means the team must have mapped skills and know each other well.

It helps to map frequently and when new team members start.

Ownership

Finally, it is important to recognise the family’s own resources and agency. This means discussing with them what they think might help before they return to Partnership – ‘homework’ or Pre-Partnership work. When they return they have done some work together and will have moved on – which is why the Partnership clinician feels like they have to join a moving bus and not just reassess all over again. Think Single Session Therapy!