MODEL OF SERVICE Engagement Developing a partnership Active Treatment Relapse Prevention
Engagement Shaping an effective working alliance Psycho-social Interventions Medication and symptom management
ENGAGEMENT Shaping an effective working alliance Conduct outreach to establish regular contact Being useful-provide practical help and support Establish open, honest communication through active listening, getting to know the person behind the illness.
ENGAGEMENT Psychosocial interventions Gaining knowledge of family Starting to assess Activities of Daily Living Awareness of physical health Awareness/assessment of substance misuse ‘Accepting’ conversations regarding perceptions of mental health
ENGAGEMENT Medication/Symptom Management Starting to assess side effects Symptom acknowledgement and monitoring Weekly medication supervision and review if necessary
DEVELOPING A PARTNERSHIP Psychosocial interventions Continue regular contact start to negotiate continued contact Building a trusting relationship through reliability and advocacy Working more in collaboration towards resolution of practical tasks
DEVELOPING A PARTNERSHIP Psychosocial interventions Information re: illness/medication if wanted Introduction to stress/vulnerability model through informal conversation Informal coping strategies Establishing relationships with family/carers as appropriate to include carers assessment, if appropriate
DEVELOPING A PARTNERSHIP Psychosocial interventions Identifying interests, strengths, skills and aspirations Monitor any physical health changes. Consider Motivational Interviewing intervention at contemplation stage re substance misuse if appropriate
DEVELOPING A PARTNERSHIP Medication/Symptom Management Assessment of side effects Assessment of symptoms Reality checking Ongoing monitoring and management of medication compliance
ACTIVE TREATMENT Shaping an effective working alliance Regular agreed contact Supporting progress and concordance with the plan
ACTIVE TREATMENT Psychosocial interventions Reinforce coping strategies Consider Occupational Therapy assessment Consider ‘family work’ if appropriate Physical health education and support
ACTIVE TREATMENT Psychosocial interventions Goal setting – strengths based/solution focused interventions-future plans- timetable for activities Help service user to repair burnt bridges to re-establish relationships Enlist family support for sustained lifestyle changes Engage in MI re: Substance Misuse if appropriate
ACTIVE TREATMENT Medication/Symptom Management On-going support Development of relapse indicators with service users, steps to be taken and advance directives
RELAPSE PREVENTION Shaping an effective working alliance Maintain/consider reduction in contact Promote development of their supportive relationships Boost self efficiency/positive reinforcement and consider other areas of development – move towards independence
RELAPSE PREVENTION Psychosocial interventions Develop a formal relapse prevention plan Continue with Psychoeduction Provide information related to health, well being and lifestyle change Help service users learn how to obtain information themselves Explore a service user becoming a peer educator for others
RELAPSE PREVENTION Medication/Symptom Management Promote independence with medication compliance Psychoeduction on long term use and effects of medication Continued symptom monitoring.
DECISION MAKING What interventions and when Risks Rights Responsibilities
SENARIO What risks do we need to consider What and whose rights should be influencing our decision making? Who holds responsibility and for what?
HUMAN RIGHTS AGENDA Fairness Respect Equality Dignity Autonomy
HOW DO WE DELIVER OUR SERVICE Daily handover Weekly team meeting-psychiatrist 3 monthly review of risk management plan at team meeting 3 monthly CPA 6 month review of relapse indicators
HOW DO WE DELIVER OUR SERVICE All staff see all service users Different voices but the same song
HAS IT WORKED? Service user- Evaluations Understand my problems They lift my spirit when I see them They are fascinated by my beliefs They treat me with respect I don’t feel isolated I need to be in my community, the AOT helps with speaking to the benefit agency I haven’t got any bad things to say except I’d like to get off the depot- they are doing their best.