Training to develop family inclusive routine practice and specialist family interventions in Somerset
| DOI | https://doi.org/10.1108/17556228200800012 |
| Pages | 23-31 |
| Date | 01 June 2008 |
| Published date | 01 June 2008 |
| Author | Frank Burbach,Roger Stanbridge |
| Subject Matter | Health & social care |
23
Training to develop family inclusive
routine practice and specialist family
interventions in Somerset
Frank R Burbach and Roger I Stanbridge
Somerset Partnership NHS Foundation Trust
The Journal of Mental Health Training, Education and Practice Volume 3 Issue 2 June 2008 © Pavilion Journals (Brighton) Ltd
Abstract
Current national policies present a challenge to the
existing mental health workforce as most staff have
not been trained to work with people within the
context of their social support network. This paper
presents two complementary training initiatives
designed to enable mental health staff to meet the
range of needs of families: (1) an in-house
accredited (one-year) course that has enabled the
successful creation of specialist family intervention
in psychosis teams; and (2) a whole-team trust-wide
training programme (three-day course) to promote
partnership working with families by both
community and inpatient teams. Issues that have
enabled the successful translation of training to
practice areconsidered.
Key words
training; implementation; family interventions;
partnership working with families
Introduction
National policies (eg. The National Service Framework,
(DoH,1999); NICE Guidelines for Schizophrenia, (DoH,
2002)) advocate a holistic bio-psychosocial approach to
mental health care. In particular,they emphasise the
importance of involving families/carers as partners in care,
as well as providing specialist family interventions. This
has considerable implications for workforce development,
as services have traditionally focused on treating the
individual, and most mental health professionals would
therefore not have had training in working with families.
In Somerset, we have implemented an extensive
training programme to develop the workforce. There are
two distinct strands to this: first, the development of a
county-wide family interventions (FI) service by means of
in situ accredited team training and, second, the training of
inpatient and community staff in family-inclusive practice.
This article will describe both of these training initiatives
and consider their complementary nature in equipping the
workforce to deliver a more comprehensive service.
Family interventions services
The NICE guidelines reflect the strong evidence base for
family interventions in psychosis. A number of
randomised controlled trials indicated that the inclusion of
family work with standard care, including medication,
significantly reduces relapse rates, improves social
functioning, reduces ‘family burden’, and reduces overall
treatment costs (see Pharoah et al,2002; Pilling et al,2002,
Pitschel-Waltz et al,2001). These studies have led to the
development of a range of training initiatives (Brooker,
2001) but there have been difficulties in implementing
these approaches (originally developed in research settings)
in standard mental health services (Brennan & Gamble,
1997; Fadden, 1997 & 1998; Kavanagh et al,1993).
One of the main implementation difficulties
identified was that practitioners were not able to
prioritise family work within their caseload due to a lack
of support from colleagues and managers. In addition,
they reported that skills taught were insufficient to
engage with the range of families.
It was in this context that we decided to develop our
own training course – the Family Interventions (Research,
Skills, Theory) in Psychosis (FIRST) course – to establish
family interventions services in the rural county of
Somerset. Our response to the implementation difficulties
identified was two-fold: first, to deliver the course to
multidisciplinary groups of staff who would go on to
provide the new service in each of the four service areas in
turn, second, to integrate psychoeducational (cognitive)
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