Step2
A Trusted Assessment (TA) has to be done from MHST before onward refer cases to Step2.
Duty Clincian
Contact 01438730570
Availablity: Mondays, Wednesdays and Fridays. 15mins slot only
Telephone conversation to cover:
Brief history on child’s mental health
Current difficulties
Risk – duration, severity. DSH – what tools are used, i.e description of wounds, SI – plans, intention, attempts
Formulation (following the assessment why is the case not appropriate for MHST and does the presentation meet Step2 criteria
Triage meetings are held on Mondays and Thursday when decisions are made regarding onward referrals.
Accepted cases will be emailed to hct.step2referrals@nhs.net (Assessment, risk assessment, safety plan)
Accepted cases will wait on our treatment list from the time they were assessed by MHST, not Step2 to reduce prolonged waiting.
Rejected TA’s can be signposted to appropriate service agreed by clinicians, i.e specialist service or community-based service i.e counselling. Alternatively follow the escalation process via integration process.
Treatment pathways
INDIVIDUAL TREATMENT PATHWAY
Individualised therapeutic interventions supporting presenting difficulties and goals.
Core ( up to 6 sessions)
Presentation and need is within the mild range for example when they are presenting with a single issue that would benefit from a brief and focused intervention. The presenting mental health difficulty it not having a major impact on daily living (e.g. in a period of two weeks it may impact on daily living up to five days).
Extended (up to 12 sessions)
Multiple presenting difficulties or difficulties that are presenting in the moderate range. Presenting difficulties would impact daily living more than half of the days in a two-week period. Self-harm and OCD would automatically fall into an extended treatment.
RELAPSE PATHWAY
When a referral has come in within one year after discharge from treatment, with the same presenting difficulty, the children and young people will be offered 2 – 3 “top-up” sessions, reviewing treatment and formulating next steps.
GROUPS PATHWAY
Anxiety Tic Group
Core presenting difficulty is a generalised anxiety which is considered to be exacerbating frequency and intensity of Tics. The group is not a specific treatment for Tics but may decrease the frequency and intensity by learning skills to manage anxiety.
Circle of Security (COSP)
Circle of Security Parenting (CoSP) is a parenting programme that focuses on promoting and fostering a secure attachment with a child.
Self-esteem group
Supporting young people presenting with low mood/anxiety and low self-esteem.
Managing Emotions Group (13+)
Core presentation is difficulties managing intense emotions that may be resulting in self-destructive behaviours. For example, self-harm, aggression, disordered eating.
Managing Emotions Group for Neurodiversity (13+)
Core presentation is difficulties managing intense emotions that may be resulting in self-destructive behaviours. For example, self-harm, aggression, disordered eating.
Phobia Group
Core presenting difficulty is a specific phobia, which is marked by avoidance and distress caused when exposed to the feared stimulus
OCD group
Core presentation is difficulties with obsessions and compulsion which are having a mild/moderate impact on daily functioning. I.e., still able to engage in everyday activities but with some disruption due to rituals. Compulsions are driven by cognitions (anxious thoughts) and are not related to Neurodiversity.
LGBTQIA+ Group
Wellbeing group focused on anxiety/ low mood and general wellbeing sleep/diet/exercise for children who identify under the LGBTQIA+ population
UNDER 5’S
Specific under 5’s provision with the under 5’s team is where there are relational and connection difficulties, focused on intervening through the parent child relationship. The three main interventions offered are:
Video Interactive Guidance (VIG). The team offer 3 cycles of VIG (equivalent of 6 sessions)
Video-feedback intervention to promote positive parenting and sensitive discipline (VIPP-SD); this intervention is suitable where there is a mental health need alongside difficult to manage behaviours. Also, for where a parent can commit to a structured piece of work to enable them to see the difficulty through their child’s eyes. 6-12 sessions.
COS-P 1:1; for when the CoSP group is not suitable, for example where the situation might be highly sensitive / parental mental health / adverse experiences for the parent such as domestic abuse.
Where there are difficulties with attachment in a child under 8 they may be offered an intervention focused through the parents depending on the child’s age/capacity. Where there are no relationship difficulties, children between 5 – 8 years old may be offered a generic treatment intervention.
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