Using Self Help materials within a stepped care service

1
Using Self Help materials within a stepped care
service

• Judy Leibowitz
• Clinical Lead, Camden Psychological Therapies
  Service
• Camden PCT
• judy.leibowitz_at_camdenpct.nhs.uk

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Self help what we are doing

• Camden first wave IAPT service
• Developed role of PCMHWs with Islington
• Stepped Care Model
• Materials
• Facilitated
• Booklets - Depression and low mood/Panic and
  phobias/ Stress and Worry/Medication Management
• CCBT web-based/ libraries
• Non facilitated
• Books on Prescription
• Websites

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SH booklets for guided self help

• Modified Northumberland booklets
• Additions
• graded practice, sleep, relapse prevention,
  worry, problem solving, worksheets
• Integrated local info
• Simple, short, easy to read
• Not workbooks flexible use
• Pan diagnostic
• Modified by feedback

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Booklets
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How materials used by PCMHWs

• Train PCMHWs on 4 booklets must be very
  familiar
• Clear protocols for use - in service context
• Choice CCBT/ GSH / groups
• Tailor goals if stepping up
• Be realistic facilitation vs recommendation
• Co-morbidities e.g. alcohol
• When do coping strategies become safety
  behaviours?

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Challenges of integrating SH into stepped care
system

• Integrating different models of change in the
  same system
• Challenge for staff and service users
• Requires
• appropriate expectations for service users
• Clear info for referrers
• Self referrals new challenge
• ?Links to mental health promotion
• Information sharing/joint working across steps

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Broadening access to self help

• Translation and same lang PCMHWs eg Somali/
  Bengali
• Audio materials - literacy/ sensory problems
• Need central support for this?
• Where service is offered
• Train others to facilitate?

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Some principles

• Consider who within system is delivering SH
  Materials
• PCMHWs GSH
• HI staff adjunct to therapy
• PC/community staff signpost to pure self help
  (active monitoring)
• Direct patient access
• Patient/ staff feedback key part of developing
  materials