An investigation into the implementation of CYP-IAPT routine outcome measures in their first year of integration into child psychotherapy practice

Taylor, Georgina Anne (2016) An investigation into the implementation of CYP-IAPT routine outcome measures in their first year of integration into child psychotherapy practice. Professional Doctorate thesis, Tavistock and Portman NHS Foundation Trust / University of East London. Full text available

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Abstract

This thesis examines the impact on child and adolescent psychotherapists within CAMHS of the introduction of routine outcome measures (ROMs) associated with the Children and Young People’s Improving access to Psychological Therapies programme (CYP-IAPT). All CAMHS therapists working within a particular NHS mental health Trust1 were required to trial CYP-IAPT ROMs as part of their everyday clinical practice from October 2013-September 2014. During this period considerable freedom was allowed as to which of the measures each therapist used and at what frequency. In order to assess the impact of CYP-IAPT ROMs on child psychotherapy, I conducted semi-structured interviews with eight psychotherapists within a particular CAMHS partnership within one NHS Trust. Each statement was coded and grouped according to whether it related to initial (generic) assessment, goal setting / monitoring, monitoring on-going progress, therapeutic alliance, or to issues concerning how data might be used or interpreted by managers and commissioners. Analysis of interviews revealed greatest concern about session-by session ROMs, as these are felt to impact most significantly on psychotherapy; therapists felt that session-by-session ROMs do not take account of negative transference relationships, they are overly repetitive and used to reward / punish the therapist. Measures used at assessment and review were viewed as most compatible with psychotherapy, although often experienced as excessively time consuming. The Goal Based Outcome Measure was generally experienced as compatible with psychotherapy so long as goals are formed collaboratively between therapist and young person. There was considerable anxiety about how data may be (mis)used and (mis)interpreted by managers and commissioners, for example to end treatment prematurely, trigger change of therapist in the face of negative ROMs data, or to damage psychotherapy. Use of ROMs for short term and generic work was experienced as less intrusive and contentious.

Item Type: Thesis (Professional Doctorate)
Additional Information: A thesis submitted in partial fulfilment of the requirements of the University of East London in collaboration with the Tavistock and Portman NHS Foundation Trust for the Professional Doctorate in Child Psychoanalytic Psychotherapy
Uncontrolled Keywords: Professional Doctorate in Child Psychoanalytic Psychotherapy, University of East London
Subjects: Children, Young People and Developmental Pyschology > Child Psychotherapy
Children, Young People and Developmental Pyschology > Adolescents - Psychotherapy
Psychological Therapies, Psychiatry, Counselling > Clinical Psychology
Research, Tests, Assessments > Social Study & Research Methodologies
Department/People: Children, Young Adult and Family Services
URI: https://repository.tavistockandportman.ac.uk/id/eprint/1339

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