Creating Capable Assertive Outreach Teams - slide presentation

The following Powerpoint presentation, 'Creating Capable Teams: AO (North) Northamptonshire A Case Study', was written by Steve Morgan (Practice Based Evidence) and Sue Jugon (AO North Team Leader)

Powerpoint: Creating Capable Teams: AO (North) Northamptonshire A Case Study (119kb)

Getting to know you, getting to know all about you...

Well, maybe not that much detail, although I am sure anyone reading this is a perfect specimen of taste and sophistication (or maybe just related to Steve).

No, what we really want to know - we being Steve (the brains) and Paul (the budget boffin) - is what visitors and subscribers to the site are looking for? There is already a huge amount of content here, harvested from the previous site, and there are some great new articles in the pipeline. But are there related area's of interest that you would like to see covered? Or perhaps there is a specific question you would like Steve to address?

Whatever your views on the site, we'd like to hear from you. With this new incarnation of the site, we finally have the option for visitors to reply to posts and it would be great to see some discussion and debate. And if you have any good ideas for the site, please drop us a line at either steve@practicebasedevidence.com or Paul@redhotbelgian.com.

Thanks for your time, hope to hear from you sometime!

Steve and Paul

'Strengths' Assertive Outreach: A Review of Seven Practice Development Programmes

The following article was first published in the Mental Health Review Journal (June 2008) and is reproduced with their kind permission.

Abstract

Assertive outreach is based on extensive international research and has been promoted in the UK in 1999 as a key area of the National Service Framework for Mental Health. Its primary aim is to provide a specialist service for people disengaged from traditional approaches of mental health services, but very little attention has been paid to how such services can be developed. Practice Based Evidence, a practice development consultancy, has engaged seven assertive outreach teams to focus on development first, and follow-up evaluation of the impact of reflective practice on team functioning. This has prompted a number of strengths-based recommendations for changing the way we think about developing services before we engage in research and evaluation.

PDF: 'Strengths' Assertive Outreach: A Review of Seven Practice Development Programmes

Excerpt from Part 3: Evaluating a Strengths Approach to Practice Development

Developing a tool to guide and capture the strengths messages

The rationale underpinning a strengths approach led to the development of a 13- item tool to help capture some measurement of how practice development and team functioning can influence positive changes in team practice. The tool should also act as a prompt to areas of good practice, so the items are designed to be a sufficiently comprehensive reflection of ethical issues, care process, team functioning, and an underpinning knowledge base. Yet, this also needs to be a manageable tool (i.e. fitting one side of paper) if it is to engage practitioners interests and be used.

Ethical practice
1. Service users are fully involved in determining the ‘priorities’ for the working relationship.
2. As a team, we regularly examine and review the impact of ‘values and principles’ on our practice.
Care process
3. Time for creative approaches to ‘engagement’ is a priority.
4. Our assessment of needs includes the identification of service user ‘strengths’.
5. We identify and manage the appropriate opportunities for ‘positive risk-taking’ in practice.
6. Our working practice draws on a broad range of ‘practical and research based’ approaches.
Team working
7. We are clear about our ‘purpose’ as an assertive outreach team.
8. We have a clearly agreed model of ‘team-working’ (within team).
9. We have effective systems of ‘support and supervision’.
10. We have clear processes of ‘decision-making’ in the team.
11. We ‘link’ effectively with other parts of the mental health system (including primary care).
Knowledge in practice
12. We make full use of the ‘diverse’ knowledge, skill and experience within the team.
13. We access appropriate expertise from outside of the team.

Developing the method of evaluation

The method focuses on evaluation of changes in practice that gives useful feedback to the teams about their global functioning, as well as indicators to priorities they may choose to focus specific attention on. This is not the same as the approach established in many of the well known research projects examining the effectiveness of assertive outreach. The research approach has been one of top-down influences, whereby external sources examine questions relating to their desire to compare outcomes to other known and established research. The evaluation approach is a bottom-up influence, whereby the practitioners are engaged in reflecting on how their team is performing in relation to practice-based outcomes.

One Foot in the Door - Mental Health Today

In 2007 the National Audit Office conducted a value for money study into the clinical and economic effectiveness of CRHT teams. Practice Based Evidence, with the service user-led ARW Consultancy, conducted a specific part of the fieldwork interviews and reporting for the study and conducted structured interviews with 25 CRHT team managers and 25 ward managers at 25 sites across England. The report below, A Foot in the Door, details the findings.

The PDF below is an article first published in Mental Health Today March 2008 and reprinted here with their kind permission. Click on the image below to download.

To read the report above you will need free software called Adobe Reader. This software can be downloaded here.

A review of the Assertive Outreach Strengths Approach textbook

February 2004 saw the publication of a textbook written by myself and Peter Ryan, with a foreword by Professor Charlie Rapp. It is primarily aimed at developing assertive outreach, but its focus on a strengths approach is applicable to all parts of the mental health system.

Why not check it out at Amazon (or read an excellent user review from Amazon below) and Elsevier Health or click on the image for more information.

4.0 out of 5 stars 'A funky approach to mental health care' by "beauchampbooks"

"In 2000, two Swedish business gurus wrote a book called Funky Business. The concept was that the corporate world had become a more interesting place in which people could be creative, risk-taking entrepreneurs. Assertive Outreach (subtitled A strengths approach to policy and practice) could be the Funky Business of mental health care; it could almost have been called Funky Mental Health Care! This is not to suggest that it lacks seriousness or depth. The design of the book does suggest a... funkier approach, but the book is a sincere and important contribution to changing policy and practice."

"Paradoxically, in some ways, it is not particularly about assertive outreach. It is really about a strengths approach which could (and arguably should) influence mental health care generally. The Strengths Model of Case Management (developed in the USA by Charles Rapp since the early 1980s) is the organising principle of the book and, indeed, Rapp contributes a foreword which describes it as "a clarion call for policy and practice to be intelligent and coherent, and anchored by the well-being of the people we serve."

"Assertive Outreach is a breath of fresh air for nurses bogged down in the mire of risk-averse, box-ticking, mechanistic organisations. It provides a perfectly clear and comprehensive account of the history, the evidence base and the present day practice of what, in the UK, is called assertive outreach and what the differences are between this and the related concept of case management. It was a delight to see a whole chapter devoted to risk-taking (instead of risk management). Throughout, the reductionism of care coordination is put in its place with the emphasis being on creative collaboration, with excellent sections on true team-working and an argument for, not just evidence-based practice, but practice-based evidence - all necessarily funky."