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The Core Study

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Item 22

Prioritising good therapeutic relationships

Target

a) Recruitment involves procedures explicitly designed to identify staff with good interpersonal skills when working with service users.

b) The CRT takes steps to monitor and develop all CRT staff's interpersonal skills with service users and families.

c) The CRT explicitly seeks feedback from service users (e.g. via survey or audit) within the last year and demonstrates action to address resulting concerns and complaints.

d) There is all source agreement that staff are caring and professional in working with service users and families.

Why this is important

Good therapeutic relationships between staff and service users are important for the success of all mental health interventions. There are particular challenges to developing these good relationships in a CRT crisis context, where staff change from shift to shift and treatment is only for a brief period. Mechanisms to promote staff's engagement with service users and listen to positive and negative feedback can help

Ways of doing this well

Several services have shared ideas about how to improve therapeutic relationships with service users.

Recruitment

West Kent CRHT have a whole day interview process with group and individual sessions, and include service users and carers on their interview panel. The document below describes how this approach works and the beneficial impact it has had on recruitment:

Brighton and Hove CRHT use the following interview questions when they interview for Band 5 staff.

For Band 6 roles they ask candidates to prepare a 15 minute presentation based on a case study, and ask similar interview questions.

Service user feedback

Edinburgh Intensive Home Treatment Team provide a service user satisfaction questionnaire to service users being discharged from the team.

Caring and professional staff

To encourage staff to think about how they interact with service users, the Barking HTT uses their Trust's Staff Charter, which sets out the values and behaviour they expect of staff.

Field mentoring

Senior members of staff in the CRT can sometimes provide the most effective guidance to more junior staff members by accompanying them on visits and providing constructive feedback on how the staff members worked with service users. This can allow a focus on the actual behaviour of the staff member and their ability to develop good therapeutic relationships.

Examples of good practice

In our fidelity review survey of 75 crisis teams in 2014, the following teams achieved excellent model fidelity, and can be contacted for advice about how they achieved this:

  • Surrey Heath HTT (Frimley), Surrey and Borders Partnership NHS Foundation Trust
  • Tower Hamlets HTT, East London NHS Foundation Trust
  • Redbridge HTT, North East London NHS Foundation Trust
  • Walsall CRT, Dudley and Walsall Mental Health Partnership NHS Trust