Practice Development in Mental Health
Listening to practitioners, and placing the resources where they can make a real impact.
'Practice Development' in Mental Health
The Practicalities
'Practice Development' requires a flexible responsive approach to the needs identified in a particular individual and team. Like most innovations, a certain amount of the challenge in the process is about working it out as you go along. Standardisation is necessary to implement the perceived wisdom of good practice from national and international research studies, but too much negates the reality of the local circumstances and constraints in which people have to operate. The trick is not to lose the important elements of the messages about effective practice in the balance of evidence and practice.
The challenges for successful implementation require the manager of the process to perform many of the following functions (not an exhaustive list):
- Being a regular presence, working alongside people, as time and consistency are essential elements in the change process.
- Supporting all functions of the team and all team members, managerial and clinical (supporting the team leader, not taking over), and providing a trusting impartial conscience and inquisitor within the team.
- Chairing meetings, to propose changes through constructive discussion e.g. implementing a strengths approach within a broadly problems-orientated culture.
- Shadowing and co-working a range of planned and unplanned interventions (assuming the roles of guide and mentor, as required); what are the aims of a specific contact? What if it doesn't go to plan? What contingency plans do you have in place? What have you learned after the event?
- Encouraging active personal reflection through a process of in vivo supervision.
- Reviewing the administrative process of care e.g. note-keeping and other forms of required documentation.
- Reviewing existing policies and procedures e.g. Care Programme Approach and risk management, defined client groups and caseload management.
- Identifying and working with resistance.
- Providing copies of relevant educational materials e.g. articles, references, clinical tools.
- Providing in vivo training that responds to the immediate needs of the individuals or teams in a client-centred way, rather than planning a series of training workshops to fulfil a pre-determined programme in a service-centred way.
- Promoting service user involvement and evaluation, as well as Practice Development Manager reports of progress and evaluation.
Steve Morgan
Practice Based Evidence
October 2001.