CAPA (the choice and partnership approach) is one of the service delivery models recommended for CYP-IAPT, and was developed in Hertfordshire Specialist CAMHS (in conjunction with Richmond).
There are many myths about CAPA; one is that it is just a demand and capacity model for service delivery. Like most myths it has an element of truth: part of CAPA is about demand and capacity - but at its heart is a model that promotes collaborative practice and shared decision-making.
Shared decision-making is about sharing expertise and making choices in collaboration with young people and their families about the many options that present in any clinical intervention. The focus of the first ‘choice’ appointment in CAPA is to get an understanding of what a young person and family want to change – the goals of the intervention, and to share ideas about the possible choices that may lead to reaching the goals.
Once goals have been agreed they can be scored to give a base-line picture of where the family is joining the CAMHS team in their journey (goals can then be re-scored in subsequent sessions to track progress).
CAPA and its goal-focused approach gives us a clear focus right from the start; because we’re starting on the right track, and goals are agreed; we start with a better therapeutic alliance and the work tends to be quicker and with better outcomes.
In the past we focused more on deciding if young people had a mental health problem. If we felt they did, we would agree to ‘treat’ them in the way we thought best. We learnt that even with the best evidence-based intervention, unless we worked closely with, and really focused on, what young people and families wanted, the work took longer or people dropped out.
Here is what some of our young service users have said about a the use of goals:
- “Setting goals makes you see where you need to go, makes you see what you are working on and what still needs to be worked on.”
- “It’s a good way of focusing in and seeing the main issues.”
- “For me I am involved in choosing my goals, and do not feel like it was all my therapists’ idea. Obviously for people who come after me it might be useful if they could choose their goals, and feel comfortable with that goal, and how challenging it is.”
- “It makes things more manageable.”
- “I think it’s a helpful thing, but you’ll have a problem one day and it’s completely different the next so it’s kind of like is there any point dwelling on something that was a problem then and talking about something that you’re actually not bothered about any more.”
For more information please go to:
CAPA - http://www.capa.co.uk/
Goals-Based Outcomes - http://www.corc.uk.net/ and http://www.iapt.nhs.uk/silo/files/a-practical-guide-to-using-service-user-feedback--outcome-tools-.pdf
Shared Decision Making - http://www.health.org.uk/news-and-events/newsletter/shared-decision-making-clear-focus-and-shared-goals/