All training placements within this training scheme have been approved for training by the Quality Assurance Group of the School of Psychiatry. All educational supervisors are required to complete appropriate training and engage in regular updates for this role.

The posts available each rotation will vary depending on the responsibilities of the consultant trainer. The following provide examples of some of the job descriptions of training posts within the scheme.

ST4-6 Training in the Southmead-based North Bristol CAMHS team with Drs Philip Shoebridge, Clare Short, Helen Stephens & Monica Potter

Role of Trainee:

The Specialty Registrar will be a member of a multi-disciplinary team providing care to children and families in an outpatient setting within the catchment area of the Bristol North CAMHS team within the North Bristol NHS Trust.  He / She will be responsible to and supervised by the Consultant Trainer one hour a week for general supervision (regular extra supervision is frequently available for other activities i.e. family therapy clinics, child psychotherapy and CBT).

Facilities:

The Department of Child & Family Psychiatry is based on the site of a large District General Hospital, Southmead Hospital.  Adequate office space and clinical facilities are available including the use of a one way screen for training and family therapy.  The Department has personal panic alarms for security purposes.  A mobile phone is available for lone working away from the department.  Southmead Hospital has excellent information technology, library and post-graduate facilities.

Population Served:

The catchment area of the Bristol North CAMHS team has a population of approximately 35,000 0-18 year old children, 9.3% of whom are likely to suffer from a mental health disorder at any one time (ONS 1999).  It is a predominately urban catchment area encompassing areas of affluence, social deprivation and mixed ethnicity. The Southmead based CAMH team covers the North area of Bristol.

Details of Multi-Disciplinary Team:

There are three 0.6 WTE Consultant Child and Adolescent Psychiatrists providing a service within this catchment area, Dr Stephens, Dr Short and Dr Shoebridge.

2.0 WTE Family Therapists (3 staff).  1.3  WTE Community Psychiatric Nurses.  0.8 WTE Occupational Therapist.  1.1 WTE Child Psychotherapists.  2.7 WTE psychologists (3 staff). 3.2 WTE Primary Mental Health Specialists (infant, primary school aged and secondary school aged)  1.0 WTE CT2s and 1.0 WTE ST4-6 in Child Psychiatry. 

Opportunities for Teaching Others:

Medical students visit the department each academic term and there are also opportunities to teach disciplines allied to Child Psychiatry.  Supervision and teaching of medical students and our CT-2 trainee is available for senior trainees if this is a training goal.  Training Tier-1 professionals in CAMHS related issues happens regularly.

Specific Features that might be of particular interest to trainees:

There are 2 regular Family therapy training clinic a week with reflecting teams.  Two colleagues are trained in EMDR. A Specialist Out-patient Eating Disorders Team (SOEDs) meets fortnightly. There are multidisciplinary complex case ADHD clinics every other month.  There are MDT small group case discussions fortnightly and CPD/case presentation opportunities for the whole team.  The AWP adult academic meetings are on site and are open to the senior trainee.  Our senior Psychologist is lead for the regional IAPT provision.  Social work liaison meetings occur monthly.

The service has developed special expertise addressing the needs of Looked After Children, Children on the Autistic Spectrum, Parent Management Training (Webster-Stratton programmes), Child Protection/Child In Need forum, CBT approaches, Words and Pictures work, Story-Stem attachment assessments and Eating Disorders.  There are links with the paediatric learning disability service.  Our infant mental health specialists have links with the local adult MN on site inpatient Mother and Baby unit.

All 4 consultants are approved trainers for ST4-6 trainees.

Dr Shoebridge has research experience, publications, and special interests in Cognitive Behaviour Therapy, and Parent Management Training.  He has specialist skills in the assessment of attachment in 4-9 yr old children and clinical applications of Attachment Theory, ADHD (he runs a combined Complex ADHD clinic with paediatricians), Clinical Evaluation, Evidence Based Practice and Group Parent Support Programmes. He works an additional 3sessions in a Tier-3+ day-patient provision for 5-12 year olds.

Dr Helen Stephens has particular interests in ASD, Eating Disorders, management, and complex adolescent mental health presentations.  She has a once a month joint clinic with paediatricians. 

Dr Clare Short has interests in teaching and training, Eating Disorders, models of joint working, out-reach work, sleep disorders and Liaison Psychiatry.

Dr. Monica Potter 

 

Base

South Bristol Child and Adolescent Mental Health Service, Knowle Clinic (Dr Melanie Merricks) and Osprey Court (Dr Monica Potter)

Trust

North Bristol NHS Trust (Children’s Community Health Partnership

On Call

1:6 for F/T ST’s. CT’s on adult trust rotas.

Team size and multiprofessional mix

Approx 13 WTE at present, 1.6 consultant psychiatry. Full range of professions represented (psychiatry, psychology, nursing, psychotherapy, OT, family therapy, PMHS)

Brief description of what the working week here entails / possible time table.

Monday: Clinics or admin

Tuesday: Clinics including choice and LAC or admin

Wednesday: Team meeting and Team family therapy clinic

Thursday: Clinics/special interest sessions

Friday: Academic programme/research/audit

The team is divided across two sites (Knowle and Osprey) with each sub-team functioning to some degree separately although with single referral intake process. Families have some choice about which clinic site to attend. Most professionals are represented in both sites (except OT).

Both sub-teams see the full range of problems and offer specialist psychiatry assessments and interventions.

The team operates to a CAPA model which has functioned very effectively since 2007.

There is a broad range of training opportunities which can be tailored to a trainees learning objectives.

Special interests and clinics

Research possibilities

Family therapy training clinic, LAC and complex needs clinic.

There are opportunities to undertake regular consultation to social services teams and/or community paediatricians.

There are opportunities to join PMHS for pre-school children to observe and take part in specialist infant/mother attachment interventions.

Research support is available and research time will be fully supported.

Psychotherapy

Family therapy is a strength of this placement with an established training clinic running weekly at Knowle clinic.

There is a joint CAMHS/AMHS family therapy clinic (Monday afternoons) run by staff from the CAMHS and colleagues from South Area Adult Team.

The team has a strength in psychodynamic psychotherapy with a number of child psychotherapists who can offer expert supervision to trainees.

CBT experience and supervision can also be offered with an IAPT registered supervisor.

Limitations and Difficulties

The split over two sites can be a challenge for all the team. Trainees are predominantly based at one of the two sites and will carry out the majority of their clinical work on that site.

Room booking is operated by the admin team, but rooms can be limited some days of the week.

Groups of children not catered for?

Children with moderate to severe LD.

Facilities

Own desk in shared office. In Knowle Clinic office is shared with other trainees (ST and CT, psychology and psychotherapy). At Osprey Court, office is shared with other multi-disciplinary colleagues.

Admin support

Admin team support all the team. No named secretaries. Admin team are excellent and supportive of all team members including trainees.

Supervision

One hour weekly.

Changes afoot?

Service re-design is currently being considered (likely 2 year timescale).

Which trainee level?

ST and CT

Other comments

 

 

 

Base

Specialist Service for Children with Learning Disability, Westgate House, Southmead Hospital

Trust

North Bristol NHS  Trust

On Call

Out of hours CAMHS on call rota 1 in 6 for full timers, banding 50%, 1 in 12 for part-timers (40%).

Team size and multiprofessional mix

Bristol Specialist Service for Children with Learning Disabilities provides a community based service for the psychiatric assessment, treatment and continuing care of children and young people aged 0 to 18 with moderate, severe and profound learning disability and emotional and behavioural and mental health problems within the Bristol PCT area

The multidisciplinary team consists of medical secretary and admin; Consultant Psychiatrist; Clinical Psychologists; Community Learning Disability Nurses; Support Workers. The team’s office base is in Westgate House in Southmead Hospital but clinicians work in the community in schools, local clinics and in homes. This post is located alongside Dr Toni Hovey in Westgate House. The team has access to Art’s Therapy Services for people with Learning Disability. Multiagency working with Bristol Children and Young Peoples Services (Education, Disabled Children’s Team and Transitions Team) is a substantial aspect of the teams work

Brief description of what the working week here entails / possible time table.

There are team meetings on the second and fourth Wednesdays mornings of the month for multidisciplinary clinical case discussion. Allocation of referrals to the team is done weekly on Wednesday monrings. There are also service development/business meetings monthly on the first Wednesday of the month. Allocation of cases to trainees is led by the trainee and trainer jointly in parallel to the trainee’s learning objectives. There are opportunities to undertake comprehensive initial assessments and on-going management of complex cases where challenging behaviour presents in the context of significant learning disabilities, neurodevelopmental problems and often physical health problems such as epilepsy. There are also opportunities for assessment of neurodevelopmental difficulties in young people with learning disabilities alongside psychiatric assessment and treatment of psychological disturbances leading to challenging behaviour or other presentations suggestive of mental illness.  The Nursing Team has significant expertise in behavioural management strategies and there is ample opportunity to observe and join them at work during behavioural analysis and development of management strategies.  Similarly there are joint working opportunities with psychologists’ including observation of ADOS assessments as well as their individual work with patients.

Special interests and clinics

Special interest opportunities include sessions in community and developmental /neuro-disability paediatrics, paediatric neurology and genetics. There are also opportunities to work with members of the team delivering Parenting Programmes; Positive Behaviour Support Service for children with challenging behaviour; family work clinics and in early 2014 a specialist sleep clinic will be up and running in SSCLD along with a Circle of Security parenting group looking particularly at attachment difficulties. There are also opportunities to attend the Complex Needs Group, a monthly multiagency consultation group providing highly challenging cases with a more focused direction.  There is also an active Service User Participation Group for SSCLD.

Psychotherapy

Behavioural Analysis and Management Strategies as well as consultations to young peoples’ professional network (multi-systemic working) are the main therapeutic interventions that are different to generic CAMHS experiences and easily available. Opportunities to consult with Arts Therapists (Art, Music and Drama) in working with a child.

Limitations and Difficulties

The trainee has to share an office with psychologists and admin staff but they have a desk and a computer. Parking is a challenge but is manageable, occasional user and community worker parking permits can be applied for though space not guaranteed.

Difficult to achieve forensic LD competencies due to the service not seeing mild LD – fewer forensic cases in the more severe LD groups

Groups of children not catered for?

 No Mild LD as these are under the care of tier 3 CAMHS,  scarcely under 5

Facilities

Nice, bright room, own desk and storage draw in filing cabinet , library nearby

Admin support

Excellent

Supervision

Regular supervision every week.  Needs of Trainee of paramount importance

Changes afoot?

The team will be integrated into a new Disabled Children and Young Adults service by September 2014 with integration with children and young people’s services

Which trainee level?

Better for ST5/ ST6 after doing a bread and butter community CAMHS job

Other comments

Opportunities to join nurse and psychologist colleagues and observing their individual creative techniques

 

Base

Swindon Camhs and Marlborough Camhs

Trust

Oxford health

On call

1:14 for WTE st4-6 with RMN, manager and consultant team

Team size and multi-professional mix

Approx10 WTE ( 1.8 Consultant Psychiatrists). Full range of professions represented (psychiatry, psychology, nursing, psychotherapy, family therapy, PMHW). Osca team on site and adolescent unit

Demographics

The service serves a local population of 200,000 in Swindon and about 100,000  for East Wilts from separate Marlborough Camhs team at Savernake Hospital

Special interests and clinics

Research possibilities

Specific opportunities related to both Swindon and Marlborough includes neuro-developmental assessment intervention consultation working both with Dr Woodhouse and Edwina Draper currently Clinical Lead for neurodevelopmental disorders for Wiltshire, Swindon and BANES.  Community clinics in both settings offer the opportunity of psychotherapy, CBT, family therapy.

Swindon OSCA also includes an opportunity to undertake liaison e.g YOT, LAC with other agencies, emergency assessment and join with the teams DBT programme. Dr Combe is the consultant with OSCA

Joint work with the LD CAMHS Service based at the Salt Way Centre in Swindon (Consultant Dr Mahal) is also available.  Management opportunities are available both in terms of shadowing and project work with the current Clinical Director, Dr Woodhouse. 

Tier 2 CAMHS work in Swindon traditionally has strong links and led to the development of Children’s Fund and Targeted Mental Health in Schools projects with other partners.  Multi-agency links are maintained to enable higher trainees to have experience within Tier 2.  Proximity to the Adolescent In-patient Unit allows a whole systems approach and care of a young person through all Tiers of the CAMHS pathway.        

Eating disorder clinics( DR Norman) are also available with multidisplinary team, parents groups, multifamily group programme etc.  Teaching opportunities of CAMHS multi-disciplinary team and opportunity to teach medical a students from Bristol University placed with the Paediatricians. Paediatric liaison opportunities are available (Dr Woodhouse, Paediatric Oncology Clinic)

Psychotherapy

Family therapy, CBT and Child Psychotherapy are strengths of this placement. Provision of supervision by child psychotherapists

CBT experience and supervision also available. Opportunities to participate in Parenting educational programmes are possible with osca team

Facilities

Own desk, computer access, in office shared with other trainees (including psychiatry, psychotherapy and psychology).

Admin support

Admin. team support

Teaching

Medical students visit the department each academic term and there are also opportunities to teach disciplines allied to Child Psychiatry. Opportunities to deliver formal lecture to Year 3 and 4 medical students. Supervision and teaching of the CT trainees may be available.

Supervision

Weekly supervision

Management Experience

Within team and within the division, opportunities are extensive. Dr Woodhouse is clinical director for the area

 

Base

Acorn House

Trust

2gether NHS Foundation Trust

On call

1: 30 for F/T ST4-6.

Team size and multi-professional mix

Approx 7.7 WTE (plus 1.8 Consultant Psychiatrists). Full range of professions represented (psychiatry, psychology, nursing, psychotherapy, family therapy, PMHW)

Demographics

The service serves a local population of 211,400 from Gloucester/Forest of Dean. Gloucestershire Children and Young People Service (CYPS) provide a service for 0-18th birthday in line with the Children’s NSF. This service is offering consultant psychiatric input consistent with the College recommended norms and .The socio-demographic mix that the service covers has 2 circumscribed local communities. It has areas of significant social deprivation (inner city Gloucester and remote and isolated areas of the Forest of Dean)

Special interests and clinics

Research possibilities

Early Intervention in Psychosis Team (Dr Gowda). Regular Specialist outpatient’s neuro-developmental service (Dr Suki) with opportunities to carry our complex assessments involving autistic spectrum disorder , Dyspraxia Attention Motor Perception (DAMP), ADHD, specific learning difficulties, etc. There are specialist clinics for Eating Disorders (Dr Owen) and a Looked After Children service. There are opportunities to undertake regular consultation to social services teams and/or community paediatricians. There are opportunities to join PMHW, local Sure Start Initiatives to observe infant/mother interactions. Research time will be fully supported (Thursdays mornings and alternative Fridays).

Psychotherapy

Family therapy, CBT and Child Psychotherapy are strengths of this placement. Provision of supervision by child psychotherapists

CBT experience and supervision also available. Opportunities to participate in Parenting educational programmes are possible with PMHWs.

Facilities

Own desk in office shared with other trainees (including psychiatry, psychotherapy and psychology).

Admin support

Admin. team support provided by one member of staff. Admin. team are excellent and supportive.

Teaching

Medical students visit the department each academic term and there are also opportunities to teach disciplines allied to Child Psychiatry. Opportunities to deliver formal lecture to Year 3 and 4 medical students. Supervision and teaching of the CT trainees would be available.

Supervision

Dr Gowda is available for clinical supervision on Mon and Wed (and Tues if he ST wishes to gain experience in Early Intervention in Psychosis.

Educational Supervision slot is weekly on Wednesday at 11am. Consultant meetings on Wed afternoon incorporate opportunities for peer supervision of complex cases.

Management Experience

Team Chairing on Wed mornings. There are regular meetings with operational managers of CYPS on wed afternoons (consultant meetings)

 

Base

Temple House, BANES OSCA (Outreach Service for Children and Adolescents)

Trust

Oxfordhealth NHS Foundation Trust

On Call

1 in 14, band 1c (20%). Have to cover Salisbury, Swindon and Bath but Trust will pay taxis. Presently most on call shifts are very quiet. Dr Rayner has only had to visit Salisbury once in the last 4 years.

Team size and multiprofessional mix

The OSCA Team consists of approximately 15 healthcare professionals working at both Tier 2 and 3 level.  Dr Rayner is the Consultant for the team, the team manager has nursing background, there is a Psychologist and the Senior mental health practitioners have SW, OT, parenting and therapist backgrounds.

Brief description of what the working week here entails / possible time table.

There is a team meetings on Monday 9am Work is flexible and can involve: assessment of mood, assessment for medication, assessment of psychotic symptoms, urgent assessment for admission. There is an emphasis on engagement, and there are lots of opportunities to do therapeutic work (CBT, motivational, family work etc) 1:1 or by joint working with other team members.  There is crisis support work in families’ houses including support to clients from the eating disorder clinic.  The team runs groups for adolescents that trainees can join.  There is a DBT service. The team also covers the RUH daily Self Harm referrals.

Special interests and clinics

Because this base also houses the BANES CAMHS team there are opportunities to work in the family therapy and eating disorder clinic.  Dr Rayner does one session a week of inreach work in Ashfield young offenders institution. The OSCA team has links with the YOT.  There is a neuro developmental clinic lead by Dr Cribb which offers ADOS and ADi assessments.  Dr Daddow does LD work for the BANES and Wiltshire CAMHS LD team.   There are also links with keepsafe work (the specialist service for children with harmful sexual behaviour)The FASS team are based in Keynsham and provide an opportunity to  learn about multi disciplinary team family court reports.

Psychotherapy

BANES CAMHS have:

Family Therapy clinic running once a week

Psychodynamic Psychotherapist willing to supervise long term 1:1 work

Several psychologists offering CBT supervision

Whether these are available in this job will depend on how many trainees there are on site, and supervisors’ workload

2 OSCA team members are DBT trained

Limitations and Difficulties

Some trainees have struggled with RIO the computerised notes system.

Groups of children not catered for?

There is less work with younger children in OSCA currently but I believe the team will expand to include some under 5s workers and already has a parenting advisor.

In the Bath area most ADHD and ASD are diagnosed and managed by paediatricians

Facilities

Own desk space and computer . Near shops. You are able to borrow an ipad which you can also use for personal activities.

Admin support

Fantastic

Supervision

Dr Rayner ensures supervision is organised every week.  It is relaxed, informal and extremely supportive.

Changes afoot

 

Which trainee level?

Any training level

Other comments

The OSCA team is informed of all sorts of training courses, some of which are free. Thoroughly recommended as placement.  Very skilled and energetic team; a rich and diverse set of people to work with.

 

Base

Monks Park House , Southmead Hospital

Trust

Avon and Wiltshire Partnership NHS Trust

(Children’s Community Health Partnership – CCHP)

On call

1:6 for Full time ST4-6

 

Team size and multiprofessional mix

Approximately 9 WTE at present. 1.3 WTE Consultant Child and Adolescent Psychiatrists. Full range of professions represented (psychiatry, psychology, nursing, psychotherapy, family therapy, PMHS).

The team has considerable expertise in training: there is a higher specialist trainee in C&A psychiatry and a core trainee in psychiatry, trainees in child psychotherapy and a training placement for student mental health nurses.

 

 

 

 

Demographics

The service serves a local population of children from North Bristol for 0-18th birthday. This teaching hospital service is offering extensive experience in the speciality of Child and Adolescent Psychiatry. The socio-demographic mix that the service covers is diverse with areas of significant social deprivation, for example Southmead, Lawrence Weston and less deprived areas such as Clifton/Redland.

 

Special interests and clinics

Research possibilities

Family therapy training clinic, LAC and multidisciplinary complex case consultation clinic. Complex ADHD clinic and opportunities to carry out complex ASC assessments. The team offers opportunities to train in the Specialist Eating Disorder clinic and experience in working with the evidence based Family-based treatment Maudsley Approach with eating disorder cases.

 

Opportunity for Joint working with Community Paediatricians and opportunity to attend Paediatric liaison meetings.

 

There are opportunities to undertake regular consultation to social services teams and/or community paediatricians.

There are opportunities to join PMHS for pre-school children and to observe and take part in specialist infant/mother attachment interventions.

 

There are a wide range of opportunities to work alongside multi-disciplinary colleagues in the hospital and in the community.

 

Non-clinical special interest time, including for research is fully supported.

 

 

 

Psychotherapy

There are opportunities for training in all therapies with supervision from experts in family therapy, psycho-dynamic psychotherapy and CBT.

 

Opportunities to work in the Specialist Family Therapy training clinic.  

 

Facilities

Own desk and computer in office shared with other members of the multidisciplinary team.  Clinical rooms are bookable in the department.

 

Admin support

 Admin team are excellent and supportive and are available for all aspects of the trainees work.

 

Teaching

 

 

 

 

 

 

 

Supervision

 

 

 

 

 

 

 

 

 

 

 

 

 

Management

Medical students visit the department each academic term and there are also opportunities to teach disciplines allied to Child Psychiatry. Opportunities to deliver formal lecture to Year 3 and 4 medical students. Supervision and teaching of the CT trainees would be available. 

 

Educational supervision slot is weekly on Wednesdays for one hour.   Team meetings occur on Wednesday mornings provides opportunity for case reflection and multidisciplinary discussion of cases.  Quarterly peer group supervision for on-call work. 

Clinical supervision and advice is available from any member of the multidisciplinary team and from the covering Consultant Child and Adolescent Psychiatrist when the Educational supervisor is on leave.

 

Opportunity for chairing of team meeting.  Clinical governance experience including Audit.  Opportunity to attend the monthly (Team Leadership Group) meetings and monthly CAPA lead meetings,  service transformation processes (ED services), and multiagency meetings.  

There are opportunities to be involved in service evaluation and service development.

 

Monthly CPD meetings in the team meeting time.

Timetable for Advanced Trainee

Day

 

Activity

Mon

Am

Non-clinical special interest

 

Pm

Non-clinical special interest

Tues

Am

Clinical special interest

 

Pm

Clinical special interest

Weds

Am

Team Meeting 9.30-11 / Case discussion/CPD

12.00 -1pm monthly Paediatric Liaison meeting

12.00- 1pm monthly Senior Leadership Group meeting

 

Pm

13.00 -14.00 1 hr supervision with Educational Supervisor

14.00-15.00 Weekly Eating Disorder team meeting

ED Team clinic

Thurs

Am

Clinic

 

Pm

Clinic/ Admin time

Fri

Am

Regional advanced trainee academic programme/clinical time

 

 

Pm

Regional advanced trainee academic programme/clinical time

 

 

Base

The Kingswood Hub. Kingswood. Bristol BS15 4DA

Trust

Avon and Wiltshire Partnership NHS Trust

(Children’s Community Health Partnership – CCHP)

On Call

1:6 for F/T trainee

Team size and multiprofessional mix

Approx 11.0 WTE at present, 2.4 WTE Consultant Child Psychiatrists. MDTeam consists of 2 Consultant Nurses, Band 8 and 7 psychologists, family therapists, an extensive PMHS team and psychotherapists.  The service has been recently invested in by SG commissioners with 3 new appointments due to start.

Training opportunities

This team provides a comprehensive range of CAMHS interventions across all 3 Tiers of CAMHS and on a case by case basis liaises with Tier-4 interventions.

There are a wide range of opportunities to work alongside multi-disciplinary colleagues to undertake assessments both in the hospital and in the community, to deliver short term and longer-term interventions and contribute to all the specialist teams.  

Management experience is available for locality team management (Team Leadership Group), service transformation processes (ED services), and multiagency forums.

There are opportunities to be involved in service evaluation and to take a role in the on-going development of the service (management and leadership opportunities in service development and evaluation).

 

Monthly CPD meetings. Team away days offering presentational opportunities.

Special interests and clinics

Active specialist CBT clinic, Complex Case Clinic (for cases stuck and or needing multi professional perspectives and reformulation), Specialist ED clinic, Paediatric liaison meetings and new Complex Psychosocial and Neurodisability Clinic (just being set up), Specialist Family Therapy Clinic, , Complex ASC clinic, Specialist LAC service, Nurse-prescriber clinics, well integrated PMHS service in several LA teams offering CAMHS consultation (FYPS and Education).

Research possibilities

Non-clinical special interest time, including for research is fully supported.

Psychotherapy

There is a senior Psychotherapist, Mick Wood (recently seconded with back fill by Rachel Pardoe).  The Educational Supervisor will arrange psychotherapy experience to meet the learning objectives of the trainee.

Limitations and Difficulties

There are challenges in working in an open plan office, though this is increasingly the trend for office provision in medicine generally.

Groups of children not catered for?

Children with moderate to severe LD.

Facilities

Desk space and computer access in office shared by all of the team. There is a lockable cabinet available for trainees use.

Admin support

Admin support is available for all aspects of the trainees work, from the admin team.

Supervision

One hour weekly.

Changes afoot?

The service is part of CCHP, and has moved to an interim provider (AWP) for one year from April 2016 with the prospect of a 5-7 year contract being actively bid for currently (April 2016) being recommissioned, with a new provider to start in April 2017.

Which trainee level?

ST4/5/6

Other comments

 

 

Monday

Tuesday

Wednesday

Thursday

Friday

Non-Clinical special interest time

9.30  – 11 Team Meetings. Case discussion / CPD / Letting go.

11.00  Psychiatric allocation meeting.

12.00 supervision with educational supervisor

Clinical time

 

TLG fortnightly 11.00-12.30

Or LAC Clinic

Clinical special interest session

Academic programme/clinical time

Non-Clinical special interest time

ED Team Clinic

Or Trainer’s O/Pt clinic

Paeds liaison meeting 2-3pm once a month

Clinical time

Clinical special interest session

Academic programme/clinical time

 

Base

Riverside Adolescent Unit - Tier 4 Adolescent Mental Health Unit

Trust

Avon and Wiltshire Partnership NHS Mental Health Trust

On Call

1:6 for F/T trainee

Team size and multi-professional mix

The team comprises:

  • two consultant psychiatrists (0.6 and 0.8 WTE)
  • a full time specialty doctor
  • a consultant psychologist (0.8 WTE)
  • two Family therapists (both 0.6 WTE)
  • OT (0.6 WTE)
  • and a team of very experienced and dynamic nursing colleagues

Brief description of what the working week here entails / possible timetable.

The Unit is commissioned by NHS England, and we are overseen by the South west arm of the NHS England commissioning body.  A local case manager is attached to the unit, and works alongside the team to look at bed use and transfer of patients when indicated.

 

The unit provides in-patient and day patient care to 16 young people.  Most of the young people are from Bristol, North Somerset and South Gloucestershire, but sometimes young people from other areas are admitted.

 

We see a wide range of severe, complex and risky psychiatric presentations, including eating disorders, psychosis, severe anxiety and mood disorders, including emotional dysregulation associated with severe attachment trauma.

 

There are opportunities to work alongside multi-disciplinary colleagues to undertake assessments both in the hospital and in the community.

 

The Unit runs a regular group programme (including DBT based skills groups) so there are opportunities to work alongside colleagues to develop skills in group-based therapy.

 

Work with parents and carers is an integral part of the Unit, and regular parent support and Non-Violent Resistance groups are run for the parents of the young people attending the Unit.

 

There is an expectation to case manage young people, and be involved in comprehensive assessment, formulation, delivery of both individual work and Family Therapy and advance knowledge and experience in medication management of complex conditions and acutely disturbed behaviour. There will be ample opportunities to develop skills in risk assessment and management.

Special interests and clinics

 

Research possibilities

There are opportunities to develop skills in the use of the MHA in young people and learn about the interactions between the MHA, Mental Capacity Act and the Children’s Act, and to arrange emergency admissions to psychiatric units, both specialist and generic.

 

A wide range of presentations are seen, so there are opportunities to be involved in assessments in many different situations.

 

There are opportunities to develop a range of therapeutic competencies including in CBT and CBT for Trauma supervised by the Consultant Psychologist who is an accredited trainer.

 

There are opportunities to be involved in service evaluation and to take a role in the on-going development of the service (management and leadership opportunities in service development and evaluation).

 

Non-clinical special interest time, including for research is fully supported.

 

The trainer sits on the Children’s Hospital Mental Health Operational Group which is a multiagency group working to improve the care and experience of children and young people with mental health presentations admitted to the hospital.

 

The trainer has direct relationships with the commissioners of the service as well as senior management within the provider organization affording ample opportunities to develop leadership and management competencies.

Psychotherapy

The team does not currently contain a psychotherapist, limiting the opportunities for specific psychotherapy experience.  The unit as a whole, however is based on Therapeutic Community Theory which in turn is based in psychodynamic and systemic theory. These are explored by an external psychodynamic group psychotherapist in the Reflective Practice Group.

 

There is a weekly dance therapy group where the trainee may be able to work alongside the group therapist.

 

The Educational Supervisor will support access to psychotherapy experience to meet the learning objectives of the trainee if required.

Limitations and Difficulties

Driving license and access to a car are useful, as some clinical time is spent undertaking joint assessments in the community.  However, this is not a requirement, and the Unit has easy access to public transport.

Groups of children not catered for?

Children under 13.

 

Children and young people with moderate or severe learning difficulties or Autism as the sole mental health diagnosis.

Facilities

Desk space and computer access in office shared with 2 other members of the non-nursing team.  There is a lockable cabinet available for trainees use.

Admin support

Admin support is available for all aspects of the trainee’s work, from the Riverside Unit admin team.

Supervision

One hour weekly.

Changes afoot?

The service is undergoing a re-procurement process which may lead to a change of provider from April 2017.

Which trainee level?

ST – recommended 5 or above

Other comments