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Hello, this is Tess from the teaching team.
I am trying to get in touch with groups 5 & 6 to determine who is present, and whether you have any questions regarding today's padlet.
Please can someone from these groups comment a contact number below so that I can call.
Please be aware that the number I call from may come up as 'unknown' on your phone. Thank you.

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Consider how you can empower a CYP to take their skills forward, as well as reflecting positively on their therapeutic journey and the skills they have acquired.
You could do this creatively...
...with certificates and sticker charts for primary school age children...
...or dairy logs for secondary school age young people.

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10. What to keep in mind when ending your therapeutic relationship

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10. What to keep in mind when ending your therapeutic relationship

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•Preparation is key in all therapeutic endings.

•Keep in mind the collaborative approach of low intensity working

•Your client and their caregiver(s) should be aware of the time-limited nature of treatment, and know when the final session is. Having a review session at the mid-way point through treatment will help to manage expectations, as well as considering your client's progress through treatment and whether any other actions are required in supporting their therapeutic experience (i.e. extending the treatment period; onward referral; etc.)

•Client may vocalise some apprehensions about treatment ending, this will be a good opportunity to problem solve.

The CYP perspective:

•May have positive outlook on ending.

•Client may assume that contact may go on for longer

•May not feel that they are ‘cured’ or ‘better’ - how might you discuss this perspective further with them?

•They may be unsure about ‘going it alone’.

•May feel that they are not responsible for the change which can lead to further apprehensions.

The caregiver perspective:

•There may be satisfaction with the ending of intervention – feeling input has been helpful.

•May be unsure about how to apply the techniques moving forward.

•Feeling like the difficulty is not ‘fixed’.

•Wants continued support from you.

Add any comments or anything else to consider below...

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It is important that your client is aware throughout treatment that the work which you do together will be brief and time-limited. This will allow their expectations to be managed. In engaging with low-intensity CBT, they are embarking upon a therapeutic journey during which they will learn the tools to help themselves to overcome their current challenges. They will have your support during the time you work together, but the idea is that they learn the skills to take forward themselves after treatment has ended. Ideally, this is when the sessions allocated for the intervention have finished (Sanders & Wills, 2005).

Therapeutic ending should be predictive (i.e. both you and your client should be aware of when treatment will end). However, there may be discrepancy in this.
Have a think about the following questions and put your answers on the attached padlet;

https://padlet.com/k_saville/z8yabjnxgsnr

•What difficulties can you foresee from the CYP's perspective?

•What difficulties can you foresee from the caregiver's perspective?

•

•What difficulties can you foresee from a practitioners perspective?

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8. Therapeutic ending in EMHP working... 

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8. Therapeutic ending in EMHP working... 

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What do we need to consider when coming to the end of treatment with a CYP:

•Full set of ROMS – this may include providing feedback on their scores over the duration of your sessions

•Goal tracking completion

•Completion of the intervention

•Relapse Prevention session

•Step-up/onward referral, where necessary

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Managing therapeutic endings is seen as a core competency in CBT work (Roth & Pilling, 2007)

Have a group discussion about therapeutic endings which you have experienced, both straightforward, and challenging.

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For info...

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Take a break and then it's time for your second padlet on 'Using creativity with therapeutic skills' - the link is on ELE under the folder with the same title.

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Have a go at the role play on the attached padet. Post your comments on the role play you have just done as well as the one before break.

https://padlet.com/k_saville/n10tag6e7jz5

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The marking scheme includes the use of verbal empathy. Do you know the difference between empathy and sympathy? How about reflecting, paraphrasing, and summarising?

Click on the link attached for information and an exercise on developing this skill.

https://padlet.com/k_saville/n4bzefw85pe0

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2. What do you know about common factor skills?

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2. What do you know about common factor skills?

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Common factor skills are the aspects of therapy which transcend all therapeutic approaches. Read the slides below to see what the term includes.

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In your groups discuss the experiences you have had of:

•Good therapeutic alliance

•Ruptures in the therapeutic alliance

•Complete disengagement or persistent DNAs

•How has your practice changed because of these experiences?

Add your comments on the following padlet

https://padlet.com/k_saville/hfscekmexznm

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"Welcome to this morning's padlet on developing and maintaining the therapeutic alliance, and therapeutic endings"

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"Welcome to this morning's padlet on developing and maintaining the therapeutic alliance, and therapeutic endings"

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This morning we will look at building and maintaining therapeutic alliances. It is recognised that the alliance is really important ....

"The therapeutic alliance refers to the quality and nature of the interaction between the patient and therapist" (Horvath & Bedi, 2002).
"A sound therapeutic relationship is a necessary condition for effective cognitive therapy" (Beck, 1985).

“We believe that these characteristics (warmth, accurate empathy, and genuineness) in themselves are necessary, but not sufficient to produce an optimum therapeutic effect” (Beck, Shaw, Rush, Emery, 1979).

That's what the theorists say, but how does this apply in the context of working with children, young people, and their caregivers and wider systems?

•McQueen and Smith (2012) argue that it can difficult to separate positive effects of the intervention from the effects of the therapeutic alliance in children's therapy.

•Carkhuff & Truax (1967) agree with the three factors of warmth, empathy and genuine positive regard being vital, and an explicit avoidance of criticism and blame.

•There are studies which link positive therapeutic alliance with positive outcomes with children and young people (e.g. Kazdin, et al., 2006; Karver, et al., 2008; Kendall, et al., 2009 in Gilbert and Leahy, 2017).

•TA can lead to increased trust between patient and practitioner and the adherence of the patient to an agreed management plan (Wampold, 2001).