Letting Go Components

9. Goal Setting and Care Plans [CAPACITY ITEM]

The service works with service users’ goals using care planning. There are regular reviews that clarify the service user’s preferences and choices. This starts in the first contact / the initial Choice appointment and continues throughout the whole contact with the service. May involve frequent routine outcome monitoring.

It is vital to spend time working out goals that are achievable and measurable that fit with the formulation. Doing this improves therapeutic and task alliance and the effectiveness of the experience for the service user. Read the Philosophy article in the Choice chapter for more information. Goals need to include how the client is going to manage the issues themselves. What resources have they got? Can extended family help?

If you don’t set goals and use Care Plans work be- comes unfocussed; clients and clinicians are not clear about what they are both working towards. Things drift. People may be seen for longer than needed. Flow through the whole system for all service users is impeded.

See Letting Go article in Chapter 5: Partnership.

10. Peer Group Discussion [CAPACITY ITEM]

The service has systems for weekly small group multi-disciplinary discussion (no more than 4 staff) to consider on-going work. This is a “letting go” task as well as developing a learning culture across many clinical competencies. This is NOT the MDT or individual supervision, but may be in addition to these.

You can either do this with different people each time (which Steve’s team likes) or have stable groups (Ann’s team). There are pro’s and con’s to each - do what works for you. This is in addition to any whole team discussion or individual supervision.

Regular Peer group discussion increases your capacity, much in the way that effective Goal Setting and Care Plans (Item 9) does. The more you work in focus and reflect on your skills and work etc. the more effective and shorter the work will be. Service users will be helped and staff will feel less stuck. There are lots of other positives to this small group discussion. It furthers cultural change, creates a learning culture and massively increases team support and relationships. So if you don’t have this, discuss in the CAPA leadership team how to start… mandated, pilot with enthusiastic peer group?