Delivery of psychological therapies and interventions: national specification
SOCIAL WORK SCOTLAND RESPONSE
Social Work Scotland is the professional body for social work leaders, working closely with our partners to shape policy and practice, and improve the quality and experience of social services. We welcome this opportunity to comment on the consultation to inform the national specification for the delivery of psychological therapies and interventions.
The social work workforce landscape is vast, with workers in adult’s services, children and families services, and Justice services assessing for and delivering services to people with learning disabilities, those with mental health challenges, and those who have experienced trauma or the impact of substance use, to name but a few areas Individuals may live in their own homes, in care home settings, in the case of children, in kinship or foster care settings, and in Justice, custodial settings. In all of these settings and with all of the service user groups, social workers, and their colleagues employed in social work settings are heavily involved in delivering psychological support.
It is with this lens that Social Work Scotland provides a response to the consultation. In order to avoid repetition, and to support reading, we have provided a covering statement for each of the “Parts”.
Part 1: Questions on the overall Specification document
Without a baseline assessment to provide evidence for understanding people’s experience of accessing psychological therapies and interventions, it is difficult to say whether the specification will provide improvement. However, we would note our support for clear and concise information that supports an understanding of standard expectations of service delivery by individuals accessing services, and those working within them. We are also pleased to note the reference to other frameworks such as the Health & Social Care Standards throughout the document and would emphasise the importance of a “read across” these various documents which will support a true whole system approach to improving peoples experience of accessing support. The Standards would benefit from an explicit link to the Equality Act
Part 2: Questions on the specific outcomes
We would note our support for clear and concise information to support an understanding of standard expectations of service delivery by individuals accessing services, and those working within them. This is in line with other developments such as the Health and Social Care Standards1 , The Quality Principles: Standard Expectations of Care and Support in Drug and Alcohol Services2 (recently updated by the Medication Assisted Treatment (MAT) Standards3 and the forthcoming Standards for Mental Health services.
However, the existence of Standards alone is unlikely to be responsible for an improvement in the outcomes of people accessing and using psychological therapies and interventions. Improvement in outcomes is deeply subjective but can be reasonably associated with social connections; housing circumstances and the cost of living impact for most individuals. Coupled with this, from a service perspective, appropriate levels of resource, including workforce, and community assets, is required to support individuals to achieve their outcomes.
Part 3: Implementation and measurement
Social Work Scotland welcomes the connection made within the consultation document to other Scottish Government led policy and strategic initiatives such as the forthcoming Mental Health Quality Standards. In seeking to implement the Specification across multiple workforces, it is important to first understand the landscape in which they are practicing.
To effectively change and improve services, the drafting of legislation, policy and guidance alone is not enough. To truly create change and embed it within practice, implementation requires to be carefully planned and managed, and given similar level of attention.
Implementation Science facilitates the identification of the key components necessary to develop and improve the ability to implement innovations in practice, as well as how to create an enabling context for the new ways of working to be sustainable. It posits that skills-based training is essential, and that this must be supported by a coaching approach. From a social work perspective, this is best supported by good quality professional supervision.
If the aim is consistent national delivery as outlined – then training, and refresher training which is timely and trauma informed is essential, as is the monitoring of standards to ensure that there is consistency of delivery across the country. In addition, consideration should be given to the fact that the physical venues should be psychologically informed environments (PIE) which is conducive to the complexity of the work. This is particularly relevant to those living and working in custodial settings. For children, consideration of child friendly and trauma informed environments based on sound evidence – such as that underpinning the Barnahus model – is critical
51.How far do you agree that the specification should be measured using a validated self-assessment tool?
52.How far do you agree that the specification should be measured using a range of indicators?