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Describing ethical competences - caveats
• turning ethical principles into competences is a challenge:
• nonetheless competences have been described for some areas of practice
• principles are abstract and require interpretation• interpretation involves relating the principle to a
specific context • hard to specify a competence that covers all potential
contexts/ eventualities
Describing ethical competences in competence frameworks
• all modality frameworks include some reference to ethical conduct – ability to work within legal and professional guidelines– practice in relation to difference
• CAMHS framework includes much more detailed consideration
• describe – the knowledge clinicians need to draw on– the usual pattern of practice
Universal & selective
prevention programmes
Generic Therapeutic Competences
Core competences for work with children/ young people
Knowledge of development in children/young people and of family development and transitions
Knowledge of legal frameworks relating to working with children/young people
Meta competences
Meta-competences for child and adolescent work
Multi Systemic Therapy
Parent training (based on social learning theory)
Systemic family therapy for anorexia
Health promotion across settings
Problem solving and social skills training (Dinosaur school)
Functional Family therapy
CBT for OCD
CBT for depression
CBT for PTSD or other trauma related problems
IPT-A for depression
Psychodynamic therapy for depression
Self-help for a range of problems
Ability to engage and work with families, parents & carers
Knowledge and understanding of mental health problems in children/young people and adults
Knowledge of, and ability to operate within, professional and ethical guidelines
Knowledge of models of intervention, and their employment in practice
Ability to foster and maintain a good therapeutic alliance and grasp the perspective & ‘world view’ of members of the system
Ability to deal with the emotional content of sessions
Ability to manage endings and service transitions
Ability to undertake a single session assessment of service appropriateness
Ability to make use of supervision
Ability to co-ordinate casework across different agencies and/or individuals
Specific Interventions
Emotional health promotion in schools
CBT for anxiety disorders
Assessment & formulation
Ability to undertake structured behavioural observations
Ability to undertake structured cognitive, functional and developmental assessments
Interventions for challenging behaviour
Ability to assess the child’s functioning within multiple systems
Substance abuse
Ability to work with groups of children or and/or parents/carers
Ability to undertake a diagnostic assessment
Risk assessment and management
Ability to make use of measures (including monitoring of outcomes)
Ability to formulate
Ability to feedback the results of assessment and agree a treatment plan
Knowledge of psychopharmacology in child and adolescent work
Ability to work with difference (cultural competence)
Disruptive behaviour disorders (ADHD, Oppositional Defiant, early onset Conduct Disorder)
Depressive conditions
Conduct disorder
Anxiety and trauma
Anorexia
Autistic spectrum disorders
Interventions for psychosis
Ability to undertake a comprehensive assessment
Ability to work within and across agencies
Knowledge of, and ability to work with, issues of confidentiality, consent and capacity
Ability to recognise and respond to concerns about child protection
Ability to communicate with children/young people of differing ages, developmental level and background.
Ability to conduct a mental state
Specialist mental health assessments
Orange shaded boxes = additional competences that should be demonstrated by all caseholding members
of a CAMHS team
Interventions for Social Communication (Howlin et al.)
Systemic approaches
Motivational interviewing
Contingency management
Systemic therapy for depression
Behavioural interventions for sleeping problems
Engagement & communication
Professional/legal issues
Assessment & planning
Blue shaded boxes = competences that should be demonstrated by all members of a CAMHS team
Unshaded boxes = additional competences that will be demonstrated by some, but not all, members of a
CAMHS team
Problem Solving
Assessment of Alcohol & Substance Misuse
Behavioural interventions for enuresis
Behavioural interventions for encopresis
Behavioural interventions for feeding problems
Ehlers & Clark
Cohen
Education & Skills programme (Breterton et al.)
Individual therapy (Kendall)
Group therapy (Barrett)
Professional/legal issues
Knowledge of legal frameworks relating to working with children/young people
Knowledge of, and ability to operate within, professional and ethical guidelines
Knowledge of, and ability to work with, issues of confidentiality, consent and capacity
Ability to work with difference
Knowledge of legal issues relevant to working with children and young people
• draws attention to legislation in the areas of:
• capacity and informed consent• parental rights and responsibilities• participation• child protection• mental health • education• data protection• equality
Knowledge of, and ability to operate within, professional and ethical guidelines
• covers practice in the areas of:
Knowledge of, and ability to work with, issues of confidentiality, consent and capacity
• covers practice in the areas of:• knowledge of policies and legislation • knowledge of legal definitions of consent to an intervention• knowledge of capacity• knowledge of parental rights and responsibilities• ability to gain informed consent to an intervention from
children, young people and their carers• ability to draw on knowledge of confidentiality and
information sharing• ability to inform children, young people and their families
about issues of confidentiality and information sharing• ability to assess the child/young person’s capacity to
consent to information sharing• ability to share information appropriately and securely
Ability to work with difference (cultural competence)
• covers practice in the areas of:
• basic stance• knowledge of the significance for practice of specific beliefs,
practices and lifestyles • knowledge of social and cultural factors which impact on access• ability to communicate respect and valuing of children and
families • ability to gain an understanding of the experience of specific
beliefs, practices and lifestyles• ability to adapt communication • ability to employ and interpret standardised
assessments/measures • ability to adapt interventions• ability to demonstrate awareness of the effects of clinician’s own
background • ability to identify and to challenge inequality
Limitations
• competence cannot be applied by rote; requires metacompetence - ability to:
• nonetheless, competence descriptions could have a role in:
• recognise when ethical considerations apply• identify and implement ethical actions that are
contextually appropriate
• specifying a curriculum• reminding us of areas of relevant knowledge • reminding us of relevant procedures