resources
Please take some time before the conference to refresh your foundational knowledge on
The Choice and Partnership Approach.
Where did CAPA come from?
CAPA began in two child and adolescent mental health services around 1999. Two child and adolescent psychiatrists, Ann York and Steve Kingsbury, who had known and trained together for many years, were working in services in London (Ann) and just outside (Steve). It was a time when there were very long waiting lists for access and treatment, and the skills of staff were historical, no longer matching the needs of the young people and families that needed help.
Steve's team had regular 'waiting list' blitzes to reduce the number of people waiting. However, they soon grew again. In Ann's team they looked at the literature and experiences of other services and decided, as a team, to pilot a couple of models. One worked well, with good feedback from families and staff and reduced waits and the whole service then used this model from 2000.
‘Steve and I both trained in demand and capacity modelling and began to realise why some things we had tried worked, and some things didn't. We ran a workshop for mental health psychiatrists at a national conference, introducing the concepts to others. This proved so popular people asked for a whole day of training! So this is what we did.
We wrote a framework called The 7 HELPFUL Habits of Effective CAMHS, which gathered together lots of things people could do to improve their services, based on evidence and experience. Again this was popular and eventually workshop materials became a book. In 2003, Ann's team introduced Choice appointments (then called Face2Face) following feedback from families that they needed to know more about their options and the growing evidence base of shared decision making.
Participants kept asking what Steve and I actually did in our services, how did the concepts actually work? As a result, we pulled together a description of the model and named it the Choice and Partnership Approach in 2004, updated and extended the book and Steve developed a website, capa.co.uk. The power of the internet meant that New Zealand (Christchurch) were the first service outside the UK to enquire about CAPA, and we visited and supported their implementation in 2007. And the rest is, as they say, history!
The naming was deliberate, to convey, through the power of language, an approach of collaborative, values- based practice, shared decision making and choices- organising processes around the experience of the people seeking help.
CAPA has spread internationally through word of mouth, such is the applicability of the framework to different settings, cultures, and health systems. It also spread successfully to adult mental services. The learning has meant that CAPA has continued to be refined and developed. The 11 Key Components remain, linked to the 7HH, but have been expanded and clarified as a set of principles to be operationalised locally. In England, CAPA has informed subsequent policy initiatives such as CYP IAPT and Thrive.
CAPA continues to spread around the world, with local service evaluation demonstrating a wide range of benefits.
Sadly, Steve died in 2015 but I continue to train and support teams on request. There is an active international forum, hosted by Whāraurau, book, fidelity tools, training, and website to support people capa.co.uk
When Steve and I started CAPA, we just wanted to make our services better for families to use and staff to work in. We had no idea we would end up supporting other services to do the same! The power of the components is the combining of process and cultural changes that support shared decision making, workforce development and flow management. It continues to spread because, I think, it is flexible and adaptable and grounded in things that work. Most models focus on one or two of those areas, but the combination is much more powerful.’
Ann York, January 2023
Originally written in 2019 for Werry Workforce (now Whāraurau) and updated January 2023
IWK Choice Appointment Video
English version
IWK Choice Appointment Video
French version
This conference is hosted by IWK Health and their partners with the planning support of uOttawa, Office of CPD
Office of Continuing Professional Development
Faculty of Medicine, University of Ottawa
725 Parkdale Avenue, Loeb Research Building, Room WM158, Ottawa, ON K1Y 4E9