CONSULTATION The art of communication

1. CONSULTATIONThe art of communication Primary Mental Health Regional Meeting 25th November 2011 CAMHS -Leicester

2. Key Features • Not a referral (Consultee retains responsibility for their work.) outcome is recorded as advice, or recommendations. • Is a partnership- where the expertise of the consultee are brought together with the consultant. C.f. Use of Interpreters. “The patient can not get a service without the knowledge and skills of both parties.”

3. ‘Strengths’ • Can reduce the numbers of people who assess children needlessly. • Might be the only specialist Mental Health input a child gets (due to nature of priority.) • Can offer consultee good quality ‘attention’, listening and support. • Priorities time to think about children’s needs.

4. ‘Needs’ • “We want action, not advice.” • Power differential between Consultee and Consultant. I.e. case of a Psychiatrist, who feels morally bound to take over the case, or offers recommendations, which even if disagreed with, have to be followed. • Risk assessment remains with the consultee, so advice is dependent on good assessment information.

5. Types of Consultation • Consultee directed • Telephone, email, letter (advice) • Triangular Consultation • With Patient/parent • Group consultation • Following a discipline.

6. Balint and other GP based models • Active or Attentive listening • Opening pathways- not following script. • Offers Containment- Clarity- Consensus • Safety-netting

7. Summary • Skills involved • Rapport building • Listening • Confidence building (awareness of power) • Closure and Safety-netting