additional unit 2: child and adolescent mental health services (camhs) care and treatment planning

7/27/2019 Additional Unit 2: Child and Adolescent Mental Health Services (CAMHS) care and treatment planning

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Uned Ychwanegol 2: Cynllunio Gofal

a Thriniaeth Gwasanaethau Iechyd

Meddwl Plant a Phobl Ifanc (CAMHS)

Additional Unit 2: Child and

Adolescent Mental Health Services

(CAMHS) care and treatment planning


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Digital ISBN 978 0 7504 7886 1

Hawlfraint y goron/Crown copyright 2012

WG15036

2

Ysgriennwch eich nodiadau yma:


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Additional Unit 2: Child and Adolescent Mental Health Services


Write your notes here:


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Training hours associated with this module = 3 hours 25 minutes.

Aims o the unit:

1. To enhance the participants understanding o the Mental Health (Wales) Measure 2010 with

an emphasis placed on the care and treatment planning process within secondary services.

2. To consider CAMHS care and treatment planning as an opportunity to promote and

acilitate an holistic approach, embedding principles o consultation, empowerment and sel

management in order to promote recovery.

Key messages or acilitators:

Care and treatment planning is a prescribed process within the Mental Health (Wales)

Measure 2010.

Coordination o care requires considerable skill and a ocus on recovery orientated practice.

The Measure, Regulations and Code o Practice contain duties on care coordinators around

outcome planning, reviewing care and treatment plans and discharge arrangements.

Introduction

This additional unit o study is specifcally designed or CAMHS practitioners. Core unit 3 is

available to support practitioners to understand their duties and responsibilities in relation to

Parts 2 and 3 o The Mental Health (Wales) Measure 2010. Key messages rom Core Unit 3 have

been included in this additional unit in order to maximise the application o care and treatment

planning within CAMHS services.

It is important or services o all descriptions to understand the expectations o children, young

people their amilies/carer(s) when they use services. Understanding and regularly confrming

these expressed needs and responding to them is a hallmark o a good quality service. This unit

seeks to ensure that participants can reect and critically examine the undamental principles on

which high quality CAMHS care and treatment planning is based.


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Learning outcomes

Required teaching resources:

DVD o audio narratives

Data projector and PC or DVD player

Flip chart

Handouts or exercises

Lesson plan

Time

(mins)Focus

Related

learning

outcomes

Teaching method/

resourcesContent

10 mins Introduction Group discussion Slides 1 4

10 minsSection 1:Reviewing Assessment

1 Group discussion DVD/audio-clip

45 minsHolistic assessmentskills

1,2,3Exercise 1Group discussion

Handout 1Slides 5 7

30 minsSection 2:Relationships recoveryand growth

1,2,3Exercise 2Group discussion

HandoutSlides 8 10Audio-clip

45 mins

Section 3:The care and

treatment plan review,revision and discharge

1 & 4

Exercise 3

Group discussion

Handouts 3 & 4

Slides11 13

15 mins

Section 4:Care & treatmentplanning. Crisis andcontingency planning

1,2,3,4Exercise 4Writing taskGroup discussion

Handout 5Slides 14

40 minsOutcome planning and

transitions4

Exercise 5 Role play

Writing task Group

discussion

Handout 6Handout 7Slides 15 17

10 mins Conclusion

Questions

Take home

messages

On completion o this unit the participants will be able to:

1 Understand the statutory duties o Parts 2 & 3 o the Mental Health (Wales) Measure 2010

2 Understand the cultural context o CAMHS care and treatment planning

3Understand signifcance o comprehensive, holistic child and young people centred care

and treatment planning

4Demonstrate the ability to work collaboratively with others to construct meaningul care

and treatment plans


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Uned Ychwanegol 2: Cynllunio Gofal a Thriniaeth

Gwasanaethau Iechyd Meddwl Plant a Phobl Ifanc (CAMHS)

Cynllun gwers manwl

Trwyr uned: (10 munud)

Sleid 1: Gallech ddangos y sleid PowerPoint cynta wrth i bawb gyrraedd

Yn dibynnu ar y seylla, gallech anteisio ar y cye i gywyno eich hun ar cyranogwyr iw gilydd.

Peidiwch threulio gormod o amser yn gwneud hyn.

Nodiadau ir hwylusydd: Mae Unedau Craidd 1 5 yn cynnwys gwybodaeth uddiol i chi ei darllen

a bod yn gyarwydd hi cyn cywynor uned ychwanegol hon.

Sleidiau 2 a 3: Maer rhain yn cywynor nodau ar canlyniadau dysgu

disgwyliedig ar l cwblhaur uned hon.

Rhan 1: (55 munud)

Adolygur asesiad

Maer syniad o gysyniad CAMHS yn ganolog i strategaeth CAMHS Llywodraeth Cymru

Busnes Pawb (2001). Yn y weledigaeth hon o CAMHS mae pob gweithiwr proesiynol ac

ymarerydd syn gweithion uniongyrchol gyda phlant a phobl ianc yn cymryd cyrioldeb am

eu lles emosiynol au hiechyd meddwl. Mae hyn yn deillio o edrych ar ddatblygiad plentyn iach

mewn ordd holistaidd lle mae ymyriadau cynnar, atal a gweithio traws sector yn allweddol igenogi iechyd plant a phobl ianc.

Mae meddwl am y system deuluol, a hynny o sabwynt amlasiantaethol, yn agwedd bwysig o

waith CAMHS ac maen cynnig rhai syniadau pwysig i ni ynglyn meddwl ac asesu holistaidd.

[Cyswllt ir clip sain] Profad o gyraniad gweithgar / gwellhd a chynnydd mewn asesiad CAMHS

o sabwynt plentyn, person ianc a rhiant (taid neu nain/goalwr os ywn bosibl).

Nodiadau ir hwylusydd: Pwrpas y clip sain yw ail-gadarnhau ir grwp od asesu a deall materion/

anghenion o sabwynt y plentyn / person ianc yn ogystal r rhiant / goalwr(wyr) yn gam

hollbwysig yn y broses o gynllunio goal a thriniaeth. Heb asesiad cynhwysawr byddain anoddllunio a gweithredu cynllun goal syn seiliedig ar ganlyniadau.


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Detailed lesson plan

Orientation: (10mins)

Slide 1: You might like to have the frst PowerPoint slide showing when participants arrive

Depending on the situation, you might like to introduce yoursel and participants to each other.

This should be kept airly brie.

Notes or acilitator: The Core Units 1 5 contain inormation that may be helpul or you to read

and amiliarise yoursel with prior to the delivery o this additional unit.

Slides 2 & 3: These provide participants with the aims and expected learning outcomeson completion o this unit.

Section 1: (55 mins)

Reviewing assessment

The Welsh Governments CAMHS strategy Everybodys Business (2001) has at its centre the

idea o the CAMHS concept. This is a vision o CAMHS which has all proessionals and

practitioners who work directly with children and young people taking responsibility or their

emotional wellbeing and mental health. This is derived rom a holistic view o healthy childdevelopment, where early intervention, prevention and close cross sector working are key to

supporting the health o children and young people.

Thinking about the amily system and multi-agency perspectives is an important aspect o

CAMHS work and oers some important insights to holistic thinking and assessment.

[Link to audio clip] Experience o active involvement / recovery and growth ocussed in a

CAMHS assessment rom a child, young person and parent (i at all possible grandparent/carer)

perspective.

Notes or acilitator: The audio clip is to reinorce to participants that assessment and anunderstanding o issues / needs rom both child / young persons perspective as well as parent /

carer(s) is a critical stage in the care and treatment planning process. Without a comprehensive

assessment an outcome based care plan will be difcult to construct and implement.


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Sleid 4 5: Goynion Rhan 2 o Fesur Iechyd Meddwl (Cymru) 2010: cyd-destun polisi

Nodiadau ir hwylusydd: Nid oes raid edrych yn anwl ar y ddeddwriaeth ei hun (gwneir hyn yn yr

unedau craidd). Ond maen bwysig bod yr holl gyranogwyr yn deall bod y materion hyn yn

oynion cyreithiol o sabwynt gwasanaethau iechyd meddwl eilaidd.

Pwrpas y gweithgaredd hwn yw helpur gr wp i ystyried beth yw asesiad holistaidd CAMHS ac i

weld a oes cysondeb r dyletswyddau ar cyrioldebau syn oynnol wrth iddynt gynllunio goal a

thriniaeth CAMHS yn l Mesur Iechyd Meddwl (Cymru) 2010.

Sgiliau asesu holistaidd

Ymarer 1: Asesiad holistaidd

Taen 1: Senario personol 1 Rhys 6 oed

Rhannwch y cyranogwyr yn grwpiau. Ceisiwch eu hannog i eistedd mewn grwpiau

amlddisgyblaethol (amlasiantaeth) os gallwch. Rhannwch daen 1. Goynnwch iddynt adolygu

senario Rhys ai deulu ac ystyried y cwestiwn canlynol.

C. Yn eich barn chi, beth ywr materion allweddol iw hystyried wrth asesu Rhys, Powel a Gwen?

Nodiadau ir hwylusydd: Ar gyer yr ymarer hwn, cymerwn od gan gyranogwyr sgiliau asesu

eisoes. Nid nod y gweithgaredd yw addysgu sgiliau asesu pellach na chynnal asesiad, ond yn

hytrach annog y grwp i eddwl am Fesur Iechyd Meddwl (Cymru) 2010 a chyawnir Dyletswyddau

wrth gynnal asesiad CAMHS cymhleth a denyddio dull amlasiantaeth wrth ynd ati i lunio

cynllun goal a thriniaeth.

Sleid 6:

Cysylltu adolygiadau holistaidd chanlyniadau

Goynnwch ir cyranogwyr ysgriennu eu syniadau ar siart troi. Ar l iddynt gwblhau hyn,dangoswch sleid 6 iw hannog i ystyried beth mae Mesur Iechyd Meddwl (Cymru) 2010 yn ei

ddatgan am yr 8 maes.

Nodiadau ir hwylusydd: Mae Mesur Iechyd Meddwl (Cymru) 2010 yn rhestru 8 maes posibl iw

cynnwys wrth gynllunio goal a thriniaeth er mwyn cenogi dull holistaidd. Maer rhain yn cynnwys

meysydd el rhianta neu berthnasoedd goalu, addysg a hyorddiant, triniaeth eddygol a

thriniaeth arall. Byddair meysydd hyn yn dylanwadu ar unrhyw asesiad a gynhelid. Rhaid ir

cydlynydd goal weithio gydar cla perthnasol a darparwyr gwasanaeth y cla er mwyn cytuno ar

ganlyniadau mewn un neu wy or meysydd hyn. Maen bwysig nodi bod y ddeddwriaeth yn

datgan nad yw canlyniadau goal a thriniaeth wedi eu cyyngu ir 8 maes hyn.


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Slides 4 5: Requirements o Part 2 o the Mental Health (Wales) Measure 2010:

policy context

Notes or acilitator: There is no requirement to explore in-depth the actual legislation (this will be

available in the core units). It is important however, that all participants understand that these

issues are legal requirements o secondary mental health services.

The purpose o this activity is to support participants to reect on their understanding o a CAMHS

holistic assessment and to see where there is consistency with the duties and responsibilities

required o them o CAMHS care and treatment planning in the Mental Health (Wales)

Measure 2010.

Holistic assessment skills

Exercise 1: Holistic assessment

Handout 1: Personal scenario 1 Rhys aged 6 years

Organise the participants into groups, try to encourage them to sit in multi-disciplinary

(multi-agency) groups i possible. Provide them with handout 1. Ask the participants to review the

scenario o Rhys and his amily and consider the ollowing question:

Q. What do you consider are the critical issues in the assessment o Rhys, Powel and Gwynhwyan?

Notes or acilitator: The exercise assumes that participants already possess assessment skills.

The activity is not aimed at teaching urther assessment skills or to conduct an assessment but to

encourage participants to reect on the Mental Health (Wales) Measure 2010 and applying the

Duties in conducting complex CAMHS assessment and multi-agency perspectives with a view to

ormulating a care and treatment plan.

Slide 6:

Linking holistic assessment to outcomes

Ask participants to write their reections on a ipchart. Ater they have completed this, continue to

show slide 6 to prompt participants about what the Mental Health (Wales) Measure 2010 states

about the 8 areas.

Notes or acilitator: The Mental Health (Wales) Measure 2010 lists 8 areas or potential

inclusion in care and treatment planning to support a holistic approach. These include areas such

as parenting or caring relationships, education and training, medical and other orms o treatment.

These areas would inorm any assessment that is conducted. The care

coordinator must work with the relevant patient and patients service providers with a view toagreeing outcomes in one or more o these areas. It is important to note that the legislation states

that care and treatment outcomes are not limited to these 8 areas.


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Sleid 7: Cwestiynau:

Ymarer 1:

Cwestiynau iw goyn:

1. Pa actorau economaidd, cymdeithasol ac amgylcheddol wnaeth eeithio ar

ddatblygiad ac iechyd meddwl Rhys? Wnaethoch chi ystyried o leia un (ond yn ddel

rydol mwy) or 8 maes a restrir yn adran 18 (1) (a) yn yr asesiad o senario personol

1 yn ymarer 1? (cyeiriwch at sleid 6).

2. Wnaethoch chi ystyried dwyieithrwydd yn yr asesiad?

3. Pa actorau o ran cryder a gwytnwch wnaethoch chi eu nodi?

4. Wnaethoch chi nodi risgiau i Rhys ac i eraill (yn cynnwys nodir risg o od yn agored i

niwed oherwydd anabledd, a materion diogelu ac amddiyn plant)?

5. Wnaethoch chi ystyried a myyrio ar hawliau plant a phobl ianc el sylaen hanodol i

ymarer da wrth gynllunio goal a thriniaeth CAMHS?


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Slide 7: Questions:

Exercise 1:

Questions to ask:

1. What economic, social and environmental actors did you consider impacted on

Rhys mental health and development? Did you consider at least one (but ideally

more) o the 8 areas listed in section 18 (1) (a) in the assessment o personal

scenario 1 in exercise 1? (reer to slide 6).

2. Did you consider the issues o bilingualism in the assessment?

3. What strengths and resilience actors did you identiy?

4. Did you identiy risks to Rhys and others (including identifcation o vulnerability due

to disability, Saeguarding and the protection o children)?

5. Did you reect and consider children and young peoples rights as a undamental

oundation to good practice in CAMHS care and treatment planning?


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DVD

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Rhan 2: (30 munud)

Perthynas phobl eraill, gwellhd a chynnydd

Mae cymorth gweithredol o ewn cyd-destun CAMHS yn annog dull holistaidd gan ystyried y person

cyan, teulu cyan a system gyan. Maer mathau o berthynas therapiwtig a grir yn allweddol isicrhau canlyniadau da. Er mwyn sicrhau gwellhd a chynnydd, mae creu amgylchedd, rhoi

dewisiadau a sicrhau amgylchiadau syn helpu unigolion i wneud cymaint ag syn bosibl drostynt

eu hunain yn gymorth iddynt od yn annibynnol Yn ogystal maen hybu eu gallu cororol.

Maen annog pobl ag anableddau i wneud y mwya ou hannibyniaeth au potensial eu hunain.

Maen rhoi ystyriaeth i gryderaur unigolyn ar teulu, y cryderau yn y seylla gymdeithasol, natur y

newid a wynebir, a ynonellau cymorth eraill.

Sleid 8: Gwellhd a chynnydd

Nodiadau ir hwylusydd: Maen bwysig bod y grwp yn deall yn iawn beth yw gwerth sylaenol

ethos syn rhoi pwyslais ar wellhd el sail ir canlyniadau a ddymunir yn l Mesur Iechyd Meddwl

(Cymru) 2010.

Mae tri phwrpas ir gweithgaredd hwn:

Cysylltu eu rl el cydlynydd goal neu aelod or tm cynllunio goal a thriniaeth CAMHS

ehangach er mwyn deall y pwysigrwydd ar cymhlethdodau syn gysylltiedig galluogi i

blant, pobl ianc a theuluoedd/goalwr(wyr) gyathrebu mewn ordd gydweithredol i hybu

gwellhd a chynnydd.

Cyathrebu yn eu dewis iaith, yn arbennig os ydyn nhwn cael problemau cyathrebueisoes, os yw gwybodaeth yn cael ei chamddeall, ei chamddehongli neu ei

hanwybyddu, o ewn eu system deuluol.

Cadarnhau ir grwp od angen ir rhai syn cynllunio goal a thriniaeth CAMHS seiliedig ar

wellhd a chynnydd ystyried y berthynas y maen nhwn ei urfo gyda phlant, pobl

ianc, teuluoedd a goalwr(wyr) ar dull y maen nhwn ei ddenyddio i gyathrebu o ewn y

system deuluol gyan ar system gyan.

Ymarer 2: Sgiliau ar gyer tw

Goynnwch ir grwp ynd atin unigol i lunio rhestr or nodweddion mewn perthynas therapiwtig

CAMHS y maen nhw wedi ei chael naill ai gyda phlentyn/person ianc neu gydag aelod o deulu/

goalwr sydd wedi hybu gwellhd a chynnydd. Mewn grwpiau bach rhowch y rhestrau hyn ar

siart troi.

Ar l cwblhaur ymarer byr hwn gwrandewch ar glip sain.

[Cyswllt ir clip sain] plentyn/person ianc dwyieithog a theulun siarad am berthynas

therapiwtig sydd:

1. Wedi helpu i greu awyrgylch o rymuso el siaradwyr Cymraeg.2. Wedi helpu hunan reolaeth a gwellhd, cynnydd a mynd yn l ar y llwybr datblygiad cywir

(e.e. cylch bywyd y teulu neu dw unigol y plentyn/person ianc).


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DVD

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Section 2: (30 minutes)

Relationships, recovery and growth

Active support within a CAMHS context encourages a whole person, whole amily and whole

system approach. The therapeutic relationships ormed are key to good outcomes. Recovery and

growth will be assisted by creating an environment, options and circumstances or individuals to

do as much or themselves as possible to maintain independence and physical ability and

encourages people with disabilities to maximise their own potential and independence. It takes

account o the individual and amily strengths, the strengths in the social situation, the nature o

the change which is being aced, and other sources o support.

Slide 8: Recovery and growth

Notes or acilitator: it is important that participants have a clear understanding o the value baseo a recovery orientated ethos as the basis o desired outcomes o the Mental Health (Wales)

Measure 2010.

The purpose o this activity is threeold:

To link their role o care coordinator or a member o the wider CAMHS care and treatment

planning team to understand the complexities and importance o children, young people

and amily/carer(s) being enabled to communicate in a collaborative way to support

recovery and growth.

To communicate in their language o need particularly when there may already be

experiencing communication difculties, inormation being misunderstood, misinterpreted

or ignored, within their amily system.

Reinorcement to participants that recovery and growth ocussed CAMHS care and

treatment planning needs to have regard to the relationship they orm with children, young

people, amily and carer(s) and the method they use to communicate within the whole

amily and whole system.

Exercise 2: Skills or growth

Ask participants to individually make a list o the qualities in a CAMHS therapeutic relationship

that they have had with either a child/young person or with a amily member/carer that promoted

recovery and growth. In small groups put these lists on a ip chart.

Ater completing this short exercise listen to an audio clip.

[Link to audio clip] child/young person and a amily talking about therapeutic

relationship that:

1. Helped create an atmosphere o empowerment.

2. Actively supported to sel manage and recover, grow and get back on the right

development trajectory (e.g. amily lie cycle or the child/young personindividual growth).


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Sleid 9: Cwestiynau

C. Gan edrych yn l ar y siart troi yn ymarer 2 a gwrando ar y clip sain, sut beth yddai gwellhd

i Rhys, Powel, Gwen?

C. Yn eich ymarer presennol a yw plant a phobl ianc yn cael rhan weithredol mewn penderynia

dau ynglyn goal a thriniaeth syn hybu cynnydd a gwellhd? Os elly, pa systemau sydd yn

eu lle i wneud hyn yn bosibl? Os nad ydynt, eallai y byddai o udd i chi gonodi yn y llyr gwaith

hwn ddull bwriad neu ymrwymiad i newid:

Yn y dyodol rwyn bwriadu sicrhau Fy mod yn er mwyn... (ydd yn hybu cynnydd a gwellhad).

Dangoswch sleid 10 a rhannwch daen 2

Sleid 10: Cyathrebu Cydweithredol

Taen 2: Rhestrau Grymuso a Hunan Reolaeth

Ceisiwch annog y grwpiau i rannu eu rhestrau gydag eraill a meddwl am ar sut y gallair pwyntiau

ar eu rhestrau hybu deialog wrth gyathrebu.

C. Beth yddai rhai or tensiynau, rhwystrau, dynameg, gwrthdaro o ran cyathrebu cydweithredol

wrth weithio mewn cyd-destun CAMHS? Pa atebion posibl ydych chi wedi eu denyddio neu

wedi eu gweld mewn ymarer clinigol?


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Slide 9: Questions

Q. Reecting back on the ipchart in exercise 2 and listening to the audio clip, what might

recovery look like to Rhys, Powel, Gwen?

Q. In your current practice, are children and young people actively involved in decisions around

care and treatment that promote recovery and growth? I so what systems are in place to

enable this? I not, you might fnd it helpul to record in this workbook an intention or

commitment to change approach:

In uture I intend to ensure I to (that will promote recovery and growth).

Show slide 10 and give out handout 2

Slide 10: Collaborative Communication

Handout 2: Empowerment and Sel Management lists

Facilitate the groups to share their lists with others and reect on how the content o their lists

might support the dialogue elements o collaborative communication.

Q. What might be some o the dynamics, tensions, barriers, conicts to collaborative

communication when working in a CAMHS context? What might be some o the solutions

that you have used or seen in clinical practice?


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Rhan 3: (45 munud)

Adolygu a diwygio cynlluniau goal a thriniaeth

Ymarer 3: Adolygu a diwygio cynlluniau goal a thriniaeth: Gadael goal

Nod y rhan hon yw helpu cyranogwyr i gael gwybodaeth am bwrpas a manteision denyddio dullcynhwysawr o gynllunio goal a thriniaeth syn cynnwys adolygiad urfol er mwyn monitro cynnydd

ar sail canlyniadau y cytunwyd arnynt mewn cynlluniau goal a thriniaeth.

Nodyn ir hwylusydd:

1. Pwrpas yr ymarer hwn yw sicrhau bod cyranogwyr yn deall beth maer ddeddwriaeth ar

rheoliadaun ei ddweud am adolygu cynlluniau goal a thriniaeth a chynlluniau gadael goal

el rhan bwysig o Fesur Iechyd Meddwl (Cymru) 2010

2. Goynnir ir grwp adolygu senario lle nad oes cynllun goal a thriniaeth ar gael iddyntgyeirio ato. Dylid goyn ir cyranogwyr dybio eu bod wedi cytuno ar gynllun goal gan

ddenyddio eu gwybodaeth glinigol, eu sgiliau ar broses drenu bresennol gyda Rhys, Gwen

a Powel yn dilyn yr asesiad yn senario 1 a bod y cynllun hwn wedi ei weithredu.

Dywedwch wrth y cyranogwyr od y senario wedi ei greu er mwyn dangos canlyniadau rhesymol ar

posibilrwydd o gwblhau triniaeth el bod modd cwblhau trin y cla. Eallai y byddai o udd atgoar

cyranogwyr o ganlyniad dysgu cychwynnol 4, ac yn rhan 3 or uned hon y byddan nhwn gwneud

gweithgareddau i ddwyn ynghyd yr holl weithgareddau ar hyn y maen nhw wedi ei ddysgu hyd yma

er mwyn ystyried asesu, cynllunio goal a thriniaeth gan gydnabod cymhlethdod CAMHS.

A thrinaeth a dod ag achosion i ben

Sleidiau 11 12: Ymgynghori a Pobl el Cenogwyr i Bobl Ianc

Maer sleidiau hyn yn amlinellur bobl y dylair cydlynydd goal ymgynghori hwy er mwyn

cytuno ynglyn chanlyniadau, cytuno ar gynllun goal a thriniaeth ac adolygu ac addasur

cynllun. Maer rhestr yn cynnwys y rhai y dylid ymgynghori hwy ac yn rhoi enghreitiau.

Maen bwysig nodi y gellid ymgynghori phobl eraill:-

Pwy dylair cydlynydd goal ymgynghori hwy, er mwyn hwylusor dasg o gyawni swyddogaethaur

cydlynydd goal; ac unrhyw un y maer cla perthnasol yn dymuno ymgynghori nhw er mwyn ir

cydlynydd goal gyawni ei swyddogaethau, ar yr amod bod y cydlynydd goal yn credu y byddai

ymgynghorir r unigolyn er budd y cla.

Nodyn ir hwylusydd: Mae taenni yn Uned Graidd 5 (taenni 1 a 2). Gellir denyddior rhain i

sicrhau bod gan y cyranogwyr wybodaeth am eu dyletswyddau au cyrioldebau yn arbennig o

sabwynt ysgriennu unrhyw dreniadau i ddod r goal i ben, a hawl i gael asesiad.


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Rhan 3: (45 mins)

Reviewing and revising care & treatment plans

Exercise 3: Reviewing and revising care and treatment plans: Discharge

The aim o this section is to support participants gaining knowledge about the purpose and

benefts o taking a comprehensive approach to care and treatment planning which includes a

ormal review to monitor progress to agreed care and treatment planning outcomes.

Notes or acilitator:

1. The exercise is designed to ensure participants understand what the legislation and

regulations say about care and treatment plan reviews and discharge as an important part

o the Mental Health (Wales) Measure 2010.

2. The participants are being asked to review a scenario when no actual care and treatmentplan is available or them to reer to. The participants should be asked to assume that they

agreed a care plan using their current clinical knowledge, skill and organisational

requirements and process with Rhys, Gwen and Powel ollowing the assessment in

scenario 1 and that this plan has been implemented.

Acknowledge to participants that the scenario has been created to demonstrate reasonable

outcomes and potential or completion o treatment so that discharge can take place.

You may fnd it useul to remind participants o the initial learning outcome 4 and that in section

3 o this unit participants will be undertaking activities to pull together all the activities and

learning so ar to consider assessment, care and treatment planning acknowledging thecomplexity o CAMHS.

Review o care and treatment plans and discharge

Slides 11 12: Consultation and people as supporters o young people

These slides outline the persons who must be consulted by the care coordinator with a view to

agreeing outcomes, agreeing a care and treatment plan and reviewing and revising the plan. The

list includes those who must be consulted and then gives examples. It is important to note that

other people may be consulted:-

Who the care coordinator believes ought to be consulted, in order to acilitate the carrying out o

the care coordinators unctions; and any person who the relevant patient wishes to be consulted

in connection with the care coordinator carrying out his or her unctions, provided that the care

coordinator believes it is in the patients best interests to consult the person.

Note or Facilitator: There are handouts in Core Unit 5 (handouts 1 & 2) these can be used to

ensure that participants have the inormation on their duties and responsibilities particularly in

relation to putting in writing any discharge arrangements and entitlement to assessment.


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Handout 3: Personal Scenario 2 Rhys aged 7

Participants to remain working in groups, provide the participants with Handout 3 (scenario 2).

Ask the participants to review the scenario and consider the ollowing questions:

Slide 13: Discussion point

Q. What inormation led to you deciding to review the care and treatment plan?

Q. What type o review is required ormal/inormal how did you decide?

Q. Who should organise the review?

Q. Who should be invited/consulted?

Q. What support might Rhys require to be actively involved in the review?

Q. What support might Powel and Gwen require?

Q. What pre-review preparation will be required or key people?

Q. How would you evaluate the care and treatment outcomes or the review?

Q. What is required to ensure eective discharge under the Mental Health (Wales) Measure 2010?

Notes or acilitator: Ask or a show o hands regarding participant choice o inormal/ormal

review. I the majority o participants choose an inormal review o the care and treatment plan,

acknowledge complexities o CAMHS and that some reviews may need to be conducted in a

ormal manner.

Formal care and treatment plan reviews

Use Handout 4 Guidelines on chairing care and treatment plan reviews

Q. Thinking about your current practice, i you need to conduct a ormal review process what other

reviews do you attend? What are the opportunities/difculties that you oresee i you were to

combine care and treatment planning reviews with other review processes?


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Discharge planning

What is required to ensure Rhys discharge is eective under the Mental Health (Wales)

Measure 2010?

Q. In terms o local impact, how might the review o care and treatment plans and discharge

planning process useully change things or:themselves as a practitioner

children and young people

amilies/carers

the team/service/organisation in which they work

the wider multiagency network involved with children and young people, amilies/carers.

Record in your workbook at least one perceived or known useul impact that changes to care and

treatment planning and the legislation will make or each group.


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Rhan 4: (55 munud)

Cynllunio goal a thriniaeth CAMHS

Bydd y rhan hon yn adeiladu ar y gwaith y maer grwp. Wedi ei wneud yn rhannau 1 3 ar asesu,

perthnasoedd, gwellhad, tw a gweithio gydag eraill mewn ordd gydweithredol gan barchu hawliau

a gwerthoedd ac ystyried cymhlethdodau gwahanol bersbectiau yn y seylla glinigol ar haenau o

gymhlethdod mewn systemau a seydliadau syn gysylltiedig dull integredig.

Bwriad yr ymarerion yw annog y grwp. I ystyried, traod a chytuno ar y materion allweddol syn

eeithio ar ywydau plant a phobl ianc, eu teuluoedd/goalwr(wyr). Goynnwch ir gr wp. eddwl

am ba aterion ddylai od yn rhan o gynllun goal a thriniaeth CAMHS au rl au swyddogaeth el

cydlynwyr mewn perthynas chynllunio goal a thriniaeth CAMHS. Mae gwneud copau o

gynlluniau goal a thriniaeth yn codi nier o aterion pwysig , yn arbennig o sabwynt plant a phobl

ianc a phobl sydd chyrioldeb el rhieni, ac mae angen ir cyranogwyr ystyried hyn.

Ymarer 4: Cynllunio goal a thriniaeth:

Taen 5: Senario personol 3 Rhys 15 oed

Goynnwch ir grwp adolygu senario Rhys ai deulu gan ystyried gwybodaeth newydd yng ngoleuni

eu rl au swyddogaeth el cydlynydd goal neu i genogi cynllun goal a thriniaeth CAMHS.

Beth ydd y cyraniad ir cynllun goal a thriniaeth ar sail yr wybodaeth hon?

Cynlluniau wrth gen a chynlluniau argywng

Maer rhan hon yn cynnwys cymryd risgiau cadarnhaol el elen hanodol o ymarer CAMHS, gan

gynnwys pwyso a mesur yn oalus y peryglon ar manteision posibl. Maer broses ddatblygu yn

ganolog ir broses o benderynu ynglyn chymryd risg gyda phobl ianc. Bydd angen i glinigwyr a

theuluoedd/goalwr(wyr) ystyried beth ywr leel briodol o ymreolaeth ac annibyniaeth ir person

ianc, ynghyd u gallu i wneud penderyniad gwybodus. Bydd penderyniadau a wneir ymlaen llaw

yn galluogi ir plentyn neur person ianc deimlo ei od e neu hi wedi chwarae mwy o ran ac wedi ei

(g)rymuso yn ystod adegau o argywng.

Yn eu grwpiau, traodwch y cwestiynau canlynol gan ddenyddio senario 3.

Sleid 14: Cynllun wrth gen ac mewn argywng

C. Beth ywr risgiau yn y senario sydd angen sylw mewn cynllun wrth gen a chynllun argywng?

Denyddiwch eu hasesiad risg er mwyn paratoi cynllun wrth gen a a chynllun argywng

C. Sut ydden nhwn cynnwys cymryd risg cadarnhaol wrth gynllunio?


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Section 4: (55 minutes)

CAMHS Care and treatment planning

This section will build on the work the participants have done in sections 1 3 on assessment,

relationships, recovery, growth and working with others in a collaborative way respecting rights and

values and taking account o the complexities o diering perspectives in the clinical situation and

the layers o complexity o systems and organisations involved in an integrated approach.

The exercises are designed to encourage participants to consider, discuss and agree the

critical issues aecting children and young people, their amily/carer(s) lives which should be part

o a CAMHS care and treatment plan and their role and unction as coordinators in relation to

CAMHS care and treatment planning. There are very important aspects relating to copies o care

and treatment plans particularly in regard to children and young people and persons with parental

responsibility that the participants need to consider.

Exercise 4: Care and treatment planning:

Handout 5: Personal Scenario 3 Rhys aged 15

Ask the participants to review the scenario o Rhys and his amily and consider the new

inormation in light o their role and unction as care coordinator or in supporting CAMHS care

and treatment planning. What will be the contribution to the care and treatment plan based on

this inormation?

Crisis and contingency planning

This section considers positive risk taking as an essential component o CAMHS practice,

involving the careul weighing up o the potential harms and benefts. Central to decision making

process or risk taking with young people is the developmental process. Clinicians and amily/

carers (s) will need to consider the appropriate level o autonomy and independence o a young

person, alongside their ability to make an inormed decision. Decisions made in advance will

enable the child or young person to eel more involved and empowered during times o crisis.

In their groups, discuss the ollowing questions using scenario 3.

Slide 14: Crisis and contingency planning

Q. what are the risks in the scenario which require attention in crisis and contingency planning?

Translate their assessment o a risk into the crisis and contingency plan

Q. How would they include positive risk taking in planning?


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Cynllunio canlyniadau

Os oes angen, ailedrychwch ar sleid 6 er mwyn adolygur meysydd canlyniadau or Mesur.

Ymarer 5: Chwarae rl Nodwch ater penodol o senario 3 y byddech yn hof ei droi yn

ganlyniad neun nod. Dewiswch 3 aelod och grwp i chwarae rl Rhys a Powel neu Gwen a

gweithiwr proesiynol syn gysylltiedig u system. Denyddiwch amcanion CAMPUS

ich helpu.

Taen 6: Cynllunio canlyniadau pethau iw cynnwys

Sleid 15: Difnio canlyniadau/nodau

C. Sut yddech chin difnior nod? - cofwch eallai bod Rhys ai daid ai nain wedi mynegir un

mater/angen ond bod y nodau/canlyniadau, er hynny, yn wahanol iawn yn eu golwg nhw.

Mae cynllunio goal a thriniaeth eeithiol yn dibynnu ar gyraniad pawb dan sylw.

Eallai y bydd raid i chi gyd-draod ar y dechrau a pharhau i draod yn barhaus er mwyn hybugwellhd a chynnydd, a pharhau i ddenyddior dull hwnnw.

C. Pwy syn mynd iw helpu i gyawni eu nod? (ystyriwch yn arbennig oed a chynlluniau Rhys ac

unrhyw gysylltiad tebygol gyda gwasanaethau oedolion)

C. Pa gamau oedd rhaid i chi eu cymryd i gyawnir nod?

C. Sut bydd cynnydd yn cael ei esur?

C. Pa mor weithgar ydd pob unigolyn o ran cyrraedd y nod?

C. Sut byddech chin gallu denyddio eiriolaeth yn rhan or broses cynllunio goal a thriniaeth?

Trosglwyddo

Mae trosglwyddo rhywun o ewn a thu hwnt i wasanaethaun agwedd hollbwysig o gynllunio goal

a thriniaeth llwyddiannus. Darllenwch daen 7 ac ystyriwch y problemau i Rhys ai daith wrth iddo

gael ei drosglwyddo ac atebwch y cwestiynau a oynnir.

Sleid 16: Trosglwyddo

Taen 7: Senario personol: Rhys 17 oed

Sleid 17: Cwestiynau

Nodiadau ir hwylusydd: Eallai bydd angen rhoi sylw i unrhyw broblemau syn gysylltiedig r

posibilrwydd o drosglwyddo goal i wasanaethau oedolion. Gallai cynlluniau Rhys i ynd ir coleg

ddylanwadu ar y broses oi drosglwyddo i wasanaethau oedolion. Eallai bydd angen ystyried hyn

wrth gynlluniau canlyniadau.

Eallai bydd y grwp yn gyarwydd phrosiectau eiriolaeth rhanbarthol neu leol. Bydd hyn yn

ddenyddiol wrth draod Eiriolwyr Iechyd Meddwl Annibynnol. Er bod yr hyorddiant CAMHS hwn yn

canolbwyntio ar ran 2 a 3 or Mesur, mae angen ir grwp od yn ymwybodol bod hawl gan gleifon

cymwys o Gymru syn dymuno cymryd rhan neu gael mwy o ran yn y penderyniadau a wneir am

eu goal neu eu triniaeth, gael help gan eiriolwr iechyd meddwl (trwy gynrychiolydd neu el arall).

Maen bwysig pwysleisio nad yw gweithwyr proesiynol iechyd meddwl yn gymwys i weithredu

el eiriolwyr.


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Outcome planning

I necessary revisit slide 6 to review the outcome areas rom the Measure.

Exercise 5: Role play Identiy a specifc issue rom scenario 3 that you would like to

turn into an outcome or goal. Identiy 3 members o your group who would role play Rhys and

Powel or Gwen and a proessional involved in their system, use the SMART objectives tohelp you.

Handout 6: Outcome planning things to include

Slide 15: Outcome/goal defnition

Q. How do you defne the goal? remember Rhys and his Grandparents may have expressed the

same issue/need but their goals/outcomes maybe very dierent. Successul care and

treatment planning relies on the contribution o all involved. You may have to initially and then

continually use negotiation and discussion to support recovery and growth.

Q. Who is going to help them achieve their goal? (consider especially Rhys age and plans and

any likely interace with adult services)

Q. What are the steps you needed to take to achieve the goal?

Q. How will progress be measured?

Q. How active will each person be in achieving the goal?

Q. How might you consider the use o advocacy within care and treatment planning process?

Transition

Transition within and beyond services is a critical aspect o successul care and treatmentplanning. Read handout 7 and consider the issues or Rhys in his transition journey and answer

the questions provided.

Slide 16: Transitions

Handout 7: Personal Scenario Rhys aged 17 years

Slide 17: Questions

Notes or acilitators: Attention may need to be drawn to any issues relating to any likely

transition o care to adult services. Rhys plans to attend college which might inuence a transer

to adult services. This may need to be considered within outcome planning.

Participants maybe amiliar with regional or local advocacy projects. It will be o value to support

their discussion on Independent Mental Health Advocates (IMHAs). Although this CAMHS training

ocuses on part 2 and 3 o the Measure, participants need to be aware that Welsh qualiying

patients who wish to become involved or more involved in decisions made about their care or

treatment are entitled to help rom a mental health advocate (by way o representation orotherwise). It is important to emphasise that mental health proessionals are not eligible to act

as advocates.


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Crynhoi (10 munud)

Awgrymwch ir grwp eu bod yn mynd ati i wneud mwy o ddenydd or wybodaeth sydd yn yr uned hon o

ran ymarer ac y bydden nhwn gallu traod y newid y maen nhw wedi dewis ei wneud o ewn

goruchwyliaeth, ymarer a thraodaethau grwp gyda chydweithwyr.

Cwestiynau Beth ydych chin mynd iw wneud yn wahanol nawr?

Mae hon yn rhan bwysig or uned ac ni ddylid ei hosgoi. Bwriad yr unedau dysgu yw herio pobl i

ymrwymo i newid a gwella eu gwaith wrth gynllunio goal a thriniaeth. Felly mae rhan or ymrwymiad hwn

yn gydnabyddiaeth gyhoeddus or hyn maen nhw wedi ei ddysgu, a pha gamau y gallant eu cymryd yn

syth i newid eu hymarer er gwell. Goynnwch ir cyranogwyr am o leia un pwynt dysgu pwysig a beth

maen nhw yn bwriadu ei newid o ganlyniad iddo.

Negeseuon a ddysgwyd

Mae cynllunio goal a thriniaeth yn llawer mwy nag ymareriad llenwi dogen.

Mae cynllunio goal a thriniaeth yn seiliedig ar werthoedd.

Mae credu mewn gwellhad wrth galon Mesur Iechyd Meddwl (Cymru) 2010.

Darllen pellach

Hawliau plant yn y system iechyd el y disgrifr yn y daen hon a gynhyrchwyd gan Achub y Plant

gyda chyraniad sta a denyddwyr gwasanaeth yn; Ysbyty Plant Cymru, Prosiect Trowch Mlaen ein

Hawliau Achub y Plant a Phrosiect Heol Marlborough Barnardos.

http://www.savethechildren.org.uk/en/docs/PDF_Health_Leaet.pd

Gwean Hawliau Plant Achub y Plant Cymru

http://www.childrensrightswales.org.uk/public-services.aspx?language=Cymraeg

Llawlyr Y Seydliad Goal Cymdeithasol er Rhagoriaeth (SCIE) ar seydlu ymarer syn sicrhau

cyranogiad da gyda phlant mewn seydliadau goal cymdeithasol. Y mater canolog ywr angen i

seydlu dull seydliadol a rennir, gan ei ddatblygu gyda phawb o uwch reolwyr i ddenyddwyr

gwasanaeth. http://www.scie.org.uk/publications/guides/guide11/culture/culture2.asp

Y Saonau Cenedlaethol ar gyer Cyranogiad Plant a Phobl Ianc

http://wales.gov.uk/topics/childrenyoungpeople/publications/participationstandards/?lang=cy

Y deunyddiau a ddenyddir yn rhai o wasanaethau Barnardos i helpu gweithwyr i gyathrebuneeithiol gyda phlant a phobl ianc. http://www.talkingheads-ltd.co.uk/circletime1.html

Mesur Hawliau Plant a Phobl Ianc (Cymru) 2010

Y Saonau Cenedlaethol ar gyer Cyranogiad Plant a Phobl Ianc

Swydda Archwilio Cymru /Adolygiad CAMHS Arolygiaeth Iechyd Cymru 2009

Llywodraeth Cynulliad Cymru. (2010) Cyawnir Dull Rhaglen Oal yng Nghymru.

Canllawiau Interim ar gyer Rhoir Polisi ar Waith. Caerdydd. Llywodraeth Cymru

Llywodraeth Cynulliad Cymru Mesur Iechyd Meddwl (Cymru) 2010


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Conclusion (10 mins)

Suggest that participants enhance the practical application o the inormation they have covered in this

unit that they could discuss the change they have chosen to make within supervision, reective

practice and group discussions with colleagues.

Questions What are you going to do dierently now?

This is an important part o the unit and should not be avoided. The learning units are designed to

challenge people to make a commitment to change and improve their work or care and treatment

planning. Thereore part o this commitment is a public acknowledgement o what they think they have

learned and what immediate steps they can make to positively alter their practice. Ask the participants

or at least one signifcant learning point and what they plan to alter as a result.

Take home messages

Care and treatment planning is much more than a document flling exercise.

Care and treatment planning is underpinned with values.

A belie in recovery is at the heart o the Mental Health (Wales) Measure 2010.

Further reading

Childrens rights in the health system as described in this leaet produced by Save the Children

in participation with sta and service users at; The Childrens Hospital or Wales, Save the

Children Turn on the Rights Project and Barnardos Marlborough Rd Caterpillar Project.

http://www.savethechildren.org.uk/en/docs/PDF_Health_Leaet.pd

Save the Children Wales Childrens Rights Website

http://www.childrensrightswales.org.uk/public-services.aspx

SCIE guide on establishing good participative practice with children in social care organisations.

The central issue is the need to establish a shared organizational approach developed with all

involved rom senior managers through to service users. http://www.scie.org.uk/publications/

guides/guide11/culture/culture2.asp

Children and Young Peoples Participation Standards or Wales http://wales.gov.uk/topics/

childrenyoungpeople/publications/participationstandards/;jsessionid=lmhtNBdBRHGgnFnvL18XZlR

DHyNzXsJMwrhX0dXSm0qFvdnJh!-1312433909?lang=eng

Materials used in some Barnardos services to support workers to communicate eectively with

children and young people. http://www.talkingheads-ltd.co.uk/circletime1.html

The Rights o Children and Young persons (Wales) Measure 2010

Children and Young Peoples Participation Standards or Wales

Wales Audit Ofce/Health Inspectorate Wales Review o CAMHS 2009

Welsh Government (2010) Delivering the Care Programme Approach in Wales Interim Policy

Implementation Guidance. Cardi. Welsh Government

Welsh Government. Mental Health (Wales) Measure 2010


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Taen 1

Senario Personol Rhys 6 oed:

Mae Rhys yn 6 oed. Maen byw gydai Nain, Gwen syn 51 oed ai Daid, Powel syn 55 oed, ar

l iw Fam (Myanwy, eu hunig erch) gael ei lladd gan ei chariad (tad biolegol Rhys) pan oedd

Rhys yn 1 oed. Ymosodwyd heyd ar Rhys a dioddeodd ana iw ben sydd wedi arwain atepilepsi a mn anabledd dysgu/cymharol.

Maer meddyg teulu wedi goyn i CAMHS weld Rhys gan ei od wedi cael ft epileptig yn yr ysgol

2 fs yn l, ac mae ei Daid ai Nain yn cael traerth annog Rhys i ynd ir ysgol bob dydd gan ei

od yn dweud bod plant eraill wedi chwerthin ar y mhen pan wnes i wlychu y nhrowsus.

Mae Rhys yn mynd at Dr Williams (Paediatregydd Ymgynghorol) bob 6 mis i adolygu ei epilepsi.

Yn ddiweddar cynyddodd Dr Williams eddyginiaeth Rhys ac nid yw Rhys wedi cael unrhyw

ftiau pellach. Rhoddodd y meddyg teulu ychydig o hanes teulu Rhys ai deuluwrth gyeirior

achos ymlaen, gan nodi bod Myanwy yn arer yed llawer o alcohol ac yn denyddio canabis ar

adegau. Roedd y meddyg teulun amau bod partner Myanwy wedi ei cham-drin yn y cartre

ai od yn camddenyddio sylweddau. Roedd y Gwasanaethau Cymorth i Deuluoedd Integredignewydd ddod i gysylltiad r teulu cyn ei marwolaeth.

Daethpwyd Rhys i glinig CAMHS gan Gwen a Powel. Eu pryder penna oedd y aith bod Rhys

yn poeni am bob manylyn bach a bod hynnyn aich ar y ddau ohonynt weithiau. Mae Powel yn

gweithio oriau hirion, mae Gwen yn gweithio ychydig o oriau tra bod Rhys yn yr ysgol ond mae

ei rheolwr yn colli amynedd gan ei bod wedi gorod mynd ir ysgol i geisio datrys ei broblemau

presenoldeb, a phan mae Rhys yn gwrthod mynd ir ysgol maen gorod aros gartre i oalu

amdano. Mae Gwen yn gofdio ac ynan mynd yn in yn ystod yr asesiad. Dywedodd wrth y

tm od yr ysgol yn ei helpu ond nad ywr Gwasanaethau Cymdeithasol yn gwneud unrhyw beth

iw helpu, heblaw am wneud y gwaith papur yn y cannoedd o gyarodydd a gawyd yn y 5

mlynedd ddiwetha.Arerair taid ar nain yw mewn tre awr, ond maen nhw wedi symud yn l ir pentre bach lle

magwyd Gwen. Mae Gwen wedi bod yn cymryd tabledi gwrth iselder ers marwolaeth Myanwy.

Dywedodd wrth y tm Alla i ddim codi o y ngwely ambell ddiwrnod ac oni bai bod Rhys yn dod

phaned i mi, buaswn yn aros yn y ngwely drwyr dydd pe bawn in cael. Criodd Nain drwy

gydol yr asesiad ac meddai Alla i ddim dod drosto, bob dydd dw in edrych ar Rhys ac maen

y atgoa o beth sydd wedi digwydd. Fe ddes i adre i geisio dianc rhag yr atgofon erchyll a

nhw au tebyg (gan gyeirio at nain a thaid a theulu Rhys o ochr ei dad) ond dydi pethau ddim

yn gwella. Mae Gwen yn ddwyieithog ac maer siarad Cymraeg gan ei bod bellach gartre

gydai rindiau. Mae Powel a Rhys yn ddwyieithog.

Gwahoddwyd Rhys i ddod yn l i CAMHS i gael ei weld ar ei ben ei hun. Caodd ei weld yn yrystaell therapi chwarae gan Aelwyn, un o nyrsys CAMHS, el rhan or asesiad.

Eisteddodd Rhys yn llonydd iawn ar y gadair drwy gydol y sesiwn, siaradodd yn dawel ond roedd

yn gallu dweud wrth Aelwyn:

Mae yna bethau hyll yn dod i y mhen. Weithiau dw in meddwl am bethau ac weithiau dw in

gweld lluniau yn y mhen sydd bob amser yr un ath f yn brio rhywun. Maen codi on arna i.

Yr un syn y mhoeni wya ywr llun ohono i yn trywanu y Nain. Maen onadwy ac alla i ddim

cael gwared arno o. Dw in ceisio peidio denyddio cyllyll achos dw in poeni y gallwn i wneud

rhywbeth onadwy, ond mae Nain yn dweud y dren o hyd amser te am nad ydw in denyddio y

nghyllell a dw in teimlon wirion pan ydw in dweud na alla i, a dim bod yn ddrwg ydw i.

Dw in trio bod yn dda ai helpu llawer pan mae hin crio. Heyd pan ydw in cerdded heibio iblant yn y nosbarth dw in poeni y mod i wedi taro yn eu herbyn au brio nhw.

Maen onadwy achos dw in caru Taid a Nain a dw in ho iawn o y rindiau.


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Handout 1

Personal Scenario Rhys aged 6 years:

Rhys is 6 years old. He lives with his Gran, Gwynhwyan aged 51 years and Grandad, Powel

aged 55 years, ater his Mum (Myanwy, their only daughter) was killed by her boyriend

(Rhys biological ather) when Rhys was 1 year o age. Rhys was also attacked and suered ahead injury which has led to epilepsy and mild/moderate learning disability.

The GP has asked CAMHS to see Rhys as he had an epileptic ft in school 2 months ago and

Grandparents are struggling to get him to go to school every day as Rhys says the other kids

laughed at me when I wet my pants. Rhys is seen by Dr Williams (Consultant Paediatrician)

every 6 months to review his epilepsy. Dr Williams has recently increased the medication and

Rhys has had no more fts. The GP included some amily history about Rhys parents in the

reerral, noting that Myanwy had been a heavy alcohol user and used cannabis on occasions.

The GP suspected that Myanwys partner had been domestically violent and misused

substances. The Integrated Family Support Services had just become involved prior to

her death.

Gwen (as she likes to be called) and Powel bought Rhys to the CAMHS clinic. Their biggest

concern was how much Rhys worries about every little thing and said it drives us both mad at

times. Powel works long hours, Gwen works a ew hours whilst Rhys is in school but her boss

is losing patience as she has had to go into school to try to sort out his attendance but when

Rhys wont go to school she has to stay at home to look ater him. Gwen become upset and

then angry in the assessment, she told the team that school are helpul but Social Services

are not doing anything to help them, except doing the paperwork at the hundreds o

meetings they have been to over the past 5 years.

The Grandparents used to live in a large town, but moved back to the small village whereGwen grew up. Gwen has been taking anti-depressants since the death o Myanwy, she told

the team that I just cant get out o bed some-days and i it wasnt or Rhys getting me a

cuppa I would stay in bed all day i I could. Gran cried throughout the assessment and said I

just cant get over it, every day I look at Rhys it reminds me o what happened, I came home

to try to get away rom horrible memories and them and their lot (reerring to Rhys paternal

Grandparents and amily) but nothing is any better. Gwen is bilingual but speaks Welsh now

she is home again with her riends, Powel and Rhys are bilingual.

Rhys was invited to come back to CAMHS be seen on his own and was seen in the play

therapy room by one o the CAMHS Nurses Aelwyn, as part o the assessment.

Rhys sat very still on the chair throughout the whole session, he spoke quietly but was able totell Aelwyn:

I get horrible things popping into my head. Sometimes I think stu and sometimes I see

pictures in my head they are always the same thing me hurting someone. I get so scared.

The one that really upsets me most is when I get a picture o me stabbing my Gran. Its awul

and I cant get it out o my mind. I try not to use knives because I worry that I might do

something awul, but Gran keeps telling me o at tea time because I wont use my knie and

I eel silly telling her that I cant and Im not being naughty. I try to be good and help her lots

when she cries. I also worry that when I walk past people in my class I might have bumped into

them and hurt them. Its horrid because I love my Gran and Grandad and like my riends a lot.


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CAMHS Taen 2

Rhestrau Grymuso a Hunan Reolaeth

Dyma ddwy restr ond mae nier o enghreitiau eraill! Mae plant/pobl ianc wedi eu grymuso

pan maen nhwn:

gwybod bod ganddynt yr un hawliau a chyrioldebau ag eraill

teimlo ymdeimlad cry o ymreolaeth

yn chwarae rhan ganolog mewn prosesau gwneud penderyniadau ynglyn u bywyd

gallu cael mynediad i wybodaeth angenrheidiol er mwyn gwneud dewisiadau

gallu dewis o nier o opsiynau

gweld bod eu hawl i ddewis yn cael ei barchu

cael y gair cynta ac ola mewn unrhyw draodaeth amdanynt

teimlon gyartal ag eraill ac yn cael eu trin yn gyartal ag eraill

cynnig cyarwyddiadau ymlaen llaw dweud wrth bobl sut maen nhwn dymuno cael

eu trin os ydyn nhwn sl.

Mae gan blant/bobl ianc hunan reolaeth pan maen nhwn:

gwneud cynlluniau yn eu hiaith eu hunain ac yn denyddio eu geiriau eu hunain

onio, ysgriennu llythyrau a llenwi urenni eu hunain i roi sylw iw hanghenion

datrys eu problemau eu hunain

traod gyda phobl i gyawni eu hanghenion

derbyn cymorth eraill ar eu telerau eu hunain heb golli unrhyw gyrioldeb

goalu amdanynt eu hunain, bod yn iach yn gororol a rhoi sylw i broblemau iechyd meddwl

gweinyddu eu moddion eu hunain

arer hunan ymwybyddiaeth a gweithredu ar hyn yn cynnwys rhagweld pan ydd argywng

yn dechrau.


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CAMHs Handout 2

Empowerment and Sel Management lists

Here are two lists but there can be many more examples! A child/young person is

empowered when they:

recognise that they have the same rights and responsibilities as others

eel a strong sense o autonomy

are at the centre o decision making processes concerning their lie

are able to access inormation necessary to make choices

are able to choose rom a range o options

see their right to choice respected

have the frst and last word in any discussion about them

eel equal to others and are treated equally by others

make advance directives telling people how they want to be treated when they

are unwell.

A child/young person is sel-managing when they:

make plans in their own language and using their own words

make phone calls, write letters and fll in orms themselves to address their needs

sort out their own problems

negotiate with people to get their needs met

accept the support o others on their own terms and without resigning responsibility

look ater themselves, maintaining physical health and addressing mental health problems

administer their own medication

exercise sel-awareness and act on this including anticipating the onset o a crisis.


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CAMHS Taen 3

Senario Personol Rhys 7 oed

Mae Rhys wedi bod yn mynychu CAMHS am y 12 mis diwetha. Mae Taid wedi lleihau ei oriau

gwaith ac mae wedi bod yn dod Rhys ir apwyntiadau. Maer tm CAMHS wedi cynnig ir taid

ar nain ddod gydai gilydd ir apwyntiadau yn arbennig yn y 4 mis ola o gyraniad CAMHS ondmae Gwen wedi gwrthod am y rheswm Ei od yn cael y cymorth iawn bellach ac am y byddain

rhaid i mi gymryd amser i wrdd or gwaith i ddod ir clinig ar gyer y nghwnsela y hun ac

alla i ddim dal i gymryd mwy o amser i wrdd. Mae Rhys wedi dod i ddeall yn dda sut y gall

drechur OCD ac mae Taid yn y helpu gydar pethau y mae Aelwyn yn goyn i mi eu gwneud

gartre. Pan mae Taid wedi bod yn dod Rhys ir apwyntiadau mae wedi cael gair gydag

Aelwyn yn yr ystaell aros ar ddiwedd apwyntiadau Rhys i gael yr wybodaeth ddiweddara am

ei ddatblygiad ac maen cadarnhau bod y rhan wya or ymddygiad syn gysylltiedig ag OCD

wedi stopio bellach.

Erbyn hyn mae Rhys yn mynychur ysgol yn rheolaidd. Mae athrawes ddosbarth Rhys wedi bod

yn cyarod yn rheolaidd gyda CAMHS ac maen teimlo ei od wedi elwa or gwaith grwp

wnaethpwyd gydag e yn yr ysgol. Yn ei hadroddiad diwetha dywed ei bod yn meddwl bod Rhys

yn llawer mwy rhydd gydag oedolion ond maen dal ychydig yn betrus gydai gyoedion.

Maen dal i gael ei ystyried yn achgen bach tawel. Mae wedi cael ei asesu gan Seicolegwyr

Addysg ac mae bellach yn cael cymorth dysgu.

Nid yw Rhys wedi cael unrhyw ftiau epileptig pellach yn y 7 mis diwetha; maen dal o dan oal

Paediatregwyr.

Yr unig gais gan Daid a Nain Rhys yn ystod y cynod y bun mynd ir CAMHS oedd bod Goal

Cymdeithasol yn cynnig rhai gweithgareddau i Rhys. Roedd Rhys heyd yn teimlo bod hyn yn

iawn ond dim ond unwaith yr wythnos. 3 mis yn l ymunodd Rhys grwp goalwyr ianc;

maen mynd yn rheolaidd ir gweithgaredd un noson yr wythnos. Mae Rhys yn mwynhau

chwaraer drymiau a byddain hof bod mewn band pan maen hwn.

Chi ywr cydlynydd goal ac mae angen i chi ynd ati i adolygur cynllun goal, gan od 12 mis

wedi mynd heibio bellach ers y gwaith cychwynnol o baratoir cynllun goal a thriniaeth.


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CAMHS Handout 3

Personal Scenario Rhys aged 7 years

Rhys has been attending CAMHS or the past 12 months. Grandad has reduced his hours at

work and has been bringing Rhys to the appointments. The CAMHS team oeredGrandparents appointments together particularly trying to engage them in the fnal 4 months

o the CAMHS input but Gwen declined to attend giving the reason Hes getting the right help

now and Im going to have to take time o to go the clinic or my own counselling and I cant

keep taking more time o. Rhys has built up a really good understanding o how he can beat

OCD and Grandad helps me with the things Aelwyn asks me to try at home. When Grandad

bought Rhys to the appointments he has talked to Aelwyn in the waiting room at the end o

Rhys appointments to catch up on things and confrms that the majority o his checking

behaviours have now stopped.

Rhys is now attending school regularly. Rhys class teacher has been meeting regularly with

CAMHS and eels he has benefted rom the group work they did with him in school. Her lastreported identifed that she thinks Rhys is much more relaxed with adults but remains slightly

anxious with his peers. He is still seen as a quiet little boy. His learning has been assessed

by the Educational Psychologists and learning support is now in place.

Rhys has had no urther epileptic fts in the past 7months; he remains under the care o

Paediatrics.

The only request rom grandparents during the time that Rhys has been attending CAMHS was

or Social Care to oer Rhys some activities. This was something that Rhys also elt would be

ok but only once a week. 3 months ago Rhys joined a young carers group; he regularly

attends an activity evening once a week. Rhys enjoys learning to play the drums and would liketo be in a band when he grows up.

You are the care coordinator and need to arrange a care plan review, as 12 months has now

elapsed since the initial preparation o the care and treatment plan.


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Camaur cydlynydd goal Sylwadau

Os na wnaed hynnyn aenorol, cytunwch ar y

lleoliad ac amser dechrau a goren y cyarod

Sicrhau bod

y lleoliad yn hwylus a hawdd iw gyrraedd

bod y cyarod yn cael ei gynnal yn brydlon i

sicrhau presenoldeb y denyddiwr

gwasanaeth ar rhai syn ymwneud r

cynllun goal a thriniaeth

Bydd amseroedd dechrau a goren yn sicrhau

bod amser digonol yn cael ei ganiatu i gynnaly cyarod heb deimlo bod unrhyw rys.

Trenwch gyarod y denyddiwr gwasanaeth i

draod y cyarod, er mwyn nodi canlyniadau

a sicrhawyd a chael barn am ganlyniadau neu

gamau pellach

A oes gan y denyddiwr gwasanaeth unrhyw arno sabwynt:

sut maer cyarod yn cael ei gynnal

pwy syn cael ei wahodd

a ydden nhwn hof dod rhywun gyda hwy

iw cenogi.

Os ywr cla yn gymwys i gael eiriolaeth

iechyd meddwl rhowch yr wybodaeth iddo /

iddi am hyn.

Dylid diweddaru asesiadau perthnasol

Gwnewch yn siwr bod gan y denyddiwrgwasanaeth gopi or cynllun goal a thriniaeth.Ceisiwch gael barn y denyddiwr gwasanaeth,(ac os ywn briodol) y goalwr ynglyn :

chynnydd tuag at gyawni canlyniadau y cytunwyd arnynt yn aenorol

a yw camau y cytunwyd arnynt yn aenorol

wedi helpu i sicrhau canlyniadau ai peidio

unrhyw newidiadau syn angenrheidiol, yn eubarn hwy, i sicrhau camau ymlaen achanlyniadau.

Os cynhelir y cyarod yn Gymraeg, Saesnegneu iaith arall maen debyg y bydd angen

cyfeithur cyarod ir rhai nad ydynt yn siaradyr iaith hon. Mae hyn yn golygu eallai y byddangen mwy o amser ar gyer y cyarod.

Cyn y cyarod

Taen 4Canllawiau ar gadeirio adolygiad o gynllun goal a thriniaeth


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Care coordinator actions Comments

I not previously undertaken agree the venue

and a start and fnishing time or the meeting

Ensure

venue is accessible

that the meeting is held at a time to ensure

attendance o service user and those

involved in care and treatment

Start and fnish times will ensure that

adequate time is allowed to conduct the

meeting without it eeling hurried.

Meet with the service user to discuss the

meeting, to identiy achievement o outcomes

and to obtain views on urther outcomes or

actions

Has the service user any views with regard to:

how the meeting is conducted

who is invited

whether they would like to bring someone to

support them.

I patient qualifes or independent mental

health advocacy- provide the inormationon this.

Update relevant assessments

Ensure service user still has a copy o the careand treatment plan. Obtain service user (andwhere appropriate) carer views on:

progress towards achievement o previously

agreed outcomes

whether previously agreed actions havesupported achievement o outcomes

any changes they think are necessary to

actions and outcomes.

I the meeting is to be conducted in Welsh,English or another language it is likely that themeeting will need to be translated or thosewho do not speak this language. This may alsomean that a longer time needs to be allowedor the meeting.

Beore the meeting

Handout 4Guidelines on chairing care and treatment plan reviews


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Anonwch wahoddiadau

Gwnewch yn siwr bod y rhai a wahoddir yn cael

eu hatgoa iddod ir cyarod

Gellir eu gwahodd i gywyno adroddiadau

ysgrienedig neu dros y n. Maer rhain ynarbennig o werthawr os nad ywr person yn

gallu dod r cyarod. Dylid conodi gwybodaeth

a roddir dros y n yn ysgrienedig a sicrhau

gydar person dawn sylw od y conod yn gywir.

Maen ddenyddiol gwahodd gweinyddwr ir

cyarod i gymryd conodion.

Gwnewch yn siwr bod unrhyw asesiadaun cael

eu diweddaru ac yn ddelrydol gwnewch yn

siwr bod y rhain ar gael ir parton perthnasol

Cysylltwch ag unrhyw rai a wahoddwyd ond

sydd heb ymateb na darparu adroddiad.

Paratowch y rhaglen

Byddair rhaglen el arer yn cynnwys

Cywyniadau ac ymddiheuriadau (gan y rhai

nad ydynt yn bresennol)

Yr wybodaeth ddiweddara am unrhyw

asesiadau

Y canlyniadau ar camau y cytunwyd arnynt

er mwyn eu cyawni (el arer maen well

rhestrur rhain el eitemau ar wahn e.e.

gwaith a galwedigaeth

Unrhyw ater arall

Amser a dyddiad y cyarod nesa

Maen bosibl y byddwch yn awyddus i gynnwys

eitemau eraill neu roi enwau yn erbyn eitemau

os bydd rhywun wedi ei wahodd i roi arweiniad

ar yr eitem honno

Mae heyd yn ddenyddiol rhoi amseroedd wrth

bob eitem i sicrhau bod y cyarod yn cadw at

amser

Dangosir rhaglen enghreitiol isod.

O leia wythnos cyn y cyarod


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Send out invitations

Ensure that those invited are prompted to

confrm attendance

Invitation can invite telephoned or written

reports. These are particularly valuable i theperson is unable to attend. Telephoned

inormation should be recorded in writing and

checked with the person

It is useul to invite an administrator to the

meeting in order to record minutes.

Ensure that any assessments are updatedand ideally ensure these are available to

relevant parties

Contact any invitees that have not responded

or provided reports.

Prepare agenda

The agenda would normally include

Introductions and apologies (rom non

attendees)

An update o any assessments

Agreed outcomes and actions to meet them

(these are usually best listed as separate

items e.g. work and occupation

Any other business

Planned time and date or next meeting

You may wish to include other items or putnames against items i an invitee is going to

lead on that item

It is also useul to put times against each item

to ensure that the meeting stays on track.

A sample agenda is shown below.

At least one week beore meeting


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Gwnewch yn siwr bod yr lle wedi ei baratoi.

Trenwch sut i eistedd mewn cylch el arer.

Gallech ddarparu dwr neu luniaeth.

Gwnewch yn siwr bod copau or rhaglen, ycynllun goal a thriniaeth ac unrhyw asesiadauneu adroddiadau ysgrienedig ar gael i bawbsyn bresennol.

Gwnewch yn siwr od pawb yn bresennol.

Ceisiwch ddechrau a goren ar amser.

Cywynwch bwrpas y cyarod.

Gwnewch yn siwr od gan bawb gopau o

bapurau perthnasol.

Cywynwch yr aelodau ac unrhyw

ymddiheuriadau.

Cywynwch bob eitem yn unol r rhaglen.

Caniatewch amser iw traod.

Gwnewch yn siwr od pob barn yn cael eichlywed.

Rhowch adborth ac arweiniad ir unigolion syn

crwydro oddi wrth y rhaglen.

Crynhowch y draodaeth.

Gwnewch yn siwr od y pri bwyntiaun cael

eu conodi.

Os oes angen darparwch genogaeth

emosiynol.

Nid yw gadael denyddwyr gwasanaeth neu

oalwyr y tu allan i gyarod tra bod eraill yn eu

traod o unrhyw udd. Yr unig gyfawnhad dros

wneud hyn yw os ywr denyddiwr gwasanaeth

wedi dweud yn benodol nad ywn dymuno bodyn bresennol.

Rl y cadeirydd yw gorodi rheolaur

cyarod, se:

Sicrhau bod pobl yn siarad heb i neb dorri ar

eu traws

Canolbwyntio ar y dasg

Hwylusor broses o wneud penderyniadau.

Maer cadeirydd yn gallu ymyrryd os ywr

cyranogwyr yn crwydro neun siarad ar draws

ei gilydd.

Dylair cadeirydd hwyluso traodaeth ond ni

ddylai ei reoli. Maen bwysig eu bod yn negydu

ac yn sicrhau bod pobl yn cael mynegi eu barn

yn hytrach na cheisio dylanwadu ar y rhai

syn anghytuno hwy.

Mae cyarodydd yn gallu bod yn straen i

ddenyddwyr gwasanaeth, goalwyr a rhaigweithwyr proesiynol. Maen bwysig sicrhau

bod y cyarod yn ddiogel a chyeillgar.

Dylid diolch i unigolion am od yn bresennol.

Os ywn briodol cytunwch ar amser a dyddiady cyarod nesa.

Nodwch unrhyw gamau y byddwch chi neu

eraill yn eu cymryd ar l y cyarod mewnperthynas diweddarur cynllun goal athriniaeth.

Maen ddenyddiol cytuno ar ddyddiad a lleoliadtra bod pawb yn bresennol - mae hyn yn sicrhauamser a lleoliad syn hwylus i bawb ac maen

arbed amser o orod trenu a chytuno dyddiadyn ddiweddarach dros y n/trwy lythyr.

Yn union cyn y cyarod

Yn ystod y cyarod

Ar ddiwedd y cyarod


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Ensure that the environment is prepared.

Arrange seating- usually in a circle.

You may wish to provide water or rereshments.

Ensure there are copies o the agenda, careand treatment plan and any assessments orwritten reports available to all those attending.

Ensure that everyone is present.

Aim to start and fnish on time.Introduce purpose o meeting.

Ensure everyone has copies o relevant

papers.

Introduce members and give any apologies.

Introduce each item in line with the agenda.

Allow time or discussion.

Ensure all views are heard.

Give eedback and prompts i individuals stray

rom the agenda.

Summarise discussion.

Ensure that key points are documented.

I necessary provide emotional support.

Leaving service users or carers outside a

meeting while they are discussed is

unhelpul. This can only be justifed where the

service user has expressly stated that they do

not want to be present.

It is the chairs role to enorce meeting rules

these are:

Ensuring people speak without interruption

Staying on task

Facilitating decision making.

The chair can intervene i participants digress

or talk over each otherThe chairperson should acilitate but not

dominate discussion. It is important that they

negotiate and ensure views are heard rather

than trying to win over those they

disagree with.

Service users, carers and some proessionals

can fnd meetings stressul. It is important to

keep the meeting sae and riendly.

Thank individuals or attending.

I appropriate agree time and date o nextreview.

State any actions you or others will be takingater the meeting in relation to updating thecare and treatment plan.

It is useul to agree a date and venue whilstpeople are present- this ensures it is mutuallyconvenient and saves time trying to agree adate by telephone/letter later.

Immediately prior to meeting

At end o meeting

During the meeting


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Dylid diweddarur cynllun goal a thriniaeth.

Dylid ysgriennur conodion.

Rhannwch y cynllun goal a thriniaeth

diwygiedig ar conodion.

Gwnewch yn siwr od y denyddiwr gwasanaeth

yn gallu arwyddor cynllun goal a thriniaeth a

chonodi unrhyw arn.

Maen ddenyddiol diweddarur cynllun acysgriennu conodion yn uan ar l y cyarod.

Dylid gwneud hyn tra ei od yn dal yn yw yny co.

Yn union cyn y cyarod


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Update care and treatment plan.

Document minutes o meeting.

Distribute amended care and treatment plan

and minutes.

Ensure service user is able to sign care and

treatment plan and record any views.

It is useul to update the plan and record anyminutes soon ater the meeting.

This is whilst it is resh in peoples minds.

Ater the meeting


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Uned Ychwanegol 2: CAMHS Taen 5

Senario personol Rhys 15 oed

Mae Rhys bellach yn 15 oed. Ddau fs yn l caodd Rhys ei atgyeirio eto i CAMHS i gael

asesiad gan y meddyg teulu gan od OCD Rhys wedi gwaethygu eto. Roedd meddyg teulu Rhyswedi ei atgyeirion l at y Paediatregwyr er mwyn cael adolygiad cynharach oi epilepsi gan ei

od wedi dweud yn ddiweddar ei od yn arogli pethau ac yn teimlo rhyw gosi ar ei groen.

Sylwodd y meddyg teulu od anafadau bach ond dwn ar ddwy raich Rhys ond pan holwyd e

am hyn, gwadodd od ganddo awydd iw rioi hun a gwadodd ei od yn hunan niweidio.

Gwelwyd Rhys yn CAMHS gyda Taid. Roedd Rhys yn awyddus i ddod yn l i draod gan ei od yn

meddwl bod yr holl gymorth yr oedd wedi ei gael yn y gorennol wedi ei helpu roedd yn help i

mi am ynyddoedd, ond maer cyan wedi dod yn l eto a dw i eisiau mynd ir coleg elly mae

angen i mi gael tren arna i y hun. Ni ddaeth Rhys ir ddau apwyntiad nesa ac er i lythyrau

gael eu hanon iw gartre, ni chawyd ateb.

Mae Rhys yn y 2 fs ola ym mlwyddyn 11 a rhagwelir y bydd yn dechrau cwrs galwedigaetholmewn coleg addysg bellach ymhen ychydig o fsoedd. Mae ei rind gorau yn yr ysgol wedi

dweud wrth eu tiwtor dosbarth heddiw bod Rhys wedi bod yn cysgu yn ei dy e ar y soa am y

3 wythnos diwetha. Nid yw Rhys wedi bod ir ysgol am 3 wythnos ond mae wedi dod ir ysgol

heddiw gydai rind. Caodd y tiwtor air gyda Rhys heddiw ac mae wedi onior tm CAMHS gan

ei bod wedi dychryn ar l gweld yr olwg arno, mae wedi colli llawer o bwysau, maen edrych yn

onadwy ac yn bell, maen ymddwyn yn rhyedd iawn ac nid ywn debyg iddoi hun.

Maer ysgol wedi cynnig cadw Rhys yn yr ysgol iw berswadio i wyta rhywbeth or cantn tra bod

y tm CAMHS yn penderynu beth ellir ei wneud iw helpu. Nid yw sta yr ysgol wedi onio Taid

na Nain rhag iddynt boeni neu wneud Rhys yn waeth.

Mae Aelwyn yn dal yn gweithio yn CAMHS. Hi oedd yr un wnaeth gyarod Rhys a Powel a

chynnal ail asesiad llawn. Roedd Aelwyn wedi onio Powel a chadarnhaodd yntau eu bod ill

daun poeni am Rhys ond yn teimlo na allen nhw bellach oalu amdano. Roedd Taid wedi

ymddeol mis diwetha ac roedd iechyd Gwen yn llawer gwaeth. Roedden nhwn teimlo nad

oedden nhwn cael unrhyw help gwirioneddol gyda bachgen mawr cry oedd yn codi on arnyn

nhw, yn cysgu gyda chyllyll o dan ei obennydd ac yn siarad eo oi hun drwyr nos. Dywed Taid

ei od yn teimlo cywilydd na all oalu am eu hunig wyr, ond nad ydyn nhwn deall pam od

ganddo gyllyll, yn arbennig ar l ir hyn a ddigwyddodd iw merch.

Foniodd Taid yr ysgol ac mae wedi siarad gyda Rhys a bydd yn dod ag e ir clinig mewn

ychydig o oriau i weld y tm. MaeTaid wedi cytuno i aros gyda Rhys tra ei od yn cael ei weld acmae eisiau gwneud popeth a all i helpu Rhys.


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Additional Unit 2: CAMHS Handout 5

Personal scenario Rhys aged 15 years

Rhys is now 15 years and 8 months old. Two months ago Rhys was reerred again to CAMHS

or an assessment by the GP because Rhys Obsessive Compulsive Disorder was much worseagain. The GP had reerred Rhys back to the Paediatrician or an earlier review o his epilepsy

as he had recently reported smelling things and eeling that his skin was crawling. The GP

noticed that there were some small but deep cuts on both Rhys arms but when asked he

denied any sel harm thoughts or behaviours. Rhys was seen at CAMHS with Powel. Rhys was

keen to come back to talk as he had ound all the help he got in the past did me good or

years, but now its all come back again and I want to go to college so I need to get my head

sorted. Rhys ailed to attend his next two appointments and letters to the home went

unanswered.

Rhys is in the last 2 months o year 11 at school and it is anticipated that he will be starting a

vocational access course at a urther education college in a ew months time. His best riendat school has today told his orm tutor that Rhys has been sleeping at his house on the soa

or the last 3 weeks. Rhys has not been into school or 3 weeks but came into school today

with his riend. The tutor spoke to Rhys today and has rung the CAMHS team as she was

shocked by his appearance, he has lost loads o weight, looks in a right mess and was really

withdrawn, behaving very oddly and not his usual sel at all.

The school have oered to try to keep Rhys at the school and get him to have some thing to

eat rom the canteen whilst the CAMHS team decide what can be done to help. School sta

have not rung Grandad or Gran as they didnt want to upset or wind up Rhys.

Aelwyn still works at CAMHS and was the clinician who met with Rhys and Powel and hadconducted a ull re-assessment. Aelwyn made a telephone call to Powel, who confrmed that

they were both worried about Rhys but elt they could no longer look ater him, Powel had

retired last month and Gwens health was getting much worse and they elt they were

getting no real help with a strapping lad who was making them eel scared, sleeping with

knives under his pillow and talking to himsel all night. Powel said he eels so ashamed that

he cant look ater their only grandchild, they cant understand why he has knives especially

ater what happened to their daughter.

Powel rang school and has spoken to Rhys and he will bring him to the clinic in a couple o

hours to see the team. Powel has agreed to stay with Rhys whilst he is being seen and wants

to do all he can to help Rhys.


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Taen 6

Cynllunio canlyniadau pethau iw cynnwys

Cynllunio canlyniadau ymddygiadol:

targedwch ymddygiad penodol

helpwch i osod nodau cyraeddadwy ar gyer newid ymddygiadol

helpwch i gael y genogaeth sydd ei hangen ar y plentyn neur person ianc er mwyn newid,

a chynnal y newid hwnnw mewn ymddygiad

helpwch y plentyn neur person ianc i dorrir newidiadau ymddygiadol hyn i lawr yn dargedau

cyraeddadwy llai

helpwch yr unigolyn i gael hyd ir adnoddau ar bobl syn gallu ei helpu i gyawni ei nodau.

Dylid ysgriennur canlyniadau gan ddenyddio egwyddorion CAMPUS h.y. dylent od yn rhaiCyraeddadwy, Amserol, Mesuradwy, Penodol, Uchelgeisiol, Synhwyrol.

C cyraeddadwy.

A amserol.

M mesuradwy.

P penodol.

U uchelgeisiol.

S synhwyrol.

Maen bwysig pwysleisio y dylid cynnwys y plentyn neur person ianc yn y broses o ysgriennu

pob cynllun goal a thriniaeth a dylid eu hysgriennu mewn iaith y byddant yn gallu ei deall.

Mae hyn yn cynnwys ysgriennu cynlluniau goal a thriniaeth yn Gymraeg neu Saesneg.

Heyd maen bwysig ystyried rl rhieni neur rhai sydd chyrioldeb el rhiant wrth baratoi

cynllun goal.

Os nad ywn bosibl cynnwys y plentyn neur person ianc, dylid conodir rhesymau pam nad

ywn rhan or cynllun ar camau iw cymryd i hwyluso cydweithio. Mae heyd yn bwysig ystyried

y rl y mae eiriolwyr iechyd meddwl annibynnol yn ei chwarae gyda chleifon i helpu eu cynnwys

wrth gynllunio goal a thriniaeth.


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additional unit 2: child and adolescent mental health services (camhs) care and treatment planning

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