Young people with complex emotional and relational needs help develop new training
Young people with complex emotional and relational (CERN) needs have been helping to shape and deliver innovative new training.
Norfolk and Suffolk NHS Foundation Trust (NSFT) has been working with Anna Freud, a leading mental health charity for children and young people, to co-create a training course for staff who work with children and young adults (aged 0-25) who have CERN, which may lead to a diagnosis of personality disorder.
Building on the Knowledge and Understanding Framework (KUF), which was originally aimed at supporting adults, a one-day pilot course was designed to provide awareness-level training for staff. The plan is for this to be expanded to play a key role in helping staff address these needs across the wider NHS and system partners.
The course was co-produced by a project team including members of the Trust’s KUF Development Team, young people with lived experience, and senior clinical leads Dr Jo Baines (consultant clinical psychologist and trust lead for PD/CEN strategy for children and young people) and Dr Charles Le Grice (consultant medical psychotherapist) along with contribution from a range of clinicians.
The planning stage featured co-production workshops, consultation meetings and train-the-trainer sessions, with careful consideration given to the needs of the young people involved in delivering the training, including wellbeing checks after sessions. It was funded by NHS England’s Workforce, Training and Education team in London.
The training was co-delivered in Bury St Edmunds by Dr Baines alongside two lived experience trainers of different ages, Courtney Reeve and Carl Coughlin, who were able to relate their individual experiences.
Twelve NSFT delegates, who work with young people, attended, from a mix of professional backgrounds, including nursing, psychology, psychiatry and social work. They reported significant improvements in their understanding of the challenges faced by young people with complex emotional and relational needs and greater confidence in providing support.
One delegate praised the training, stating: “It was invaluable to have individuals with lived experience providing insights into their personal journeys, helping clinicians improve the care we provide.”
The involvement of young people with lived experience was also highly valued by the young people themselves. One said: “Being able to use my voice to speak on behalf of myself, and many others who feel silenced by their condition, felt hugely empowering.
"I absolutely loved using my experience to talk about my struggles and victories, guiding staff members to think differently about people like me.”
The course is now being redeveloped into a two-day version to be rolled out in the spring, building on the experience gained, feedback received at the pilot stage, and the recommendations of an evaluation report from Anna Freud.
NSFT deputy chief executive and chief medical officer Dr Faisil Sethi said: “Working together has really paid off in developing this training for staff in what is a really complex field. Including the young people who have experience of the service has been vital in making sure any training is meeting their needs.”
Claire Evans, director of education and training and clinical director at Anna Freud, said: “It has been a joy to work on this programme alongside NSFT, which really demonstrates the power of participation. At Anna Freud, we believe collaborating with children and young people is essential for enhancing mental health services. That’s why young people with lived experience are central to this training.
“It’s particularly important that we build knowledge about young people with complex emotional and relational needs, who often face stigma if diagnosed with a personality disorder, along with challenges accessing appropriate care and treatment. They can be at high risk of self-harm and suicidal ideation, underscoring the urgent need for better awareness amongst health professionals.
"We hope this pilot can serve as a foundation for helping professionals better understand and navigate the complex feelings and behaviours these young people may experience.”
Case study: Courtney Reeve
For Courtney Reeve, being able to get involved in the work NSFT is doing for young people has been a lifeline.
The 26-year-old was asked if she would be a lived experience trainer on the CERN course for staff, alongside Carl Coughlin, after joining the Particip8! Group for young people.
“I was involved in interview panels through participation, and during a full day of interviews, I got talking to Jo Baines, who is a learned experience trainer. She asked me if I would like to get involved,” said Courtney.
Courtney had not long left CERN services and went from, in her words “a bit of a nervous wreck trapped in my home, to delivering training for staff”. She is hoping her new confidence will help her in the next steps of her recovery journey.
“The training means young people have a better experience because staff understand their needs,” she said. “When you are diagnosed it can be terrifying.”
Courtney’s recent experience of services blends well with Carl’s longer-term diagnosis which gives the training a personal feel and allows for interaction.
The aim is for Particip8! members to be involved again further down the line to get feedback from young service users.
Jo said: “I have worked with Carl for many years developing the trust-wide PD strategy, and I met Courtney when she joined one of our CFYP interview panels as an expert-by-experience.
"After working with Courtney interviewing, I thought that she would be a really valuable addition to our project team and approached her to ask about whether she would be interested in joining the project which she was – and we have all worked together on this ever since.”