The AMBIT Full Competency Framework describes 20 competencies for an individual worker in an AMBIT trained team. However, AMBIT is unambiguously a team approach and alongside this individual framework we are developing some ideas about what a team competency framework would look like. This page indicates some initial work on this idea. Our proposal is that an AMBIT team could be identified as having five core competencies of its work. These are:-

The team's ability to:-

1. Mentalize the Client
2. Mentalize the Team
3. Mentalize the Network
4. Learn as a team
5. Evaluate client outcomes

We have tried to think about how a team competency can be demonstrated. For each of the five competencies, we have included a list of possible alternative ways in which this aspect of team practice could be shown. Teams are not expected to do all of these but if they are doing none of them, then perhaps a part of the AMBIT model is not being used. This may be appropriate but it would seem useful if it is explicit and choosen rather than happening by default.

However, we are nervous about appearing to reduce a competency to a single practice. This would be unhelpful but, at the same time, if there is no explicit way by which a competency could be observed to be taking place, there is a possibility that the competency itself may be marginal to mainstream team work. As ever, the AMBIT approach is to try to balance top down definitions with appropriate local adaptations.

1. Mentalizing the client

An ability for the team to support each other in drawing on knowledge that the intervention aims at increasing the young person’s capacity to mentalize.

An ability for the team to support each other in adopting the mentalizing stance in working with young people.

An ability for the team to support each other in using the mentalizing loop in working with young people and their carers.

Team Practices that support Mentalizing the Client

• Group supervision in which a team member presents a case and the rest of the group mentalize the client and the worker either through discussion or through role play.
• Explicitly using the mentalizing stance or the mentalizing loop in joint work with young people
• Using mentalizing based formulations as the basis of casework interventions.
• Using the mentalizing approach explicitly as part of individual supervision.

2. Mentalizing with your team

An ability for the team to support each other in recognising that the mentalizing capacity of colleagues within a team (including oneself) is likely to fluctuate in response to anxiety, stress and other expected aspects of work with hard to reach young people.

An ability for the team to support each other in using the ‘thinking together’ approach to consulting with a colleague in a team, as a way of ensuring that sense is made of the worker’s own feelings about a particular young person or clinical situation, and the possible impact of this upon the work.

An ability for the team to support each other in being able to challenge colleagues where evidence of a non-mentalizing approach to the work is present, and to support them to regain their own mentalized explanations for the behaviours that they are working with.

Team Practices that support Mentalizing the Team

• Using 'thinking together' method of case discussion in team meetings.
• Using 'thinking together' in individual supervision.
• Training all new staff in the team about 'thinking together'

3. Mentalizing the Network

An ability for the team to support each other in making sense of the behaviour of staff from other agencies in terms of understandable mental states and intentions of agents in that organisation.

An ability for the team to support each other in adopting a position of respect towards staff from other agencies and to demonstrate this by positive curiosity about their work with the young person.

An ability for the team to support each other to identify all key participants from the youth’s professional network who have an investment in the youth’s outcomes, including family members where appropriate and other formal and informal key stakeholders.

An ability for the team to support each other in facilitating collaboration between professionals at all levels of the service system that takes into account professional beliefs about the nature of the young person’s difficulties, what may be helpful in addressing these problems, and beliefs about role responsibilities in a multi-agency system.

Team Practices that support Mentalizing the Network

• Using the method of network sculpting to reflect on difficult cases
• Using the dis-integration Grid as part of case formulation
• Using network sculpting as part of team training events.

4. Learning as a Team

An ability to reflect with team colleagues on interactions with young people and/or professionals in the network and in a systematic way agreed within the team (e.g. discussion in a team meeting) in order to enable collective learning about effective practice.

An ability for the team to support each other to make use of the team wiki manual in order to ensure that clinical decision making is consistent with evidence based practice and the AMBIT model as applied to the specific local team.

An ability for the team to support each other to engage in team discussion about important areas of practice with young people in order to develop a shared approach to a particular difficulty or situation that commonly arises with this client group.

An ability to contribute into achieving a consensus approach to common clinical dilemmas based on team reflection and discussion and to manualize practice guidance from this.

Team Practices that support Learning as a Team

• Having planned manualising meeting at set times throughout the year.
• Using the manual as part of case discussion.
• Re-writing aspects of core AMBIT practice adapted to local service needs

5.Evaluating Client Outcomes

An ability for the team to support each other to recognise the importance of remaining curious as to whether a particular method of work with a young person is be experienced as helpful to them.

An ability to support and contribute to the development of systematic methods within a team to evaluating whether young people are experiencing the service as beneficial to their problems.

An ability to focus on continued evaluation of outcome from multiple perspectives, ensuring that both the young person and the AMBIT worker communicate their respective viewpoints and consider the viewpoint of the other.

An ability of the team to support each other to complete an AIM assessment with a young person or with a member of the network who knows the young person well or a family member as part of an initial assessment of the young person’s needs.

Team Practices supporting Evaluating Client Outcomes

• Having a systematic method of recording client outcomes at the point of discharge
• Discussing client outcomes as part of team awaydays.
• Reporting on client outcomes to the commissioners and including the team in such reports
• Meeting with young people to consider outcomes and how these could be improved.