Manualization Boundaries

24th September 2014
If the team is to collaborate together to achieve the aims of this novel Manualization (which is really ServiceDevelopment), then clear boundaries and rules about how they interact with the manualized material are required:

Sharing our clients' thoughts

    1. The KeyWorker is expected to bring Service User Feedback from the client.
    2. The client can also do so directly/anonymously in set ways, that are laid out in Service User Feedback).
    3. The aim for the team in this situation is to respond thoughtfully, and where possible and appropriate, to incorporate service-user feedback into further practice development, which is central to AMBIT.
    4. Critically important is DataSecurity - NO CONFIDENTIAL CLINICAL MATERIAL IS EVER UPLOADED - teams are responsible for the content that they upload.

Sharing own thoughts

    1. It is important for each team member to explore and share their own thoughts (Mentalization) about what they are doing with their local team - team members are expected to be active participants in refining their TeamTemplate;
    2. Each KeyWorker should be prepared to offer material to contribute towards manualization at team meetings. See How to do team manualization. See also Team Meetings and What material to share in team reflection and manualization? for more detail on this.

Sharing a Team's thoughts.

    1. Teams may (we hope and expect) develop better ways of addressing specific circumstances/new therapeutic modalities/clearer explanations/etc that become part of their 'TeamTemplate'.
      1. Making changes to a TeamTemplate is a TEAM-based decision, and should always be authorised by the team manager.
      2. In general team manualization occurs after team-based discussion (see Team Meetings) and agreement amongst a group that is accepted as quorate (see Reflective Quorum) and thus authorised to make such changes.
      3. It is never appropriate for a single team member to make edits to the TeamTemplate without such consultation and debate amongst the wider team. This means that the process of manualization forces teams to debate and reflect between each other upon "what we do, and why."
    2. Once robust outcomes data has been collected (see Outcomes measures), a team may agree these changes warrant consideration for inclusion in the CoreTemplate, that acts as the template for other teams to download and start work with. If there is sufficient evidence (see Research) or there is sufficient consensus (rules for this to be debated) the change will be adopted, or offered as a parallel version with some brief description of:
      1. "What is different",
      2. Evidence from outcome evaluations/trials,
      3. Details of the specific target population and local ecology/geography/cultural factors for which this version is attuned.
Ultimately these processes will allow other teams seeking to work in this way to select the "semi-bespoke" manual "off the peg" that most nearly fits their needs in terms of the target client group, outcome data, etc.