Service Delivery

28th December 2013
The Core Features of AMBIT defines eight markers of the AMBIT STANCE, and these collectively define the five key features of AMBIT PRACTICE that are the elements of service delivery without which AMBIT cannot be said to be delivered. These key features of practice are laid out below:

1. Mentalization


Just as it is a skill that is formed within relationships, and is essentially about negotiating and acting adaptively within relationships, so mentalizing in AMBIT might be seen as the 'oil' that helps to lubricate the various related parts in the complex system required to help very complex young people and families; different workers and different methods of working.

AMBIT insists on Working in multiple domains, and this is included in the process of drawing up the Formulation and Treatment Aims - which is essentially about developing a mentalized understanding of What's the problem?.

Many of the interventions that an AMBIT practitioner makes with young people or their families are designed explicitly to increase or repair mentalizing.

In AMBIT, mentalizing is also plays a key part in determining how individual and relatively autonomous team members work together in a team-based approach.

2. Active Planning - as part of Working with your CLIENT


A key innovative feature of this approach is the promotion of Working in multiple domains mainly (at least initially) via one KeyWorker - who have also been described as BarefootPractitioners; these are trained to deliver a wide variety of interventions in multiple domains and contexts.

To avoid the gravitational pull towards chaos in such conditions, Active Planning is applied to make explicit the goals (intentions) underlying all work - from the briefest interactions (Thinking Together) to the long term Care Plan.

3. SupervisoryStructures - as part of Working with your TEAM


Clear SupervisoryStructures, including disciplined ways of managing peer-to-peer case discussion support the KeyWorker who is often exposed to highly invalidating environments that reduce their own capacity to use Mentalization

4. Addressing Dis-integration - as part of Working with your NETWORKS


As part of the AMBIT stance, the KeyWorker takes responsibility for trying to increase the integration of services and informal support networks around the young person by taking active steps in Addressing Dis-integration.

5. Manualization - as part of LEARNING at work


Specific interventions are manualized, using a novel wiki-based approach, that encourages a marriage (or conversation) between 'top-down' evidence-based modules, and 'bottom-up' locally-authored material that documents a local team's ongoing learning ("practice-based evidence") and existing expertise. Included in the manual are the Boundaries that help to SUSTAIN best practice.