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:
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.
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.
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
MentalizationAs 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.
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.