Description of services

There is a total of 15 posts for higher trainees on the scheme, with 12 out-patient placements and three in-patient placements. Trainees rotate every year on 1 October. Outpatient placements are generally for a year; inpatient placements are for six months. Job allocation meetings are usually held in May each year and trainees usually agree on placements as a group after discussions have taken place with educational supervisors about learning objectives that need to be met. All posts provide a range of experience in Child and Adolescent Psychiatry and several offer specialised experience for specific disorders. Opportunities are available in:

• Generic services
• Adolescent services
• Neuro-developmental services
• Learning disability
• Paediatric liaison services
• Eating disorders
• Looked after children teams
• Specialist refugee mental health teams
• Adolescent forensic psychiatry
• Substance misuse
• Early Intervention Psychosis
• Collingham Gardens Children’s inpatient Unit (a national centre).

Some of the specialist experience can be made available as special interest sessions.

A CAMHS team meets a wide range of the mental health and psychological needs of children and adolescents within a geographical area and are made up of CAMHS professionals from several disciplines who work together to provide integrated care. This scheme will put trainees in a CAMHS placement across the three Trusts. In some Trusts such as CNWL, CAMHS transformation has led to the development of more specialist sub-teams within each clinic. Trainees may be based in a specific team but other training opportunities are available within clinics according to training needs including: Learning disability/neurodevelopmental disorders

• Eating disorders
• Paediatric liaison
• Young offenders
• Looked after children.

Treatment models include:

• Family therapy
• Parenting
• Individual psychotherapy
• Behavioural/cognitive therapy
• Group therapy (such as Webster Stratton groups)
• Psychopharmacology.

Opportunities are generally available for supervised experience in a range of psychological therapies.

The scheme offers many placements that provide experience of working with children and young people with a range of neurodevelopmental difficulties. These include Autism Spectrum Disorder [ASD], Attention Deficit Hyperactivity Disorder [ADHD], tic disorders and other complex neuro-developmental difficulties. Interventions provided by the Neurodevelopmental Teams generally include:

• Assessments: Trainees can receive training to use the Autism Diagnostic Interview [ADI] and Autism Diagnostic Observation Schedules [ADOS].
• Individual interventions including cognitive behavioural therapy [CBT] and behaviour management.
• Support groups for parents of children with ADHD and ASD and where indicated referral to family therapy
• Liaison with school and other professionals.
• Psychopharmacological treatment.

Trainees can work closely with local paediatric services and thus promote the collaborative working between paediatric and mental health services. Trainees will be expected to assess children and young people’s physical, psychological and social needs and provide individual therapeutic interventions, liaison with other agencies and offer support to and work collaboratively with hospital staff. Opportunities for paediatric liaison are specifically available at St Mary’s Hospital and Chelsea and Westminster Hospital.

Many of the placements in the scheme offer the opportunity for trainees to gain the necessary competencies required for the management of children and adolescents with learning difficulties.

Some of the placements within this scheme offer eating disorders experience, for example, there are opportunities at Ealing CAMHS and other options that can be made available within the Community Eating Disorders Service for Children and Young People (CEDS-CYP) within CNWL.

Tier 4 inpatient placements are for six months for full time trainees, and usually one year for part time trainees. Inpatient experience for the scheme is obtained at Collingham Gardens for children ( under 13 years) and Lavendar Walk adolescent unit, both in CNWL NHS Trust, and The Coborn Centre for Adolescent Mental Health in East London (adolescent unit which also has a PICU).

Opportunities to obtain experience in assessing and managing emergencies are also available in Urgent Care Teams (CNWL) and the Alliance Team (West London NHS Trust) according to training needs.