title: The Adolescent Mentalization-based Integrative Treatment (AMBIT) approach to outcome evaluation and manualization: adopting a learning organization approach.
abstract: AMBIT (Adolescent Mentalization-Based Integrative Treatment) is a developing team approach to working with hard-to-reach adolescents. The approach applies the principle of mentalization to relationships with clients, team relationships and working across agencies. It places a high priority on the need for locally developed evidence-based practice, and proposes that outcome evaluation needs to be explicitly linked with processes of team learning using a learning organization framework. A number of innovative methods of team learning are incorporated into the AMBIT approach, particularly a system of web-based wiki-formatted AMBIT manuals individualized for each participating team. The paper describes early development work of the model and illustrates ways of establishing explicit links between outcome evaluation, team learning and manualization by describing these methods as applied to two AMBIT-trained teams; one team working with young people on the edge of care (AMASS - the Adolescent Multi-Agency Support Service) and another working with substance use (CASUS - Child and Adolescent Substance Use Service in Cambridgeshire). Measurement of the primary outcomes for each team (which were generally very positive) facilitated team learning and adaptations of methods of practice that were consolidated through manualization.
authors.affiliation: Anna Freud Centre, London, UK p.fuggle@nhs.net.
authors.forename: Peter
authors.initials: P
authors.lastname: Fuggle
authors.affiliation: Anna Freud Centre, London, UK.
authors.forename: Dickon
authors.initials: D
authors.lastname: Bevington
authors.affiliation: Cambridgeshire Adolescent Substance Use Service (CASUS), Cambridge, UK.
authors.forename: Liz
authors.initials: L
authors.lastname: Cracknell
authors.affiliation: Adolescent Multi-Agency Support Service (AMASS), Islington, UK.
authors.forename: James
authors.initials: J
authors.lastname: Hanley
authors.affiliation: Cambridgeshire Adolescent Substance Use Service (CASUS), Cambridge, UK.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Hare
authors.affiliation: Anna Freud Centre, London, UK.
authors.forename: John
authors.initials: J
authors.lastname: Lincoln
authors.affiliation: Adolescent Multi-Agency Support Service (AMASS), Islington, UK.
authors.forename: Garry
authors.initials: G
authors.lastname: Richardson
authors.affiliation: Adolescent Multi-Agency Support Service (AMASS), Islington, UK.
authors.forename: Nina
authors.initials: N
authors.lastname: Stevens
authors.affiliation: Adolescent Multi-Agency Support Service (AMASS), Islington, UK.
authors.forename: Heather
authors.initials: H
authors.lastname: Tovey
authors.affiliation: MAC-UK, London, UK.
authors.forename: Sally
authors.initials: S
authors.lastname: Zlotowitz
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000458:organization & administration*; D055317:Evidence-Based Practice; D005178:Faculty; D006801:Humans; D007858:Learning; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care / Q000458:organization & administration*; D010348:Patient Care Team / Q000458:organization & administration*; D011584:Psychology; D000068217:Social Workers; D019966:Substance-Related Disorders / Q000628:therapy; D056345:Theory of Mind
keywords: Adolescent mental health; hard-to-reach; learning organizationsorganizations; manualization; mentalization-based therapy; outcome evaluation; outreach teams