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CEDAR CREATE

CEDAR CREATE

Consultancy, Research and Evaluation, Transformation and Executive Education

CEDAR CREATE is the home of our knowledge exchange, research, transformation and impact activity.

Our current collaborators include NHSE & I, Every Mind Matters, Uppsala University, Washington State, Maudsley Centre for Child and Adolescent Eating Disorders, the ABFT team at Drexel University and Emerging Minds (UKRI).

Consultancy and Transformation

We can provide services with support and guidance to develop their workforce, maximise effectiveness and improve access to evidence-based psychological practices and therapies.

We can support you with:

  • Consultancy to support service planning, development and implementation
  • Staff training
  • Operational guidance
  • Leadership development
  • Developing accessible, outcome-led services and pathways
  • Valuing and developing expert by experience involvement
  • Guidance, advice and coaching

Email us for more information

Training Enhancement and Executive Education

We support professional development for businesses and individuals through flexible and bespoke training packages, including:

  • Training in health care leadership and service improvement to develop the workforce and support organisational growth. 
  • Continuing Professional Development
  • Masterclasses for organisations, teams or individuals
  • Short courses and micro-credentials 
  • Bespoke training tailored to your service requirements

Email us to discuss training options

Research and Evaluation

CREATE facilitates support for the commercialisation, implementation, and evaluation of training and novel therapeutic approaches that have been developed by CEDAR staff, or in collaboration with research partners.

We deliver and contribute to excellent clinical research by developing a research environment that is nationally and internationally competitive. 

We contribute to the impact of research, workforce initiatives and training programmes by supporting and evaluating the delivery and implementation of psychological treatments, evidence-based training, practice and policy. 

We can support you with:

  • Evaluating the delivery and implementation of psychological treatments
  • Evaluating the delivery and implementation of evidence-based training and new workforce roles
  • Using outcomes and data to improve patient care and service effectiveness
  • Facilitating and understanding the impact of research

Email us to discuss a potential project

Current CEDAR CREATE projects

In collaboration with the Maudsley Centre for Child and Adolescent Eating Disorders, this intensive 4-day training provides an overview of the Family Therapy for Eating Disorders model (FT-AN), often referred to as the Maudsley Approach. This treatment model places strong emphasis on family working and involvement and supports the family to take a more active role in finding ways to overcome their child’s difficulties. The course also provides an understanding of other disordered eating diagnoses including Bulimia Nervosa.

Who is it for:

NHS professionals put forward by their service

Contact:

For more information, please email CREATEprojects-cedar@exeter.ac.uk

The Attachment-Based Care Milieu Programme (ABC Milieu Programme) works with administrators, doctors, occupational therapists, nurses, HCAs, psychologists, family therapists and support staff in inpatient treatment facilities. Sitting within the inpatient training programme, this will help the entire staff team to take a more psychotherapeutic approach to milieu management, in contrast to a behavioural management model. While managing safety is critical, an attachment-based lens, is grounded in trauma-informed care models. ​

The programme promotes an atmosphere of safety and trust for both patients and their families. Transparency and collaboration become key therapeutic elements. Staff challenge patients to identify unexplored trauma and disappointments while helping caregivers develop more emotion-focused, attachment promoting parenting skills.

Who is it for:

NHS professionals put forward by their service

Contact:

For more information, please email CREATEprojects-cedar@exeter.ac.uk.

Often with experience, practitioners are expected to take on clinical supervisory roles often without any training or knowledge of supervision model.  This training provides an opportunity to learn about what makes effective clinical supervision and to explore how professionals can embed this in their practice.  

The training will support Devon Partnership Trust practitioners to be able to distinguish clinical supervision from caseload management supervision, develop awareness of some models of clinical supervision and the different tasks involved in effective supervision, understand the importance of the supervisory alliance and how to manage ruptures and understand how to structure supervision to optimise the experience for the supervisee and increase effectiveness.

Who is it for:

Devon Partnership Trust staff

Contact:

For more information, please email CREATEprojects-cedar@exeter.ac.uk.

The South West Provider Collaborative and University of Exeter’s CEDAR Team are working in partnership to deliver a 10-day training programme to improve the CAMHS service across the South West. MDT staff from across the region will come together to hear from experts in topics such as autism/ASD, managing risk, DBT skills, eating disorders, looked-after children and many more.

Who is it for:

NHS professionals put forward by their service

Contact:

For more information, please email CREATEprojects-cedar@exeter.ac.uk.

Funded consultancy is underway with University of Washington and Washington State to implement Low-Intensity CBT into the state healthcare system. Change in the legislature has been secured to recognise supported low-intensity CBT as an approved psychological therapy.

Further work will begin to consider wider implementation issues with service providers and other professionals. Once implemented there is opportunity for wider research looking to adapt the CEDAR low-intensity CBT interventions for the state context and accommodate different populations in the diverse state.

Funded consultancy continues with Uppsala University on a range of projects adapting and evaluating low-intensity CBT interventions for a range of informal carer groups. These include parents of children being treated for cancer, informal carers of people with milder forms of dementia and for people with renal failure.

The dementia research has adapted funded research undertaken with CEDAR and extended it into the Swedish context that has needed to address professional implementation barriers. The research is now being located in community groups where informal carers are being supported by trained peers to support a behavioural activation intervention for people with mild dementia and low mood.

Within the renal failure context, funded development work has developed a competency framework for a new apprenticeship role, Assistant Wellbeing Practitioner (Renal), soon to be published. This work attracted additional funding from the Kidney Association to employ a Band 3 Healthcare Assistant to apply competencies within the renal speciality to be evaluated. Following evaluation, work has potential to inform an apprenticeship training programme to develop a variation on the Healthcare Assistant Practitioner apprenticeship.

This work has also served to involve CEDAR with funding from the Marie Sklodowska-Curie Fellowship, which is European-wide research funding to promote collaboration between Universities supporting a PhD student, Chelsea Coumoundouros. Chelsea will be joining CEDAR for a 3-month sabbatical undertaking multidisciplinary working with a Consultant in Renal Medicine, specialty allied health professionals and the Improving Access to Psychological Therapies Step 2 workforce to examine barriers to implementation focussed on supporting emotional wellbeing in informal carers.

The CEDAR low-intensity CBT interventions are the most commonly used in IAPT services in England and widely used across the world. Following evaluation currently under review for publication, NHS Improvement (NHSI) has sought approval to translate the CEDAR interventions into nine languages to help improve access to people with English as a second language or struggle to engage with interventions in English. NHSI are currently in discussion with the University Design team to receive funding to help adapt the interventions around the translations.

CEDAR is also soon to engage in discussion with NHS Every Mind Matters who have requested use of the CEDAR interventions for their programme, with adaptations to consider to be consistent with the programme. Requests were also made to translate the CEDAR interventions info French Canadian for use within Quebec, Canada. Interventions have now been adapted for all provinces with a model of support based around mental health social workers being developed. Collaborative research opportunities to evaluate this approach with University of Laval are being discussed.

Contact:

For more information, please email CREATEprojects-cedar@exeter.ac.uk.

CEDAR CREATE research

The COVID pandemic has had a significant impact across the NHS and healthcare sector and has contributed to a significant increase in children and young people’s mental health difficulties. Subsequently, access to digital psychological treatments became (and remains) an important medium through which to deliver assessment and intervention.

With funding from NHS England, the team have undertaken a survey-based study to understand how CAMHS professionals and the children, young people and families they support have been impacted by this increase in remote and digital delivery. The study will aim to develop our insight into difficulties associated with IT and internet provision and how it may have adversely impacted on those unable to seek or access support due to digital poverty.

As a team, we are passionate about understanding the impact staff working within mental health have on the community and we are working with a range of our South West CAMHS and voluntary sector and community partners in support of improving outcome data quality and reporting for the Children and young people’s Wellbeing Practitioners (CWPs) and Education Mental Health Practitioner (EMHP) Programmes.

We collect, analyse and present data demonstrating the impact of these early intervention roles across a range of community and education settings. The team produce service and regional level reports in support of service development, commissioning intelligence and the sustainability of the roles.

As part of our collaborative engagement and support with EMHP and CWP services, we have also developed and provided organisations with a bespoke outcome and data collection tool that is both easy to use and effective in collecting outcome data for practitioners.

The CEDAR CREATE research and evaluation team have been successful in bidding for Emerging Minds funding. Building on the success of our Children's Wellbeing Practitioner (CWP) programme and its evaluation, the team will work to develop our understanding of what have been the key contributing factors in the effective implementation of this evidence-based provision into children and young people’s mental health services.

Through collaborative engagement with a range of professionals, providers, children, young people and their families, the project aims to conduct a wide-ranging qualitative study to develop our understanding of the real-world factors that have supported the successful application of the CWP programme. Following analysis of this information, the project will then aim to co-develop a range of resources aimed at supporting effective implementation of the CWP programme and wider evidenced-based practice roles.

Our primary outputs from the study will be:

  1. A freely available CWP workforce implementation toolkit for services to use to develop their individualised implementation plan
  2. Freely available CWP and evidence-based practice training resources for service to use to support staff training and to promote an understanding of evidence-based low-intensity psychological interventions in their services
  3. Integration of the tool and guidance into relevant clinical training programmes and virtual workshops delivered by the CEDAR team, to support providers across the UK to use the workforce implementation toolkit and to develop their individualised implementation and evaluation plan.

In collaboration with Dr Laura Pass and Dr Shirley Reynolds, we are evaluating the effectiveness of behavioural activation (BA) delivered by Children’s Wellbeing Practitioners (CWP) across the South West.

As part of their training in low-intensity interventions, Dr Pass has guided cohorts of CWPs to use BA with adolescents experiencing low mood. We have data from 364 young people who have received a course of BA since March 2021. Of these, we have paired data on the Revised Children’s Anxiety and Depression Scale (RCADS) low mood subscale for 96% of all young people. Referral and session information will be analysed alongside routine outcome data to establish effectiveness of the intervention delivered by professionals from a low-intensity workforce.

This multi-disciplinary, cross-sector qualitative research project explores the experiences of children and young people approached by Police prior to a Section 136 but not detained, and/or detained by police under Section 136 of the Mental Health Act. It is a collaboration between Young People Cornwall, a charity supporting the mental health of children and young people, Cornwall Partnership NHS Foundation Trust, Cornwall Police, Cornwall Suite 136, and the University of Exeter.

The focus of the research is to understand the lived experience of children and young people who have been admitted under a Section 136. The aim is to better understand the process, improve the experience, and ultimately reduce the number of Section 136's happening in Cornwall. The University of Exeter is supporting the research design, methodology, ethical application, data analysis and interpretation. Findings will add to the growing literature around the Police's use of Section 136 on children and young people, and the impact it can have on the young person.

We are currently working on developing a publication, to be presented at an international conference, on Goal Based Outcomes (GBO) in therapeutic settings.

Setting goals is an important part of community mental healthcare for children and young people. To our knowledge, no studies have compared emotional and externally observable behaviour goals and the relationship between goal achievement and wider therapy outcome (i.e., low mood and anxiety) in CWP services. Using content analyses, the descriptions of the goals children and young people set during their therapy were categorised and frequency of goal themes was calculated.