Background: Improved detection and clear referral systems are prerequisites for effective early intervention. Although specialist early intervention services are being introduced in Britain, changes are still required in the practice of existing primary and secondary care staff. Aims: This paper describes an exploratory evaluation of a partnership approach to help existing staff adapt their practice to support early intervention. Methods: Policies and procedures of the service described were compared systematically with national policy guidance. Structured interviews with 53 primary care and mental health staff were used to explore changes in their knowledge, attitudes and professional practice. Results: The service model complied with most UK national policy requirements for early intervention. There was increased awareness and knowledge of early psychosis and improved detection, assessment and intervention practice on the part of primary and secondary care staff.Conclusion: It appears possible to influence the practice of existing staff to deliver early intervention using an economical service model. Declaration of interest: This work was supported by educational grants from Janssen-Cilag/ Organon and Lilly.

Similar to findings following recovery from depression, LD-ATD can reduce specificity of AMT in the absence of lowered mood in healthy individuals with a strong family history of depression. These findings may reflect a 5-HT-dependent cognitive vulnerability to depression in different populations and warrant further research.

Accessible summary Dramatherapy groups are being used to help people with learning disabilities move from hospital back to their homes. The staff who support people to attend the groups talked about their experiences. The staff felt the groups help people stay well, build friendships and get support quickly if needed. The staff felt that the groups were helpful for themselves too as they felt supported and learned new skills. Abstract BackgroundThe UK Government's Transforming Care Agenda for people with learning disabilities has struggled to meet its goals of reducing inpatient beds and building community‐based support. This article reports on the experiences of support staff who attended dramatherapy groups developed to assist transitions from an inpatient hospital and to prevent re‐admissions through post‐discharge support. The groups provide ongoing support and a place where relationships can be developed between supporter and those supported. Materials and MethodsA focus group with a purposive sample of paid support staff. The data was synthesised using a thematic framework approach. ResultsThemes include: (a) new way of supporting and (b) hospital connection. The groups helped improve social interaction, friendship building, communication and self‐confidence. Additional benefits include the pooling of support and a connection with professionals that enables difficulties to be caught early. ConclusionsSupport workers valued these dramatherapy groups, recognising how the intervention enabled  people with learning disabilities to develop relationships and provide easy access to mental health professionals. Support staff also found benefits for themselves which included shared support and an increased understanding and insight into the people they support.

This article shares how a psychological services department has drawn on mindfulness practice and Acceptance and Commitment Therapy to foster a culture of self-care and compassion.

Purpose The purpose of this paper is to show that Acceptance and Commitment Therapy (ACT) may have utility with this client group in routine clinical practice. Design/methodology/approach This uncontrolled double case study describes the targeting of ACT processes with people referred to a mental health service for people with intellectual disabilities because of distressing intrusive thoughts. It includes qualitative data to illustrate the opinions of the participants eight weeks after the end of therapy. Findings Both clients described rapid relief from distress, with some additional untargeted benefits emerging too. The participants provided follow-up qualitative data in which they described how the therapy had helped them as well as areas where it had not. Research limitations/implications This paper presents uncontrolled case studies selected from routine clinical practice. They were selected due to their similarity of outcome and will not represent the experience of every client treated this way. Practical implications The practical implications are that a therapy often considered to rely on the use of metaphors and the manipulation of complex metacognitions may be useful for people with more limited verbal and cognitive ability if the therapy is adapted to meet their level of ability. Originality/value There has been very little published on using ACT with an intellectual disabilities population. This paper has originality value in that it illustrates the application of the approach in routine clinical practice. Additionally, the qualitative follow-up allows the participants’ voices to be heard about their experience of this approach.