Thanks Chris, Sarah and Steve for your helpful responses. I think the items are ideal areas for consideration when assessing strengths and risks, but also for the assessment of physical, psychological, social and political needs. As you know we are piloting the START to do this as part of applying the health career model. Initial feedback was good but the e-proforma we used (which included evidence boxes, formulation and intervention sections), was felt to take too long and many never fully completed it. In a sense we 'overcooked' the process as previous version was broadly welcomed! Therefore, attempting to make adjustments to make the process more efficient and practically useful. Will feedback to the group in due course. Another query; on average how long do people find the START takes to complete? Thanks again. Mike ----- Original Message ----- From: christopher webster To: startgroup@xxxxxxxxxxxxx Sent: Friday, July 10, 2009 5:52 PM Subject: [startgroup] Re: START Hi Mike, Not sure I can add much. But, obviously, the HCR-20 provided a platform for us.And having a couple of senior, very experienced,nurses (Mary-Lou and Connie) made the essential difference. Somewhat later, as I explained in a paper given at the Montreal IAFMHS meeting on our joint behalf, I realized that a dictionary of synonyms and antonyms could have saved us some work. I really do,though, believe that the only way to set up an SPJ device that has any hope of working is to establish a small group of colleagues willing to work together assiduously until the task is done. It is not a task for a committee and it is not a task for an individual person. It should, of course, be a topic to be studied and researched in its own right. Thanks, Roger, for getting this going! Cheers(We should be a formidable presence in Vcvr) Chris. ----- Original Message ----- From: Mike Doyle To: startgroup@xxxxxxxxxxxxx Sent: Thursday, July 09, 2009 4:15 PM Subject: [startgroup] START Nice one Roger! Looking forwarwd to networking with alll on the list. First query; where did the 20 items of the START come from? Thanks Mike