[startgroup] Re: START time frames
- From: <mj.doyle1@xxxxxxxxxxxx>
- To: startgroup@xxxxxxxxxxxxx
- Date: Mon, 20 Jul 2009 22:42:29 +0100
Hi Sarah
Thanks for this. I think this list is proving, and will prove, really useful
for clarifying issues related to the START.
BW
Mike
---- "Desmarais wrote:
> Hi Mike,
> In our service and in training we suggest that START assessments are
> conducted every 3 months (as an outer limit) and that item ratings reflect
> what has happened since the last START assessment, or the past 2-3 months for
> an initial START assessment. Version 1.1 now provides some clarification
> regarding this issue on pp. 25-26:
>
> Time Frames
>
>
> Any risk assessment should be anchored in an evaluation of relevant
> historical factors. Although dynamic in nature, assessors are prompted to
> consider both current and historical information in their START assessments.
> Strength and vulnerability ratings of 0, 1, or 2 on the START items will
> normally be based on functioning over the past two to three months or since
> the previous START assessment. Key and critical items capture information
> regarding current or past functioning which may be particularly relevant to
> treatment and risk management planning. Identification of signature risk
> signs will require an indepth review of historical information, but may
> describe current or past functioning. Specific risk estimates will forecast
> over weeks to a maximum of three months as specified in the START Time Frame.
> Current Management Measures are also future-oriented, describing those
> strategies that will be used until the end of the START Time Frame or as
> necessary (e.g., times of crisis, transition, or other change in
> circumstance).
>
>
> Sarah L. Desmarais, Ph.D.
>
> Junior Research Scientist, Forensic Psychiatric Hospital
> BC Mental Health & Addiction Services
>
> Post Doctoral Research Fellow, School of Population and Public Health
> Postdoctoral Teaching Fellow, Department of Psychology
> University of British Columbia
>
> ________________________________
>
> From: startgroup-bounce@xxxxxxxxxxxxx on behalf of Mike Doyle
> Sent: Sat 18/07/2009 9:10 AM
> To: startgroup@xxxxxxxxxxxxx
> Subject: [startgroup] Re: SV: Re: START
>
>
> Hi Kare
>
> Yes, I was disappointed about not being able to stay longer in Edinburgh, but
> new role has placed a number of restrictions on my time. In any case I
> believe the conference went very well. At least next year I won't be expected
> to nip back to the office after a day!
>
> Our original form takes about 25 minutes the first time, although extended
> format with evidence boxes etc takes 1 hour +.
>
> I guess there may be a threshold at which the START becomes impractical as a
> 'brief clinical guideline'. Many staff mistake the 'short term' aspect as
> meaning it takes a short time to complete and I seem to recall some mention
> in the early days that it could be done in 8 minutes!
>
> I am also interested to hear what time period people use to rate items; e.g.
> previous week, month, 2-months etc., as this is obviously crucial to the
> rating and dynamic nature of the tool.
>
> Thanks for your response.
> Mike
>
>
>
> ----- Original Message -----
> From: Kare.Nonstad@xxxxxxxxx
> To: startgroup@xxxxxxxxxxxxx
> Sent: Wednesday, July 15, 2009 10:05 AM
> Subject: [startgroup] SV: Re: START
>
> Hi Mike. Sorry You had to leave Edinburgh so soon. Isn`t it allways
> tempting to try to make a good thing do even more? I have had to curb my
> enthusiasm repeatedly in my ideas to make the START jump trough flaming rings
> etc. I like Your model, though. There is a need for developing some kind of
> meta-model concerning our branch of psyciatry.
> We probable are a chatty bunch here in Trondheim, as in my experience,
> a START meeting takes about an hour, maybe one and a half if we do the
> treatment plan in the same meeting. This is in the beginning of the patients
> stay, after a couple of STARTs, we usually make it in approx. 45 minutes.
> Maybe we should look into this.
> Kåre
>
> ________________________________
>
> Fra: startgroup-bounce@xxxxxxxxxxxxx
> [mailto:startgroup-bounce@xxxxxxxxxxxxx] På vegne av Mike Doyle
> Sendt: 14. juli 2009 22:30
> Til: startgroup@xxxxxxxxxxxxx
> Emne: [startgroup] Re: START
>
>
> 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
> <mailto:christopherwebster@xxxxxxxxxxxx>
> 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 <mailto:mj.doyle1@xxxxxxxxxxxx>
> 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
>
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