Psychological consultancy in mental health teams

Literature Review:
Psychological consultation is a common activity in mental health services, but evidence concerning its theoretical grounding, processes, and outcomes are relatively rare. Fifteen mixed method consultation studies were included in the review. Studies were assessed for methodological quality, and found to range from limited to strong. Cognitive behavioural consultation was the main approach used and consultation was most frequently delivered via formulation meetings. Psychological consultation appears to particularly improve staff understanding about clients and consultants should remain visible and accessible to teams. Practical and methodological developments are suggested to the consultation evidence base.
Research Report:
This empirical study aimed to measure the effectiveness of cognitive analytic consultancy (CAC) offered within a community team and then to explore the possible mechanisms of change. An A-B with follow-up small N case series (N=5) design was used that utilised a mixed methodology employing outcome measures and semi-structured interviews. There were significant improvements in client fragmentation, staff competence and emotional exhaustion, and alliance from a client perspective. Potential mechanism of change included the therapists approach, using the sequential diagrammatic reformulation, and acknowledging that difficult processes helped recovery. Further head-to-head trials comparing CAC to other consultation frameworks appears warranted.