North of Scotland CAMHS Tier 4 Network – Decider Skills
Background to project
The Decider Skills were originally developed in 2010 in response to an identified service need in the
adult mental health services in Guernsey. The aim was to reduce impulsivity and increase resilience
and confidence by learning thirty-two evidence-based skills based on cognitive behavioural therapy
(CBT) and dialectical behaviour therapy (DBT). The skills are designed to enable participants to make
changes to help manage distress, regulate emotion, increase mindfulness and effective
communication. The skills are delivered in an effective, fun, and creative style that makes them easy
to learn and teach.
Through discussion with staff across the North of Scotland it has been identified that staff would
strongly support the provision of Decider Skills and would welcome the opportunity to train in this
approach. The reports from other services show positive benefits for young people learning these
skills with them reporting better emotional regulation and finding they are more able to be less self-critical.
Aims of the training
• For staff across the North of Scotland to be trained in and be able to offer Decider Skills
• To support young people across learn emotional regulation skills
• For staff in the Inpatient Unit and Outpatient teams to learn a different, creative group
approach to delivering CBT and DBT based skills
• Networking opportunity for North of Scotland CAMHS staff
Progressing the training
Funding was very generously provided by the Foundation for Professionals in Services to
Adolescents which enabled a 2 day training Decider Skillsfor staff working with young people across
the North of Scotland (including transport and accommodation costs for colleagues from the two
island boards who otherwise would have struggled to attend)
Two trainers were identified by The Deciders Ltd to provide training on 5th and 6th September 2019.
40 clinicians were identified and attended the training. The clinicians attended from across the
North of Scotland CAMHS outpatient services and the Regional Inpatient Unit. The training was very
popular with the event being oversubscribed
Feedback was overwhelmingly positive with the following feedback from the training:
Progress
Since completing the training, the group has become embedded in the Inpatient Unit and proved
to be very popular with the young people with a good regular weekly attendance. This is a fairly
new group but has been measured using the DERS 18 questionnaire which measures aspects of
emotional regulation. The results of the group are promising:
DERS-18 Questions (% young people showing improvement in brackets)
Awareness
I pay attention to how I feel (33%)
I am attentive to my feelings (100%)
When I’m upset, I acknowledge my emotions (66%)
Clarity
I have no idea how I am feeling (66%)
I have difficulty making sense out of my feelings (66%)
I am confused about how I feel (33%)
Goals
When I’m upset, I have trouble getting work done (100%)
When I’m upset, I have difficulty focussing on other things (100%)
When I’m upset, I have difficulty concentrating (66%)
Impulse
When I’m upset, I become out of control (66%)
When I’m upset, I have difficulty controlling my behaviour (66%)
When I’m upset, I lose control over my behaviours (66%)
Non-acceptance
When I’m upset, I become embarrassed about feeling that way (33%)
When I’m upset, I feel ashamed with myself for feeling that way (100%)
When I’m upset, I feel guilty for feeling that way (100%)
Strategies
When I’m upset, I believe I will remain that way for a long time (100%)
When I’m upset, I believe that I’ll end up feeling very depressed (66%)
When I’m upset, I believe that wallowing in it is all I can do (66%)
The community teams have initially used Decider Skills individually but have plans to offer group
programmes in the near future having had positive feedback from young people and their families.
The inpatient and outpatient teams using decider skills have built on relationships that were
developed during the training and have kept in contact. They have shared ideas and how they have
progressed Decider Skills in their area and there is hoped a peer support and development group
will be developed.