The Timid to Tiger Programme is an evidence-based programme utilising a cognitive behavioural therapy (CBT) approach for parents of children aged 3 to 11 who present with anxiety. The programme aims to provide early support and intervention for parents and families, to prevent them waiting a long amount of time for Child and Adolescent Mental Health Services (CAMHS) community level support. Timid to Tiger is delivered by the local authority Multi-Agency Support Team (MAST) in Sheffield, with support from CAMHS Primary Mental Health team.
Co-Production
From start: No
During process: Yes
In evaluation: No
Evaluation
Peer: No
Academic: Yes
PP Collaborative: No
Find out more
Richard Haslett - Clinical Nurse Specialist & Kirsty Saunders - Primary Mental Health Worker
The Timid to Tiger Programme is an evidence-based programme utilising a cognitive behavioural therapy (CBT) approach for parents of children aged 3 to 11 who present with anxiety. The programme aims to provide early support and intervention for parents and families, to prevent them waiting a long amount of time for Child and Adolescent Mental Health Services (CAMHS) community level support. Timid to Tiger is delivered by the local authority Multi-Agency Support Team (MAST) in Sheffield, with support from CAMHS Primary Mental Health team.
Access
Delivering this programme within the MAST has increased access for families, as referral and subsequent acceptance to a community CAMHS team is not a requirement for participation. A consultation model is used to help identify appropriate cases, with families also able to self-refer into the programme. This has reduced the strain on CAMHS wait lists and enabled families to receive support around parenting strategies and psychoeducation at an earlier stage. More practitioners are now available to run programmes more regularly, in different areas of the city at different times and days, to increase accessibility for families.
Support for families and carers
During the programme each family has an identified MAST worker to help ensure that they feel supported and prepared before, during, and after the programme, including supporting onward referral into community CAMHS when need for further input is identified.
Multi-agency working
Formulation, implementation and review of the programme was achieved through collaboration between the CAMHS primary mental health team and local authority colleagues with the MAST. ‘Upskilling’ of the MAST workforce has increased understanding of anxiety and anxiety management, and has enabled co-facilitation and delivery of the programme.
Outcome monitoring
The programme has received positive feedback from parents and families, who showed a reduction in stress levels and a better understanding of anxiety. The programme was reviewed using the Revised Children’s Anxiety and Depression Scale (RCADS), Parenting Stress Index (PSI) and the Strengths and Difficulties Questionnaire measures at the start and conclusion of the programme.
What makes this service an example of positive practice?
The Primary Mental Health (PMH) team in general is an asset to the local authority MAST service as without our support there would be significantly more referrals into the community CAMHS teams. Our team provides support, consultation and guidance to the MAST, as well as completing joint visits this provide the MAST worker with a specialist CAMHS approach to managing certain scenarios as well as supports and guides them in their individual work with families. We have offered training and development to the MAST workers and help to ensure referrals are appropriately placed across the city, as well as supporting citywide multi-agency training through development and delivery. Our team is part of the daily screening of cases that come in to the community CAMHS team to ensure that they are appropriately placed at the right levels of service or with the right support, while we also offer a source of liaison between CAMHS and the local authority. We have been involved in supporting Enhanced Evidence Based Practice Trainees to work within the MAST team and provide supervision and screening of cases for them. Alongside this, our team works to support colleagues in the community team by providing capacity for cases within the CAMHS system, supporting the liaison between workers, and helping to publicise the positive work that the community team does.
The implementation of the Timid to Tiger programme has increased access to psychological therapies at a Primary Care level for children, young people and their families.
Further details
Commissioning
Sheffield CCG
Providers
Sheffield Children’s NHS Foundation and Sheffield City Council Herne Hill Group Practice
Workforce (whole-time equivalent)
2.7 mental health nurses (band 6)
2 social workers (band 6),
2.6 clinical nurse specialists (band 7)
1 team manager (band 8)
Population size
551000 (all ages)
Caseload
Groups consist of up to 10 parents and 3 groups run each term (9 in the year). Sessions are weekly and the programme lasts 10 weeks.
Prevention and resilience – universal and early intervention for at risk
Access and advice – consultation lines, triage and signposting
