Walk-In Therapy in Rural Mental Health Clinics: Creating the Context, Training the Staff

In rural settings, numerous complex challenges exist to the provision of high quality mental health services that can respond quickly to client needs. This article describes an immediate access service delivery model and a training program designed to assist staff in rural mental health clinics to implement the model.

This paper describes a service delivery and training model developed in Calgary Alberta, Canada, for clients living in rural areas who are seeking mental health services. Alberta is about the size of Texas, with only two urban centres containing about half the province’s population, (1.5 million people). In 1981 the Alberta Mental Health Board (AMHB) contracted with Wood’s Homes, a comprehensive service organization with orphanage roots dating back to 1914, to provide mental health treatment services to children, adolescents and their families in the Calgary region. At that time there were limited community resources for this population and none that provided campus-based (residential) short-term intensive treatment in a community context. Over time and as a result of the success of the resid

Also on Day 3 Wood’s Homes’ CEO provided an overview of her research on supervision, in order to provide both supervisors and supervisees some new ideas about how the supervision process can make a difference to high-quality clinical work. This research explored the context, content and connections involved in the supervisory experience as described through interviews with 13 experienced female social work supervisors (Matheson, 1999). Concepts concerning power balance, responsibility, leadership, teaching and empowerment were applied to the walk-in single session format of service delivery.

There is no single model of therapy used at the walk-in service. However, the therapists who developed the service are oriented to family systems approaches emphasizing brief forms of interventions that highlight client resources and strengths (Walter & Peller, 1992. Berg & Miller, 1995. Lipchik, 2002). Pragmatism is the central organizing principle. Therapists are encouraged to adopt an approach and therapy style that fits for the client and addresses the client’s need (Amundson, 1996). Each fifty-minute session is organized in accordance with the Milan team’s approach, which allows for the therapist team to consult with one another regarding useful interventions (Boscolo et. al., 1987).

The Alberta Mental Health Board’s Community Clinics conducted an evaluation of their services and found that there was a need for the clinics to broaden their scope of service. The findings were positive regarding the quality of therapy clients received but indicated that increased access and more ability to address urgent issues were required.

One week of immersion training in the walk-in model of single session therapy, starting with management staff and continuing with front-line therapists, has enabled a significant new form of service delivery to get underway in rural mental health clinics throughout Alberta. This service delivery model has enabled the clinics to expand the range of services to clients, reduce wait lists and paperwork, and increase staff collaboration.

Some topics in this essay:
Wood’s Homes, Health Board, Health Clinics, White Epston, Family Centre, Regional Managers, Affordable Clients, Red Deer, Homes’ CEO, Miller Slive, mental health, single session, walk-in service, family centre, service delivery, eastside family centre, eastside family, alberta mental health, alberta mental, health clinics, mental health clinics, wood’s homes, single session therapy, mental health board, health board,