Page 113 - Hospital Authority Convention 2018

Parallel Sessions

PS4.4 Collaborative Service Programmes 16:15 Room 221

A Stepped-care Model with the Support of Psychology Assistant in Clinical Psychological Service
Ngan J
Department of Clinical Psychology, Pamela Youde Nethersole Eastern Hospital, Hong Kong
The service review of clinical psychological services in Hospital Authority (HA) in 2008/09 by an external consultant showed HOSPITAL AUTHORITY CONVENTION 2018
that the number of clinical psychologists (CP) in HA was less than required. In the recommendation, the consultant suggested
to differentiate the core from non-core duties of CP and to adopt a Stepped-care Model to address the needs of patients. In
this connection, a Psychology Assistant (PA) post, which is equivalent to a supporting rank of Patient Care Assistant I (PCAI),
was established.
The Stepped-cared Model, which was based on the Improving Access to Psychological Therapies Programme (IAPT) in UK,
addressed mainly the common mental health problems such as depression and anxiety. This model aims at maximising
effectiveness and efficiency about resource allocation in therapy, and defining service to be provided along the stepped-
care spectrum including low and high-intensity therapies. The Stepped-care Model was piloted in palliative care programmes
and primary care service in 2012/13. Results of outcomes studies, in terms of quality and efficiency, in both services were
encouraging. Up to now, there are 25 PAs in seven clusters, serving specific programmes or rendering support to different
services, including adult mental and medical services, child and adolescent mental health services, palliative care and
primary care services. Another evaluation with data collected from 2012 to 2015 also reviewed similar improvement in service
efficiency and quality as measured by standardized outcome measures.

The success of the Stepped-care Model with PA taking up the low intensity duties of clinical psychologists consistently
showed improved service quality and efficiency in settings which applied the model. This model is applicable across
programmes and services, and is cost-effective, sustainable and highly recommended to become a standard model of
clinical psychological service for wider application in HA.
Monday, 7 May 2018

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