FOR USE BY MH DBT SERVICE ONLY

Procedure for Sending and Receiving Texts/emails with Service Users receiving Dialectical Behaviour Therapy

An important component of Dialectical Behaviour Therapy (DBT) treatment is the generalisation of skills. To aid this, telephone/email coaching is included as part of the treatment package. This is for the service user only and not for the use of anyone else, including professionals. It is for skills coaching only. All other requests should go to the usual services e.g. CTT or out of hours service. Ideally skills coaching will be offered by the service user’s individual therapist as they are aware of which skills the service user knows, what methods of coaching are more likely to be beneficial, what has worked before, what situations may be arising that require skills, etc. If this is not possible then other arrangements need to be made to provide this function. Sometimes other members of the DBT team will use this e.g. to provide cover if the therapist is on annual leave.

Therapists usually offer DBT telephone contact to their service users within the hours they are at work. In addition, some therapists offer out of hours telephone coaching to their individual DBT service users. This procedure refers only to these circumstances. Time taken for providing telephone coaching is claimed back via arrangements agreed with the therapist’s manager e.g. Time Off in Lieu (TOIL), using the usual systems in place in the locality for monitoring and authorising TOIL. (NB: This service is not provided when the therapist is on annual or sick leave). Coaching is provided by the therapist carrying a work mobile phone which the service user can text for coaching or via NHS mail to the service user’s email address. Southern Health DBT Staff will be issued with Trustmobiles which must be pin/passcode protected and in good working order. If not, staff will report this to their line manager. Theft or loss of the mobile device will be reported immediately in line with Trust Incident reporting policy and procedures. The Information Asset Register will indicate which mobiles are being used for DBT texting. All phones will be handed in and cleansed prior to being re-issued or new staff members are issued with a new handset.

The service user is aware that the therapist may not respond to a text/email immediately. If the service user needs immediate help, but the therapist has not responded, they are aware that they should use the usual means of support they would normally access e.g. G.P., out of hours service, etc.

When the therapist responds to a text or email, they may do so by phoning, texting or emailing the service user. As there may be several such texts/emails, and the therapist is often at home in the evenings or at the weekend, they will only record these messages when next in the work base. As a minimum, the record would state that a text was received and responded to. If the therapist assesses the risk to have increased to such an extent that actions by the therapist are required, the therapist would telephone the appropriate service, e.g. 9am - 5pm Monday to Friday the Care Co-ordinator at the CTT base and after 5pm and before 9am the Out of Hours number. They will leave their details and be phoned back.

Service users will be made aware of this procedure when out of hours texting is introduced. If they wish to receive telephone/email contact in this way, they will be asked to sign a consent form which includes an acknowledgement that texts to a mobile phone or emails are not secure and confidentiality cannot be guaranteed. An up to date copy of the DBT Patient email/text consent form will be kept in the service user’s SCR and/or EPR. A ‘sign post’ progress note will be documented in the EPR to confirm the DBT service user email/text consent form has been completed. The form should be reviewed regularly for example, at care plan review.

Author:

Alida Towns, Business Manager

Signed off by: Lesley Stevens, Clinical Director

FOR USE BY MH DBT SERVICE ONLY

Dialectical Behaviour Therapy (DBT)

EMAIL/TEXT CONSENT FORM ~ AWARENESS OF USE

Service User name: ……………………………………

Service User DoB: ….………………………………….

NHS number: ……………………………………

I confirm I wish to communicate with Southern Health NHS Foundation Trust by text/email and I understand that:

  • we are using email/text as part of the Dialectical Behaviour Therapy (DBT) treatment approach to aid me in using skills in my everyday life;
  • any decision to use email/text communication will be discussed, specific boundaries will be agreed as to the use of texting/email and an entry of this discussion will be made in my clinical records;
  • my DBT therapist will send texts/emails to me and receive texts/emails from me, and call me on my mobile phone, in order to help me use the DBT skills in a range of situations;
  • the use of this telephone/mobile number /email contact is for my use only and not for the use of anyone else, including professionals;
  • email/text is not a totally secure system for sending and receiving information;
  • when sending emails/texts I will only identify people by first name;
  • text and email communications will be documented in my clinical records.
  • no texts or emails – either sent by me or the staff member – will be forwarded to anyone else without consent of either party unless in the unlikely event the staff member deems it necessary to do so due to assessed risk to myself or others. I will be informed if this is the case;
  • it is my responsibility to inform the service of any changes in mobile numbers or lost mobiles as soon as possible;
  • my therapist may not respond immediately if I text them. If I need immediate help but the therapist has not responded, I am aware that I should use the usual means of support I would normally access e.g. Community Treatment Team or out of hours service;
  • my therapist will contact the out of hours number or other emergency services in the unlikely event that they consider this necessary;
  • any decision by either me or the staff member identified below to stop the use of email/text will be respected. Any resumption will therefore require a new Consent Form.
  • I am aware that my carer may be made aware of email/text communication between me and the staff member. The decision to inform the carer of email/text communication between me and the staff member will only take place after a risk assessment. An entry will be made in the clinical records. Confidentiality will be respected by staff at all times;

I am signing to confirm that I have understood the conditions as set out above. I have read the Procedure for Sending and receiving texts set out above and have been made aware of the associated risk with regards to data protection.

Print Service User Name: ……………………………………………………………………………..

Signature: ……………………………………………………. Date: ………………..

Name of member of staff: ………………………………………………………………………

Signature: ……………………………………………………. Date: ………………..

SH IG 10 \ Version 2 \ July 2014