As part of caseload management for community learning disability teams (CLDTs), it would appear reasonable that services would have a mechanism for prioritizing referrals and discharge planning. However, any formal mechanism in relation to these two aspects apparently is lacking within the literature. This theoretical article attempts to illustrate this evidence-base need, and demonstrate how a prioritization and/or discharge planning system would aid CLDTs. In light of the scarcity of material for the learning disability sector, information has been examined from other health domains such as mental health. The paper also presents a discussion on whether rationing of services is best done via explicit or implicit means. Issues related to setting referral criteria and the allocation of referrals are also considered. Although suggestions have been made for CLDTs, it is difficult to do so whilst the evidence base for this sector is so lacking.
People with severe and enduring mental health difficulties attending groups on 10 inpatient wards were asked to identify the ‘Most Important Event’ (MIE) in each group session they attended, as part of a routine service evaluation. Using the methods of thematic analysis, five main themes were identified from the 192 Most Important Events recorded over the course of one year: Being part of a group, Communication, Help and support, Hope for the future, and Relationships. The main themes and subthemes were largely compatible with Yalom’s therapeutic factors, but also suggested that more fundamental levels of therapeutic factors may be present in groups with people with severe and enduring mental health difficulties. These factors include feeling connected, communication, and a sense of belonging. This evaluation of Most Important Events in inpatient groups adds to the evidence base in the field of group analysis and group psychotherapy.
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