SHINE’s stepped care approach

SHINE provides multi modal interventions which are accessed after an individual needs assessment following referral during a 1 hour to 1.5 hours appointment. These are based on the stepped care approach outlined by NICE where young people can move up or down a care pathway determined by complexity of need. SHINE has adapted this model to provide a wide range of services for young people and their families depending on need.

Drop in Clinic – this provides access for both the general public and referred clients on Wednesdays between 4 p.m. and 8 p.m. This may include bibliotherapy (information giving and review) and basic brief intervention work. There is also access to Consultant lead clinics, where fixed appointments can be made for young people and/or their families to receive specialist 1:1 input with an obesity specialist/nutritionist/eating disorder specialist/Motivational Enhancement Therapist (MET).

Six week preparation courses – these short programmes are ideal for young people who are socially isolated and lack confidence to join bigger groups, or for those who have low self esteem or anxiety which prevents them from participating in group work or attending school. These courses are designed to help young people become more integrated into mainstream activities.

Twelve week courses – at Tier 3 level, many young people we support have a long weight loss journey and often present with associated co-morbidities such as Type 2 diabetes, high blood pressure, fatty liver, genetic disorder, anxiety and depression. SHINE offers course based support for young people and their families for up to fifteen months which comprises of four healthy lifestyle related programmes in twelve week modules with three intakes per year (January – March, April – July, September – December). The initial programme comprises of a Psycho-social Intervention (PSI) course (1 induction session, 5 nutritional sessions, 5 psycho-social sessions and 1 consolidation session and an awards of achievements session). On completion of this module individuals attend a review session where their care pathway is reviewed. This may result in them choosing to leave the programme or continuing by enrolling on a further 12 week module of group work support (examples include sports and leisure module, healthy lifestyles behaviours, satiety and eating patterns and mindfulness courses). Alternatively they may attend the Drop In specialist clinic for 1:1 specialist support.

Specialist Support – those with complex needs may require more in-depth 1:1 support either for nutritional therapy, behavioural therapy or counselling. SHINE provides 6-8 therapy sessions with a choice of a variation of therapeutic orientations including person centred therapy, Behaviour Modification, Cognitive Behavioural Therapy, Motivational Interviewing anger management, mindfulness and art and creative therapy. In these sessions young people can explore underlying issues which may be having a negative impact on their weight.

Residential – a one week residential is held annually after young people have undergone at least 2 of the above interventions. This is an intense one week programme which enables young people to really focus on resistance and barriers to weight gain. It combines psycho-educational programmes with a high impact physical activity programme with tasks and challenges to increase motivation making the course interactive and fun.

Collaborative working with other services – many young people who attend SHINE are also linked with other specialist services such as Ryegate (Learning Disability Unit), Child and Adolescent Mental Health Service (CAMHS), Multi-Agency Support Team (MAST), and Social Services. Many young people who attend our programmes are on care plans which includes obesity management. This requires sharing of information through confidential report writing and attendance at multi agency meetings. The needs of each individual child are paramount.

There is also a strong link with Sheffield Children’s Hospital Endocrinology Unit for access to Tier 4 services for support for young people with co-morbidities such as Type 2 diabetes, fatty liver and polycystic ovaries. Treatment at this level may include anti-obesity medication (Xenecol) and bariatric surgery.

If you are interested in learning more about any of the services we offer contact us.