The Time Map: a practical clinical and training tool
by Bev Moss, Northern Sydney Central Coast Area Health Service, Mental Health Drug & Alcohol
The Time Map kit was developed for use in a clinical setting to map a comprehensive history with a young person experiencing a first episode of psychosis.
This collaborative tool assists with the mapping of emerging psychotic symptoms, substance use and life events on a timeline. It includes prodromal symptoms as well as symptoms of psychosis, mania, depression and suicidality. Substance use, stressors, help seeking attempts, and coping strategies can be included on the record.
The Time Map kit uses a flexible, visual and engaging approach to mapping the timeline of the illness. The kit includes tools to assist the clinician in providing psycho-education and developing relapse prevention and recovery plans collaboratively with the young person.
In Northern Sydney Central Coast Area Health Service (NSCCAHS) training on "Best Practice in Early Psychosis" was offered to any clinician who has contact with young people experiencing a first episode of psychosis. The Time Map kit was used throughout the training to assist clinicians in understanding first episode psychosis and developing skills in assessment and recovery interventions.
Clinicians from a non- mental health background found the Time Map most useful in helping them understand psychosis and develop skills in assessment and clinical interventions.
The kit was developed in collaboration with clinicians from 5 early psychosis services. The kit includes:
- Fax roll paper and texta pens
- A set of symptom cards
- A set of supports / coping strategies cards
- A set of substance use cards
- Record sheet and 2 relapse prevention plan forms
- Guidelines on how to use the tool with clients
- Birchwood Insight Scale1 (modified to add past tense to questions and scoring schedule.)
- Client and clinician evaluation form
- Planning form
Resources
Some of the resources from the Time Map kit are available below:
- Time Map guidelines on use - A4 version (
pdf - 86 KB) - Time Map guidelines on use - A5 booklet format ( pdf - 94 KB)
- List of drugs used on the cards ( pdf - 14 KB)
- List of the coping strategies used on the cards ( pdf - 15 KB)
- List of the symptoms used on the cards ( pdf - 22 KB)
- Example record sheet ( pdf - 16 KB)
- Relapse prevention plan 1 ( pdf - 12 KB)
- Relapse prevention plan 2 ( pdf - 12 KB)
- Stress vulnerability model ( pdf - 25 KB)
Note: All Time Map resources are copyright NSCCAHS Mental Health Drug & Alcohol Service. Please acknowledge NSCCAHS Mental Health Drug & Alcohol Service as the source in any use of these resources. They may not be reproduced for commercial use or sale. Please contact Bev Moss (see below) for more information regarding the use of these resources.
Evaluation
| Consumer Evaluation | |
|---|---|
| 50% | I feel relieved that other people have experienced something similar to me. |
| 100% | I now understand what has happened to me. |
| 100% | It gave me an opportunity to talk about what had happened. |
| 75% | I feel less confused now. |
| 100% | It helped me explain what had happened to me. |
| 100% | I can see that these experiences were part of an illness, not my personality. |
| 75% | I now feel more hopeful about the future. |
| 75% | I now have a greater sense of control. |
| 100% | I know what I can do to help prevent a relapse of symptoms. |
| 100% | I feel that the clinician who did the Time Map with me now understands what I experienced. |
| Clinician Evaluation | |
|---|---|
| 25% | The Time Map helped me to establish a therapeutic relationship with the client. |
| 75% | It will enable me to target future interventions to the specific needs of the client. |
| 75% | We developed a relapse prevention plan together. |
| 100% | The Time Map provided a structure for the sessions. |
| 100% | I know that this type of intervention is consistent with "best practice" in early psychosis. |
| Evaluation by non-mental health clinicians who attended the training workshops | |||||
|---|---|---|---|---|---|
| 29 clinicians - 16 from services other than mental health/drug & alcohol and 13 from drug & alcohol services - were asked to evaluate the usefulness of the Time Map as an adjunct to the training. | |||||
| Question | Strongly disagree | Disagree | Not sure | Agree | Strongly agree |
| The Time Map helped to clarify the prodrome and triggers for psychosis. | 3 | 26 | |||
| The Time Map helped to clarify the acute symptoms of psychosis. | 1 | 5 | 23 | ||
| The Time Map helped to clarify the phases of illness and the emergence of symptoms over a period of time. | 1 | 4 | 24 | ||
| The demonstration of the Time Map on the DVD clarified how the tool could be used with a client. | 3 | 26 | |||
| The information on the Time Map helped to clarify the Stress Vulnerability model. | 3 | 7 | 19 | ||
| The information on the Time Map helped to clarify how to develop a relapse prevention plan and recovery plan with a client. | 2 | 4 | 23 | ||
References
- A self-report insight scale for psychosis: Reliability, validity and sensitivity to change.
Birchwood, Max; Smith, J; Drury, V; Healy, J; et al., Acta Psychiatrica Scandinavica. Vol.89(1), Jan 1994, pp. 62-67.
Contact
Early Psychosis Coordinator
Northern Sydney Central Coast Area Health Service, Mental Health Drug & Alcohol
Phone: 02 9887 5592
