Second Edition Miranda Wolpert, Rita Harris, Sally Hodges, Peter Fuggle

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FOREWORD: NOVEMBER 2015

Introduction to THRIVE Elaborated

Since we published the THRIVE: The AFC-Tavistock Model for CAMHS a year ago in November 2014 it has 

generated a lot of interest. We are delighted by this. 

We want to take this opportunity to clarify and elaborate as relevant, including addressing areas of potential 

confusion, as well as updating the document in light of our emerging thinking and elaboration of elements of 

the framework.

It is important to note that nothing relating to the central ideas of the framework has been changed.

For those who have read the November 2014 document, what this document adds is:

•  Further emphasis on how THRIVE, whilst it does not in itself provide a blueprint for implementation, is 

aligned to implementation models, including the Choice and Partnership Approach (CAPA) – addressed in a 

new section on THRIVE and implementation

•  More detail and clearer elaboration of how THRIVE aligns with the payment systems work which was 

developed in parallel, both in terms of the needs-based groupings themselves but also in terms of the 

shared decision making principles that are at the heart of the work – addressed in a new section on THRIVE 

and payment system project development

•  Greater elaboration of what is meant by Thriving and how this can be supported by services – addressed  in 

a more detailed section on Thriving

•  Further elaboration of a potential model for selection of outcome measurement and metrics

In the light of potential confusion caused by use of the term CAMHS (which has come to be associated with 

particular forms of provision such as specialist NHS provision), for this edition we are referring to “children and 

young people mental health services” to encompass the full range of provision to support mental health needs 

of young people across agencies and organisations.

In this edition we have made clearer the way THRIVE draws on and aligns with the thinking of the Choice and 

Partnership Approach (CAPA) and the Child Outcomes Research Consortium (CORC). We also emphasise how 

THRIVE is aligned to many key initiatives and shares principles, ethos and commitment with a wide range of 

professional organisations and associations’ missions and values. We continue to welcome feedback about 

these links, and are happy to incorporate into online resources as these are developed.

As ever we welcome comments and thoughts, and look forward to producing further elaboration based on 

learning from across the country and beyond in the coming years.

Miranda Wolpert

November 2015

On behalf of the THRIVE authors

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ACKNOWLEDGEMENTS FOR THRIVE ELABORATED (2015)

We want to thank many colleagues who have helped shape our thinking whilst in no way implicating them 

in any of the ideas presented below. These include colleagues who have been central to the development of 

models of children and young people mental health services including Peter Wilson, Richard Williams, Caroline 

Lindsey, Margaret Murphy, Peter Hindley, Ann York, Steve Kingsbury, Mick Cooper and others, and those 

that have led the way in adult mental health including Richard Layard and David Clark for their inspiration 

and support.

We would also like to thank our colleagues in the Department of Health, NHS England and Department for 

Education; in particular Kathryn Pugh, Anne O’Herlihy, Margaret Oates, Cathy James, Helen Kay, Karen Turner, 

Barbara Fittall, Sue Nowak, Jacqueline Cornish and Geraldine Strathdee for the many long discussions and 

intense debates over the years.

Thanks to colleagues who have helpfully commented on the current model include David Trickey, Jane Dutton, 

Rachel Surtees, Julia Smith, Isobel Fleming and members of the CYP IAPT service development group, in 

particular those parents and young people who bring expertise by experience.

Our thinking draws on work being undertaken as part of the payment systems work. Members of the Payment 

systems project group are: Panos Vostanis, Miranda Wolpert, Simon Young, Ben Ritchie, Isobel Fleming, Rob 

Senior, Ann York, Peter Martin, Roger Davies, Bruce Clark, Pat Howley, Lynne Howey. We also draw on discussions 

with those involved in advocating for young people and families including Sarah Brennan and colleagues from 

YoungMinds, Jane Sedgewick, Cathy Street and colleagues from GIFT, Yvonne Anderson and colleagues from 

Cernis and Kate Martin and colleagues from Common Room. 

Members of the Child Outcomes Research Consortium (CORC) Committee were involved in developing ideas 

around the MINDFUL model of performance management and quality improvement. The CORC Committee 

comprises Miranda Wolpert, Ashley Wyatt, Tamsin Ford, Duncan Law, Julie Elliott, Ann York, Mick Atkinson, Alan 

Ovenden, Kate Martin and the CORC Team are Matt Barnard, Jenna Jacob, Kate Dalzell, Benjamin Ritchie, Andy 

Whale, Amy MacDougall, Elisa Napoleone, Victoria Zamperoni, Lily Levy, Sally Marriott, Craig Hamilton, Alison 

Ford, Deborah Sheppard and Danielle Antha.

As always, our work is enhanced by the design input of Slavi Savic and editing of Izzi Whelan.

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INTRODUCTION 

As we noted in November 2014, children and young people mental health services

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 across England have 

never been so prominently in the spotlight. This has continued to be the case into 2015. In 2014, the Health 

Committee quoted a government minister as describing services as “dysfunctional” and the committee 

referred to “serious and deeply ingrained problems” with respect to commissioning (Health Committee, 2014). 

A government-sponsored taskforce (to which several of the authors contributed) resulted in the influential 

Future in Mind document jointly produced by the Department of Health and Department of Education (2015) 

and additional funds have been announced to support children and young people mental health services 

transformation in line with this document.

The Tavistock and Portman NHS Foundation Trust and the Anna Freud Centre (AFC) published their suggested 

new model for children and young people mental health services, the THRIVE: The AFC-Tavistock Model for 

CAMHS

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, in November 2014 (Wolpert, Harris et al., 2014). We stressed from the outset that whilst we felt that 

the THRIVE model offered a radical shift in the way that services are conceptualised and potentially delivered, 

along with suggestions for how they might be reviewed and improved. We were not presenting THRIVE as a 

“tried-and-tested one-size-fits-all implementation model”, but rather as a framework to allow for greater clarity 

of thought, planning and action.

We are continuing to share our thinking as it develops to help inform the current national debate on the future 

of children and young people mental health services and as a basis for future provision. This work is broader 

than the traditional CAMHS NHS delimited support and is based on a whole system approach encompassing 

education, social care and a range of partners. 

It is important to note that nothing relating to the central ideas of the framework has been changed. 

The current version of our thinking (THRIVE Elaborated) seeks to re-emphasise that whilst THRIVE does not in 

itself provide a blueprint for implementation it is aligned to implementation models including the Choice and 

Partnership Approach (CAPA) (York & Kingsbury, 2013). 

This edition also provides more detail as to how THRIVE aligns with the payment systems work, which was 

developed in parallel and informed the development of aspects of the framework. 

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 In the light of potential confusion caused by use of the term CAMHS (which has come to be associated with 

particular forms of provision such as specialist NHS provision) for this edition we are referring to children and young people 

mental health services to encompass the full range of provision to support mental health needs of young people across 

agencies and organisations.

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We are aware there are a number of initiatives across the country which use “Thrive” in their title. We use the term 

to reflect our core commitment to young people “thriving” and to represent our commitment to provision that is Timely, 

Helpful, Respectful, Innovative, Values-based and Efficient.

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