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Note:
Due to the high volume of Attention Deficit Hyperactivity Disorder (ADHD) pre-screening requests we receive, there is currently a wait for the completion of pre-screens. Please ensure that both parts of the form (home and school) is completed before sending to us in order to prevent any further delay and additional strain on our resources.
Step2 is a children and young people’s mental health service working with 0-19 year olds in Hertfordshire. We offer brief, goal focused interventions to those who have mild to moderate mental health difficulties which are causing distress and impacting on day-to-day life. Young people should already have accessed specific help for their mental health prior to referral (which may include input from their health visitor or school nurse, counselling or group work). We offer either group or 1:1 interventions and this will depend on the nature of young people’s difficulties.
Step2 is an early intervention child and adolescent mental health (CAMHS) service working with mild to moderate mental health difficulties, as such, we do not work with children and young people who have been medicated for a mental health presentation. Where a child or young person requires medication to manage their mental health condition, they no longer meet Step2 criteria. If however, the presenting needs of the child are deemed to be most suitable to be treated by Step2 then we would expect the prescribing physician to be responsible for deciding whether that young person remains on medication or stops. If the family and physician do not feel it is appropriate to stop medication, then treatment will need to be sought elsewhere.
We also offer a screening service for suspected Attention Deficit Hyperactivity Disorder (ADHD) which is available for young people who have a GP in West or South Hertfordshire - for more information see the Making a referral section. For children in East and North Herts please see https://www.enherts-tr.nhs.uk/services/adhd-add/referral-information/
The Step2 under 5s clinicians offer parent/infant relationship focused work using strengths and evidence based approaches to promote emotional health and wellbeing for infants and young children. Interventions offered include 1:1 and group approaches.
The service operates on Mondays to Fridays between 9am and 5pm. We have one main base at Starfish House in Stevenage and offer clinics on specific days of the week at other sites throughout Hertfordshire.
We are not an emergency service, please contact NHS 111 or emergency services in these circumstances.
Our dedicated administration and clinical team celebrating after being commended for "Excellence in Partnership working" by the Trust.Contact the service
Please call us on 01438 730 570 or email hct.step2@nhs.net.
Please note that you may need to leave a message when you call as our administrators may be on other calls or dealing with our clinical record system.
We will always aim to be professional, fair and respectful. In return, NHS staff have the right to have safe working conditions free from harassment, bullying and violence, to be treated fairly, equally and free from discrimination.
Please note that we are not an emergency service, please contact NHS 111 or emergency services in these circumstances.
- Reception phone number: 01438 730 570
- How the service is provided
- Who is eligible for the service
- What will happen at your appointment
- Useful information
- Making a referral
- Patient experience
How the service is provided
The service operates on Mondays to Fridays between 9am and 5pm and we therefore offer appointments across the working/school day. We have one base at Starfish House and offer some clinics on specific days at other sites throughout Hertfordshire.
All of our mental health practitioners are trained to work with young people who have mental health difficulties. We are closely aligned with the nationally recognised and evidence based “Children and Young People’s Improving Access to Psychological Therapies” programme (see cypiapt.com for information).
The service is managed and led by Lisa Britton (service manager). A small team of administrators offer an important role in supporting the running of the service.
We understand that sometimes people can’t get to their appointments. However, missed appointments cost us approximately £150 and contribute to our long waiting times. Please note that if you miss an appointment then you will lose that session. If you miss two appointments you will be discharged from the Step2 service.
Clinics
We operate out of Starfish House in Stevenage and also offer clinics on specific days of the week at other sites throughout Hertfordshire.
We will let you know by post where your appointment will be held. We aim to offer appointments in an area close to your home address though this is not always possible. Sometimes we may offer appointments that are a longer distance away in order to see you as quickly as possible. We are occasionally able to book other premises if there is availability.
Bedford Road Health Centre, Bedford Road, Hitchin, SG5 1HF
Tel: 01462 427 100. There is only disabled parking available at the centre - there are a number of pay and display car parks a short distance away.
Bowling Road Clinic, Bowling Road, Ware, SG12 7EF
Tel: 01920 462388
Elstree Way Clinic, Elstree Way, Borehamwood, WD6 1JY (for treatment sessions only).
Tel: 020 83598500
The Marlowes Health and Wellbeing Centre, 39-41 Marlowes, Hemel Hempstead, HP1 1LD.
Tel: 01442 913569. There is limited parking - there are a number of pay and display car parks a short distance away.
Peace Children’s Centre, Peace Prospect, Watford, WD17 3EW.
Tel: 01923 470600. Free parking is available on-site.
Starfish House, 3 North Road, Stevenage, SG1 4AT.
Tel: 01438 730 570. Free parking is available on-site.
Waltham Cross Health Clinic, Stanhope Road, Waltham Cross, EN8 7DJ (for treatment sessions only).
Tel: 01992 818500
Who is eligible for the service
We offer a service to young people aged 0-19 with a GP in Hertfordshire who have a mild-moderate mental health difficulty which is causing distress and impacting on day to day life.
Referrals can be made by any professional who has a good knowledge of the young person’s difficulties. All young people need to have already accessed specific help for their mental health prior to referral (which may include input from the school nurse, counselling or group work). For children aged under 5 years, parent / carers will need to have accessed support from their health visitor, the family support service or via a parenting programme prior to accessing support from Step2.
Examples of mental health difficulties that young people may access the service for include:
- Anxiety
- Phobias
- Low mood
- Mild self-harm
- Emotional regulation (which is not due to difficult social circumstances or as a result of an unmet neurodevelopmental need)
- Mild obsessive compulsive difficulties
As a mild to moderate mental health service we do not work with children and young People who have been medicated for a mental health difficulty as this would not indicate mild to moderate symptoms.
Our Under 5s clinicians will work on developing relationships between parent carers and their children. In order to access the service, the referred child needs to present with difficulties which are not typical amongst their peers or due to a developmental difficulty. Additionally, the parent carer needs to be willing and able to engage in a therapeutic intervention focusing on their relationship with their child. Typical reasons for referral would include:
- Difficulties with self-regulation such as toileting, feeding and sleeping. In such cases physical causes need to be ruled out.
- Difficulties in emotional and behavioural regulation including frequent severe emotional outbursts, defiance, aggressive and or destructive behaviour, being fidgety, lacking concentration, impulsivity and attempts to control their parent or others.
- Emotional difficulties such being withdrawn, clingy, anxious, overly fearful of ordinary situations, displaying ritualistic behaviours.
Please note that our work does not focus directly on these symptoms but on the relationship which contributes to these.
For the ADHD screening service, young people are eligible if they are registered with a GP in West or South Hertfordshire and demonstrating significant difficulties both at home and school with attention and concentration, levels of activity and impulsivity. Families will be sent a screening pack (or can access a screening pack from the Step2 website) which will need be completed in full and returned to the service for a paper-based screen. Should we find that your child meets the criteria for further assessment; the completed forms will be passed to Single Point of Access, another organisation independent of Step2, who will identify which specialist clinic will offer you an appointment.
What will happen at your appointment
Initial assessments
If a referral is accepted in the service because it meets our referral criteria, an initial clinic based assessment or telephone appointment will usually be offered. This should be attended by the referred young person (unless they are under 5) and at least one parent/carer. At this appointment we will ask you a number of questions which will cover:
- The difficulties you are experiencing
- How things are in the family
- How school is going
- Any ideas you have about what makes the difficulties better or worse
- How things have developed over time
- How you might like things to be different (your goals)
Ahead of the initial appointment you may also be asked to complete two questionnaires if you feel able to do so. These are called the “Strengths and Difficulties Questionnaire” and the “Revised Children's Anxiety and Depression Scale” (see corc.uk.net/outcome-experience-measures for more information). If you need help to complete the questionnaires then please let us know.
All of this information together helps us to get a good picture of the situation and how we might be able to help. Wherever possible, we always aim to make decisions together in partnership with you. Whilst some of the questions we ask and suggestions we make can sometimes feel a little challenging, you always have the right to say no to the things we may suggest. We want to know your views and always aim to put the young person at the centre of our work and put your best interests first.
We will use our “next steps” leaflet to record the outcome of the initial assessment appointment. We offer brief interventions focused on your goals and mental health difficulties. We are likely to offer you a group or 1:1 intervention and this will depend on the nature of your difficulties. If it is agreed that the service is not likely to be in the best position to help, we will try to think of alternative options with you and write back to you and the person who made the referral to the service.
We will record what is discussed on our clinical record system which is shared with other health professionals. We do find it helpful to talk to other people such as school teachers and health professionals to support your progress. We will not do this without your permission. We only talk to other professionals without your permission if we are very worried about your safety or someone else's.
After your initial assessment we will do our best to offer you an appointment to get going with this plan as soon as possible, although we can have long waiting times. We will send you a letter after around three months if you have not been seen.
Step2 First Steps Webinar
After your assessment you will receive a link to book onto our webinar. This will either be the start of your treatment or your entire treatment offer. You will need to download the workbook below prior to the webinar, please make sure you download the correct workbook relating to the age of your child.
First steps webinar - Age 8 - 11 workbook
First steps webinar - Age 12 - 19 workbook
Group interventions
If you are offered a group intervention, this will be with other people who are experiencing similar difficulties and will last for between four and six 90 minute sessions. Sometimes it can feel a bit worrying to attend a group but our clinicians are very experienced in helping you to feel at ease and get the most from the group. We ask for a parent / carer to join young people at group sessions as it is a helpful way to support progress after the group sessions have finished. The group sessions will help you to identify a range of strategies that you can use to help with your difficulties. This is referred to as a “toolbox” as different tools are needed for different situations.
Goal-focused 1:1 interventions
If you are offered a 1:1 intervention then we will offer you up to six 60-minute sessions and contact you to let you know the location of the appointments. We often find it helpful for parents/carers to support young people at these appointments, which may include joining part of the sessions or supporting with home based tasks/projects.
We use our training and knowledge from working with lots of other young people and families to support you, and do our best to help you work towards your goals. Outcomes are usually better for young people when they practice agreed tasks or activities between sessions.
Interventions for parent / carers
For referrals of younger children, we will often offer interventions to parent/carers as this tends to achieve better outcomes. The Step2 under 5s clinicians offer parent/infant relationship focused work using strengths and evidence based approaches to promote emotional health and wellbeing for infants and young children. Interventions offered include 1:1 and group approaches.
Useful information
We understand that sometimes people can’t get to their appointments. However, missed appointments cost us approximately £150 and contribute to our long waiting times. Please note that if you miss an appointment then you will lose that session. If you miss two appointments you will be discharged from the Step2 service.
Occasionally we will ask to record sessions to support your interventions and / or our development. We will discuss this with you if appropriate.
Information for children and young-people about mental health and wellbeing
Other organisations
The following organisations and websites offer helpful information and resources to young people, families and professionals:
- ChatHealth for children/young people offers confidential advice and support about problems with friends or family, alcohol or smoking, feeling sad or angry, bullying, relationships and changes to your body.
Tel: 07480 635164 / Website: chathealth.nhs.uk - Families Feeling Safe Ltd provide Families Feeling Safe programmes across Hertfordshire and provide protective behaviours services to children aged 0-19 years and their families working in partnership with schools and children’s centres.
Tel: 01438 728653 / Website: protectivebehavioursconsortium.co.uk - Family Lives is a national family support charity providing help and support in all aspects of family life. They offer telephone support 24 hours a day, seven days a week.
Tel: 0808 800 2222 / Website: familylives.org.uk - Hertfordshire County Council offer free parenting programmes, many of which address specific concerns identified by parents.
Website: hertsdirect.org/parentingsupport - Kooth is an award winning online support service for children and young people aged 10-25. It is a free, anonymous and confidential website where young people 10-24 can access free online services including; drop in chats with counsellors, booked 1:1 chats with a counsellor, themed message forums, secure web-based email and online magazine.
Website: KOOTH.com - MindEd offers free online education to help parents/carers/professionals to identify and understand children and young people with mental health issues.
Website: minded.org.uk - YoungMinds offers a free confidential online and telephone support service for parents/ carers worried about their child’s mental health and emotional wellbeing.
Tel: 0808 802 5544 (Monday-Friday 9.30am-4pm)
Email: parents@youngminds.org.uk / Website: youngminds.org.uk/parent/parents-helpline-and-webchat
Books and resources
You may find the following books and resources of use, depending on the nature of your difficulties:
Anxiety
- Kate Collins-Donnelly (2013) “Starving the anxiety gremlin: A cognitive behavioural therapy workbook on anxiety management for young people”. Published by Jessica Kingsley.
- Cathy Creswell and Lucy Willetts (2019) “Helping your child with fears and worries: A self-help guide for parents”. 2nd Edition. Published by Robinson. This is an evidence based programme which helps parents consider how to help their anxious children.
- Jo Derisley and others (2008) “Breaking free from OCD”. Published by Jessica Kingsley. This is an evidence-based book guiding families through the ways in which obsessive and compulsive difficulties can be understood and managed.
- Dawn Huebner’s “What to do guides for kids”. Published by Magination Press. These focus on anxiety management and guide children and parents through cognitive behavioural techniques.
Low mood
- Dennis Greenberger and Christine Padesky (2015) “Mind over mood: Change how you feel by changing the way you think”. Published by Guilford Press. This is a cognitive behavioural workbook aimed at older teens and adults.
Parenting infants and young children
- Margot Sunderland (2016) “What every parent needs to know”. Published by Penguin. This focuses on infant / child development and attachment and how parents can predict their child’s needs.
Emotional regulation
- Ben Sedley (2015) “Stuff that sucks”. Published by Robinson. This is a useful book for young people who wish to develop their ability to cope with strong feelings and distress.
Making a referral
Referrals can be made by school or any other health professional, for instance GP, school nurse, health visitor etc.
Referral form for 5 - 19 year olds
Guidance criteria for referring to CAMHS Step2 (under 5s)
Guidance criteria for referring to CAMHS Step2 (5 - 19-year-olds
ADHD pre-screening for West and South Hertfordshire
In the West and South of Hertfordshire (for children and young people registered with a GP under the Herts Valley CCG) only, Step2 completes a pre-screening process for referrals where a child or young person is showing signs of Attention Deficit Hyperactivity Disorder (ADHD). In order to initiate this referral process you must download the referral form which requires completion by parents/carers and school. Please read the guidance carefully. The completed paperwork then should be sent directly to hct.step2referrals@nhs.net. We require evidence from two settings; if the child is out of education please book a call with an ADHD specialist who can advise you where best to get the form filled out.
Patient experience
We are keen to seek feedback on your experience of the service. You can do this by speaking to your clinician, calling the clinic on 01438 730 570 or by emailing hct.step2@nhs.net. We also consult with young people and their families about service developments via an “Ambassadors Group”. If you would be interested in being consulted then please also email or call us.
We will always aim to be professional, fair and respectful. In return, NHS Staff have the right to have safe working conditions free from harassment, bullying and violence, to be treated fairly, equally and free from discrimination.
Recent survey results highlighted that 96.67% of people would recommend the service to family and friends.
Please complete a FFT survey link by clicking here or click here.
Recent comments from our survey include:
“Thank you very much for my CBT sessions and all the help you have given me. It has helped me a lot and made a real difference”.
“The clinician who phoned was lovely and listened and answered all questions”.
“It helps with understanding and techniques”.
“I felt I was listened to and questioned in a way that was helpful. I felt my views were valued and although this meant that Step2 would not be able to provide a service on this occasion I fully understood why”.
“My daughter’s anxiety surrounding vomit is so much better after her sessions, I would definitely recommend this service to any of my friends/family”.
“Great service if the young people attending are at early stages of understanding and dealing with anxiety. The outcome was decided jointly. Felt time was given to listen and hear what the difficulties are. Appreciated that appropriate suggestions were made for future support”.
If you would like to share your story or speak to the Trust about your experience of the service, please contact the Patient Experience team on 01707 388036 or email hct.patientexperienceteam@nhs.net
Thank you to all the young people and parents/carers who gave up their time to support us in the development of this webpage.
