North of Scotland CAMHS Tier 4 Network – Decider Skills

Background to project
The Decider Skills were originally developed in 2010 in response to an identified service need in the
adult mental health services in Guernsey. The aim was to reduce impulsivity and increase resilience
and confidence by learning thirty-two evidence-based skills based on cognitive behavioural therapy
(CBT) and dialectical behaviour therapy (DBT). The skills are designed to enable participants to make
changes to help manage distress, regulate emotion, increase mindfulness and effective
communication. The skills are delivered in an effective, fun, and creative style that makes them easy
to learn and teach.

Through discussion with staff across the North of Scotland it has been identified that staff would
strongly support the provision of Decider Skills and would welcome the opportunity to train in this
approach. The reports from other services show positive benefits for young people learning these
skills with them reporting better emotional regulation and finding they are more able to be less self-critical.

Aims of the training
• For staff across the North of Scotland to be trained in and be able to offer Decider Skills
• To support young people across learn emotional regulation skills
• For staff in the Inpatient Unit and Outpatient teams to learn a different, creative group
approach to delivering CBT and DBT based skills
• Networking opportunity for North of Scotland CAMHS staff

Progressing the training
Funding was very generously provided by the Foundation for Professionals in Services to
Adolescents which enabled a 2 day training Decider Skillsfor staff working with young people across
the North of Scotland (including transport and accommodation costs for colleagues from the two
island boards who otherwise would have struggled to attend)

Two trainers were identified by The Deciders Ltd to provide training on 5th and 6th September 2019.
40 clinicians were identified and attended the training. The clinicians attended from across the
North of Scotland CAMHS outpatient services and the Regional Inpatient Unit. The training was very
popular with the event being oversubscribed

Feedback was overwhelmingly positive with the following feedback from the training:

Since completing the training, the group has become embedded in the Inpatient Unit and proved
to be very popular with the young people with a good regular weekly attendance. This is a fairly
new group but has been measured using the DERS 18 questionnaire which measures aspects of
emotional regulation. The results of the group are promising:

DERS-18 Questions (% young people showing improvement in brackets)

I pay attention to how I feel (33%)
I am attentive to my feelings (100%)
When I’m upset, I acknowledge my emotions (66%)

I have no idea how I am feeling (66%)
I have difficulty making sense out of my feelings (66%)
I am confused about how I feel (33%)

When I’m upset, I have trouble getting work done (100%)
When I’m upset, I have difficulty focussing on other things (100%)
When I’m upset, I have difficulty concentrating (66%)

When I’m upset, I become out of control (66%)
When I’m upset, I have difficulty controlling my behaviour (66%)
When I’m upset, I lose control over my behaviours (66%)

When I’m upset, I become embarrassed about feeling that way (33%)
When I’m upset, I feel ashamed with myself for feeling that way (100%)
When I’m upset, I feel guilty for feeling that way (100%)

When I’m upset, I believe I will remain that way for a long time (100%)
When I’m upset, I believe that I’ll end up feeling very depressed (66%)
When I’m upset, I believe that wallowing in it is all I can do (66%)

The community teams have initially used Decider Skills individually but have plans to offer group
programmes in the near future having had positive feedback from young people and their families.
The inpatient and outpatient teams using decider skills have built on relationships that were
developed during the training and have kept in contact. They have shared ideas and how they have
progressed Decider Skills in their area and there is hoped a peer support and development group
will be developed.


Read the report

Find out more

CBT & DBT Evidence

A summary of the evidence basis for Cognitive Behaviour Therapy (CBT) and Dialectical Behaviour Therapy (DBT), the psychological theory and practice that serve as the foundation for the Decider Skills.


James Murray & Lia Tostevin

The Decider Life Skills in Schools

Evidence suggesting increased mental health and wellbeing problems with children gives a rationale for developing and delivering proactive interventions. The Decider Skills is a framework that aims to teach children skills to manage their emotions and wellbeing. This study looked at whether students who participate in the programme as a whole-school approach would demonstrate an increased ability to recognise and better manage their emotions as rated by themselves, their parents, and their teachers.


The Decider Skills - The Evidence

The Decider Skills - evidence for each of the skills


The Decider Life Skills - The Evidence

Read the evidence underpinning each of The Decider Life Skills


Dr Bruce Perry, Beacon House

The Three Rs

Dr Bruce Perry, a pioneering neuroscientist in the field of trauma, has shown us that to help a vulnerable child to learn, think and reflect, we need to intervene in a simple sequence.


The Decider Life Skills in a primary school

The Decider Life Skills as a whole school approach at Amherst Primary School, Guernsey


Prison Case Study

A Case Study of The Decider Skills being effectively used in a Prison


Evaluation of Upturn Young Person’s Service

University of Southampton's report into Upturn Young Person's Service 2017 using The Decider Life Skills


Chris Phillps & Jenny Burgess, NHS Grampian 2018

NHS Grampian: The Decider Skills Pilot Group

Results from The Decider Skills pilot group held in Aberdeen


The Decider Life Skills in Guernsey

A poster presentation providing a summary of studies 2017


Ann Cunningham & Marion Pink 2019

Wicklow, Ireland

Summary and outcomes for The Decider Skills course in Wicklow, Ireland from January to March 2019.


Eimear O'Sullivan & Eimear Grogan 2018

Building resilience in mental health nurses

Increasing resilience by teaching The Decider Life Skills to student mental health nurses in Ireland


The Decider Life Skills in a secondary school

Ladies College in Guernsey implemented The Decider Life Schools as a pilot project over the 2015-2016 academic year.


The Decider Skills pilot study 2013

Results of the initial pilot study with 20 long term mental health service users which formed the foundation of The Decider Skills programme in 2012-2013.


Dr James Murray

CAMHS data for The Decider Skills

Outcome data for young people who completed The Decider Skills group in 2016


NHS Highland and Robert Gordon University 2018

Delivering The Decider Life Skills via Highland Pharmacists

A multi-perspective evaluation of specialist mental health clinical pharmacist prescribers practising within general practices in NHS Highland


Portlaoise Poster

The Decider Skills group show evidence of a reduction in global distress, anxiety and depression


Ayres & Vivyan

Guernsey's Mental Health Services - The Decider Life Skills Workshops

During 2016, 55 service users and 23 staff attended The Decider Life Skills half day workshop. Brief report and feedback.


The Hub

The Hub in a Guernsey secondary school

The Hub teaches The Decider Life Skills to a target group of students


STOPP skill - the evidence base


Lockdown in a specialised rehabilitation unit


Palumbo, R., Di Domenico, A., Fairfield, B. et al.


When twice is better than once: increased liking of repeated items influences memory in younger and older adults