I-Thrive Model

Plymouth Educational Psychology Service

The I-Thrive Emotional Health and Wellbeing Model is an integrated, person centred, and needs led approach, that focuses on a broad range of wellbeing services for children, young people, and their families.

This model is based upon the THRIVE Framework for system change in mental health services (Wolpert et al., 2019).The THRIVE framework was developed by a collaboration of authors from the Anna Freud National Centre for Children and Families and the Tavistock and Portman NHS Foundation Trust.

It conceptualises need in five categories:

Thriving
Getting Advice and Signposting
Getting Help
Getting More Help
Getting Risk Support.

Emphasis is placed on prevention and also the promotion of mental health and wellbeing across the whole population. Children, young people and their families are empowered through active involvement in decisions about their care through shared decision making, which is fundamental to the approach.

These needs-based groupings provide a helpful framework to better understand the range of emotional health, wellbeing and mental health services in Plymouth.

Find out more about the National I-Thrive programme

I-Thrive need categories

Thriving

Those whose current need is supported to maintain mental wellbeing through effective prevention and promotion strategies. Thriving is a concept to indicate the wider community needs of the population supported by prevention and promotion initiatives.

All those children, young people and families who do not currently need individualised advice or help are considered to be thriving. This assumes that not everyone requires or would benefit from interventions. The THRIVE framework would suggest this group should receive community and population level initiatives that support wellness, emotional wellbeing, and resilience.

Getting advice

Those who need advice and signposting. The promotion of resilience, to build the ability of a community (school/family) to prevent, support and intervene successfully

The THRIVE model of provision would suggest that wherever possible, this provision should be provided within education or community settings, with education often (though not always) the lead provider and educational language (a language of wellness) as the key language used. Enhancing self-efficacy and agency.

Getting Help

Those who need focused goals-based input.

The THRIVE model of provision would suggest that, wherever possible, provision for this group should be provided with health as the lead provider and using a health language (a language of treatment and health outcomes is sometimes used); with a greater emphasis on ending an intervention if it was felt not to be working or if was felt gains no longer outweighed costs or potential harms. This grouping comprises those children, young people and families who would benefit from focused, evidence-based treatment / intervention, with clear aims, and criteria for assessing whether aims have been achieved.

Getting more help

Those who need more extensive and specialised goals -based help. This grouping comprises those young people and families who would benefit from extensive long-term treatment / intervention which may include inpatient care but may also include extensive outpatient provision / longer term support.

The THRIVE model of provision would suggest that wherever possible, provision for this group should be provided with health as the lead provider and using a health language (that is a language of treatment and health outcomes).

Getting risk support

Those who have not benefited from or are unable to use help, but are of such a risk that they are still in contact with services This grouping comprises those children, young people and families who are currently unable to benefit from evidence-based treatment but remain a significant concern and risk. This group might include children and young people who routinely go into crisis but are not able to make use of help offered, or where help offered has not been able to make a difference; who self-harm; or who have emerging personality disorders or ongoing issues that have not yet responded to treatment.

The THRIVE model suggests that there be an explicit recognition of the needs of children, young people and families where there is no current (health) treatment available (or that they are engaging with), but they remain at risk to themselves or others.

Please note:

In Plymouth, we took a decision to apply the i-Thrive need categories across our whole children's system. In doing so we recognise nearly all children's services contribute to emotional health, wellbeing and mental health through one or more of the i-Thrive need categories.

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