Since last posting the IMP name has been superceded, which I can't help feeling a minor twinge about. Reflecting our integration into the growing family of Mentalization-Based therapies (MBT, MBFT, MBT-A, MBGT-A) - a great honour - Integrative Multimodal Practice is now known as Mentalization-Based Integrative Outreach (M-BIO).

The model continues to develop in response to feedback from the various settings where it is more or less explicitly part of the service model. Currently there are:

* The YOUS team in Cambridgeshire
* The AMASS team in Islington
* The Derry and Omagh CAMHS IMP services
* A small team from the charity Kids Company is in the middle of training.
* A new Adolescent Outreach team in Plymouth is due to train in early 2010.

The TiddlyManual is moving on - slowly, mostly late at night, but things are developing. It can be found at http://imp.peermore.com/imp/recipes/imp/tiddlers.wiki and visits and feedback are welcome. It is designed for delivering complex multimodal interventions in an integrated and more or less evidence-based way to hard-to-reach young people who currently access very little support at all; of course the technology and principles make it possible envisage this being used in many other areas of work where complex operationalised protocols are available (health visitors? district nurses? Community Psychaitric nurses? etc)

Key areas that I am keen to stress are:

*The Opensource parallels - a treatment manual that is not guarded but is shared - "can we make this work better?" is the ethos...
*The fact that the manual can be a reference work, but can also add almost limitless interactivity if downloaded copies are used as "workbooks" in which clinical notes are recorded.
*The importance of the Social Rituals and Disciplines that are required for a team to work around a Tiddlymanual - growing their own locally-attuned version, so that it functions as what we might describe as a "Mentalized" description of the team's self identity.

I am finding that introducing the interactive version of the manual works best by finding a "champion" in the team who can tolerate the clunkiness and frutrations of working with something that is obviously new, crudely shaped, and a 'work in progress' rather than a readymade product.