What is AMBIT?
AMBIT is an approach to support teams develop systems of help around particularly vulnerable, excluded, and underserved clients who may have little confidence or trust in the possibility of ‘help’ being helpful in their lives, and whose many difficulties often attract large numbers of different teams and professionals around them, that can make it complicated to coordinate who does what, and when, and may sometimes be rather overwhelming to the very people we are trying to help.
AMBIT stands for Adaptive Mentalization Based Integrative Treatment, but many simply call it AMBIT. The literal meaning of the word – ambit – relates to one’s sphere of influence. This is apt, because AMBIT applies mentalization theory and practice not only to direct work with clients, but to teams, wider multi-agency networks and teams’ capacity to learn and adapt.
Mentalizing is the human capacity for making sense of behaviour by considering the mind that is driving the behaviour. We can mentalize ourselves and mentalize others. Mentalizing capacity is fragile, however - both in those we try to help and in us as workers, our colleagues and multi-agency partners. Under conditions of stress or distress, we struggle to mentalize.
AMBIT assumes that working alongside people who are experiencing significant distress can (and should) at times cause powerful emotions in workers and therefore that it is inevitable that breakdowns in mentalizing will impact the people to whom we offer help, their friends and family, us as workers and our colleagues and multi-agency partners, impacting in turn on the effectiveness of the help we provide.
AMBIT helps workers to apply mentalizing in:
Direct work with clients;
How we function and support one another in teams;
How we integrate and make sense of complex helping networks;
How teams and systems can maintain a culture of learning and adaptation.
Mentalizing is at the centre of the AMBIT approach.
We encourage teams to adapt AMBIT to fit their local context. Rather than suggesting a complete change of all working practices, AMBIT seeks to strengthen existing practice in a team and to provide a stable, sustainable platform for that team to develop its own expertise and effectiveness. AMBIT is designed to support teams that may already have specific specialist interventions/therapeutic methods in place (for instance, DBT, MBT, CBT, IPT, Counselling, Gangs work, Exploitation work, Psychiatry, etc.) and seeks to strengthen the conditions in which these interventions are being delivered in order to improve their outcomes.
AMBIT has been designed from its inception as an ‘open source’ approach to the development of best practice. It is an example of a ‘deployment-focused’ innovation that has been built as a co-production, using the dialogue and feedback from the multiple teams/workers and their clients in the multiple international settings where it has been applied. In this sense AMBIT speaks from experience of the challenges in this kind of work, and this - we believe - is one of the reasons for its acceptability and popularity with workers who have been influenced by it.
All of AMBIT’s learning and all of its learning resources are freely available via the wiki manual (a user-adaptable website) in which the AMBIT model has been incubated from the very beginning, slowly developing and improving in response to feedback. You can access all of this information and resources here: https://manuals.annafreud.org/ambit.
All wiki manuals are open access, and this encourages the sharing of learning in a community of practice.
As well as the online wiki manual, there is also a book (soon two books!) describing the approach (and ‘use instances’ across the world): Bevington, Fuggle, Cracknell and Fonagy (2017) Adaptive Mentalization Based Integrative Treatment: a guide for teams to develop systems of care.