Division of Clinical Psychology

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“Experts by Experience and Clinical Psychologists working together using psychological values and practice to enable positive life changes and to offer hope and humanity to all”.

The DCP has developed this Strategy over the last few years. It was jointly initiated and overseen by a number of Experts by Experience (EbE) and clinical psychologists who share a commitment to working together in partnership. By ‘Expert by Experience’, in this context, we mean service users, carers and members of the general public with direct or indirect experience of working with clinical psychologists, in a non-professional capacity. There has been preliminary discussion of the fact that there are many clinical psychologists who would also describe themselves as Experts by Experience and this will be considered further over the next year.

We have an Experts by Experience Strategy Steering Group and, in addition, many of our Faculties and Branches are making great strides in co-working and co-production.The current membership of the Experts by Experience Strategy Steering Group is:

  • Jo Hemmingfield - DCP EbE lead for England
  • Julia Faulconbridge - DCP UK Chair
  • Annie Mitchell - DCP South-West Branch 
  • Simon Mudie - DCP EbE lead for Wales and GTiCP EbE involvement Co-Chair
  • Tracey Smith - GTiCP EbE involvement Co-Chair
  • Sheelagh Rodgers - DCP MSU Director

Jo Hemingfield gives us a brief summary of the work this year:

“The DCP UK Experts by Experience strategy steering group, along with the rest of the DCP has been trying in the last year to ‘keep the show on the road’.  The BPS office had always supported us to navigate their systems when necessary in order to put on successful and energising coproduced events.  We have kept the show on the road by focussing on such events.

In November, DCP Yorkshire and Humberside co-designed and delivered an event organised by Pinderfield Hospital’s Patient Experience Group, facilitated by Rebecca Ellis, “Bridging the Gap”. 

The Leadership and Management Faculty led by Amra Rao, coproduced “Superhuman vs Simply Human - what kind of leaders do we want”. 

Glasgow saw the Group of Trainers in Clinical Psychology conference include experts by experience from 20 universities. 

In December there is a 2-day event in Bristol which features adults and children who have been told they have a learning disability and their parents co-presenting (more details below)

FPOP are running a workshop/conference on working with the evidence base in psychological interventions in dementia at the London BPS on 3rd December which includes two EbEs who are going to present on the day and participate in the working groups.

Ensuring our publications hit the mark in reflecting the views of the community is a work in progress, building on some involvement in early documents in the “Understanding….” series towards more meaningful coproduction at every level.

The latest edition of the Child and Family Clinical Psychology Review  (CYPF Faculty) on the topic “Participatory practices in collaboration with children, young people, their families, communities and professionals” was co-edited with two members of the Faculty’s Youth Panel

The Understanding Depression document is nearing completion and an update of Understanding Bipolar document is commissioned. The goal is to have documents that are appropriate, helpful, engaging and accessible to the whole community with the best understandings from clinical psychology.

The Understanding Eating Disorders Document (due shortly for publication) is really bought to life with some creative pieces and some ‘real life experience’ contributions by those with lived experience."

Funding for EbEs

Over the last four years we have not been able to pay all our EBEs for the time they have been giving to us except where this was happening before the moratorium on funding. This has severely limited the progress we have been able to make and we are grateful that some have been able to stick with us through the difficult times. There is now a working group being set up to find a solution to funding EbEs led by Annjanette Wells and we are hopeful that this will soon be resolved.

Plans for 2019

Once we have a payment mechanism in place then we will be able to redevelop our EbE strategy, moving beyond “keeping the show on the road” to a connected strategy across the whole DCP.

Jo writes: “Now is the time for re-energising the DCP and the EBE work. We are looking at 'Being Human' at the DCP Conference in January and developing our understanding of all our common experiences and how trainees and clinical psychologists connect with their own distress supported by Natalie Kemp from In2gr8 and others. We’ll be dusting down and looking again the role descriptions to appoint new colleagues, looking at what our proposed structures, policies and ideas around systems for payment might be and updating these. As the DCP is re-established we will move forward together with fresh learning about people’s experiences, helping us all to connect with the frustrations and joys of trying to access life-transforming services in UK “.
 

Bristol Conference

Judith Samuel, Chair of the Faculty for People with Intellectual Disabilities (FPID) writes:

"Our Journey together: people with learning disabilities in and clinical psychologists in partnership. This is a joint venture between the DCP UK Experts by Experience strategy and steering group, FPID and CYPF Faculty Learning Disabilities Network with the support of DCP South West. All the sessions, videos and posters are being co-produced by Experts by Experience and clinical psychologists. The themes being addressed are improving wellbeing, service training and research. In the evening there will be an interactive Forum theatre piece by Mind the Gap, one of Europe’s leading learning disability theatre companies. We hope that outcomes from the conference will include improved engagement by Experts by Experience with learning disabilities in the work of the Faculties. The conference has proved very popular both in offers to present and to attend. I understand that the conference is oversubscribed and that there is a waiting list. 

The organizers are only sorry that a larger venue was not chosen. We will need to bear this in mind in the future."

Thu, 15/11/2018 - 17:31

It is now ten months since I took over as Interim DCP Chair. It has been a demanding and challenging year and I am glad to report that the future of the DCP in the BPS feels a great deal more positive and secure now than it did in January. I would like to thank the Executive, the Branch and Faculty Chairs and all the others who have been so supportive in working through the many key issues.

 

Positive News about Funding for Roles

The proposals developed with the Roles Working Group by Annjannette Wells and her team have now been accepted by the Board of Trustees. I would like to thank Annjanette for the significant amount of work that she has done to help us reach this point and to the CEO, Sarb Bajwa for his support.

 

The basic agreement is that elected roles can be paid either through secondment if the person is employed or on a contract for services if they are independent. There will be a day rate payable of £325 for executive activities and £250 for governance activities; there will be an expectation of 12 days/year pro bono in addition to the paid days. There will be agreements reached on the work to be undertaken and payment will be paid 3 months in arrears. This will operate for the whole of 2019 and then be reviewed in the light of the other changes that will be taking place in the BPS. 

Recompense/funding will also be applied for the whole of 2017 and 2018.

This has been such a significant development for the DCP. It enables us to draw a line under the last few years of dispute with the BPS over the funding needed for the DCP to work effectively for the membership and gives us a firm base on which to move forward.

 

In preparation for elections in January we will be developing criteria for the roles and funding. We will also develop selection criteria to check candidates’ suitability for the role before election. There is going to need to be considerable work done quickly to operationalise the policy and to develop the detail in time for our elections but we are confident that this can be done.

 

Plans for 2019

Now that we have a funding mechanism in place we are making plans for the structure of the Executive, the Branches and Faculties for 2019 and deciding how to distribute funding across the various parts of the DCP. There has been discussion with Branch and Faculty Chairs throughout this process and we hope to trial some new ways of improving connectivity and communications. The budget setting and business planning processes will be finalised early in the new year.

 

Society Review

There have been significant levels of consultation over the September and October led by Judith Tolland, the external consultant appointed to lead the Review, and Liam Gallagher, BPS Project Officer. A number of our Faculties and Branches have been able to take part and there has also been a meeting with the Exec. We feel that we have been able to have good involvement in the process and are currently optimistic that the outcomes will be broadly positive from our perspective. It seems clear that in the future the BPS will be

both a professional body and also a learned society.

 

Other Changes in the BPS

  • There will be an enhanced Policy and Communications Team in the BPS. This will include a full time Senior Policy Advisor for Mental health who will work with us and the other relevant networks within the BPS
  • An external consultant has been appointed to lead a review of all BPS Communications. DCP have contributed to this, including sharing the findings of our own review led by Lawrence Moulin and we look forward to the improvements that are so badly needed
  • It is expected that there will be additional BPS staffing so that they are able to support the networks and members effectively

 

 

BPS Interim Senate

I attended this on 11 and 12 October. It was a positive experience where there was further discussion of the Society Review and how we can all work better together.  This was the first meeting of this new body and it is recognised that there are a number of lessons to be learned from this for the future developments. There are two decisions that are particularly important for us to be aware of and to be ready to work with:

 

1. Policy Proposals

There had earlier been a call for proposals for the BPS priority proposals. DCP submitted one jointly with Division for Academics, Researchers and Teachers in Psychology (DART-P) proposing that the BPS priority in 2019 should be the mental health and psychological wellbeing of children and young people with a focus on staff and students in schools and universities. The policy team combined this with a proposal for DECP and DOP around exams and testing. Our proposal won with approx. 60% of the votes and the other two – asylum seekers and refugees and future technology were tied at 20% each. This will therefore be the main priority area for the Policy Team and we will need to engage with the planning and operationalising of this, so that our perspective as clinical psychologists is truly brought to bear.

 

2. Inclusivity and diversity

There was a decision to have a wide-ranging approach to addressing issues of inclusivity and diversity across the BPS and in the subject from school upwards. Those of you who are on Twitter may have noticed that this quickly sparked a lot of interest and debate (which included some important statistics on the percentage of BME applicants at each stage of the clinical training pathway). We are discussing how we can take this forward and revisit our Inclusivity Policy.

 

Thu, 08/11/2018 - 09:20

There are major and fast moving developments at a national level in Health Education England (HEE) and elsewhere that are aiming to expand the psychological workforce. Whilst this has been happening for a while, there is increased impetus due to the recognition that workforce is perhaps the major impediment to the delivery of more and better services in the NHS. The fact that there are many more psychology graduates who want to work in health provision than there are training places in the current professions is a major driver and developing more types of worker at lower costs and with lower salaries obviously has an attraction to policy makers. 

It all seems very fragmented both from a national perspective and in terms of the involvement and influence for us, as applied psychologists, working in Health, Education and Social Care so the DCP Executive have started to try to map the landscape and to monitor changes.

As workforce issues are often complex, it seems important that a multi-dimensional approach is taken to address key issues around a range of areas including: 

  • A life span approach across health & mental health 
  • Training routes & support for new roles & ways of working 
  • Career progression pathways 
  • Retaining & supporting existing staff (including wellbeing) 
  • Setting standards for training & recruitment
  • Improved intelligence about the workforce 
  • Developing leadership capacity 

New Roles in Psychological Therapies

Some of the existing roles and new developments we have mapped are: 

Apprenticeship scheme / Clinial Associate psychologists

The apprenticeship scheme is being developed at Exeter University in association with the Committee on Training in Clinical Psychology (CCTP). They hope that if the scheme develops high quality standards that are accepted by the national body, then any subsequent apprenticeship training would need to follow them. Exeter have formed a partnership with a large mental health Trust in Cornwall and are putting together a consortium of ‘trailblazer sites’ that will employ the apprentice associate psychologists.  

Associate roles have been in place in Scotland for several years, though not through an apprenticeship route, and the Society did develop some standards around this role a few years ago in anticipation that it could become more developed. 

Adult IAPT 

In Low Intensity IAPT these are mainly Psychological Wellbeing Practitioners (PWPs and in High Intensity IAPT, they are mainly CBT therapists.


Psychological Wellbeing Practitioners (PWPs)

This role is well established in adult IAPT and the Society accredits the courses. Some PWP's are now becoming employed in other parts of the Mental Health system

Children's Wellbeing Practitioners (CWPs)

This is a new development that adapts the PWP role for Children and Young People. The first courses have been run this year. Preparatory work has been undertaken to establish BPS accreditation process for these and some other training courses under CYP-IAPT 

Educational Mental Health Workers

This is another new role coming from the implementation of the Green Paper on transforming children and young people’s mental health provision. They will work in Mental Health Support Teams (and will initially work in schools linking closely with community services and supervised by NHS specialist staff in CAMHS. Their role will be providing evidence-based interventions for mild to moderate mental health issues, training, support, and consultation. Pilot projects are planned to be in place by the end of 2019. The work to develop the curriculum and role specification has been taking place and seven Higher Education institutions s will be involved in delivering the training. Trainees will be employed by NHS Trusts from January 2019 with 210 posts in 2019 rising to 800 in 2021. 


Groups and Committees

There are a number of groups where workforce issues are being discussed, including

BPS Workforce Working Group

Chaired by Catherine Dooley. Amra Rao and Esther Cohen-Tovee represent DCP on this. 

Psychological Professions Networks (PPNs)

Currently Adrian Whittington (Kent, Surrey and Sussex) and Gita Bhutani (North West) are Chairs funded by HEE and Esther is unfunded Chair for North East. We understand that another PPN is forming for Yorkshire and Humber. Gita and Adrian are working closely with HEE to establish a direct voice for the PPNs at national level. Discussions have been productive and PPN advice is being sought across multiple HEE workstreams nationally. This includes helping to craft the final version of the NHS Workforce Strategy, supporting the development of consultant practitioners, advanced clinical practitioners, and multiple other areas. The PPNs have produced a very useful paper on workforce:

 

Work on Developing Career Paths / Psychology Graduates

There has been considerable interest at HEE and NHSE in facilitating more effective supply of psychology graduates into the NHS workforce. There are also known problems with bottlenecks and inefficiencies in the wider psychological professions career paths that are hindering the most effective supply of workforce. There are several concurrent projects addressing these two issues and clinical psychologists, particularly from PPNs are closely involved:

  • HEE Task and Finish Group on New Roles for the Psychological Professions
  • The initial scope will be the graduate psychologist supply into low intensity wellbeing practitioner roles issue. The group will explore options for creating routes to practitioner competencies at undergraduate or postgraduate level in a more coherent and efficient programme, with different funding routes on the table e.g. degree apprenticeships. 
  • HEE Commissioned Project on Psychological Professions Career Paths
  • The National Workforce Skills Development Unit at the Tavistock has been commissioned to explore the current state of career paths across the psychological professions e.g. IAPT/Practitioner Psychology/CYP IAPT/Counselling/Psychotherapy to describe issues and risks.
  • PPN (Kent Surrey and Sussex) Tube Map of Psychological Professions Careers
  • This project will work up a design for an interactive career path map for the psychological professions, possibly tube-map style. Each profession will be a station, possible lines between them will be plotted, and recommendations made for unblocking bottlenecks etc.

CSR (Comprehensive Spending Review) Group, now DCP Subcommittee on Workforce and Training

This was set up by DCP to address the threat to trainee clinical psychology funding, chaired by Tony Lavender. It became a Society group for a short period and after the BPS withdrew support it was adopted by the DCP. It has been a very effective group, with representation of key people including PPN Chairs and representatives from the devolved nations. Its remit has expanded to cover workforce issues more broadly, placing clinical psychology training in the wider context. We have agreed that this will be reflected by a change in name and terms of reference and it will become the DCP Subcommittee on Workforce and Training. This will be the group who will continue to map what is happening and seek to have influence for clinical psychologists in all proposed developments.

If anyone is aware of any further issues or developments then please let us know.

Julia Faulconbridge
DCP Chair
29 October 2018

Tue, 30/10/2018 - 09:57

Dr Julia Bower, Clinical Psychologist
Having received a bursary to attend the recent Division of Clinical Psychology Conference in Cardiff, I was asked to share some of my highlights from the day.

There were so many informative and passionate talks showcasing psychologists work from around the country that choosing which talks to go to was difficult in itself.

I particularly enjoyed hearing about the work by the editorial group who have recently produced new guidelines on 'Understanding Psychosis', a comprehensive and accessible document providing information in a matter of fact way, myth busting, and challenging media stigma.  Research from Newcastle University focussing on the experiences of visual hallucinations show cased the determination of clinicians to understand individual experiences to continue to develop innovative and person centred interventions.

The second half of the morning was spent with the Positive Behaviour Support Academy in Wales looking at service based research applying the principles of PBS across a range of inpatient services.  Promoting and teaching the model to multidisciplinary teams and working collaboratively with service users highlighted the versatility and collaborative nature of the approach.

Lunch was an opportunity to network, before the highly anticipated keynote speaker, Susie  Orbach, linking into the overarching theme of the conference, and how psychologists can be heard in society, using professional skills outside of the consulting room to affect social policy.

Ending the day in a reflective discussion was the perfect way to think about the great examples of leadership seen during the conference and how to take this forward.  Reflecting on perhaps an uncertain landscape, but sharing the core skills good leadership should embody.

Victoria Russ, Trainee Clinical Psychologist, University of Southampton
The Division of Clinical Psychology's 2018 Annual Conference was held in Cardiff and debuted its new two-day format. With the theme of 'Being Bold in Changing Times', the conference aimed to celebrate the innovative, creative and courageous endeavours across Clinical Psychology research and practice in the face of growing financial pressures and social inequalities. The conference consisted of talks, workshops, and poster presentations from researchers, clinicians and Experts by Experience, with wide representation from NHS, independent, third sector, and international organisations.

Having been able to attend just one of the two days, I am sure I missed out on some great talks and thought-provoking debates, however this is an overview of the first day of the conference.

The conference opened with a series of workshops. The first of which I attended was entitled: 'Understanding Alters in Dissociative Identity Disorder (DID)'.

Dr Mike Lloyd (Clinical Psychologist - Cheshire & Wirral NHS) presented the therapeutic journey of a client with DID who had been accessing NHS community and inpatient mental health services for much of her adult life with limited success in reducing her distress.

Within the context of the client's distressing trauma background, Dr Lloyd described dissociation as a deliberate act within the brain to self-soothe in the face of intolerable stress and anxiety - a survival method.

Through sharing excerpts from videoed therapy sessions, an interactive session was facilitated whereby audience members were invited to hypothesise about the function and characteristics of her alters, and what their experience had been at the time of the trauma.
Dr Lloyd explained how understanding what had, and had not, happened to the alters enabled him to identify the focus for therapy, for example, teaching his client to play was fundamental in her therapeutic journey. Dr Lloyd concluded by presenting the impressive impact of therapy on the overall reduced cost to services, as evidenced by a reduction in inpatient admissions and contact with community services for this client.

The international keynote speech was delivered by Dr Susan McDaniel (Distinguished Professor of Psychiatry and Family Medicine, Director of the Institute for the Family in Psychiatry, Associate Chair of the Department of Family Medicine, and Director of the Physician Faculty Communication Coaching Program at the University of Rochester School of Medicine). The talk focused on psychologists' opportunities to tackle some of the world's most pressing global health problems including; radicalisation, racism and political divide. Dr McDaniel reminded us of where psychologists can play a key role at community and societal levels in creating constructive and disruptive change.

Psychologists' knowledge of theories and science, for example, and our understanding of psychological mechanisms that activate moral concerns can be applied to a variety of community problems. Dr McDaniel spoke of the danger of not speaking to others with different opinions whereby we might lose the opportunity to challenge our own thinking. She encouraged psychologists to be involved in debates and to facilitate others to have open and respectful discussions with people with differing views.

Dr McDaniel then shared the work of clinical psychologists who are applying their psychological knowledge and skills to address societal issues. Dr Abdulrehman, for example, whose work includes preventative and proactive approaches to recognise mental health problems, builds police and community relationships and addresses divisiveness.

Dr McDaniel ended with a poignant message to reassure those of us who perhaps felt overwhelmed at the prospect of changing the world! "See your work as one piece of a larger puzzle".

Isobel Clark (Consultant Clinical Psychologist), Lucy Johnstone (Independent Trainer) and Simon Mudie (Expert by Experience and DCP Wales Lead) presented a workshop exploring the challenge of 'Working in Diagnostically-Based Systems'. In light of the recently published Power Threat Meaning framework document and the Beyond Diagnosis movement, the workshop centered around how to practically and sensitively challenge diagnosis-based thinking and incorporate a trauma-informed formulation driven approach in our working lives.

Lucy Johnstone offered encouragement in being calm and confident in our position as psychologists to use formulation-driven approaches as opposed to diagnostic labels. We were invited to encourage staff to exercise their curiosity, develop hypotheses and offer their own views to explore meaning behind a client's diagnosis and symptoms. In particular, suggest using "I" language, for example, "When he/she does....., I feel...." and then relate this to what this tells us about the client, their relationships and their experiences.

It was highlighted that the formulation can be used as a discussion point with teams to facilitate flexibility in thinking and encourage staff to consider the meaning of events for their respective clients. We were also reminded to be mindful that the client's experience of trauma can be missed or overlooked in teams, and to ensure that these experiences are appropriately considered. After a few members of the audience expressed their frustration and subsequent discouragement of working in diagnostically-based systems, Isobel Clark used the metaphor of building a sandcastle where we work hard to build something great, but sometimes the tide will come in and wash away our sandcastle. We were encouraged to remain persistent, embrace the challenges and, if necessary, re-build our sandcastles.

The keynote speaker was Expert by Experience and independent health and social care consultant Jacqui Dyer whose talk was titled, 'From Surviving to Thriving.' Jacqui emphasised that psychologists have a key role to play as leaders in tackling the complexity of discrimination within services.

We were reminded of the challenges in accessing appropriate mental health services for black and minority ethnic communities. Jacqui argued for the need to take a cooperative approach, i.e. where co-production is present at every level of service design in order to ensure parity of esteem for vulnerable communities. Jacqui emphasised that by creating ongoing dialogue and taking a systemic approach, communities have the opportunity to be on a level where their voices are heard. Jacqui brought our attention to the ways in which these approaches have already proved successful in ensuring service users and Experts by Experience have a voice that is heard, for example,  the Mental Health Taskforce, Lambeth's Black Thrive partnership.

Jacqui argued that the development and implementation of local and national policies that operate within the political and policy landscape enables services to move from surviving to thriving.

Overall the conference was filled with thought-provoking debates concerning current international issues in Clinical Psychology with an engaged audience keen to offer their experience from clinical practice and spark enthused-discussions.

 

Thu, 22/02/2018 - 15:36

Dr Julia Bower, Clinical Psychologist
Having received a bursary to attend the recent Division of Clinical Psychology Conference in Cardiff, I was asked to share some of my highlights from the day.

There were so many informative and passionate talks showcasing psychologists work from around the country that choosing which talks to go to was difficult in itself.

I particularly enjoyed hearing about the work by the editorial group who have recently produced new guidelines on 'Understanding Psychosis', a comprehensive and accessible document providing information in a matter of fact way, myth busting, and challenging media stigma.  Research from Newcastle University focussing on the experiences of visual hallucinations show cased the determination of clinicians to understand individual experiences to continue to develop innovative and person centred interventions.

The second half of the morning was spent with the Positive Behaviour Support Academy in Wales looking at service based research applying the principles of PBS across a range of inpatient services.  Promoting and teaching the model to multidisciplinary teams and working collaboratively with service users highlighted the versatility and collaborative nature of the approach.

Lunch was an opportunity to network, before the highly anticipated keynote speaker, Susie  Orbach, linking into the overarching theme of the conference, and how psychologists can be heard in society, using professional skills outside of the consulting room to affect social policy.

Ending the day in a reflective discussion was the perfect way to think about the great examples of leadership seen during the conference and how to take this forward.  Reflecting on perhaps an uncertain landscape, but sharing the core skills good leadership should embody.

Victoria Russ, Trainee Clinical Psychologist, University of Southampton
The Division of Clinical Psychology's 2018 Annual Conference was held in Cardiff and debuted its new two-day format. With the theme of 'Being Bold in Changing Times', the conference aimed to celebrate the innovative, creative and courageous endeavours across Clinical Psychology research and practice in the face of growing financial pressures and social inequalities. The conference consisted of talks, workshops, and poster presentations from researchers, clinicians and Experts by Experience, with wide representation from NHS, independent, third sector, and international organisations.

Having been able to attend just one of the two days, I am sure I missed out on some great talks and thought-provoking debates, however this is an overview of the first day of the conference.

The conference opened with a series of workshops. The first of which I attended was entitled: 'Understanding Alters in Dissociative Identity Disorder (DID)'.

Dr Mike Lloyd (Clinical Psychologist - Cheshire & Wirral NHS) presented the therapeutic journey of a client with DID who had been accessing NHS community and inpatient mental health services for much of her adult life with limited success in reducing her distress.

Within the context of the client's distressing trauma background, Dr Lloyd described dissociation as a deliberate act within the brain to self-soothe in the face of intolerable stress and anxiety - a survival method.

Through sharing excerpts from videoed therapy sessions, an interactive session was facilitated whereby audience members were invited to hypothesise about the function and characteristics of her alters, and what their experience had been at the time of the trauma.
Dr Lloyd explained how understanding what had, and had not, happened to the alters enabled him to identify the focus for therapy, for example, teaching his client to play was fundamental in her therapeutic journey. Dr Lloyd concluded by presenting the impressive impact of therapy on the overall reduced cost to services, as evidenced by a reduction in inpatient admissions and contact with community services for this client.

The international keynote speech was delivered by Dr Susan McDaniel (Distinguished Professor of Psychiatry and Family Medicine, Director of the Institute for the Family in Psychiatry, Associate Chair of the Department of Family Medicine, and Director of the Physician Faculty Communication Coaching Program at the University of Rochester School of Medicine). The talk focused on psychologists' opportunities to tackle some of the world's most pressing global health problems including; radicalisation, racism and political divide. Dr McDaniel reminded us of where psychologists can play a key role at community and societal levels in creating constructive and disruptive change.

Psychologists' knowledge of theories and science, for example, and our understanding of psychological mechanisms that activate moral concerns can be applied to a variety of community problems. Dr McDaniel spoke of the danger of not speaking to others with different opinions whereby we might lose the opportunity to challenge our own thinking. She encouraged psychologists to be involved in debates and to facilitate others to have open and respectful discussions with people with differing views.

Dr McDaniel then shared the work of clinical psychologists who are applying their psychological knowledge and skills to address societal issues. Dr Abdulrehman, for example, whose work includes preventative and proactive approaches to recognise mental health problems, builds police and community relationships and addresses divisiveness.

Dr McDaniel ended with a poignant message to reassure those of us who perhaps felt overwhelmed at the prospect of changing the world! "See your work as one piece of a larger puzzle".

Isobel Clark (Consultant Clinical Psychologist), Lucy Johnstone (Independent Trainer) and Simon Mudie (Expert by Experience and DCP Wales Lead) presented a workshop exploring the challenge of 'Working in Diagnostically-Based Systems'. In light of the recently published Power Threat Meaning framework document and the Beyond Diagnosis movement, the workshop centered around how to practically and sensitively challenge diagnosis-based thinking and incorporate a trauma-informed formulation driven approach in our working lives.

Lucy Johnstone offered encouragement in being calm and confident in our position as psychologists to use formulation-driven approaches as opposed to diagnostic labels. We were invited to encourage staff to exercise their curiosity, develop hypotheses and offer their own views to explore meaning behind a client's diagnosis and symptoms. In particular, suggest using "I" language, for example, "When he/she does....., I feel...." and then relate this to what this tells us about the client, their relationships and their experiences.

It was highlighted that the formulation can be used as a discussion point with teams to facilitate flexibility in thinking and encourage staff to consider the meaning of events for their respective clients. We were also reminded to be mindful that the client's experience of trauma can be missed or overlooked in teams, and to ensure that these experiences are appropriately considered. After a few members of the audience expressed their frustration and subsequent discouragement of working in diagnostically-based systems, Isobel Clark used the metaphor of building a sandcastle where we work hard to build something great, but sometimes the tide will come in and wash away our sandcastle. We were encouraged to remain persistent, embrace the challenges and, if necessary, re-build our sandcastles.

The keynote speaker was Expert by Experience and independent health and social care consultant Jacqui Dyer whose talk was titled, 'From Surviving to Thriving.' Jacqui emphasised that psychologists have a key role to play as leaders in tackling the complexity of discrimination within services.

We were reminded of the challenges in accessing appropriate mental health services for black and minority ethnic communities. Jacqui argued for the need to take a cooperative approach, i.e. where co-production is present at every level of service design in order to ensure parity of esteem for vulnerable communities. Jacqui emphasised that by creating ongoing dialogue and taking a systemic approach, communities have the opportunity to be on a level where their voices are heard. Jacqui brought our attention to the ways in which these approaches have already proved successful in ensuring service users and Experts by Experience have a voice that is heard, for example,  the Mental Health Taskforce, Lambeth's Black Thrive partnership.

Jacqui argued that the development and implementation of local and national policies that operate within the political and policy landscape enables services to move from surviving to thriving.

Overall the conference was filled with thought-provoking debates concerning current international issues in Clinical Psychology with an engaged audience keen to offer their experience from clinical practice and spark enthused-discussions.

 

Thu, 22/02/2018 - 15:36

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