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.