Clinical Risk Assessment and Management: The Critical Role of Formulation

I wanted to share the really positive experience I had at the recent BPS CPD day on Clinical Risk Assessment and Management: The Critical Role of Formulation delivered by an effervescent and very informed Dr Caroline Logan. 

Well it was always going to be a risk - navigating the perpetual roadworks of the M62 in order to get to Manchester by 10.  So I ustilised the 5 -Ps...

 

the Problem - getting to Manchester before the start of the programme at 10

Precipitating factors = Traffic and roadworks

Perpetuating factors = Traffic and roadworks worsened by a broken down lorry that resulted in a lane closure and even more traffic.

Predisposing factors = vulnerability factors = the drivers - literally

Protective factors  = I left home at 7.15 to ensure I arrived in  plenty of time (TomTom said 2 hours - tops!)

then I encountered the remaining 3Ps in a continuous revolution...

 

When I eventually got there - 10.30 I was met with "why didn't you get the train?"

Wish I had...

The day was exciting and informative, with Caroline connecting with each one of us as she picked up on comments we had made about our work and interpretation. 

The day provided  

1. An overview of the most recent thinking on the structured professional judgement approach to clinical risk assessment and management. 
2.  An understanding of the critical role of formulation as the bridge between risk assessment and risk management.
3. Skills in risk formulation
4. A framework for evaluating risk formulations
5. Skills in the communication of risk formulations

 

The HCR-20 version 3 was discussed in detail. We even talked about the current DSM-V debate!  A very interesting and fulfilling day with a very fulfilling lunch!

 

Campaign for a Royal College of Psychologists

At the time of writing, 449 out of a required 500 BPS Members, Associate Fellows and Fellows have signed up to the campaign for the establishment of a Royal College of Psychologists (RCPsychol). 

As reported by the Campaign group:

"With the new RCPsychol, the professional interests of all psychologists will be seen to be substantively protected by psychologists. The BPS has all the infrastructure in place to do this, but the campaign feels that this is not being given the recognition it deserves by government, business stakeholders, international organisations and authorities, as the BPS is not perceived to be of the same status as other chartered institutions who have adopted a royal institutional title.

The aim of the campaign is to petition the BPS to work towards the status of becoming (or creating) a Royal College, such as “The Royal College of Psychologists” or “The Royal College of Chartered Psychologists”. The choice of name and associated membership grades, their privileges and responsibilities would ultimately be a matter for Council. 

The principal reason for the BPS operating under the name of a Royal College is to bring the BPS in line with other Royal Colleges in the UK, e.g. Royal College of Physicians, Royal College of Speech and Language Therapists, etc.

The BPS has had a Royal Charter since 1965, BPS Royal Charter and is already doing what other Royal Colleges do but without the visible authority of a Royal College per se. The status of a Royal College of Psychologists will give the present BPS a well-deserved place among sister Royal Colleges, and raise it to the status of a definitive authority in the eyes of the public, both at home and internationally. It will also give visible regard to the Royal Charter granted to the Society 45 years ago."

This is a very important step and one I urge other BPS Members to sign up to before 26th March 2013. We have a long established professionsl career and need to move forward with a sense of our history alongside a determination to develop further and take us into the future. Read about the past and the future and then decide what action you may be able to take that is relevant to you.

Please feel free to leave your comments below.

not a neuropsychologist but a clinical psychologist interested in neuropsychology

I am a clinical psychologist and have a  particular interest in neuropsychology and am experienced in conducting neuropsychological assessments.  When working in Australia I was a member of the (4-person) organizing committee, and also presented at, Novita Children’s Services (formerly the Crippled Children’s Association) inaugural Acquired Brain Injury conference - the first Australian ABI conference that focused on children.  The conference has become a biannual event. 

At the same time I established (with another psychologist and two social workers) a Brain Injury Support Service for children and adolescents with acquired brain injuries.  We received referrals for neuropsychological assessments, rehabilitation programmes, and for the education and support of schools in reintegrating children back into the learning environment.  Individual therapy and family support was included.

Building upon my interest, my current research involves looking at the role of memory in the development of post traumatic stress disorder in adult patients who have spent time in Intensive Care. 

From a therapist's perspective I have looked at the therapeutic environments of people living with dementia in enabling them to feel emotionally secure and therefore less distressed.  This thesis was completed as part of a Diploma in Disability Psychotherapy run by Frankish Training.  This work has been presented and published at the 2012  British Psychological Society Faculty of Psychology of Older People (FPoP), formerly PSIGE, conference in Bristol, UK: “Application of the Frankish Model of emotional development in the therapeutic holding of people with dementia: A pilot study”.  For more information about helping older people to age well see http:www.psige.org/info/home

Counselling Psychologists

Counselling psychologist: Job description

Counselling psychologists use psychological theory and research in their therapeutic work with clients, staff groups and organisations. Clients may present with a variety of problems ranging from anxiety and depression arising from difficult life issues to more serious mental health problems.

Life issues could include bereavement, relationship difficulties, domestic violence or the aftereffects of childhood sexual abuse, while mental health problems could include eating disorders, post-traumatic stress disorder (PTSD) or psychosis. Some individuals may have simply come to a point in their life, where they feel the need to take stock and consider options for moving forward.

Staff teams may need assistance to develop Support Plans for individuals; may need assistance in understanding the meaning behind behaviours that challenge; or may need to find a support mechanism to aid them in avoiding burnout issues.

Organisations can utilise the therapeutic understanding and expertise of Counselling Psychologists to understand system dynamics; to create new and therapeutic environments; and to develop new therapeutic models of care and support.

Practising as a counselling psychologist requires a high level of training and self-awareness, achieved through personal therapy, as well as the ability to work collaboratively with the client in a holistic, insightful and facilitative way to enable them to consider change.

Counselling psychologists work with diverse client groups, including children, adults, students and young people, families and couples, and older people. They work in many different settings, such as health and care services, hospitals, prisons, probation services, consultancy, and in private or public organisations.

Typical tasks include:

• undertaking assessments, including assessment of mental health need, risk assessment and psychometric testing;
• formulating a psychological explanation of the client’s issues;
• planning and implementing therapy;
• evaluating the outcome of therapy;
• establishing a collaborative working relationship with the client based on trust and respect;
• writing reports and record-keeping;
• training and supervision of other psychologists;
• management, audit and development of services and organisation;
• multidisciplinary teamworking;
• continuing personal and professional development (CPD);
• undertaking research, either individually or as part of a team

Empathy & Compassion in Society Conference

Speakers

Tomorrow marks a unique opportunity for those involved in the fields of policy, education, health and social care to come together to hear internationally acclaimed scientists, leaders and change makers in a series of presentations and workshops focused on Empathy & Compassion in Society. The Conference actually begins with a free event for young people, an encouraging sign that the focus of empathy and compassion will begin with hope for the future and the encouragement of our young people to award status to these ideas.
The conference is being supported by a range of organisations dedicated to making a diference in the daily lives of individuals and the overarching consideration of national and international peoples.
As a group of psychologists we are committed to active investment in cutting edge science and provision of services to enable as many individuals as possible to achieve their potential. As a result we are endeavouring to stay abreast of such movements and to incorporate these ideas into our work with individuals and organisations.
The publication of the Winterbourne report, after the revelations of the dreadful treatment of those within the care system at Winterbourne, gave particular emphasis to the importance of compassion in the care and support of vulnerable people. We will attend the conference and hopefully let you have feedback on how it goes and what outcomes there may be. Watch this space....

CPD, who has responsibility?

We all know the rules and requirements of CPD for Practioner Psychologists. We also know that it is in the interests of our practice and the support we offer to others, to stay up to date with professional development. For those of us who are employed there is an expectation that our employer will provide CPD or foot the bill. For those of us who are self-employed there is obviously a need to source and pay for our own. Is there a point at which the two cross over? Is there some form of CPD that would benefit you directly in your practice, that would make little or no difference in business or efficiency terms for your employer. Are there just things you are plain interested in? Are there things you could be doing to help yourself?

We need to bear in mind that many daily activities count towards CPD. None of us can practice without supervision and this counts. Teaching individuals, managing provisions, reading articles, networking with other professionals - all of these things count towards the maintenance of CPD. In a climate of fiscal austerity, take responsibility for some of your own CPD and find training or interests that inspire and motivate you to take ownership of your own CPD. Tackle the issue head on and gain a sense of choice and autonomy in where you place your attention. Both you and the individuals you support will make greater gains than attendance at perfunctory training in areas that hold little professional passion for you.

Frustration with the lack of psychotherapy for adolescent sex offenders.

Over the last few years I have been asked to assess adolescent sex offenders either pre-trial or pre-sentencing.  More often than not these adolescents have experienced trauma that predates their offences and often I recommended psychodynamic therapy in addition to the traditional sex offender treatment programme.  I recommend this not just because it would be beneficial to the psychological development of the individual, but also because if (as is also common) the adolescent is emotionally under-developed as a result of their trauma, the psychotherapy will enable them to develop to such a point that they would be able to fully engage with sex offender treatment.

So last week I was asked to reassess an adolescent who was applying for parole whom I had recommended the above with concern that his mental health would deteriorate.  I was saddened to discover that his mental health had worsened and I considered him to be of greater risk than two years previously.  He had not received psychodynamic psychotherapy, but had been accessing sex offender treatment but had not completed it, in my opinion due to an inability as a result of his emotional incapacity.  This left me feeling frustrated, but ready to improve awareness and try to change this.