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Year 5 Exam > Clinical Examples and Other Panic Stuff > Flashcards

Clinical Examples and Other Panic Stuff Flashcards

1
Q

What could be the outcome of countertransference reactions?

A

Blurred boundaries

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2
Q

Give some examples of blurred boundaries.

A

Inappropriate levels of disclosure
Not working with/acknowledging transference/countertransference
Therapeutic alliance break down
Inability to discuss the case reflectively in supervision
Reinforcing client’s and own relationship patterns
Difficult therapy ending

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3
Q

How can you bring self-disclosure into transference/countertransference/boundaries?

A

One sign of blurred boundaries is inappropriate disclosure, however disclosure is sometimes important.
Need to consider why disclosing and discuss in SV.

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4
Q

Who can you cite for the use of transference/countertransference?

A

Pope and Tabchnick (1993)

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5
Q

What form can transference take?

A

Affective states
Behavioural tendencies
Symbolic role relationships

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6
Q

How can you bring power in for transference?

A

Clinician is in a position of authority. This tends to just be true, so use how the person responds to power if it seems extreme, while trying to equal the power relationship.

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7
Q

How can we get in touch with countertransference?

A

How do we feel in response to the client?
What do we do?
What do we hope for (DNA)?

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8
Q

Give an example of using transference/countertransference in therapy.

A

Client who had complex presentation and complicated history. Did not really understand what we were supposed to do/why she was there/what was wrong but knew that something was.
Confused history from parents, poor communication from them and to them.
Led to poor communication in the team, unsure of what to do, how to help, avoidance of being with the girl. Blame on parents.

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9
Q

What are the major defences in baF?

A

Splitting off and projecting outward intra-group sources of anxiety and aggression.

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10
Q

What are the secondary defences of baF?

A

Idealisation of the leader

Denial of aggression

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11
Q

Talk about baF in normal terms.

A

A person cannot cope with the idea that the leader or anyone in their group might be bad so they make outside people the enemy and idealise the leader. They have no aggression in them at all - so they say.

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12
Q

What are the major defences of baD?

A

Denial and repression of aggreassive and destructive impulses towards the leader.
Idealisation of the leader.

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13
Q

What are the secondary defences of baD?

A

Splitting - idealising the group ‘believers’ and hating the ‘non-believers’
Scapegoating the non-believers

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14
Q

Talk about baD in normal terms.

A

People feel that they have no hope and they must depend on the leader for everything. It is therefore not safe to hate the leader and they will turn against anyone who does.

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15
Q

What is parallel process?

A

When the dynamics of a therapeutic relationship are acted out with a supervisor.

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16
Q

Give an example of parallel process.

A

Being unforthcoming, avoidant and grumpy with a supervisor when a client has been that way.

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17
Q

How can parallel process be used?

A

If the supervisee does as the client does, she can learn how best to overcome this.

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18
Q

Who talks about psychologically working in teams?

A

The BPS and NIMHE (2007)

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19
Q

Give four examples of what clinical psychologists can offer to teams.

A

Peer consultation/supervision
Reflective practice
Advocating/involving users and carers
Research/evaluation/development

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20
Q

Give four things that make for effective team working.

A

Clear and achievable objectives
Differentiated, diverse and clear roles
Necessary authority, autonomy and resources
Capacity for effective dialogue

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21
Q

How can clinical psychologists support effective team working?

A

Setting goals and targets
Understanding and recognising different team roles - celebrating difference and diversity
Mediating effective dialogue by modelling reflection on transference

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22
Q

How can clinical psychologists promote effective participation of service users and their relatives/carers?

A

Involve them in their own care planning and delivery
Involve them in practice development (feedback, team community meetings, accessible information, staff training)
Involve them in service development, leadership and management

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23
Q

Give 3 examples of teaching and training.

A

Attachment for foster carers
Attachment in in patient settings
PD training

24
Q

Give three advantages of integrating psychologists into teams.

A

They can become involved in initial conversations about clients

Offers more opportunities to influence the team and better understanding of psychology

People are more able to be challenged because you have better working relationships

25
Q

Give three advantages of being separate from the team.

A

More time for clients, less for meetings etc.

Better placed to provide consultation, supervision, teaching/training?

More of an independent viewpoint?

26
Q

What is regression?

A

The move towards more primitive/basic defences when faced with anxiety.

27
Q

Give 3 examples of some more basic defences and what they look like.

A

Primitive categories - good/bad; enemy/ally; all/nothing
Splitting
Projective identification

28
Q

What kind of context perpetuates paranoid-schizoid dynamics?

A

Vicious competition
Win/lose
Mistrust and secrecy

29
Q

For what does CPA stand?

A

Care Programme Approach

30
Q

What should a CPA involve?

A

Formal written care plan outlining risk and details of plan for crisis
Regular reviews of CPA
Choice, respect, dignity

31
Q

Give three elements of ‘leading with care’.

A

Reading other people’s emotions and be appropriately empathic

Caring for my own physical and mental wellbeing to ensure a positive atmosphere within the team

Share responsibility for the emotional wellbeing of my colleagues

32
Q

Give two examples of when you have led with care.

A

Noticed a staff member responding strangely and offered the space to talk, discuss and reflect

Acknowledged my own feelings and been aware that my behaviour may be different from normal so monitored this and explained it where necessary

33
Q

Give an example of evaluating information.

A

SSP

34
Q

Give an example of engaging the team.

A

Team away days

35
Q

Give an example of developing capability.

A

Teaching and training

Supervision with assistant

36
Q

What is a possible problem with ‘flat hierarchies’?

A

It obscures power differentials that are naturally there. Why not just name it?

37
Q

In a ‘not knowing’ approach, who is the expert on what?

A

Client on content

Therapist on process

38
Q

Who talks about ‘knowing, not knowing and partial knowing?

A

Anderson 1997

39
Q

Give three things to think about when considering the safety of a client.

A

Confidentiality
Safeguarding
Ethics

40
Q

What must be considered in person centred planning and patient led healthcare?

A 
Giving SU and families information about available treatment options
Client dignity and respect
Assessing the suitability of therapy
Terminating therapy if not effective
Informed consent
41
Q

Who is our regulatory body?

A

HCPC

42
Q

What are the general guidelines on dynamic risk assessments?

A

They are ongoing, not static
Ethics
Impartiality when working with controversial groups/MCA
Boundaries, contracting and self-disclosure

43
Q

What is involved in best practice guidelines?

A

Specifics for practitioners

Laws and regs re: e.g. confidentiality, team working, information sharing

44
Q

What does the Darzi (2008) report talk about?

A

High quality care for all

Quality should be at the heart of the NHS

45
Q

Give three policies about dispersed leadership.

A 
NIMHE (2007) New Ways of Working for Everyone
NHS Healthcare Leadership Model (2011)
Francis Report (2013)
46
Q

How do you bring the Francis Report into leadership?

A

You need it for protection

47
Q

Who talks about Joint Working?

A

DoH (2009) New Horizons
NWW (NIMHE, 2007)
DoH (2012) Transforming Care: National Response to Winterbourne

48
Q

What policies are involved in personalisation?

A

DoH (2010) Personalisation through person-centred planning
DoH (2009) New Horizons
Health and Social Care Act (2012)
Mansell (2010) - Raising Our Sights

49
Q

What talks about patients as consumers??

A

Health and Social Care Act (2012)

50
Q

Who talks about access to general NHS services for PwLD?

A 
Mental Health National Service Framework (1999)
Greenlight Toolkit (2004)
VP, VPN (DoH, 2001;2009)
Equality Act (2010)
Disability Discrimination Act (2005)
51
Q

What policies are available for MDT working?

A

NIMHE (2007) New Ways of Working for Everyone

BPS (2007) NWW for Applied Psychologists

Darzi (2008) NHS Next Stage Review (dispersed leadership)

52
Q

What are the four ethical decision making principles in BPS Code of Ethics and Conduct (2009)?

A

Respect
Competence
Responsibility
Integrity

53
Q

Who talks about respect, competence, responsibility and integrity?

A

BPS (2009)

54
Q

What are the HCPC Standard of Ethics, Performance and Conduct (2008)?

A

Act in best interest of SU
Respect confidentiality
Record keeping and effective communication
Honesty and integrity

55
Q

Who talks about connecting communities?

A

Hannah (2009)

Year 5 Exam (28 decks)

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