Populations and Settings

Question 1

What are the issues an individual who is receiving a diagnosis could face?

Answer 1

The label can come with prejudice, this means other people may make incorrect judgements about someone with this label
People receiving the diagnosis may also judge themselves
Sometimes a diagnosis can provide relief, as after years of confusion there is finally an answer
Diagnoses help people access the support they need

Question 2

What are some issues with the diagnostic methods we use in psychology?

Answer 2

Diagnostic methods (ICD-10 and DSM5) reflect the complexities of receiving an accurate diagnosis
These diagnostic methods don’t always overlap
The diagnosis also depends upon who is doing the diagnosing

Question 3

What is the HPC? What does it do?

Answer 3

The health and care professions council
Registered with these to call yourself a clinical psychologist

Question 4

What is the BPS? What do they do?

Answer 4

BPS (British psychological Society)
Support clinical psychologists, no need to still be a member of the BPS

Question 5

What are some types of population groups that clinicians use?

Answer 5

Children and adolescents 0-18 years

Working aged adults 18- 65 years

Older people
65 plus years

People with learning disabilities

Question 6

What are some types of subpopulation groups?

Answer 6

MIMHS Mothers and Infant Mental Health Service, starts at 18 years, not accepting anyone under 18

Early Interventions Psychosis from 14 to 65 years

Eating Disorder Services, 14 years to adult, not accepting anyone under 14

Question 7

What services are available in Medway and Kent?

Answer 7

Kent and Medway services
Medway 0- 19 years
Kent 0-18 years

These mainstream services run alongside two other services
Neurodevelopmental and Learning Disability Service
Eating Disorder service

Question 8

Do older people use mental health services?

Answer 8

Globally, the population is ageing rapidly
Mental and neurological disorders among adults account for 6.6% of the total disability for this age group
15% of adults aged 60 and over suffer from a mental disorder

Question 9

How are the learning disabilities services set up by age?

Answer 9

Up until 18: North East London Foundation Trust NELFT
After 18, Kent and Medway NHS and Social Care Partnership Trust (KMPT)

Question 10

How are learning disabilities classified?

Answer 10

IQ <20: profound learning disability
IQ 20-34: severe leaning disability
IQ 35-49: moderate learning disability
IQ 50- 70: mild learning disability

Things are changing slowly, we use ABAS (assessment of daily functioning) alongside IQ

Question 11

What treatments do the learning disability services offer?

Answer 11

Specialised adapted treatment plan
Individualised care plan
Support for the service users as well as the family members
Therapeutic interventions
Education

Question 12

What is the KMPT learning disability criteria?

Answer 12

To receive a diagnosis:
IQ of 70 or below
Limitations in at least 2 areas of adaptive, social and communication skills
Both of these have to appear before the age of 18 years

The eligibility for treatment: Diagnosed learning disability
Engage in behaviour that is a risk to themselves or others
evidence of mental illness, psychological disturbance, personality disorder AND/OR behaviour that challenges their quality of life

Question 13

What are some challenging behaviours?

Answer 13

Culturally abnormal behaviours of such intensity, duration and frequency that the physical safety of the person or others is put in jeopardy
They can be self injurious e.g. biting self
Or aggressive behaviours e.g. hitting or pushing others

Question 14

What treatments are available to young people?

Answer 14

CBT (cognitive behavioural therapy) for anxiety and depression - Aaron Beck

DBT (dialectical behavioural therapy) skills for mood dysregulation - Marsha Linehan

Question 15

Why is understanding child development important as a clinical psychologist?

Answer 15

Understanding child development is key
In children, melatonin peaks later in the day compared to adults
Prefrontal cortex development in children means children may struggle with impulse control and rational decision making

Question 16

Is CBT accessible for people with learning disabilities?

Answer 16

Nonverbal people may pick their skin or pull their hair
CBT is adapted for them

Question 17

What is the ABC model?

Answer 17

Clinical psychologists observe and assess using the ABC model

ABC
A: antecedent (what happened before?)
B: behaviour
C: consequences (what happened after?)

Question 18

How are you diagnosed with psychosis? What are the treatments?

Answer 18

Hallucinations: where a person hears, sees, feels, tastes, smells things that aren’t there
Delusions: a person believes things that when examined rationally are often untrue

Treatments:
Early Intervention for Psychosis service
CBT

Question 19

How are you diagnosed with a personality disorder? What is the treatment for this?

Answer 19

After 18 for a full diagnosis
Emotionally unstable

Treatments:
DBT
2 years of psychotherapy
Brenchley Unit which offers a range of advice and support from professionals

Question 20

What are the treatments for EDs?

Answer 20

All age ED service in Kent called NELFT
RO-DBT made by Tom Lynch, adapted DBT model
Huge amount of monitoring e.g. BMI, blood tests, feeding programmes

Question 21

How do clinical psychologists work in forensic settings?

Answer 21

Write reports for court, give evidence to court as an expert witness
Group based treatments e.g. anger management, sex offender treatment programmes

Question 22

Do clinical psychologists work in health settings?

Answer 22

Some patients are comorbid with physical health and mental health
e.g. cardiovascular, sex health, diabetes
Clinical psychologists can work in both hospitals and community settings
Helps people promote healthy lifestyles to promote health problems
Use evidence based models to support people like the Kubler Ross 5 stages of grief