Psychology, professionalism & regulations Flashcards
Psychotherapist vs Psychologist
talking therapy such as CBT
vs
medical treatments, risk assessment and hospital detention
Body satissfaction males vs females
comparable but manifest in different ways
Drivers for aesthetics treatments
Body Image
Ageing
Social media
Advertising
Culture
Psychological factors
What is the Keogh review
Department of health report
States people considering treatment should access to clear independent evidence based information for informed decision
including risk and how complications are managed
Sir Liam Donaldson, CMO 2005 observation
lack of balanced information
consultations by non-medical professionals
At risk/vulnerable patient groups (5)
Mental health issues - anxiety, depression OCS
Recent life events - bereavement, relationship issues, redundancy
Under pressure for appearance - bullying, deadline
Under 18
Lack capacity to consent
Keogh report 2013
There should be a register of all practitioners
Dermal fillers should be classified as a prescription-only medication
All practitioners must be properly qualified
All non-surgical procedures must be performed under the supervision of a clinical professional
Financial offers should be banned, and there needs to be a mandatory code of conduct for advertising
Regulations in Scotland
From April 2016, independent clinics in Scotland were regulated by HIS
Healthcare Improvement Scotland (HIS)
Independent clinics must register with HIS – application is a non-refundable £1,990
Beauty therapist not required to register
JCCP stands for
Joint Council of Cosmetic Practitioners
JCCP was formerly known as
‘Treatments You Can Trust’ (TYCT) and ‘SaveFace’.
TYCT won a recent tender to merge their members with the newly formed Joint Council of Cosmetic Practitioners (JCCP
Cosmetic practioners bodies (6)
Joint Council of Cosmetic Practitioners (JCCP)
British College of Aesthetic Medicine (BCAM)
British Association of Cosmetic Nurses (BACN)
British Association of Dermatologists (BAD)
British Association of Aesthetic Plastic Surgeons (BAAPS)
British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS)
The Hair and Beauty Industry Authority (HABIA)
HEE guidance for practitioners 2013 and 2014
Each modality under the HEE review is given a qualification requirement
All practitioners performing injectable treatments are required to study to a postgraduate degree level
Clinical oversight is required for treatment with cosmetic injectables
HEE Guidelines (2013 and 2014) for training providers
Training courses must have their own degree awarding powers or be Ofqual-regulated, or work in partnership with such organisations
A minimum of 50% of the curriculum must be devoted to the development of practical skills
Delegates must subsequently pass a rigorous and standardised assessment
Supervisors must be able to provide clinical oversight and be proficient with the treatment being trained in (a minimum of 3 years experience)
General Medical Council (GMC) guidance for doctors (April 2016)
Doctors must market their treatments responsibly, including not offering financial incentives for cosmetic procedures
Doctors must conduct a face-to-face consultation and seek consent themselves without delegation
Patients should be given a cooling off period in order to make a voluntary and informed choice to proceed with treatment
Doctors should take particular care when treating young persons
Doctors should be mindful of the psychological drivers for cosmetic treatments and when these may be pathological
CPSA responsibilites (4)
Reviewing evidence and updating guidelines on existing defined modalities and future emerging modalities
Setting the standard for clinical and practice proficiency
Collect adverse event data and developing patient outcome and experience measures
Working in partnership with the JCCP on standards with regard to aesthetic treatments
components of the mental state examination in aesthetic practice
Appearance - poor eye contact, unusal
Thought content - wanting a quick fix, appearnce avvoidance
History
Mood - tearful, emotionally detached “not my nose”
Jargon
Unable to make informed decision
Insight - unreleastic expectations
BDD in general population vs clinic
0.7-2.4%
vs
3-18%
What is Body Dysmorphic Disorder
When taking an interest in your appearance tips over into an all-consuming, never-ending source of worry.
Key Signs of BDD
obsessively worrying about their face or a specific area of their body
regularly comparing their looks with other people’s
frequently looking at themselves in mirrors, or avoiding their reflection altogether
making a lot of effort to conceal perceived flaws, including with makeup and clothing
picking at their skin to make it “smooth”.
Other symptoms of BDD
feeling they need unnecessary plastic surgery and/or tweakments
experiencing shame, guilt and loneliness
self-harming
isolating themselves
believing their face or body lacks proportion or is not symmetrical
worrying people think they are vain
developing obsessive compulsions as coping mechanisms
wearing heavy makeup
tanning excessively.
Where to refer patients with suspected BDD
Body Dysmorphic Disorder Foundation UK charity
Counsellor or psychotherapist
Offer support
BDD patient history
worries about appearance
do they avoid social interaction
effect on their life
comparing themselves to others
struggle with personal relationships
how much time do they spend thinking about appearance
Suicide in BDD
80% experience ideation
24-28% have attempted suicide
suicide completion 22x higher compred to general pop
How is BDD treated
CBT
SSRIs
Psycotherapy and counselling
How to refuse a BDD patient
explain goals are psychosocial
treatment unlikely to have impact on self confidence or wellbeing
unlikely to meet their expectations with aesthetics treatment
offer NICE recommended treatemt/support
Percentage of clinic attenders with anxiety or depression
20%
Psychological screening tools
COPS - cosmetic procedure screening questionnaire (self reporting scale)
BDDE-SR - body dysmorphic disorder examination self report
BSSQ-DV - Body Dysmorphic Disorder Questionnair , dermatology version
Cooling off period
two weeks following assessment
access to information to make consent - written
JCCP responsibility
oversee training
public register of qualified practicioners
premise standard
Advertising Standards Authority
You cannot refer to the medication directly or indirectly, nor to the use of toxin for treatment
you may list the name of your treatment, for example Botox (3 areas)
cannot detail areas or what treatment does
With the exception of your pricelist, you cannot mention that you offer toxin, nor the effects treatments can offer in any patient-facing material.
No Before&after toxin images
Reporting adverse events
to the MHRA via yellow card scheme
formally recordede
Key principles of MCA 2005
everyone has capacity until proven they dont
decisions agaist social norms or advice does not mean they lack capacity
Common Law confidentiality
confided information not to be disclosed further without permission
Data protection act 2018
data related to living individual who can be identified
including expresiion of opinion, all forms of media
Human rights act 1998
repect and protect privacy and confidentiality of health records
When can you break confidentiality
public protection
child protection
patient risk of harm to themselves
Premise requirements
toilets
hand sink
structures and fabric material can be cleaned
Substace hazardous to health are stored safely
Privacy during treatment
Decontamination of equipment
Sharps disposal codes
PURPLE - Cytoxic or cytostatic (including BTX)
ORANGE - sharps not cominated with drugs/chemicals
YELLOW- sharps contaminated with drugs
Personal data vs sensitive data
Personal - identifiable (name, address, DOB)
Sensitive - medical, sexual orientation, religion, political, crimiminal record
Basic information governence framework
policies for information storage, distaster recovery and contingency
auditing and review
roles and responsiblities of individuals
Data protection act 2018 & GDPR
data used fairly and lawfully
transparency in data use
used for specified and explicit purpose
securely
Recommended time to keep medical records
up to 10 years
like GP practices
digital records can be held longer
Criteria for photo taking device
do not store on cloud storage which communicates with other devicecs
mobile phones are not secure whilst being trasported
