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Supporting Families and Individuals Experiencing Psychosis
Supporting Families and Individuals Experiencing Psychosis
Supporting Families and Individuals Experiencing Psychosis
Supporting Families and Individuals Experiencing Psychosis
Supporting Families and Individuals Experiencing Psychosis
Supporting Families and Individuals Experiencing Psychosis
Supporting Families and Individuals Experiencing Psychosis
Supporting Families and Individuals Experiencing Psychosis
Supporting Families and Individuals Experiencing Psychosis
Supporting Families and Individuals Experiencing Psychosis
Supporting Families and Individuals Experiencing Psychosis
Supporting Families and Individuals Experiencing Psychosis
Supporting Families and Individuals Experiencing Psychosis
Supporting Families and Individuals Experiencing Psychosis
Supporting Families and Individuals Experiencing Psychosis
Supporting Families and Individuals Experiencing Psychosis
Supporting Families and Individuals Experiencing Psychosis
Supporting Families and Individuals Experiencing Psychosis
Supporting Families and Individuals Experiencing Psychosis
Supporting Families and Individuals Experiencing Psychosis
Supporting Families and Individuals Experiencing Psychosis
Supporting Families and Individuals Experiencing Psychosis
Supporting Families and Individuals Experiencing Psychosis
Supporting Families and Individuals Experiencing Psychosis
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Supporting Families and Individuals Experiencing Psychosis

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  • 40 min talk
  • Suraba ’ s audit
  • Major research undertaken by helen hughes interviewed carers about to be published
  • Transcript

    • 1. Working with Families Sophie Holmes Consultant Clinical Psychologist
    • 2. Working with Families <ul><li>What do we do </li></ul><ul><li>Specific Issues </li></ul><ul><li>Feedback from Carers </li></ul><ul><li>Future Work </li></ul>Sophie Holmes Consultant Clinical Psychologist
    • 3. Services Offered <ul><li>Identify who is close to the person </li></ul><ul><li>Offer Carers Assessment </li></ul><ul><li>Give Information/Signposting </li></ul><ul><li>Offer Family Intervention </li></ul>Sophie Holmes Consultant Clinical Psychologist
    • 4. Who is a carer? <ul><li>Problems with the label </li></ul><ul><li>Often more than one person </li></ul><ul><li>Involvement may fluctuate </li></ul>Sophie Holmes Consultant Clinical Psychologist
    • 5. Confidentiality <ul><li>Only 10% of clients withhold consent to share information (- CMHT) </li></ul><ul><li>If multiple carers can complicate how information can be shared </li></ul><ul><li>Can always listen </li></ul><ul><li>Risk </li></ul>Sophie Holmes Consultant Clinical Psychologist
    • 6. Caring Sophie Holmes Consultant Clinical Psychologist
    • 7. Information Sharing <ul><li>Carers Education Groups </li></ul><ul><li>One off Education Sessions </li></ul><ul><li>Meeting members of care team </li></ul><ul><li>Rethink </li></ul><ul><li>Family Work </li></ul>Sophie Holmes Consultant Clinical Psychologist
    • 8. Family Intervention or Work <ul><li>Recommended by NICE </li></ul><ul><li>Lots of Evidence that it Works </li></ul><ul><ul><li>Reduces Relapse </li></ul></ul><ul><ul><li>Reduces Stress for Carers </li></ul></ul><ul><ul><li>Improves Person ’ s ability to engage in social/educational/employment </li></ul></ul>Sophie Holmes Consultant Clinical Psychologist
    • 9. What do we offer? <ul><li>Psychoeducation </li></ul><ul><li>Stress Management </li></ul><ul><li>Problem Solving </li></ul><ul><li>Staying Well Strategies </li></ul><ul><li>Communication Skills </li></ul>Sophie Holmes Consultant Clinical Psychologist
    • 10. <ul><li>Work in Pairs </li></ul><ul><li>Needs Led </li></ul><ul><li>Assessments Offered Individually </li></ul><ul><li>Flexibility in approach </li></ul>Sophie Holmes Consultant Clinical Psychologist
    • 11. <ul><li>Non blaming </li></ul><ul><li>Family members are equal partners </li></ul><ul><li>Not essential to involve all </li></ul><ul><li>Integrated into usual care </li></ul>Sophie Holmes Consultant Clinical Psychologist
    • 12. Family Intervention for Psychosis <ul><li>50% have significant contact with carers </li></ul><ul><li>53% were offered FI </li></ul><ul><li>37% offered in previous year </li></ul>Sophie Holmes Consultant Clinical Psychologist
    • 13. Issues in Early Intervention <ul><li>Guilt </li></ul><ul><li>Adjustment </li></ul><ul><li>Loss and Grief </li></ul><ul><li>Dealing with Uncertainty </li></ul>Sophie Holmes Consultant Clinical Psychologist
    • 14. <ul><li>Relationship with the system </li></ul><ul><li>Siblings </li></ul><ul><li>Holding Hope for the Future </li></ul>Sophie Holmes Consultant Clinical Psychologist
    • 15. Strong Emotions <ul><li>Anger </li></ul><ul><li>Anxiety </li></ul><ul><li>Depression </li></ul><ul><li>‘ This is the child I gave birth to, and I hate to see her in such pain. It ’ s almost as if I can feel it with her ’ </li></ul>Sophie Holmes Consultant Clinical Psychologist
    • 16. Diagnostic Uncertainty <ul><li>Schizophrenia </li></ul><ul><li>Bipolar Disorder </li></ul><ul><li>Psychosis </li></ul><ul><li>Social Phobia </li></ul>Sophie Holmes Consultant Clinical Psychologist
    • 17. Services <ul><li>Maze like </li></ul><ul><li>Gate Keeping </li></ul><ul><li>Hold contradictory views on mental health </li></ul><ul><li>Solid walls between teams/services </li></ul>Sophie Holmes Consultant Clinical Psychologist
    • 18. Siblings <ul><li>‘ They only ever wanted to talk to my parents – not to me ’ </li></ul><ul><li>‘ My parents wanted to protect me from it all, so they wouldn ’ t talk about it ’ </li></ul><ul><li>‘ I wonder if the same thing will happen to me ’ </li></ul>Sophie Holmes Consultant Clinical Psychologist
    • 19. What Do Carers Value? Sophie Holmes Consultant Clinical Psychologist
    • 20. What is Assertive Outreach? <ul><li>Team Approach </li></ul><ul><li>Caseload of 10-12 </li></ul><ul><li>Frequent & flexible client contact </li></ul><ul><li>Extended hours service </li></ul><ul><li>Recovery Principles </li></ul><ul><li>Carers Support </li></ul><ul><li>Multi-disciplinary and Inter-agency liaison </li></ul>Sophie Holmes Consultant Clinical Psychologist
    • 21. <ul><li>Flexibility Valued </li></ul>Sophie Holmes Consultant Clinical Psychologist “ . . . put up pictures, moved flat, taken off doors. . . Having an MRI scan and they were there. He had a police caution and they went and sorted him out for that. Well these things don't happen just, you know, they happen quickly, don't they? Whereas if you're working to a system where you use your diary you can't respond quickly enough. ”
    • 22. Carers described AO staff as ‘ Extension of the Family System ’ <ul><li>‘ AO workers go far beyond the call of duty ’ </li></ul><ul><li>‘ they know the family better because they come and visit…they have more of an understanding of stuff that goes on inside the house ’ </li></ul>Sophie Holmes Consultant Clinical Psychologist
    • 23. Carers Valued Psycho-education from AOT staff Sophie Holmes Consultant Clinical Psychologist “ It helps, to understand more about the illness and the sort of bad behaviour. It helps to understand it a bit more. . . He can be quite difficult, but I do try, you know to be sort of relaxed with him. . . I've learnt on the course that. . . people that are ill, they don't like a lot of expressed emotion, so I do try and not to be too emotional. ”
    • 24. Future… <ul><li>Improve service in 24/7 settings </li></ul><ul><li>Needs of Children/Young carers </li></ul><ul><li>Training of Staff </li></ul>Sophie Holmes Consultant Clinical Psychologist

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