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Preventative Work & Promotion          of Psychological Wellbeing             in Clinical Psychology                      ...
Preventative Approach     • “…interventions that anticipate a disorder,         or promote optimal health prior to the    ...
Why useful in mental health?     • 450 million people alive today suffer         mental health disorders (WHO, 2001)     •...
Focus of interventions     • Why don’t individuals seek help?           – Stigma           – Failure to identify symptoms ...
Types of Prevention     Programmes     • Universal     • Selective     • IndicatedMonday, 14 May 2012
Prevention Programmes     • Depression in adults – prevention of         development of moderate depressive         episod...
Prevention Programmes     • Depression in children – reduction in         depressive episodes and symptoms of         depr...
Recommendations for     Prevention Programmes     • In order to be most effective, a screening       process should be use...
Prevention Programmes?     Early Bird     The NAS EarlyBird Programme is autism-       specific and has three content thre...
Prevention Programmes?     Mellow Parenting / Mellow Babies     • Aims to support parents with relationship       problems...
Prevention Programmes?     The Solihull Approach     • Integrated model of working     • Resource packs and training for c...
‘Mental capital’                      over the course of life                        Beddington et al. (2008)Monday, 14 Ma...
Early Intervention in Childhood     • Maximising protective factors: proactive         approach to mental health and wellb...
Pyramid Clubs     • Screening of children at risk: Strengths       and Difficulties Questionnaire       (SDQ; Goodman, 198...
Pyramid Clubs     • SDQ completed as follow-up measure     • Rich data set (pre- and post- activity club)       but little...
Nurture Groups     • For primary school children with social,       emotional or behavioural difficulties (as       measur...
Examples with Adults     • Role for CPs in training, consultancy and         research at multiple levels. Some         exa...
Media     • May 2008 BBC launched 2 year       “Headroom” campaign     • Includes on air programming, outdoor       events...
Media     • Peter Kinderman (Professor of Clinical         Psychology at the University of Liverpool)         developed “M...
Media     • Benefits = BBC so reaching large         audience, multifaceted “intervention”,         increasing knowledge?,...
Positive Mental Attitudes (PMA) –     Workplace Programme     • Visit workplaces throughout Glasgow to       provide menta...
Positive Mental Attitudes (PMA) –     Workplace Programme     Aim for participants to leave with increased     understandi...
Positive Mental Attitudes (PMA) –     Workplace Programme     • PMA run other projects (Later Life, School       based, As...
Why are psychologists best placed?      • Knowledge base          - expertise in area          - Increase own knowledge   ...
Barriers to preventative mental health     practice     • Who to target?     • Is it possible within current resources of ...
Future Directions     • Shift in paradigm needed – become more         prevention focused     • Further research needed   ...
Any questions?Monday, 14 May 2012
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Preventative approaches in clinical psychology

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Transcript of "Preventative approaches in clinical psychology"

  1. 1. Preventative Work & Promotion of Psychological Wellbeing in Clinical Psychology Shona Brown Fleur-Michelle Coiffait Gráinne O’Brien Louise Roach Trainee Clinical Psychologists University of EdinburghMonday, 14 May 2012
  2. 2. Preventative Approach • “…interventions that anticipate a disorder, or promote optimal health prior to the onset of a disorder (Goldston, 1977). • Physical health – immunizations, obesityMonday, 14 May 2012
  3. 3. Why useful in mental health? • 450 million people alive today suffer mental health disorders (WHO, 2001) • Personal impact • Economic implications (Layard Report, 2005) – Focuses on individual levelMonday, 14 May 2012
  4. 4. Focus of interventions • Why don’t individuals seek help? – Stigma – Failure to identify symptoms – Unaware of local resources Targeted by prevention of mental health problems and promotion of mental health wellbeing.Monday, 14 May 2012
  5. 5. Types of Prevention Programmes • Universal • Selective • IndicatedMonday, 14 May 2012
  6. 6. Prevention Programmes • Depression in adults – prevention of development of moderate depressive episodes and reduction in symptoms of anxiety and depression (Seligman et al., 1999; Munoz et al., 1995)Monday, 14 May 2012
  7. 7. Prevention Programmes • Depression in children – reduction in depressive episodes and symptoms of depression (Clarke et al., 1995; Jaycox et al., 1994) • Substance misuse, anxiety, suicide...Monday, 14 May 2012
  8. 8. Recommendations for Prevention Programmes • In order to be most effective, a screening process should be used. Focus on participants especially at risk • CBT is a popular model on which to base a programme • Group programmes are common, but individual approaches are also possibleMonday, 14 May 2012
  9. 9. Prevention Programmes? Early Bird The NAS EarlyBird Programme is autism- specific and has three content threads. It helps parents to: • understand their childs autism • structure interactions in which communication can develop • pre-empt problem behaviours and handle those that occur.Monday, 14 May 2012
  10. 10. Prevention Programmes? Mellow Parenting / Mellow Babies • Aims to support parents with relationship problems with their infants and young children • Combines personal support for parents with video and direct work with parents and children addressing parenting problemsMonday, 14 May 2012
  11. 11. Prevention Programmes? The Solihull Approach • Integrated model of working • Resource packs and training for care professionals • Focuses on containment, reciprocity, and behaviour management • Research suggests 66% reduction of parental anxietyMonday, 14 May 2012
  12. 12. ‘Mental capital’ over the course of life Beddington et al. (2008)Monday, 14 May 2012
  13. 13. Early Intervention in Childhood • Maximising protective factors: proactive approach to mental health and wellbeing • Minimising effect of threats to mental wellbeing: early interventionMonday, 14 May 2012
  14. 14. Pyramid Clubs • Screening of children at risk: Strengths and Difficulties Questionnaire (SDQ; Goodman, 1989) • Multi-agency meeting to select 10 children • 10 week activity club hosted by schools • Trained volunteers provided by National Pyramid Trust (charity) run the clubsMonday, 14 May 2012
  15. 15. Pyramid Clubs • SDQ completed as follow-up measure • Rich data set (pre- and post- activity club) but little published research • Children with and without difficulties appear to benefit from attending. • Significantly larger effect size for children with identified difficulties (Ohl et al., 2008)Monday, 14 May 2012
  16. 16. Nurture Groups • For primary school children with social, emotional or behavioural difficulties (as measured using Boxall Profiles) • Small ‘nurturing’ class with increased staff ratio • Taught social skills and practical skills as well as curriculum based work • Routines, explanations in contextMonday, 14 May 2012
  17. 17. Examples with Adults • Role for CPs in training, consultancy and research at multiple levels. Some examples: - media e.g. BBC’s “Headroom” - specific programmes e.g. Positive Mental Attitudes Workplace Intervention in GlasgowMonday, 14 May 2012
  18. 18. Media • May 2008 BBC launched 2 year “Headroom” campaign • Includes on air programming, outdoor events and interactive website • Aim “to actively encourage people to assess their mental wellbeing and take simple, practical steps to manage or improve it”Monday, 14 May 2012
  19. 19. Media • Peter Kinderman (Professor of Clinical Psychology at the University of Liverpool) developed “Mind Spa” component of website • Participants complete online assessments of their mental wellbeing and receive offer of personal life coach to explore results and develop plan with goals for the futureMonday, 14 May 2012
  20. 20. Media • Benefits = BBC so reaching large audience, multifaceted “intervention”, increasing knowledge?, reducing stigma? (need for well conducted research) • But.. Many similar websites (e.g. Chris Williams’ LLTTF, Mood Gym). Waste of resources? Risk that users (and possibly referrers) will feel overwhelmed with choice?Monday, 14 May 2012
  21. 21. Positive Mental Attitudes (PMA) – Workplace Programme • Visit workplaces throughout Glasgow to provide mental health awareness sessions to staff. • Assist organisations to develop mental health and wellbeing policies • Claim benefits to organisation (e.g. reduced staff absence and staff turnover). • Broader aim of increasing knowledge and reducing stigmaMonday, 14 May 2012
  22. 22. Positive Mental Attitudes (PMA) – Workplace Programme Aim for participants to leave with increased understanding of: • Mental health, mental health problems and their causes • How to maintain their own mental health and that of those around them • Mental health and wellbeing resourcesMonday, 14 May 2012
  23. 23. Positive Mental Attitudes (PMA) – Workplace Programme • PMA run other projects (Later Life, School based, Asylum Seekers and contribute to Scottish Mental Health and Arts Festival) • Funding and management input from NHS • Input from CPs based in primary care mental health team – consultancy role with regards content of programmes and research supervisionMonday, 14 May 2012
  24. 24. Why are psychologists best placed? • Knowledge base - expertise in area - Increase own knowledge • Interdisciplinary working • Scientist Practitioner – Research, audit and evaluationMonday, 14 May 2012
  25. 25. Barriers to preventative mental health practice • Who to target? • Is it possible within current resources of clinical psychology? • Where responsibility lie? – ‘Bystander effect’ (Ball, 2008)Monday, 14 May 2012
  26. 26. Future Directions • Shift in paradigm needed – become more prevention focused • Further research needed – Need to ascertain validity and effectiveness of interventions. • CPs well placed to contribute to this research agendaMonday, 14 May 2012
  27. 27. Any questions?Monday, 14 May 2012
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