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
  • Supporting Families and Individuals Experiencing Psychosis

    1. 1. Working with Families Sophie Holmes Consultant Clinical Psychologist
    2. 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. 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. 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. 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. 6. Caring Sophie Holmes Consultant Clinical Psychologist
    7. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 19. What Do Carers Value? Sophie Holmes Consultant Clinical Psychologist
    20. 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. 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. 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. 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. 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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