Hello! I'm afraid I have to go now. Thanks so much for all the questions - I answered as many as I could - if I didn't get to yours have a look through the others - it might be answered there.

Wishing you all a good festive period. Here's an article on coping with christmas in case it's helpful: https://www.bps.org.uk/psychologist/coping-christmas

Research jobs in clinical settings can be good, support worker posts, charity roles, voluntary work (e.g. Childline or Samaritans). There are lots of ways to get experience and see if you like the role. Talk to clinical psychologists if you can too to get a sense of what the role is like and also what other roles are around. Good luck!

ooh and the book - I'd recommend Yalom - Love's Executioner. It's quite psychodynamic in model which is not what I use but it's brilliantly written and I like the way he acknowledges his mistakes.

Hello! I'm nearly out of time again but here's a paper I published recently: https://pubmed.ncbi.nlm.nih.gov/35915459/

And self-reflection is hugely important. I use a mix of things - supervision and writing and peer supervision. I probably use self reflection and peer supervision more as time goes on but it's still really important to have regular supervision from someone who is just doing this for you - we can all have unconscious biases and can benefit from someone helping us to spot them and improve our practice.

It has some stats involved but you get taught that. Don't let it put you off!

Not necessarily the case for everyone but sometimes strong unusual thoughts might be protective against things in reality which feel very hard to manage.

Some are quoted on the amazon page: https://www.amazon.co.uk/Year-Change-Your-Mind-Therapy/dp/1838959092

Very happily for me it was one of Apple books' best books of December and also one of the Independent's best books of December.

Not yet but hopefully soon! Article here is based on some of the chapter on December: https://www.bps.org.uk/psychologist/coping-christmas

Hi! Such a good question. It's very confusing I think to find this sort of information out clearly. Clinical Psychologists should be registered with the Health and Care Professions Council (HCPC) but this doesn't tell you about specialisms. You can ask them though - have you had special training in this, do you have any accreditation, what is your experience? For example CBT therapists are often accredited with the British Association for Behavioural and Cognitive Psychotherapies. I'm really sorry you had this experience though - it's not good. I hope you were able to give feedback. If they are a clinical psychologist you can also complain to the HCPC, or through the NHS service if it was through one of those. Best of luck and hope you find a therapist who is more helpful.

Hi!

Firstly I am really sorry, that your partner had these experiences and that you have both had to manage difficulties with the healthcare systems in response.

I think there is no easy answer to this one, and unfortunately the risk assessment questions which are needed from a clinical point of view can feel like they get in the way sometimes. They are the best tool we have and it's important to try to assess risk but they're not a very good one.

In terms of what can be done in response to a lack of compassion - I think it depends on your level of energy partly. You could write to an individual clinician to give feedback, or it's always possible to complain - in the UK the Patient Advisory and Liaison Service is independent and can manage complaints about the service you have been involved with. Making a complaint means it gets put on record and the clinicians involved will get that feedback, which hopefully will help improve the service. However it depends on whether you feel that this would be helpful for you as well - if you feel like you have the time and inclination to put a complaint together. I'm not saying this to put you off at all - just to acknowledge that this can sometimes feel like an extra burden.

Whatever you decide, I really hope you find some support which is helpful for both your partner and you.

This is a really great point. I think they are different too. Some people have made a similar argument to yours: https://www.researchgate.net/publication/336746147_Contesting_the_term_%27compassion_fatigue%27_Integrating_findings_from_social_neuroscience_and_self-care_research

I think we maybe don't know quite enough about the subtleties of the differences yet, but this is something I'm trying to get my head around at the moment.

Aha I found your question! Thank you for writing this. I'm so sorry that things are so hard at the moment. It feels like things have always been difficult but in recent years have really bene stretched so so thin. I do think that staffing problems contribute to barriers to care. That's not to say that some agency staff aren't brilliant, but I think it's harder to have the same sense of continuity and team cohesion. It's also so stressful for the senior nurses managing the rota and trying to fill shifts. I do also think there is hope though because retention of staff is better in some wards than others, so I think we can learn from what is working in some places as well as from the research.

Hello!

I'm really sorry to hear you have complex post traumatic stress disorder. That's so difficult to live with. I would really recommend seeking some professional help with it if you can - if you are in the UK your GP is usually first point of access or you can self refer to some Improving Access to Psychological Therapies services. If the waitlists are too long then private therapists often often sliding scales of fees. It's important to get someone who has training and experience in dealing with CPTSD. If it is related to childhood experiences then this book is also a good resource - although not a substitute for individual therapy https://www.amazon.co.uk/Overcoming-Childhood-Trauma-Helen-Kennerley/dp/1841190810

Best of luck with it.

Ah thank you!

Hi! I'm a big fan of compassion focussed therapy but I don't think the evidence base is there to suggest it should be prioritised over CBT. I think it's important to be guided by what the evidence says is most effective, and for a lot of problems that is CBT at the moment. It doesn't mean that won't change as more studies are done with other modalities though. I also think patient choice is important - giving people the information about what the research says helps, but also telling them what the different therapies are like so they can be involved in the decision making. One of the reasons I made the podcast Let's Talk About CBT was to demystify the different types of therapies which are based on cognitive behavioural principles. There's an episode on CFT in there too! https://letstalkaboutcbt.libsyn.com

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With clinical psychology - if AP positions are hard to find you might have more luck with a research assistant post on a study which has clinical components. Voluntary work can also help if you are able to do a bit of that on the side (e.g. things like phone lines often provide training). Good luck!

Not yet but hopefully soon! This article has some of the ideas from the December chapter in https://www.bps.org.uk/psychologist/coping-christmas

Thank the person for letting me know and problem solve together what would be helpful going forward. It's really helpful to have feedback!

Sorry! Will try to find your question!

Hi! Firstly, I am really sorry that you've had this experience. I hope you've got good support around you now. It's really difficult to feel like you've missed out on a lot. I hope you have found someone to talk to about the negative coping mechanisms you mention too - to help with finding and practising alternatives.

In terms of improvements to assessment of mental health in children now - it depends which country you are in as to what is available, but in the UK there is a new initiative to bring mental health workers into schools with a new type of worker (educational mental health practitioners). Historically sometimes clinical psychologists or counsellors were embedded in schools but funding for this dwindled and the new EMHPs are a response to try to get to students earlier if they are having problems. It has only just started so it's too soon to say how it's going but I think the idea of getting in early is a good one. There are also some fab research projects looking at early intervention, for example CUES: https://cues-ed.co.uk/what-we-do/

Hello! I'm back for half an hour now to answer a few more queries!

Ah! Just seen there are a couple of questions I haven't been able to answer. I will pop back on Tuesday. Sorry to have to go now.

Thanks for the questions all! I'll pop back on on Tuesday for half an hour at 10Am (GMT) in case there are any more.

Wishing you all well over this festive bit and into the new year.

Wowser this is a big'un!

Main changes I would like to see in the mental health field relate to adequate funding. There has been so much talk of "parity of esteem" between mental and physical healthcare but I would like to see "parity of funding" and also proper investment in social care and third sector services. I'd also love our knowledge of staff wellbeing and the impact on compassionate care to advance so that we can more effectively help both patients and staff.

That's an amazing image of it rolling down the hill. The pressures being passed on feels very true. I think there's also the bit about how people who have been traumatised respond to a system around them and how the trauma influences the system too. It's so complex. Important to recognise anyone could be involved in this as a dilemma though, as you say.

There was an article in The Psychologist magazine this week (the British Psychological Society mag) which summarised a book called Hospitals in Trouble by John Martin. I haven't read the book but the authors said certain quite practical aspects of ward location and culture influenced whether care became poor. The factors included ward location, personal and professional isolation of staff and lack of training opportunities. Obviously this is no excuse for abusive practice but I did think it was interesting to think about what factors could act as roadblocks to make abuse less likely.

Thank for your perspective on intervention efficiency - that's a very helpful thing for me to think about.

Whoops! Thought this had disappeared so answered it twice!