3rd May 2018

Attending Dick L, Hazel L, Brian L, Rod ?, Zib L, Thelma F, Rod, Michael, Terry G, Margaret I, Angela D, Tim W, Francis W, Sue C, Norma Y.  

Apologies: Rod C. Carenza W. John I, Ann R, Sarah W.

Minutes of last meeting were approved as a true record

Matters arising There were no matters arising

Guest speaker Hope Samuel (Consultant Clinical Psychologist )

Dick introduced Hope to the group and working at the HPFT’s New Wellbeing Centre in Hemel Hempstead.

Hope outlined her 18 year background with the HPFT as a Clinical Psychologist and Tavistock trained Psychotherapist.  She currently works with adults (though she did once work in CAMS in Charing Cross).

She is one of two Clinical psychologists working part time (5 sessions per week) in the North West Quadrant ie she in Hemel Hempstead and the other based in St Albans.  She is now a manager of a small team and is additionally responsible for supervisions and training.  She reports to Andrew Nichols (known to the group).

Hope defined clinical psychology in simple terms as the science of psychology together with clinical knowledge dealing psychological distress and promoting Wellbeing.   She added that she spends lots of time in sitting in groups and with individuals and doing lots of talking.  Additionally, she makes contribution to – research, teaching and spreading the word.

Hope stated that while Clinical Psychologists usually have their first degree in clinical psychology (becoming a registered / regulated MH professional), there are alternative routes.

The first is for those with an acceptable first degree in another discipline who can then take a 1 year conversion course (self-funded) to Psychology followed by a course of training on-the-job with placements in a range of disciplines. This on-the-job training is paid employment, like an apprenticeship say with the HPFT under Hope’s supervision.

There is also an allied self-funded 3 year course focussing on a range of different therapies

In response to the question “what do psychologists do”? Hope replied that she sees patients (adults > 18) who have chronic enduring problems.

Most are referred from either; the Wellbeing Team, CAT or even some from the Eating Disorder team.

A good referral would be someone who opts into the service ie says yes to attending regularly (28 days target).  Without the opt-in, unacceptable high non-attendance rates would likely occur.

When patient attend for the first time (sometimes it might be over several sessions), the aim is to carry out an initial assessment. Questions often asked are open questions and could include:

Why have you come along today?

Why now, has something happened?

Is this the right time for help?

What problem do you have?

What do you feel like?

What is good

How do you manage?

What are your relationships with parents/friends?

Who supports you? Carers etc

Finding out about substance abuse will be necessary to reduce/remove before therapy will be offered. Assessing risk and previous suicide attempts are clearly important.  Finding out about how the patient feels about themselves including how psychologically minded they are is also part of it.

Those accepted will start the chosen therapy within 18 weeks.

Essentially there is a therapeutic continuum ranging from CBT at one end with DBT (often offered to PD patients) in the middle through to psychoanalytical therapy at the other end (often delving into early relationships and childhood)

Whichever the chosen therapy, it will be goal based and will follow the appropriate NICE guidelines.  Before therapy starts patients are asked to complete a CORE questionnaire and a score is recorded.  On completion of the therapy the same questionnaire is reapplied and the new score recorded. A positive improvement here will indicate some measure of success (not the only one).

Other therapies/techniques mentioned included: Art Therapy, Mindfulness, EMDR for PSTD patients.

With a waiting time of up to 18 weeks, how patients cope with the wait depended on their assessment, their problems and the recommended treatment.

Dick asked about forensic psychology and Hope described that as being involved with criminal justice. Other branches mentioned during discussion included Educational psychologists and Industrial psychologists.

Hope answered the question about the relationship of the psychiatrist and the clinical psychologist by emphasising that they take a team approach each making their contribution according to their expertise.

To the question “Do therapists have therapists”?  Hope responded that they don’t have to, but many do – she does and finds it very helpful.

And to the question “If you had a magic wand, what would you put right immediately”? More money and more people in post in the service was her answer.

Conversation then turned to the new Wellbeing Centre and Hope asked the group what we thought of it.

Most comments were about minor issues that would be expected as it was still very early days.  Some good points included: more central, now got MH signage, open plan offices for clinical staff who can also meet in the common kitchen thus promoting integration.

 Frances described the lack of help available to those patients with enduring conditions schizophrenia.  Discussion also included the now disbanded Assertive Outreach Teams and the Community Support Groups that are also gone.  It was suggested that given enough time the wheel will have turned and their function reinvented under a new name eg Recovery Group.

Hope described the benefits to the HPFT if Carers from the group got involved with the recruitment interviewing process concluding that our contribution was invaluable.

Hazel had asked for more information about CBT which, due to lack of time, was left unanswered.  Hope promised to pick up this point should she be asked to return.

 The group thanked Hope in the usual way.

 Upcoming events

BBQ – June now the 14th June we will also be joined by Julie Nicholson MIND

Day out – July (see below)

No meeting – Aug

Wellbeing for Carers – Louise Plant HPFT + 2 colleagues – Sep

Chris Lawrence HPFT – Oct

Jane Padmore HPFT – Nov

Dick presented the latest information about our “Day out” and effectively ruled out the Bletchley Park option.  After some discussion it was agreed that the Windsor Boat trip should be dropped in favour of the Lea Valley boat trip because the latter’s price per head included food and if we took our own cars we would save the costs of the mini bus further reducing the price per head. Additionally, it was agreed that the chosen day should be Wednesday.

Capel Manor Gardens in Essex was also discussed as a possible morning visit together with the Lea Valley boat trip in the afternoon but this was not really viable and in any case it was pointed out that we went to Wisely Gardens last year.

Any Other Business

Terry reminded the group that Dick and Hazel had written their personal statements of what they get from the group and he encouraged others to give theirs. He also asked the group to consider questions they would want answered by the suggested future speakers.

Dick reported his visit to the Chorley Wood Carers group (attended by Ann R, and run by Maggie E).

He also reported his surprise that,  on receiving some suicide statistics, he learned that a Coroner will not attempt to find out or share information on why it happened.  They will only provide the verdict.  This is not helpful in trying to develop measures of prevention.

Lastly he reported that his efforts to increase H&S for carers has been taken up by Carers in Herts and will be part of the upcoming Carer’s Week.

Date of next meeting –14th June 2018 our BBQ