I worked as a clinical psychologist in the NHS with Islington CAMHS for 1 year across the general CAMHS team and Children Looked After team. I then worked as a group facilitator and clinical consultant to Speek Health for 1 year. In between those jobs I was travelling. These roles involved assessment and formulation of individuals struggling with a range of mental health difficulties (as well as parents), care planning and risk management, providing therapeutic intervention (individual and group), service development and governance, delivering training and supervision, etc.

No.

I am looking for some flexibility in my work life and hope that I might be able to develop a range of professional experience in different settings depending on where I am needed and how I feel in different places. Additionally I have seen first hand the challenge of services requiring urgent resource and hope I can offer high quality care when needed.

I was facilitating a group session supporting parents of children who self-harm and one of the parents disclosed a potential safeguarding issue that raised concern about their wellbeing as well as their child’s safety and also caused distress within the group. I remained calm and compassionate in my communication and offered the individual additional time one-to-one after the group finished, to protect both the individual and group needs. I acknowledged the impact observed in the group and held a little space for this along with some reassurance and then encouraged the attendees to shift back into the focus of the group session for that day, and guided the closing of the group to a note of hope. I provided the one-to-one support to the individual in question following the group and followed our safeguarding procedures with their consent (took detailed notes, discussed with the safeguarding lead, made use of supervision, made a referral to social services).

Whether or not the individual is making eye contact, how slow or energised they are in their movements, the position and posture they stand or sit in (e.g. folded arms, hunched over, kicking the chair back), how far or close they choose to be in relation to me or others in the room, tone of voice, facial expressions, any gestures or mannerisms they make, their clothing (e.g. hiding under a hoodie), indications of self-care (or lack of) such as washing and grooming, etc.

It depends on the situation. In mental health services, I might seek information that is applicable to their review and from suitable resources (e.g. available clinical notes, discussion with their care co-coordinator or other professionals involved in their care, family or other involved individuals if appropriate consent is in place). I could then use this information to create a tentative updated formulation. If it was deemed necessary (e.g. relating to particular decisions about care), I might discuss with the MDT whether or not a Mental Capacity Act needs to be carried out or any other relevant procedures of concern depending on the nature of their distress and presentation at the time of review. I would generally always discuss such situations with my supervisor and also attempt to connect with and involve the individual as best as possible. Ultimately, it would also depend on the processes and procedures of the service.

I believe these processes are in place for the benefit and safety of everyone, so I would cooperate with the official procedures and investigations that I might be asked to be involved in, listen carefully to the information with the view to understanding my potential role in the incident or situation, provide honest and candid information from my own perspective (written detail and verbal), and be mindful of any learning opportunities I might be able to take from the situation to supervision and moving forward. Ultimately, I would hope to seek resolution while staying true to the facts of the situation rather than relying on personal emotion or opinion.

Clinical governance is a systematic approach to maintaining and improving the quality of patient care within healthcare services. It refers to a framework through which healthcare organisations and their multi-disciplinary teams are accountable for continuously enhancing service standards and safeguarding high levels of care. Key components can include risk management, clinical audit, education and training, evidence-based practice, patient involvement, and staff management. It ultimately ensures that healthcare providers deliver safe, effective, and patient-centred care.

During my work in a CAMHS service, the MDT decided that a child on my caseload should be urgently referred on to a specialist service, which would bring my therapeutic work with her to an end. When I informed the child and her mother about this, her mother become angry and verbally aggressive towards me and then ‘shut down’ and withdrew all communication. I remained calm and warm in my communication, suggesting that we talk further when she felt ready. I rang twice each week, which she ignored, leaving a voicemail to inform her when I would check in again. Eventually she answered and we spoke about her anger and disappointment and the decision. I validated her perspective on her daughter’s care and also her difficult experiences with healthcare professionals in the past, which helped her to feel more receptive to a better understanding from me about why the decision was made and the huge value it could have. I held in mind that her reaction appeared not to hurt me, but was partly a result of her own underlying fears and trauma. This allowed me to support her process in a more helpful way and for us to reach some resolution so that we could plan together how to close her daughter’s therapy sessions with me in a safe and positive way. I made use of supervision throughout this process.