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Psychology%20in%20Healthcare

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Title: Providing Psychological Healthcare Author: Ray Miller Last modified by: Ray Miller Created Date: 6/17/1995 11:31:02 PM Document presentation format – PowerPoint PPT presentation

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Title: Psychology%20in%20Healthcare


1
Psychology in Healthcare
  • meeting the needs of clients

Prof. Ray Miller Chartered Clinical Psychologist
and Chartered Health Psychologist Professional
Advisor for Psychology, NHS Lothian Past
President, The British Psychological Society
(2006-07)
2
Definitions
  • Psychology
  • The scientific study of mental and behavioural
    processes
  • Applied Psychology in Healthcare
  • The application of a knowledge of normal and
    abnormal mental and behavioural processes to
    issues of physical and mental health and
    well-being and health care delivery

3
Healthcare Objectives
  • Promote good health
  • Prevent ill health
  • Identify, assess and treat psychologically based
    dysfunction
  • Promote recovery and rehabilitation
  • Promote and facilitate good psychological
    practice
  • Promote and facilitate quality health care
    delivery

4
Recent Scottish Policies (Dec 2006 Dec 2007)
5
Projected change in age structure of Scotland's
population, 2004-2031
PERCENTAGE CHANGE
0-15 16-29 30-44 45-59
60-74 75
AGE (years)
Source GROS, http//www.gro-scotland.gov.uk/stati
stics/library/popproj/04population-projections/lis
t-of-figures.html 2004-based populations.
6
Rates per 1000 in GP Practice
  • Range
  • Dementia 1.2 to 1.6
  • Psychoses 2.7 to 8.6
  • Personality disorder 7.2 to 4.0
  • Psychosocial problems 4.6 to 10.0
  • Organic with psychological 13.1 to 16.6
  • Psychosomatic 24.5 to 34.5
  • Neuroses/ affective disorder 55.7 to 116.6

7
Psychological Distress
  • Prevalence of neurotic symptoms - by gender
    (people aged between 16 to 64 years) All figures
    are percentages
  • Diagnosis and rate Female Male All
  • (past week) 1993 2000 1993 2000 1993 2000
  • Sleep problems 28 34 21 24 25 29
  • Fatigue 33 33 21 23 27 28
  • Irritability 25 24 19 20 22 22
  • Worry 23 23 17 18 20 20
  • Depression 11 12 8 11 10 12
  • Concentration and forgetfulness 10 11 6 9 8 10
  • Depressive ideas 11 12 7 9 9 10
  • Anxiety 11 10 8 9 10 9
  • Somatic symptoms 10 9 5 6 8 7
  • Worry about physical health 5 7 4 7 5 7
  • Obsessions 12 4 7 5 9 6
  • Phobias 7 6 3 4 5 5
  • Compulsions 8 4 5 3 6 3
  • Panic 3 2 2 2 3 2
  • Source ONS, 2000, Psychiatric morbidity among
    adults living in private households in Great
    Britain.

8
Cost of Mental Ill Health
9
Cutting the Costs
10
BPS Membership
11
Divisions
12
Divisions
  • DECP
  • SDEP
  • DCP
  • DOP
  • DFP
  • DCoP
  • DTRP
  • DHP
  • DoN
  • DSEP
  • Special Groups
  • Social Services
  • Coaching

13
DCP
14
Training and Competence
  • 4 year honours degree experience 3 year
    doctoral level
  • 7 to 10 years in total
  • Skill Knowledge Practice Review
    Competence
  • Basic interpersonal skills
  • Theoretical framework
  • Supervised therapeutic practice
  • Continuing professional development
  • Personal development (reflective practitioner)

15
Pay Scales
16
Context
  • Health Issues
  • Health Policy
  • Healthy (and unhealthy) behaviour
  • Public Health
  • Mental Health
  • Physical Health
  • Research and Development

17
Basic skills
  • Establishing Maintaining Communication
  • creating the environment active listening verbal
    non verbal cues genuineness empathy respect
    confidentiality trust agreement sharing par
    tnership exploring setting boundaries network
    ing ending
  • Within an ethical and professional code of
    practice

18
Theoretical frameworks
  • some major models
  • Counselling Client - Centred (Rogerian/Humanistic
    )/ Skills Model (Egan)
  • Psychodynamic
  • Cognitive - Behavioural
  • Cognitive Analytic
  • Systemic
  • IPT, DBT, REBT, EMDR, Personal Construct,
    Solution focussed, etc.
  • Eclectic/ integrative

19
Assessment
  • Intellectual IQ, Mental Ability
  • Cognitive Memory, Perception, Thinking,
    Processing
  • Personality Sociability, Stability, Traits
  • Emotional State Anxiety, Depression,
    Attributions
  • Functional Behaviour, Skills, Aptitudes,
    Strengths and Weaknesses

20
Therapy in practice
  • Enable clients to
  • Access and use relevant information
  • Identify aims and goals
  • Decide on options for action
  • Acquire appropriate skills
  • Implement a course of action
  • Review outcomes

21
Successful therapy
  • A model (formulation) of the problem understood
    and accepted by the client
  • A model for the therapy understood and accepted
    by the client
  • Actual change in cognitions and behaviour
  • Reinforcement in the real world
  • Change equation reason benefits gt inertia
    costs

22
Presenting problems
  • Emotional problems anxiety, depression, anger
  • Organic impairment and trauma
  • Behavioural problems obsessions, phobias, habits
  • Relationship problems social and sexual
    dysfunction
  • Addiction, dependency and self control
  • Coping with illness / injury and rehabilitation
  • Coping with living stress, bereavement, disaster

23
Personal and Professional Development
  • Supervision - external review of practice
  • Establishing networks - support, onward referral
  • Updating - refreshing the old
  • Professional advances - acquiring the new
  • Evidence based - efficacy and effectiveness
  • Research - breaking new ground
  • Personal awareness - reflective practice
  • Personal therapy - physician heal thyself

24
Service model
  • Consultancy and advice
  • Training and development
  • Support and supervision
  • Direct and indirect intervention
  • Research, monitoring and evaluation
  • Skill mix service delivery
  • Responsive to national and local needs and
    priorities
  • Delivered within team approach to holistic
    healthcare

25
No Health without Psychological Health
  • Children and Education
  • Health Promoting Schools
  • Childhood obesity
  • Immunisation uptake
  • Parenting skills/ abuse and neglect
  • Workplace
  • Scotlands Health at Work
  • Workplace stress
  • Work/Life balance and retirement
  • Absenteeism

26
No Health without Psychological Health
  • Lifestyle
  • Smoking
  • Alcohol
  • Exercise
  • Diet
  • Mental Health and Wellbeing
  • Mental Health (In)Capacity Acts
  • Choose Life
  • Doing Well by People with Depression
  • Stigma (See Me)
  • Mental Health Delivery Plan

27
No Health without Psychological Health
  • Physical Health
  • Cardiac rehabilitation
  • Diabetes
  • Sexual health
  • Chronic Illness and Rehabilitation
  • Social wellbeing
  • Social inclusion/ Fair for All
  • Public Health
  • Confidence and wellbeing
  • Anger and violence

28
Benefits
  • Health promotion/ prevention and lifestyle change
  • Early and proactive intervention
  • Individual formulation and care plan
  • Realistic treatment alternatives
  • Increased adherence and satisfaction
  • Recovery focus
  • Comprehensive healthcare

29
Your Professional Body (www.bps.org.uk)
30
BPS Research Digest
  • Free
  • E-mailed fortnightly
  • Key information on the latest, interesting
    research
  • Join in online discussions
  • Sign up at www.researchdigest.org.uk

31
Download
  • Powerpoint presentation can be downloaded or
    viewed at
  • www.raymiller.net/download
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