The first ever national Psychological Professions weeks is taking place this week (16 to 20 November).

There is an online national conference taking place across all four days, free for anyone to join here. The Psychological Professions Network (PPN) is a family of twelve Psychological Professions you can see more about who these professions are and why its import for service users that the professions are joining together to have a stronger voice in this short animation.

London recently appointed Dr. Estelle Moore as Psychological Professions Network Fellow to develop the collaborations across the Psychological Professions across London. Estelle also leads the Psychological Therapies professions in our neighbour Trust West London.

Here in CNWL we employ people from 11 of the Psychological Professions in the Network, more than 600 staff in total. Next January will see a new profession joining us Clinical Associates in Psychology, when six apprentices join us as part of the first ever cohort to train in England.

During the week, we will share examples of the work the psychological professions do in the Trust.

Here are some examples of the work the psychological professions do in the Trust, some you will be familiar with but for others this is a great opportunity to shine a light on some of the less well known areas of services.

Sexual health services at Mortimer Market Centre

The Sexual Health Psychology service, based at the Mortimer Market Centre, forms part of CNWL’s multidisciplinary HIV and sexual health services.  Many of our patients living with HIV have found Covid-19 particularly challenging. For some, the uncertainties of a novel virus and fear around transmission have been reminiscent of the emergence of HIV/AIDS in the 1980s. Some patients have felt understandably worried about their health. Those already experiencing loneliness have found stay-at-home restrictions further isolating.

We rapidly adapted our service, from routinely seeing patients in person in clinic, to delivering assessment and therapy virtually by telephone and videoconferencing. Adopting a virtual model enabled us to provide continued psychological support to our patients during these difficult times. It has also been an opportunity for us to modernise our service.

Many of our nurse and health care support worker colleagues in sexual health were redeployed to critical care settings during the first wave of Covid-19. On their return, we facilitated reflective practice groups and felt humbled to bear witness to their experiences and commitment to patient care.

Trauma informed approach in inpatient care: examples from St Charles Hospital and Harrow Acute Services 

The psychologists at St Charles Hospital & Harrow Acute Services are supporting colleagues to develop a Trauma Informed Approach (TIA; Sweeney et al., 2016) to services informed by the Power Threat Meaning Framework (PTMF; Johnstone & Boyle, 2018) and the Woodhaven approach.  Here is how the ideas started and have been developing in those services, other in-patient psychologists have also been developing this framework in their local areas. 

Harrow Acute Services first implemented the use of TIA using the PTM Framework in their service in 2018, starting with weekly team formulations and weekly training for their inpatient teams. This model of the formulations and training was then introduced across different sites within CNWL in 2019. The initiative and early conversations around TIA itself came from a wider piece of work in 2018 which was considering inpatient experience across acute adult sites at CNWL. The Harrow TIA team have also developed a series of stabilisation packs (topics include ‘Soothing and Safety’, ‘Mindfulness’, ‘Distraction and Distancing’ etc.) as part of the first stage of interventions designed to build a repertoire of coping skills for those who are admitted to a mental health ward.

At St Charles the application of team formulation using the PTMF and the above materials developed by Harrow began in May 2019. Staff members attending the sessions were initially offered some informal teaching on TIA and the PTM Framework. Advanced Clinical Practitioners (ACP’s), trainee ACP’s, ward managers and matrons have been actively involved in facilitation, having attended training with Dr Lucy Johnstone, author of the PTMF. In addition to this, the Psychology team at St. Charles have also developed a group programme called ‘Creative Recovery’. The group programme features groups such as ‘Distress Tolerance: Creating a Soothing and Self Care Box’, ‘Understanding Emotions’, ‘Living a Valued Life’, ‘Working towards building Compassion’, ‘Narrative Approaches’ and ‘Interpersonal Skills’.

During team formulation, the PTMF is used to think about “what has happened to someone?”, “How it has affected them?”, “How did they make sense of it?” and, “What did they have to do to survive?”. In addition to this, the team considers how they themselves are feeling, where they might be stuck and strengths/achievements of the person being formulated. The session concludes with the team creating and sharing responsibility for an action plan.

As we continue to develop and embed this in our services, anecdotal evidence suggests that team formulation is a powerful tool in providing better care for our patient population. A salient example of this is, one facilitator stating ‘I really believe that this person’s admission was much shorter and more successful because of the use of the formulation that had been conducted. As a result of the formulation we felt that we knew much more about this person and consequently completely adapted our approach to the way we have approached this person in the past’. Furthermore, informal feedback following sessions commonly include staff feeling ‘more confident moving forward’, ‘I feel as though I know so much more about this person than I did before’, ‘We treated this person’s difficulties psychologically by adapting our approach’ and sometimes also highlighting when we haven’t been thinking about what someone’s story is ‘We didn’t really answer what has happened to this person’.

Offender care

Offender Care employs over 50 psychologists and psychological therapists to deliver trauma informed therapies within the mental health services in eleven sites, across prisons, Immigration & Removal Centres and secure hospitals, with children and adults, men and women and across the range of security categories. Psychologists also lead four specialist Offender Personality Disorder (OPD) services (in the womens' prisons in Surrey and the community with the National Probation Service in North West London) and the Sexual Behaviour Service in the youth estate. We are proud of the range of therapies and approaches we offer and the feedback we receive from our service users about how therapies and contact with our services have helped them in their recovery journeys.

Read about Faye and Caasha

Faye Qassem, Psychological Wellbeing Practitioner - CNWL Talking Therapies Service Brent

Faye Qassem"As Psychological Wellbeing Practitioners (PWP) we work within a stepped care approach to assess and treat people with symptoms of depression or anxiety. PWPs offer brief, goal-oriented, guided self-help using CBT principles, to help clients understand and manage their cycle of low mood/anxiety.

We liaise with other services to offer collaborative care to meet clients needs, often working with an in-house Employment Support Service, or signposting to other relevant services based on our comprehensive signposting database.

We offer treatment in a range of modalities including computerised CBT, telephone/video , face-to-face and group workshops.

Our team is made up of diverse backgrounds and cultures, offering treatment in a range of languages to facilitate engagement. 

We have an aim to continue to increase access to psychological services. As a first-generation British Arab therapist, I am very aware of the concepts within our community that hinder access to care. I am keen to challenge the stigma within the Arab and Muslim community, by modelling an acceptance as a representative of this culture, educating and normalising experiences of mental health. We aim to work within the community to understand their needs and adapt our work in order to work together towards better mental health."

Caasha Abdirahman, Psychological Wellbeing Practitioner - Kensington and Chelsea Talking Therapies

Caasha Abdirahman"My name is Caasha Abdirahman and I am a Psychological Wellbeing Practitioner at The Kensington & Chelsea IAPT Service. I currently play a key role in IAPT providing short-term, evidence-based treatment.

Before qualifying, I worked in Secondary care as a support worker and progressed on to become a team leader. I then briefly worked at Change Grow Live, a Drug and Alcohol service as a recover worker. Following on from this I began a MSc in Health Psychology and worked part-time as an administrator at Community Living Well (CLW) to fund my studies.

Although I knew I wanted to pursue a career in psychology, I was completely unaware about the IAPT route. Following a personal development plan meeting at CLW, I began shadowing Step 2 Groups and my manager at the time encouraged me to apply for the Low Intensity CBT training at UCL. I have now been qualified for almost two years. Albeit difficult at times, this is an incredibly rewarding role and I am continually honing my skills in formulation and treatment planning in accordance with NICE guidelines."

Dr Elaine Johnston, Lead Clinical Psychologist for Adult Intensive Care, Chelsea & Westminster Hospital, talks about the work she has been involved with as a member of the British Psychological Society Crisis, Disaster and Trauma Section

As a member of BPS Crisis, Disaster & Trauma Section committee (as well as my current clinical work in intensive care and supporting acute healthcare staff), I was invited in March by BPS President, David Murphy, to join a BPS taskforce, comprising psychologists from different disciplines, brought together to collaborate efforts in response to the Covid-19 Pandemic. This has been an incredible opportunity to contribute to strategic work in the profession but that has that has influenced national policy and the media, as well as producing helpful guidance documents and resources for the public and professionals.

As a member of the 'wellbeing subgroup' I contributed to the very first set of guidance produced by the group, for managers of acute healthcare staff

Since then, over 80 guidance documents and resources have been produced by the wider group on a range of topics such as supporting children & young people, psychological needs of people recovering from coronavirus, bereavement, and remote working

Most recently, the wellbeing subgroup have created a serious of practical resources (a short document summarising impacts of the pandemic on psychologists' wellbeing, links to resources, webinars and video stories). Although intended for psychologists, these will be of interest to psychological therapists and other health and social care staff and can be accessed freely here.

Older People and Healthy Ageing Services

CNWL psychology for older people work with a wonderfully diverse population across five boroughs of London. We work with older people across bed-based care units and community teams working with complex biopsychosocial presentations and often with people who often face social inequalities, whether this be through life circumstances, heritage, or age.

We are proud to work as fully integrated members across our older adult teams maximising the identity and recognition of psychology, enabling timely and appropriate access to psychological practice. We also have five borough wide leadership, governance, and professional development structures, making use of a wide range of knowledge and skill in the group.

Below are some examples of our recent practice, development, and innovation in individual boroughs.

In KCW we have been involved in developing a Behaviours that Challenge (BtC) care home intervention team, a pilot OA Psychology-led service in partnership with the Bi-borough Adult Social Care and Health Dementia Programme Board, delivering person-centred, holistic assessment, formulation, and assessment to people presenting with behaviours that challenge, and the Care Home teams caring for them. This project has been extended beyond the initial time span.

Older Adult psychologists in K&C have been focussing on developing innovative ways of adapting delivery of psychological therapies and cognitive assessment to clients in the context of COVID 19 situation.

In Brent we have been focusing on adapting the delivery of psychological services to be able to continue to meet the needs of residents in the Borough during the COVID pandemic. We have been doing this in collaboration with our service users and wider older adult teams. One of our service users has made a short video about their experience of recovery from depression during COVID, which is being made into a resource to share with other service users and teams.

In Harrow, with the support of OA Psychology and its developments in delivering psychosocial interventions to people living with dementia, the memory service has achieved MSNAP accreditation.

In Hillingdon OA Psychologists have been working with service users and MDT colleagues to develop innovative ways of adapting the delivery of psychological therapies to older people, both individually and in groups, in the context of COVID 19. We are also currently looking at collaborating with psychologists in other service areas in the Borough to access training to further develop services in the borough.