Assessments

Basically, getting a phone has been extremely confusing. As I mentioned yesterday, I purchased a phone from Tesco for 30 pounds. So that is approximately 50 US dollars. After setting it up and

Tree lined walk to the hospital

trying to get it to work (which is not very easy, especially when switching from an Iphone) I decided to top-it-up for about 10quid so I can use the data when I go to Edinburgh and then England this weekend. What they didn't tell me is that you cannot use a USA registered credit card to do any top ups. This goes for both for paying online and over the phone! So that means each time I need a top-up, or anyone else who uses the phone, they would have to buy a voucher. I wish I would have known this when I purchased the phone so that I could have gotten a voucher at the same time. Welp. Guess I know what I'm doing after work tomorrow!

In other news, had an interesting day at work, too! But in a good way! I was allowed to start scoring some psychological assessments. It is all very Clinical Psychology.

CORE

First there is the CORE, which is supposed to measure how the client has been feeling in the past week in the areas of subjective well-being, problems/symptoms, life functioning and risk/harm. This assessment is usually done at the start of therapy and at the end to measure therapeutic outcomes.

DASS: Depression Anxiety and Stress Scale

The final assessment I was able to scale today was a DASS, or Depression, Anxiety and Stress Scale. This was probably the most straightforward self-report of the bunch. You just had to calculate the total scores and simple scores for each of those targets (D, A, and S) and then interpret it using a "severity scale." So that was fine.

The hospital on this rainy morning

DES: Dissociative Experiences Scale

Finally there is the DES which is the Dissociative Experiences Scale. These questions to relate to the client's experiences in daily life with dissociation. A high score may be a flag to further investigate Dissociative Identity Disorder in the client. When we think of DID in the states, we generally think of multiple personality disorder and the extreme case of Sybil -something we have always thought to be very rare. Apparently not so here. Most of the cases involving complex childhood trauma I have been told have some connection to dissociation (though nowhere near as severe and dramatic as the Sybil story). I find this all confusing just because it really goes against what I have previously learned. I am curious whether this is an issue here and we don't see it because of our most common treatment module: CBT? Though CBT is still popular here, CBASP, or Cognitive Behavioral Analysis System of Psychotherapy is used for the complex trauma cases (the ones that I'm told experience dissociation the most). From what I've read, this theory involves a great deal of interpersonal transference, which is what psychodynamic theory revolves around. I am just wondering whether there is a connection between the lack of diagnoses of dissociative disorders, since psychoanalytic therapies are seldom found in the states due to insufficient insurance reimbursement guarantees. Maybe out of the CBT mindset we would acknowledge more dissociative traits in clients? I don't know. Just a thought!

Anyway, the DES test is rated on a Likert scale from "Never" to "Always." Here are some samples:

"Some people have the experience of driving or riding in a car or bus or subway and suddenly realizing that they don't remember what has happened during all or part of the trip."

"Some people find that they become so involved in a fantasy or daydream that it feels as though it were really happening to them" 

This was in the interpersonal therapy book I
was reading today! All textbooks should have
Harry Potter references!

After that, I sat in on a teams meeting coincidentally about exactly what I was planning on doing with some of my time here. Apparently a few weeks ago, before I arrived, the NHS administered a survey to the staff asking questions about what they think is working well in the system, what is not working so well, and what can be done to change those issues. This is EXACTLY what I was intending on doing. I have a copy of all of the responses. What is interesting is that very few people from the Psychological Therapies team answered it because they did not want to point fingers at other aspects of the overall care team! Being new to the team, I basically just sat back and listened to all of the different comments. We broke into two different task groups during the three hour period, so I was able to hear the concerns and solution proposals of a wide array of mental health professionals. It was really beneficial! Not sure what tomorrow has in store for me (except a trip to Tesco) but we shall see!