Reflection: 13th of June

My supervisor is awesome.
The rest of the staff at the hospital is awesome.
I love the work I am doing.

But PHONES are not awesome and I feel like just abandoning it and going back to being phone-less. It was less stressful that way. Seriously. People keep telling me different things (like people who are paid to provide service support) and I keep spending money and nothing is working. I have been pretty calm these last few weeks considering I just moved halfway across the world, but it is THIS that is making me frustrated.

Anyway, about my day:
I am getting to help create a new therapy group for victims of childhood trauma. This one is going to be a women's group (over 18) that combines psychoeducation and more traditional group therapy. In the past they have run 18 week sessions using a compressed form of this 32 week model that is supposed to reflect evidence based research. I think the book is called The Trauma Therapy Group: A Guide for Practitioners. This is second-hand information, but I've been told that evidenced based research is severely lacking from the trauma field, as it is difficult to get funding for treatments that are NOT Cognitive Behavioral Therapy, basically, which is shown to not be working in the long run for trauma survivors. The theory that the facilitators are planning on working from is CBASP, which I mentioned before is considered a "cognitive analytic" theory. Really interesting, been doing some more reading about it. Anyway, I am basically compiling these information packets tomorrow to be distributed to group members, just things for them to read and start normalizing their reactions to their experiences. Apparently last time they ran a group with a similar model, they jumped right into working, bringing up the themes of neglect, isolation and fear almost immediately.

SO my job is going to be to read through the book aforementioned, whatever book it actually is, and look at that 32 week model. Then I'll look at the previous 18 week model that was used by the NHS. Then I will go through the collection of handouts used in psychoeducation groups (like lectures) about childhood trauma, and try to integrate all of it into something cohesive, informative, and able to promote healing. The three facilitators already have a general guidelines of what they want to discuss and how they want to structure it, but I am to synthesize the information more, it seems. I think I'll have a better idea once I do the reading!

After work tomorrow, from which I will be leaving about an hour early, I'm catching the bus to Edinburgh to spend the night at a hostel. In the morning, I'll be going to a number of sites in the Borders and then hopping into England to spend the afternoon at Alnwick Castle. So I will not be posting tomorrow, but hopefully Saturday night or Sunday I'll be able to share some good stories!

Day Two

Today was a low key day at the internship in terms of work for me to do, however, I loved this because it meant I could talk to many people! From 9:30am-12:30pm I attended a training about assessing clients who are "at risk."

This means determining whether they are at a risk of hurting themselves or others. It was a really interesting session to be a part of because their system is so different than ours. I am trying to pickup on the rules and requirements given to mental health professionals by the NHS. It is a very collaborative system, so therefore their confidentiality and ethic laws are different. Even the responsibilities and roles of each person in the "team" are different than ours. I am still trying to learn all the terminology and understand how all the pieces fit together. Everyone has been really nice so far though! I cannot wait until I can start doing clinical work. 

Some impressions about the system - it is much more team oriented. Everyone has the opportunity to receive mental health care, however it is a long process to get into therapy if you want to go through NHS (which is free). However, you do have the option to seek private care. The staff of NHS, particularly in the Psychological Therapies department where I am situated,

Old building, Old keys. But I accessorized mine!

is really mixed. There is a clinical psychologist, a few other doctoral level psychologists, psychiatrists, masters level therapists who are trained in specific therapy models, nurse therapists (which I still don't completely understand), social workers, occupational therapists (who seem to do social work type things) and physiotherapists. Everyone works together and collaborates on cases depending on the needs of the patient - even the general practitioner who does all the referrals has rights to access the information. Very different than here. The staff likes this because they are able to understand each case from a multiprofessional perspective. From what I understand though, each organization within the NHS uses a different database to store info, so there are some issues with everyone having access to all of the documentation. This is something that is being worked on now, however.

I also started reading up on some popular psychological/therapeutic literature for Scotland. Some of the popular theories used here are Cognitive Behavioral Therapy (big surprise), Interpersonal Therapy (ITP), Cognitive Behavioral Analysis Systems of Psychotherapy (CBASP), Cognitive Analytic Therapy (CAT) and Psychodynamic Therapy. I started reading a book on IPT today as I'll be sitting in on one of the therapist's sessions who is a specialist in this technique. I also read an introduction to CBASP because I really was not familiar with that at all. I am curious as to how these therapies are delivered!

 Since towards the end I did not have much left to do, I was encouraged to just to go outside and enjoy the sun. They are so much more relaxed here - there isn't such thing as a time clock in the hospital! I LOVE the fact that coffee/tea is offered after almost every greeting. The coffee here is almost never instant either...someone ground up coffee beans and made me a cup today! At the house, it's always from a french press. I'm afraid by the end of the summer I'll be spoiled by these luxuries!

I am not sure what tomorrow will have in store at the internship, but hopefully I can continue to talk to some of the other staff and form a better understanding of NHS. 

Swans again on the walk home!