Results indicate that insecure attachment styles of preoccupied and fearful were associated with increased symptom reporting. Social support and anger mediated the relationship between attachment style and symptom reporting.

Esther Wilcox is a ClinicalPsychologist at Sussex Partnership NHS Foundation Trust, Worthing, UK. AbstractPurpose -This paper aims to share information and reflections on the process of setting up case formulation meetings in a community intellectual disability team supporting adults with intellectual disabilities. Design/methodology/approach -The case formulation meeting was set up and pioneered by a clinical psychologist working in the team. This paper offers a description of the process of setting up the meetings and experiences of initial meetings. Findings -Evaluations of the meetings were consistently positive, but attendance from the team members was dependent on ongoing marketing of the meetings by the team's psychologist. Feedback suggested that there may be direct benefits to the clinical work of the team and that the conversations allowed for improved management of risk. This suggests that time spent on facilitating such meetings can help to improve the quality of a service. Originality/value -Other papers have helpfully shared experiences of setting up formulation meetings in other settings. To the author's knowledge, this is the first paper which shares the experience of setting up and running a case formulation meeting in an adult community intellectual disability team setting. The paper's focus on meetings which floundered, and focus on lessons learnt for the continuation of the meetings is also of practical value.

Purpose -There is little research addressing the delivery of training for health professionals who are interested in using cognitive-behaviour therapy (CBT) techniques as an adjunct to their current role. This paper describes the establishment and evaluation of a CBT training course to develop CBT skills in staff working with people with intellectual disabilities in Trust healthcare settings. The course would enable staff to learn how they could incorporate these skills into their daily practice to help them understand and work more effectively with people with intellectual disabilities. Design/methodology/approach -A CBT training course was designed to teach staff the use of a number of basic and specific CBT techniques and principles that staff could use within their current roles. Specific issues in relation to people with intellectual disabilities were included, e.g. understanding cognitive deficits as well as cognitive distortions. The course ran for six sessions on a fortnightly basis, followed by a twomonth follow-up session. Participants completed a pre-and post-assessment questionnaire and kept a reflective diary. Findings -The training clearly focused on teaching skills that were feasible for staff to use in their own work settings. The evaluations, especially from the reflective diaries and the post-course questionnaires clearly demonstrated that this aim was achieved. Originality/value -This was a pilot study as there has been no previously published evidence of using this approach within intellectual disabilities services. A further training course has been planned to continue evaluating the effectiveness of this approach.

In April 2018 I was approved by the Secretary of State to be an Approved Clinician for the purposes of the Mental Health Act (MHA). I started working in this role in June 2018 following a re-banding and re-contracting process within my role as the qualified psychologist in a 10-bedded NHS assessment and treatment unit (ATU) supporting adults with learning disabilities. In this article I outline the process of becoming approved and reflect on my experiences in my first year (ish) of working as an Approved Clinician in the ATU.

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