"Playing the diagnostic game" enables psychologists to manage an array of tensions and anxieties: conflicts between belief and practice, relationships with colleagues, and dilemmas of position and power. It also potentially limits a concerted questioning of diagnosis and consideration of alternatives. An alternative conceptual framework for non-diagnostic practice is needed to aid the collective efforts of clinical psychologists developing their practice beyond diagnosis, some of which have been highlighted in this study. Until then, ways of mitigating the perceived threats to questioning diagnosis need further exploration, theorising and backing.
This article reflects on the past and present of the clinical psychology doctorate training programme, and looks ahead to the future in the context of the changes within the wider NHS.
Routine screening for alcohol misuse in older people with cognitive impairment receiving services in memory clinics is feasible and acceptable. The process of completing alcohol screening tools with older adults receiving services at memory clinics may increase awareness of the potential impact of alcohol on cognitive functioning and provide practitioners with an opportunity to educate service users about the ways that their drinking is affecting their memory. Several techniques to facilitate completion of screening tools were identified. Future research should evaluate the reliability and validity of alcohol screening tools with older people through corroborating screening results with other assessment methods.
This paper describes a systemic exercise for clinical staff facing multiple changes to team structure and threats to their sense of belonging. The exercise was adapted from a consultation intervention that addressed a team's resourcefulness in responding to behaviours that challenge in intellectual disabilities (Smyly, 2006). As clinical psychology trainees from outside the Child and Adolescent Mental Health Service (CAMHS), we aimed to facilitate a context in which staff could share past experiences of collectively overcoming challenges, and in this way nourish a sense of belonging. Through building layers of dialogue, taking the observer perspective and reflection in the context of such threats to personal, professional and team identities, a shared direction may be claimed again.
Practitioner points
Providing space for teams to reflect on past experiences of overcoming challenging situations may empower teams and enhance a sense of belonging during difficult transitions
Moving towards an explorative and interactive space for personal and professional selves, away from problem‐saturated narratives, creates a context for innovation and change
Exercises that develop layers of conversation can scaffold relational risk‐taking, celebrate difference, and guide collaboration towards developing narratives of belonging
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.