It has become evident that Psychiatric Intensive Care Units (PICU) accept aggressive, violent patients often with criminal histories and personality disorders. This paper aims to document the effects that this patient group can have on a PICU and the significant role that psychotherapy can offer this complex patient group. The conclusions have been drawn from psychotherapeutic work on a PICU (Pathways on Tagore, NELMHT). Such patients present unique therapeutic and emotional challenges to staff. As a result staff need to recognise and address these issues. This paper identifies and discusses a number of central themes, challenges and practical skills that may be important in enabling the successful treatment of such patients within a PICU setting.
The importance of psychological support for orthognathic patients has taken an increasing precedence over recent years and is embedded in orthognathic commissioning guidelines. Furthermore, attention towards mental health-related conditions and their management is of prime importance and continues to be a key area of focus within healthcare settings. With this in mind, this paper aims to outline our experience of establishing a need for and subsequently securing funding to establish a clinical psychology service within an existing orthognathic service in the NHS. The information outlined may be of benefit to orthognathic teams seeking to secure such psychological support within their respective units.
Recent research has highlighted the significance of the role of psychological interventions in cancer care services (CCS). Government health policies and cancer organisations have laid out a detailed schedule of targets and initiatives to develop the role of specialist psychological services. While the research demonstrates the effectiveness of psychological interventions for both service providers and service users, their presence remains nominal. Instead, most CCS rely on professions allied to medicine and nursing staff to fulfil this role, at the expense of and/or in addition to their own specialist skills. This article offers a brief overview of current research as well as clinical reflections on the case for specialist psychological services in cancer. It also highlights the practical implications of ignoring this ‘psychological gap’ on the patient journey, service providers and highlights the impact on local finances and the wider economy
Background: Little has been written on the availability of specialist level 2 supervision groups to support community practitioners regarding the emotional components of their palliative and end-of-life caseload. Adapted level 2 groups (AL2Gs) have been piloted in three community teams in the NHS to address this. Aims: This study aimed to evaluate whether access to AL2Gs benefited community palliative and end-of-life practitioners at three sites. The outcomes for those who attended and those unable to attend were considered. Findings: Attendees found AL2Gs beneficial, reporting better confidence and wellbeing, plus a sense of containment through group cohesion and trust in the facilitators and fellow AL2G members. Most would recommend the groups to all staff working in community palliative care. Practitioners who were not able to attend relied on informal and ad-hoc peer support, and had concerns about their skills in managing patients’ psychological needs. Conclusion: Community nurses benefit from attending AL2Gs to support them with their palliative care/end-of-life caseloads. It is recommended that all community staff involved in this type of care have access to regular clinical supervision, especially in a group format.
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