Faculty of Medical Psychotherapy Annual Conference 2018 Radission Blu, Cardiff Wednesday 25-Thursday 27 April 2018
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
.
Faculty of Medical Psychotherapy
Annual Conference 2018
Radission Blu, Cardiff
Wednesday 25-Thursday 27 April 2018
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018RCPsych Faculty of Medical Psychotherapy Annual Conference 2018
Contents Page(s)
1
USEFUL INFORMATION
2
CONFERENCE PROGRAMME
6
INTRODUCTION TO EXPERIENTIAL GROUPS
8
PRESENTATION ABSTRACTS AND BIOGRAPHIES
8
Wednesday 25 April
9
Thursday 26 April
13
Friday 27 April
19
POSTER EXHIBITION (ALPHABETICALLY BY SURNAME)
SAVE THE DATE 2019 29
MEDICAL PSYCHOTHERAPY SEMINAR SERIES 30
NOTES 31
Add evens that
Please note a presentation link (with non-editable pdf versions) will be emailed
after the conference to all delegates after obtaining the authorisation of the authors
of the presentations.
NB this can take approx. 3 weeks.
Unfortunately, it is not always possible to supply presentations due to some
items being unpublished and copyright issues.
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018Useful information
Exhibition
The Royal College of Psychiatrists is pleased to welcome
Bookmark
RCPsych Sustainability in Psychiatry
Certificates of attendance
Certificates of attendance will be emailed to delegates within one week of the conference. This
conference is eligible for 2 (Pre conference workshop), 1.5 (Guest lecture), 6 (Thursday), 6 (Friday) &
6 (Saturday) CPD hours subject to peer group approval.
Speaker presentations
A link to all of the speaker presentations we have permission to share will be emailed to registered
attendees after the meeting.
Feedback
A detailed online feedback form can be found at https://www.surveymonkey.co.uk/r/MedPsych18
All comments received will remain confidential and are viewed in an effort to improve future meetings.
This link will be emailed to all delegates after the conference.
Cloakroom
The cloakroom is situated on the first floor just outside the meeting and events suite.
Fire exit
No fire drills scheduled for today, so if alarm sounds it is a real fire! The Evacuation point is just opposite
the hotel entrance outside John Lewis.
Wi-fi
There is free wi-fi available through-out the hotel.
Mobile phones
Please turn off or switch to silent.
Toilets
The toilets are situated just outside the meeting and events wing along with the disabled toilets .
Twitter
@RCPsych #MedPsychConf
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018
1FINAL PROGRAMME
WEDNESDAY 25 APRIL
Time/Room Session
16:30-18:30 Pre conference workshops
Workshop A Translational Medicine meets Psychotherapy: from findings in relational
Room: neuroscience to consulting room practice
Azzurro II Professor Jeremy Holmes and Tobias Nolte
Workshop B Cognitive Analytic Therapy and the Social Self: Addressing the Systemic and
Room: Bianco Psycho-social Dimensions of Mental Health
Dr Ian Kerr
18:45-19:30 ACOMP Drinks Reception
Room:
Azzurro
Lounge
Guest Lecture
20:00-21:45
Chair: Dr Steve Pearce
Room:
Azzurro II The Family Institute; 50 Years in collaboration, what about the next 50?
Mr Billy Hardy
21:45 Close
THURSDAY 26 APRIL
Time/Room Session
09:00-09:30 Registration, Refreshments and Exhibition Viewing
Room:
Azzurro I
Room:
Azzurro II Plenary Session
Geo political issues and Psychotherapy
09:30-11:20
09:30-09:40 Welcome
Dr Mark Evans
Chair – Dr Ian Kerr
09:40-10:30 Immigration, culture and identity in psychotherapy
Dr Salman Akhtar
10:30-11:20 Where have all the adults gone? Power and the mind of the politician
Mr Philip Stokoe
11:20-11:45 Morning Refreshments, Exhibition and Poster Viewing
Room:
Azzurro I
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018
211:45-13:00 Plenary Session
Room:
Azzurro II
11:45-11:55 Culture and Mental Health: Personal Reflections
Ms Aakta Patel
11:55-12:10 Plenary discussion
12:10-13:00 Minding the Gap : understanding the difficulties in recruitment in Psychiatry and
Medical Psychotherapy
Dr William Burbridge James, Dr Clare Cribb, Ms Stephanie Guidera and Dr Neda
Mehrpooya
13:00-14:00 Lunch, Exhibition and Poster Viewing
Room:
Azzurro I
Room: Bianco Additional meeting: Working lunch for psychotherapy tutors - Dr Maria Eyres and
Dr Jo O’Reilly
14:00-15:15 Experiential Groups
Rooms:
Azzurro II,
Bianco, Verde
and Rosso
15:15-15:30 60 second poster presentations
Room: Chair: Dr Haroula Konstantinidou
Azzuro II
Towards Improving the Provision of Psychological Therapies: A Quality
Improvement Project with the Southwark and Central Integrated Psychological
Therapy Team
Karia Beinerte
The quality of the psychotherapy experience for CT’s and patients in South
London and Maudsley psychotherapy department
Sophie Butler
Psychological formulation for staff working on a Psychiatric Intensive Care Unit
Charlotte Cliffe
Setting up a multi-disciplinary Balint group on an inpatient unit – the successes
and difficulties
Anneka John-Kamen
Service Evaluation of the Mentalisation Based Treatment Programme at St
Bernard’s Hospital
Jeremy Greening
Does talking about work place stresses reduce sickness and improve well-being?
Geofferey Ijomah
An Audit on Prescribing Practices for People with Personality Disorder Presented
at Local Personality Disorder Forums
Justin Kerr
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018
3Developing a psychoeducational support group for parents receiving
Mentalization-Based-Therapy for Personality Disorder – challenges and learnings
Marion Neffgen
Stress and Struggles in 21st Century Healthcare
Parvinder Shergill
Improving the Quality of Outcome Monitoring Data at the Camden and Islington
Psychodynamic Psychotherapy Service
Giles Story
15:30-16:00 Afternoon Refreshments, Exhibition and Poster Viewing
Room:
Azzurro I
16:00– 17:15 Workshops
Workshop A Humility: the concept and its clinical relevance
Room: Bianco Dr Salman Akhtar
Workshop B Working with certainty, from consulting room, through institutions to politics
Room: Verde Mr Philip Stokoe
Workshop C Introduction to Interpersonal Dynamics Consultations: A Simple
Room: Rosso Psychotherapeutic Tool for Improving Difficult Patient-Team Interactions
Dr Sandra Scott, Dr Thomas Hillen, Dr Ching Li and Professor Michael Maier
Workshop D
Room: Dynamic Interpersonal Psychotherapy (DIT): Psychodynamic practise, alive and
Azzurro II relevant for the NHS
Dr Richard Taylor
Room:
Azzurro II Chair: Dr Maria Eyres
17:15-17:25 Culture shot
Dr Jason Hepple
17:25– 18:05 MDMA Therapy for Addictions: A Child Psychiatrist's Perspective
Dr Ben Sessa
18:05 Close
18:05-18:45 AGM
Room:
Azzurro II
18:05-19:00 Trainees meeting
Room: Bianco
19:30 - late Conference dinner with drinks reception
After Dinner Speaker: Professor Rob Poole
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018
4FRIDAY 27 APRIL
Time/Room Session
08:30-09:00 Registration, Refreshments and Exhibition Viewing
Room:
Azzurro I
Room:
Azzurro II Plenary session – ‘The Agony and the Ecstasy’
Chair – Dr Jo O’Reilly
09:00-09:50 How an enlightened view of "illegal" drugs could revolutionise psychotherapy
Professor David Nutt
09:50-10:40 I don’t know why they call this Ecstasy!” – What’s going on in MDMA-assisted
Psychotherapy for PTSD?
Dr Michael Mithoefer
10:40-11:10 The agony and the ecstasy: Taking the edge off?
Dr Susan Mizen
11:10–11:40 Morning Refreshments, Exhibition and Poster Viewing
Room:
Azzurro I
Room:
Azzurro II Chair – Dr Jason Hepple
11:40-12:10 Plenary discussion
12:10-12:45 What does the new field of Computational Psychiatry have to offer to
psychotherapy
Dr Michael Moutoussis
12:45-13:45 Lunch, Exhibition and Poster Viewing
Room:
Azzurro I
13:45-15:00 Experiential Groups
Rooms:
Azzurro II,
Bianco, Verde
and Rosso
15:00-15:30 Afternoon Refreshments, Exhibition and Poster Viewing
Room:
Azzurro I
Room:
Azzurro II Chair: Dr Susan Mizen
15:30–15:40 Culture shot
Ms Stephanie Guidera
15:40- 16:10 Early Intervention in Borderline Personality Disorder: a critical review of the
HYPE programme
Dr Tiago Gandra and Dr Amit Bhaduri
16:10– 16:45 Challenges in the psychotherapeutic treatment of perversion and violence
Dr Andrew Williams
16:45-17:00 Closing plenary & poster prize presentations
17:00 Close of Conference
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018
5Introduction to Experiential Groups
Some may not be familiar with the use of small groups as a tool for personal learning in workshops and
conferences. The following is intended to be a guide to the process and underlying theoretical frame.
Learning in groups gained through an experiential group process is a well-recognised although
underused form of learning which adds an affective dimension which can bring alive academic and
cognitive knowledge. It is learning with and from each other. It can be an exciting and at times
disturbing experience. To be most effective it requires an attitude of openness and trust in the process
and colleagues. It can be a deeply satisfying experience that additionally promotes closer bonds
between colleagues.
The groups will be themed to fit the overall conference theme of politics and neuroscience. Specifically
the theme of the groups is “Taking account of the political, social and neuroscientific: implications for the
professional identity of medical psychotherapy?”
The task of the groups is to explore the theme in whatever way each group chooses. The task of the
group conductor is to enable the group to keep to task partly through understanding unconscious
processes which militate against this. In other words the conductor models a reflective function for how
well the group is managing its task. This responsibility can be taken up by the group members as the
group progresses. This model has been embodied in what is known as the Double-Task model designed
by Harold Bridger based partly on his work with Bion at Northfield during the war. Task one is ‘the task’,
and task two is reflection upon how well the group is achieving task one. This is the model for the
Tavistock Institute of Human Relations annual group relations conference.
In order to do this beyond setting the theme there are no other instructions or agenda for the groups. It
is an open discussion analogous to free association. It is a setting within which to explore the theme of
our attachments through here-and-now experience of attachments formed in the groups.
Jill Savege Scharff & David E Scharff in their book “Tuning the Therapeutic Instrument: Affective
Learning of Psychotherapy” describe the process as follows: -
“The individual’s task is to discuss the theoretical and clinical material that has been read or presented
and at the same time to examine intellectual and emotional responses to it. As each member attempts
to do this, discussion follows, and a group process develops. The group’s task is to facilitate its
members’ learning from all levels of experience. While studying the theoretical and clinical material
provided, the group examines its own process to discover how the individual’s inner world combines with
the personalities of others to illustrate the concepts and to foster or impede the learning.”
What learning is facilitated by such a group process? It is personal learning based around how each
individual aligns themselves to the group process both in relation to the task and anti-task processes. In
Bion’s terms ‘valency’. It allows the individual to understand the basis of their membership of the group,
the roles they adopt. This of course relates to family dynamics but these are not the focus of attention,
rather it is the group and social processes that derive from them which are the focus of attention. To be
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018
6clear this is not intended to be a form of therapy and is not therefore Group Analysis.
All of the group conductors are qualified Group Analysts and have considerable experience of conducting
groups across a range of settings.
As is normal for experiential processes confidentiality is a key principal. In this setting confidentiality
refers to personal information that may be revealed in the group. Themes explored in the group and
learning from the group is part of the conference and can be shared with other attendees. There will not
be a session of formal feedback to the whole conference.
Group conductors will meet together to process the experience of the groups as a whole as part of the
overall learning process for themselves and the group organisers. If possible and helpful we may write a
summary of this to be sent to all delegates.
You will be invited to comment on how you found the group experience along with any suggestions you
may have for improving it as part of the conference feedback.
John Hook
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018
7PRESENTATION ABSTRACTS AND BIOGRAPHIES
(as at 17 April 2018)
WEDNESDAY 25 APRIL 2018
Pre-conference workshops
Translational Medicine meets Psychotherapy: from findings in relational neuroscience to
consulting room practice
Professor Jeremy Holmes and Tobias Nolte
Cognitive Analytic Therapy and the Social Self: Addressing the Systemic and Psychosocial
Dimensions of Mental Health
Dr Ian Kerr
This workshop will aim to explore some of the systemic and psycho-social aspects of mental health, both
within therapy and beyond, from both theoretical and practical perspectives. It will be broadly based
around the cognitive analytic therapy (CAT) model of the social Self and will include consideration of
recent background scientific developments supporting this.
Dr Ian Kerr is a psychiatrist and medical psychotherapist currently working in NHS Lanarkshire. He has
trained in and has experience of a range of modalities ranging from Jungian analytic, group and
therapeutic community work to cognitive and trauma-based models. He has a particular interest in
psychotherapy integration and has been involved in contributing to and further developing the cognitive
analytic model (CAT) developed by Anthony Ryle and and is co-author of the current standard
introductory text. His clinical and research interests focus have focused particularly on challenging and
'hard to help' presentations (including so-called personality disorders), and on the broader systemic and
psycho-social dimensions of mental health.
Guest Lecture
The Family Institute; 50 Years in collaboration, what about the next 50?
Mr Billy Hardy
Mr Billy Hardy is Consultant Psychotherapist &Senior Lecturer in Systemic Psychotherapy and Course
leader, MSc Systemic Psychotherapy at the Family Institute, University of South Wales.
**************************
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018
8THURSDAY 26 APRIL 208
Plenary Session: Geo political issues and Psychotherapy
Dr Ian Kerr, Chair
Immigration, culture and identity in psychotherapy
Dr Salman Akhtar
Dr Salman Akhtar works at the Department of Psychiatry, Jefferson Medical College Philadelphia, USA.
Where have all the adults gone? Power and the mind of the politician
Mr Philip Stokoe
In this presentation, I shall give a psychoanalytic explanation for the way that we are all drawn into
primitive group processes in groups, organisations and society. I shall show how the means by which we
can protect the adult function in society have been destroyed by the political commitment to the
Neoliberal Free Market concept leading to the extraordinary behaviour resulting in Brexit and Trump. I
shall offer an idea of how to address this problem.
Mr Philip Stokoe is a Psychoanalyst (Fellow of the Institute of Psychoanalysis, Training Analyst with the
British Psychotherapy Foundation) in private practice working with adults and couples, and an
Organisational Consultant, providing consultation to a wide range of organisations.
He worked as a Consultant Social Worker and Senior Lecturer in the Adult Department of the Tavistock &
Portman NHS Foundation Trust from 1994 to 2012 finishing as Clinical Director.
He writes and teaches on a wide range of topics including Psychoanalytic understanding of society and
politics.
Culture and Mental Health: Personal Reflections
Ms Aakta Patel
Ms Aakta Patel is a member of the RCP Medical Psychotherapy Executive group.
Minding the Gap: understanding the difficulties in recruitment in Psychiatry and Medical
Psychotherapy
Dr William Burbridge-James, Dr Clare Cribb, Ms Stephanie Guidera and Dr Neda Mehrpooya
Dr William Burbridge-James will talk about the recurring recruitment problems in psychiatry and medical
psychotherapy and the college’s strategy to address this. He will think about what draws people to
become doctors, psychiatrists and psychotherapists; touching on underlying anxieties and themes of
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018
9altruism, empathy, identification, and the experience of the psychotherapy with a person.
Dr William Burbridge-James has been a Consultant Psychiatrist Psychotherapy in Southend-on-Sea
since 2004. He is clinical lead for the psychotherapy department which specialises in working with
patients who have complex psychosocial difficulties. Alongside colleagues he developed a specialist
programme for people who attracted a diagnosis of Personality Disorder. He has worked with trust staff
to promote understanding of working with Personality Disorder, and also run workshops for carers and
psychiatrists on self-harm.
He is Chair of the Medical Psychotherapy Specialist Advisory Committee (SAC) and training programme
director for higher training in psychotherapy in the Eastern region and psychotherapy tutor in EPUT.
The concept of a Medical Psychotherapist, as recognised by the Royal College of Psychiatrists, is little
known about in mental health services in Wales, even in some psychiatric circles. How can we think
creatively about generating and sustaining a group of practitioners and trainers, and recognising them,
in order to ensure we have a well rounded, psychologically competent psychiatric workforce for Wales?
Dr Clare Cribb is a general adult psychiatrist with a longstanding interest in psychotherapy. My ability
to pursue this as a career has been frustrated by the limited opportunities to train in psychotherapy in
Wales. I am now however close to qualifying as a systemic psychotherapist, and am shortly due to start
in a Medical Psychotherapy post in West Wales. I am dedicated to working towards improved
psychotherapy training opportunities for Welsh trainees in psychiatry.
Workshops
Workshop A: Humility: the concept and its clinical relevance
Dr Salman Akhtar
Not available at the time of print
Workshop B: Working with certainty, from consulting room, through institutions to politics
Mr Philip Stokoe
Not available at the time of print
Workshop C: Introduction to Interpersonal Dynamics Consultations: A Simple
Psychotherapeutic Tool for Improving Difficult Patient-Team Interactions
Dr Sandra Scott, Dr Thomas Hillen, Dr Ching Li and Professor Michael Maier
Interpersonal Dynamics Consultations (IDC) have previously been used successfully in psychiatric
settings and we have now examined their utility in medical settings.
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018
10Patients’ engagement with treatment impacts outcome in psychiatric and medical settings. Human
factors can hinder optimal treatment in real life settings and lead to non-compliance, non attendance,
revolving door admissions, overuse of services and violence.
IDC explore how patients engage with different health care professionals and enable teams to find better
ways of working with challenging patients. They are offered to multi-disciplinary teams and we
encourage that the whole team attends because each member may have a unique perspective on
interacting with the patient. This contributes to a fuller understanding of the patient’s way of relating to
professionals.
Consultations last about one hour and cover clarification of why this patient is brought for consultation,
presentation of patient’s medical and relationship history, live completion of the IDC-4D perspective,
case formulation of why problems with implementation of the care plan keep occurring, and a review of
the existing care plan and action points. The IDC-4D perspective systematically looks at how (1) the
patient experiences others, (2) experiences him/herself, (3) staff experience the patient, and (4) staff
experience themselves when working with the patient.
Higher trainees in psychiatry learned how to run IDCs in four half-days and gained experience in
facilitating consultations in pairs and were offered regular supervision. This helped them with gaining
important competencies in leadership, psychotherapy, and managing severe and chronic presentations.
Ching Li is a higher trainee in Child & Adolescent Psychiatry who has currently taken up a Fellowship in
Medical Education at the London Deanery where she expands on the previous work on Interpersonal
Dynamic Consultations in Medical Settings.
Thomas Hillen is currently ST6 in Medical Psychotherapy at the Halliwick Unit for Personality Disorders
in London. He previously trained in Child & Adolescent Psychiatry and has a particular interest in
psychodynamic psychotherapy and the relational aspects of psychiatry. He worked closely with Prof M
Maier and Drs Kirtchuk and Reiss when he was a Fellow in Medical Education at the London Deanery and
piloted Interpersonal Dynamic Consultations in Medical Settings.
Sandra Scott is currently an ST5 in forensic psychiatry working in the Woman’s service, The Orchard,
WLMHT. Her previous work has included family therapy, cognitive behavioural therapy and parent/child
work. Since July 2016 she has been involved in the project that undertakes interpersonal dynamics
consultations in the acute hospital sector.
Our project team include Michael Maier (Head of London School of Psychiatry), Gabriel Kirtchuk
[Consultant Medical psychotherapist] and Dr David Reiss (Consultant Forensic Psychiatrist)
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018
11Workshop D: Dynamic Interpersonal Psychotherapy (DIT): Psychodynamic practise, alive and
relevant for the NHS
Dr Richard Taylor
Dynamic Interpersonal Psychotherapy (DiT) is a 16 session psychodynamic psychotherapy where an
individual is helped to identify a core, recurrent ‘pattern’ of relating leading to maladaptive consequences
and affective symptoms. DIT was explicitly developed out of the Psychoanalytic/dynamic Competences
Framework (Lemma et al., 2008) and is consequently drawn from those psychoanalytic/dynamic
approaches with the strongest empirical evidence for efficacy, based on the outcome of controlled trials.
It is specifically designed to address presenting symptoms of depression and anxiety. DIT is the brief
psychodynamic therapy model now offered at Step 3 within IAPT. The National Institute for Health and
Clinical Excellence (NICE) guidelines for depression state that brief psychodynamic therapy is one option
that can be considered for depressed patients either when the patient has not responded to CBT
interventions, or where the patient actively opts for a psychodynamic approach. The British
Psychoanalytic Council accredits DIT.
Dr Richard Taylor is a Consultant Psychiatrist in Medical Psychotherapy and currently is the Clinical
Lead of the Regional Eating Disorders Unit in Edinburgh. Richard has a diploma in group work practice
from the Institute of Group Analysis and is deputy chair of MBT Scotland and an Anna Freud National
Centre for Children and Families accredited tutor and trainer in Mentalization Based Therapy for
borderline personality disorder. In addition, he is an accredited trainer and supervisor in Dynamic
Interpersonal Therapy (DIT) with the Anna Freud National Centre for Children and Families, London .
Richard is an IPT supervisor and trainer with IPT-UK at Edinburgh University. He has recently begun an
IPT-Group training programme for rural villages in Tanzania, Africa in conjunction with NHS Lothian and
the The Tumaini (Scotland) Fund.
Plenary Session
Culture shot
Dr Jason Hepple
Dr Jason Hepple is a consultant in psychological therapies for Somerset Partnership NHS Foundation
Trust. He is a CAT psychotherapist and trainer. He trained in classical violin and played in the Oxford
University Orchestra and the Salieri string quartet. He has developed a love of folk music and enjoys
improvisation and merging classical and traditional styles.
MDMA Therapy for Addictions: A Child Psychiatrist's Perspective
Dr Ben Sessa
MDMA-assisted psychotherapy represents the most innovative and interesting psychiatric drug treatment
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018
12of the last 50 years. This talk will describe the mechanism, safety and benefits of MDMA Therapy. Dr
Sessa will present his ongoing MDMA Therapy for Alcoholism study currently underway in Bristol.
As a child psychiatrist who now works in adult addictions and psychopharmacology research, Dr Ben
Sessa have seen too many cases of child maltreatment and abuse follow that sad and inevitable
trajectory from childhood pain into adult mental illness and addictions. Trauma underpins most chronic
anxiety, affective and substance use disorders. Yet our best treatments are poor; with high rates of
relapse. We paper-over the cracks of our patients' symptoms with long-term maintenance drugs. But
how do we get to the heart of their problems; their trauma?
**************************
Friday 27 April 2018
Plenary Session: The Agony and the Ecstasy
How an enlightened view of "illegal" drugs could revolutionise psychotherapy
Professor David Nutt
For about 15 years in the 1950s and 60s psychedelic drugs such as LSD and psilocybin were widely
studied in psychiatry with good outcomes reported. Since their being banned on account of recreational
use in 1967 almost all studies have stopped. In recent years we and a few other groups have
resurrected psychedelic therapeutic research with psilocybin [magic mushroom juice]. Results have been
very promising with significant treatment effects in resistant depression, end of life anxiety and
depression, and OCD. The mechanism of action is still being studied but it appears that the psychedelic
effect facilitates psychotherapy interventions. Overall it seems a new era in psychopharmacology and
psychotherapy is developing.
Professor David Nutt DM, FRCP, FRCPsych, FMedSci, DLaws is currently the Edmund J Safra
Professor of Neuropsychopharmacology and Head of the Neuropsychopharmacology Unit in the Centre
for Academic Psychiatry in the Division of Brain Sciences, Dept of Medicine, Hammersmith Hospital,
Imperial College London. He is also visiting professor at the Open University in the UK and Maastricht
University in the Netherlands.
After 11+ entry to Bristol Grammar he won an Open Scholarship to Downing College Cambridge, then
completed his clinical training at Guy's Hospital London. After a period in neurology to MRCP he moved
to Oxford to a research position in psychiatry at the MRC Clinical Pharmacology Unit where he obtained
his MD. On completing his psychiatric training in Oxford, he continued there as a lecturer and then later
as a Wellcome Senior Fellow in psychiatry. He then spent two years as Chief of the Section of Clinical
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018
13Science in the National Institute of Alcohol Abuse and Alcoholism in NIH, Bethesda, USA. He returned to
England in 1988 to set up the Psychopharmacology Unit in Bristol University, an interdisciplinary
research grouping spanning the departments of Psychiatry and Pharmacology, before moving to Imperial
College London in December 2008 where he leads a similar group with a particular focus on brain
imaging and translational medicine studies on these disorders.
He currently is the founder Chair of DrugScience.org.uk (formerly the Independent Scientific Committee
on Drugs - ISCD) and has held many leadership positions in both the UK and European academic
scientific and clinical organisations. These include presidencies of the European Brain Council, the British
Neuroscience Association, the British Association of Psychopharmacology and the European College of
Neuropsychopharmacology as well as Chair of the UK Advisory Council on the Misuse of Drugs. He is a
Fellow of the Royal Colleges of Physicians, of Psychiatrists and of the Academy of Medical Sciences. He is
also the UK Director of the European Certificate and Masters in Affective Disorders courses and a
member of the International Centre for Science in Drug Policy.
David has edited the Journal of Psychopharmacology for over twenty five years and acts as the
psychiatry drugs advisor to the British National Formulary. He has published over 500 original research
papers and a similar number of reviews and books chapters, eight government reports on drugs and 31
books, including one for the general public, ‘Drugs Without the Hot Air’, which won the Transmission
book prize in 2014 for Communication of Ideas.
David broadcasts widely to the general public both on radio and television; highlights include being a
subject for The Life Scientific on BBC radio 4, several BBC Horizon programs and the Channel 4
documentaries Ecstasy and Cannabis Live. David is much in demand for public affairs programs on
therapeutic as well as illicit drugs, their harms and their classification. In 2016, he was advisor to the
BBC Religious affairs dept on their groundbreaking programme on psychedelics in religion
http://www.bbc.co.uk/programmes/p0438553. He also lecturers widely to the scientific and medical
communities as well as to the public e.g. at the Cheltenham Science and Hay How the Light Gets In
Festivals, Glastonbury and other music festivals as well as many Café Scientifiques and Skeptics in the
Pub. He also speaks regularly to schools.
In 2010, The Times Eureka science magazine voted him one of the 100 most important figures in British
Science, and the only psychiatrist in the list. In 2013, he was awarded the Nature/Sense about Science
John Maddox prize for Standing up for Science and in 2016 an Honorary Doctor of Laws from the
University of Bath for contributions to science and policy.
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018
14I don’t know why they call this Ecstasy!” – What’s going on in MDMA-assisted Psychotherapy
for PTSD?
Dr Michael Mithoefer
For millennia cultures around the world have used methods of shifting consciousness as catalysts to
healing. Modern Western psychotherapy generally has not made use of the healing potential of non-
ordinary states, but over the past 15 years there has been a resurgence of research using psychedelics,
primarily MDMA or psilocybin, as adjuncts to psychotherapy with very promising results. This paper will
present the results of MDMA-assisted psychotherapy, administering MDMA only 3 times at monthly
intervals during eight-hour therapy sessions has been effective for many people who had not responded
to prior psychotherapy or medications. The therapeutic method emphasizes access to the innate healing
intelligence within each individual, and the therapist’s role as facilitator rather than director of the
process. The workshop is aimed at allowing participants to:
Summarize the history and pharmacologic effects of MDMA.
Summarize the design and results of recent clinical trials using MDMA-assisted Psychotherapy for
PTSD.
Describe the therapeutic methods used in MDMA-assisted psychotherapy shown in a video clip
from a research psychotherapy session.
Michael Mithoefer, MD has conducted Phase II clinical trials of MDMA-assisted psychotherapy for both
crime-related and military PTSD. He has trained therapy teams and been Medical Monitor for other
Phase II MDMA studies in the US, Israel and Europe. He is currently training and supervising research
therapists for multicenter Phase 3 trials of MDMA-assisted psychotherapy that have recently been
granted “Breakthrough Therapy” designation by the FDA. He is board certified in Psychiatry, Emergency
Medicine and Internal Medicine, and is a Fellow of the American Psychiatric Association and Clinical
Assistant Professor of Psychiatry at The Medical University of South Carolina.
The agony and the ecstasy: Taking the edge off?
Dr Sue Mizen
The chemical and neurophysiological effects of psychedelics and other substances which have been
‘misused’ or used as a form of self-medication are now better understood and new therapeutic
applications are being discovered. I will be providing a Medical Psychotherapist’s view on defences in
trauma and addictions and the implications of combining chemical and psychological interventions both
for understanding the neurobiological and psychotherapeutic understanding of post-traumatic stress and
addictions and thinking about applications to clinical therapeutic work in secondary mental health
settings.
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018
15Dr Sue Mizen is a Consultant Medical Psychotherapist and SAP Jungian Analyst. She trained at the
Cassel Hospital in West London before becoming a Consultant at Charing Cross Hospital Fulham. She
wrote the business case for and currently leads the Devon Partnership Trust Specialist Personality
Disorder Service. She is developing a neuroscientific psychotherapeutic Relational Affective Model, for
teams working with people with severe and complex Personality Disorder. She is interested in the
interface between neuroscience and psychoanalysis and is undertaking a PhD in Neuroscience. She is the
Chair of the Medical Psychotherapy Faculty at the RCPsych and Chair of the Talking Therapies Task
Force.
Plenary session
What does the new field of Computational Psychiatry have to offer to psychotherapy
Dr Michael Moutoussis
Psychotherapy has great strengths, but also weaknesses. We have tried to understand these for decades
through clinical, empirical and theoretical studies but there are many patients that we still can't help well
despite our understanding. I will briefly describe a new, complementary approach to psychiatry, namely
computational psychiatry. This takes affect and belief seriously, puts them on a formal basis. Here,
advances may help formalize and test hypotheses regarding how patients make unhelpful inferences,
and how maladaptive beliefs may be maintained: bread-and-butter issues for psychotherapy. More
specifically, a probabilistic reasoning, or Bayesian, approach helps delineate which apparent inferential
biases and beliefs are in fact near-normative, given patients’ current concerns, and which are not. I will
briefly illustrate the example of avoidance, and specifically avoidance of internal states. Unfortunately,
so far researchers in computational psychiatry considered mostly basic beliefs and choices, and shying
away from the importance of relationships. I argue that computational psychiatry has great potential to
help psychotherapy if it considers more closely what people are prepared to dare within relationships,
and how avoidance operates within relationships. However, this ambitious goal will require collaboration
between therapists, experts-by-experience and computational psychiatry researchers in order to form
testable predictions out of factors claimed to be important for therapy.
Dr Michael Moutoussis is interested in computational models of psychiatric disorders. Are the
sufferings and satisfactions of an unwell brain the phenomenal correlates of inappropriate computations?
Focusing this question well greatly benefits from clinical experience. Clinical relevance is thus
paramount. Within our very promising field of computational psychiatry it is crucial to delineate with
greater certainty which domains of normative information processing 'give way' in psychiatric disorders
and which are only peripherally involved. My clinical interests in psychosis, personality disorder and
'functional' bodily symptoms have inspired me to study how people perceive each other's mind as well as
their own body.
In terms of biography, I was born and raised in Athens, Greece. I studied Physics – my first love. I then
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018
16studied Medicine, physiology and psychiatric research methodology while carrying out early
mathematical modelling relevant to psychiatry. I earned specialist medical registration as a psychiatrist
in Psychotherapy. In my Ph.D. I carried out experimental (clinical-psychological) and computational
(temporal-difference and ideal bayesian observer) studies of paranoid delusions.
Plenary session
Culture shot
Ms Stephanie Guidera
Ms Stephanie Guidera is a young classical singer from Liverpool and is passionate about the life
changing interventions that Psychotherapists and Psychiatrists have brought to her life. Having
completed an intensive two year MBT based therapy programme, she is contributing to the innovative
development of Mersey Care Psychotherapy services and sits on recruitment panels for Mental health
staff. Stephanie is a member of the RCP Service User Fora and the Medical Psychotherapy Executive
group. She is also a proud patron of the Dyspraxia Foundation.
Early Intervention in Borderline Personality Disorder: a critical review of the HYPE
programme
Dr Tiago Gandra and Dr Amit Bhaduri
The term ‘borderline’ captures a loosely defined and heterogeneous group often associated with frequent
presentations to services and complex challenges regarding engagement and treatment. While the past
two decades have seen the emergence of psychological therapies tailored to this particular group, the
long journey to access specialized treatment can come at the cost of sustained damage to the relational
and vocational spheres of the patient’s lives, and sometimes with significant iatrogenic harm along the
way.
Early intervention in the area of personality disorders is a more recent development with its roots in the
Melbourne-based HYPE programme. Its mission is indicated prevention and early intervention in young
people aged between 15 and 25, presenting with features of Borderline Personality Disorder. The
service model relies on an integrated team approach which includes psychologically-informed case
management, individual psychological treatment (CAT) and psychologically-minded psychiatric care.
The speakers’ experience at the end of an extended clinical placement in HYPE will be the starting point
for a psychodynamically informed discussion surrounding the basic tenets of this service.
Dr Tiago Gandra is a dual trainee currently based at the Tavistock, where he is in the process of
completing his dual training programme in Adult Psychiatry and Medical Psychotherapy. He has a special
interest in psychoanalytic theory and practice and its applications in the field of personality disorders.
Tiago has recently returned from an Out of Programme Experience in Melbourne, where he worked in the
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018
17HYPE clinic at Orygen Youth Health.
After completing his training in adult psychiatry in north London, Dr Amit Bhaduri was recently
appointed as a consultant psychiatrist with the Norfolk Youth Service based in Norwich, working with
young people aged between 14 and 25.
His experience in a personality disorder service in Islington using Mentalisation-Based Therapy made him
wonder about whether some of his patients could have been better supported earlier in their lives. This
curiosity led him to Melbourne, where he worked at Orygen Youth Health for two years, in early
intervention programmes for borderline personality disorder, psychosis and those at-risk of developing
psychosis.
He is also halfway through his practitioner training in Cognitive Analytic Therapy.
Challenges in the psychotherapeutic treatment of perversion and violence
Dr Andrew Williams
Dr Andrew Williams is a Consultant Psychiatrist in Forensic Psychotherapy at the Portman Clinic, and
Head of Adult Complex Needs at the Tavistock and Portman NHS Foundation Trust. He is a
psychoanalyst, co-editor of ‘Forensic Group Psychotherapy: The Portman Clinic Approach’ and co-author
of ‘Assessing Risk: A Relational Approach’.
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018
18POSTER EXHIBITION
(Alphabetically by surname)
1. Towards Improving the Provision of Psychological Therapies: A Quality Improvement
Project with the Southwark and Central Integrated Psychological Therapy Team
Dr Karina Beinerte, Dr Jacob Krzanowski, Dr Lorraine Gordon, Dr Caroline McCurrie, Dr Barbara
Wood, South London and Maudsley NHS Trust
AIMS
The Single Point of Access (SPA) meeting serves as the gateway for patients referred to the borough
of Southwark’s provider of secondary psychological services the Southwark and Central Integrated
Psychological Therapy Team (S&C IPTT). Responding to the growing number of referrals the authors
examined how the S&C IPTT allocates its psychotherapeutic interventions. In clarifying this process
the aim was to better support the decision making of assessors and referrers with the hope that
these changes would improve the services provision of psychological treatments to a patient
demographic with a complex needs.
METHOD
Relevant components of the SPA’s role were formulated by collecting qualitative data from a baseline
assessment. Questionnaires were provided to all regular attendants of the SPA meeting. Answers
were summarised to identify central concerns and themes. Six domains needing improvement were
found leading to the proposition and planning of five specific interventions. Reassessment following
the implementation of changes will be examined at regular reviews in the future.
RESULTS
A number of significant changes were implemented in response to the themes identified. Several of
these changes involve changing the structure of the meeting to better support decision making
including extending its duration and allocating specific time for complicated referrals. In addition a
number of tools were developed including an adapted referral form better reflecting the decision
making process of the SPA. The most exciting developments included a visual framework allowing
the SPA to better navigate the variety of psychotherapeutic services across sectors as well as a
system which allowed for decision making and waiting list to be better informed by the service’s
capacity.
COMMENTS
Changes informed by this project are believed to have helped streamline referrals for and eventual
allocation of services provided by the S&C IPTT. It is felt that future regular review and application of
similar projects will allow for further and increasingly robust improvements.
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018
192. Psychological formulation for staff working on a Psychiatric Intensive Care Unit
Dr Charlotte Cliffe, Core Trainee, Camden and Islington NHS trust, St Pancras Hospital; Dr Aishani
Kanagasundrem, Foundation Doctor, Camden and Islington NHS trust, St Pancras Hospital; Dr
Juanita Isaacs, Clinical Psychologist, Camden and Islington NHS trust, St Pancras Hospital
Background: Mental health staff working on a Psychiatric Intensive Care Unit (PICU) often deal with
high levels of violence and challenging behaviours. As a result, staff may face difficulties in building
relationships with patients and formulating positive attitudes, particularly towards the more unwell
service users. Studies have looked at attitudes in mental health services towards general psychiatry
inpatients throughout the world, with similar reports that patients with disturbed behaviour may
foster negative attitudes. However, research has looked at whether psychological interventions for
the staff can improve these attitudes and relationships between staff and patients.
Aims: This pilot study tested the feasibility of introducing psychological formulation to a female PICU.
The aim was to determine whether psychological formulation would improve attitudes of staff and
their understanding of patients’ behaviours, when they are particularly challenging, in a PICU setting.
Method: We conducted pre and post surveys using the validated ATAMHs attitude scale before and
after formulation sessions delivered by a clinical psychologist. Higher scores on the ATAMHs
demonstrate more negative attitudes towards patients.
Results: Eighteen staff members were included in the pilot study, representing a variety of clinical
roles: junior doctors, support workers and mental health nurses. Scores demonstrated an
improvement of attitudes, using the ATAMHs scale, with a total decrease in 41 points, mean decrease
in 15 (from 78 to 63) using a Mann Whitney test p value=0.3.
Discussion: Although limited by low numbers and statistical non significance, this pilot demonstrates
an improvement in attitudes and stigma felt towards patients from staff. Further study is needed
with larger data sets, to determine the significance and importance of psychological formulation for
patients with challenging behaviour in a PICU setting.
3. Setting up a multi-disciplinary Balint group on an inpatient unit – the successes
Robert Freudenthal, Victoria Allan, Dimitrios Chartonas, Anneka John-Kamen, Rachel Gibbons
Affiliation: Barnet Enfield Haringey mental health NHS Trust
Aims
The inpatient eating disorders unit treats people who are significantly unwell with anorexia nervosa.
The clinical interactions on the ward can be challenging, however there can be limited reflective
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018
20space for the team. A Balint group was established in order to encourage reflective practice as a
means to further understanding of the patients and the team dynamics.
Methods
A multidisciplinary fortnightly Balint group for the inpatient team was set up. The group was
externally facilitated and followed the guidelines of the British Balint Society. During each session a
staff member would present a patient they had difficulty with, and the group would reflect about the
case, focusing on the emotional aspects of the clinician/patient relationship.
Participants completed a questionnaire at baseline in which they were asked about the most
challenging aspects of their interactions with patients, as well as a feedback questionnaire after six
months of attending the group. The facilitator also identified themes that came up repeatedly.
Results
22 participants completed the questionnaire at baseline, and 24 participants completed the
questionnaire after six months of attending the group. Some topics came up repeatedly in the
questionnaire responses, such as valuing the opportunity to listen to the views of others from
different professional disciplines, understanding that others have similar struggles and having
somewhere to discuss difficulties within the workplace.
The key themes identified by the facilitator included the anxieties raised in the team through the
close proximity to death on the unit, there being a feeling of battle between the staff and the patient,
and the sense that the patient’s individuality gets lost behind the illness.
Conclusion
The feedback from the themes that came up in the group, and from participants, suggest that the
multidisciplinary Balint group has been helpful for the team relationships. Through reflection on
difficult emotional and interpersonal processes, the Balint group process has both deepened the
understanding of the team of the psychological defences at play in how the team interacts, as well as
furthering the understanding of some of the patients’ difficulties on the eating disorder unit.
4. Service Evaluation of the Mentalisation Based Treatment Programme at St Bernard’s
Hospital
Dr Jeremy Greening
Aims: The 18 month MBT programme involves both weekly individual and group psychotherapy.
Patients join the programme following successful completion of a 10-week psychoeducation course.
Currently there are no inclusion or exclusion criteria. The aim of the project was to carry out a
service evaluation to assess the specific characteristics of the patient group. The results will inform
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018
21guidelines. This will help to improve waiting times and produce a more targeted service.
Methods: The names were collected of all the patients who were invited to the MBT course since it
started in 2013. Patients were excluded who did not start the MBT course or sufficient time had not
elapsed for enough follow up. The eighteen months of the MBT course plus six months either side
were studied. Twelve patients fulfilled these criteria. Data was then collected from the patients’
electronic notes.
Results: Ages were evenly divided (50% were 35 and under, and 50% 36 and over). 10 out of 12
(83.3%) of the cohort were women. Unemployment of the group was high (58.3%). Average length
of time in MBT was 15.9 months. 75% of patients completed the course. 75% of the patients had a
history of suicide attempts, self-harm or both. 83.3% reported a history of abuse or neglect. 41.6%
had a diagnosis of personality disorder (but only 8.3% had a diagnosis of EUPD). 58.3% have
received psychotherapy in the past. Non-Urgent contact with services in the six months prior to MBT
was 58.3%, during MBT was 33.3%, but then increased again to 50% in the six months following.
Conclusions: The majority of patients were able to complete the MBT course, which for this cohort is
impressive. The population appears to be relatively well chosen and at the more severe end of the
spectrum, though there is a low rate of EUPD diagnosis in cohort. Next step will be to introduce
guidelines for inclusion in the MBT group and then to re-assess.
5. Does talking about work place stresses reduce sickness and improve well-being?
Dr Geoffrey Ijomah, Consultant Forensic Psychiatrist with special interest in Medical Psychotherapy,
Pertemps Medical, Milton Keynes; Victoria Sleight, Art & Music Therapy and Chaplaincy & Spiritual
Care Teams Manager, Nottinghamshire Healthcare NHS foundation Trust; Deborah Fairlie, Drama
therapist and Counselling Psychologist, Cognitive Analytical and Integrative Psychotherapist,
Nottinghamshire Healthcare NHS foundation Trust.
BACKGROUND & AIMS
Reflective practice meetings are recommended for supporting the well-being of organisations and
mental health practitioners but few evaluations have been conducted.
This pilot study evaluates the outcome of introducing a forum to discuss the psychological and
emotional impact of providing patient care in a high secure hospital setting.
METHODS
A mixed methods observational study.
Participants; A team consisting of art therapists, music therapists, assistants and departmental
manager, n=8.
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018
22Intervention; Reflection on team relationships, re-organisations, organisational culture and the
emotional impact of work. Duration; 90 minutes, monthly using a group psychotherapy model.
OUTCOME MEASURES & ANALYSIS
Sickness records; Comparisons of Pre-treatment and Post-intervention levels of sickness absence.
CORE-OM (Clinical Outcomes in Routine Evaluation) at 3, 10 and 15 months post-intervention.
Semi-structured interviews and thematic analysis of the experience of reflective practice.
RESULTS
Statistically significant reductions in sickness absence days (Two sample t test p=0.034)
Staff wellbeing improved as the intervention was continued.
At interview the participants reported the experience of reflective practice meetings as being
beneficial and developing interpersonal learning, especially in improving understanding of others
roles, impact of behaviour on others and ability to talk directly rather than letting issues bubble
under the surface.
CONCLUSIONS/COMMENTS
Reflective practice meetings delivered in this way were associated with improvements in staff well-
being, team relationships and a reduction in sickness absence.
The treatment was cost effective in terms of costs saved through reducing staff sickness levels,
increased resilience and productivity in terms of adaptation to an increased workload.
Success of the initial evaluation led to the expansion and adoption of the model by the wider
department encompassing approximately 120 staff.
6. An Audit on Prescribing Practices for People with Personality Disorder Presented at
Local Personality Disorder Forums
Dr Justin Henry Kerr and Dr Neelima Reddi, Surrey and Borders Partnership NHS Foundation Trust
The aim of this audit was to investigate local prescribing practices against the practice standards
identified by the Prescribing Observatory for Mental Health-UK (POMH-UK).
Audit Standards:
1. There is a crisis plan in the clinical records
2. A clinician’s reasons for prescribing antipsychotic medication is documented in the clinical records
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018
23Treatment Targets:
1. Antipsychotics should not be prescribed for more than 4 weeks in the absence of a co-morbid
psychotic illness
2. Z-Hypnotics should not be prescribed for more than 4 weeks
3. Benzodiazepines should not be prescribed for more than 4 weeks
4. Medication prescribed for more than four weeks should be reviewed considering a) therapeutic
response b) possible adverse effects and c) be documented in the clinical records
Using a retrospective cohort design, an audit of 60 patients who were presented at local Trust
Personality Disorder Forums (PD Forums) was conducted. The most recent 15 patients presented at
each of the Trust’s 4 PD Forums were selected.
Data collection was performed by accessing electronic clinical records. A database was created using
Microsoft Excel based upon the POMH-UK Audit data collection form.
Results were compared to the POMH practice standards and previous results from the 2014 POMH-UK
re-audit
The results showed that 87% of patients had a crisis plan documented. 45% had rationale for
prescribing antipsychotics documented.
Regarding treatment targets, 42% of patients were prescribed antipsychotics, 17% were prescribed
Z-Hypnotics and 28% were prescribed benzodiazepines for more than four weeks respectively. 90%
of patients had a documented medication review at which 80% had therapeutic response considered,
27% adverse effects, and 62% adherence.
Compared to the Trust-wide 2014 re-audit there were lower or similar rates of prescribing. Fewer
patients had adequate documentation of crisis plans and reasons for prescribing antipsychotics.
Similar levels of documentation at medication review were observed compared to the National 2014
results. Following local discussion of the results a prospective re-audit will be conducted.
7. Developing a psychoeducational support group for parents receiving Mentalization-
Based-Therapy for Personality Disorder – challenges and learnings
Dr Marion Neffgen and Jill Gill, Southwest-London & St. George’s Mental Health NHS Trust
Aims
Parents receiving treatment for personality disorder can be considered at increased risk of
experiencing stress and difficulties with their parenting capacity and needing extra support. The aim
of this pilot was to develop a complementary group with a focus on psychoeducation and support for
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018
24parents receiving MBT within an NHS Complex Needs Service (CNS).
Methods
The group consisted of a psycho-educational part based on the MBT-informed Reflective-Parenting
model developed at Anna Freud Centre, and an unstructured support part. 20 patients with children
under 18, receiving MBT or Psychotherapy under CNS were invited to an information session and 12
fortnightly sessions of the “Parents-Support-Group”. Self-rating outcome measures, a feedback
questionnaire at the end and reflective notes from facilitators served to evaluate the pilot. Feedback
was also sought from those who dropped out.
Results
Engagement was difficult despite promising attendance at the information session; only 5 attended
the group regularly and 3 dropped out after attending between 1-5 sessions.
Challenges in group sessions included keeping the group focussed on the task and containing
members’ difficult emotions.
Several members reported gaining important insight into their own and their children’s behaviour and
emotions during conflicts and consequently tried out new behaviours with positive effects.
All who completed the feedback questionnaire reported finding the group a positive experience.
Conclusions
The group was welcomed as a positive addition to the service by CNS-staff and patients attending
the group but uptake and drop-outs were disappointing. Reasons for that need to be investigated.
Containing group dynamics was one of the main difficulties. Supervision both from a group therapy
and model specific perspective seem essential.
The Reflective-Parenting model was developed for the general population, so the approach needed to
be adapted for this client group. Further evaluation with larger sample and validation is needed.
Evaluation of outcomes was difficult because of small sample and questions over validity of measures
used with this patient group.
RCPsych Faculty of Medical Psychotherapy Annual Conference 2018
25You can also read
