Psychology in Healthcare What Psychology has meant for me… Prof. Ray Miller Clinical and Health...

Psychology in HealthcareWhat Psychology has meant for me…

Prof. Ray MillerClinical and Health Psychologist

Retired Professional Advisor for Psychology, NHS LothianPast President, The British Psychological Society

The making of a Psychologist

May 2013 Psychology in Healthcare

Prof. Ray Miller 2

Why Psychology?

“The greatest discovery of my generation is that human beings can alter their lives by altering their attitudes of mind.”

William James (1842-1910)

“I am not what happened to me, I am what I choose to become.”

Carl Jung (1875-1961)

“Man is not a rational animal, he is a rationalizing animal.”

Robert A Heinlein (1907-1988)


Prof. Ray Miller 3

Definitions

Psychology

The scientific study of mental and behavioural processes

Applied Psychology in Healthcare

The application of a knowledge of normal and abnormal mental and behavioural processes to issues of physical and mental health, well-being and health care delivery


Prof. Ray Miller 4

Our Health and Well Being Today

“The nature of health threats have changed dramatically; infectious disease now only accounts for 2% of deaths. Most people now die in old age and of non-communicable diseases such as circulatory (accounting for 34% of deaths), cancers (27%), and respiratory diseases (14%). Vast improvements in public health have meant that the biggest threats to our lives now are diseases that usually occur later in life. The onset of diseases that occur earlier in life are at least partly linked to the way we live our lives.”

(DoH - 2010 report)


Prof. Ray Miller 5

Europe

Mental illness is one of the top public health challenges in Europe as measured by prevalence, burden of disease and disability.

Across Europe, neuropsychiatric disorders are the second largest contributor to the burden of disease accounting for 19% of the total.

Mental disorders are by far the most significant of the chronic conditions affecting the population of Europe, accounting for just under 40% of all years lived with disability.

The prevalence of mental disorders does not appear to be changing significantly over time, though more people are accessing treatment and support…

(Mental Health Strategy for Scotland: 2012-2015)


Prof. Ray Miller 6

Causes of Dysfunction

Bio Medical Illness v Psychological Function Model


Prof. Ray Miller 7

Bio Psycho Social

Viruses Bacteria Lesions Genetics Senesence BioChemistry Neurology

Behaviour Emotions Beliefs Attitudes Coping Stress Pain

Class Education Employment Ethnicity Culture Sex/Gender Age

Biopsychosocial Model

Psychology Healthcare Objectives

Promote good health Prevent ill health Identify, assess and treat psychologically based

dysfunction Promote recovery and rehabilitation Promote and facilitate good psychological practice Promote and facilitate quality health care delivery Develop and research innovation in healthcare


Prof. Ray Miller 8

Context

Health Issues Health and Social Policy Healthy (and Unhealthy) Behaviours Public Health and Health Promotion Physical Health, Fitness and Well Being Mental Health, Fitness and Well Being Service Planning and Delivery Research and Development


Prof. Ray Miller 9

Scottish Policies (2007 & 2012)


Prof. Ray Miller 10

Scottish Health Surveys


Prof. Ray Miller 11

(http://www.scotland.gov.uk/Topics/Statistics/Browse/Health/scottish-health-survey/Publications)(http://www.scotpho.org.uk/publications/reports-and-papers/887-scotlands-mental-health-adults-2012)

WEMWBS(http://www.healthscotland.com/documents/1467.aspx)

12May 2013 Psychology in Healthcare

Prof. Ray Miller

Health Survey 2011

The first stage interview includes questions every year about: general health and long-term conditions mental health and wellbeing cardiovascular disease, hypertension and diabetes eating habits, including fruit and vegetable consumption smoking and drinking physical activity dental health demographic and other background details.Risk clustering

• The most common combination of risks is being overweight and not meeting the physical activity and fruit and vegetable recommendations (15% of adults in Scotland had these three risks). A further 10% had these three risks and also drank outwith the recommended limits.

• 44% of adults in Scotland drank outwith the recommended limits and had at least one of the other risks.


Prof. Ray Miller 13

Scotland's Ageing Population


Prof. Ray Miller 14

http://www.scottish.parliament.uk/S4_FinanceCommittee/Reports/fiR-13-02w.pdf

Common Mental Disorder

(England 2007)


Prof. Ray Miller 15

Common Mental Disorder

(England 2007)


Prof. Ray Miller 16

Cost of Mental Ill Health


Prof. Ray Miller 17

Demand for Psychology

England: “Improving Access to Psychological Therapies”

Scotland: “The Matrix”


Prof. Ray Miller 18

Psychologist Numbers

(http://www.isdscotland.org/Health-Topics/Workforce/Psychology/)


Prof. Ray Miller 19

Psychologists per 100,000 population

(Scotland 2012)


Prof. Ray Miller 20

What do they do?


Prof. Ray Miller 21

Who do they do it with?


Prof. Ray Miller 22

No Health without Psychological Health

Children and Education– Health Promoting Schools– Childhood obesity– Immunisation uptake– Parenting skills/ abuse and neglect

Workplace – Scotland’s Health at Work– Workplace stress– Work/Life balance and retirement– Absenteeism


Prof. Ray Miller 23


Lifestyle– Smoking– Alcohol– Exercise– Diet

Mental Health and Wellbeing – Mental Health & (In)Capacity Acts– Choose Life– Doing Well by People with Depression– Stigma (See Me)– Mental Health Recovery


Prof. Ray Miller 24


Physical Health– Cardiac rehabilitation– Diabetes– Sexual health– Chronic Illness and Rehabilitation

Social wellbeing – Social inclusion/ Fair for All– Public Health– Confidence and wellbeing– Anger and violence


Prof. Ray Miller 25

Service model

Consultancy and advice Training and development Support and supervision Direct and indirect intervention Research, monitoring and evaluation Skill mix service delivery Responsive to national and local needs and priorities Delivered within team approach to holistic healthcare


Prof. Ray Miller 26

Benefits

Health promotion/ prevention and lifestyle change

Early and proactive intervention

Individual formulation and care plan

Realistic treatment alternatives

Increased adherence and satisfaction

Recovery focus

Comprehensive healthcare


Prof. Ray Miller 27

Training and Competence

4 year honours degree + experience + 3 year doctoral level 7 to 10 years in total Skill + Knowledge + Practice + Review = Competence Basic interpersonal skills Assessment and Formulation Theoretical frameworks for intervention Supervised therapeutic practice Continuing professional development Personal development (reflective practitioner)


Prof. Ray Miller 28

Basic skills

Establishing & Maintaining Communication creating the environment active listening

verbal & non verbal cues genuinenessempathy respectconfidentiality trustagreement sharingpartnership exploringsetting boundaries networkingending

Within an ethical and professional code of practice


Prof. Ray Miller 29

Assessment

Intellectual: IQ, Mental Ability Cognitive: Memory, Perception,

Thinking, Processing Personality: Sociability, Stability, Traits Emotional State: Anxiety, Depression,

Attributions Functional: Behaviour, Skills,

Aptitudes, Strengths and Weaknesses


Prof. Ray Miller 30

Intervention (Therapy)

Presenting problems

Emotional problems: anxiety, depression, anger

Organic impairment and trauma

Behavioural problems: obsessions, phobias, habits

Relationship problems: social and sexual dysfunction

Addiction, dependency and self control

Coping with illness / injury and rehabilitation

Coping with living: stress, bereavement, disaster


Prof. Ray Miller 31

Intervention (Therapy)

Theoretical frameworks

Psychodynamic [Freud, Adler, Jung]

Counselling: Client Centred [Rodgers] / Skills Model [Egan]

Cognitive [Ellis, Kelly]

Behavioural and Cognitive–Behavioural (CBT) [Wolpe, Beck]

Cognitive Analytic Therapy (CAT) [Ryle]

Systemic [Minuchin]

Positive Psychology [Seligman] ACT, IPT, DBT, REBT, EMDR, Personal Construct, Solution

focussed, Problem Solving, Mindfulness, etc. Eclectic/ Integrative


Prof. Ray Miller 32

Therapy in practice

Enable clients to:

Access and use relevant information Identify aims and goals Decide on options for action Acquire appropriate skills Implement a course of action Review outcomes


Prof. Ray Miller 33

Successful therapy(John Teasedale)

A model (formulation) of the problem understood and accepted by the client

A model for the therapy understood and accepted by the client

Actual change in cognitions and behaviour Reinforcement in the “real world”

Change equation: reason + benefits > inertia + costs


Prof. Ray Miller 34


Prof. Ray Miller 35

Post QualificationRegistration

Protected titles

The titles below are protected by law. Anyone using one of these titles must be registered with the Health Professions Council, or they may be subject to prosecution and a fine of up to £5,000.

Practitioner psychologistRegistered psychologistClinical psychologistCounselling psychologistEducational psychologistForensic psychologistHealth psychologistOccupational psychologistSport and exercise psychologist

Personal and Professional Development

Supervision - external review of practice Establishing networks - support, onward referral Updating - refreshing the old Professional advances - acquiring the new Evidence based - efficacy and effectiveness Research - breaking new ground Personal awareness - reflective practice Personal therapy - physician heal thyself


Prof. Ray Miller 36

NHS Pay Scales


Prof. Ray Miller 37

Professional Body(www.bps.org.uk)


Prof. Ray Miller 38

What the BPS does

The British Psychological Society promotes excellence and ethical practice in the

science, education and practical applications of psychology.


Prof. Ray Miller 39

Key missions

be the learned society and professional body for the discipline

make psychology accessible to all

promote and advance the discipline

be the authoritative and public voice of psychology

determine and ensure the highest standards in all we do


Prof. Ray Miller 40

Achieved through

Supporting members’ careers and professional development

Providing information to the public

Increasing the awareness and influence of psychology in society

Raising standards of education, training and practice


Prof. Ray Miller 41

Undergraduate approved courses

Establishes, develops and maintains the standards of Psychology degrees in Higher Education through accreditation of courses:

– Course Content– Facilities (Labs/ Libraries)– Teaching standards– Staff/ Student ratio

Required for progress to professional psychology and registration


Prof. Ray Miller 42

Developing the profession

Organising conferences and events

Recognising excellence in the science and practice of psychology

Setting standards in psychological testing

Preserving and recognising the history of psychology

Publishing


Prof. Ray Miller 43

Publishing 11 academic journals

Monthly publication of The Psychologist (free to members)

BPS Blackwell book publishing partnership (Discounts)

Research and Occupational Digests

Specialist and regional newsletters

Consultation papers, advice and guidance


Prof. Ray Miller 44

Subscriber

For anyone who is interested in psychology but has no applicable qualifications or students who are not studying an approved undergraduate psychology course.

e-Subscriber £10 Subscriber £24


Prof. Ray Miller 45

http://www.bps.org.uk/what-we-do/benefits-belonging/membership/membership

For students As a Student Member you get: membership of Student Member Group (SMG)

The Psychologist magazine free every month

PsychTalk, a newsletter written by students

exclusive discounts (books, journals, conferences, events)

transfer to graduate membership free of charge

recognition of belonging to the professional body, with the chance to join member networks (make contacts/ friends)

access to a range of high street discounts and offers


Prof. Ray Miller 46

What is Psych-Talk?

www.bps.org.uk/smg/

Psych-Talk is the magazine for the Student Members of the British Psychological Society. Psych-Talk is written by students for students and contains loads of articles and information about studying psychology, careers in psychology and keeping you up to date with the Student Committee activities.

Contributing to Psych-TalkBeing published in Psych-Talk looks pretty impressive on your CV.


Prof. Ray Miller 47

Cost of student membership

See the video – what other students think: http://www.bps.org.uk/videos/members-explain-

benefits-belonging

Find out more and download application: http://www.bps.org.uk/what-we-do/membership/

student-member/student-member

Student Members £59.00 £55.00

Student Members not earning a taxable income

£24.00 £20.00

Core Subscriptions Non Direct Debit & Quarterly DD Payers Annual Direct Debit Payers


Prof. Ray Miller 48

And it doesn’t end there…

PsyPAG is a national organisation for all psychology

postgraduates based at UK Institutions. Funded by the Research Board of the British Psychological Society, PsyPAG is run on a voluntary basis by postgraduates for postgraduates.

Graduate member (MBPsS)– Becoming a Graduate Member of the Society is the

starting point to your career as a psychologist.– Also a great way to keep up with all psychology can

contribute to your career even if you are not employed as a psychologist.


Prof. Ray Miller 49

Free online Digests(fascinating updates and news

from the latest publications)

http://bps-research-digest.blogspot.co.uk/Emailed to you fortnightly

http://bps-occupational-digest.blogspot.co.uk/Emailed to you monthly


Prof. Ray Miller 50


Prof. Ray Miller 51

Join the future of Psychology

DCP (Clinical)

DECP (Education &

Child)

SDEP (Scottish

Education)

DOP (Occupational)

DFP (Forensic)

DoN (Neuropsychology)

DHP (Health)

DCoP (Counselling)

DARTP (Academic, Research

& Teaching)

DSEP (Sport & Exercise)

Special Groups Psychology & Social

Care Coaching Psychology


Prof. Ray Miller 52

BPS Membership

6,95211,843

24,604

43,764

48,950 49,678

05,000

10,00015,00020,00025,00030,00035,00040,00045,00050,000

1975 1985 1995 2005 2010 2012

BPS Growth in Members


Prof. Ray Miller 53

Scottish Branch

1,131

1,688

3,1203,475 3,527

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

1975 1989 1995 2005 2010 2012

Growth in Scottish Branch Members


Prof. Ray Miller 54

Your Professional Body

(www.bps.org.uk)

That’s All Folks…

55May 2013 Psychology in Healthcare

Prof. Ray Miller

Psychology in Healthcare What Psychology has meant for me… Prof. Ray Miller Clinical and Health...

Documents

Transcript of Psychology in Healthcare What Psychology has meant for me… Prof. Ray Miller Clinical and Health...