Disruptions from a Traumatic Event: A Clinical Vignette

The paper presents a clinical vignette regarding the psychological assessment of a seven years old boy, following a traumatic event, an accident with a bus that resulted in his grandfather’s death. We wish to illustrate how the administration of projective techniques, like the Rorschach, can reveal several manifestations of the impact that the traumatic event had on the chil

Stigma and treatment of eating disorders in Ireland: healthcare professionals' knowledge and attitudes

Objectives: This study examines aspects of health professionals’ knowledge and attitudes about eating disorders (EDs) , which might impede the effective detection or treatment of EDs in Ireland. Methods: 1,916 health professionals were invited to participate in a web-based survey. Participants were randomly allocated to view one of five vignettes depicting a young person with symptoms consistent with Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, Depression or Type 1 Diabetes. Study-specific questions examined participants’ responses to the vignettes and ED knowledge and experience

How are junior doctors managing patients with self-limiting illnesses at their first presentation? A video vignette study

Purpose: To conduct a video vignette survey of medical students and doctors investigating test ordering for patients presenting with self-limiting or minor illness. Methods: Participants were shown six video vignettes of common self-limiting illnesses and invited to devise investigation and management plans for the patients’ current presentation. The number of tests ordered was compared with those recommended by an expert panel. A Theory of Planned Behaviour Questionnaire explored participants’ beliefs and attitudes about ordering tests in the context of self-limiting illness. Results: Participants (n=61) were recruited from across Australia. All participants ordered at least one test that was not recommended by the experts in most cases. Presentations that focused mainly on symptoms (eg, in cases with bowel habit disturbance and fatigue) resulted in more tests being ordered. A test not recommended by experts was ordered on 54.9% of occasions. With regard to attitudes to test ordering, junior doctors were strongly influenced by social norms. The number of questionable tests ordered in this survey of 366 consultations has a projected cost of $17 000. Conclusions: This study suggests that there is some evidence of questionable test ordering by these participants with significant implications for costs to the health system. Further research is needed to explore the extent and reasons for test ordering by junior doctors across a range of clinical settings

The identification and psychological treatment of panic disorder in adolescents: a survey of CAMHS clinicians

Background Panic disorder is experienced by around 1% of adolescents, and has a significant impact on social and academic functioning. Preliminary evidence supports the effectiveness of panic disorder specific treatment in adolescents with panic disorder, however panic disorder may be overlooked in adolescents due to overlapping symptoms with other anxiety disorders and other difficulties being more noticeable to others. The aim of this study was to establish what training National Health Service (NHS) Child and Adolescent Mental Health Services (CAMHS) clinicians have received in psychological therapies and panic disorder and how they identify and treat panic disorder in adolescents. Method CAMHS clinicians from a range of professions (n = 427), who were delivering psychological treatments to children and adolescents with anxiety disorders, participated. They completed a cross-sectional, online survey, including a vignette describing an adolescent with panic disorder, and were asked to identify the main diagnosis or presenting problem. Results Less than half the clinicians (48.6%) identified panic disorder or panic symptoms as the main presenting problem from the vignette. The majority of clinicians suggested CBT would be their treatment approach. However, few identified an evidence-based treatment protocol for working with young people with panic disorder. Almost half the sample had received no training in cognitive behaviour therapy (CBT) and around a fifth had received no training in delivering psychological treatments. Conclusions Only half of CAMHS clinicians identified panic disorder from a vignette and although CBT treatments are widely offered, only a minority of adolescents with panic disorder are receiving treatments developed for, and evaluated with young people with panic disorder. There is a vital need for clinician training, the use of tools that aid identification and the implementation of evidence-based treatments within CAMHS

The hardest part is knowing I will survive: The use of music and creative mediums to enhance empathy and facilitate life-long distance learning in professionally qualified clinicians

© Redfame Publishing Inc.Music is an experience that can cross personal and professional domains alongside cultural, gender, age and generational boundaries; it can also enhance the learning process through emotional processing and connection. This paper focuses on the learning experience of qualified clinical psychologists (CPs) working in the United Kingdom. This group of CPs had experience of undertaking experiential learning and reflective writing during their professional training. It considers the potential to continue a learning process, 3 years post qualification, through long distance methods using vignette-based material. Empathising with, and understanding, the position of others from differing backgrounds is an important competency within the therapeutic work of CPs and this comes alongside acknowledging and understanding ones‟ own experiences, both past and present. CPs work with difficult life experiences and complex issues; connecting constantly can be exhausting and, perhaps, unrealistic. Yet, to truly empathise one must connect with, and understand, the lived experiences of others. We will consider what helps and hinders this process, and how music and other creative mediums can be effectively used in learning even via long distance methods. We will further consider how CPs may be well placed to enhance the learning about, and processing of, difficult emotional experiences for themselves, other clinicians and the people they might work with.Peer reviewe

You have come by way of sorrow: enhancing empathy in clinicians by using personal experiences to construct professional learning materials

© The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).You have come by way of sorrow You have come by way of tears But you’ll reach your destiny Meant to find you all these years “By way of sorrow” by Julie Miller Professional clinicians experience and manage life too, so can we use subsequent learning to enhance our and others’ professional work?Peer reviewedFinal Published versio

Eating disorder literacy and stigmatising attitudes towards anorexia, bulimia and binge eating disorder among adolescents

Little research has investigated adolescents’ understanding of eating disorders (EDs) or attitudes towards people affected by EDs. This impedes the development of targeted health promotion interventions. In the current study, 290 adolescents viewed a vignette depicting a target with either Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, Depression or Type 1 Diabetes. Subsequent questionnaires assessed understanding of and attitudes towards the disorder described . Adolescents recognised the symptoms of depression significantly more frequently than any ED. Relative to depression and Type 1 diabetes, participants held targets with EDs more personally responsible for their illness and ascribed them more negative personality characteristics. The data revealed a particularly unfavourable view of Binge Eating Disorder, which was conceptualised as a failure of self-discipline rather than a medical condition. The results confirm previous findings that EDs are more stigmatised than other mental or physical health conditions and extend the findings to an adolescent cohort

Narrative vignettes and online enquiry in researching therapist accounts of practice with children in schools : an analysis of the methodology

This article reviews a research methodology which uses a qualitative, narrative approach to online, in-depth analysis of vignettes. The research sought to investigate the ways in which dramatherapists, based in different countries, understood the nature of therapeutic change in their work with children. The article describes the approach to the generation of data through the internet by a combination of vignettes, aMSN messenger and email. It reports on the approach taken to the analysis of data with samples from the findings. Participants kept a diary of their response to the research and the article draws on this within its analysis of the methodology

Are lay people good at recognising the symptoms of schizophrenia?

©2013 Erritty, Wydell. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.This article has been made available through the Brunel Open Access Publishing Fund.Aim: The aim of this study was to explore the general public’s perception of schizophrenia symptoms and the need to seekhelp for symptoms. The recognition (or ‘labelling’) of schizophrenia symptoms, help-seeking behaviours and public awareness of schizophrenia have been suggested as potentially important factors relating to untreated psychosis. Method: Participants were asked to rate to what extent they believe vignettes describing classic symptoms (positive and negative) of schizophrenia indicate mental illness. They were also asked if the individuals depicted in the vignettes required help or treatment and asked to suggest what kind of help or treatment. Results: Only three positive symptoms (i.e., Hallucinatory behaviour, Unusual thought content and Suspiciousness) of schizophrenia were reasonably well perceived (above 70%) as indicating mental illness more than the other positive or negative symptoms. Even when the participants recognised that the symptoms indicated mental illness, not everyone recommended professional help. Conclusion: There may be a need to improve public awareness of schizophrenia and psychosis symptoms, particularly regarding an awareness of the importance of early intervention for psychosis

Teaching Graduate Trainees How to Manage Client Anger: a Comparison of Three Types of Training

The authors examined the effects of three types of training (supervisor-facilitated training, self-training, biblio-training) on 62 graduate student therapists\u27 state anxiety, self-efficacy for dealing with anger, and helping skills (i.e., reflections and immediacy) in response to videotaped vignettes of angry clients. Training overall was rated as very helpful, and trainees increased in self-efficacy for working with client anger. Supervisor-facilitated training was rated as more helpful than, and was preferred to, self-training and biblio-training; it also led to more reflection of feelings in response to clients. Results suggest that vignettes such as these might be a helpful adjunct to training once students have competency in the basic helping skills