Advance Notice: Annual StakeholderOpen Meeting, Sept 8th 2011

Welcome to the 10th edition of the NWCPP newsletter. This edition includes details of our forthcoming Open Meeting, news of an exciting logo design competition, an interview with Rebecca Williams about her training experiences in Hull, details of an award-­winning therapeutic community in Flint-­

an update on the research activity of the Programme Team. Once again, huge thanks for the many positive comments about the Newsletter, and a further call for any ideas for fu-­ture articles to be sent to me at Bangor.

Robert Jones -­ Newsletter Editor

Plans are well advanced for our Annual Open Meeting which will be held on Thursday September 8th 2011. Our guest speaker will be Pam Skinner who will deliver a pres-­entation on "Leadership and the Future of Clinical Psychology”. The day will also in-­clude research presentations by the 3rd year Trainees. It should be an interesting and stimulating day so keep the day clear in your diaries. Further details via e-­mail nearer the time.

In search of a logo.....The NWCPP does not have a unique logo that distinguishes it as separate from Bangor University and from the School

very proud of the very close ties with the School of Psychology at Bangor, and have proudly used both logos in the banner on

to date, we also feel we should have a separate, distinguishing logo of our own.

We have therefore opened a “Logo com-­petition” and are looking for individuals to submit a logo design to the Programme by Friday 26th August 2011. The winning entry will receive a bottle of champagne and the logo will be formally adopted at the Open Meeting on Sept 8th.

Further details from Robert Jones at the Programme (r.s.jones@bangor.ac.uk).

Judith Roberts

Rachel Herrick

Kirsten Hayston

Helen Aslett

Rose Murphy

Naomi Simcock

Currently on placement withKim Moore, Rose previouslyworked as an IAPT practitionerand in a medium secure unitin Bristol.

Currently on placement withEleri Jones, Judith previouslyworked on a PhD exploringawareness in mild cognitiveimpairment and as an assistantin LD services.

Currently on placement withRenee Rickard and KeithMathews, Bethan previouslyworked as a Health Psychologyresearcher.

Currently on placement withCarolien Lamers, Helenpreviously worked as aresearch officer at Bangorinvestigating the needs ofcaregivers of newly diagnosedcancer patients.

Currently on placement withAndy Muse, Naomi previouslyworked as an assistant workingwith looked after children andtraining their carers inTreatment Foster Care.

Currently on placement withKaren Kemish, Rachelpreviously worked as anassistant in LD, Older Adultsand Child Services.

Currently on placement withIan James and Kim Moore,Anna previously worked for avoluntary organisationcoordinating and delivering aproject supporting 16-25 yearolds with mental healthproblems.

The ten members of the 2010 cohort joined theprogramme on the 1st of October and began theirplacements in November so we thought it wouldbe nice to get to know them a bit.....

Welcome to the First Year Cohort

Anna Ripley

Bethan Henderson

Joanne Fullerton Megan Marks

Currently on placement withBob Woods, Joanne previouslyworked in LD services inNorthern Ireland.

Currently on placement withLouise Cunliffe and JoanneKelly-Rhind, Megan previouslyworked as an assistent witha CAMHS team in Ysbyty GlanClwyd and with a youth workproject in Wrexham.

Currently on placement withKaren Addy, Kirsten previouslyworked as an assistant in LD,Older Adults, AMH and PainServices.

Jean Ruddle reports on an

award-­winning Therapeutic

Community that meets weekly

in Flintshire

In the 1997 NHS document, ‘Personality Disorder: No longer a diagnosis of exclusion’, it was stated that ‘In many services people with personality disorder are treated at the margins – through A&E, through inappropriate admissions to inpatient psychiatric wards, on the caseloads of community team sta! who are likely to prioritise the needs of other clients and may lack the skills to work with them’. "is is at best - whereas at worst, these clients have been actively excluded from services. With the abolition of the ‘treatability test’ services now have a duty to provide a service for clients who present with these di#culties.

Although this document is over 10 years old, things have been slow to change. Since 2007, I have been involved in the setting up of services for adults with personality problems in Flintshire and, over the last 18 months, I have been involved in the First Day "era-peutic Community (TC) for Wales – ‘Taith’ in Wrex-ham.

Contrary to the idea that TCs are new approach, they pre-date the NHS as a model of working. In the 1960s Robert Rapoport described the three fundamental beliefs held by sta! in a TC, these are: 1. Everything is treatment2. All treatment is rehabilitation3. All patients should get the same treatment

In 1999 Haigh described the $ve universal qualities of a modern day TC as:

1. Attachment – a culture of belonging which reconstructs a secure attachment from which changes in deeply ingrained patterns of relating can be brought about.

2. Containment – a culture of safety where child-hood feelings of pain, rage & despair can be re-expe-rienced and expressed without criticism or rejection, but at the same time within the boundaries of what constitutes permissible behaviour. "is is achieved through the use of rules & boundaries.

3. Communication – a culture of openness-made possible by attachment & containment– where members feel listened to. It also allows a sense of opportunity for enquiry and a sense of freedom with possible change.

4. Involvement – a culture of participation & citizenship in which everything that happens in the community can be used for therapeutic e!ect.

5. Agency – a culture of empowerment, based on the idea that the greatest therapeutic impact comes from the work the individual does rather than a therapist. Within limits, responsibility for everything that happens in the group is shared by all group members. "ere is no assumption that the sta! views are more valid than anyone else’s – the idea of a ‘%attened hierarchy’.

Taith is a group which meets every Monday at Glyndwr University. "ere are $ve sta! members: three quali$ed sta! and two ex-service user consult-ants. "e ex-service users are vital in ‘bridging the gap’ between sta! and service users and challeng-ing the ‘what would you know?’ dynamic that o&en occurs with this client group. "ey also bring their own knowledge of services and represent ‘healthy’ role models to group members. As well as this, they will challenge the quali$ed sta! if they think we’re overstepping our boundaries!

"e model of service user involvement and ex-service users on the sta! team was instrumental in Taith winning the 2010 NHS Wales award for ‘Citi-zens at the heart of service design and delivery’.

At the award ceremony the judges stated: “"e "erapeutic Community Day Service was particu-larly impressive as it is truly led by citizens, who decided on the design, the process, their roles and who gave each other incredible support in a mental health area where services are like a desert.”

All decisions are made by the group through a pro-cess of voting and each member – be they sta! or service user, gets one vote. When voting on a deci-sion, people either vote for, against, or abstain. As there is a maximum of 12 places in the group, the service users will always out-number the sta!. Deci-sions can be anything from whether to extend the lunch break to whether or not to discharge a mem-ber for breaking the rules.

Prospective members meet with the group then opt in to attend a selection meeting. "ere are no one-to-one sessions with sta!, and decisions about who joins the group are also collectively made by the group. "is is about helping empower people to take on responsibility and live with the consequences of their decisions. "e day is run to a strict timetable and there are rules to keep the group safe. All jobs – be they vote counter, timekeeper or chair of the day – are done by group members not sta!, and there is an expectation that everyone will eventually partake in all of the roles – these are rotated every six weeks through a process of elections. "e day is broken up into a series of groups and always starts with sta! supervision and then a business meeting.

Following this there is a therapeutic space where individuals can work with each other on their spe-ci#c problems: feedback from peers being the most di$cult and valuable part of the space. "e a%er-noon group might include an information meeting, a selection meeting, elections or invited speaker, and the #nal space is an ‘a%ergroup’ where indi-viduals are encouraged to talk about anything that’s a!ected them during the day – to try and leave it there. Individuals can stay in the service for a maximum of 18 months – we had our #rst ‘gradu-ate’ of the service just before Christmas last year.

My personal experience working in Taith is that its like nothing else I’ve done previously, and the only way to understand it, is to see and experience it in action. With this in mind, and within the philoso-phy of the model, visitors are welcome to spend the day with the group (providing the group votes on it), so I invite any interested individuals, to e-mail the visitor co-ordinator at taithgroup@googlemail.com with a request.

Jean Ruddle

Jean Ruddle (continued)

CITIZENS AT THE CENTRE OF SERVICE REDESIGN AND DELIVERY

Robert Jones interviews

Rebecca Williams on her

recollections about training

on the Hull Programme

In previous newsletters we have

looked at different routes that people

in the area have followed in order to

-­

gists. In this edition, we caught up

with Dr Rebecca Williams. Rebecca is

with the Specialist Childrens’ Servic-­

Health Board. Rob Jones asked her a

series of questions about training on

-­

wanted to work in the LD special-­

ism?

Rebecca Williams (continued 2/3)

Placement three was in Adult LD in Hull –

there are intellectual and emotional rea-­

sons why I felt like I had come home. I

had a supervisor who was trained in Ge-­

stalt therapy and psychodynamic therapy

and she was fantastic, and really got me

thinking, making sure that with every cli-­

ent I used a different psychological model

-­

tidisciplinary team and I just felt like this

was my client group. I guess I am quite

blunt and prefer visual ways of working

like my limitations could be an advantage

working with people with LD. The work

was so varied and I met many clients who

had unbearable things happen to them, or

unbearable lives, and I felt I could really

make a difference by hearing them and

their stories, and helping them to speak up

and speak out.

My fourth placement was a specialist

placement in a Children’s Disability service

-­

ibly varied and I had an excellent supervi-­

sor. I ran a couple of groups for parents

and kids, did a lot of assessment work and

worked with a really diverse population (a

lot of Muslim women) which was a new ex-­

perience for me, coming from North Wales.

-­

apy placement in Adult LD – back to the

previous LD supervisor, where I took on

individual clients for therapy and ran a

therapeutic group for adults with LD. This

was a tough placement, working mostly

with people who had suffered abuse, and

again I just felt that this was where I was

best suited, where I could really make a

difference to people’s lives.

I think the real reason I ended up in LD is

because the sense of not being heard and

not being able to speak that I got from the

people I worked with, was one that was

familiar to me from my own life.

But all the other things (the variety, my

own weaknesses becoming strengths,

you need to have in adapting things to

suit people’s needs) are also exciting and

interesting.

Rob: After these experiences, what did it feel like coming back to North Wales to live and work?

It was great for me coming back to North

Wales – I missed the mountains so much

and as you know most of my life outside

of work revolves around them.

Coming to work in a mainly behavioural

department was interesting – I think

initially people thought I had some funny

ideas! It was also a challenge for me to

use my Welsh, which I hadn’t really spo-­

ken much for 8 yrs, and to begin working

therapeutically with people in Welsh –

that part wasn’t too bad, but sometimes

attending meetings in social services re-­

ally stretched my limited vocabulary!

Rebecca Williams (continued 3/3)

I’ve been really lucky over the last ten years to work in some great multi-­agency teams, which is something that is very important to me, and I think North Wales has so many people in LD who really want to collaborate and make things better for people with LD. I haven’t regretted mov-­ing back once!

Rob: I’m interested in comparisons

between your training experiences in

Hull and with what happens in North

Wales.

Bangor and Hull were pretty similar in many ways. Both were small courses with intakes of about eight people and so a nice feel to them. I think the main differ-­ences were in the academic side of things. In Hull, it felt like there was a lot of as-­

year;; there was a lot more observation, videoing and presentations – for feedback from staff and from your peers. For ex-­ample, you had to submit an audio-­tape of a therapy session for each of the core placements which was marked by a course team member and your supervisor, as well as client satisfaction measures, in addition to the equivalent of an RCA and feedback from your supervisor.

We also had case presentations and re-­search presentations every Thursday for all three years, which everyone took turns doing – all the course team would be there, and you would be marked on your performance, but most daunting were the

years!

The presentations were a good way of learning about what was actually hap-­pening in different placements and you often learnt about new techniques (e.g. sculpts, etc.) from your peers.

Obviously no one likes being observed, but I learnt so much from these exer-­cises that, again, I wouldn’t have been without them, and I think it gives you a

certain standard.

We also began our large-­scale research -­

pleted two small-­scale projects – we weren’t much encouraged to consider qualitative research (but I love a chal-­lenge!). However I think the format of the thesis write up in Bangor is much better as you are ready to publish.

Other than that, it’s hard to say there are advantages or disadvantages to either course. The original Hull format of go-­ing through from degree to doctorate with hindsight wouldn’t have suited me, I think I needed the few years out I had before the degree and between the two gave me a chance to explore other parts

that’s an individual thing. A lot of people on the Hull course were older, but about half had come straight through from A-­

were 24, and they have made excellent clinicians – I guess it depends on how ready you are to enter the profession.

Rob: Many thanks Rebecca

In the last year the Programme Team continued their impressive tradition of cutting-­edge research. This article lists the publications by team mem-­bers that have appeared since 2010.

Aguirre, E., Spector, A., Hoe, J., Russell, I. T., Knapp, M., Woods, R. T., & Orrell, M. (2010). Maintenance Cognitive Stimulation Therapy (CST) for dementia: A single-­blind, multi-­cen-­tre, randomized controlled trial of Maintenance CST vs. CST for dementia (Study Protocol). Trials, 11, 46.

Blacher, J., Glidden, L. M., & Hastings, R. (2010). Families research: No longer mono-­chromatic. Journal of Applied Research in Intellectual Disabilities, 23, 1-­2.

Clare, L., Woods, R. T., Whitaker, R., Wilson, B. A., & Downs, M. (2010). Development of an awareness-­based intervention to enhance quality of life in severe dementia: trial plat-­form (Study Protocol). Trials, 11, 73.

Crane, R., Kuyken, W., Hastings, R. P., Roth-­well, N., & Williams, J. M. G. (2010). Training teachers to deliver mindfulness-­based inter-­ventions: Learning from the UK experience. Mindfulness, 1, 74-­86.

Daley, D., & Birchwood, J. (2010). ADHD and academic performance: Why does ADHD im-­pact on academic performance and what can be done to support ADHD children in the class-­room? Child Care, Health & Development, 36, 455-­464.

*Doody, M. A., Hastings, R. P., O’Neill, S., & Grey, I. M. (2010). Sibling relationships in adults who have siblings with or without intel-­lectual disabilities. Research in Developmental Disabilities, 31, 224-­231.

Eames, C., Daley, D. Hutchings, J., Whitaker C.J., Hughes, C., Jones, K., Hughes, K & By-­water, T. (2010). The impact of group leaders behaviour on parents acquisition of key par-­enting skills during parent training. Behaviour Research and Therapy, 48, 1221 -­1226.

* indicates publication with a clinical trainee

Eldevik, S. Hastings, R. P., Hughes, J. C., Jahr, E., Eikeseth, S., & Cross, S. (2010). Us-­ing individual participant data to extend the evidence base for Intensive Behavioral Inter-­vention for children with autism. American Journal on Intellectual and Developmental

Disabilities, 115, 381-­405.

Eldevik, S., Jahr, E., Eikeseth, S., Hastings, R. P., & Hughes, J. C. (2010). Cognitive and adaptive behavior outcomes of behavioral intervention for young children with intel-­lectual disability. , 34, 16-­34.

Grey, I., Pollard, J., McClean, B., MacAuley, N., & Hastings, R. (2010). Prevalence of psy-­chiatric diagnoses and challenging behaviors in a community-­based population of adults with intellectual disability. Journal of Mental Health Research in Intellectual Disabilities, 3, 210-­222.

Hill, C. (2010). Using matched groups to ex-­plore child behavior problems and maternal well-­being in children with Down syndrome and autism. Journal of Autism and Develop-­mental Disorders, 40, 610-­619.

R.P. (in press). “Someone might have a PhD in autism;; they will never have the under-­standing of someone whose had 37 years of it”. Support experiences and future support needs of individuals with Asperger syndrome in middle adulthood. Autism.

-­alas. M., Oliver, C., Howlin, P., Moss, J., Petty, J., & Tunnicliffe, P. (in press). ‘You have to sit and explain it all, and explain yourself’. Mothers’ experiences of support services for their offspring with a rare genetic intellec-­tual disability syndrome. Journal of Genetic Counseling.

-­

Journal of Intel-­

lectual Disability Research

-­

Journal of Intellectual and Developmental Dis-­

ability

Journal of Applied Research in Intellectual Dis-­

abilities

-­-­

British Journal of

Learning Disabilities

Disability

and Society

-­-­

Psychology, Learning

and Teaching

British Journal of

Healthcare Management

-­ British Journal of Healthcare

Management

European Journal of

Behavior Analysis

-­Insights on Learning Disability

-­

Psychological Therapies for

Adults with Intellectual Disabilities

Psychology of

Sexualites Review

-­Journal of Child and Family Studies

-­

-­

Journal of

Applied Research in Intellectual Disabilities

-­

School Psychology

International

International Journal of Geriatric Psychiatry

-­-­

Research in Developmental Disabilities

-­International Psy-­

chogeriatrics

-­

Non-­pharmacological Therapies in De-­

mentia

Noone, S. J., & Hastings, R. P. (2010). Using acceptance and mindfulness-­based workshops with support staff caring for adults with intel-­lectual disabilities. Mindfulness, 1, 67-­73.

Olazaran, J., Reisberg, B., Clare, L., Cruz, I., Pena-­Casanova, J., del Ser, T., Woods, B., Beck, C., Auer, S., Lai, C., Spector, A., Fazio, S., Bond, J., Kivipelto, M., Brodaty, H., Rojo, J.M., Collins, H., Teri, L., Mittelman, M., Or-­rell, M., Feldman, H.H. & Muniz, R. (2010). Non-­pharmacological therapies in Alzheimer’s

De-­

mentia and Geriatric Cognitive Disorders, 30, 161-­178.

Pownall, J., Jahoda, A., & Hastings, R. P. (in press). Sexual understanding and develop-­ment of young people with intellectual dis-­abilities: Mothers’ perspectives of within-­family context. American Journal on Intellectual and Developmental Disabilities.

Quinn, C., Clare, L., & Woods, R. (2010). The impact of motivations and meanings on the wellbeing of caregivers of people with demen-­tia: a systematic review. International Psycho-­geriatrics, 22(1), 43 -­ 55.

Reilly, D. E., Huws, J. C., Hastings, R. P., & Vaughan, F. L. (2010). The life and death of a child with Down syndrome and a congenital heart condition: The experiences of six cou-­ples. Intellectual and Developmental Disabili-­ties, 48, 403-­416.

Totsika, V., Felce, D., Kerr, M., & Hastings, R. P. (2010). Behavior problems, psychiatric symp-­toms, and quality of life for older adults with intellectual disability with and without autism. Journal of Autism and Developmental Disor-­

ders, 40, 1171-­1178.

Totsika, V., Hastings, R.P., Emerson, E., Lan-­caster, G.A., & Berridge, D.M. (2011). A population-­based investigation of behavioural and emotional problems and maternal men-­tal health: Associations with autism spectrum disorder and intellectual disability. Journal of Child Psychology and Psychiatry, 52, 91-­99.

Totsika, V., Toogood, S., Hastings, R. P., & Mc-­Carthy, J. (2010). The effect of Active Support Interactive Training on the daily lives of adults with an intellectual disability. Journal of Ap-­plied Research in Intellectual Disabilities, 23, 112-­121.

Totsika, V., Toogood, S., Hastings R.P., & Mc-­Carthy, J. (2010). The effect of Active Sup-­port Interactive Training on the daily lives of adults with an intellectual disability. Journal of Applied Research in Intellectual Disabili-­

ties, 23, 112-­121.

Tzanakaki, P., Grindle, C. F., Hastings, R. P., Hughes, J. C., Kovshoff, H., & Remington, B. (in press). How and why do parents choose Early Intensive Behavioral Intervention for their young child with Autism? Education and Training in Developmental Disabilities.

Williams, C., Daley, D., Burnside, E., Ham-­mond-­Rowley, S. (2010). Does item overlap account for the relationship between trait emotional intelligence and psychopathology in preadolescents? Personality and Individual Differences, 48, 867-­871.

Williams, R. W., Roberts, G. W., Irvine, F. E., & Hastings, R. P. (in press). Exploring deci-­sion making in intellectual disability nursing practice: A qualitative study. Journal of Intel-­lectual Disabilities.

Windle, G., Hughes, D., Linck, P., Russell, I., Woods, B. (2010). Is exercise effective in promoting mental well-­being in older age? A systematic review. Ageing & Mental Health, 14 (6), 652-­669.

Windle, G., Woods, R.T., Markland, D.A. (in press). Living with ill-­health in older age: the role of a resilient personality. Journal of Happiness Studies.

Woods, B. & Laidlaw, K. (2010). Editorial: Cultural issues: introduction to special sec-­tion. Aging & Mental Health, 14, 245-­246.

Woods, B. (2010). National Dementia Plan – Wales (Commentary). International Journal of Geriatric Psychiatry, 25, 923-­924.