Doctorate in Clinical Psychology

University of Exeter

Adults Through the Lifespan Series

2014-15

Conveners

Carolyn Evans

Nadja Krohnert

Rationale

The purpose of this curriculum is to provide trainees with a theoretical context for the development of clinical skills necessary to work with adults throughout the lifespan, their families and carers. Both transient and long term psychological problems commonly experienced by adults in various settings and services will be considered. The focus will be on developing transferrable clinical skills in the areas of assessment and formulation of the psychological problems commonly found in adult services with a view to guiding and evaluating the appropriate interventions. These interventions include those routinely provided by clinical psychologists in individual, group and service contexts. This series will seek to develop the core competencies of clinical psychology, while also focusing on developing the knowledge and skills base to work with common psychological presentations of adults across the life span. Attention will be also given to the appropriate national context and policies relevant to this area and to the specific needs of adults who are particularly vulnerable due to age or health issues. However, some of this content will be covered in other series within the academic programme, e.g. Learning Disabilities, CBT, Health and other series.

In order to ensure that the curriculum is relevant and reflective of people’s experiences and aspirations for services for people with mental health difficulties, all teaching is encouraged in include the voice of lived experience. This may be through delivering, or co-delivering of taught session by people with lived experience or by other means.

This series is informed by the following professional guidelines

The Faculty for the Psychology of Older People (FPOP; formerly PSIGE) British Psychological Society.

Standards for Doctoral Programmes in Clinical Psychology Approved: May 2014. British Psychological Society.

Standards of Proficiency for Practitioner Psychologists. Health and Care Professions Council.

Good Practice Guide : Service User and Carer Involvement within Clinical Psychology Training. British Psychological Society

Intended Learning Outcomes

On completion of the series trainees –

  1. Will demonstrate an understanding of the various biopsychosocial processes that promote psychological wellbeing and/or contribute to the development of mental health problems of adults across the lifespan (GMC, PA).
  2. Will have an understanding of adults’ views of their mental health needs across the lifespan and of the services provided to them (GMC).
  3. Will have an understanding of how to assess, formulate, intervene in and evaluatecommon, complex and severe and enduring psychological presentations. These currently include; depression, anxiety (including OCD), PTSD, psychosis and personality disorders, dementia and long-term conditions (GMC, PA, PF, PI, E).
  4. Will also be aware of their own stereotypes, assumptions, values and beliefs about specific groups, e.g. older and vulnerable people and how these might influence their clinical practice within this specialty (GMC, PPSV).
  5. Will demonstrate an awareness of their ethical responsibilities in relation to adult work, especially with regard to the potential abuse of vulnerable people who may be frail or suffering from progressive conditions (GMC, PPSV).
  6. Will have an awareness of and a preparedness to develop skills in the use of neuropsychological assessment techniques with adults who have presenting problems such as dementia or stroke (GMC, PA).
  7. Will have the knowledge framework and skills to assess and manage risk of harm (GMC, PA).
  8. Will have considered the complex issues relating to report writing and the feedback of results to clients, carers, teams and referrers (GMC, CT, OSIL).
  9. Will have an understanding of complex clinical formulation from the perspective of different orientations and be able to consider/develop an appropriate intervention drawn from these orientations (GMC, PF).
  10. Will be able to demonstrate an awareness of issues relating to evidence-based practice within this speciality(GMC, E, R).
  11. Will have an awareness of priorities for services and the role of clinical psychologists in meeting the demands outlined in the national policy (GMC, CT, OSIL).
  12. Will have considered how a clinical psychologist can best work within those systems that tend to be oriented towards the medical model (GMC, PPSV, CT, OSIL).
  13. Will have explored the clinical psychologist’s role in developing new services for adults(GMC, CT, R, OSIL).
  14. Will have heightened awareness of the rapid political and organisational changes in services for adults nationally and have familiarity with key documents and initiatives (GMC, R, PPSV, CT, OSIL).
  15. Will have explored issues in the assessment and treatment of adults, especially in the light of the Mental Capacity Act (2005) and the Mental Health Act (1983, amended 2007) (GMC, PPSV, CT, OSIL).
  16. Will have given a deeper consideration to the existential and spiritual dimensions of working with adults (GMC, PPSV, CT, OSIL).
  17. Will develop and understanding of pharmacology including the use and abuse of prescription and illicit drugs (GMC).
  18. Will have explored the debates surrounding the validity of psychiatric diagnosis, particularly in the light of the publication of the DSM V in 2013 (GMC, PA, PF, PI, CT, OSIL).
  19. Will develop a deeper and more reflective understanding of how long term conditions, diminished quality of life, DNAR and end of life issues can impact on both professional and client groups (GMC, PA, PF, PI, E, R, PPSV, CT, OSIL).

Teaching/Learning Methods

Trainees will be expected to adopt an adult approach to learning, contributing from their existing knowledge and skills and acquiring new knowledge and skills through attendance at university lectures, locality-based study sessions (locality packs), through work on the problem based learning exercise and private study. A variety of teaching/learning opportunities will be offered including, lectures, small group working, and experiential learning exercises. Trainees will also be expected to undertake preparatory reading and complete learning projects for some teaching sessions. Core references will be provided prior to the course and additional references and handouts will be given for specific sessions.

Transferrable Skills

Trainees will continue to build upon their core therapeutic skills of creating alliances, gathering information, making a formulation, planning and carrying out an intervention, drawing the intervention to a close and evaluating the outcome. Trainees will also have the opportunity to refine more academic skills of literature searching, critical appraisal of journal articles and presentation of research findings to their peers. They may also have some opportunity for teaching their peers within the seminar series.

Course Content

Lectures:

  1. Wed 1st October: Introduction to Series (Carolyn Evans/Nadja Krohnert)
  1. Wed 1st October: Attachment in Childhood & implications for adult mental health (Helen Brotherton)
  1. Thu 2nd October : Introduction to Psychosis (Phil Self)
  1. Mon 6 October 2-5: Challenges and pleasures of working therapeutically with Older Adults: The Psychology of Ageing (Sompar Group,)
  1. Mon 13th October: Psychosis – working with individuals & families (Phil Self)
  1. Thur 23rd October: Recovery & medicines – (Elina Baker)
  1. Wed 29Oct:Neuropsychological Assessment and Rehabilitation of Dementia(Sompar Group)
  1. Thurs 30 Oct:Introduction to the Psychological Impact and Care of Long Term Medical Conditions across the Lifespan ( Carolyn Evans)
  1. Thurs 30 Oct:‘How do we know who we are?’ A relational understanding of meaning and development across the lifespan (Dr Jason Hepple)
  1. Mon 3 Nov 2-5pm: Behaviour that Challenges (Sompar Group)
  1. Mon 3rd Nov: Assessing and managing risk of suicide (Nadja Krohnert)
  1. Wed 5 Nov 9.15-12.15: ‘The Neurology and Neuropsychology of Stroke: Challenges of Suddenly Imposed Disability’.(Dr Adam Bevins)
  1. Thurs 13 Nov: Loss, Transition and End of Life/DNAR: Debates & Ethical Issues (Carolyn Evans).
  1. Thurs 13 Nov:Professor George Giarchi on ageing
  1. Mon 1st Dec: Childhood Trauma & Adult Mental Health (Gilli Watson)
  1. Mon 12 Jan: Working with Ethnic and Religious Difference (Kauser Ahmed)
  1. Mon 19th Jan: Working with Personality Disorder - (Sue Mizen)
  1. Tue 20th Jan: Sexual violence (Jo Bromley)
  1. Tue 20th Jan: Domestic violence(Jo Bromley)

Locality Packs (Self/Group Study in locality)

  1. Fri 10th October: Critical Approaches to psychosis and recovery(Elina Baker, locality pack)
  1. Fri 10th October: The DSM-5 debate and its implications (Lucy Johnstone – locality pack)
  1. Fri 14th Nov: ‘The Impact of Stroke in Adults of Working Age and Older People’ (Adam Bevins)
  1. Fri 14th Nov: Additional Older Adult reading:
  1. Mon 25th Nov: Understanding and formulating PTSD – (Nadja Krohnert, Anke Karl & Rachel Handley, locality pack)
  1. Mon 25th Nov: Childhood Abuse and Adult Distress (Gilli Watson, locality pack)
  1. Mon 5th Jan: Different approaches to working with Personality Disorder (locality pack)
  1. Tues 17th March:: ‘Older Adults in Residential Settings’(Carolyn Evans)

Assessment

1.Problem based learning (PBL) exercise. Trainees will be presented with a PBL derived from a learning disabilities context and will work on this task in small groups. Each group will present the results of the exercise, which is formatively assessed. Trainees will also submit an individual written summary of the exercise after further experience on placement, which is summatively assessed.

2.Clinical Practice Report. Trainees will submit a report of some aspect of clinical activity on placement following the guidelines set out in the Academic Handbook.

Core Text

Relevant reading and references are provided for each teaching session. Additional core text are:

*Bryden, C. (2005). Dancing with Dementia: My story of living positively with dementia, Jessica Kingsley.

Bender, M. (2001). Explorations in Dementia. London and Philadelphia, Jessica Kingsley.

Coleman, P.G. & O’Hanlon, A. (2004). Ageing and development. London: Arnold.

Cooper, M. (2003).Existential therapies.New York: Sage Publications

Doka, K. J. (2002). Living with Grief: loss in later life. Washington: Hospice Foundation of America.

Duffy, M. (Ed.)(1999).Handbook of counselling and psychotherapy with older adults. London: John Wiley

Marshall, J., Gurd, J. & Kischka, U. (Eds.) (2012)Handbook of clinical neuropsychology. Milton Keynes: O.U.P.

*Hepple J, Pearce, J. & Wilkinson;P. (2002)Psychological Therapies with Older People: Developing Treatments for Effective Practice.London: Routledge

Holden, U. (1995). Ageing, Neuropsychology and the New Dementias: definitions, explanations and practical approaches. London: Chapman & Hall.

James, O. (2008). Contented Dementia. Vermillion.

*Jetton, J, Haslam, C. & Haslam, A.(eds) (2011). The Social Cure. Psychology

Press.

Katz, J., Peace, S. & Spurr, S. (2012) Adult Lives: A life course perspective. Open University and Policy Press.

*Kitwood, T. M. (1997). Dementia Reconsidered. Buckingham: Oxford University Press.

Laidlaw K. (2003).Cognitive behaviour therapy with older people.London: John Wiley and Sons Ltd

Lezak, M. D. (1995). Neuropsychological Assessment (3rd Ed.). New York: Oxford.

Lishman, W. A. (2012). Lishman’s Organic Psychiatry: A textbook of neuropsychiatry (4th Ed.). Wiley-Blackwell.

McGowan, F. (1994). Living in the Labyrinth: a personal journey through the maze of Alzheimer’s Disease. New York: Delta.

Papadopoulos A. and La Fontaine, J. (2000). Elder Abuse: Therapeutic Perspectives in Practice. Winslow.

*Sheard, D. (2007 to 2009). Feelings Matter Most. Series of four books.

Sherman, B. (1999). Sex, Intimacy and Aged Care. Jessica Kingsley

Snowdon, D. (2001). Aging with Grace: The Nun Study and the science of old age. 4th Estate.

Walsh, D. (2006). Dementia Care Training Manual for Staff Working in Nursing and Residential Settings London: Jessica Kingsley

*Woods, R. T. (1996). Handbook of the Clinical Psychology of Ageing. Chichester: Wiley.

Yalom, I. D. (1980). Existential Psychotherapy. New York: Basic Books.

Preliminary Neuropsychology Reading List:

Lincoln, N.B., Kneebone, I.I. & MacNiven, J.A. (2012) Psychological management of stroke. Wiley: London.

Rohkamm, R (2004) Colour atlas of neurology. Thieme: Stuttgart.

Robinson, R.G. (2006) The clinical neuropsychiatry of stroke (2nd Ed) Cambridge University Press (0521840074)

Websites:

There are many good websites and here are a few to get you started:

  1. Dementia Advocacy and Support Network International

DASN International is an internet based support network established to:

Since its founding in 2000, DASNI has evolved as an international group of people with dementia. Approximately one-third of members have dementia themselves.

  1. National Dementia Strategy on the DoH website
  2. For a European dimension
  3. For an international dimension

Please reference according to APA guidelines at