Dr Deborah Christie Consultant Clinical Psychologist

Child and Adolescent Psychological Services

Medical Team

Multidisciplinary team meeting

Consultation with Psychology

Specialist psychology

SpecialistNeuro-

psychology

Individual therapy

Family Therapy

MDT work

Group Work

Ongoing Consultation

Local Services

Review

RheumatologyEndocrinologyOrthopaedicsMetabolic Surgery Urology HaematologyOncologyFatigueChronic Pain

Mysterious llness!

Chronic PainDiabetesHealthy Eating and Lifestyle Programme (HELP)Late effects of cancerNeuropsychology

Our starting point

• What has been

helpful before?

• What has not

been helpful?

• What could we do

differently?

Skills, Strengths and Abilities

Preferred futures? New stories? Goodenough?

Focusing on the solution

Bladder Exstrophy

• Feeling “normal but not “normal”

• Disclosure• Bullying

How bovvered are you?

• How Important is it that you change?

• How Confident are you that you could succeed?

• How much of a Priority is it?

1 2 3 4 5 6 7 8 9 10

Make the intervention fit the patient not the patient fit the intervention?

Low ConfidenceLow ImportanceLow/High Priority

High ConfidenceLow importanceLow/High Priority

Low ConfidenceHigh ImportanceLow/High Priority

High ConfidenceHigh ImportanceLow Priority

High ConfidenceHigh ImportanceHigh Priority

Advantages of Change

Disadvantagesof Status Quo

Ginger Rogers could do everything that Fred Astaire could do -

only she could do it backwards and in high heels!!!

Leading or following?