What are clinical practices? - Chapter 5

What are the economic costs of mental health problems?

At least 1 in 4 people in the UK experience a diagnosable problem each year. Mental health problems cost the economy around £105.2 billion in the UK each year. Apart from the fact that it can cause suffering for the people themselves, it is important that good care is available given the costs.

What about mental health professionals?

The general practitioner is often the first point of contact for mental health care. General practitioners can often already provide an initial assessment and, for example, prescribe medication. In addition, GPs can refer to more specialized care, depending on the problem. Community mental health nurses (CMHNs) or community psychiatric nurses (CPNs) are registered nurses who specialize in mental health issues and possess a range of skills.

When an individual is referred for a more detailed assessment, they often go to a psychiatrist or a clinical psychologist. A psychiatrist is a medical practitioner specializing in diagnosing and treating mental illness. A clinical psychologist are graduates in psychology and have had at least three years of intensive training after college to learn the skills necessary for clinical practice. In addition, they specialize in assessing and treating mental health issues.

In addition, counsellors, psychotherapists, occupational therapists, social workers, and licensed mental health professionals are involved in mental health care. Counsellors are trained in talk therapy, supporting clients in dealing with the issues in their lives. Psychotherapists are involved in treating mental health problems more through psychological means than medical means. Occupational therapists specialize in evaluating and (re)training skills used in daily life. Social workers specialize in the social needs of the client, such as housing. Licensed mental health professionals provide treatments to clients to help them cope with mental health issues in their daily lives. Often work is conducted in a multidisciplinary team (MDT), in which workers from all kinds of different disciplines participate who are specialized in different aspects of care.

What mental health services exist?

Most people with mental health problems can be treated on an outpatient basis, which means that these people can live in the community and receive treatment at a health centre, day clinic or larger general practice. However, some may require inpatient hospital care, meaning treatment is voluntary in a hospital. In addition to psychiatric hospitals, there are regional security units for people involuntary under the Mental Health Act, for people coming out of prison under the Mental Health Act and for people coming from a normal hospital because they need treatment in a safer environment.

How is mental health care organised?

The care must be structured so that the different skills of the professionals can focus on the different problems that exist. In the United Kingdom, care is currently organized around different groups, for example children and young people with physical and mental health problems and people with brain damage or neurological disabilities.

What is the recovery model?

Physical illnesses are easier to cure than mental health problems. The recovery model is a broad approach to treatment that recognizes the influence and importance of socio-economic status, work and education and social inclusion in helping to recover. It's a holistic approach. There are several key features of recovery:

• Heap
• A safe base
• Developing self-awareness
• Supportive relationships
• Empowerment and Inclusion
• Coping strategies;
• Phrase, developing a goal

What are the most important skills and competences of the psychologist?

The clinical work of a psychologist normally consists of four phases: assessment, formulation, intervention and evaluation. Assessment is the first stage of trying to understand a client's problems, what might be causing these problems and how they are maintained and how the client would like to change. Often this is followed by a diagnosis, which is a classification of the client's symptoms according to diagnostic criteria. Mainly, the clinical interview is used to obtain information in the assessment. This is followed by the formulation phase, in which clinical information is used to explain the client's problems and develop a plan for treatment. The third phase is the application of the intervention, a psychological treatment based on the formulation. This can be based on different theoretical approaches and in consultation with the client. Finally, evaluation is the phase in which it is examined whether a treatment has the desired effect. This can be done in discussion with the client or with the help of questionnaires.

What is the reflective practitioner model?

Despite the fact that not all clinical psychologists are happy with the scientist-practitioner label (because they use alternative philosophical approaches, for example), they are generally expected to use a reflective practitioner model in their work. This is a key competence in which one reflects on one's own experiences in working with a client and on the interaction with the client. The advantages of this are that it facilitates the development process to become an autonomous, qualified and self-managing professional, that it offers the opportunity to develop in the work and to reflect on the needs of each individual client and that it stimulates self-motivation and self-directed learning.

How does the regulation and continuing of professional development take place?

The Health and Care Professions Council (HCPC) is a body responsible since 2009 for regulating and maintaining a register of clinical psychologists in the UK, ensuring they meet specified standards of training, skills, behavior and health. This register also specifies that 'clinical psychologist' is a protected title, meaning that this title can only be used if the person has received appropriate training and is registered with a regulatory body relevant to the title. If a clinical psychologist is qualified to join the registry, he or she is expected to engage in continuing professional development (CPD) throughout their career: the commitment of licensed therapists to regularly update knowledge of recent advances in treatment techniques.

What does clinical psychologist training look like?

In the United Kingdom, the first requirement to become a clinical psychologist is to have completed a degree in psychology or equivalent study so that they are eligible for graduate basis for chartered membership (GBC) of the British Psychological Society. After obtaining this qualification, you can apply for a place in a clinical training course, which has high requirements to achieve. Good research skills are also an important quality. Applications for clinical training courses are regulated in the UK by the Clearing House of Postgraduate Courses in Clinical Psychology (CHPCCP).

Clinical training can be divided into three components:

1. Academic component: consists of learning all theory about psychological problems.
2. Clinical Internship Component: Consists of gaining experience working under supervision.
3. Research component: consists of developing research skills.