The Aspiring Psychologist Podcast - Developing Skills in Non-Invasive History Taking as an Aspiring Psychologist

Episode Date: January 17, 2022

Show Notes for The Aspiring Psychologist Podcast Episode: 6Developing Skills in Non-Invasive History Taking  Thank you for listening to the Aspiring Psychologist Podcast. Being able to run assessment and history taking sessions with your clients in a way which feels supportive and non-invasive is key. Here’s my toptips for how to do it from a position of curiosity and non-judgement. Highlights: Welcome: 00:30 Attunement: 02:00         Outcome Measures: 03:00Session Content & Structure: 05:00Non-Judgment: 09:00 The Person and their relationship to the difficulties: 11:30Being honest about the intrusion: 13:30 The Single session intervention: 14:00    Links: To check out The Clinical Psychologist Collective Book: https://amzn.to/3jOplx0To check out The Grief collective Book: https://amzn.to/3pmbz5tTo check out The Our Tricky Brain Kit: https://www.goodthinkingpsychology.co.uk/tricky-brainConnect on Socials:Facebook: https://www.facebook.com/GoodThinkingPsychologicalServicesInstagram: https://www.instagram.com/drmariannetrent/LinkedIn: www.linkedin.com/in/dr-marianne-trent-psychology Twitter: https://twitter.com/GoodThinkingPs1

Hi there, it's Marianne here. Before we dive into today's episode, I want to quickly let you know about something exciting that's happening right now. If you've ever wondered how to create income that works for you, rather than constantly trading your time for money, then you'll love the Race to Recurring Revenue Challenge with my business mentor, Lisa Johnson. This challenge is designed to help you build sustainable income streams. And whether you're an aspiring psychologist, a mental health professional, or in a completely different field, the principles can work for you.

There are also wonderful prizes to be won directly by Lisa herself. And if you join the challenge by my link, you can be in with a chance of winning a one-to-one hours coaching with me, Dr. Marianne Trent. Do you want to know more? Of course you do. Head to my link tree, Dr. Marianne Trent, or check out my social media channels, or send me a quick DM and I'll get you all the details. Right, let's get on with today's episode. If you're looking to become a psychologist, then let this be your guide. episode. With Dr. Marianne Trent and saying really lovely things about the podcast. Thank you for subscribing and sharing it with your network. It is so greatly appreciated. Today I'm going to be thinking with you about history taking

in a way that doesn't just feel like an onslaught and doesn't feel like it's just really hard work for you and really invasive for the client that you're spending time with. So yeah, let me see how well I can do this on an audio podcast. I feel like it might be a little bit better presented with a PowerPoint or a Canva or something, but I will try and use my very best describing ways for you. Now let's also just think about which discipline of psychology you are going to be striving for. I believe that good history taking is appropriate to all disciplines, be that clinical or counselling, forensic, health, counselling, education. You know, the world is your oyster but I think that really good history taking in a way that does feel human is so important. So I really like this question because it shows us the attunement

and being on board with how it feels for a client and this is absolutely something that I have gone through myself as well in my kind of metamorphosis, shall we say, as a developing clinician, because we're always developing. There's always better and different ways to do things. Every day is a school day and we're never going to be complete. You know, we can always change and adapt and grow and, you know know hear really great ways of doing things and think I am having that. Don't let that be daunting though because we do learn to to be good enough but you know when you work in this mental health field and you see practice that really connects with you it's okay to borrow that and to kind of bring that into your fold of the way that you work and the way

that you aspire to be with people. It might be just worth telling you that in my private practice, what I do in terms of outcome measures is I send those in advance of the appointment. I use a clinical note system called write up, but it might be that whichever organisation you work in, there's also some sort of electronic form giving capacity so it means you can send those questionnaires in advance and then have the person send them back to you before the appointment and why I like that because it allows me to screen for risk you know as a rudimentary measure and to look at you know look at getting those scored ahead of the session and my virtual assistant will pop them into a whizzy spreadsheet for me and it also automatically creates graphs so

at the assessment I can show these graphs to the person and we can talk them through together but maybe you know if it's at all possible in your job plan, even if there are paper questionnaires, whether you've perhaps got a junior member of the team who could phone the client in advance and do those questionnaires with the client so that you're using your time together with the client optimally. You know, people don't always attend appointments. You might have had a DNA and you'd have this data then that relates to the patient and they haven't shown up. But there's always ways for thinking about how you can get that data without you having to use your valuable clinical time with people to read those questionnaires. Because actually, that's what I hate. People don't like it very much either. I'm a skilled clinician and I'm sure you are too and actually it's just not good good use of my time or the client's time to have me read all those questions aloud but whether you know they might want to get there early to do those

questionnaires so maybe you can give them an earlier time but of course if the client is having to do those on that day then it might take them outside of their window of tolerance too so it's thinking about the best way of doing that but in terms of the actual session content for history taking and for initial assessments I'll take you through the approach that I use so I don't actually use pre-filled or pre-formatted forms. I like to go a bit old school. I like a bit of A3 paper. So I like to, for each client that I assess and each that I treat, I like to have this A3 piece of paper. And when I'm with them, I go through what gender they see themselves as. And so I draw the appropriate shape, either a circle or a square. And I think the non-binary shape is a diamond, but I might be wrong.

Let me know if I am. So I would draw that and I draw that in the middle of the page. I'd put their name and their age in the shape too. And I'd be thinking with them about people in their family so just looking really to draw a basic family tree and as I'm just doing that on my lap people are talking and at the beginning of the session I would explain to the client that I'm with that I'll be making some notes as we talk and it's just to help me remember because actually as a result of today I'm going

to be writing a report an assessment report and I want to make sure that I'm remembering it well enough but I'll be doing it in such a way that if you want to know what I'm writing at any point please do just let me know and I'm not writing big things I'm just writing notes to help me remember but please if you did want to ask at any point or you wondered what I was writing or why I'd written it I'm really okay with it being a transparent process so please do feel free to ask. So once I'm padding out my family tree I'm looking to work out if their parents are still alive, if they've got any siblings, if their grandparents are alive, if there have been any significant bereavements and who they feel closest to, if anyone. And also it's always really

important to ask about any pets or any really important friends or aunts or uncles, people that are kind of on their team, that feel like they're on their page. And people often don't expect you to be asking these questions and often asking about strengths too things that are going well in their lives and I'd usually follow the same pattern so the top left of my document would be my kind of problem focused section and it usually crops up in conversation I might say to them so you know what what brought you here today because I often don't know anything about clients before I meet them. And even when I was in the NHS service, I sometimes wouldn't want to read too much about clients. So I knew they'd been through the triage

process, and they were deemed as being likely to benefit from a psychology assessment. But I like to hear from clients at the time that the client tells me which could also I guess be a bit frustrating for clients too because they're like oh no I've already told someone all of this I was hoping you'd know already but yeah I think there is value in giving people the experience to tell you things themselves so I've been looking at the problems and also thinking about the goals goals would usually be top right for me what they're aiming to get out of therapy or treatment, what would feel useful and the strengths is between those two. So if we're looking at my piece of A3, we've got problems on the left, top right is goals and then next to goals I would have strengths,

next along from that to the left there'd be medication and also a column for self-soothing so that might be really adaptive things like going for a walk or some yoga or mindfulness or meditation but it might also include slightly less adaptive techniques like smoking alcohol or self-harm so whatever helps them get through each day currently but of course you know i'm exploring these in a way that feels non-judgmental so absolutely going with the stance that there's no judgment here and actually we understand these methods as just being able to get through each day the best we can with the resources we've got and on some days we might

have more resources or we might be better resourced than other days and just trying to explore with them really thinking about that window of tolerance and trying to think about ways we might be able to help them thicken and broaden that window of tolerance. Let's think some more about this assessment and history-taking after this brief advert. This book is a chance to be supported in grief And to learn how to support one another Over 50 stories written by those that are grieved They've been there too, so they know how you suffer It's the Grief Collective

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wanting to understand themselves or someone they care about. Thank you. Stories of life lost and learning to heal. The Grief Collective. Written by people who get how you feel. Okay, welcome back. So what we are doing is we're building up a picture of the difficulties that the person has had and then their relationship to those difficulties. I'd also have a section for thinking about previously tried, you know, therapies or psychology input. So if they've already had a year of counselling or 20 sessions of CBT, then I'll be putting that down as well. I'd also be asking them about their opinion for how it went and whether it's informed

their choice for a future therapy, you know, a future whatever we've got on, whatever you're assessing for. And I would also have a section for ideas. So as we're talking, I might scribble down an idea, for example, if I notice they're being really harsh on themselves, then I'd likely scribble down a CFT book or you know a group that we might have running so this is when I come to to summarize at the end of our session that I've already got you know my informed thinking about what I think might be a reasonable plan so that we're able to send them away with a plan that feels helpful. Of course risk is key but if you've covered the questionnaire and

the things beforehand then you'd have an idea of risk too but in terms of coping strategies risk often comes up too so this is you know I hope a useful approach for you and obviously you need to adhere to whatever your service is asking you to do. if you've got certain hoops then you're going to need to make sure you're jumping through those in regard to what questions and boxes need ticking and fulfilling whatever you've been asked to achieve you know for what your service is funded to to strive for so I think doing that sensitively and being transparent about that with the client is really helpful and the way that I would do that is I'm really sorry I know this can feel like a bit of a deluge of questions and it can I know people have told me it can feel a little bit intrusive but the way we're funded and the way that we have to keep our records means that I need to ask everybody the same questions.

And so that's how I'd handle it. But if you've got any other questions about how to do this, I'd be really happy to answer them. And to think with you again about the way we can do this in a way that feels like you're on the same page as the client and not kind of on an opposing team, not just like you're hiding behind a clipboard, because I think that can feel really challenging both for you and for the clients that you're working with. So it's just brought to mind for me something that we call the single session intervention. So I don't tend to do assessments just for assessment's sake, but I'd often use aspects from the Our Tricky Brain kit which you can find out more information about on my website or in the show notes to help clients to understand why they feel the way they feel and to think with them about useful stuff that they can take away

from the session. So I might teach them a breathing technique or think with them about the window of tolerance, stuff that they can actually you know leave our session feeling like they're in a better a stronger position than they were when they entered the building because often even to get to a psychology assessment you've already had to perhaps have a team assessment or some other kind of assessment from a triage service you might already have had a long wait and you might have an even longer wait to come or it might be that you don't actually meet the criteria for intervention so isn't it great that if you've got you know an ability to feel better from you know 60 to 90 minutes with someone that's a really special chance that we get with people to get it right so it might feel like

you've already said everything that feels pertinent. You might not want to be saying it all again. So whether you can use your history taking your assessment session to test out actually how able and capable they are to access the kind of stuff that you'd be having on offer when they actually started to receive the services from you or your service. So if you're trying to do loads of breathing with them or distress tolerance or mindfulness and they just can't do it they don't get it then actually it's maybe an indication that maybe your service isn't going to meet their needs in the way that might be optimal for them at this time so i hope this will be useful and if it is

please do rate and review and subscribe and I will look forward to catching up with you on our next podcast episode very soon take care of you if you're looking to become a psychologist then let this be your guide with this podcast at your side you'll be on your way to being qualified it's the aspiring psychologist with dr marianne my name's yana and i'm a trainee psychological well-being practitioner. I read the Clinical Psychologist Collective book. I found it really interesting about all the different stories

and how people got to become a clinical psychologist. It just amazed me how many different routes there are to get there and there's no perfect way to become one and this kind of filled me of confidence that no I'm not doing it wrong and put less pressure on myself. So if you're feeling a bit uneasy about becoming a clinical psychologist I definitely recommend this just to put yourself at ease and everything will be okay but trust me you will not put the book down once you start