The Aspiring Psychologist Podcast - How to understand and work with Risk as an Aspiring Psychologist

Starting point is 00:00:00 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,

Starting point is 00:00:32 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. I just wanted to start today's podcast episode by just giving you a little warning that it is going to cover risk. It's going to cover examples of how someone might pose a risk to

Starting point is 00:01:15 themselves or to others. If you might find this triggering, then please take my permission and give yourself permission to listen to this at a time where you feel more robust and able to um to engage with the con 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 Podcast with Dr. Marianne Trent. Hi, welcome along to the Aspiring Psychologist Podcast. Thank you for listening.

Starting point is 00:02:05 And I hope you will find today's episode really useful. This is another special request episode today. And you can make any special requests you might have for topics for the podcast by heading to my website, goodthinkingpsychology.co.uk forward slash podcast and then there at the top of the page is information for how you can submit any requests that you might have please do because I want this to be super useful for you and yeah I want this to be user led, as well as just being generated by me. Because, you know, knowing that you are recognizing that I might have some useful stuff to teach you, and you reaching out to me to ask, ask for me to teach it to you is just the most incredible

Starting point is 00:03:00 feeling. So yeah, thank you very much for all of the feedback that I've had and for continuing to listen. It means a great deal. Just a little caveat before we begin to let you know that the risk I will be talking about is when someone is discussing perhaps risk to themselves or someone else. But don't worry if you want some more tips on practical risk management, because that is coming up soon in an interview I'll be doing with a psychiatrist where we discuss how to kind of optimally prepare the environment and factors to consider about minimising risk to yourself, to colleagues and to clients too. It's also worth saying that when working with risk, it's really important to work collaboratively

Starting point is 00:03:53 with your multidisciplinary team and of course with psychiatry and with supervisors and anybody else you might have on board as part of your team. So do take my advice in conjunction with your own best practice guidelines. Okay, so no matter what area of psychology you are wanting to work in, it is likely that you will encounter risk and working with risk as you progress throughout your career. It's certainly something that crops up for me daily in clinical practice, even if just to discuss it, you know, whether it's a current thing for clients or not. Now, of course, when we're working in services, risk can look like risk to themselves. Risk can look like risk to others. It's not really the done thing to define a word by using the word, is it? So let me define risk without using the word risk okay so risk might

Starting point is 00:05:08 look like someone who wants to self-harm it might look like self-harm that is superficial it might look like self-harm that is more significant it might involve that they have you know perhaps a plan to end their own life you may also be party to information where they're saying that they want to harm someone else and that might be in a forensic service or it might be that you suspect that they are having some sort of psychotic episode or some sort of change. So it might be that people are in, you know, perfect lucid thought telling you that they think, you know, so and so is going to, you know, be hurt. And that, of course, is a significant event that needs to be recorded and needs to be handled with the client at the time. So yeah, you might handle that in a number of different ways. If you haven't already listened

Starting point is 00:06:14 to episode eight of the Aspiring Psychologist podcast, then it might be useful for you to do that either before listening to this episode or after. So episode eight is all about boundary setting as an aspiring psychologist. And in that I go through, you know, confidentiality and consent. And that is also really useful stuff to draw upon. So I'm not going to go over all of that content again, because I don't want to, you know, duplicate what I've already said, because you won't find that useful. But I will pay lip service to what I've said. But you might well find it helpful to listen to episode eight if you haven't already, because that is going to be a more full account of what we're talking about here with respect to confidentiality

Starting point is 00:07:08 and consent. So as you'll know, when we're working with people, we've already gone through our confidentiality and consent. And that is especially useful when you then get issues where risk is cropping up so if someone were to say that they you know wanted to hurt themselves or someone else then you will then obviously respond appropriately in the moment but also think with them about your you know your needing to keep themselves and others safe and that they're aware that you have that duty of care to do that you've got that clinical responsibility that you've got to look after everybody to keep them safe it's a big job guys it's a big job let's take a boat take a moment take a breath it is a big job and it matters and what you're doing matters um but we're here we're in the moment and the client has suggested that they want to to hurt themselves or someone else it can be useful useful to think about time frame. It can be useful. So if, for example, someone has said that they, you know, they've got a plan to end their own life, then it can be useful to think about, well, have you have you got a in mind for a particular time or a particular date and they might well tell you

Starting point is 00:08:46 or they might well not and when people are less wanting to share information then it's it's more worrying it can be more worrying obviously this is going to be a case-by-case example and you will definitely need to access supervision of your own about this so please don't just use this advice to formulate your plans but it can be in mind and especially if you're not yet in clinical practice it can be useful for you to think about what would I do what might I do how could I handle? So that's my little caveat. This is a guide, but you will obviously need to follow your own protocols and procedures and check in with your management and your supervisors. So someone has told you that they've got a plan.

Starting point is 00:09:41 They perhaps won't share with you what time frame it's going to be, but maybe they have shared with you the method and it's, you know, detailed enough that that feels worrying, you know, that feels scary. And it might be that if it involves harm to someone else that they've shared with you details about what that might involve and what kind of time frame that might take as well and you know it's it's tricky because you're going to be feeling all kinds of things going on you're going to be feeling you know pressure you're going to be feeling um you know, the importance and the significance of getting this right. When I was an aspiring psychologist, certainly sometimes when I was even working as a trainee psychologist,

Starting point is 00:10:35 if somebody told me that they wanted to end their life, then there might have been a tendency or a desire to run out of the room as soon as possible and kind of get psychiatry involved. But actually, we need to think about how that feels as a client communicating this painful information. And actually, what can be really useful is to work through with the client, you know, what they're thinking and what they're feeling, exploring a little bit about what might have contributed to the way they're feeling and why. Really try to help contain the person you're speaking to so that they feel like they have shared something with you that then feels safe it's not left them feeling over vulnerable or overstretched how you respond and when you respond and with what flavor and tone of compassion and warmth and empathy and positive regard really does matter. You know,

Starting point is 00:11:48 if we are to run out of the room when someone tells us something like that, then it might actually lead the client to feeling that their problems are too big to cope with, or that they it might lead to them feeling even more you know unsafe or you know less contained and when people are not contained you know what we know is that they're going to be acting from more from a point of you know the red area of their window of tolerance they're not going to be able to engage their soothing and calming thoughts. You know, they're going to be all out of whack. And, you know, logical thought with compassion on their side is not going to be, you know, firing. OK, so what we're wanting to do is we're wanting to help the client feel heard, seen, valid, important. We don't want to be running away.

Starting point is 00:12:48 We're going to break for a quick break here and I'll be back afterwards to talk with you more about how we can recognize and work with risk as aspiring psychologists. Thank you. It's right here in this book. It's the Clinical Psychologist Collective. It's the Clinical Psychologist Collective. Hi, I'm Max and I work as an assistant psychologist in the Learning Disability Service in West Yorkshire. Like most people working in psychology, I'm slowly but surely working myself up to that seemingly impossible goal of getting onto the clinical doctorate. With that end goal in mind, I thought I'd have a look at what's out there and see what books might be helpful for this. I came across Marianne's book The Clinical Psychologist Collective and decided that this would be a great buy for me to help me on my journey.

Starting point is 00:14:16 I found Marianne's book really informative and most insightful. I especially liked how the stories reassured me that you don't need to be academically perfect to become a psychologist and that as long as you have good interpersonal skills such as compassion and empathy you will get there. I would highly recommend this book to all aspiring psychologists and also those who want to know a bit more about the world of clinical psychology and maybe want to work in that field one day if you're looking to become a psychologist then let this be your guide filled with lessons and experience that will help you get qualified.

Starting point is 00:15:08 So come and take a look. It's right here in this book. It's the Clinical Psychologist Collective. It's the Clinical Psychologist Collective. Okay, welcome back. So before we broke, we were thinking about what risk is, what it might look like, what it might involve and how we can try to optimally respond. It's important that you are able to get information about what people are telling you because it might be that you need to communicate that accurately to other services as well. It might be that you are going to need to summon an ambulance or you are going to need to summon police um coast guard you know it might be that you need to call

Starting point is 00:16:13 the railways emergency line um is it transport police i think it's transport police but a quick google will reveal who the right people to contact are. I believe there's a specific telephone line for if someone has suggested that they are going to attempt to end their own life on the railway. And what I will do is I will try and dig that out and put that in the show notes for you. When I was working in the NHS, we were given like a little card to have on our keys, which gave the number, but it snapped off. And so I don't have it anymore. But there is a specific number that you can call. So I will try my best to get hold of that. Yeah, pop it in your diary because it might be really useful. So I have always, when working in clinical roles, at the front of my diary, I have had important numbers, including the crisis team, including Samaritans, including, you know, numbers such as, you know, transport police and, you know, any relevant people in your area that help in crisis situations, because it really could make the difference if you're having to scrabble around and look for a

Starting point is 00:17:35 number in a moment where actually there isn't much time. It's much better to be able to open up your diary, get to where you need to be and respond. So take a little bit of moments, especially if you're setting up a new diary for the year or you're setting up in a new role. You know, get a little bit of an idea of what do I do if the worst happens? What do I do if something happens that means I need to take immediate safeguarding actions? So it might be that you've got your local adult or child safeguarding contact details in your important phone number section. They would be very useful ones for you to have indeed. indeed so yeah a little bit of time in advance of when you're going to need this information

Starting point is 00:18:27 is absolutely time well spent in my opinion when we are getting to know clients it can be useful to think about screening for risk so there are of course specific screening measures that you can use i tend to when it's generic just use the core outcome measure because it does screen for risk and it will tell you whether someone is clinically significant for risk or not so that's a really useful place to start but of course things like the GAD7 and the PHQ9 they also screen a little bit for risk as well but yeah it's an idea to monitor risk so you know it can be useful to do before during and after measures so your before might happen at assessment your during might happen you know at the point that you start therapy or mid therapy and then depending on how long your intervention is you might want to repeat those measures as well and then obviously have measures

Starting point is 00:19:39 again at the close but what we'd be hoping for is that with whatever brilliant work that you and your team are doing, that their well-being improves, their problems decrease, their functioning gets better. And of course, their risk decreases. That is, you know, the gold standard for what I would think of as a piece of work well done indeed. And of course, you know, what we've covered in the boundary setting episode of the podcast is, well, what happens if it's only really after you have the session that you, you know, your cogs start whirring or you piece together something that you hadn't really picked up on in the session or you suddenly think well actually now I've discussed that with my supervisor that does feel a lot riskier than I felt it was at the

Starting point is 00:20:40 time you know what do we do then And it might be that you're needing to access safeguarding or refer to safeguarding or activate, you know, a keep safe plan without getting hold of the client if in fact you haven't been able to get hold of them. And if you haven't been able to get hold of them that's further evidence that we need to put our keep safe plan in place. Now most services that I'm aware of ought to have care plans so it's hopefully something that you're familiar with and it might be something that all of your multidisciplinary team feed into as well so there might be care planning elements from psychiatry there might be care planning elements from from a care coordinator or from you know occupational therapy for example and you might well be able to feed into that as well with any work that you've

Starting point is 00:21:38 been doing so care planning is where we are getting a sense of what might be useful and how we're going to achieve that. But elements of risk would be covered there as well. And in your individual trust or environment, there will likely be risk screening tools and risk screening measures that go into the care planning process. So I'm trying to think what the name of my clinical note software was called in the nhs it was either epex or lorenzo and i can't for the life of me i think it was epex the most recent one um it's only just under a year ago you know fallen straight out of my head or was it care notes i think it was care notes so yeah I think there's three different genesis's there of epex lorenzo and care notes and I've also used rio as well but these clinical notes systems will often have um you know ways to to specifically screen for and manage

Starting point is 00:22:41 risk so do check out your organizational practices as well but so to summarize you know what we've done in today's podcast episode is we've thought about risk to selves risk to others and ways to manage record and monitor that risk it's also useful to think about whether self-harm always means, you know, suicide. And when we're working with adolescent population and we're working with parents of adolescents, sometimes it can be helpful to just separate those two actions a little bit. So if you've got a young person who's cutting, for example, but cutting in a superficial way, then it doesn't always

Starting point is 00:23:25 necessarily equate that that client is suicidal so sometimes it can be useful to you know with the client's consent share that with the family you know actually the client the client has told me or you know you might you might I've sometimes fed that back with a young person in the room at the same time as their parent actually you know so and so is not suicidal they're not feeling suicidal but they are feeling you know a bit lost or a bit wobbly and they're finding that this helps them have some control at the moment and of course what we want to do is move towards being able to learn skills to you know ameliorate this distress you know so that they can have control in different ways so you know sometimes having that conversation with people can be useful and of course what we know is that people who do self-harm

Starting point is 00:24:19 are more likely to go on to have you know know, suicidal thoughts or intentions, but it's not always the case. So, you know, we can't be resting on our laurels here and guaranteeing that, you know, that someone is not going to become suicidal, but currently at the point of assessment, if that is indeed what you are assessing, it looks like there is no suicidal intent currently. Oh, people, this is big stuff, isn't it? This is important stuff. And you are out there doing this work or you will be in future. And it matters, you know, it matters to you, it matters to clients that you may be working with currently. It matters to clients who you may not even have met yet. It matters to clients who may be out there living their best life right now. But when they need you, you will be there and you will have that theory and practice ready to roll to help make that

Starting point is 00:25:29 difference and that is so incredible well done to you and thank you for listening to this episode I hope you find it useful like I said it was a special request so if you've got any special requests of your own, then do go and check out the podcast section of my website, goodthinkingpsychology.co.uk forward slash podcast to submit your special requests. I hope you find the upcoming information on the compassionate Q&A. You can watch, depending on when you're listening to this, you can definitely watch the first one and by the time this comes out you might well be able to watch the second one on replay as well

Starting point is 00:26:09 the easiest way to do that is by heading to good thinking psychological services on youtube whilst you're there be rude not to you might as well like and subscribe you know subscribe to the channel like all the, fling a few comments in. It would be so welcomed. Thank you for listening and I hope you find the content useful. I'll look forward to catching up with you next week. Don't forget that new episodes land at 6 a.m. on a Monday, UK time. So subscribe via podcast channels and that's when they'll drop into your podcast library or

Starting point is 00:26:46 just go searching for them at 6am on a Monday and be hot off the press. Take care, have a lovely day, whatever you're up to. And again, thank you for being part of my world. Thank you again for being part of my world and for listening right to the end we've just got a little bit coming up about the compassionate q and a series and then you can enjoy the jingle take care and like i said if you'd like to get involved with your own story for the aspiring psychologist collective then do check out the details in the show notes for how you can request more information. But if you head to my website, which is goodthinkingpsychology.co.uk

Starting point is 00:27:32 and then head to my books, there will be information there for you. Being well supported during any interview season is so important. I have therefore planned some compassionate question and answer support sessions for you. You are absolutely welcome to come along to all of them, some of them, none of them. No need to book and here are the dates for you monday the 28th of february from 7 30 p.m monday the 21st of march 7 30 p.m monday the 4th of april 7 30 p.m and monday the 9th of may 7 30 p.m and they will all be

Starting point is 00:28:20 live streaming via my socials which includes Twitter, YouTube, LinkedIn and Facebook so you can absolutely pick your favourite platform and they'll all be available on replay as well. Hope you find it so useful and I will look forward to catching up with some of you then. Take care. 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 Podcast

Starting point is 00:28:56 with Dr. Marianne Trent My name's Jana 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 with 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'd 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

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The Aspiring Psychologist Podcast - How to understand and work with Risk as an Aspiring Psychologist

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