The Aspiring Psychologist Podcast - Using Outcome Measures as an Aspiring Psychologist

Episode Date: January 24, 2022

Show Notes for The Aspiring Psychologist Podcast Episode: 7Using Outcome Measures as an Aspiring Psychologist  Thank you for listening to the Aspiring Psychologist Podcast. Outcome measures are important and due to the way services are funded they are likely part of the day-to-day life of an aspiring psychologist. Here’s my run through of ways to use them and to optimise their use. Welcome & Intro to Outcome Measures: 00:30 How I gather data about myself: 02:00   Adult Mental Health: 03:30 Whizzy spreadsheet alert: 05:00The ACE scale: 06:30 Maslow’s Hierarchy: 07:30Yana: 09:00Self-Actualisation: 11:00Demonstrating Change using outcome measures: 14:30 Using self in therapy: 16:00Embracing data as a psychologist & Close: 18:00  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 SocialsFacebook: https://www.facebook.com/GoodThinkingPsychologicalServicesInstagram: https://www.instagram.com/drmariannetrent/LinkedIn: www.linkedin.com/in/dr-marianne-trent-psychology Twitter: https://twitter.com/GoodThinkingPs1

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If you're looking to become a psychologist, then let this be your guide. episode. With Dr. Mary Andrews Hi, welcome along to the Aspiring Psychologist podcast. Today we are going to be thinking about outcome measures. And in case you're not sure, outcome measures are questionnaires or ways of us gathering data about people to be able to use firstly as a baseline so we know where people are currently on their level of functioning and then secondly we might do them mid-intervention and then we might do them at the end of the intervention and if you're working in perhaps in an IAPT service you will be well versed in outcome measures because some services they ask clients to do outcome measures every single session and certainly when I worked in a CAM service, we also used to like to use outcome measures to see how well aligned the session was to the client's needs.

And I will level with you, that one could feel a little cringy, you know, asking, how was it for you? How did I do? And, you know, it's whether it's entirely valid, asking someone to your face, you know, how was I? So the way that I gather outcome data about myself as a clinician is that my virtual assistant, Hannah, tends to ask clients for me and then they email her. Just kind of puts a little bit more, I don't know, not confidentiality, because, of course, Hannah would know who had sent the feedback through. But it just feels like people can be, you know, honest um if things haven't met their needs ideally um you know so it just feels maybe slightly less I don't know narcissistic to ask Hannah to ask uh on my behalf you know how we're doing as a service um I know in a service I

previously worked in we used to have something called Feedback Wednesday which was every Wednesday anyone coming through the service was given a questionnaire by reception as they arrived and asked to kind of fill it out after their appointment and just drop it in a box and it could be anonymous if you wanted it to be and that's a really useful way of gathering data about services but in terms of what I do so I work in largely adult mental health I would say so the measures I use don't screen necessarily for things like psychosis and don't screen for you know memory. I'm looking at kind of depression, anxiety, you know, trauma, to come up with an idea of how someone is functioning, you know, whether their well-being is impacted upon, whether they have any risk to themselves or others and and you know how many problems they've got

really so that measure is nicely represented by the core CORE which is freely available so technically it's called the core OM so the core outcome measure and that's a series of 34 questions and um you know they cover all of those aspects functioning problems well-being and risk um and it covers like the last week um from when people are filling it in um and you know the options would be not at all only occasionally sometimes often or most or all of the time uh and some of the questions are negatively weighted so that they you know so that you are mixing it up a little bit and of course if you're asking someone about a positive thing um and they feel that most or all of the time then that would be like a zero score

whereas if it was something negative and the answer was most or all of the time, then that would be like a zero score. Whereas if it was something negative and the answer was most or all of the time, then that would be a score of four. So when I was an assistant, I designed a spreadsheet using Excel to automatically score this, which I still use and yeah some of my supervisors across the time have used it as well because they've liked it because they can be a little fiddly to score so the way that I've done it is that it just means that you pop in the answers you know your numerical answers 1 to 34 with either 0 1 2 3 or 4 and then it will automatically tell you whether things are clinically significant and if they are you know where their levels of you know impact are most keenly felt and they'll do some whizzy little graphs as well so yeah that's the kind of thing I used to get up to when I was you know when I was an aspiring clinical psychologist. So yeah, so they're a useful

measure. So I would do those along with the GAD-7, which is an anxiety measure, and the PHQ-9. I also quite like the ACE scale, which is the Adverse Child childhood experience scale. Now I often send all of my measures ahead of time through my clinical software called WriteUp so people can do them in the comfort of their own home before our first session but I actually don't send the ACE scale so if you're familiar with the ACE scale it's all about the first 18 years of life and covers trauma. And some of the questions, you know, they're not that nice. You know, it's about domestic violence. It's about sexual abuse. It's about physical violence and harm. And so I don't want to flood clients with that um and i think what i will do is i maybe will do a special podcast episode

on adverse childhood experiences and you know how they show up for our clients and how they can be indicated so i'll do that as a as a special feature um with perhaps some disclaimers about some of the stuff i'll be saying in it but I think that's probably going to be a better use of our time rather than just laboring the points on the eight scale here. So why do we monitor this information? Well primarily it's because we want to know like I said we want to know where clients are starting's because we want to know, like I said, we want to know where clients are starting. But also, we want to know that what we are doing, you know, the approaches that we said would be helpful, are in fact helpful. And if they're not making shifts, then it's a really good chance for us to see, you know, what the barriers are, what's getting in the way of those clients making

progress. And it might be that, you know, it can be really useful to look at Maslow's hierarchy. So I'll often look at that with clients when I'm thinking about formulation, just to get an idea of where they're at. So for those of you who are not familiar with Maslow's hierarchy it's a full title is the Maslow's hierarchy of needs and it's like a multi-colored pyramid with at the bottom the safety and risk needs you know emotional love needs and as it goes up and up and up the you know know, as it would with the pyramid, it gets smaller and smaller. And the bit right on top would be self-actualization. So, you know, what you might be doing now by listening to this podcast is self-actualization. Let's just use this

time now to have a short break, and I will be help you get qualified. 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 Hi, my name's Yana and I'm a trainee psychological wellbeing practitioner. I read the book, 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 will be okay but trust me you will not put the book down once you start. Filled with lessons and experience that will help you get qualified. 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. clinical psychologist collective hi welcome back so self-actualization um yes that is what we are doing now we are furthering our development needs which comes in the self-actualization category and you know if you were for example supporting a client who was trying to access you know a higher education course but they you know were sofa surfing or they were in a domestically

violent relationship or you know they didn't have enough money for food what you might well notice is that they would struggle to engage and pay attention and really benefit from that higher education course and in the same way if they've got all of those you know emotional turmoil needs but also you know physical safety and you know where am I going to sleep tonight that takes center stage and so any work with you to do kind of therapy or processing is just it's probably going to be set, you know, set up to fail. So it can mean that you're having slightly difficult conversations with people that now might not be the right time, which is really tricky because people are are like well i really like you you know i really trust you and i you know i want to i want to get better um and you're like i know i know you do um and you know you're really moved with their distress um but we're not necessarily

closing to all services you know in an ideal world we might be able to to refer to you know other relevant local services and that might be you know shelter for helping with homelessness or you know the local housing office crisis team or you know a refuge someone that helps with domestic violence you know because actually they've got more pressing needs and in terms of services with long waits it might be that you're able to you know come to an arrangement that once they can get themselves settled that your service won't won't make them wait for the lengthy wait again, you know, once they can get that stuff resolved, that because, you know, if their circumstances haven't changed significantly, since you last saw them, that they can sort of, you know,

monopoly style, pass go and collect their 200 pounds, if you what I mean so yeah that's all useful functions of outcome measures but another really nice function is when you're able to sit with a client and show them how far they've come and that makes you as a clinician feel pretty good as well. You know, you've taken someone from really struggling, you know, really not thriving, really finding every day, you know, challenging. You know, they might be really low in mood. They might be having ideas of life not being worth living they might be you know really struggling with their functioning and you know these things that you can't measure would be changes in facial expression changes in how engaged the person seems so we have this um you know concept called flat effect and that's when someone just doesn't really move their face much you know they're not they're not super expressive and you know to begin with people can be really

understandably problem focused and can seem a little trickier to engage and as the intervention starts to shift as their world starts to open up again, they become more interested in you as a person as well. So watch out for, you know, clients saying, well, how are you? You know, are you all right? Because they, you know, they like you, hopefully. That's why they're continuing to come back to sessions, either virtually or in person. You're a key part of the intervention so i'm absolutely on board with roger's uh principles about um you know us being our therapeutic relationship and ourselves being one of the most key parts of the intervention because if they don't like you they ain't coming back you know and so I absolutely think that a

human first interaction is the way to go and my training most definitely you know taught me more about using more of myself in therapy appropriately of course But I have done a psychodynamic placement within training, which meant that, you know, you very much play your cards close to your chest. But since qualifying, I really, you know, think I'm much more confident with being human, human and certainly discovering and exploring the compassion focused approach really helps me not only be my authentic self but um you know just be warm engaging and non-judgmental as well so it really helps me to bring those core you know aspects of the Rogerian theory into into my practice and you know I think when people meet me on the street um you know I'm not that different um in person I might shower my kids a bit less

how annoying children can be can't they um Especially at bedtime. I don't know if you've got kids but lately mine are pushing it a little bit at bedtime running into each other's bedrooms the little rogues. So yeah just because you're a psychologist it doesn't make you a wonder parent because no such thing exists. So yeah just to recap I do use outcome measures and when I've been in every service I've worked in I like a bit of data I like to be able to demonstrate that changes are happening some services of course you know once you've made those changes on the measures you are out you're out of there so it's useful to know the data but really i think we need to be in a position where we are embracing data as clinical psychologists we're not shying away from it

and with the you know the technological advances we've had lately it doesn't need to be paper heavy so you absolutely can find electronic ways of doing this and getting the data back to you and storing the data if it is obviously compliant with whatever your organizational policies are on that. I hope you found this useful. As ever, if you've got any questions about anything, just give me a shout and I'll look forward to catching up with you for our next episode very soon take care bye It's the Aspiring Psychologist Podcast with Dr. Marianne Trent. My name's Jana and I'm a trainee psychological wellbeing 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'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 start.