Psychology in Integrated Care (PIC) service
The Psychology in Integrated Care (PIC) service is part of the Derbyshire Health Psychology Service. We provide support Clinical Psychology support to the DCHS Integrated Community Teams across Derbyshire for their work with complex patients through case discussion, reflective practice and training (see more information below). Our goal is to support the teams in delivering high-quality, psychologically informed care.
Please note:
- We do not offer psychological therapy to patients - this can be accessed via Derby and Derbyshire NHS Talking Therapies (NHS TT), Community Mental Health Teams, Health Psychology Service and others.
- We do not complete patient assessments e.g. capacity assessments.
- We are not a therapy service for staff (Resolve and Wellbeing are able to provide this).
- We do not provide crisis support.
- We are not a replacement for your usual supervision.
We prioritise support in the care of complex patients, reflective practice, and targeted training. However, we will aim to respond to informal one-off queries related to team culture, staff wellbeing or mental health and clinical uncertainties. This will typically involve a brief conversation followed by advice and signposting to other appropriate support services (e.g. Employee Relations, Organisational Development Group, Resolve, Wellbeing team or other staff support resources).
- Please contact us by email health.psychology@nhs.net and provide:
- Your name, contact details, role / job title, team and location (i.e. Details of the person making the request).
- Brief reason for request including main challenges and needs.
- Please mark your email For Attention Of the PIC team. We will be in contact to discuss the request and think with you about how we can help. Alternatively, you can get in contact by telephone 01246 515 520.
Support with Complex Patient work
We can support teams in managing patients with complex behavioural, mental health, or psychosocial needs where there is complexity which impacts on recovery, care and quality of life. For example we can help teams to:
- Consider the impact and support needs of a patient’s Mental Health (e.g. Depression, Anxiety, Trauma, Personality Disorder, Neurodiversity) in relation to their physical healthcare. This might include help to:
- Manage anxiety (e.g about medication, treatment, equipment, pain, appointments).
- Improve engagement (concordance with treatment / care plans, patient and care team relationships, self-management, trauma informed care)
- Improve service use (manage discharge difficulties, inappropriate use of services, frequent re-referrals, setting and holding boundaries, provide consistent care)
- Understand psychological aspects of specific conditions (e.g. wounds, diabetes, respiratory conditions, Functional Neurological Disorder)
Our support may include:
- Case discussion (with individual staff member or team.
- Joint visits (requires patient consent).
- Attendance at CST/CNS meetings.
- Advice and guidance to support psychologically informed care, treatment concordance, discharge planning, and mental health impact.
Develop a formulation (a shared understanding of the patient and their wider context bringing together the team’s experience and knowledge with psychological models and knowledge). The formulation may be used to support you in problem solving and identifying creative and alternative solutions to improve patient outcomes.
Support with problem solving (care and discharge planning, psychological ideas and techniques to help you in your work with your patient, signposting to appropriate services, especially where there is a mental health need)
Improve relationships (explore their different experiences of and with the same patient, to support holding clear boundaries and consistent care where there are factors which challenge this)
Help you feel more confident in your work (around capacity and unwise decisions, supporting self-management, having meaningful, whilst difficult, conversations with your patient)
Please contact us if you would like to discuss support for your work with a patient or with a common clinical theme.
Reflective spaces offer a safe, structured environment for teams to process the emotional and clinical challenges of their work. These sessions:
- Can be one-off (e.g. following a difficult incident or situation) or a short series of sessions to help embed learning or explore ongoing challenges
- Will be time-limited with a view to transitioning to self-facilitation
Reflective practice is especially valuable in high-pressure teams and teams who are struggling. It can help teams manage stress, reduce burnout, and improve cohesion.
Please contact us if you would like to discuss a Reflective Space for your team.
We can provide bespoke training to upskill staff in psychologically informed care.
A training request may be prompted by a common identified theme or to help a team build on and apply learning from other DCHS training (e.g. Quality Conversations, Suicide Awareness). Some examples of training we have delivered for teams include:
- Risk and capacity
- Mental health awareness
- Managing boundaries
- Care concordance and behaviour change
- Communication styles and strategies
- Psychological aspects of specific health conditions (e.g. wound care, FND, pain, diabetes)
Training will be prioritised for teams with the greatest need and aligned with clinical priorities.
Please contact us if you would like to discuss training for your team.
What is a Reflective Space?
In your roles within DCHS it is likely you will encounter unpredictable and challenging situations, times when you feel stuck, and experience strong emotional responses to your work.
A Reflective Space is an intentional pause, to think, talk about and make sense of our experiences, especially where challenges have arisen.
A Reflective Space can help you to understand your experiences at work.
It can provide an opportunity for learning from experience, a time to step back from events and experience, study their meaning, and draw conclusions.
As well as hearing about the experiences of others in the team, it can help us return to our roles with new insight and fresh perspectives.
Coming together as a team can allow us to feel more connected, buffering us against the emotional experiences we may come across within the caring profession.
Actions may arise from the Reflective Space, but the intention is as a place to reflect and learn rather than generating things to do.
Reflective Spaces should be set up in a way which supports participants to feel safe to talk about their own thoughts, feelings and experiences without fear of judgement or criticism.
Having clear rules, expectations and boundaries around confidentiality are important for this. Usually these would be discussed and agreed at the start of new Reflective Space.
Below are the basic ground rules that we would expect to be upheld. A group may also agree some additional rules of their own. It is a good idea to write these down and keep them safe for future reference.
Expectations
- Group members to listen respectfully to the contributions of others.
- If a reflective space takes place online, having cameras on, will help people feel listened to and understood by other people.
- Group members to ensure they are in a confidential space, where information shared in the group cannot be overheard by anyone not taking part in the group; this is important for both online and in person sessions.
- Group members come with a willingness to take an active part in the discussions.
- Everyone is responsible for what they feel comfortable to share within the group.
Confidentiality
- Group members should decide together what (if anything) to let managers know about.
- Group members may choose to share their own thoughts and experience of the reflective space with other people, but they should not give any details about information shared in the group by other members.
- Any information shared beyond the group should be done so from their own experience and in general terms or themes, so that it is not possible to identify any individual group member or person spoken about.
- To the support the flow of discussion between group members, they are not there as a presenter.
- They will not bring an agenda and will work with content arising in the space.
- They may support the group in thinking about any action to be taken forwards but would not usually be responsible for taking specific actions forwards as this may compromise their role as an independent person.
- Where a significant risk to self or others is raised a facilitator may escalate the issue and share the information appropriately to prevent harm. The facilitator would advise the group of this where possible.
- Online sessions should not be recorded to protect confidentiality.
- There is no requirement for any written record to be made.
- Where a decision to make a written record is made this should be agreed by the group for a clear purpose and confidential (anonymised and unidentifiable), describing themes rather than details, precise dates / times of the meetings should not be specified.
- The responsibility for any written record is best rotated among group members.
- Any written record should be destroyed after a year.