Sunday 29 April 2012

UK Psychologist working in Australia

UK Psychologist working in Australia - tips I wished someone shared with me

Before I moved to Australia some people were unsure if I could practice as a psychologist in Australia having trained in the UK. The good news is, yes you can. The not so good news is, it requires a lot of patience and money!

Below is the process required to practice as a psychologist in Australia and a few tips that I wish someone would have shared with me before I arrived.

Stage 1. Assessment of Psychology Qualifications:
The first form to complete is the Assessment of Psychology Qualifications which is carried out by the Australian Psychological Society (APS): http://www.psychology.org.au/Assets/Files/Assessment-of-Quals-Migration-form.pdf
This is an 8 page form which requires certified* copies of:

  • certificates
  • academic transcripts
  • evidence of your thesis (title page, abstract and contents page)
  • registration with HPC and membership with bodies such as the BPS
*Certified copies means someone signs that it is the true copy of an original. This can include people like a notary public or Justice of the Peace (this can be a rather expensive exercise if they charge per document and I needed at least 12 documents signed). Alternatively you can obtain a ‘statutory declaration’ from the Police Station. I’m not sure if the Police offer this service in the UK, but in Australia you can go to the Police station and ask for a ‘stat dec.’ and they do it for free.

Question j) of the form requires you to think back to your training years and provide information on the following:

What was the name of the practice/institution where the compulsory practical experience/supervised internship was undertaken?
What was your role?
Provide details of your supervisor(s) including name(s), profession(s) and academic credentials(s).
How many clients did you work with?
What were the start and end dates for your compulsory practical experience?
How many hours per week did you attend your compulsory practical experience?
What was the total number of hours you attended your compulsory practical experience?
How many hours of face-to-face supervision did you receive?

Tips:

  • I had lost my academic transcripts but the UK universities were more than happy to post me a copy free of charge.
  • The APS require copies of your undergraduate and masters/doctorate thesis, but just the title page, abstract and contents page. I did my undergraduate degree nearly a decade ago but luckily my parents still had a copy of it in the attic! You also need to remember the name of your supervisor.
  • Once you have compiled all this information the APS inform you it will take up to 8 weeks. In my case it took 6 weeks.
  • This will cost you $920 for the privilege.

Stage 2. Applying to become a member of the Australian Psychological Society (APS):
The next process is to become a member of the APS. This is a much shorter application form, and I suggest you apply soon after your qualifications have been recognised because they still have all your original documents.

  • Membership costs $505 and this include a variety of benefits such as: online CPD logging system (their website is pretty good), access to journals, online CPD, etc.

I have to say that my overall experience with the APS has been very positive, when you call the staff at the APS they have been very helpful.

Stage 3. Applying to the Australian Health Practitioner Regulation Agency (AHPRA):
Just when you thought it was over, you pretty much have to go through the first stage all over again. You are required to fill in the AGEN-76 form: (http://www.psychologyboard.gov.au/Standards-and-Guidelines/Forms.aspx)
  • Start filling in this form while you are waiting for stage 1, so once you get the go ahead from the APS, you can immediately send this off however you cannot apply to AHPRA until you have completed stage 1.
  • AHPRA have harsher rules than the APS. Transcripts have to come directly from Universities in the UK. They do not accept copies, and want to see a postmark from the UK. This can take up to 2 week to request the university to do this, and of course the time it takes to post a letter from the UK to Australia.
  • You will also need to ask HPC to write a letter to confirm you are a psychologist of ‘good standing’. HPC were more than happy to do this for me and did not charge for the service.
  • This whole process will set you back $827 and will take at least 8 weeks to complete once they receive your form. I called up a week after I had posted my form and they claimed they had not received it yet, so factor in another week and a half between you posting it and AHPRA ‘receiving it’.

Other Stages:
There are other stages to go through, but they are not compulsory (i.e. obtaining a Medicare Number - only if you work for a private practice, and the ‘APS Find a Psychologist Service’) but I’ll write a blog post about this another time.  

Summary:
I have found the whole process to be frustrating, tedious, and rather expensive. Patience is the key, and taking lots of deep breaths! I appreciate this process needs to be thorough to maintain the integrity of our profession, however I found the process of obtaining registration with APHRA identical to the initial process of applying to the APS. Why the duplication? It’s a shame they cannot join forces to streamline the process since they require the same information.

I have spoken to Australian colleagues who trained in Australia and they too found APHRA to be a long drawn out process - so it ain’t just cos I’m foreign!  

For me, the process from beginning to end has taken 16 weeks and cost me $2252 (£1445). However, I’m really excited to start my new job in Australia and obtain some international experience...plus living and working near the beach makes up for a lots of things ;)

I realise this post might become outdated over time so please do add comments or links below to any updates that occur.  This post was written in hopes that as more psychologists like myself travel around the world gaining more experience can help each other out.

Wednesday 11 April 2012

Therapeutic Story Writing



Therapeutic Story Writing for children with emotional and behavioural difficulties


Presenting problem:
Children are often referred to me for emotional and/or behavioural difficulties. The cause of these difficulties can be wide ranging. It is common for children to find it hard to talk about their difficult emotions and feelings. Some children find an issue is too overwhelming or too painful to talk about. Other children cannot stop talking about an issue and will inappropriately discuss it with anyone. Often children have not reached the linguistic maturity to be able to verbally navigate and process complex issues.


Therapeutic Story Writing is one way of exploring unresolved or troubling issues in a non-confrontational manner. See below for information on Therapeutic Story Writing and two case studies where Therapeutic Story Writing resulted in some some very successful results.


What is Therapeutic Story Writing?
Therapeutic Story Writing was developed by Trisha Waters in 2002. It is an intervention which uses the medium of story writing to support children with emotional and behavioural difficulties.


Trisha Waters (2004) explains that Therapeutic Story Writing works through metaphor that unconsciously emerge within children's own story writing in order to address issues that may be too emotionally overwhelming for children to talk about directly. This approach, which encourages children to write from their core sense of self, can also increase children's motivation to write, and therefore supports the development of both emotional and academic literacy.  


Who is suitable for Therapeutic Story Writing suitable?
  • Children attending the Therapeutic Story Writing group need to be able to write independently to some degree (at least a National Curriculum level 2c is recommended).
  • Waters suggests that children need to be between the ages of 7 - 12.
  • Therapeutic Story Writing is suitable for children with general emotional and/or behavioural difficulties. This can include: children who are having difficulty with a divorce/separation, children who have been abused, bullied, friendship issues, not coping with a bereavement/loss, or suffered trauma of some kind.
  • If running a group it is important to be aware of how individual children may affect the group dynamic. The facilitator needs to feel the group will be manageable. Dr. Waters (2004) considers that often children with EBDs will fall into one of the following two categories: 1.) Withdrawn and need encouragement to join in group discussion; 2.) Acting out, attention seeking with difficulty listening to others.  The inclusion of children from both categories created a broader dynamic within the group.
Trisha Waters  suggests it is sometimes useful to include one or two children who do not have overt emotional anxieties and are not on the Special Educational Needs register in order to provide positive role models for other group members. This can also help to normalise the group and avoid any possible stigmatising in the minds of other children.


How long are the sessions?
Ideally each session will be in the same room and occur on the same time and day each week. Consistency itself can represent a therapeutic factor for children whose lives have been disrupted. Each session lasts for fifty minutes.


Case Studies:
Olivia - case study 1:  
Olivia was a 9 year old girl in Year 5. Over the summer holidays she was held hostage in her family home. When she returned to school staff described her as a ‘different girl.’ She was displaying signs of anxiety and becoming withdrawn. Olivia completed a 7-week Therapeutic Story Writing group session.


When Olivia first joined the Therapeutic Story Writing group her stories always involved a menacing figure, often in the form of a fairy tale monster-like creature. In the first couple of sessions Olivia found it difficult to conclude her stories. It was as if problem solving an ‘ending’ was too painful or overwhelming for her. I facilitated the other group members to imagine different endings of Olivia’s story. Half way through the sessions Olivia’s stories started to develop an ending, including a fish that could help her breath under water and talk to her about escape routes.


By the 7th week the menacing figures had completely disappeared from Olivia’s stories. Her last story was a touching tale about enjoying Christmas with her family. Pre and post measures on the Behaviour Profile showed a significant improvement in Olivia’s emotional development. Olivia’s mother and class teacher reported that Olivia was happier and ‘back to her old self’.


On reflection the use of Therapeutic Story Writing enabled Olivia to explore a traumatic experience that she was unable to speak to anyone about. Using the metaphors in her stories she was able to work through some very difficult emotions. The supportive presence of the group (although no one else knew of her hostage experience over the summer) also helped Olivia reconnect with her peers in a positive way.


Ben - case study 2
Ben was a twelve year old boy in Year 8 at a mainstream secondary school. Ben lived with his maternal grandparents after Social Services removed him from his mother’s care. Ben was subject to physical abuse and neglect. Ben’s biological father was in prison. Ben presented with emotional and behavioural difficulties at school and was at risk of permanent exclusion.


I encouraged Ben to engage in Therapeutic Story Writing. I was unsure how he would respond and I was also concerned he was too old for this intervention. Ben surprised me by how much he did engage and enjoy writing his stories. On the first one to one session he developed a character called Storm the dog. Every week Storm went on different adventures such as : ‘Storm and the playground bullies’,‘ Storm on the bus’ and ’The day that Storm forgot his homework.’ Ben would happily start writing the beginnings of  the stories (which often reflected everyday incidents in his own school life) but always asked earnestly, ‘but what should Storm do now?!’ He needed help to jointly discuss how Storm could problem solve a way out of these situations.


Ben explained that his character was called ‘Storm’ because he created mayhem wherever he went but he couldn’t help it. When he drew Storm, he had scars on his body. Ben was unable to tell me where Storm got his scars from but it is reasonable to hypothesise that these could represent the scars from Ben’s own physical abuse in his early years. I never made my hypothesis or interpretations explicit to Ben, it felt safer for him to explore his issues through the metaphor of Storm.


Ben avoided permanent exclusion and started to demonstrate more pro-social skills amongst his peers. Although I was worried that Ben was too old for Therapeutic Story Writing, his emotional development was delayed therefore he quite happily worked within the story metaphor. Therefore I suggest looking at the emotional age of a child, and not just the chronological age when deciding to use Therapeutic Story Writing as an intervention. I typed up the stories and along with his drawings we made up a booklet for school and home. When Ben became distressed at school he liked reading the book to himself or reading it through with his trusted Teaching Assistant.


Interested in training or further reading?

  • Please visit http://www.therapeuticstorywriting.com/ for information on how to join a 3 day course in Therapeutic Story Writing. I can highly recommend it.
  • Waters,T.(2004) The Use of Therapeutic Storywriting to Support pupils with emotional difficulties. Support for Learning·Volume 23·Number4·
  • Waters,T.(2004) Therapeutic Storywriting: A Practical Guide to Developing Emotional Literacy in Schools.London:David Fulton.
  • Waters,T.(2004) Writing Stories with Feeling:an evaluation of the impact of Therapeutic Storywriting Groups on pupils’ learning, SERSEN Report, Therapeutic Storywriting.com.


Tuesday 3 April 2012

Blog Introduction

My husband has always enjoyed hearing the stories I share with him when I return home from my work as a psychologist. He has often said to me that I should share these stories -not only for their merit in practical psychology- but because he says “these stories are interesting because they are real”.  Accordingly, at the heart of this weblog is an effort to tell some of those stories.

The rationale behind my blog is to explore how I use psychological theories & frameworks and put them into practice. It is not written in academic prose but in a plain, simple and accessible language (the way I would explain these stories to a parent, teacher or colleague). My aim for these stories is to think about how we can use psychological knowledge to help us support the children and families we work with on a daily basis.

One of the main purposes of this blog is as a tool for self reflection and as a way to record my own continuing professional development. I consider myself to be a life-long learner so would be interested to hear how other people are using psychology in their everyday practice.

DISCLAIMER: All names have been changed to protect confidentiality and assure anonymity. All the stories on this blog are well over 3-5 years old and intentionally masked so privacy is maintained.

Monday 2 April 2012

About Me


As a Child & Educational Psychologist I am professionally trained to doctorate level and use evidenced-based models of psychology and child development. I work with children, young people, schools, families and other professionals in a wide range of contexts within the community.  I support the learning, social, emotional and behavioural development (SEBD) and mental health needs of children and young people aged 0-19.  I have a decade worth of experience in:

  • Offering consultation within a psychological problem solving framework.
  • Undertaking a range of learning, developmental, social, emotional and behavioural and curriculum based assessments.
  • Implementing direct psychological interventions, including: therapeutic based interventions (both long and short term); learning based interventions; and behaviour based interventions.
  • Providing psychological system-level interventions at family, school, community and local authority levels to support change and development.
  • Delivering Continuing Professional Development and training to a wide range of professionals and schools at whole school, group and individual level.
  • Setting-up and running group interventions such as circle of friends, anger management, therapeutic story writing, and parent groups.
  • Undertaking research and evaluation studies in schools and other contexts and facilitate schools in carrying out their own action research projects.
  • Advising on steering groups and panels to offer psychological advice.

My specialist interests lie in autism, interventions for emotional and behavioural difficulties, using CBT with children and young people and using Video Interaction Guidance in my practice.

I am a member of the Australian Psychological Society and the British Psychological Society. I am accredited by the Australian Health Professionals Registration Agency and the Health Professionals Council (HPC) in the UK.  

Family History

Figure 1: William Tuke
People sometimes ask about my surname ‘Tuke Flanders’. ‘Tuke’ is my maiden name and I have retained it to assure my heritage is maintained for future generations. My ancestor, William Tuke (1732-1822)[1], was appalled by the inhumane treatment of patients in mental asylums of his era (the well known practice of visiting ‘Bedlam’ to watch the ‘insane’ as entertainment, was widespread at the time). In response to this, William Tuke pioneered ‘The York Retreat’ which used a more humane model with psychologically based approaches as the foundation by which he founded his retreat.

The approach William used became known as ‘Moral Treatment’ [2] and influenced practices in European asylums in the 1800s. Most notably, Williams work influenced Philippe Pinel, a French physician famous for unchaining the mental patients of Paris.

William’s son, Henry Tuke, 
and grandson, Samuel Tuke carried on his good work after his death (and my work carries forward this lineage). The York Retreat still exists to this day, and something I am very proud of as a ‘Tuke’ who hopes to carry on the good practice of treating everyone with the best possible psychological practices to this day.





Figure 2: The York Retreat


For more information:
[1]= http://en.wikipedia.org/wiki/William_Tuke
[2]= http://www.bbc.co.uk/history/historic_figures/tuke_william.shtml
http://www.sciencemuseum.org.uk/broughttolife/people/williamtuke.aspx

Sociograms

The use of Sociograms in child psychology


Presenting issue:
A school wanted help with a Year 2 class (age 7-8) who were having difficulty getting along with each other. Staff reported that some days they seemed to ‘hate each other as a class’.

I had  recently heard Robin Banerjee’s presentation about Sociograms at the Division of Educational & Child Psychology Conference in January 2010. I was inspired by his talk and thought Sociograms would be a useful tool to unpick the class dynamics.

What is a Sociograms?
Quoting directly from Banergee’s webiste: http://www.sussex.ac.uk/Users/robinb/socio.html

  • A Sociograms is a visual representation of interpersonal relationships within a group.  
  • It can be especially useful in an educational context, in order to help teachers and other staff understand more about pupils' peer relationships.  It is often a useful starting point for identifying and addressing the social and emotional needs of pupils.

How did I incorporate sociograms into my work as a practicing psychologist?
Observation:
I observed the class three times, mainly because the teaching position was a job share and I wanted to see if the class dynamics were affected by the presence of a different teacher. I also wanted to see if the children behaved differently in the morning compared to the afternoon which warranted more than one visit.

On reflection, did I need to observe so many times? Perhaps not, but by being there I felt like an ‘anthropologist in the field’ which paid back later during the final consultation session with the class teachers because I felt that I really knew the children.. Can you still use sociograms and not carry out observations if you don’t have time? Absolutely yes. For me it was the ‘cherry on the cake’ but it isn’t essential.

Consultation with class teachers:
Consultations with both class teachers were carried out before the classroom observation and after I collated the data. This is essential because It was an opportunity:

  • to unpick what was currently occuring in the classroom.
  • to think systemically about outside factors that perhaps were influencing the class dynamics
  • to feedback results to give a greater understanding of the class dynamics and work together to problem solve some ideas to help remedy issues.

Collecting the ‘data’:
Banergee explains that “Sociograms are made on the basis of pupils' nominations of classmates in response to questions.  The exact wording of the questions can vary depending on interests, but a common scenario involves asking pupils to nominate three classmates with whom they most like (ML) to play/spend free time and three  classmates with whom they least like (LL) to play/spend free time”.

This can be done as a whole class activity. Pupils (individually) record their answers to the questions on a piece of paper to be collected and kept confidential by the psychologist. You need to be mindful of children with learning difficulties who may need some extra support. It can be done with individual children, but for a busy psychologist this can be time consuming.

During the DECP conference I recall Dr Mark Turner quite rightly question the ethical nature of asking children to record who ‘they least like’ to play with. In using the Sociogram in my practice this was something I felt a little uncomfortable with but I counterbalanced this potential issue with a short ‘PSHE’ type introduction. It was explained to the Year 2 class what we were doing, why we were doing it and how someone would feel if they were told to their face that they were put in the ‘least liked’ column. It’s part of life to like some people more than others, what is more important is treating everyone with respect and kindness. The advantage of observing three different sessions meant that I could monitor this situation. The class teachers reported that no short or long term issues occured from this exercise.

‘Analysing’ the data:
Banergee’s website gives a step-by-step guide to administering the sociometric survey and generating the visual representation which is, in essence, the sociogram. Banergee assures that your data is confidential (although you don’t need to write in children’s names anyway), however, be mindful that you are most likely adding to Banergee’s own research and data collection.  It generates an interesting diagram like this:


Figure 1: Sociogram generated from Banerjee's website.


Banergee also gives some advice on interpreting the sociogram. I found this very useful to use alongside the other psychological models you naturally draw on in a consultation.

How did the use of a sociogram help class teachers?
The sociogram generated from the children’s answers were shown to the class teachers. The results of the sociogram prompted the following discussion points/explorations:

Supporting ‘rejected’ and ‘controversial’ children

  • Results from the Sociograms shows that four pupils were considered to be ‘rejected’ by peers. Class teachers reflected that they will need to monitor these children’s feelings and their patterns of thinking, and it will be important to support these pupils' development in targeted work. In addition, the links in the Sociograms provides valuable information for supporting and managing these pupils in group work. For example the Sociograms shows that Jane likes to play with Sally. It was decided to sometimes pair these two children occasionally to help Sally to feel less isolated.

  • The children we are viewed by peers as ‘controversial’ were explored. Children who fall into this category are considered to be dominant, perceived to be popular yet they may be also seen as aggressive, disruptive and intimidating. The class teachers reflected that this group of children did have an impact upon the class ethos and that it needed to be monitored.

The ‘popular’ children

  • The class teachers were able to successfully spot the children who were considered ‘popular’ because they consistently show socially competent behaviours. I felt it was important that there were not too many surprises from the sociograms findings because it is empowering for class teachers when they ‘know’ and understand some aspects of their class dynamics.
  • The class teachers discussed how they could utilise the ‘popular’ group of children to model good interaction and friendship skills. Although it was recognised that children in this group would need support to do this and cannot be solely relied on to fulfil this role.

Using observation skills in combination with the Sociogram

  • Based upon classroom observations it was evident that some children in the class are able to learn, but they are not emotionally ready to learn. The class teachers requested some resources on the following areas to support pupils to develop skills to: a) Work co-operatively. b) Learn it is okay to lose and c) Listen to each other.

Preparing for transition

  • The results from the sociogram helped inform the Head Teachers of the Infant and Junior School to make decision on how to compile new class lists for the new academic year. The new Year 3 classes were trailed while the pupils were still in Year 2. This enabled the children to become comfortable with their new class set up and gave scope for ‘tweaking’ before the new academic year.

Class teachers evaluation of using a Sociogram

  • The class teachers commented that “the Sociogram gave us a useful insight into the psychology of our class. How we, as adults, view the inner workings of a peer group is different to how children will view their peer group. Seeing a glimpse of what our children experience has helped us to understand the class dynamics and how this needs to be supported.


Summary
Overall using a sociogram was extremely useful for the purpose of unpicking and exploring class dynamics. The visual representation helps the mind to visualise and understand how children are connected within the classroom system. When the work was reviewed with the class teachers 3 months later they reported an improvement in their understanding of the classroom dynamics following the work with the Sociogram. This subsequently informed how they responded to issues and they felt the class were happier. 


Using Sociograms was a helpful springboard in which to discuss and explore other issues and compliments other psychological frameworks such as the consultation model and Solution Focused Thinking. Above all it helped the school staff to problem-solve different ways to move forward with a new and fresh understanding that was illuminated by the sociogram.

I would be interested to hear from other psychologist who have used Sociograms in their work. What do you think of it as a tool? What are your success stories?



Further Reading:


Banerjee, Watling and Caputi (2011) Peer Relations and the Understanding of Faux Pas: Longitudinal Evidence for Bidirectional Associations. Child Development, Vol 82 (6) pp.1887-1905


Caputi, Leece, Pagnin and Banerjee (2012) Longitudinal effects of theory of mind on later peer relations: The role of prosocial behaviour. Developmental Psychology Vol 48 (1) pp.257-270