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							     Dr Deborah Christie
Consultant Clinical Psychologist
       Child and Adolescent
      Psychological Services
Rheumatology                                                  Chronic Pain
Endocrinology                                                 Diabetes
                                                              Healthy Eating
Orthopaedics
Metabolic
                                   Medical                    and Lifestyle
                                                              Programme
Surgery
Urology
                                    Team                      (HELP)
                                                              Late effects of
Haematology                                                   cancer
Oncology                                                      Neuropsychology
                     Multidisciplinary
Fatigue
                      team meeting
Chronic Pain                                     Specialist psychology
Mysterious llness!

                             Consultation with              Review
           Local               Psychology
           Services


  Specialist    Individual      Family    MDT       Group        Ongoing
   Neuro-        therapy       Therapy    work      Work        Consultation
 psychology
         Our starting point
• What has been
 helpful before?
• What has not
 been helpful?
• What could we do
 differently?
Focusing on the solution


    Skills, Strengths
    and Abilities



     Preferred futures?
     New stories?
     Goodenough?
Bladder Exstrophy
         • Feeling “normal but
           not “normal”
         • Disclosure
         • Bullying
    How bovvered are you?
• How Important is it that you
  change?
• How Confident are you that you
  could succeed?
• How much of a Priority is it?

1   2   3   4   5   6   7   8   9   10
 Make the intervention fit the patient
 not the patient fit the intervention?
Low Confidence      High Confidence
Low Importance      Low importance
Low/High Priority   Low/High Priority


Low Confidence      High Confidence     High Confidence
High Importance     High Importance     High Importance
Low/High Priority   Low Priority
                                        High Priority
             Disadvantages
             of Status Quo
Advantages
of Change
Leading or following?

        Ginger Rogers could do
        everything that Fred
        Astaire could do -
        only she could do it
        backwards and in high
        heels!!!