Core clinical skills
One of the prime duties of an organisation is to keep its employees proficient in the core clinical skills. You can focus on these with targeted training days as follows:
Assessment
Covering
- The headings to cover in an assessment interview
- Questionnaire measures in assessment. (Includes access to APT originated forms for subsequent use.)
- Behavioural and observational measures
- How assessment relates to risk-assessment
- A proper assessment is the cornerstone of a good clinical intervention. Without a good initial assessment and regular assessment later,, how can your intervention be ‘evidence-based’? How can you know whether you are helping or hurting the person?
Goal setting
Having clear goals and pursuing them enthusiastically is one of the best predictors of success in clinical practice and yet the confusion between goals and interventions and a general lack of ‘goal-clarity’ is all too frequent.
Covering
- What is a goal, what an intervention? Is “raising the person’s self-esteem” a goal?
- Maybe goals do have to be ‘smart’ and ‘achievable’, but are these really the most important aspects in clinical practice? If not, then what are?
- Do goals really have to be ‘agreed’: what if your client’s goal is to shoot the person he believes is poisoning him? But if you can’t agree goals then how can our interventions be ‘collaborative’?
- What makes good treatment goals and what are the over-arching factors in achieving them?
Session planning
Even good, experienced professionals will sometimes see clients simply because ‘that is what they do’ – with no clear session plan in mind. A yet to have a clear structure to your session is one of the fundamental ‘quality-control’ measures. And this applies whether you have forma, sitting-down, interviews or informal, standing up doing something else interactions.
Covering
- The 7 sections in a properly constructed treatment session. How to do it right every time!
- How to do it right even when it’s all falling apart
- How to cement progress so that the next session isn’t just a re-run of the previous one
Forming and maintaining good relationships
Goleman famously observed that the quality of the relationship between helper and helped was the best single success or failure in therapy. So what makes for a good relationship?
Covering
- The single quickest and easiest thing you can do to transform your team’s relationships with its clients
- "You never get a second chance to make a good first impression" is truer than its cliché status might suggest
- So how should you handle the first moments and minutes?
- "Remember you’re a friendly professional, not a professional friend" – sounds good but what does it mean? It is good, but why?
- ‘Boundaries’ are all very well, but too often they are the refuge for professionals who don’t really know what’s meant to be in those boundaries anyway. So what does constitute a good therapeutic relationship, and what are its boundaries?
Good listening
‘Good listeners’ are worth their weight in gold, simply because they enable the person to clarify their own thoughts, develop their own goals, work out how they want to achieve them, without ‘interfering’ too much. This invariably leads to motivation on the part of the client.
Covering
- What makes a good listener: the key components of becoming someone others can – and want to – talk to
- Knowing what makes a good listener is one thing, becoming a good listener is another. How to develop your skills after today
- Why most people can’t think things through without your listening, but can with it
- What it the person cannot work out what they think about things, even though they are being listened to well?
- What about when the person is talking incoherently, either through psychosis or through other reasons?
Validation
Validation is the key thing that your friends provide that makes you feel good. It makes you feel like a good person, competent, ‘part of the human race’. Hopefully you do the same for them. Highlighted in DBT, it is rightly fashionable in clinical practice at the moment and deserves to remain so.
Covering
- What is validation and why is it so powerful?
- The 5 different ways of doing it, and the importance of choosing the right one … more or less
- What to do when what the other person is saying simply isn’t ‘valid’
- Can you ‘over-validate’? (Yes, and it’s as bad or worse as not validating at all.) How to avoid doing so
Problem solving
Problem-solving is probably the most useful and far-reaching skill that a professional can have. So many people have significant problems that they simply cannot solve by themselves that our ability to help them do so is crucial.
Covering
- Identifying the problem. How to get the problem so it is (a) the one the person wants to solve and (b) it is going to be solvable.
- Problem-solving strategy. In fact there are different strategies depending on the intransigence of the problem. We cover them all!
- Giving advice. If ‘over-prescription’ is one frequent error, then ‘under-prescription’ is the other. How to give advice in a way that it is (a) helpful and (b) likely to be utilised
- How to tell whether your (joint) solution is the right one – whether the solutions ‘works’.
Conflict resolution
Based on APT’s Preventing Face to Face Violence course and Davies and Frude’s book of the same title, this can with some justice claim to be the gold standard in conflict resolution training.
Covering
- How aggression comes about; the underlying neuroanatomy
- The different types of aggression and how they need to be handled differently
- The underlying attitudes that can make or break any intervention
- The 4 key factors of Body Language: the element that provides 80% of communication
- 7 key verbal strategies and how to choose the right one
- Getting good: how to practise when you don’t have major incidents
DICES® risk assessment
This day provides the gateway to the DICES® risk assessment and management system. It provides you with all the DICES® risk assessment forms and covers how to use them.
Covering
- Brief-DICE (screening measure)
- DICES-S (suicide risk)
- DICES-SN&V (self-neglect and vulnerability)
- DICES-V (violence)
- DICES-SA (sexual assault)
- C&A-DICE (risks pertinent to children and adolescents)
- Substance-DICE (risks pertinent to substance misuse)
- Older-DICE (risks pertinent to older adults)
DICES® risk management
Bad risk management is bureaucracy that inhibits good clinical work. The best form of risk management actually facilitates providing an excellent service to clients, and does so in a way that ensures you are professionally safe if the worst were to happen. DICES® risk management shows how to do this.
Covering
- How to record you belief that a person represents a specific risk
- How to identify relevant interventions; and why it is important to identify even the interventions you won’t use
- How to choose the best option
- How to explain your choice; when you must do this, how you can elaborate it
- Why it is important to share your thinking with others: how to do it
Relaxation Training
To teach people how they can relax at will is one of the most effective single interventions available to clinicians, and this course shows how to do it. A predominantly practical course teaching a practical skill, this is one where you should be prepared to practice your skill and also to be practised on. The day has a clear simple aim: to teach you how to train others to relax using either a Jacobsonian method (muscular relaxation) or Benson’s method (focusing on breathing, a ‘mantra’ and developing a passive attitude).
Covering
- Demonstration of the Jacobsonian method
- Practice and feedback
- Demonstration of Benson’s method
- Practice and feedback
- Discussion of appropriate uses of relaxation