Pip Calvert and Jak Smith on Cognitive Analytic Therapy in Neuro

I am joined by Clinical Psychologist and Neuropsychologist Pip Calvert, and Cognitive Analytic Therapist, Jak Smith, to talk about the application of cognitive analytic concepts to neuro work. 

Transcript

9
00:00:52.650 --> 00:01:07.800
ingram wright: So, welcome to the new row clinic welcome to pip calvert and jack Smith you've kindly agreed to join me today for a conversation about cat in neuropsychology I wanted to say cat therapy, but that would be a redundant additional word wouldn't it, of course.

10
00:01:09.120 --> 00:01:09.750
ingram wright: But so.

11
00:01:13.800 --> 00:01:23.250
ingram wright: So I we're going to start as conventional for this podcast with them you're going to introduce yourselves, I wonder if you want to go first pick yeah sure so.

12
00:01:24.630 --> 00:01:30.090
i'm a consultant clinical neuropsychologist I work in an acquired brain injury service.

13
00:01:32.700 --> 00:01:50.820
Pip Calvert: Nearly community and base that I also do an enriched service into our local year rehab, which is the level to your rehab unit so post acute and i've been working there for nine years and i'm also trained practitioner.

14
00:01:53.850 --> 00:01:54.360
ingram wright: And jack.

15
00:01:55.890 --> 00:02:02.280
Jak Smith: yeah and my name is jack Smith and got a background in counseling and psychotherapy.

16
00:02:03.330 --> 00:02:13.890
Jak Smith: Currently work as part of the cognitive analytics therapy service which sits within tertiary level service as part of the Center for special psychological therapies.

17
00:02:14.760 --> 00:02:33.990
Jak Smith: and spent a lot well spent some time in the neural psychology Center for new rehabbing you as a service development a psychological therapy service and so that sits across for awards community and our patients are to level one and.

18
00:02:37.770 --> 00:02:47.250
ingram wright: jack I sort of for warned you that you have a counseling psychology background and i'm just wondering, I will will ask you the similar question pit but but jack.

19
00:02:47.910 --> 00:02:54.960
ingram wright: i'm just wondering about that journey into neuropsychology you prepared to tell us a bit about you know what sort of captured your interest.

20
00:02:56.850 --> 00:02:58.860
ingram wright: or working in a euro setting I should say.

21
00:03:00.180 --> 00:03:08.850
Jak Smith: yeah so just to clarify the early part and i've got a counseling background, so I didn't do a counseling psychology doctoral degree in counseling.

22
00:03:10.140 --> 00:03:21.840
Jak Smith: And then lay it on the train and become a registered psychotherapist so my background was informed by psychodynamic models take me on track relations theory in.

23
00:03:22.710 --> 00:03:32.010
Jak Smith: In the experience across the NHS about eight years in special services in in addictions in working with adults and children.

24
00:03:32.700 --> 00:03:46.380
Jak Smith: long and short periods of therapy and actually what happened is I found myself in euro psychology because I was asked to go and develop the counseling psychotherapy service within the Center when you have we haven't used psychiatry.

25
00:03:47.400 --> 00:04:01.770
Jak Smith: I didn't have a formal training don't have a formal training in a new rule, and so it was a real intensive learning curve really under quite quite robust supervision agreement and.

26
00:04:02.940 --> 00:04:12.090
Jak Smith: and learn with the patients and teams that was working with, I suppose, and in many ways I probably felt a little bit.

27
00:04:13.440 --> 00:04:31.170
Jak Smith: out there in the unknown, but I also think that that not knowing possession of it something different, you offered me the opportunity to begin to listen to the patients that we see in our clients have family and perhaps hear things that were not being treated by other.

28
00:04:32.820 --> 00:04:39.570
Jak Smith: Multi disciplinary team, so the challenge really was how do we begin to find a language.

29
00:04:40.740 --> 00:04:42.420
And how do we begin.

30
00:04:43.650 --> 00:04:46.470
Jak Smith: Listen, both to the objective and subjective nature.

31
00:04:47.880 --> 00:04:48.870
we're experiencing.

32
00:04:50.190 --> 00:04:51.120
In the therapy room.

33
00:04:53.970 --> 00:04:54.330
yeah.

34
00:04:56.280 --> 00:04:57.660
Jak Smith: that's where the loop started.

35
00:04:58.020 --> 00:04:58.470
ingram wright: Thank you.

36
00:05:00.390 --> 00:05:01.080
ingram wright: What about you.

37
00:05:02.250 --> 00:05:04.860
ingram wright: How did you how did you get into new row work.

38
00:05:07.980 --> 00:05:14.670
Pip Calvert: probably a little bit further back, I remember going to do my undergrad in psychology and I was really interested in mental health, particularly what.

39
00:05:14.910 --> 00:05:22.290
Pip Calvert: would be labeled as schizophrenia don't know I just really sparked my interest for learning about here, and of course it was always presented as a brain disease.

40
00:05:23.100 --> 00:05:29.100
Pip Calvert: So I just got really into that and and started more about the brain and then we were learning about the brain that really sparked my interest.

41
00:05:29.610 --> 00:05:36.810
Pip Calvert: And so I came out of the gate I want to work in brain stuff didn't really know what that was about massively and then I did I did.

42
00:05:37.500 --> 00:05:45.720
Pip Calvert: Two or three assistant post, but one was in your psychology acquired brain injury that and that's about really, really sparked my interest and.

43
00:05:46.650 --> 00:05:49.860
Pip Calvert: Then I went and worked in secondary care mental mental health.

44
00:05:50.670 --> 00:06:02.760
Pip Calvert: And that's where I came across across CAP was also my Supervisor was accountable, one of my supervisors was a counseling psychologist that was also really interested in euro so I was already started to kind of get that that blend.

45
00:06:03.480 --> 00:06:13.170
Pip Calvert: And I when I got on the doctor I was just absolutely convinced, I wanted to be in in Europe, and particularly quite brain injury service, but I also wanted to be a mental health, I wanted to do both.

46
00:06:14.550 --> 00:06:20.340
Pip Calvert: And that's what I ended up I ended up doing so in every single one of my placements I made sure I was doing something near related.

47
00:06:20.940 --> 00:06:33.660
Pip Calvert: And, and then, when I came out, I was lucky enough to get to two positions one in your psychology practice and then acquired brain injury and one in the in a secondary care mental health and mental health service.

48
00:06:35.430 --> 00:06:43.140
ingram wright: Thank you Pepsi so it's it's helpful to hear about people's journeys it's one of the things that others have talked about in the podcasts and about how.

49
00:06:45.660 --> 00:06:51.720
ingram wright: I sorry, there was a real there was sorry i'm just pausing now there's a real loud noise I think it's probably my emails it's just.

50
00:06:52.230 --> 00:06:52.830
ingram wright: Did you hear.

51
00:06:54.510 --> 00:06:58.140
ingram wright: Did you just hear that, so I keep trying to shut down it restarts.

52
00:06:58.710 --> 00:07:01.530
Pip Calvert: Okay, I let me just make sure i've got everything shut down.

53
00:07:03.030 --> 00:07:04.380
Pip Calvert: Right okay sorry about that.

54
00:07:04.950 --> 00:07:11.400
ingram wright: Sorry, so we're just going to pick up from where you finished pit I can edit it out and make it all sound seamless.

55
00:07:12.330 --> 00:07:16.680
ingram wright: So thank you for that um it's interesting to hear about your journeys into sort of new row.

56
00:07:17.070 --> 00:07:21.750
ingram wright: settings and it's one of the things that's come up on the podcast and there are a lot of people listening are sort of.

57
00:07:22.080 --> 00:07:37.260
ingram wright: at the early stages of developing their interests in various aspects of clinical practice, so I think it's really helpful to hear about your journeys and we're here to talk about cat and and I guess, one of the first things is for those people who don't know.

58
00:07:38.280 --> 00:07:46.110
ingram wright: Would either of you volunteer to describe you know what are the key characteristics, what do we need to know about cats to to sort of begin to have a conversation about it.

59
00:07:48.390 --> 00:07:52.020
ingram wright: So if you want to go first obviously eating to answer that question.

60
00:07:52.410 --> 00:07:54.030
Pip Calvert: also got up my presentations.

61
00:07:55.620 --> 00:07:57.210
ingram wright: you've got some notes to help.

62
00:07:59.100 --> 00:08:05.970
Pip Calvert: really interesting question in terms of because I think we know it in CAP, but then when you're actually asked to describe it can all get a little bit.

63
00:08:06.300 --> 00:08:15.390
Pip Calvert: Willie and, of course, that particular psychologists and psychotherapist we all get accused of being bullied I was, I was trying to think about how do I do this the signal, but now i'm waffling so i'm clearly failed in.

64
00:08:16.470 --> 00:08:23.310
Pip Calvert: There anyway, so the way I would describe it when i'm teaching it to people is it's an integrative psychotherapy.

65
00:08:23.580 --> 00:08:33.750
Pip Calvert: So it's based a lot on object relations and so that way of how we learn to relate to one another through our relationships and then the how that helps us relate to ourselves.

66
00:08:34.590 --> 00:08:40.440
Pip Calvert: it's also based on some of the got skis work about how important social interactions are in our own development.

67
00:08:41.010 --> 00:08:49.980
Pip Calvert: And then the cognitive element of it is that Tony Ryan, who developed it it really like how competent therapy describe difficulties very, very clearly so.

68
00:08:50.280 --> 00:08:57.870
Pip Calvert: It made it a bit more accessible, the more psychodynamic psychoanalytic and therapies, I guess overall it's about.

69
00:08:58.560 --> 00:09:04.890
Pip Calvert: helping us understand almost have to describe how we relate to one another and we relate to ourselves as well.

70
00:09:05.220 --> 00:09:18.600
Pip Calvert: And then, where that comes from that it comes through all of our relationships from very early on, all the way through you know and it continues developing really I guess that's probably how I talk about it does that fit with you jack.

71
00:09:20.670 --> 00:09:33.600
Jak Smith: yeah I think it covers a lot of what I would say as well, really, I think one of the important things, for me, often the whole gun line, particularly working in your own complex disabilities is is how.

72
00:09:34.620 --> 00:09:34.890
We.

73
00:09:36.030 --> 00:09:44.340
Jak Smith: kind of learned to relate to ourselves and our template of ourselves others in the world, now this isn't just through our relational experiences with.

74
00:09:45.450 --> 00:09:50.700
Primary caregivers book with cultures that were brought up in the time society.

75
00:09:52.080 --> 00:09:53.850
political influence on things.

76
00:09:55.050 --> 00:10:04.410
Jak Smith: yeah and how these kind of interactions become internalized really the kind of inner dialogue and we anticipate people will see your screen is the scene ourselves.

77
00:10:06.510 --> 00:10:14.070
Jak Smith: And how we learn really to develop ways of adapting and survive and and to get on.

78
00:10:15.090 --> 00:10:18.900
Jak Smith: You know in directed behavior in to get things to get our needs met and.

79
00:10:20.250 --> 00:10:27.480
Jak Smith: How these patents can be very helpful but, but they can come a time when the maybe become problematic or limiting.

80
00:10:28.650 --> 00:10:30.090
belief of mine from the devil.

81
00:10:31.650 --> 00:10:47.550
ingram wright: So thinking about a new row a new row setting and I suppose, in response to what you've both said how does cat have particular or find particular applications with new row populations or on euro settings have you got some notes on that pip.

82
00:10:50.610 --> 00:10:53.610
Pip Calvert: You gotta take the MIC you can't you won't be able to see on the podcast but.

83
00:10:53.670 --> 00:11:01.890
ingram wright: No more no more next is holding up pip is holding up books that she's got for reference, just in case some of the questions get tricky.

84
00:11:02.490 --> 00:11:14.700
Pip Calvert: i've got the arts, because all of a sudden, I had this anxiety about how do I talk about this, because she just wants you doing it you don't really think about how to explain it until you're in conversation I was clearly a bit anxious about being.

85
00:11:15.000 --> 00:11:25.980
ingram wright: The question the question, the question is, what is it about cat that particularly works in in the euro setting right well, what is it that that makes you believe that it has a particular application.

86
00:11:27.540 --> 00:11:28.740
jack do you want to go first.

87
00:11:31.530 --> 00:11:32.880
Jak Smith: So I think i'm.

88
00:11:33.960 --> 00:11:51.300
Jak Smith: Flying car really in new population that experience of doing that cross, and if we population groups and and I think what I find helpful is cats desire to understand the whole person not just symptoms of the condition, so you know.

89
00:11:52.470 --> 00:12:00.030
Jak Smith: we've got it designed to kind of think about how people have experience the world and grow know.

90
00:12:01.110 --> 00:12:10.920
Jak Smith: How that informs how they relate cells, but it also gives an insight and how they might relate to a condition that been diagnosed with and and how that influences people's.

91
00:12:12.330 --> 00:12:20.640
Jak Smith: ability to self manage or to engage in a new rehab program or this idea that health care is fundamentally relational.

92
00:12:21.750 --> 00:12:25.140
Jak Smith: So we're entering in to relationships with people.

93
00:12:27.390 --> 00:12:42.870
Jak Smith: Colleagues, with clients patients family, and so I think can can be applied, both as an individual treatment model, but it off as a framework for thinking about systems or thinking about kind of team consultation.

94
00:12:45.510 --> 00:12:45.900
yeah.

95
00:12:47.340 --> 00:12:47.550
But.

96
00:12:49.440 --> 00:12:53.340
ingram wright: What about you have you have you had time to find the right page in the in the in the chapter.

97
00:12:53.700 --> 00:12:54.630
Pip Calvert: yeah, why do you think I asked.

98
00:12:55.800 --> 00:13:00.000
Pip Calvert: And I agree with everything that that tracks just said, I think.

99
00:13:01.110 --> 00:13:01.770
For me.

100
00:13:03.030 --> 00:13:08.880
Pip Calvert: What I found when I was doing my cat training the clients that I would tend to think more about in it was.

101
00:13:09.060 --> 00:13:18.570
Pip Calvert: My newer clients, rather than the people I was working within an adult mental health, because that that service was always very cat had the anyway, that was one of the reasons I went to work.

102
00:13:19.440 --> 00:13:29.220
Pip Calvert: And I always kept thinking about the newer clients and for those of us who you know around your psychology new particular brain injury.

103
00:13:29.880 --> 00:13:34.470
Pip Calvert: We talk a lot about what somebody was like before that they had their brain injury seen about lovely where the pre morbid.

104
00:13:35.100 --> 00:13:43.950
Pip Calvert: And and that's a big thing for me about thinking about yeah who was this person, how did they manage and cope and survive in the world how did they relate to people beforehand.

105
00:13:44.340 --> 00:13:54.480
Pip Calvert: Because if we're actually going to truly understand how the brain injury has impacted on them, we really need to understand who they were before how they related so.

106
00:13:55.320 --> 00:14:01.170
Pip Calvert: That got me thinking about how cat could help us then think about who that person is how they coped.

107
00:14:01.560 --> 00:14:11.100
Pip Calvert: Because, particularly when you have something so huge like a brain injury or any other neurological you know condition, whatever it might be i'm obviously talking about brain injury because it's what I specialize in.

108
00:14:12.090 --> 00:14:22.590
Pip Calvert: When when something like that huge happens, of course, you're going to go to your usual coping strategies, I know what i'm Mike I go to my coping strategies when i'm really stressed and I haven't had anything that huge happened to me.

109
00:14:23.070 --> 00:14:31.770
Pip Calvert: So why wouldn't they go to that and I think what I was finding a lot in my work is that things would be interpreted in the lens of the brain injury.

110
00:14:32.400 --> 00:14:41.940
Pip Calvert: So it's always about the brain injury and and one of course my You know, as I see my role as a as a psychologist is to question that sometimes ago, is it the brain injury or is it.

111
00:14:42.240 --> 00:14:52.830
Pip Calvert: This is them as a person and that's not a judgment it's not a criticism it's just it's, we need to recognize that because it's an IT alters how we work with that person and what we're targeting and what we're trying to do.

112
00:14:53.820 --> 00:15:09.180
Pip Calvert: So CAP to me then helped me think about how do I frame that how do I have a way to put that together, which you can then add into that gut brain injury understanding.

113
00:15:10.380 --> 00:15:19.230
Pip Calvert: And it also helped me then think about how I have conversations with the stuff about well, maybe they're doing that because this is how they used to cope.

114
00:15:19.560 --> 00:15:29.400
Pip Calvert: beforehand, why don't we chat their relatives and it was just a way of pulling together all of that, and then the other thing I would say, an awful lot in my work.

115
00:15:29.940 --> 00:15:39.720
Pip Calvert: with how the person with the brain injuries be related to by the staff, so no stuff you know I mean the fact that it's such a hard job, and you know they're they're also.

116
00:15:40.080 --> 00:15:48.450
Pip Calvert: doing everything they can, but of course they bring their own stuff with them, and you could you could I could see that in the world, you know, because that the.

117
00:15:49.170 --> 00:15:58.740
Pip Calvert: People will get quite worried or parenting to people and then you see the person with a brain injury real reacting quite strongly to that and to be quite splitting those reactions.

118
00:15:59.010 --> 00:16:06.030
Pip Calvert: To it's just a way of being able to help people frame that and think about it and and I guess also.

119
00:16:06.600 --> 00:16:17.280
Pip Calvert: being influenced by predator knows work, so you know the American year psychologists, who is a big advocate of using or psychodynamic and psychoanalytic approaches in in brain injury.

120
00:16:17.640 --> 00:16:23.070
Pip Calvert: And it was my way of sort of crossing the two over of how do I make this accessible to me because I understand.

121
00:16:24.000 --> 00:16:33.090
Pip Calvert: Cat as much as I can, as always stuff to learn how do I bring those two together so it's kind of bringing my two passions together it just seemed to work, it just seemed to help me.

122
00:16:33.660 --> 00:16:38.370
Pip Calvert: talk to the people I was working with about how do we understand this person and how do we help them work better with.

123
00:16:39.690 --> 00:16:40.050
yeah.

124
00:16:41.100 --> 00:16:42.360
ingram wright: Going jack do you want to come in on.

125
00:16:42.510 --> 00:16:53.220
Jak Smith: Well i'm just excited hearing that because that's really my experience with something about cats, you know this cognitive description of psychoanalytic ideas makes it accessible.

126
00:16:55.680 --> 00:16:57.960
Jak Smith: To the people that were working with, but the teams.

127
00:17:00.960 --> 00:17:04.500
ingram wright: And, especially as I was listening to you both talk, I was thinking about.

128
00:17:05.310 --> 00:17:06.120
Jak Smith: Well it's not.

129
00:17:06.960 --> 00:17:07.590
Oh sorry.

130
00:17:09.060 --> 00:17:12.270
ingram wright: it's a bit of a bit of a delay, did you get that as well pip.

131
00:17:12.570 --> 00:17:14.340
Pip Calvert: I didn't, but I could see you both pause.

132
00:17:16.950 --> 00:17:17.760
ingram wright: sorry about that.

133
00:17:18.480 --> 00:17:23.790
ingram wright: So I just crushed over you there jack I didn't realize I did do you want to just pick up from where you were.

134
00:17:27.450 --> 00:17:29.100
ingram wright: yeah where were you.

135
00:17:30.270 --> 00:17:40.530
ingram wright: Well, I pip you finished you finished your bit, and then I think we got about 10 seconds in and from my end it looked like you froze and then I jumped in.

136
00:17:41.640 --> 00:17:50.580
ingram wright: Okay yeah but just just just go from whatever thought you've got and we'll just leave it in as if it's as if it never happened yeah.

137
00:17:51.510 --> 00:18:02.580
Jak Smith: Great so what comes to mind when pip was talking was just the value of cat in ny brings a cognitive description to psychoanalytic ideas and this.

138
00:18:03.120 --> 00:18:19.920
Jak Smith: makes quite a complex language accessible to not only the teams that were working in but the patients or family that we're supporting as well, and we can begin to kind of understand yeah quite complex ideas will use it.

139
00:18:21.300 --> 00:18:21.630
yeah.

140
00:18:24.360 --> 00:18:33.630
ingram wright: I guess you were both talking, I was thinking about how the so much complexity working in Giro populations isn't so as a neuropsychologist who has sort of.

141
00:18:34.380 --> 00:18:45.960
ingram wright: diagnostic assessment biases i'm listening to you both talk and thinking, this is something that's unreachable to me right so i'm i'm comfortably in my diagnostic assessment camp.

142
00:18:46.980 --> 00:18:52.800
ingram wright: And i'm wondering if, in the teams that you work with there's that kind of split between those who are working.

143
00:18:53.130 --> 00:19:04.380
ingram wright: At a relational level with the clients and those who are much more focused on diagnostic assessment would you accept that that is a bit of a split in terms of how we practice if you're nodding.

144
00:19:04.560 --> 00:19:19.920
yeah I definitely say within your psychology because, of course, understand psychology has tended to come from all over the place, most traditionally where let's support the neurologist let's call it the neurosurgery surgeons about diagnosing a presentation, whether it's you know.

145
00:19:21.570 --> 00:19:31.590
Pip Calvert: Progressive condition or fits the brain injury, so I think understandably lots of yours psychologists, in particular, would identify with that and then think.

146
00:19:32.070 --> 00:19:40.350
Pip Calvert: That I I I certainly see a new generation coming through her much more interested in working with the person post that let's understand.

147
00:19:40.800 --> 00:19:45.930
Pip Calvert: But actually I saw, so I think it's really helpful for within diagnosing as well i've certainly found it.

148
00:19:46.260 --> 00:19:54.360
Pip Calvert: really helpful and thinking about what's going on between me and the person i'm working with was were actually thinking about how they got a brain injury or no.

149
00:19:55.170 --> 00:20:03.990
Pip Calvert: or what's the extent of it, so I, I can see influencing all of those areas we I think I think i'm just gonna be there isn't it it's that it's that development and.

150
00:20:04.620 --> 00:20:15.720
Pip Calvert: Also, the question about can you do therapy with somebody who's had a brain injury and of course polly that depends on the severity of it but that's always been one of the debates in you know in brain injury so.

151
00:20:16.650 --> 00:20:17.490
ingram wright: what's the answer.

152
00:20:18.390 --> 00:20:18.960
Pip Calvert: Is you can.

153
00:20:19.860 --> 00:20:28.740
Pip Calvert: Absolutely okay it's just how you do it what you do what you're targeting and what you're expecting if people, because one of the things I talk a lot about so.

154
00:20:29.400 --> 00:20:37.200
Pip Calvert: A cell phone and another consultant your psychologist vicki target we do a lecture on your psychology and adult mental health to the.

155
00:20:38.400 --> 00:20:45.000
Pip Calvert: first year trainees on the Manchester training course one of the things we talk about is how we can add out.

156
00:20:45.930 --> 00:20:53.310
Pip Calvert: therapy psychological therapy, because we actually asked a lot of people in psychological therapy regardless if you've had a brain injury or not so.

157
00:20:54.030 --> 00:21:09.930
Pip Calvert: I think, of course, you can but it's what it's what you're doing and it's the timing of it or is it actually the intervention is more with the family or the or the staff and actually That in itself is therapeutic it depends what we mean by psychological therapy yes.

158
00:21:11.880 --> 00:21:21.990
ingram wright: Do you do you think in terms of of of I suppose thinking about for him therapy might be most appropriate where there might need to be modifications.

159
00:21:23.640 --> 00:21:32.940
ingram wright: Is there some kind of prerequisites of diagnostic assessment process that has to be undertaken, or is it is, it is it possible, in your experience, just to dive straight in.

160
00:21:34.290 --> 00:21:38.310
ingram wright: Because i'm wondering sometimes some of the barriers to accessing therapy might be actually.

161
00:21:38.910 --> 00:21:48.390
ingram wright: We need to understand this person's cognition before we can work with them right so that involves an extra step in the process which might well prove to be a barrier in terms of the Max in therapy.

162
00:21:48.750 --> 00:21:59.700
ingram wright: You can't access conventional therapy because you've had a brain injury and we need to understand whether your memory and your attentional systems are up to the job in terms of being able to tolerate that that that therapy.

163
00:22:01.620 --> 00:22:02.250
ingram wright: What do you thoughts.

164
00:22:03.000 --> 00:22:05.670
Pip Calvert: Jackie you Okay, if I if I jump in on those okay.

165
00:22:07.560 --> 00:22:16.350
Pip Calvert: Sorry for the people who can't see on the podcast and yeah I think I don't think there's any hard and fast, I think, absolutely, we need to.

166
00:22:16.680 --> 00:22:25.020
Pip Calvert: Understand about where the person is at cognitively if we're, not that I think we're putting them under a lot of pressure, because then there's that expectation that they can engage in.

167
00:22:25.440 --> 00:22:30.240
Pip Calvert: In more traditional psychological therapies, whether that's cognitive behavior therapy or whatever it is.

168
00:22:30.990 --> 00:22:36.330
Pip Calvert: So yes, I think there is, I think, on the converse of that, though I think we often don't think about people who.

169
00:22:36.660 --> 00:22:41.310
Pip Calvert: Technically don't have a brain condition and why they're called me she has out because everybody.

170
00:22:41.580 --> 00:22:48.060
Pip Calvert: With with mental health presentations will have something going on with their cognition it's just not necessarily because of an organic cause.

171
00:22:48.420 --> 00:22:50.430
Pip Calvert: Of the we would talk about in terms of the brain injury.

172
00:22:50.880 --> 00:22:57.720
Pip Calvert: So look, I mean if you look at any of the literature, you know people who are anxious and again vicki ticket and I talked about this in our lecture that.

173
00:22:58.020 --> 00:23:05.340
Pip Calvert: Anybody who's actually I mean Have you ever had that experience, I know I certainly have a being in an exam and you're sat there, and you put your pen down.

174
00:23:05.880 --> 00:23:07.830
Pip Calvert: And then you can't find your Pen, you know it's there.

175
00:23:08.520 --> 00:23:10.950
Pip Calvert: Because you've just put it down you can't actually see it.

176
00:23:11.220 --> 00:23:17.820
Pip Calvert: So I can't visually scan and pick that out, which is a cognitive process because i'm under have massive amounts of stress and anxiety that point in time.

177
00:23:18.060 --> 00:23:31.890
Pip Calvert: And then, all of a sudden it's there and then the paranoia kicks in about somebody just move that i'm losing my mind slightly so in any kind of situation there's always something cognitive going on and I don't think we think about just general Sarah.

178
00:23:33.390 --> 00:23:37.260
ingram wright: suggesting that psychological assessment is a prerequisite for every project.

179
00:23:40.740 --> 00:23:45.750
Pip Calvert: And what I think what i'm saying is that course, we need to think about what some of these abilities are.

180
00:23:46.470 --> 00:23:54.360
Pip Calvert: And, and you know if we just look at the general literature OK, I can never remember what the own the source of it is you know that that adage that we hear that.

181
00:23:54.600 --> 00:23:58.980
Pip Calvert: Even if you go to your GP you're only remember one in four things that get talked about yeah.

182
00:23:59.610 --> 00:24:04.440
Pip Calvert: automatically We therefore need to adapt and think think about that and that's just always where I come from.

183
00:24:05.310 --> 00:24:11.700
Pip Calvert: So yeah somebody who you know, certainly doesn't have day to day memory, so you know they can't remember you.

184
00:24:12.450 --> 00:24:21.180
Pip Calvert: that's going to be quite challenging but does that mean you don't call it a beauty with them absolutely not, I mean the people in the podcast wrote see but i've got bright blue hair.

185
00:24:21.600 --> 00:24:29.550
Pip Calvert: And it's one of my my goatees now see if somebody will remember me if they don't remember my name or what we talked about like blue hair or MBA.

186
00:24:30.810 --> 00:24:37.530
Pip Calvert: You know if if somebody doesn't have you know very good language abilities, again, we obviously need to think about that I think those those.

187
00:24:37.890 --> 00:24:42.360
Pip Calvert: People those difficulties are the most challenging to support in terms of psychological therapy.

188
00:24:43.140 --> 00:24:49.440
Pip Calvert: And through through a prerequisite in terms of a cut off, I think the things that you have to think about absolutely.

189
00:24:50.010 --> 00:24:56.790
Pip Calvert: But I have always been so surprised by the people that work with way you think this person's got a really bad memory problem.

190
00:24:57.480 --> 00:25:04.440
Pip Calvert: But yet we're doing work and it's how I saw them so there's a lady i'm working with a moment and others confidentiality, or it may too much.

191
00:25:05.070 --> 00:25:10.950
Pip Calvert: But she she has quite profound memory difficulties, but I spoke to her recently and she's like I remembered your name.

192
00:25:11.370 --> 00:25:17.490
Pip Calvert: And that was a real huge breakthrough for her but we've done so much work and she's feeling so much better in herself.

193
00:25:17.880 --> 00:25:28.980
Pip Calvert: because of course we know we can make people feel better, even if they can't remember how they felt better and what necessarily has been talked about so memory doesn't always have to be an explicit declarative I remember all the facts and figures.

194
00:25:29.460 --> 00:25:39.090
Pip Calvert: of it so again it's what we're talking about I think sometimes you just have to get to know the person, a little bit before you can make that make that decision, so do you dive right in yeah.

195
00:25:39.840 --> 00:25:48.210
Pip Calvert: But do you spend a bit of time getting to know that person, I guess, a bit like you would do if you're assessing somebody suitability to engage in in therapy, full stop.

196
00:25:49.230 --> 00:26:02.670
Pip Calvert: You know if you're in a mental health services i'm not send me now we used to do it varied into the number of sessions, just to see if how somebody would find talking in this way and being able to engage in that same thing to me it's just thinking about in slightly different way.

197
00:26:05.400 --> 00:26:08.670
ingram wright: jack you anything anything to add to what pip set there.

198
00:26:11.430 --> 00:26:16.830
Jak Smith: And I think one of the things that are valuable not being in the room, psychologists was just.

199
00:26:19.530 --> 00:26:22.320
Jak Smith: Working together and collaborating doing joint assessments.

200
00:26:23.700 --> 00:26:26.400
Jak Smith: And having a pre assessment conversation.

201
00:26:27.540 --> 00:26:30.540
Jak Smith: Thinking closely with colleagues and being able to join up you know.

202
00:26:31.620 --> 00:26:41.070
Our expertise and suppose but, but also that, if the kind of lived experience of the person you're looking for something you have to meet that yeah.

203
00:26:42.630 --> 00:26:50.280
Jak Smith: It feels important and, of course, there are options and ways of working with the model flexibly, I think, recording sessions, with people.

204
00:26:52.830 --> 00:27:01.260
ingram wright: I wondered if some of those sort of adaptations and not quite as great and profound are prominent in the work as we might think they are.

205
00:27:01.530 --> 00:27:10.650
ingram wright: Because on the flip side of this as you were talking, I was thinking you know, one of the things that i'm pushing for is for conventional access to conventional mental health services for individuals.

206
00:27:11.130 --> 00:27:19.230
ingram wright: who've had brain injuries, because often people are denied access because of their medical condition, and it may well be that sort of.

207
00:27:19.830 --> 00:27:25.560
ingram wright: Conventional service which is sensitive to the variation in people's abilities, whether it's attention or memory, or whatever.

208
00:27:25.950 --> 00:27:35.730
ingram wright: is perfectly suitable to someone who's had a brain injury provided those difficulties are not profound or severely debilitating in terms of the mentality of the therapy that's delivered.

209
00:27:38.250 --> 00:27:42.900
Pip Calvert: I I i'm a big advocate for for that as well because there.

210
00:27:43.560 --> 00:27:48.900
Pip Calvert: I mean there's a limited number of us in terms of who do work with people you know whether it's some different tracks background.

211
00:27:49.080 --> 00:27:55.260
Pip Calvert: And works collaboratively with other people to understand what those cognitive difficulties are and how it might impact on engagement therapy.

212
00:27:56.040 --> 00:28:04.230
Pip Calvert: yeah or people like me and yourself and Graham who are you know trained in terms of your psychology stuff there's there's a limited amount visiting some internal psychological therapist full stop.

213
00:28:04.230 --> 00:28:10.650
ingram wright: But yes, I think, the more we can help people access those because the difficulties might not actually be directly about the brain injury.

214
00:28:11.040 --> 00:28:21.660
Pip Calvert: And you know it's one of those ethical things and i've actually really I need to concentrate on the people who've had the brain injury and it's about that, so my skill that's where my expertise is, of course, I can help.

215
00:28:22.350 --> 00:28:29.340
Pip Calvert: in other ways, but I would then be reducing the amount of services available to those people that require special simpler.

216
00:28:30.030 --> 00:28:36.990
Pip Calvert: So absolutely I think there is, I think we don't, as I said before, I don't think we think about it enough in general terms, in terms of psychological therapy.

217
00:28:37.620 --> 00:28:40.770
Pip Calvert: it's not thought about, and you know in.

218
00:28:41.370 --> 00:28:49.440
Pip Calvert: I think it's becoming more thoughts about I really like when I see people talk about what were the headlines so let's just review at the end of the meeting that's a perfect cognitive strategy.

219
00:28:49.800 --> 00:28:57.600
Pip Calvert: You know let's come back let's actually focus on that let's think about the headlines takeaway brilliant that's called as a strategy so it's no it doesn't have to be.

220
00:28:58.200 --> 00:29:04.200
Pip Calvert: Really high level, it might be encouraging note taking because why as a clinician are we, the only person taking notes.

221
00:29:04.500 --> 00:29:11.940
Pip Calvert: It shouldn't feel threatening that the other person in the room is taking its taking notes, is it about a recording of the session is it a session summary.

222
00:29:12.180 --> 00:29:19.770
Pip Calvert: There are very basic things that we can do and Okay, it might mean that you lose on doing that inverted commas for people can't see me.

223
00:29:20.400 --> 00:29:32.340
Pip Calvert: If we lose 10 minutes of having a conversation, but actually if you can make use of that 10 minutes in a way that helps somebody gain an awful lot more from the other 15 minutes or 45 minutes or whatever, like the session you do.

224
00:29:33.150 --> 00:29:44.340
Pip Calvert: that's much more of a benefit it's the idea of maybe you go a bit slower to get a bit a bit server and I think I think every psychological therapy should be doing that anyway, regardless.

225
00:29:49.200 --> 00:29:51.510
Jak Smith: just wanted to add something if I can i'm not sure.

226
00:29:57.090 --> 00:29:58.020
Pip Calvert: I think he might just.

227
00:30:01.980 --> 00:30:04.740
ingram wright: To spend the whole of Saturday editing this.

228
00:30:07.260 --> 00:30:18.450
ingram wright: By remain very grateful to was all sparing the time to have this conversation jack it was it was a bit too late at the start you're very much back with us now, if you want to do you want to pick up from where you.

229
00:30:18.900 --> 00:30:27.780
ingram wright: Were you were it's quite it's quite a demanding working memory task isn't it remembering what you're about to say 30 seconds ago it's proving your point pip yeah.

230
00:30:27.840 --> 00:30:43.470
Pip Calvert: Absolutely, because let's face it, when that happens, sometimes we have to be the person who then goes, I think you were roughly around here, which means we have to be cognitive on the ball and that's a cognitive intention yeah yeah.

231
00:30:44.040 --> 00:31:00.450
ingram wright: We just had a moment during the podcast where we realized that the challenge the challenges of recording a podcast mirrored some of the challenges of anybody engaging in therapy and maintaining attention to it to a dialogue which is quite complex and emotive right absolutely so perfect.

232
00:31:01.380 --> 00:31:07.380
Pip Calvert: cuz cuz I can I remember where jack was up to other than he said, can I just add something in yeah sure, because then I was gonna let him.

233
00:31:08.460 --> 00:31:15.840
ingram wright: Know gonna let you know jax had plenty of time to think about what he was about to say yeah.

234
00:31:16.410 --> 00:31:16.980
And so.

235
00:31:19.050 --> 00:31:25.170
Jak Smith: Just to keep this cat really what i've been doing to try and keep up with the conversation is not something that I dialogue.

236
00:31:25.620 --> 00:31:33.960
Jak Smith: And so you just you're right, I think, cuts valuable in in and your population thinking cognitively with people is.

237
00:31:34.890 --> 00:31:51.720
Jak Smith: that these are tools that help people to keep hold of a dialogue, you know we map we call sequential diagram matic reformulation we're talking about one thing we might move to another and we're doing this together and we're doing in a way that's using the words if the person, you know.

238
00:31:53.190 --> 00:32:08.640
Jak Smith: And it's always on desperately trying to keep hold of the conversation i'm also leaning on the map is a cognitive strategy for making sure I don't get too lost in it helped me navigate something that feels quite fragmented and destroying it on my side because of connection.

239
00:32:10.020 --> 00:32:13.080
Jak Smith: In the room, or we reconnected and the man was that right.

240
00:32:13.260 --> 00:32:13.560
yeah.

241
00:32:14.910 --> 00:32:23.130
Pip Calvert: I love that because yeah absolutely just by by the nature of cat and this is what we call a map so it's basically.

242
00:32:23.370 --> 00:32:33.000
Pip Calvert: For those people who have never seen it is, it will literally draw out some of the patterns that we're talking about, so we have ways of describing how people relate to one another, so it might be.

243
00:32:33.870 --> 00:32:38.340
Pip Calvert: Controlling to controlled, we would talk about so that means that one person seems like the taking.

244
00:32:38.820 --> 00:32:45.420
Pip Calvert: command and they're they're being controlling so the other person with them feel controlled, and we would describe that by writing out in a certain way.

245
00:32:45.870 --> 00:32:55.200
Pip Calvert: And then we would write how people were then cope with that so it's a real visual tool, so if somebody struggles from a cognitive point of view about remembering what they've heard.

246
00:32:55.680 --> 00:33:03.930
Pip Calvert: They are better at remembering what they see and it's a perfect way of doing that and I apologize now I think my cat might be making a good appearance.

247
00:33:05.700 --> 00:33:14.490
Pip Calvert: yelling in the background, and so yeah it's a perfect perfect well and I think the sorts of stuff about that around cat that.

248
00:33:15.360 --> 00:33:23.970
Pip Calvert: helps people with cognitive difficult to since we're in cat we use letters as well and we're not you know it's obviously not the only therapy that tends to use letters.

249
00:33:24.330 --> 00:33:34.740
Pip Calvert: But we'll do that to sort of summarize our our initial understanding there's no reason you didn't couldn't add to that later on, so people have got a letter and, obviously, it depends on the density of that letter and how you write it.

250
00:33:35.250 --> 00:33:46.560
Pip Calvert: But as as therapists, we should also be thinking about what people might can manage and cope with that letter it's lovely there's so many things that we can just naturally adapt that are already in CAP.

251
00:33:47.670 --> 00:33:50.130
Pip Calvert: To us, with people who have cognitive difficulties.

252
00:33:51.000 --> 00:34:01.740
ingram wright: Do you think I mean either of you do you think that there are particular clients and we're talking about cognitive limitations, generally speaking, not just in the sort of brain injury population but.

253
00:34:02.850 --> 00:34:11.820
ingram wright: As as they might apply to the to the characteristics of cat, I suppose, as a as an interaction as a form of therapy and but other particular clients you think.

254
00:34:12.510 --> 00:34:23.880
ingram wright: cat is unsuitable for it, it doesn't work for where you'd actually be thinking you know cat isn't for you, maybe you ought to go to someone who delivers therapy in a slightly different way, or maybe you need something else at this point in time.

255
00:34:24.240 --> 00:34:28.380
ingram wright: What what what's been your experience of that kind of dilemma space.

256
00:34:32.010 --> 00:34:39.510
Jak Smith: yeah I think the other therapies that work probably that with different presenting problems or.

257
00:34:41.340 --> 00:34:44.880
Jak Smith: Difficulties cuts that definitely has a relational focus.

258
00:34:45.990 --> 00:34:47.250
Everything has to have to the next.

259
00:34:48.720 --> 00:34:53.100
Jak Smith: element to it, and I think in terms of.

260
00:34:54.480 --> 00:35:06.660
Jak Smith: suitability some something about stability and having a clear focus in some ways, it does not have to be pinned down at the beginning, but about what the works, going to be.

261
00:35:07.980 --> 00:35:09.930
Jak Smith: In terms of the neural population.

262
00:35:11.040 --> 00:35:19.860
Jak Smith: And we might work with it with the team, you know that bringing a difficult in they feel that this person needs therapy and kind of see.

263
00:35:20.640 --> 00:35:40.260
Jak Smith: The reasons wine, it also have a space of what it might be struggling with and how we might use caps consultation mother, with the team to think about what it what it's like to work with this person and why we feel stuck and yeah i'm staying away from talking about complex people because.

264
00:35:41.370 --> 00:35:43.710
it's healthcare stuff we bring.

265
00:35:46.500 --> 00:35:47.640
let's be honest yeah.

266
00:35:48.990 --> 00:35:54.270
Pip Calvert: And I don't think there's a difference between so we talked about using or doing cat.

267
00:35:54.630 --> 00:36:02.280
Pip Calvert: To doing cat would be more of the therapy, the more traditional kind of therapy, because that can have different levels to it as well, so it depends on the.

268
00:36:03.030 --> 00:36:11.070
Pip Calvert: Traditional traditional account you'll be doing a lot of work for understanding that person's path and therefore how that's related to their their present difficulties.

269
00:36:11.850 --> 00:36:19.920
Pip Calvert: In your settings I often don't necessarily do the really a lot of the digging because that's not what the person comes with so they come without.

270
00:36:20.220 --> 00:36:27.420
Pip Calvert: Having this problem because i've got this new presentation so it's all about the new presentation so i've got to start where they're at and.

271
00:36:28.110 --> 00:36:36.660
Pip Calvert: And so you wouldn't necessarily always do that digging but you doesn't mean you can't do an understanding about how they relate to people so again there's different levels of their.

272
00:36:37.170 --> 00:36:43.470
Pip Calvert: where's the using a cat would be more as well jack is talking about without consultation and supervision and helping to.

273
00:36:43.950 --> 00:36:50.730
Pip Calvert: Just I was smiling when jack said about when people come good this personally therapy, because you know the like that, and now okay.

274
00:36:51.150 --> 00:36:55.290
Pip Calvert: And i'll always have that in my head about is this because you'll find it difficult to support this person.

275
00:36:55.620 --> 00:37:01.770
Pip Calvert: So they might therapy could help them to actually are they ready for that is that, where they see it, because if they're not there, then we're not we're not doing that.

276
00:37:02.070 --> 00:37:06.810
Pip Calvert: So maybe I start using cat to help you think about what might be going on for them.

277
00:37:07.410 --> 00:37:16.380
Pip Calvert: So it might be a consultation about let's think about the person, what do you know about them and we can map that out, or it might be thinking about how you're relating to their difficulties.

278
00:37:17.370 --> 00:37:24.900
Pip Calvert: Again, you can do it now and that kind of way I think me in my experience and.

279
00:37:25.830 --> 00:37:31.320
Pip Calvert: It depends, where the persons that we've obviously already talked about cognition you know if they've been really severely impaired.

280
00:37:31.680 --> 00:37:44.610
Pip Calvert: Then doing individual you know cat work with them is probably not going to help, but it doesn't mean that we can't have an understanding of them using a cat cat approach not might be talking to family and staff members about how they found working with this person.

281
00:37:45.840 --> 00:37:52.560
Pip Calvert: And, but I think there is definitely stuff around how people just find talking generally about about emotions.

282
00:37:53.610 --> 00:38:05.880
Pip Calvert: And where they might come from and how they relate to people and maybe to themselves if that isn't even within their vernacular not because they've got a language difficulty from the neurological condition, but just it's just not in their.

283
00:38:06.330 --> 00:38:11.610
Pip Calvert: Their repertoire because they've never really experienced that they're going to really struggle something like like car.

284
00:38:12.630 --> 00:38:19.950
Pip Calvert: So it doesn't but doesn't mean you can't do some pre work with that it's all about exploring it with the person that you're trying to explore the possibilities are so.

285
00:38:20.790 --> 00:38:28.620
Pip Calvert: there's very few people that I would rule about doing something with them to support and try and make life, a bit easier, but what am I doing traditional.

286
00:38:29.010 --> 00:38:37.470
Pip Calvert: What we will call cat which is either 16 sessions or 24 sessions probably not and I don't do an awful lot of that work in my role.

287
00:38:38.040 --> 00:38:50.490
Pip Calvert: Just because there is always other things going going on, so we often have to jump about with our and now you've got a letter from the dvla We just need to sort that out, but we can talk about how you cope so have you just done it somewhere.

288
00:38:51.210 --> 00:38:58.230
Pip Calvert: And withdrawn and ignored it and now it's got to about point or benefits or things like that always tells us something about their coping strategies.

289
00:38:58.680 --> 00:39:10.200
Pip Calvert: So we're always having to jump jump about, which means that traditional therapy is actually really difficult to do, but it doesn't mean we can't use cat to help people think about how they cope and manage.

290
00:39:12.060 --> 00:39:13.770
that's interesting just.

291
00:39:15.030 --> 00:39:15.450
Because it's.

292
00:39:16.530 --> 00:39:18.450
Jak Smith: A window within my role i've got.

293
00:39:20.580 --> 00:39:25.890
Jak Smith: different parameters, you know I don't I don't get pulled into the kind of other aspects of the.

294
00:39:27.570 --> 00:39:39.150
Jak Smith: claims and things and and and allows us to really think about 13 so some people really might want to tell back to think about what what does it mean to be dependent.

295
00:39:39.510 --> 00:39:40.470
Pip Calvert: On people.

296
00:39:42.210 --> 00:39:55.350
Jak Smith: not uncommon for me to hear people come and talk about feeling like a child, again, or you know these kind of interested in themselves, I suppose, in people might have a desire to think more about what is it about the situation now that.

297
00:39:57.150 --> 00:40:08.820
Jak Smith: How do you cope with that How does that change how you feel in the world and relationships and so cat can really offer a framework for that.

298
00:40:11.550 --> 00:40:20.910
Pip Calvert: For that word that I hear an awful I don't want to be a burden on my family so again that's something about how they're relating to themselves, but then also how they are anticipating the family relating.

299
00:40:21.330 --> 00:40:28.920
Pip Calvert: To them, so cats cats presents a really nice way of thinking about that so yeah I agree jack I think it depends on the parameters of.

300
00:40:30.570 --> 00:40:32.850
Pip Calvert: My roles wider just.

301
00:40:35.070 --> 00:40:37.020
use it in different different way.

302
00:40:38.640 --> 00:40:42.690
ingram wright: I was gonna ask you both about language it's interesting that you know you've.

303
00:40:43.050 --> 00:40:56.730
ingram wright: picked up on terminology that's often used whether it's burden pre morbid pick you mentioned earlier on, it is an awful term isn't it, but we use it and and we don't necessarily question its usage or complex jack is a term you are.

304
00:40:57.870 --> 00:41:10.500
ingram wright: Perhaps raising a bit of an eyebrow about in terms of how it might be used to describe a person and I presume you are quite careful about the language that you use and you do see it as laden with meaning and importance people.

305
00:41:12.150 --> 00:41:17.100
Definitely definitely other than the other one that I don't know if you hear jack I always.

306
00:41:18.150 --> 00:41:28.890
Pip Calvert: i've got an interesting case for you red flag red flag red flag quite it's quite interesting so yeah language is incredibly important and.

307
00:41:29.730 --> 00:41:38.100
Pip Calvert: it's heavily laden and it's laid in in different ways for different people and we can't always be fully aware of that, but.

308
00:41:38.610 --> 00:41:49.020
Pip Calvert: I really liked how jack was describing earlier that, coming from a non euro background it made him, be able to question some of that but also maybe hear things that that may be traditional.

309
00:41:49.590 --> 00:41:55.920
Pip Calvert: approaches to your psychology wouldn't here and I totally agree agree with that, I think that kind of relates to what I was saying about seeing things through the.

310
00:41:56.220 --> 00:42:03.000
Pip Calvert: lens of the brain injury or the neurological condition, and I think, to be free of that sometimes is a really it's a really good thing.

311
00:42:03.510 --> 00:42:14.520
Pip Calvert: And, but then, of course, you need you need the balance to two languages, a year is incredibly important and using the person's language is so important, we might then frame it and suggest.

312
00:42:15.330 --> 00:42:24.930
Pip Calvert: You know, a term like I said controlling before judgmental and that might not be how somebody else would describe it, so we need to use that that language.

313
00:42:25.470 --> 00:42:33.210
Pip Calvert: Because also I think some of those language that some of those terms like say have a meaning for somebody else, so you might label it, you know you might see.

314
00:42:34.020 --> 00:42:41.760
Pip Calvert: This quite critical other people were then you're very criticized by that because we've got that reciprocal role going on, so they don't want to use that word because that's.

315
00:42:42.060 --> 00:42:58.770
Pip Calvert: too difficult for them at that point in time, so you have to find a different way of describing it and yeah I think language is incredibly important not to be pathology rising and just be human with it, and I think if we can't describe things way that is non jargon is.

316
00:43:00.420 --> 00:43:09.000
Pip Calvert: potentially controversial I don't think we're doing our jobs properly, and I think we are failing that we work with if we aren't able to describe it in a different way yeah.

317
00:43:11.790 --> 00:43:12.210
ingram wright: yeah.

318
00:43:12.450 --> 00:43:18.030
ingram wright: reaches his country controversial point in the in the podcast there, I admit it.

319
00:43:18.060 --> 00:43:19.020
Pip Calvert: If I.

320
00:43:20.280 --> 00:43:21.750
Pip Calvert: get my Armor on and be shot.

321
00:43:24.990 --> 00:43:26.610
ingram wright: Jackie sorry I interrupted you.

322
00:43:36.900 --> 00:43:39.330
ingram wright: jack's got some lovely drawings, to help him.

323
00:43:40.380 --> 00:43:43.680
ingram wright: reorient to the conversation we were having about 30 seconds ago.

324
00:43:47.310 --> 00:43:48.210
ingram wright: Did you want to come in on that.

325
00:43:50.460 --> 00:43:51.120
Like no.

326
00:43:52.470 --> 00:43:52.680
yeah.

327
00:43:56.880 --> 00:44:08.670
Jak Smith: yeah we were just talking about language in the power of words really isn't in cat today and logic model and it thinks a lot about dialogue in a dialogue.

328
00:44:09.420 --> 00:44:22.500
Jak Smith: Our external dialogue and and you know there were, I think I was just picking up on something about how we might have good intentions with a certain type of dialogue, but it could set up.

329
00:44:23.460 --> 00:44:31.650
Jak Smith: and certain patterns really so this idea of use it or lose it was often Nice does come up in in new rehab and.

330
00:44:33.030 --> 00:44:41.580
Jak Smith: being kind of been in a position to be able to hear and patients in the in the Center reflect on how they felt they always had to meet you always have to be doing.

331
00:44:42.090 --> 00:44:54.060
Jak Smith: And sometimes when they weren't able to do that, they felt like they weren't fill in the expectation, and so we could begin to think about this part and just you know through something that really well me and in me get it.

332
00:44:55.350 --> 00:44:57.840
Jak Smith: But there's also another side of the dialogue that.

333
00:44:59.970 --> 00:45:03.060
Jak Smith: It has a different meaning, as well as a consequence.

334
00:45:04.470 --> 00:45:14.190
Pip Calvert: yeah yeah and we can't always be aware of that, because I think as clinicians and we could become quite anxious about that I go I can't say this because what about that.

335
00:45:14.610 --> 00:45:25.470
Pip Calvert: I think if someone's you go in with them well meaning intention, but you then listen to the reaction and response to it, and then you might need to name that with the person that word seems like it's got.

336
00:45:26.190 --> 00:45:28.800
Pip Calvert: a really big meaning for you, so I apologize if.

337
00:45:29.460 --> 00:45:39.180
Pip Calvert: You know that's a good can we talk a bit about that you invite them to talk about that and actually that's a really good way of assessing how able to even to engage in those kind of those kind of conversations.

338
00:45:39.870 --> 00:45:57.210
Pip Calvert: And then it's just about adapting adapting and you might then get to a point where that feels a bit more tolerable but you've got to start somewhere so as long as your intention is is good and you're open and curious and listening to the feedback you'll be fine that's that's no additional.

339
00:46:02.190 --> 00:46:05.220
ingram wright: Checks noting vigorously I see you're talking pig.

340
00:46:07.770 --> 00:46:12.690
Jak Smith: I just like that idea of open curiosity to learn together really you know to.

341
00:46:15.390 --> 00:46:17.520
Jak Smith: feel very relational very collaborative.

342
00:46:19.170 --> 00:46:21.390
Jak Smith: Co produced you know, like.

343
00:46:22.770 --> 00:46:23.130
This.

344
00:46:25.110 --> 00:46:30.330
ingram wright: So we've all been sitting anxiously thinking when did the quiz questions going to happen, what.

345
00:46:30.630 --> 00:46:31.620
ingram wright: i'm thinking now my.

346
00:46:32.370 --> 00:46:38.460
ingram wright: Now might be a good now might be a good time well i've been sitting anxiously thinking when the quiz questions gonna happen.

347
00:46:39.390 --> 00:46:51.360
ingram wright: So i'm going to start with i'm going to i'm going to start with jack and no reference to any notes Okay, some of these questions you'll have heard before, but you just have to pick one there's no right or wrong answers for the audience to judge okay.

348
00:46:52.530 --> 00:46:52.890
ingram wright: jack.

349
00:46:52.980 --> 00:46:53.730
ingram wright: Miller, I.

350
00:46:56.370 --> 00:47:00.600
ingram wright: Say jack's going first and mixer or hippocampus jack.

351
00:47:10.290 --> 00:47:14.640
ingram wright: What did you what did you choose you just broke up there, you are the head along thinking time.

352
00:47:16.320 --> 00:47:17.640
ingram wright: makes it all hippocampus.

353
00:47:20.340 --> 00:47:22.320
ingram wright: hippocampus confident answer.

354
00:47:25.020 --> 00:47:26.550
ingram wright: pip teams are dreams.

355
00:47:28.740 --> 00:47:29.520
dreams.

356
00:47:31.140 --> 00:47:33.960
ingram wright: Perfect jack gold or silver.

357
00:47:37.590 --> 00:47:38.040
silver.

358
00:47:40.770 --> 00:47:42.690
ingram wright: pit pole vault or gymnastics.

359
00:47:43.980 --> 00:47:45.600
gymnastics I got more of a chance at it.

360
00:47:48.600 --> 00:47:49.440
ingram wright: Cattle dog.

361
00:47:52.410 --> 00:47:52.770
No.

362
00:47:53.820 --> 00:48:01.140
ingram wright: My cat is now horribly sitting on my lap so we got we've got cats actually in the room we're talking about cats.

363
00:48:05.940 --> 00:48:10.530
ingram wright: it's holding up a cat and pick fruit so fiber right.

364
00:48:12.420 --> 00:48:13.830
ingram wright: jack lemmon or line.

365
00:48:15.270 --> 00:48:15.930
Jak Smith: line.

366
00:48:17.280 --> 00:48:20.550
ingram wright: pip left or right hemisphere left.

367
00:48:23.280 --> 00:48:27.780
ingram wright: jack tea or coffee, I think I know the answer to this coffee.

368
00:48:30.960 --> 00:48:34.050
ingram wright: On pip netflix or I play.

369
00:48:35.880 --> 00:48:36.480
netflix.

370
00:48:37.650 --> 00:48:40.260
ingram wright: brilliantly brilliant well I think hundred percent to both of you.

371
00:48:41.460 --> 00:48:42.450
ingram wright: sticking with it.

372
00:48:43.860 --> 00:48:48.420
ingram wright: I have a final question, I have a final question which we had a bit of discussion.

373
00:48:49.170 --> 00:48:57.030
ingram wright: offline didn't worry about which is about how would you think about inviting colleagues in euro settings when you're a psychologist or therapist working in.

374
00:48:57.360 --> 00:49:04.920
ingram wright: neuro settings with neuro populations to use cat frameworks and ideas I mean, is it about big becoming a cat therapist or is it about.

375
00:49:05.640 --> 00:49:15.660
ingram wright: Using some of the ideas that we've talked about today or thinking differently about the work that you do what what are your thoughts about the sort of audience that aren't currently trained or experienced and using cat.

376
00:49:19.980 --> 00:49:20.160
You.

377
00:49:23.220 --> 00:49:23.820
Jak Smith: Know i'm.

378
00:49:24.870 --> 00:49:41.760
Jak Smith: Quite at the beginning of my career really I suppose i'm really excited about the possible, and you know the possibilities what cat could offer Nero, so I would encourage as many psychologists and people interested in human clinical psychology training.

379
00:49:43.200 --> 00:49:50.190
Jak Smith: And in terms of suggestions and using cat concepts in practice, I think, important thing really is that.

380
00:49:51.900 --> 00:49:57.300
Jak Smith: If people are going to begin to think in in a cat way in a relational way they've got appropriate supervision.

381
00:49:58.860 --> 00:50:09.030
Jak Smith: And you know because we wouldn't want to do any harm people, it can be quite powerful way of work, and when we work in relational models like cat.

382
00:50:09.780 --> 00:50:19.020
Jak Smith: And, but I wanted to offer something that I thought might be helpful any new sites, which is that there's a paper by somebody called Steve potter us in the world, and he.

383
00:50:19.500 --> 00:50:29.550
Jak Smith: wrote something called the help as dance and it's it's paper but it's also a questionnaire that describes familiar patterns in healthcare staff.

384
00:50:30.240 --> 00:50:49.920
Jak Smith: And it helps us to begin to think a little bit about our own reciprocal roles and our own responses in healthcare settings and I think if we're to begin to think about work in all relation and we have to have a good idea about ourselves, first and foremost and.

385
00:50:51.300 --> 00:50:55.320
Jak Smith: And so yeah so so maybe, starting with something like that, or even a cat therapy.

386
00:50:57.390 --> 00:50:57.690
and

387
00:50:58.710 --> 00:51:01.710
Jak Smith: it's not it was a huge part of my dreams.

388
00:51:05.670 --> 00:51:13.710
Pip Calvert: yeah i'd agree with that, I think, if you can start thinking about it any which way doesn't have an account mean obviously i'm going to advocate because.

389
00:51:14.760 --> 00:51:26.370
Pip Calvert: I find incredibly helpful and it's something that draws me to the if you can start to think more about how to relate to people that to me, is a massive massive star.

390
00:51:27.630 --> 00:51:37.860
Pip Calvert: And and yeah I mean reading articles, and so there are there are a few out there there's not massive amounts out there, on top of this definitely few.

391
00:51:38.190 --> 00:51:45.720
Pip Calvert: Because i'm going to plug my own, but I wrote, and you can just Google, it does come up free it's it's not it's not something that you have to pay to access.

392
00:51:46.290 --> 00:51:57.540
Pip Calvert: And, and then yet supervision and just chatting to so it might be that you contact somebody who is capturing but maybe not in in euro, and then you can put your two heads together.

393
00:51:57.840 --> 00:52:05.850
Pip Calvert: It might be that you contacted somebody like me who is Julie trained and that I agree with jack I think the supervision is is incredibly important.

394
00:52:06.150 --> 00:52:15.690
Pip Calvert: A because it's a big part of of cat anyway in terms of started to think about as you think about your own stuff and and what might you might be in acting and so.

395
00:52:16.410 --> 00:52:22.530
Pip Calvert: When we talk about acting we talk about what are you bringing to it and almost have you in the patient or miss class a little bit.

396
00:52:22.980 --> 00:52:26.400
Pip Calvert: And because you've both got your own stuff that just happens to trigger each other.

397
00:52:27.270 --> 00:52:34.380
Pip Calvert: And that's really, really important, I think, if you anybody even start there then you're starting to think about using cat in your approach.

398
00:52:35.010 --> 00:52:41.010
Pip Calvert: But yeah people want to go and train and it absolutely do I don't regret it at all I think it's incredibly helpful.

399
00:52:41.400 --> 00:52:47.430
Pip Calvert: i'm also starting my cat training, because I was working in mental health, I finished it in in euro and i've applied it more a year.

400
00:52:48.240 --> 00:52:56.910
Pip Calvert: And that's where i'm now specializing so yeah if you can think about patterns, think about how you're relating to each other that that to me would be brilliant.

401
00:52:57.360 --> 00:53:10.620
Pip Calvert: And like I said before, if you're thinking about how people related to one another, before then you're illogical condition brilliant you're already doing something that will add value to that person's input and isn't that what it's all about.

402
00:53:12.840 --> 00:53:25.800
ingram wright: Thank you, both of you for just spending the time today it's been lovely having this conversation i'm certainly persuaded that a lot of the ideas that you've shared are really important to was working in euro setting, so thank you for your time.

403