Dr Sarah

What practitioners read most in August; plus a free depression webinar The Mental Elf Monthly - Your monthly dose of mental health research, evidence, and impact.

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In psychotherapy, there are principles and there are preferences.

People tend to mistake their personal preferences for principles.

We have 400+ therapeutic modalities because of preferences, not principles.

What if unknown male members of staff watching female survivors of sexual violence sleep wasn’t as therapeutic or reassuring as it sounds?

I’ve been asked to do some training on our wards to support psychological skills & compassionate care.

But is this really about training?

The wards are so stretched. Maybe to start with we need wards where care-givers feel meaningfully cared-for? Then compassionate care may flow more naturally?

🤔

🤦🏻‍♀️ really??? Do they read what they’ve written before they send it out? With the wider experience I’m also interested in the pay scale too

As psychologists we can say things like "we're curious", "we try to understand what's going on" etc. It's not "just listening", there's a depth & skill- it's hard to articulate. But it's wise to resist getting drawn in to jargon or psychobabble. At its heart our work is about being real with people.

Yes!! Had a couple of bits where I was trying to go between sessions as I just couldn’t decide. Or then got FOMO for seeing people’s comments about ones I’d missed!

My #BIGSPD25 poster contribution, challenging the “BPD” diagnosis & current practice of using OOA placement. If you fancy a chuckle at my poor presentation skills give the central QR code a scan & I’ll talk at you for about 15 minutes 😉

😂😂😂

Love these 🥰

Interesting to hear about the brief intervention clinic they’d set up, meeting people where they’re at (crisis point) & working with them/sitting with them for a small number of sessions including family/carer one.

The outcomes showed 50% didn’t need to access more, ⬇️ bed days & ⬇️ costs #BIGSPD25

two women are standing next to each other in a room and one of them is wearing an orange fur coat . ALT: two women are standing next to each other in a room and one of them is wearing an orange fur coat .

Goodbye to another year #BIGSPD25

Hope everyone has a safe trip home 🥰 I’m on the train back & ready to do a few hours work when I get in (the downside of living so close to the venue 😂). However, I’m then off for the weekend as it’s my birthday tomorrow.

Date for your diary #BIGSPD25! The 2026 @bigspd.bsky.social conference will be in Blackpool #BIGSPD26 16-18 June 2026

Sign up later in the year on the BIGSPD website so you don't miss the announcements when they come later this year: bigspd.org.uk/conferences-...

Well deserved 🥳 congratulations @hoppypelican.bsky.social #BIGSPD25

In the audience Q&A it was clear that everyone was moved by the process. Marie, Susan & Roisin talked about healing, forgiveness & permission giving. Roisin encouraged to share ‘rage on a page’. They’re holding onto the idea of (r)evolution & hope that has come throughout the conference ❤️ #BIGSPD25

They were tasked with things each week to share with Steven (10 weeks) with a final task of 500 words - the video we saw showcased this. Which they recognised 500 words were “not a lot” to share their experiences. But they did it! 😊 #BIGSPD25

Whilst they all recognised it was hard (probably an understatement), they also noticed the sense of pride & achievement in this. Steven (the facilitator) sounds like he really helped them with his patience, kindness & encouragement #BIGSPD25

Nuala started by showing a video of a number of the ladies sharing their creative writing projects. I may have shed a few tears 😢 wow! So powerful!

She moved onto a panel type question & answer with Marie, Susan & Roisin talking about their experiences #BIGSPD25

#BIGSPD25 workshop parallel next with a showcase of a creative writing project by Nuala Cassidy, Marie Coyle, Susan Cull & Roisin Donnelly from Beyond Personality Differences Northern Ireland.

Day 3 #BIGSPD25 started with Professor Brin Grenyer speaking to us all the way from Australia 🐨🦘🇦🇺 (sorry 🤦🏻‍♀️) via the power of the internet. His talk was on the stepped care approach that has been introduced across New South Wales.

#BIGSPD25 day 2 done! 😴

Lots more catching up today with peers old & new, near & far 🥰 that’s some of the best parts of this conference for me.

Keep up with the # to find other posts for #beyondtheroom

Back again tomorrow for the final day 😊

I was inspired for a ‘(r)evolution’ with Jen to help lived experience practitioners get the respect they deserve…including accreditation when they train in a therapeutic modality, good support/supervision & career progression - not being confined to a band 3 #BIGSPD25

If we consider what’s missing then what’s the synthesis? #BIGSPD25

What resonated most with me for this talk was the way services create ‘artificial roles’ that makes it harder to share our lived experience.

Jen: ‘patient or professional? I’m both’

Jen shared the differences between them & discussed what’s missing…. #BIGSPD25

The key part of this that stood out for me is that in clinical services we are working with ‘more complexity’ than those in the research studies; and whilst DBT is still effective, it’s not as much (particularly quality of life) - is this because of team variability though? #BIGSPD25

Which side are you on? #BIGSPD25

For cont.:
- prescribing in the nhs (poly pharmacy, clozapine)
- is NHS inpatient any safer? Most just promote physical containment
- NHS chose to erode their services
- is it a CQC issue? Maybe they should have standards?

Lastly, people could be neglected otherwise #BIGSPD25

For:
- easy to demonise private providers when it’s the NHS willingly sending people their
- does the NHS have a specialism really? (Does 10 days DBT training make you specialist?)
- when does the nhs ever follow NICE guidance? In fact they make things up (e.g. 72 hour admission fallacy) #BIGSPD25

Against cont.:
- NCISH encouraged no out of area placements in its annual report(s)
- costs are extortionate (£2bn p/yr)
- NHS put people somewhere so they don’t have to deal with them
- “it’s not a lifeline”
#BIGSPD25