Hello and welcome to The Care Guy's blog.
Please have a look around and feel free to comment on anything that catches your eye.
I hope to make this a useful resource, not just a 'come and buy my services' blog and the comments and opinions of visitors is likely to be a big part of making the blog a success.
I look forward to hearing from you.
(The Care Guy)
» Depression category
Posted on 2:49pm Friday 6th Jul 2012
Listed under: Anxiety, Challenging behaviour, Dementia, Depression, Mental health, Personality disorder, Psychology, Psychosis, Support work, The guide
If you have a mobile phone, a kindle, an iphone or ipad or any of a number of other electronic readers you can get the entire Mental Health Workers Guide from Kindle. If you don't have a kindle don't worry - just download the app (it's free) and turn your phone or PC into a Kindle reader.
Then nip on over to the Kindle store and get your copy of The Mental Health Workers' Guide in handy Ebook format.
The ebook is the completed version of the developing blog series. It covers:
What’s a mental health worker worth?
The problem of specialisation
Three models of mental health and disorder
The biological (medical) model
The social model
Merging the two (stress and vulnerability)
The importance of physiology
The meaning of psychiatric diagnoses
The psychology of anxiety
The psychology of depression
Delusions part 1
Delusions part 2
Types of dementia – Alzheimer’s
Types of dementia – Vascular
Types of dementia – Lewy Body
Types of dementia – Parkinson’s
Types of dementia – Korsakoff’s
Types of dementia – Fronto-temporal
Types of dementia – Mixed
Orientation and memory
The CAM scale
Working with the limbic system
High Expressed Emotion
Sympathy is not usually helpful
More on the Stress & Vulnerability model of mental health and disorder
The invalidating environment
The Self-fulfilling prophecy
The meaning of recovery in mental health
The three types of recovery
Duty of care: A slug in a bottle
‘Hanged if you do, hanged if you don’t’ – a duty of care myth
There is no ‘us and them’
People are just people
Coping skills develop slowly
Lapse is different from relapse
Don’t expect your service user to perform perfectly.
The word ‘support’ is meaningless in and of itself
“It’s just behavioural” (A workers’ excuse for lazy thinking)
Challenging behaviour means….
Behaviours that harm the individual
Behaviours that harm other people
Do we need help?
Consequence, learned behaviour and the need for boundaries
Maintaining the problem
The whole team approach
No ‘Pedestals’ And Staff Safety
Effective, Consistent Care
‘Corporate’ Identity – “You’re All The Same.”
Self-harm as a response to trauma
Responding to a person who harms themselves
Individual v Organisational risk (Risk-free is impossible. Manageable risk is the way to go)
Don’t flap (more haste – less speed)
The saviour fantasy
You’re probably not an emergency service – don’t try to behave like one
Ignoring the positive
Exaggerating the negative
Magical thinking (the Wizard did it)
Socratic dialogue and ‘the razors’.
The sticks we use to beat ourselves
Who put us in charge?
Posted on 10:19pm Monday 7th May 2012
In case you missed it...
I recently delivered training on mental health (the basics) to a group of support workers in Glasgow. Not only were these people a joy to work with they were also generous enough to let me record the training and then post the recordings on the internet. Thanks also to Frank, the organisation's training manager for consenting to these recordings 'going public'.
Posted on 1:40pm Wednesday 11th Apr 2012
Readers of my blogs might be forgiven for thinking that I’m opposed to psychiatry and the biological model. After all I regularly complain about the standard medical approach with it’s heavy reliance upon medication to treat mental disorder – especially relating to antipsychotics for people diagnosed with disorders like schizophrenia and bipolar disorder. But that doesn’t mean I’m ‘antipsychiatry’ – it just means that I’m cautious. This is especially true where medications are concerned.
The list of side effects that accompany psychotropic drugs can be a major problem but the same is (and has always been) true of all medications from AZT to aspirin. If a particular person suffers side effects from a particular drug then there’s a case for trying a different drug or even a different dose but that, in itself, is not really a case for scrapping all antipsychotic medication. All we can really say is that we need to be cautious about medication and avoid the ‘hammer to crack a nut’ approaches of the past.
Medications are biological tools. They are chemical preparations designed to make chemical changes in the body. This is because of an assumption that mental disorders are caused by physical (specifically chemical) problems. But is this always true?
Combat veterans are known to develop psychotic disorders as a result of their experiences whilst on active service. It seems ridiculous to assume that all these men and women (who had passed psychological evaluation before entering the battlefield) suffer from organic brain disorders. Yet their symptoms are similar, if not identical to those experienced by many of their civilian counterparts, diagnosed with major psychotic disorders and treated with chemical medications.
Combat veterans suffer a form of psychosis that is
caused not by biology but by stress.
For these people I think that there is an excellent case for using medication to treat their distress and to provide a degree of respite from their symptoms but that’s not the same as cure. That’s one thing I do disagree with traditional psychiatry about…
I believe in recovery.
Happily though, so do many modern psychiatrists. People like me who advocate recovery aren’t so much joining the mainstream as the mainstream is catching up. That’s a nice feeling.
There are, of course many people who argue vehemently that psychiatry is flawed and that medication should never be ‘used on’ mentally ill people. However, sincere though I’m sure these people are, they may well fall into the same trap as the overly zealous arguments in favour of medication. They may be too general.
Just as not all cases of psychosis seem likely to be chemical, so not all cases need necessarily be purely stress related. Whether the argument is in favour of medication or against it there is a real problem with polarisation and over-generalisation in mental health care. The disadvantage of these ‘black or white’ arguments is that they assume that everyone is the same and that everyone needs the same sort of intervention.
This sort of one-sidedness can feel easy and comfortable for those doing the arguing but there’s a price to be paid for superficial reasoning. The price is poor treatment because of flawed assumptions that compare chalk and cheese and assume that they are the same thing.
And that price is not generally paid by the individuals doing the arguing. It is paid by the mental health service-user whose options for recovery are limited not by ignorance but by stubborn refusal on both sides of the argument to look beyond their own, pet theories.
If I seem a little hard-nosed about this it’s for good reason. I was trained in the traditional way where medication and unquestioning acceptance of the biological hypothesis were everything. I was at the extreme ‘medical’ end of the continuum.
Then I was lucky enough to be selected for further training at the Post Graduate level. I spent two years part time being exposed to the other side of the argument and, like many of my peers, became just as rabid in my defence of social and psychological perspectives instead. I was for a while the typical antipsychiatrist (or more accurately ‘antipsychiatric nurse’). And that felt good.
Today I’ve moved on a little from either of those two positions. Now I am able to see past the partisan posturing of either side and I try to walk the middle line. It seems to me that balance is everything. Isn’t that usually the case in the real world?
I no longer see much of a place for extremism in
mental health care – especially when those
who pay the price are not the ones making the arguments.
Please don’t misunderstand me though. I am far from an apologist for the biomedical status quo. I believe that biomedical psychiatry may well have something positive to offer psychotic individuals in relation to symptom management but in most cases that’s about all. I think that true recovery is generally achievable in other ways. But that’s for a different post.
Posted on 7:06am Friday 2nd Mar 2012
Depression is one of the most common psychological problems in modern Britain. More people are seeking professional help because of depressive illnesses than ever before.