Dr Deborah Christie Consultant Clinical Psychologist Child and Adolescent Psychological Services Rheumatology Endocrinology Orthopaedics Metabolic Surgery Urology Haematology Oncology Fatigue Chronic Pain Chronic Pain Diabetes Healthy Eating and Lifestyle Programme (HELP) Late effects of cancer Neuropsychology Medical Team Multidisciplinary team meeting Specialist psychology Mysterious llness! Local Services Specialist Neuropsychology Individual therapy Review Consultation with Psychology Family Therapy MDT work Group Work Ongoing Consultation 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 Low Importance Low/High Priority High Confidence Low importance Low/High Priority Low Confidence High Importance Low/High Priority High Confidence High Importance Low Priority High Confidence High Importance 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!!!