Dr Deborah Christie Consultant Clinical Psychologist Child and Adolescent Psychological Services

Medical Team Multidisciplinary team meeting Consultation with Psychology Specialist psychology Specialist Neuro- psychology Individual therapy Family Therapy MDT work Group Work Ongoing Consultation Local Services Review Rheumatology Endocrinology Orthopaedics Metabolic Surgery Urology Haematology Oncology Fatigue Chronic Pain Mysterious llness! Chronic Pain Diabetes Healthy Eating and Lifestyle Programme (HELP) Late effects of cancer Neuropsychology

Our starting point What has been helpful before? What has not been helpful? What could we do differently?

Skills, Strengths and Abilities Preferred futures? New stories? Goodenough? Focusing on the solution

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?

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

Advantages of Change Disadvantages of Status Quo

Ginger Rogers could do everything that Fred Astaire could do - only she could do it backwards and in high heels!!! Leading or following?