In this study, we examined changes in attachment style as measured by the Relationship Scales Questionnaire before and after six weeks of intensive group psychotherapy. We also investigated whether changes in attachment style were associated with changes in interpersonal functioning. Results indicated that participants showed increases in secure attachment and decreases in fearful attachment and, to a lesser degree, preoccupied attachment styles. Change was not found in the dismissive attachment style. Changes in Secure and/or Fearful (but not Preoccupied) attachment styles were related to changes in interpersonal functioning on seven of the eight subscales of the Inventory of Interpersonal Problems. Overall findings suggest intensive group psychotherapy programs show promise for reducing attachment pathology and improving interpersonal functioning. Assessing differential responsiveness to psychotherapy may help us align our interventions to better address differing attachment styles through modifications in focus and approach.

the 12 item VCDQ; for chronic cough the 19-item LCQ), and patient satisfaction questionnaires and flexible laryngoscopy performed post therapy. Results Eleven people have completed SLT over Skype™ to date, and all demonstrated improvement in symptoms following therapy. Patients with VCD showed a decrease in score on the VCDQ from median (range) 48 (12-53) pre therapy to 40 (7-42) post therapy [minimal clinical important difference (MCID) 5]. Patients with chronic cough showed an increase on the LCQ from median (range) 6.4 (4.6-8.2) pre therapy to 12.2 (10-14.6) post therapy (MCID 1.3). Improvements in laryngeal tension and sensitivity were noted in all cases. All patients gave positive feedback in their patient satisfaction questionnaire scoring "very satisfied" or greater. On three occasions Skype connection problems delayed sessions by a few days. Conclusions Virtual consultations provide the opportunity to treat patients in a more time efficient and practical way, and improvements in patient-reported symptoms and laryngeal appearances were similar to those of patients attending therapy sessions in chest clinic. This data gives support to pursue formalised tariffs for a specialised telehealth service. We feel that Skype should continue as a regular therapy option for patients and other members of the multi-disciplinary team (MDT) should consider this method of therapy delivery. Background BTS guidelines (2008) states that "local anaesthesia (LA) should be used for all arterial blood gas (ABG) specimens except in emergencies 1 as it improves the patient experience. A survey conducted in 2012 revealed only 5% of junior doctors regularly use LA with ABGs. 2 We were interested to determine if this has improved and establish whether medical students are being orientated to this practice. Methodology This is a multicentre prospective study. A questionnaire survey was distributed to 4th year medical students and junior doctors affiliated with UCL Medical School. Questions related to their actual experiences of using LA with ABGs and barriers to using LA. Results 94 medical students completed the questionnaire. Students used LA 17% of the time out of 54 supervised procedures. 29% were actively discouraged from using LA by their supervising doctor. 10% felt the general culture amongst supervising doctors was resistant to using LA. P113Amongst the 86 surveyed doctors, 91% never or rarely (<10% of the time) used LA, 5% sometimes (<25% of the time) and 3% used it regularly (>75% of the time). 65% of doctors were not aware that LA was advised in national guidance. 40% of respondents felt it would not reduce the pain of the procedure and 38% did not know the technique involved of using LA. Conclusion The use of LA is extremely poor as has been found previously.1 The reasons reflect a lack of awareness and a culture that is experienced from the moment the enter the clinical environment as medical students. In order to improve the

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