Biscuits and perseverance: reflections on supporting a community intellectual disability team to reflect

Abstract

Esther Wilcox is a ClinicalPsychologist at Sussex Partnership NHS Foundation Trust, Worthing, UK. AbstractPurpose -This paper aims to share information and reflections on the process of setting up case formulation meetings in a community intellectual disability team supporting adults with intellectual disabilities. Design/methodology/approach -The case formulation meeting was set up and pioneered by a clinical psychologist working in the team. This paper offers a description of the process of setting up the meetings and experiences of initial meetings. Findings -Evaluations of the meetings were consistently positive, but attendance from the team members was dependent on ongoing marketing of the meetings by the team's psychologist. Feedback suggested that there may be direct benefits to the clinical work of the team and that the conversations allowed for improved management of risk. This suggests that time spent on facilitating such meetings can help to improve the quality of a service. Originality/value -Other papers have helpfully shared experiences of setting up formulation meetings in other settings. To the author's knowledge, this is the first paper which shares the experience of setting up and running a case formulation meeting in an adult community intellectual disability team setting. The paper's focus on meetings which floundered, and focus on lessons learnt for the continuation of the meetings is also of practical value.

A systematic review of team formulation in clinical psychology practice: Definition, implementation, and outcomes

“…Four authors defined team formulation as ‘formulation‐focussed consultation’ or similar (Ingham, ; Murphy, Osborne, et al ., ; Ramsden et al ., ; Wilcox, ). Likewise, Berry et al .…”

“…Summers () was judged to be of low quality due to information which was either missing or unclear, for example, the process of using Grounded Theory was not reported, raising concerns as to how data were handled. Two opinion articles did not consistently substantiate their arguments as to the benefits of team formulation (Davenport, ; Wilcox, ). This issue poses a problem for readers who are unable to assess how well supported the results or opinions regarding team formulation are.…”

“…Psychological theory was used in two ways: to explore material arising from the team formulation session through psychodynamic (Christofides et al ., ; Davenport, ; Summers, ) or systemic approaches (Ingham, ; Wilcox, ); and to produce a diagrammatic/written formulation, typically using cognitive‐behavioural models (Berry et al ., , ; Murphy, Osborne, et al ., ; Ramsden et al ., ).…”

“…Table 2 provides descriptive information for the 11 articles included in the review. Five quantitative (Berry, Barrowclough, & Wearden, 2009;Ingham, 2011;Ramsden, Lowton, & Joyes, 2014;Whitton, Small, Lyon, Barker, & Akiboh, 2016), three qualitative (Christofides et al, 2012;Murphy, Osborne, & Smith, 2013;Summers, 2006), and three descriptive (Davenport, 2002;Rowe & Nevin, 2013;Wilcox, 2013) articles were retained. From articles providing information, at least 300 staff (predominantly qualified nursing and support staff), 10 clinical psychologists, and 41 service users were represented.…”

“…The remaining studies defined team formulation as a shared understanding. Staff contributed their ideas and experiences to generate a set of hypotheses (Wilcox, 2013) which formed a formulation product (Berry et al, 2009Ingham, 2011Ramsden et al, 2014) to explain the service user's presentation in the context in which they were receiving care (Davenport, 2002;Murphy, Osborne, et al, 2013;Summers, 2006).…”