Sowing seeds

I was late to plant my vegetable seeds this year. Due to Defra restrictions to prevent avian flu, our chickens were living in our polytunnel until the end of March. It then needed digging over and the raised beds building for this year, as well as some plans for irrigation. We don’t have any staging in there yet, and I don’t have a greenhouse here in which to start my seedlings. And so because it seemed complicated and I didn’t have much energy due to ongoing health irritations, we reached the second weekend in April without any seeds planted. I could have conceded, as I did last year, and bought seedlings to plant out, but that seemed like a lazy option and I knew taking a shortcut makes me feel less proud of the results. Plus I have accumulated a stockpile of seeds that needs to be used, and the kids love planting, so that is what we spent the first weekend of the Easter holidays doing. Thankfully most of them have sprouted quickly and just reached the size where I have started planting them out (though some have not grown at all).

It struck me whilst I was planting out the seedlings and topping up the seed trays that sowing seeds is an act of faith that they will sprout and grow to produce plants, flowers, fruit or vegetables given time and nurture. Whilst generally the freshest largest seeds do the best, that isn’t always the case as weather conditions and wildlife can easily disrupt your plans in the garden. Sometimes the most promising looking seeds don’t lead to viable plants, or the most lush looking plants fail to produce fruit, whilst the least promising looking seeds or most straggly plants can sometimes surprise you with an abundant harvest down the line. Some of the outcome depends on skill, some on diligence and some on factors outside of our control. Each time you have to prepare the soil, sow the seed and water it regularly to see what comes out. It is an investment of resources and energy that will hopefully be repaid in the future. That idea was resonant for me for a number of reasons.

Firstly, I am trying to invest effort in improving my physical health. The motivation for that comes from looking forward into the prospective futures available to me, and how my health and fitness will affect me and my family. It has become much clearer that what I eat today, or the exercise I do or don’t do, has an impact on me that I’ll feel in the future. I’m making an effort to be more active, get enough sleep and to eat more vegetables and less processed food (I’m a big fan of spring greens at the moment – they are so cheap to buy, but are deliciously sweet and tasty, as well as being seasonal and grown in the UK). So far I have lost 10lbs but I have bigger goals, and want this to be the beginning of cumulative changes in my life. I want my kids to have an active, happy Mum who does lots of stuff with them, rather than a perpetually tired Mum who is preoccupied with work stress. There is a famous Reddit post that talks about non-zero days and effort being a gift from past you to future you that I would recommend reading if you haven’t stumbled upon it yet.

Investing energy for the future potential also connects to the wider theme of working in mental health – where we and the client invest time and energy in trying to make the future better for them – and also that of trying to make a career in psychology. As application season passes on the forum, we can see the hope and heartache that this involves. Many people become almost obsessional about checking the forum for news of when courses have short-listed, and when the offer letters come out – so much so that it completely changes the traffic pattern to the forum (which normally has an average visit time of over 10 minutes, in which the typical user views many pages, but has two months per year in which repeat checkers raise the number of visits, but bring the average visit time down to 2 minutes, often just viewing a single page over and over again).

The early years of most psychology’ careers are seen as an investment necessary to pass the career bottleneck of being selected for training. Prior to that, many applicants feel they are gambling their time on a potential future that may never happen. There is a sense of trying to tick boxes, but not knowing exactly what the boxes are, or why they are necessary which I think needs to be explored and challenged. For many people, it seems like those early stages feel pointless in and of themselves. They are not seen as a long term career plan, and are therefore easily dismissed as being worthless except to jump hoops to try to gain a clinical training place, but I think they have merit in their own right. Many people gain great satisfaction from doing these “low level” care jobs, and they are invaluable in the daily lives of many people in their times of greatest need. They are also a fantastic way in which you can gain and apply the basic psychological skills of listening, empathy and compassion to client’s lives, and to experience the ways that the system around them can help or hinder their wellbeing. Being a mindful and reflective frontline care worker (or researcher) is the time at which people engage the most in the lives of clients, and ensures that the advice we give later down the line is grounded in reality. It also lets us experience the hard work and competing pressures of the staff we may end up advising from the lofty perch of being a qualified health professional, so it is a shame to see so many people horizon gazing to the detriment of getting the most out of the moment they are in.

The same theme of investing time and energy to create something for the future is true in setting up a small business. All over the country people are ploughing in their own money and time to set up small ventures, despite the time involved being more than full-time hours and the initial return often being much less than minimum wage. I hadn’t realised when I set out that even when the business has been running for a while, you often end up having to repeat this process over and over again. As staff move on, or contracts change, or the balance of work stops being enjoyable, or you hit hurdles along the way you have to regroup and use the available resources to fulfil your commitments, or even to start over in a new direction. That process can be disheartening, but it can also be an opportunity for growth, and is a good reminder for those running a business to take a step back and look again at the short, middle and long-term goals of the business and the methods used to achieve them. It is hard when a business feels so personal to lose a member of staff, or to have to step away from a long-standing contract or area of work, but it can allow you to invest more energy in trying to plan the business you want to create.

The toughest part of running a business rather than being self-employed is wanting to do the right thing for your employees, whilst also achieving the aims of the business and creating an enjoyable role (and some profit) for yourself. It can be particularly hard to make good financial and business decisions as a caring, empathic, progressive person who wants to do the right thing by everybody else involved, so it is extra important to have good business and financial advice if you are not just responsible for yourself, and your own plans for the future. The owner of the business is always the last to get paid, and feels responsible for the well-being of every other member of staff – even though for them it feels more like a job, and less like a personal mission.

In a social business we are also the ones responsible for deciding how we provide our services, and what the focus will be. There is endless demand for my services as a court expert witness, as a trainer and consultant to the residential and foster care sector, but I know if I get too swept up into delivering services personally I don’t leave enough capacity to steer the business. So I have to pick and choose the activities that best align with my long-term goals. I have to plan the future of my company in a way that has the most impact on recipients and creates a financial reward for me and my employees in the future. That “triple bottom line” of caring about people (employees and service recipients) and the planet (systems and wider issues) as well as profit (earning enough to pay employees and yourself) is part of the joy and challenge of running a socially worthwhile business.

The sheer number of choices and possibilities can be quite overwhelming at times, and each decision feels like it needs knowledge that I don’t have to make it in an informed way. For example, I need to decide whether to formalise the social enterprise structure within which we deliver our outcome measurement tools. If we do it will open doors to sources of investment that might allow us to scale more rapidly and would be closed to a traditional company. However investment always comes with strings attached and can easily change the direction of the company, or reduce the autonomy with which it operates. It feels similar to decide on a new office base. Do I rent a serviced office, commit to a 3 year rental of a unit on a local farm, or get a business loan and purchase a small building? What if we need to grow or shrink so that this choice doesn’t fit the company structure in 12 months time?

It is hard to predict the future impact of seemingly small choices in the present. I can see why anxiety can sometimes make these choices overwhelming, as it is easy to end up with endless background research and tables of pros and cons that are immobilising. I’m sometimes tempted to make them with a coin toss* or a counting rhyme as we did on the playground at primary school. Like sowing seeds, we just have to research and plan the best we can within reasonable time constraints and then follow the instructions and see what grows!

 

*I was once told to toss a coin and then check if your reaction was relief or to want to make it “best of three” and to then follow your gut rather than the result. It seems as good a method of decision making as any other.

My opinions about representing Clinical Psychology and the future of the British Psychological Society

I’ve probably been a member of the BPS for 20 years now, and with it the Division of Clinical Psychology and the Faculty for Children, Young People and their Families, and within that the network for Clinical Psychologists working with Looked After and Adopted Children (CPLAAC). I’ve been to the annual Faculty conference every year since I qualified, except for the one early in my maternity leave. I read some of the publications and I follow some of the social media. Over the last decade, I’ve done a long stint on the Faculty committee, and I’ve spent 5 years as chair of the CPLAAC network. I’ve responded to policy documents, represented them on committees, written papers and edited a periodical. So you’d think with all the energy and time I have put in that I am a great fan of the organisation.

Unfortunately, whilst I am hugely admiring of many of the individuals involved with the DCP and Faculty, and some of the recent Presidents of the Society, I’m pretty ambivalent about it as a whole. I think their website and social media suck. I spent ages looking at how to help them with that through the faculty, only to find out the scope for change was minimal and was within their user-unfriendly structure. Most of it was hard to navigate, and key documents were hard to find, the documents and information on the site were often out of date and much of the content was hidden behind walls for members and separated into silos by the Society structure that were impenetrable by topic. I was censored and then locked out of the BPS twitter account whilst live tweeting talks from a conference on behalf of the faculty because I quoted a speaker who was critical of the BPS’s communication with the media and public.

My experience of running clinpsy.org.uk is that we make everything accessible, searchable and google indexed (apart from the qualified peer consultation forum that is a closed group, and the archive of livechats and other member content that can only be seen when logged in). We are also able to respond to things immediately, and often talk about current affairs. So it is quite a contrast. The view of the BPS on the forum is fairly negative, despite myself and several other qualified members trying to put the advantages of having a professional body.

One theme comes up across both spaces – that lots of people like to moan, but very few are prepared to take the actions that help to change things for the better. So, when a document is put out to consultation, or members are canvassed for views by BPS Divisions or Faculties it may be that no clinical psychologists respond at all, or perhaps just one or two nominated by the committee, someone with a vested interest, or the same old voices who feel a greater sense of responsibility for the group. I’m sure the same would be true on the forum, as lots of people like to read the content, some like to ask questions but few actually write up content for the wiki, or help with the maintenance tasks like checking and updating links. However, people pay quite a lot for their BPS memberships, whilst the forum is entirely free and run by volunteers, so it is perhaps fair to have different expectations of service. The difficulty being that the BPS expect the few members who do contribute to do so for free, in their own time, over and over again. I worked out that one eighth of my working time as a self-employed person was being spent on unpaid committee and policy work, and I don’t think that this was unusual. Certainly the chairs of networks and faculties give up a large amount of their own time, and although higher up the tree some days are paid, these are not paid sufficiently to reflect the amount of time that is spent on the job.

So when the DCP sent me a link to a survey recently, I had to reflect my views and tell them that I don’t think that the BPS works for clinical psychologists in the UK, and this is predominantly because of the nature of the larger organisation.

I have witnessed time and time again that clinical psychologists, including those on faculty committees and in the DCP committees, are inhibited rather than facilitated in responding to topical issues, speaking to the media, expressing opinions or taking action by the slow, conservative and censorial wider organisation of the BPS. Even sending representatives to sit on government fora, guidance or policy making organisations involves an overly bureaucratic process of formal invitations and nominations that often means the window has closed to have our voice heard. Likewise the process for agreeing documents for publication is onerous and slow and means months of delay. The Royal Colleges and bodies for other health professions make responses to news items in a timely way, but we don’t. We are constantly told not to be political by expressing any opinion, when, as I understand them, the charity rules are not to be party political rather than not to express opinions that affect political policy at all. I would argue that our role as powerful professionals, effective clinicians, supporters for our clients and compassionate human beings requires that we are political in the wider sense, because we should be advocating for the psychological wellbeing of the population and putting the case for provision of adequate mental health services. I would consider that this includes an obligation to argue against policies that cause hardship and emotional distress, and to put forward a psychological understanding of events and individuals in the news.

Whilst there are great people involved in the committees and a lot of good will and energy, the BPS itself makes contributors impotent. It inhibits rather than amplifies the messages we should be sending outwards and it fails also to represent us as a professional group. It is not effective at representing our interests in government policy, national or regional workforce issues, professional negotiations, disputes about funding or other professional matters.

The structure of the BPS also drowns out the fact that the majority of practitioner members are clinical psychologists by giving equal weight to tiny factions and much too much weight to academics and students – the focus on the latter two groups means that the BPS failed to address issues of regulation properly and has left us with a legacy of problems with the remit and standards of the HCPC (including who is included and excluded in the scope of regulation and the criteria for equivalence of international psychologists, which I will no doubt blog about another time). In these areas it has not only failed to promote the profession, but also to protect the public.

Unlike other professional bodies, the BPS does not offer much by way of professional advice and representation for its members (eg about workforce and pay issues, disputes with employers). It doesn’t act like a union to defend individual members or the interests of the profession, or provide us with insurance or collective bargaining. It doesn’t show our value to the public or those in power through media statements, responses to news and current events and policies, representation on government and policy bodies. It is ineffective in building the status and public awareness of the profession. I believe our professional body should constantly articulate the need for proper mental health services and highlight the useful role the profession can play in meeting those needs. Likewise it should constantly express opinions about government policy and other issues that may be harmful to the psychological health of the population, and highlight what we think would help and the role we as a profession can play in systemic changes and in planning strategies at the population level that prevent or reduce distress.

So I think radical change is needed. If that isn’t possible as a program of reform from within, and Jamie Hacker Hughes’ Presidency suggests it wasn’t, then we need to split the DCP away from the BPS and/or build something new that is fit for purpose.

If you also have an opinion about the BPS and/or DCP, whether or not you are a member, please answer their survey here. Feel free to cut and paste any part of this blog into your response if you wish to do so. Likewise feel free to share a link to this page, and if you are an aspiring or practising clinical psychologist you are welcome to join in the discussion about the BPS on the clinpsy forum.

Seeking collaborator to change the world

LifePsychol Ltd is a company with a clear social purpose – to improve outcomes for people who have experienced adversity through the application of clinical psychology, particularly children who are Looked After in public care after trauma or maltreatment. We deliver effective psychological services for Looked After and adopted children by providing assessments, formulations, therapeutic interventions, consultation, training and outcome measurement tools for placement providers. And we are very much in demand. But at the moment we are clinician led, and we really need a COO with complementary business skills as the company scales up, to ensure that we make the maximum impact going forward.

We are at a very exciting time, with the potential of rapid growth and the first evidence of efficacy for our pathway emerging. We have started the process of applying for DfE Innovation Programme funding, and we have great support from key people (Sir Martin Narey, government advisor who just reviewed the future of children’s homes in the UK, described our pathway and tools as “the missing link for the sector”, Jonathan Stanley at the Independent Children’s Homes Association described them as “the new gold standard for our members”, whilst Lord Listowell said the government should fund part of the cost to ensure there is input from a clinical psychologist in every residential care home). Despite having done no marketing, we have more enquiries about joining our system than we can keep pace with. We are already used in over 100 children’s homes, and we have a growing number of local authorities who wish to roll out our pathway across their entire catchment. We are looking at how we train and license other clinicians to deliver the model both in the UK and internationally.

We have a great clinical team, a graduate project manager/admin, a fantastic professional network and a great product set. What is important to us now is getting the right person to drive the business side forward at this critical time. To do that we really need someone with business skills and experience, combined with a passion for making social change to take on a leadership role on the financial/business side of the company. We are therefore seeking an extraordinary COO who will help us achieve extraordinary things.

Who are we looking for?

You need to genuinely care about making the world a better place, and to share our goal of making a measurable difference to the lives of vulnerable children and young people. As a clinician CEO it is vital for me to have someone I trust to bounce ideas around with, who will ensure that we are on a sound financial footing to enable us to deliver our ambitious plans. You will be familiar with all aspects of the finances for running a business, have a good working knowledge of the UK social care system and be a dynamic manager, but with a willingness to turn your hand to other aspects of the business (from fundraising to recruitment to CRM) until we are large enough to take on a full team. You understand the value of evidence-based practice and you have a good awareness of the financial demands of the social impact sector. You are the kind of person that can nail down complex ideas and grand ambitions into concrete and achievable plans that will make genuine social change.

You will ideally be based in Derbyshire at our new Matlock office and will help to develop a team there, but with some travel to other sites. However, we already have a base in Milton Keynes that I visit fairly regularly, along with existing relationships and use of shared working space in North London (Kings Cross), so if you are the right person then these might be possible alternative locations, provided you are prepared to travel regularly to meet with me in Matlock and are comfortable using video chat in between times.

How to apply

If what we are looking for sounds like you, and you are looking for a new challenge, please get in touch and we can set up a meeting. Or if you know someone that might be the right fit, please pass this information along to them. Email lifepsychol@gmail.com to express an interest. No agencies or recruiters please.

Background information:

LifePsychol currently consists of a small clinical team who provide assessment and therapy services, particularly for children and families, and services commissioned by local authorities to support Looked After Children, adoption or families at the edge of care. Our Clinical Psychologists also provide expert assessments for the family court and to local authorities considering entering proceedings. We provide consultations advice on service development and service evaluations for social enterprise and third sector organisations. Our main specialist area is around attachment, trauma and maltreatment and how this evidence base can inform the care of children who do not live in their family of origin. We therefore provide training for adoptive, foster and residential carers, as well as health, social care and legal professionals, and have a network of associates who provide regular consultation into organisations.

However, our primary goal at present is nothing less than to improve the quality of placements for all Looked After Children in the UK. LAC are a particularly vulnerable group of children and young people because their needs are complex, and often include mental health, developmental difficulties, problems with relationships and behaviour. We hope to achieve this ambitious goal by training carers and implementing a new set of standards for care providers (PRIME) and through regular use of outcome measures (BERRI).

The PRIME standards are about ensuring that strategies carers use are evidence-based, individualised to the background and needs of each child, evolve as the child’s needs change, and are based on a thorough psychological assessment and a multi-faceted formulation of the child’s needs. We believe that having advice from a clinical psychologist to inform the care of all Looked After Children (and other children with complex needs) will both reduce stigma and improve outcomes, whilst helping carers to feel better equipped to meet the children’s needs. We have developed a training program and care pathway as one means to implement these standards for placements.

We have also developed a set of online tools for commissioners and placement providers to use to identify and track the needs of children in their care. The tools are known by the acronym ‘BERRI’ because they explore Behaviour, Emotional well-being, Risk to self and others, Relationships and Indicators of psychiatric or neurodevelopmental conditions that may require further assessment or diagnosis. We want every young person with complex needs to have a service that meets their needs in an effective and evidence-based way. We have therefore developed tools that allow us to gain a more holistic picture of children’s needs, to track how this changes over time and to target particular concerns and monitor the effectiveness of interventions to address them.

Our first data suggests that we can reduce concerns about children significantly within six months of using the pathway and tools we provide, and our services gain exceptional feedback from carers and professionals, but we hold ourselves to tough standards of evidence, and gather data about our effectiveness every step of the way.

Note: The BERRI questionnaire and online tools were developed to improve the outcomes for children Looked After in public care in the UK. However, the system is also applicable to those receiving other forms of intensive or multi-agency input, such as those on the edge of care, attending special schools, placed in inpatient services, secure units or involved with services for young offenders. The system would also be equally applicable in other countries, and could be adapted to other populations (eg adults using mental health inpatient services, people with learning disabilities, or those within the criminal justice system).

How to recruit (and what to do with my therapy company)

My working life has been increasingly focused on improving outcomes for Looked After Children. I deliver training and consultancy to care providers such as residential care companies and fostering agencies, as well as to health, social care, education and legal sector professionals. I have also developed a suite of online tools to help commissioners and providers to assess needs, track progress and evaluate outcomes for Looked After Children, including www.BERRI.org.uk  I think the introduction of clinical governance processes to the social care sector is long overdue, and I’m hoping that I can contribute to a culture change that drives up standards for Looked After Children. Signs are good, in that Jonathan Stanley chair of the Independent Children’s Homes Association (ICHA) said “you have set the gold standard for care providers” and Sir Martin Narey said “this is the missing link” when it comes to residential care. So I am trying to make this my business.

I’d like to find someone to help me take that forward, who has the kind of financial/business/admin skills that will complement my clinical skills and ensure we run efficiently as a company. Perhaps a business graduate with lots of energy, or an experienced admin who wants a new challenge. Ideally able to come to meetings in Derbyshire at least once a week. I’ve been inundated with demand, which is great, but it means I need help to keep organised and on top of all the competing demands in my new line of work. And that means that I need to give up, hand over or sell on other things I have been involved in.

With that in mind, I am wanting to make a plan for what to do with my existing therapy and court work business in Milton Keynes when I move out of area in a month from now. It’s a profitable business, and meets the needs of a client group who fall between health and social care. We offer edge of care assessments, psychological therapy and support to prevent kids coming into care, to support placements, enable rehabilitation to family, or for children and families who want help with parenting or a mental health issue. We also do court expert witness work for the family courts, and provide consultation into two sets of children’s homes.  However, the only other qualified CP involved is going on maternity leave soon and there is nobody else to provide cover. If I was staying in the area and/or had the time and mental capacity to continue running it myself, I would. But given I can’t, I want to make a good landing for it. And that means either recruiting a temporary or permanent clinical psychologist, or selling the business on to somebody who has the capacity to build on it.

I also need to recruit to provide cover for the services that I supervise within Keys group whilst various staff are on maternity leave, as well as to new vacancies within Keys. But despite the enormous importance of the work, and the fact it is highly valued, and as part of a well-equipped team without many of the niggles of the NHS (for example, we provide tea and coffee, you get your own desk and computer, and the caseload is manageable) recruitment pathways are not as easy when you are outside of the NHS and the first point people look at when seeking work is NHS jobs. We’ve tried BPS appointments memorandum and various recruitment agencies and websites, but so far nobody suitable has applied. So what now?

If anyone has any ideas, the company information is below:

1) My company in Milton Keynes

Lifepsychol/Evolving Families offer therapy to about 10 families, some court expert witness work, and consultation at a day rate into Keys in south Bucks and Peterborough. The qualified CP is going on maternity leave and I am moving out of area. We therefore either need to:
a) sell the business as a going concern to somebody or a company who can pick up the clinical provision (this could potentially include the evolving families business name, bank account, social media, website and email address, with ongoing referrals and enquiries – to run either as a traditional company or as a social enterprise)
b) recruit a member of staff to pick up this work and be an ongoing employee
c) recruit sessional cover of 2 days per week for 6 months to cover the maternity leave

2) To help run my BERRI project

A business graduate or experienced admin who can turn their hands to all kinds of tasks to make a small business work effectively, from responding to email and telephone messages, to keeping on top of the finances, client account management, customer support and converting enquiries into subscribers. Basic salary, plus bonus related to success of company, and the chance to grow with us and earn ‘sweat equity’ in year three. We are flexible and family-friendly. May be able to work some hours from home, but must be able to meet in Derbyshire at least once per week. It may be possible to start part-time and build up, if you are returning to work after a career break.

I would welcome enquiries about any of the above options to lifepsychol@gmail.com

2) Within Keys we have several vacancies to deliver consultation as part of our psychology pathway, and to supervise the APs doing assessments. There may also be scope for some direct therapy. We would either be able to offer permanent contracts for full or part time work, or sessional work which would be contracted for six months initially and then potentially extended.

Vacancies include:
– Full time or part-time posts to cover Warrington/Manchester
– Full or part-time post to cover Shrewsbury area
– Full or part-time post based at Sheffield/Chesterfield/Peterborough
– Full or part-time post to cover Taunton and/or South Wales (we have about 2 days work in each location, but can top this up to full-time with input into another project)

With all of the above, hours, location and salary are negotiable dependent on experience. Email lifepsychol@gmail.com and/or juliehamilton@bettercare.co.uk

Also, if anyone has any contacts to circulate the same around the clinical courses, we would be interested in prospective applications for trainees due to qualify this year.