The Psychology of Case Management podcast

The show that helps Personal Injury professionals use psychological ideas to achieve more for catastrophically injured clients by maximising rehabilitation outcomes and achieving the best level settlements possible.

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For notes and transcripts for Season One, click here.

Find all published episodes at: https://psychologyofcasemanagement.podbean.com

Season Two

Notes to the Episodes

Episode 1: Linking trauma and pain


Dr Melanie Lee and Dr Alan Bowman kick off our second season by describing their journey into pain management, working with personal injury clients and chronic pain, reactions to pain and trauma in the body and the mind... and ways to work with them.

Keywords:

trauma, pain, complex, chronic, multidisciplinary, interdisciplinary team, personal injury, relationship, holistic, acknowledgement, traumatic injury, grief, physical, mental, psychological, biological, interruption, interference, identity, therapy, formulation, communication, biopsychosocial, expectations, attachment, wellbeing, connection, integration, assessment, commission bias, gift exchange theory, uncertainty, pacing, prioritizing, planning, process, ACT, CAT, physiotherapy, occupational therapy, fatigue, concentration, attention

Quotes:

7:31 (Mel) "When you’re with someone in pain, because it’s such an unbearable experience for everybody, it is very tempting to turn away from it or jump to a conclusion or a solution very quickly… because we hate seeing people in that much distress." 16:34 (Alan) "Trauma is not a psychological thing; it’s not a biological thing. It’s both." 23:47 (Mel) "Some of the things that make the biggest difference are not direct manipulation of the physical sensations."

2:10 Guests’ journey into pain management

5:30 being warned off working in pain

6:40 Working in pain management with personal injury clients

9:00 Chronic pain

11:40 The body’s reaction to pain and trauma

14:57 Psychosomaticism

17:00 The effects of pain on a patient’s psychology

21:28 Treatment focus

24:16 acknowledgment and validation

28:38 Interdisciplinary working

33:20 Managing expectations and outcomes

36:32 Repairing fragmentation

37:57 Not focusing just on physical progress

40:53 How Trust Pain Management work

45:20 How to work with them

46:43 Three practical tips

Guest: Dr Melanie Lee and Dr Alan Bowman, Trust Pain Management

Presenter: Dr Shabnam Berry-Khan, Director of PsychWorks Associates

Editor: Emily Crosby Media




Episode 8: Understanding and managing client spending habits


Today, Shabnam explores another side of ’retail therapy’ and what spending behaviours can tell us about our clients’ underlying motivations and needs. She suggests how psychological approaches such as Compassion-Focused Therapy can help perceive anxieties that may lie beneath the surface gratification, and offers tips for professionals working in the Personal Injury field.

For Shabnam's list of 14 spending questions, please refer to the transcript of episode 8.

Keywords:

money, clients, spending, trauma, injury, compassion-focussed therapy, rules, family members, litigation, threat, drive, trigger, behaviour, choices, motivation, avoidance, distress, underlying emotions and beliefs, self-esteem, conflict, overspending, underspending, compulsive spending, avoiders, rulers, getters, pleasers, controllers, spending, saving, risk-taking, risk avoidance, generalist, particularist, impulsive, reflective, change-adaptive, change-avoidant, anxiety, irrational behaviour, psychology, relationships, groundrules, discomfort

1:00 How money issues can affect your client relationship

2:45 Research around money

9:16 Exercise about spending

14:50 The personal injury context

17:53 How psychology can help – Compassion-Focused Therapy

21:26 Shabnam’s tips

Quotes:

2:45 “The issue of money is actually a common clinical and professional problem.”3:08 “Money can be used to understand underlying psychological motivations and needs.”4:40 “People would rather talk about their sex lives than share their financial data!”22:34 “Dopamine hits mask anxiety and fears, which is what our clients and their families will inevitably be experiencing.”

Presenter: Dr Shabnam Berry-Khan, Director of PsychWorks Associates

Editor: Emily Crosby Media




Episode 2: Families and brain injury


Ndidi Boakye joins us to talk about the importance of the family in rehabilitation, because an individual doesn’t recover in isolation. She explains what is meant by the ‘system’ around a client, the impact of an injury on the family, what support a family could need, and the challenge to get wider family issues recognized as part of the injury trauma. Ndidi examines systemic factors in assessment, the risks of not considering spouses/families, cultural issues, and what case managers can do.

Keywords:

family, couple dynamic, family functioning, trauma, loss, grief, system, litigation, neuropsychology, rehabilitation, culture, social context, dutifiul, adjustment, divorce, separation, psychoeducation, brain injury, affected person, research, minority backgrounds, collectivist, discrimination, disability, settlement, adultification, children, parentification, double jeopardy, needs assessment, carer burden, distress, resilience, resourcefulness, narrative

2:10 Ndidi’s background

5:00 What is a system

8:00 The impact of injury on the family

10:30 The importance of a stable system to rehabilitation

12:00 What support the family need

13:05 Lack of research in this field

15:00 The challenge to get wider family issues recognises as part of the injury trauma

18:00 The role of case managers

18:40 Focusing on systemic factors in assessment

21:00 Perpetuating social stigma by not considering spouses/families

23:00 Issues for minority clients

24:45 What case managers can do

  • Involve the family

  • Give access to resources

  • Ask family members about their mental health

Quotes:

5:01 "Families are key to ensuring that the things that are learned in the rehab context continue."

10:59 "The individual doesn’t recover by themselves. They need a system around them.”

Guest: Dr Ndidi Boakye, The PsychPractice

Presenter: Dr Shabnam Berry-Khan, Director of PsychWorks Associates

Editor: Emily Crosby Media




Episode 3: Racism


Today I’m going solo on a topic that is both difficult and close to my heart. I want to look at racism through the lens of my family history, childhood and educational experiences, adult and professional life, and where it comes up in the personal injury/case management field. I’ll offer some ideas for steps we can all take towards meaningful change, and I’m open to constructive feedback. After all, "the best things in life are on the other side of a difficult conversation" (Kwame Christian).

Blog post referenced in the episode:

https://www.psychworks.org.uk/post/reassessing-safety-in-a-socio-cultural-context

Keywords:

race, silence, upset, discomfort, race relations, unconscious biases, racism, Pakistani, Muslim, school, safety, displacement, violence, trauma, education, non-white, obedience, Stephen Lawrence, Macpherson Report, institutional racism, police failings, multiculturalism, university, South Asian, Black, research, 9/11, 7/7, intergenerational trauma, token gestures, mistrust, prison, mental health, human rights, recruitment, training, dialogue

0:20 Toni Morrison quote

0:36 Motivation for this episode

3:36 Shabnam’s family history

7:47 Experiences growing up

12:28 Change in atmosphere after 9/11

13:22 Challenges in case management

16:59 Top three courageous steps

Quotes:

2:00 “In the past, whenever I have raised the race topic, it has almost always been met with silence.”

13:56 “Every referral my team receives is met with an unspoken fear that the colour of my skin, or my colleagues’ skin, might put a client off.”

21:34 “If you have come here to help me, you are wasting your time. But if you have come because your liberation is bound up with mine, then let us work together.” (Queensland Aboriginal activist group)

Presenter: Dr Shabnam Berry-Khan, Director of PsychWorks Associates

Editor: Emily Crosby Media




Episode 4: Motivational Interviewing


Do you have clients where, the more you try to offer sound information and advice, the more they tend to back off and resist? Stephen Rollnick and William Miller felt this in their helping roles, and came up with Motivational Interviewing to minimize barriers in their work. Now MI has an excellent research base and is applied in all sorts of settings from forensic to educational to sports. It’s getting better known in the brain injury world, too. In this episode, case manager Andrew Rose, introduces us to the theory and practice of MI and why he finds it such an excellent tool.

Keywords:

communication, language, motivational interviewing, training, brain injury, case management, David Manchester, challenging behaviour, Australia, BABICM, drug/alcohol dependency, coming alongside, conversation, behaviour change, commitment, motivation, framework, collaboration, autonomy, compassion, rolling the resistance, reflective listening, summaries, open questions, affirmation, Verna Morris, ambivalence, emotions, feedback

1:04 Intro Andrew

4:47 What is motivational interviewing?

6:35 Scientific framework

8:36 Key elements of MI

10:44 How MI and brain injury are linked

13:00 How popular is MI in the brain injury world?

15:00 Where can you train?

15:51 How would we know if we are doing MI already?

18:05 Applications of MI

19:10 Evidence base

20:27 Three tips

28:29 Contact details for Andrew

Quotes:

6:21 “You can’t force someone to change. You’ve got to help them find that internal motivation.”

11:30 “What you’re demonstrating to your clients, using these skills is: I am listening to you, I’m understanding you, I’m accepting you.”

29:30 “Motivational Interviewing is a tool that could help everyone in the case management world.”

Guest: Andrew Rose, Director of AKA Case Management

Presenter: Dr Shabnam Berry-Khan, Director of PsychWorks Associates

Editor: Emily Crosby Media




Episode 5: HR Matters in Personal Injury


This week’s podcast looks at managing care teams through an HR lens, and the expert eye of Cecily Lalloo, whose company has a specialism in care sector HR, including case management. She talks to us about the importance of empathy, training, communication and relationships, working at the speed of the family, and sometimes having to let people go. Cecily is even writing a book on the subject.

Keywords:

human resources, HR, care team, case managers, deputies, families, relationships, employee/employer obligations, expectations, recruitment, induction, management, contract, training, home, trauma, care staff, care worker, DBS, communication, performance management, nurturing, holiday, staff meetings, absence, overnight, shifts, rotas, grievance procedures, Embrace HR

4:16 Why did they specialise in PI?

7:30 Empathy in HR

11:00 How the HR process works in Case Management

13:30 Working at the speed of the family

19:00 Performance management and letting people go

24:00 The family as context

25:55 Cecily’s book

28:57 How to communicate with your team

33:03 Training

35:30 Three top tips

41:00 Contact details:

w: https://embracehr.co.uk/

e: hello@embracehr.co.uk

Quotes:

11:24 “The contract is key, because the contract helps to set the expectations.”

24:00 “The family are not the employer but they are the context.”

34:10 “Very often I find that if something’s not dealt with, the molehill starts becoming a mountain.”

Guest: Cecily Lalloo, Embrace HR

Presenter: Dr Shabnam Berry-Khan, Director of PsychWorks Associates

Editor: Emily Crosby Media




Episode 6: The Neuroscience of Pain


This week, Dr Romy Sherlock takes us beyond ‘issues in the tissues’ and into the neuroscience of pain: it’s not just about treating physical symptoms, but encompasses our use of language, the client relationship, and the way we deal with witnessing others’ pain. Brace for the traditional top tips for Personal Injury professionals, and an invitation to join the discussion.

Keywords:

persistent pain, chronic pain, teams, hopeful, Retraining Pain, medico-legal, rehabilitation, neuroscience, pain management, complicated, Lorimer Moseley, David Butler, nervous system, danger, safety, overprotective, medicalized, physical, emotional, multidisciplinary, psychological, DIMs, SIMs, complex, empathy, righting reflex, polyvagal theory, sympathetic, parasympathetic, overwhelming, subjective, collaborative, webinars

2:33 Romy’s interests and what led her to specializing in pain7:10 The neuroscience of pain12:48 Moving away from only treating the physical17:50 Use of language in treating pain21:31 How to deal with witnessing pain in others26:00 Polyvagal theory and its relevance to pain28:00 Client relationship as part of pain assessment30:52 Three top tips for Personal Injury professionals to use in their work35:20 Shabnam’s reflections37:00 Pain webinars

Quotes:

7:55 “It’s more than just ‘issues in the tissues’ sometimes we can’t make sense of why people have pain.”

11:33 “We need to ask ‘What is setting off your danger system?’ and ‘How do we help you create safety in your nervous system?’”

Free webinar on pain management run by Retraining Pain on 16 November 2021: https://www.eventbrite.co.uk/e/help-your-clients-retrain-their-pain-tickets-172136784757

Guest: Romy Sherlock: Retaining Pain

www.retrainingpain.co.uk | info@retrainingpain.co.uk

Presenter: Dr Shabnam Berry-Khan, Director of PsychWorks Associates

Editor: Emily Crosby Media




Episode 7: Research in Case Management


Dr Devdeep Ahuja talks to us today about the importance of research to the formation of a professional identity for Case Management – and you don’t have to be ‘a researcher’ to do it! We can all collect, structure, pool and learn from the evidence that comes from our intuitions, practice, experience and outcomes – even individual case studies. Dr Dev tells us what the the Case Management Society (CMSUK) is doing to support this process, and invites us to join in.

Keywords:

research, practice, case management, physiotherapy, professional identity, evidence, literature, effectiveness, pain, outcome measures, standardization, clinical practice, interventions, validation, funding, justification, evidence-based practice, practice-based evidence, bottom-up, data, anecdotal, experience, sharing, learning, CMSUK, monitoring progress, framework, journal, references, NICE guidance, reflection, Journal Club, intuition, research grants, research-aware, structure, reports, NHS


2:24 Devdeep’s journey into research

5:39 Why is research important?

8:00 Research from a consumer/patient perspective

9:35 Broadening a definition of evidence

11:50 How to share experience based evidence

13:30 Professionalising Case Management

16:00 Case management is more than just an organization role

16:45 Missing framework and epistemology

18:26 Getting started with research

21:28 CMSUK journal club

22:45 Referencing and engaging with research

26:00 Subjective nature of case management research

27:34 How CMS are encouraging research

30:56 Top three ways to increase reliance on research

Links:

https://www.cmsuk.org/

https://uk.linkedin.com/in/devdeepahuja

https://rtwplus.com/

Quotes:

6:39 “Research forms the basis of a professional identity.”

12:30 “It’s so easy to do practice based research but it needs open-mindedness towards sharing and learning together.”

18:26 “You don’t have to be a researcher to do research.”

Guest: Dr Devdeep Ahuja, CMSUK

Presenter: Dr Shabnam Berry-Khan, Director of PsychWorks Associates

Editor: Emily Crosby Media





Transcripts - with links