Episode 1a: The value of the Therapeutic Alliance

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In this episode, I talk to Dr Alice Nicholls about the therapeutic alliance and how to cultivate a productive relationship with our clients.

Keywords:

psychology, case manager, solicitor, therapist, care team, therapy team, legal team, working relationship, therapeutic alliance, rapport, emotional bond, client-centred, person-centred, counselling, unconditional positive regard, recruitment, support worker, litigation, problem-solving, paralysis, listening, validation, connecting, pain, upset, suffering, needs, trauma, safety, containment, manipulation, communication, safety, honesty, professionalism, goals, values, collaboration, help, compassion, cultural or religious factors, openness, respect, boundaries, relatable, checking, connection, rupture and repair, at-risk behaviours, sustainability.

2:57 What is the therapeutic alliance?

6:39 A metaphoric exercise

9:58 Overcoming paralysis in a case

11:53 The impact of trauma

14:13 Feelings of manipulation when emotions are high

16:59 Bringing your professional needs to the table

18:47 Being values led and transparent

20:03 Framing your work as ‘help’

21:19 Religious and cultural factors

22:21 Being more approachable

23:28 Remaining boundaried and professional

26:03 Better outcomes for your client

27:47 The therapeutic alliance as a work in progress

28:58 Practical tips to improve your therapeutic alliance

31:43 Asking the questions even when things are going well

32:43 When it all goes wrong - rupture and repair

35:33 An example from Shabnam’s experience

37:55 The benefits to your work - sustainability

Guest: Dr Alice Nicholls

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

Editor: Emily Crosby Media

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Episode 1b: Managing stress for clients and ourselves

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Dr Alice Nicholls returns to discuss stress, its symptoms and triggers, and what we can do to mitigate it.

Keywords:

stress, personal injury, clients, fight, flight or freeze, threat, survival, control, stressors, capacity, case management, signs and symptoms, supervision, communication, triggers, sleep, coping strategies, breathing, avoidance, self-care, kindness, replenishing, glorifying being busy, perfectionism, good enough, outsourcing, , expectations, compassion, acknowledgement, burnout

1:36 What is stress?

4:10 The effects of stress

6:09 The psychological theory of stress

8:54 Stopping our automatic responses

10:00 Burnout

12:45 Stress in Case Management

14:20 Recognising the signs and symptoms of stress

18:32 Recognising stress in ourselves

20:20 The importance of supervision

24:07 Triggers of stress

28:53 Coping strategies

31:08 Avoidance

33:00 Positive coping strategies

34:45 Avoiding punishing ourselves with self care

36:40 Admitting stress in Case Management

38:32 Neutralising triggers and accepting ‘good enough’

42:51 Focussing on what does work

43:55 Having high expectations

44:58 Self compassion

47:00 Mindfulness practices

Guest: Dr Alice Nicholls

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

Editor: Emily Crosby Media

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Episode 10: Acceptance and Commitment Therapy

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Dr Laura Krieger talks to me today about Acceptance and Commitment Therapy: join us for some mindfulness practice, and a wide-ranging conversation introduction to ACT and its applications in the world of personal injury.

Keywords:

adjustment, struggle, distress, emotions, relationships, stuckness, feelings, Acceptance and Commitment Therapy, ACT, mindfulness, experiential, intrusive thoughts, being in the present, grounding, noticing, values, Steven Hayes, meaningful change, action, psychological flexibility, valued living, problem-solving, validation, denial, expressing not suppressing, observing, chessboard, identity, fusion, chronic conditions, creative hopelessness, slowing down, space, avoidance, anxiety, diffusion, self as context, committed action, valued living, engaging the senses, burnout, small changes.

1:52 Introducing Dr Laura Krieger

2:20 Mindfulness practice to demonstrate one of the principles of ACT

5:39 What you notice from the exercise

7:23 Why is ACT helpful?

9:18 What ACT is about

10:44 Six core processes to psychological flexibility

13:50 Increasing the therapeutic alliance through relationships

15:24 Not trying to change difficult feelings

16:17 Noticing distress

18:06 It’s not denial

19:24 The chessboard metaphor

20:30 We are more than one identity

21:36 The evidence base

23:26 Creative hopelessness

24:58 Giving clients space

28:26 Avoidance perpetuates distress

29:40 Practical applications

37:13 Take-home message

Quotes:

7:52 “When we are in the present moment, we’re not worrying about the past, we’re not worrying about the future, so it’s a really helpful grounding strategy.”

10:09 “Meaningful change happens with action.”

13:15 “It’s not always appropriate to jump into advice giving and problem solving. Sometimes there’s a step before that the clients need, that we all need, where our feelings are validated.”

20:03 “We existed before, and we exist after the trauma. The trauma is something that has visited us. It is not us.”

39:18 “We can be the CEO of our lives.”

Guest: Dr Laura Krieger, PsychWorks Associates

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

Editor: Emily Crosby Media

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Episode 2: How to work with challenging behaviours

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I’m joined once again by Dr Alice Nicholls to discuss the management of challenging behaviours.

Keywords:

brain injury, catastrophic injury, post-traumatic amnesia, confusion, recovery, complex, challenging behaviours, understanding, support, quality of life, risky behaviours, risk of harm, access to community, restriction, disruption, stress, frequency, intensity, swearing, family, care teams, multidisciplinary, aggression, anger, managing emotions, environment, training, framework, performance, expression, adjustment to injury, outlet, communication, unmet needs, reinforcement, misunderstanding, consistency, behavioural management, systemic, strategy, multiple perspectives, hypothesis, tentative, professional network, case managers, solicitors, collaboration, treating behaviours, practical steps, data collection, prevention, top tips

0:24 Challenging behaviours following brain injury

2:21 Introducing Dr Alice Nicholls

3:20 How do you define challenging behaviours?

5:06 Some examples of challenging behaviours

8:29 Why do challenging behaviours happen?

12:35 Consistency in behavioural management

14:17 Collaborating with the whole team from the beginning

17:00 Going forward with a working hypothesis on treating behaviours

18:58 Practical steps to take when meeting challenging behaviours

22:45 Data collection to aid prevention

26:11 Dr Alice’s top three tips

Quote: 26:49 "My top tip, or my take-home message, is that challenging behaviour is always meeting an unmet need."

Guest: Dr Alice Nicholls

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

Editor: Emily Crosby Media

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Episode 3: The role of trauma in injury work

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Today I’m joined by Dr Marianne Trent of Good Thinking Psychological Service, to talk about grief and trauma.

Keywords:

Psychologist, human, compassion-focused therapy, case managers, solicitors, personal injury, grief, trauma, threat, hopes and dreams, grieving, reptilian brain, mammalian brain, shame, fault, triggers, family, ecosystem, fragility, crying, tears, witness statements, assessment, litigation, re-traumatisation, rehabilitation, recovery, safety, containment, depression, support.

1:50 Marianne’s work and Compassion-Focused Therapy (CFT)

3:25 Specialising in personal injury work

5:00 A definition of trauma

8:00 The overlap between trauma and grief

9:08 A definition of grief - unfairness and loss

10:07 Safety and containment

10:48 Using CFT with traumatised clients

15:00 The effects of trauma on a whole family after an accident

16:58 Understanding the fragility of the family context

18:30 Tips for working with trauma - don’t be scared of tears

20:43 Avoiding re-traumatisation through the legal process

26:47 The Our Tricky Brain Kit

29:08 The Grief Collective book

Quote: 22:42 “I appreciate that there are lots of sad stories in offices all over the country, all over the world; but these are still real people’s lives, and real people need support. Real people need help.”

Guest: Dr Marianne Trent

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

Editor: Emily Crosby Media

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Episode 4: Why we all need to tame our inner critic

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My reflections as host to (a) a new podcast and (b) an established inner critic.

Keywords:

Reflections, podcast, mindset, inner critic, best life, treating psychology, case management, work/life balance, catastrophic personal injury, thrive, self-doubt, worry, childhood, emotional security, caring professions, sacrifice, criticism, doubting, berating, should, ought, must, shame, self-critical, self-worth, resilience, confidence, compassionate, therapy, value, relationships, replenishment, wobble, authentic, reflection, comfort, strength, confidence, space, balance, sustainability.

0:56 Inner critic

2:09 The purpose behind this podcast

3:54 Triggering your inner critic

5:15 Tracing the origin of your critical voice

7:00 How I have tamed my inner critic

7:41 Noticing the voice

9:58 Allowing yourself balance and fairness

11:10 Finding supporters

12:48 Positive statements

13:36 Thinking about how other people see you

16:11 Giving yourself space for balance

17:50 The benefits of taming that inner critic

Quotes: “I do believe that we need to be nourished in the journeys that we are taking with our clients.” “It’s ok to want to thrive in caring professions like the one we do. We don’t have to always sacrifice ourselves.”

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

Editor: Emily Crosby Media

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Episode 5: Top tips for managing care teams

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I speak to Dr Stavros Orfanos, PsychWorks Associates psychologist, about the lessons for case managers from his research into group processes.

Keywords:

care teams, medico-legal, interactions, group dynamics, group interactions, outcomes, therapy, group processes, engagement, participation, conflict, friction, anger, avoidance, personality, structure, medium, leader, characteristics, focus, client, case managers, behaviour, decision-making, monitoring, attention, care needs, supervision, commonalities, care package, team meetings, avoidance, reflective, being proactive, communication channels, reactive, healthy group environment.

3:12 Stavros’ research and PhD

5:01 What are group processes?

6:38 How do they apply to care teams?

8:40 How groups work

10:17 What do we lose by not thinking about group processes?

11:20 Practical ways to optimise your team

12:05 Ensuring engagement

13:51 Monitoring conflict

14:30 Identifying avoidance

15:11 Supervision as a reflective practice

16:02 Being proactive

21:03 What to do when groups break down

22:20 When to bring in help

Quotes: “What’s really important is that case managers pay attention and really monitor the interactions between group members... Be proactive about monitoring and identifying group processes... The most healthy groups in the end are ones who have gone through some conflict but are able to work through it.”

Guest: Dr Stavros Orfanos

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

Editor: Emily Crosby Media

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Episode 6: Compassion-Focussed Therapy

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Dr Alice Nicholls returns to tell me all about CFT and its relevance for personal injury work.

Keywords:

threat, clients, soothing, drive, compassionate, system, compassion, personal injury, oncology, compassion-focused therapy, CBT, CFT, shame, critical, evolutionary, motivational systems, cortisol, dopamine, oxytocin, threat-drive loop, burnout, trauma, critical internal voice, doing, being, kindness, sustainable, connecting, universality, human, suffering, balance.

1:20 How Dr Nicholls got into CFT

1:49 A history of CFT

3:15 The scientific basis of the model

9:40 The Threat-Drive Loop

12:20 The effects of an overly critical internal voice

13:04 How compassion helps

14:48 Breaking out of the loop

16:48 Ways to activate the soothing system

18:00 Using compassion in your life

19:05 Universality of CFT

21:43 The need for compassion in case management

23:50 The effect of staying stuck

25:10 Tips for personal injury professionals

• 25:36 Noticing

• 26:19 Soothing

• 27:10 Remembering kindness

28:13 Soothing doesn’t need to feel overwhelming

29:30 Framing experiences with CFT

31:02 Fight criticism with compassion

34:16 Generating compassion in difficult cases

35:25 Compassion doesn’t always come easily

Quotes:

18:26 “To be compassionate is to be wise, and to be strong, as well as to be kind.”

31:02 “People who are being critical are people who are in threat… and once you realise that, it’s much easier to be compassionate towards them.”

Guest: Dr Alice Nicholls

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

Editor: Emily Crosby Media

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Episode 7: Rehabilitating love

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I'm joined by Dr Giles Yeates of Rppling Minds to discuss an approach to the rehabilitation of brain injury survivors in the context of their intimate relationships. For links to resources mentioned in this episode, please see the transcript below.

Keywords:

couples therapy, relationships, brain injury, survivor, partner, heartbreak, disconnection, emotional, neurorehabilitation, attachment, emotion-focused therapy, EFT, counselling, stroke, communication, reconnection, vulnerability, withdrawal, confusion, personality change, divorce, separation, distress, rehabilitation, love, depression, Headway, Different Strokes, information, ripples.

01:47 How Dr Yeates got into this field

08:21 EFT couples training

11:16 Application with couples after brain injury

17:36 Common challenges for male survivors - confusion

20:04 Working on issues between people

23:47 Divorce

26:25 Rehabilitating love

33:37 Opening up the conversation

40:04 Putting yourself in their shoes

42:44 Summary

45:46 Rippling Minds

Quotes:

“Any approach to emotional change for a survivor of brain injury really needs to be in the moment and at a slow pace to really let things be processed and sink in.”

“You want your empathic husband or wife back who you had before the accident, but they may not come back to you without you opening the door, unlocking the lock yourself.”

“To see your partner being different can actually have a destabilizing effect on your sense of self.”

“We need to stop thinking about the change happening to a survivor’s brain, on its own. We need to think, actually what’s happening is a two-way process between people.”

“Dare we rehabilitate love after brain injury? Why not?”

Guest: Dr Giles Yeates, Rippling Minds

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

Editor: Emily Crosby Media

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Episode 8: Imposter syndrome

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This episode is an exploration of 'Imposter Syndrome' and the effects it can have for many people on their professional and personal lives. I reflect on personal experience and ways to move beyond perfectionism and self-doubt, towards more realistic, healthier expectations of ourselves.

Keywords:

imposter syndrome, self-doubt, discomfort, upbringing, achievement, confidence, perfectionist expert soloist natural genius, superhuman, incompetence, insecurity, perspective, calibrating, accomplishments, self-help, 6 out of 10, good enough, balance, mindset, productivity, self-worth.

05:00 Five personality types associated with imposter syndrome

10:02 The effect of imposter syndrome on personal injury professionals

11:23 Learning to feel comfortable in the discomfort

12:38 Talking to people you trust

13:31 Remind yourself of your accomplishments

14:16 Reframe your thinking

15:29 Good enough is good enough

18:20 Speaking your truth

Quotes:

“Research shows that imposter syndrome can be especially prolific in the helping professions.”

“The insecurity and doubt that you feel are in fact reflections that you are normal and human

There is no perfect method for this game called life.”

“If you’re always striving for 100%, you need to turn it down a notch or so.”

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

Editor: Emily Crosby Media

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Episode 9: Recruitment

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Today I'm speaking to Lara Crombie about many aspects of recruitment: finding a good fit, psychometric testing, unconscious bias, the recruitment process, CVs and interviews, job description and personal specifications, getting help with HR, some pitfalls to avoid, and ultimately how to do it really well.

Keywords:

recruitment, care package, rehab goals, carers, support workers, personal injury clients, case managers, deputies, families, niche, dynamics, litigation, care team, aptitude, attitude, fit, job description, person specification, adverts, flexible, humour, psychometrics, conversation, sustainable, intuition, interview, unconscious bias, screening, race, gender, social media, application form, timetable, paperwork, team management, offer letter, contract, liaison, onboarding, timely, partnership, Finders Keepers.

1:24 Guest intro

2:45 Why go to a niche recruiter

4:50 How they recruit

6:37 How to find ‘fit’

7:56 Psychometric testing

9:23 Unconscious bias on gender and race

13:47 The recruitment process

15:33 The best candidate isn’t always looking for a job

17:11 CVs

18:15 Interviews

21:45 How long does the process take?

23:35 Writing the job description and personal specification

26:00 Help with HR

29:40 The pitfalls of working with a recruitment team

31:16 What can personal injury professionals do to recruit smoothly?

• Tell your recruiter everything

• 33:11 Interview quickly

• 34:33 Help them to work with clients/families

35:45 Summary

38:57 Contact details

Quotes:

6:05 “It’s great to have specific experience in certain areas, but more often than not, it’s the attitude and aptitude of the person. That’s the most important thing, alongside the fit with the family.”

17:30 “Great carers don’t always have great CVs… or any kind of CV, in fact.”

28:59 “It’s not only about finding people for our clients. It’s ensuring that they’re going to stay.”

38:40 “Bear in mind that skills can be learned and people can be developed, but the attitude and aptitude has to be right.”

Guest: Lara Crombie, Finders Keepers Recruitment

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

Editor: Emily Crosby Media

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