How do you get rid of a destructive, manipulative psychologist? No, it’s not the opening line of a joke. It’s a question I’ve been wrestling with for over a year.
In February 2011, the psychologist expert appointed by the Court of Protection to report on Steven and his best interests wrote an excellent report. It was instrumental in the judge’s decision that Steven could live in his own home permanently. In his report, he identified some areas that he believed would benefit Steven, input from external professionals, like occupational therapy, speech therapy and, psychology. Absolutely fine and welcome. Unfortunately, the matter was left with Hillingdon to arrange the input and where they have an in-house service, they will not look for a more appropriate resource elsewhere. You may remember the year long battle I have had to arrange respite. Hillingdon assessed a need for respite but the only option they would fund was the very unit where Steven was detained for a whole year against his Article 5 & 8 Human Rights. Thankfully that is all sorted but there has been a more insidious, troublesome issue rumbling away.
An in-house psychologist was appointed to Steven’s care team in the autumn of 2010. Steven was still in the positive behaviour unit at the time and the council were well into their plan of moving him to the hospital in Wales. It was never clear what her role was at the time; lots of talk about “coordinating processes” and “facilitating dialogues”. One of the dialogues she had with one of the workers at the unit, who fortunately hadn’t left their integrity at the door when they clocked on was that “Mr Neary is the tough nut we have to crack”. And I was duly called to meet her for the first time. I think I would have preferred to have had four wisdom teeth extracted with a spoon. It was a deeply dispiriting experience and she wouldn’t let me leave the room until I came up with five positive things about Steven’s experience in the positive behaviour unit. Fortunately, I put my SAS training to good use and scaled the Civic centre walls and made my escape.
Fast forward six months and Steven was now at home and a team was assembled to deliver his care. All agreed that this psychologist would have a valuable role in coordinating all the support and her input on Steven’s behaviour would be important.
One area where she has had considerable input has been in form design. We now have a log for daily purposes. This log has to include; what Steven has ate, what activities he has done, what independent tasks he has carried out, what his mood and behaviour has been like; how have the support staff and myself dealt with any difficult behaviours. I now have over 500 of these sheets. 500 statements like “Had pears, bananas, grapes, satsumas for breakfast”, “Put his pyjamas in the washing machine”, “Watched Countdown calmly”. And every month the team pour over these sheets suggesting how the forms could be amended to produce more useful data.
On top of the daily log, we have an “incident log” and an “incident log summary”. The incident log is an A4 document that is intended to describe any incidents of challenging behaviour that occur. This form has been through many versions. The summary is a table for each month that looks like this:
|3.5.12||0||1||Steven attempted to throw book at Dad|
And so on and so forth….. Our friend is then meant to analyse the documents and offer her professional support in changing or managing whatever she identifies as amiss.
This might be a productive exercise if she didn’t have such an obvious hidden agenda. Sadly, she is still trying to crack that tough nut. She is a corporate tool, still in a litigatious place, where the function is to find fault at anyone involved in Steven’s care (outside of the council’s own staff). All the dialogue seems geared to one thing – a return to court and Hillingdon being able to say “We told you so”. Never mind that this tactic failed horribly for them a year ago and the judge berated them for trying to find evidence to support a theory they had invented and after a year in their care, they had been unable to build any evidence that was truthful.
Here’s a flavour of what I mean. I sometimes forget to send the logs off. Remiss of me I know but sometimes I might prefer to be watching a DVD or having a music session with Steven. In March, I was a month behind, so submitted two months worth of logs. I was shocked to find that the psychologist had arranged an urgent meeting on receipt of the logs to:” review how incidents are being recorded and managed, given the recent escalation in aggressive behaviours and review how anxiety is being recorded and managed”. And what was this “recent escalation in aggressive behaviours”? Well, in February we had three incidents; in March we had four! Fuck – batten down the hatches, things are escalating out of control. (For those statisticians reading this, in April we had two incidents by the way).
A week later, the psychologist suddenly turned up at my meeting with Steven’s dietician. Do psychologists do that?
A few days later, she requested dates and times of all Steven’s community activities, so she could “observe” the support staff dealing with him. There was no way I could put Steven’s hard working team in that position because the agenda is so murky.
And to the latest encounter that has prompted this piece. Yesterday was the latest two monthly meeting. “Incidents” have remained at 2/3 per month. It would be great if it was 0 but we are dealing with someone with autism here and the awful meltdowns that accompany the condition. Unfortunately one of the recent incidents happened in the day centre Steven attends each Friday and was witnessed by the new speech therapist. So, off we’re launched again. Redesign of forms for clearer data; training for all the staff; observations etc etc etc. The support worker had completed the daily log form and one of the day centre’s own incident reports but had forgotten to do our own incident report. Bring back hanging eh? In the midst of all the earnest discussion, the psychologist said “and of course, we don’t want another airport incident”. It was low, and mean, and possibly unethical. The judge pulled them up on it last year; firstly for the lack of supervision during the incident and secondly in how Hillingdon tried to use the incident to smear Steven in that appalling press release they circulated. And one year one, they are still doing it. I pointed out to her that not only was she dismissing the work done by myself, the support staff and Steven himself but also her own colleagues who have worked hard in the five years since the airport incident. She just smiled.
I have made two complaints now and said that I will not be engaging with her but each meeting she bounces back like an aggressive Tigger. I’ve thought about reporting her to her professional body; as a counsellor myself, I am aware of the ethical standards that exists within the various bodies and I’m sure she must be breaking several of hers.
It is sickening that after being crucified by a High Court judge, being pilloried in the press and as I found out last week at the DoLs conference, being used nationally as the worst example of bad practice, nothing fundamentally changes in the attitude.
And as usual, we’re left with not having a service that could actually be quite useful to Steven.