15 The service user experience
Case study 1: young male experiencing his first psychotic episode
9.15 a.m. Monday
A phone call from the GP to the crisis intervention and home treatment team:
CPN:
1. What additional information would you and your mentor need from the GP in order to inform your approach to the initial visit?
2. How would you and your mentor approach your initial visit taking into consideration how Christopher and his family may be feeling?
3. What would be the priorities for the first visit?
4. What might you discuss or clarify with your mentor before the visit in relation to your role and learning?
You may want to refer to the sections on assessment (Ch. 8) and forming therapeutic relationships (Ch. 7) to help you with these questions. The students’ top tips in Chapter 4 may also help you to think about what role you could have in this scenario and how you might approach this with your mentor to achieve your learning goals.
11.30 a.m. Monday
5. What factors should you consider in terms of your personal safety when visiting someone in their own home for the first time?
6. How might you greet Christopher’s mum once you have been introduced?
The section on practicalities in Chapter 5 will help you with this one. There should also be a policy relating to this in your practice area which you should read before going out on home visits, even if you are with your mentor. You could also look at the communication section in Chapter 6 to help you consider how you might enhance your approachability when meeting Christopher’s mum.
7. What questions might your mentor ask to initiate the assessment process?
8. What style of questioning might be appropriate at this stage?
Chapter 8 on assessment will give you some ideas about how to work through this scenario. You may also have observed your mentor or other professionals in practice and learnt from their approach.
9. How might you initially respond to Christopher’s mum?
10. What are your impressions of what is going on for Christopher?
11. Thinking about the Stress Vulnerability Model, what might be the factors which are increasing Christopher’s stress and vulnerability at this time?
It seems like Christopher’s mum is highly distressed by the situation and would benefit initially from reassurance and support. Additional reading, such as Gamble and Brennan (2000) and Chapter 10 on working with people who experience voices and unusual beliefs, might help you understand what might be going on for Christopher and inform your decision around your course of action.
The document Keys to Engagement (1998) published by the Sainsbury Centre for Mental Health and Chapter 7 on forming therapeutic relationships might offer you some ideas on approaches to working with Christopher. You could discuss with your peers what risks are present in this scenario. Chapter 12 will also help you to identify the risks and possible ways of working with them in a way that is therapeutic.