Dis-integrative processes in an Individual Clinician

28th December 2013
A wide range of different Dis-integrativeProcesses are encountered, operating in different DOMAINS and LEVELS of dis-integration - in this case the individual clinician.

Some examples are given here, but this is in no way an exhaustive list: plotting the processes at work for a patient, using the grid below, is an important exercise for Keyworker and Team to practice.

Amongst these, at a Conceptual Level the individual clinician may find that he or she has only a partial formulation (see Formulation and Treatment Aims) of the problem, that doesn't adequately fit the clinical problem (attributing it to psychotic symptoms, without including the major disruption caused by an alcoholic parent, for instance.)

At a Practice/Skills Level the clinician may find he or she uses favourite skills rather than skills that are best suited to addressing the problem (delivering CBT and working with medication, for instance, while omitting to work with the family to empower them to assist with mainaining treatment adherrence.)

At a Service Delivery Level it may be that the available therapeutic resources do not fit with the model of therapy; there may be unmet need as regards provision of the level/intensity of input required to support the young person to remain at home on account of the keyworker's caseload.

These are just a few examples and others can be found. See also Dis-integrativeProcesses and the Dis-integration grid.