Setting the Scene for the Psychotherapy Case ( RANZCP ) – Dr Neil Jeyasingam
Dr Neil Jeyasingam is a former research scholar of the Institute of Psychiatry (Sydney) and Institute of Psychiatry (UK) and specializes in phenomenology and personality disorders in the elderly. In public practice, he is the in–patient clinical lead for an old–age psychiatry service, as well as ECT Clinical Director. He is also the Binational New South Wales Representative for the Faculty of Old Age Psychiatry, a Foundation Accredited Member of the Royal Australian and New Zealand Psychotherapy Faculty, a Clinical Lecturer with Sydney University, and Senior Lecturer with Western Sydney University.
He is also founder of Profectus Psychiatry.
The thing is though, defence mechanisms don’t actually need to be maladaptive, they don’t need to be unconscious, they also don’t need to reduce anxiety…it’s one of the complex things, so when you are writing up the case it looks from the start that it’s all stuff that you are familiar with, but there is actually quite a large amount of theory and reading that you need to get through.
Why would you give someone 40 sessions over a year of psychodynamically-informed psychotherapy? Can anyone tell me – why 40 sessions?
Question to audience
It’s about conducting the therapy [from the start] in a way that is going to lead to a writeable case.
Dr Jeyasingam begins his presentation with an overview of the long-term psychotherapy case and discusses its place in accredited psychiatrist training, the standards expected of candidates, and the requirements for progression.
Starting with the marking scheme, Dr Jeyasingam explains the process in detail and talks with the audience about the mental state examination; looking at the patient interview, he discusses how you would be able to comment on psychodynamic issues, and covers formulation.
He moves on to the clinical progress of the patient and communication liaison with all other parties involved in the treatment and management of the patient.
Dr Jeyasingam concludes this section of the presentation with a review of the assessment process and the role of the supervisor.
Take Home Points
- Candidates need to know how to document the psychodynamic section of a case.
- Candidates need to have a clear idea about their assessment and management plan before they move on to the clinical progress.
- It is important to pay attention to the patient selection process and supervisory advice in developing an optimum treatment management plan.