Staff roles at the Croft

The Croft has a large team of professionals to look after the everyday needs of children and their families and to provide treatments and therapies. Here's what each of the teams does:
 

The role of the family therapy team
Family therapy is an approach that tries to understand how a child’s difficulties connect with the key people in his or her life. These can include parents, carers, siblings, wider family, friends and school, etc. Understanding the way these relationships connect can be helpful for all those involved.

Sometimes the number of adults involved in a child’s life (parents, doctors, social workers, therapists, etc) can make things very complicated, and part of our role is to understand how these complications may affect the child and the child’s family.

Family therapy usually involves children being seen with their parents together with their brothers and sisters. At least two members of staff will be involved in most meetings. Occasionally, it may involve working with brothers and sisters without parents or working with the parents without their children.

At The Croft it is usual to meet once a week for family therapy, from Monday to Thursday.

The role of doctors
Psychiatrists are doctors who are interested in how people think, feel and behave. A psychiatrist who specialises in children's problems is called a child psychiatrist. They work together with other members of the team to try to help children and their families manage better.

At The Croft, the consultant psychiatrist (Dr Jo Holmes) has a role in assessing children and families before they come to the unit and working with families to agree the aims of the admission. Once children and families are admitted to the unit, Dr Holmes will oversee their care. She chairs the weekly team meeting when all children are discussed and plans for the following week are worked out.

Psychiatrists have particular skills in diagnosis and working with other members of the team to suggest appropriate treatments. At The Croft we usually have child psychiatrists in training working on the unit. We are also fortunate to have a paediatrician, Dr Catriona McConnachie, who is a permanent member of staff. Doctors on the team will monitor children’s medication and suggest changes as needed. They will also work with the nursing team to monitor children’s physical well-being.

The role of the nursing team
The nursing team consists of trained nurses and heath care asistants. They are involved with the children and parents throughout the day and night, carrying out a variety of functions.

The role of the clinical psychologist
The role of the clinical psychologist is to apply psychological theory to the assessment and management of children and families referred to The Croft. What does this mean in practice?

Assessment

Neuropsychological assessments
Some children have psychometric assessments during their stay. Part of the psychologist’s role is to make sense of any previous assessments and decide if further ones are required. For a significant number of children, it is particularly important to gain a detailed understanding of the nature and extent of any specific difficulties or cognitive impairment that might be contributing to their difficulties. All results are shared and explained to parents.

Behavioural assessments
During a child’s stay at The Croft there are many opportunities for a child’s behaviour to be observed during the day programme or when interacting with parents in the residential setting. It is the psychologist’s role to help staff to formalise and structure these observations through the use of standardised instruments or specifically constructed rating scales. The aim of these observations is to inform parents and professionals' understanding of the child’s behaviour in order to suggest future interventions or treatment.

Treatment

Working with parents
The clinical psychologist has a particular expertise in child behaviour management. At The Croft, this means working in close partnership with parents and staff in delivering behavioural advice to parents. This may be done on an individual basis or in a group setting via the Behaviour Management Group.

Although the admissions are brief, the opportunity to do direct work with parents on an in-patient basis is both unique and considerable. The particular challenge for The Croft is that these parents will have had varying degrees of advice prior to admission, and reviewing with parents their understanding of previous psychological treatments is an essential part of any future treatment.

The clinical psychologist works at several levels, individually with families and with the wider system where appropriate, as well as indirectly with other members of the team. For example, the psychologist might work alongside a nurse to help interpret a piece of interactive play between parent and child.

Behavioural treatments are wide ranging, including parenting packages such as 1,2,3 Magic or ideas from the Webster Stratton Parenting Course, or using video to give feedback to parents.

Working with children
Psychologists use their particular knowledge of the psychological underpinning of the child’s difficulties to apply the appropriate treatment - eg, the knowledge that a child who falls within the Autistic Spectrum has problems with ‘theory of mind’, or knowing that a child with ADHD has difficulties inhibiting behaviours or organising him/herself, will allow the appropriate interventions to be made.

Individual treatments might include, for example, cognitive behavioural treatment of obsessional compulsive behaviours, social skills development for children in the autistic spectrum, anxiety management, anger management, self esteem enhancement etc. These would be delivered in a variety of ways, depending upon the developmental level of the child and the nature of their difficulties, through play, drawing, talking, etc.

Due to the short admission times, the focus of these sessions may sometimes only be to assess the child’s ability to access this form of treatment, once they are discharged back to their local services.

Evaluation
As a scientist-practitioner it is part of the psychologist’s role to evaluate, together with other members of the multi-disciplinary team, the process of change that occurs during children's and families' admission to The Croft. This is an ongoing project and particularly important given the unique nature of working directly and in partnership with families in an in-patient setting.

Specialist expertise

The Croft staff team has developed particular expertise in the assessment of pervasive developmental disorders (Autism and Asperger's Syndrome). We use structured instruments, the Autism Diagnostic Interview (ADI) and the Autism Diagnostic Observation Schedule (ADOS) as part of these assessments.

The page was last updated on 04 November 2013 by andrea.bateman.

Cambridgeshire and Peterborough NHS Foundation Trust
Elizabeth House, Fulbourn Hospital
Cambridge, CB21 5EF

T 01223 219400 (open 8:30am to 5pm)
F 01480 398501

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