Using One Page Profiles to make person-centred rehabilitation a reality

12 August 2016

In this guest post Dr. Samantha Townsend, a Clinical Psychologist on the Complex Rehabilitation Unit at The Walton Centre in Liverpool, shares her experiences in implementing One Page Profiles to drive person-centredness in this unique and challenging environment.

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I first learnt about One Page Profiles through a training course when I worked in Learning Disability services. With Gill’s support, I was convinced of their value right from the start and was able to see real improvements in how we worked. Not only did we improve relationships with the people we supported, but we were able to give them solutions and interventions that were really tailored to what they needed. It spurred me on to become a Trainer in Person-Centred Practices and One Page Profiles myself, and I was better-placed to really embed the practices into where I was working.

A practical way to meet national guidelines

I am a Mersey Care NHS Foundation Trust Clinical Psychologist working as part of a team of Psychologists across the Cheshire and Merseyside Rehabilitation Network. This is a network of wards in different hospitals, and community services, providing specialist rehabilitation to patients with brain injuries or complex physical trauma. The CMRN ensures that each patient receives the right rehabilitation at the right time, in the appropriate environment. My particular wards are based at the Walton Centre, the host organization of the CMRN and the earliest point that a patient can enter the network. When I moved from Learning Disabilities into the CMRN, it wasn’t long before I started wondering about the possibilities in this new area.

Our patients come to us for a variety of different reasons. They may have sustained a brain injury or physical trauma in a car accident, for example, or experienced neurological trauma as a result of an illness. What is often a common thread is the very real emotional trauma that the individual and their loved ones are going through. The person may have lost their autonomy, identity or ability to communicate. They may not be able to walk or perform other physical tasks. And given the nature of brain trauma, this may also have happened very suddenly. It’s so crucial, therefore, that we’re doing the best we can to help restore their sense of self, and treating them as the individual they are, and their family know and love.

Although most UK rehabilitation guidelines state person centred care in rehab is important, what they don’t state is how to go about doing so. One Page Profiles offered me a practical solution to take forward, and are anchored in best practice for Clinical Psychology. They just fit the bill in so many ways, such as:

  • Helping us to see the person, even when they may not be able to be communicate or be minimally conscious, by collating information from families and loved ones. For example, we might learn about a favourite type of music, and far from being just a ‘nice to have’, this can give us a better chance in rehab sessions. For example, someone with left sided attentional neglect has a much better chance of paying attention to their neglected side if there is an ipod placed to their left, playing their favourite tune, in an Occupational Therapy session. This is the kind of joint work we do to maximise our patients’ rehabilitation.
  • Providing us with a framework for therapeutic work. The profiles help us deal with loss of autonomy and identity by supporting us to help people to control or keep their identity. We also learn how to best support people when they are feeling upset, in a way that is personal to them.
  • Building relationships with families and loved ones. Even at difficult times, we have found that almost all families are very eager to share their loved ones stories. It’s inspiring, and an honour to hear them. Not only that, but we welcomed a Trainee Clinical Psychologist, Laura Binsale, to the unit; and she found that staff felt One Page Profiles enhanced their therapeutic relationship with families.
  • Supporting smooth, integrated journeys. For many, the Walton Centre is the beginning of a rehabilitation journey through the Network. The One Page Profiles move with the individual through the Network, making it easy for staff to get information about what really matters to them alongside the information we hold about their clinical condition. Sometimes we also record information about cognitive strengths and difficulties as a ‘One Page Profile Plus’. Over the last few years, I have trained over 50 staff across the Network in One Page Profiles, from a variety of disciplines.
  • Being easy to update as changes happen. As people’s circumstances change, they might need different types of support. One Page Profiles are ideally suited to being updated, and as a result continue to provide at-a-glance information that explains how to best support someone at whatever stage in their time with us.

 

With all these positives, I sometimes forget about the challenges I’ve faced in getting us here. Implementing something new like this will always invite questions and meet some resistance. If I were to offer advice to anyone thinking of bringing One Page Profiles into a new setting, it would be to be prepared for a journey. You’ll need to bring your colleagues with you, engage others in something they might not be familiar with, sometimes you’ll open yourself up to emotional conversations with families, and you’ll need to learn about when it is appropriate to have these conversations and when it might not be the right time. But, given all these challenges, has it been worth it?

Colleagues are telling us that it is working

Laura, who joined us at the unit from Lancaster University, undertook a thematic analysis of staff member’s experiences of working with Psychology. Here are some of the quotes she got from my colleagues on the theme of our developments in person-centred rehabilitation:

“I actually love that it gives you a sense of the person before the injury because in such severe injuries like the ones we see you can forget they have had this amazing life before.” Isobel

 

 “One Page Profiles enable you to see the person, rather than just a patient in a bed with all of these difficulties.” Kate-Marie

 

“The first thing I do is look for the One Page Profile so that I can hold a conversation with the patient that is meaningful to them.” Marie

 

This feedback has been really encouraging for us at the Walton Centre, and motivates us to keep on with our efforts. It just goes to show, even in the most difficult of circumstances, person-centred approaches can make a real difference to people’s quality of life and the care they receive.

If you would like to learn more about Sam’s experiences, you can e-mail her at samantha.townsend@thewaltoncentre.nhs.uk.

If you would like to know more about Laura’s research you can email her at l.binsale@lancaster.ac.uk.

Helen Sanderson Associates can support you to learn more about One Page Profiles and how to implement them in your organisation. To find out more, explore our courses, bespoke support or online learning packages; or just contact us for a chat.

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