Society

Including President's column, Spearman medal, and end of life care report

President’s column
Liz Campbell
Contact Liz Campbell via the Society’s Leicester office, or e-mail: [email protected]

One of the key strengths of the Society is in its diversity and in the breadth of interest of our members. From students to Fellows, from applied practitioners to esoteric experimentalists, we encompass a wide span
of psychology and psychologists. From time to time this does produce tensions between what different subgroups perceive as competing interests. I think that this kind of tension and debate is very healthy. It reminds me of Walt Whitman’s famous quotation: ‘Do I contradict myself? Very well, then I contradict myself,
I am large, I contain multitudes.’

One of our hidden ‘multitudes’ is the group of over 3700 chartered psychologists with practising certificates who do not belong toa Division and therefore do not necessarily have access to an adjectival title such as ‘occupational’ or ‘educational’. I havehad quite a volume of correspondence from individuals who are in this position. They area group who are without lobbyists internally because they do not have a voice through a Division or a Section, and they are therefore without formal representation within our structures. However, we have been keepingthe interests of this group in mind in our deliberations about statutory regulation.

The debate about the Society’s position
on statutory regulation has been progressed through the meetings of the Representative Council. These Representative Council meetings allow members from all the different component groups of the Society to come together to consider the key issues. They also allow the airing of our different opinions and a method for reaching a united voice. These discussions, and our internal consultations, have led to our current policy.

We are still waiting to hear the government’s final intentions in relation to the statutory regulation of psychologists. Meanwhile we have been having constructive meetings with the Department of Health and with a Scottish minister and officials. They have not been able to confirm the final details of the legislation as yet. However, from what we have been told, some form of government-led regulation will
be introduced in 2009.

The regulator will become the body with legal responsibility for the maintenance of the official register of psychologists, the investigation of complaints about registered psychologists’ conduct, and the monitoring of registered psychologists’ CPD.

The impact on the Society of the changes arising from statutory regulation has been the subject of consideration by a working group, which has produced some proposals about the possible future shape of the Society. These recommendations and an explanatory paper are now being circulated via the boards, committees and member networks. This will also be available on the website. We would welcome as wide a response as possible to these proposals by 15 September. Please send your responses to Chrissie O’Rourke at the Leicester office or to [email protected].

Once the responses have been collated, they will be taken to the meeting of Representative Council on 9 October for discussion. Some changes to the Charter and Statutes of the Society are likely to be needed, which will require a ballot of members. The timetable for this is difficult to estimate as it will depend in part on the final details of the legislation for the regulatory framework.As well as entailing these internal changes for the Society, government-led regulation allows us an opportunity to move our focus away from inward-facing activities and to focus more on how we can contribute to society both in the UK and internationally. As a charitable body we must keep our aims firmly in sight. We will soon be starting to develop a new Strategic Plan for the Society to guide our activities through the next few years. We welcome your views: please become involved in the consultations about the Strategic Plan later this year.  

 
Spearman Medal
Tom Manly

Dr Tom Manly, of the Medical Research Council’s Cognition and Brain Sciences Unit, Addenbrooke’s Hospital, has been awarded the 2008 Spearman Medal for hiswork linking basic cognitive neuroscience to clinical applications.

Dr Manly came to psychology in 1990, graduating with first class honours from the Polytechnic of Central London. He went on to take an MSc in clinical psychology at University College London, followed in 2000 by a PhD at the University of London. His main areas of interest have lain in the fields of normal psychology, neuropsychology and cognitive rehabilitation.

As someone who successfully straddles the boundary between service-based research in clinical settings and basic neuroscience in academic institutions, Dr Manly has made use of his varied expertise by being active in teaching clinical psychologists in pre- and post-qualification training courses and contributing to clinical workshops in the UK and overseas. He is also a committee member of the Division of Neuropsychology.

Dr Manly’s nomination highlighted how his work in pure neuroscience has informed his clinical practice, and how his clinical experience has in turn informed research.
Working in a research setting, Dr Manly examined the remarkable effects of alerting cues in keeping people focused on what they are supposed to be doing. He conducted experiments that examined the effects of periodic alerting cues, not directly related to the nature
of the task itself, which merely remind people to orientate their attention to it generally. From this work emerged an understanding that the basic processes of task performance could be modulated by a sustained top-down signal, maintaining the task goal.

Crucially, this finding was then applied by Dr Manly to the clinical setting where people with certain brain injuries, particularly those to the frontal cortex, were known to experience profound levels of disorganisation in everyday life. Dr Manly’s insight was that in many cases the person’s key difficulty lay in the maintenance of attention, and that simple alerting cues can help them remain focused, breaking them out of their otherwise debilitating behaviours.

The nomination also cited how Dr Manly has turned his clinical practice into a source of inspiration and information for his research, establishing a remarkable association between spatial processing and arousal. In people with unilateral spatial neglect there is a tendency to miss information from one side of space (almost always the left). This may mean they ignore people approaching them from one side, or leave one half of a plate of food untouched. People with this unilateral spatial neglect tend also to be drowsy and to have difficulty maintaining attention. Dr Manly has shown that low arousal is a causal factor in spatial bias.
Through the studies conducted with his patients he found that as arousal declines, so attention is progressively biased away from the left side of space. In his most recent work he has imaginatively applied this understanding to people with attention deficit hyperactivity disorder (ADHD), who despite their exuberant presentation have been found to have lowered levels of alertness. Dr Manly and his colleagues examined spatial function in children with ADHD and found that deficits in sustained attention were associated with an unusual degree of rightward bias. Though this work is at an early stage it suggests a new and potentially important understanding of ADHD and paths to remediation.

Speaking of the award, Dr Manly said: ‘I am delighted to have been offered the award, both personally and for those of us working in brain injury rehabilitation. For me, good ideas tend to happen between people rather than in any individual and I am indebted to the many colleagues who have contributed to the work cited.
I would also like to thank the Medical Research Council for their support and for creating an environment in which clinicians can work alongside academic psychologists to the benefit of both fields.’

 End-of-life care

Patients who are dying, and their families, need well coordinated and clear communication in their final weeks. This is one of the conclusions reached by the Society in its Professional Practice Board report The Role of Psychology in End of Life Care, published in May. 

The report examines many of the key issues surrounding end-of-life care, such as the appropriateness (or not) of continuing to provide active treatment and care; euthanasia and physician-assisted dying; disadvantaged dying (i.e. those who are neglected because of ignorance or prejudice) and managing staff burnout for those working in such a demanding field. The document also aims to help staff who provide end-of-life care across health and social care settings including specialist palliative care, oncology, older people services and services for people with learning difficulties.

Christine Kalus, chair of the working party that produced the report, said: ‘It is apparent that people’s choices about care and preferred place of death often change as they become more unwell, and staff need to take account of these changes. They also need to be sensitive to the motivations of individuals and families, which are likely to be very different as the dying person becomes more debilitated as a result of their illness or disability.


Professor Shelia Payne, another working party member, said the document should be seen as an ongoing commitment. She said: ‘Dying is the business of all of us, not simply the policy makers and healthcare professionals. As the impact of legislation such as the Mental Capacity Act encourages individuals to make advanced decisions about their care, we will be constantly encouraged to consider how we want to look after ourselves and be looked after in the final stage of our life.’
I    The report, which has been sent to members of the Commons and the Lords, to Chairs in Palliative Care and other external stakeholders, is available at www.bps.org.uk/pracguide

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