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''1. Supporting families of those with both chronic and acute conditions'':
''1. Supporting families of those with both chronic and acute conditions'':
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*Reassurance to family members of those affected by chronic and acute conditions is essential in the treatment and recovery of the patient<ref>JAMISON, R. and VIRTS, K. 1990. The influence of family support on chronic pain. Behaviour Research and Therapy
,
vol. 28, no. 4, pp. 283-287.</ref>.
+
*Reassurance to family members of those affected by chronic and acute conditions is essential in the treatment and recovery of the patient<ref>JAMISON, R. and VIRTS, K. 1990. The influence of family support on chronic pain. Behaviour Research and Therapy
.
vol. 28, no. 4, pp. 283-287.</ref>.
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*Programmes designed to include families in the care of relatives with chronic conditions can be implemented, particularly in the terminal setting. These programmes can guide family members with goal setting, supportive communication techniques and provide them with the tools to assist in monitoring clinical symptoms and medications<ref>ROSLAND, A. and PIETTE, J. 2010. Emerging models for mobilizing family support for chronic disease management: a structured review. Chronic Illness
,
vol. 6, no. 1, pp. 7-21.</ref>.
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*Programmes designed to include families in the care of relatives with chronic conditions can be implemented, particularly in the terminal setting. These programmes can guide family members with goal setting, supportive communication techniques and provide them with the tools to assist in monitoring clinical symptoms and medications<ref>ROSLAND, A. and PIETTE, J. 2010. Emerging models for mobilizing family support for chronic disease management: a structured review. Chronic Illness
.
vol. 6, no. 1, pp. 7-21.</ref>.
*For those with career threatening injuries (e.g. professional athletes or manual workers), coping with potential loss of income can be extremely stressful for both themselves and their families. <span id="1384266633621E" style="display: none;"> </span>
*For those with career threatening injuries (e.g. professional athletes or manual workers), coping with potential loss of income can be extremely stressful for both themselves and their families. <span id="1384266633621E" style="display: none;"> </span>
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<br>In order to get families to adopt a supportive role there often needs to be a change in cognition. Unrealistic and irrational thoughts regarding their loved ones prognosis may be detrimental to the treatment process. Therefore, where possible, such beliefs should be addressed to reduce the potential of any maladaptive behaviours<ref>BASCOM, P. and TOLLE, S. 1995. Care of the family when the patient is dying. Western journal of medicine
,
vol. 163, no. 3, pp. 292.</ref>. For those with acute conditions that may result in loss of earnings or concept of self, CBT may help to prevent anxiety and cognitive distortion (e.g. catastrophising), as well as increased adherence to the rehabilitation protocol<ref>ROSS, M. and BERGER, R. 1996. Effects of stress inoculation training on athletes' postsurgical pain and rehabilitation after orthopedic injury. Journal of Consulting and Clinical Psychology
,
vol. 64, no. 2, pp. 406.</ref>.
<br>
+
<br>In order to get families to adopt a supportive role there often needs to be a change in cognition. Unrealistic and irrational thoughts regarding their loved ones prognosis may be detrimental to the treatment process. Therefore, where possible, such beliefs should be addressed to reduce the potential of any maladaptive behaviours<ref>BASCOM, P. and TOLLE, S. 1995. Care of the family when the patient is dying. Western journal of medicine
.
vol. 163, no. 3, pp. 292.</ref>. For those with acute conditions that may result in loss of earnings or concept of self, CBT may help to prevent anxiety and cognitive distortion (e.g. catastrophising), as well as increased adherence to the rehabilitation protocol<ref>ROSS, M. and BERGER, R. 1996. Effects of stress inoculation training on athletes' postsurgical pain and rehabilitation after orthopedic injury. Journal of Consulting and Clinical Psychology
.
vol. 64, no. 2, pp. 406.</ref>.
<br>
<br>
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''2. To work effectively with other members of the MDT, particularly in challenging settings e.g. palliative care, oncology:''
''2. To work effectively with other members of the MDT, particularly in challenging settings e.g. palliative care, oncology:''
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*When those working in palliative care settings have been interviewed with regards to work place stressors, more stressors were related to difficulty with colleagues, work environment, and occupational roles than with the interaction with patients and their families<ref>VACHON, M. 1987. Team stress in palliative/hospice care. Hospice Journal
,
vol. 3, no. 2-3, pp. 75-103.</ref>.
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*When those working in palliative care settings have been interviewed with regards to work place stressors, more stressors were related to difficulty with colleagues, work environment, and occupational roles than with the interaction with patients and their families<ref>VACHON, M. 1987. Team stress in palliative/hospice care. Hospice Journal
.
vol. 3, no. 2-3, pp. 75-103.</ref>.
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*Seeking support from colleagues is often preferred and more accessible then official support models in place for those working in health provision areas with high stress<ref>FERNANDES, C., BOUTHILLETTE, F., RABOUD, J., BULLOCK, L., MOORE, C., CHRISTENSON, J. and GRAFSTEIN, E. 1999. Violence in the emergency department: a survey of health care workers. Canadian Medical Association Journal
,
vol. 161, no. 10, pp. 1245-1248.</ref>.
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*Seeking support from colleagues is often preferred and more accessible then official support models in place for those working in health provision areas with high stress<ref>FERNANDES, C., BOUTHILLETTE, F., RABOUD, J., BULLOCK, L., MOORE, C., CHRISTENSON, J. and GRAFSTEIN, E. 1999. Violence in the emergency department: a survey of health care workers. Canadian Medical Association Journal
.
vol. 161, no. 10, pp. 1245-1248.</ref>.
<br>With an insight into the cognitive and behavioural components of our own actions we can develop higher self-monitoring traits along with increased empathy. This in turn may lead to further understanding of fellow professionals within the MDT thus enabling us to defuse any potentially volatile situations. Furthermore, many of the environments in which physiotherapy skills are required tend to be highly stressful and emotional. As a result we may be required to engage in supportive behaviour and cognitive reasoning with colleagues.<br>
<br>With an insight into the cognitive and behavioural components of our own actions we can develop higher self-monitoring traits along with increased empathy. This in turn may lead to further understanding of fellow professionals within the MDT thus enabling us to defuse any potentially volatile situations. Furthermore, many of the environments in which physiotherapy skills are required tend to be highly stressful and emotional. As a result we may be required to engage in supportive behaviour and cognitive reasoning with colleagues.<br>
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''3. To ensure optimal personal mental health for AHP’s:''
''3. To ensure optimal personal mental health for AHP’s:''
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*The Health and Safety Executive recognises that there are many factors in the workplace that contribute to strains on NHS professional’s mental health. These include: excessive demands, lack of control, lack of support, poor working relationships, role ambiguity and organisational change<ref>INSTITUTE OF DIRECTORS AND HEATLH AND SAFETY EXECUTIVE. Institute of Directors and Health and Safety Executive
. 2007
. Leading health and safety at work [online]. [Viewed 29th October 2013]. Available from: www.hse.gov.uk/pubns/indg417.pdf</ref>.
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*The Health and Safety Executive recognises that there are many factors in the workplace that contribute to strains on NHS professional’s mental health. These include: excessive demands, lack of control, lack of support, poor working relationships, role ambiguity and organisational change<ref>INSTITUTE OF DIRECTORS AND HEATLH AND SAFETY EXECUTIVE
, 2007
. Institute of Directors and Health and Safety Executive. Leading health and safety at work [online]. [Viewed 29th October 2013]. Available from: www.hse.gov.uk/pubns/indg417.pdf</ref>.
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*The 2009 Boorman Review reported that the NHS loses 10 million working days annually due to sickness costing the NHS an estimated £555million, with mental health along with MSDs being the primary cause. Combined they are the leading cause of health-related early retirement in the NHS<ref>BOORMAN, S. 2009. NHS Health
&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;
Well-being Interim Report. [online]. [Viewed 29th October 2013]. Available from: http://www.nhshealthandwellbeing.org/pdfs/NHS%20Staff%20H&
amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;
amp;WB%20Review%20Final%20Report%20VFinal%2020-11-09.pdf</ref>.
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*The 2009 Boorman Review reported that the NHS loses 10 million working days annually due to sickness costing the NHS an estimated £555million, with mental health along with MSDs being the primary cause. Combined they are the leading cause of health-related early retirement in the NHS<ref>BOORMAN, S.
,
2009. NHS Health
.
Well-being Interim Report. [online]. [Viewed 29th October 2013]. Available from: http://www.nhshealthandwellbeing.org/pdfs/NHS%20Staff%20H&WB%20Review%20Final%20Report%20VFinal%2020-11-09.pdf</ref>.
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*The Work Foundation estimates that presenteeism due to poor mental health leads to a loss of working time nearly 1.5 times that caused by sickness absence due to mental health in the United Kingdom<ref>HASSAN, E., AUSTIN, C., CELIA, C., DISLEY, E., HUNT, H., MARJANOVIC, S., SHEHABI, A., VAILLALBA-VAN-DIJK, L. and VAN STOLK, C. 2009. The work foundation; health and well being at work in the United Kingdom. [online]. [Viewed 29th October 2013]. Available from: www.nhshealthandwellbeing.org/pdfs/Interim%20Report%20Appendices/Literature%20Review.pdf</ref>.
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*The Work Foundation estimates that presenteeism due to poor mental health leads to a loss of working time nearly 1.5 times that caused by sickness absence due to mental health in the United Kingdom<ref>HASSAN, E., AUSTIN, C., CELIA, C., DISLEY, E., HUNT, H., MARJANOVIC, S., SHEHABI, A., VAILLALBA-VAN-DIJK, L. and VAN STOLK, C.
,
2009. The work foundation; health and well being at work in the United Kingdom. [online]. [Viewed 29th October 2013]. Available from: www.nhshealthandwellbeing.org/pdfs/Interim%20Report%20Appendices/Literature%20Review.pdf</ref>.
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<br>By having an understanding of ones own cognitive state, AHPs may be able to overcome the inherent stressors in their jobs. It has been documented that self-directed CBT can reduce an individual’s own stress, anxiety, depression and cognitive dissonance<ref>BOUDREAU, R., MOULTON, K. and CUNNINGHAM, J. 2010. Self-directed cognitive behaviour therapy for adult with diagnosis of depression: systematic review of clinical effectiveness, cost-effectiveness and guidelines. Canadian Agency for Drugs and Technologies in Health.</ref><ref>PROUDFOOT, J., EVERITT, B., SHAPIRO, D., GOLDBERG, D., MANN, A., TYLEE, A. and GRAY, J. 2004. Clinical efficacy of computerised cognitive–behavioural therapy for anxiety and depression in primary care: randomised controlled trial. The British Journal of Psychiatry
,
vol. 185, no. 1, pp. 46-54
.
</ref>. As CBT incorporates the introspection of thought process from Cognitive Therapy and the goal of behavioural change from Behavioural Therapy, CBT can be a useful tool for physiotherapists in their own development as a competent and holistic professional<ref>CLOUDER, L. 2000. Reflective practice in physiotherapy education: a critical conversation. Studies in Higher Education
,
vol. 25, no. 2, pp. 211-223.</ref>
. Enhanced insight into maladaptive thoughts may lead to a reduction in mental health issues, likely resulting in a decrease in work days lost in the NHS
. <br>
+
<br>By having an understanding of ones own cognitive state, AHPs may be able to overcome the inherent stressors in their jobs. It has been documented that self-directed CBT can reduce an individual’s own stress, anxiety, depression and cognitive dissonance<ref>BOUDREAU, R., MOULTON, K. and CUNNINGHAM, J. 2010. Self-directed cognitive behaviour therapy for adult with diagnosis of depression: systematic review of clinical effectiveness, cost-effectiveness and guidelines. Canadian Agency for Drugs and Technologies in Health.</ref><ref>PROUDFOOT, J., EVERITT, B., SHAPIRO, D., GOLDBERG, D., MANN, A., TYLEE, A. and GRAY, J. 2004. Clinical efficacy of computerised cognitive–behavioural therapy for anxiety and depression in primary care: randomised controlled trial. The British Journal of Psychiatry
.
vol. 185, no. 1, pp. 46-54</ref>. As CBT incorporates the introspection of thought process from Cognitive Therapy and the goal of behavioural change from Behavioural Therapy, CBT can be a useful tool for physiotherapists in their own development as a competent and holistic professional
. Enhanced insight into maladaptive thoughts may lead to a reduction in mental health issues, likely resulting in a decrease in work days lost in the NHS
<ref>CLOUDER, L. 2000. Reflective practice in physiotherapy education: a critical conversation. Studies in Higher Education
.
vol. 25, no. 2, pp. 211-223.</ref>. <br>
<br>
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