Triumph in the face of a
Anonymous This piece is an interview of a client who accessed a community mental health team in the South of England, by the trainee clinical psychologist with whom she engaged in therapy. It concerns her experiences of numerous annual Department of Work and Pensions medical assessments, and an eventual complaints procedure she followed in 2018. This led to the cancellation of an enforced medical assessment, an event that left the client feeling “triumphant in the face of adversity,” aware of her own strengths, and hopeful for the future. The client wishes for both her and the psychologist’s identities to remain anonymous, therefore the names below are pseudonyms.
Coral Westaway is a clinical psychologist committed to trauma-informed and community approaches, working in an adult mental health team in the NHS and with homelessness services in Somerset.
Email:
Coral.westaway@outlook.com
Andrew: Could you give a little background to your story and experiences with the department? Tabby: I have had to endure the Department of Work and Pensions medical assessment process for seven years in a row. Each time, I felt suicidal for months because of the stress of the process. I had accessed this community mental
heath team in order to reduce rituals of ‘obsessive compulsive disorder’, which I have had difficulty with for over 40 years, as well as other mental health challenges. Unfortunately, however, the therapy overlapped with being told by the department that I was due another medical assessment. This meant that it was very difficult to concentrate purely on my therapy goals. A little later, purely by chance, I came
Clare Watson is a clinical and community psychologist, working to transform mental health services for socially excluded young people with London-based charity MAC-UK. Email:
Clarewats@gmail.com
across a complaints procedure, through the Centre for Health and Disability Assessments’ Customer Relations Team* (see below for further details), and, after writing to them, the initial decision that I had to attend a face-to-face medical assessment was cancelled on their recommendation. Andrew: What have these experiences been like for you? Tabby: I think it’s important for practitioners to understand the extent to which this situation can impact upon their clients. This is essentially an existential threat to people, and they may react accordingly. Over the years,
including this one, I have feared that I wouldn’t have enough money for food or to pay the bills. Some people will be in poverty if they lose the only source of income that they have. I feared I wouldn’t be able to pay the rent; people can lose their homes. I feel that the system is totally unjust and unfair. Andrew: What was it like to be in therapy at this time? Tabby: This may obviously impact upon therapy as their priorities will change. It was helpful for me to be able to discuss this, at times at length, and for my previous therapeutic goals to take a back seat. This engendered trust between the two of us, and meant that at times when I was less anxious or pre-occupied, I could talk about other traumatic life experiences relevant to my obsessive compulsions. So, in some ways, this f lexibility was beneficial in the long-run. Andrew: What would you say to practitioners who may be seeing clients in similar situations? Do you have any tips? Tabby: Staff should be aware that there are options available for people like me who have a clear rationale as to why they should not have to go through a medical assessment. There is the address I wrote to, as well as another on their website* (see below). Aside from this, I believe that staff
can help clients with keeping calm and trying to help them carry on with their normal routines, which I found very useful. I tried to remember the positives
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Context 164, August 2019
Triumph in the face of adversity
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