What to do if asked about an unfamiliar issue or diagnosis?

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What to do if asked about an unfamiliar issue or diagnosis?

Postby pianohead » Mon Apr 16, 2018 11:51 am

Hi all,

Not wanting to stray too far from the topic of this thread, but I am really hoping for some advice around a query I have had since my previous (and first) interview in 2016. In line with the rules I know I can't divulge too much, but in short:

I was asked about a specific disorder (a fairly obscure one, and one which I imagine the majority of applicants won't have worked with), and the models which I would apply when working with clients with this presentation.

I am now feeling anxious about my upcoming interview with Salomons (different course to my previous interview).. Several threads on this forum give the impression that interviews won't expect you to know the precise model and intervention to use when dealing with any given presentation as this would form part of the course learning, yet this wasn't my experience previously. Failing reading up on (and memorising!) every disorder and the relevant NICE guidelines etc.. is there a better way to ensure that (should a similar question come up in my next interview) I would feel a bit more prepared? This completely threw me, especially as it has a very specific treatment (which I had to look up post interview!).

Anyone else had a similar experience? Any thoughts would be very welcome!
Last edited by maven on Mon Apr 16, 2018 5:26 pm, edited 1 time in total.
Reason: split topic, as it was distinct and will get more responses and be found more easily in searches in its own thread
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Re: Interview structure

Postby ell » Mon Apr 16, 2018 1:14 pm

If I was confronted with a question about a diagnosis that I didn't know anything about, I might hypothesise how the person might experience it, and then talk about models I could use around that. For example, if it was a diagnosis that is life long, I might talk about models of acceptance. Or if it was something that is about heightened emotion, I might talk about emotion regulation approaches or mindfulness. Not sure if this would be a good enough answer, but that would be my approach if I was clueless otherwise. Or I'd be honest and say I don't know anything about that particular diagnosis or associated models, and then I would talk about supervision and looking at the research. And internally freak out! (which I still do, working in a qualified post).
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Re: Interview structure

Postby pianohead » Mon Apr 16, 2018 2:16 pm

Thank you so much ell - that is really helpful advice :)
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Re: What to do if asked about an unfamiliar issue or diagnos

Postby BlueCat » Mon Apr 16, 2018 8:43 pm

Hi pianohead. I would maybe go one step further......and suggest that the course probably deliberately asked you a very specific question that they didn't expect anyone to know the answer to......because.....they had no interest in whether or not anyone knew the "correct" answer....because there are very few "correct answers" in the field of clinical psychology.

What there are, are formulations, informed understandings, competing hypotheses, and psychological approaches to clinical presentations.

I would suggest that that particular question was probably designed specifically in order to see how the candidates could think on the spot, under pressure, and to assess the candidates ability to apply their psychological knowledge and think psychologically.
There's no such thing as bad weather, just the wrong clothes. Billy Connolly.
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Re: What to do if asked about an unfamiliar issue or diagnos

Postby miriam » Mon Apr 16, 2018 9:37 pm

I always try to highlight to people the value of going back to first principles, and thinking upwards from the basics, rather than trying to learn every possible fact. And we know that being able to cope with ambiguity, complexity and incomplete facts is pretty much one of the KSF definitions for higher grades within psychology. So I quite like the idea also.
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Re: What to do if asked about an unfamiliar issue or diagnos

Postby ell » Tue Apr 17, 2018 8:07 am

Good advice from above. Yep, go in with the mantra of 'assessment, formulation, intervention, evaluation'... Those things don't need specific diagnosis knowledge, and actually allow you to move past the diagnosis.

My general advice would be to look past the question and whether or not you know the 'answer', and ask yourself what the interviewers might be trying to assess with that question. Not necessarily possible when you're in the middle of it, but certainly after the event as a learning exercise.
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Re: What to do if asked about an unfamiliar issue or diagnos

Postby pianohead » Tue Apr 17, 2018 12:39 pm

Thank you all, one thing I should have clarified however is that this was not in the context of a vignette etc., unfortunately for this question I was not given any information about a particular client's presentation which is why it threw me so much!

I was literally asked "what model could you apply when working with clients with diagnosis x" with no further information :?

I agree with the above that usually I would try and pull together as much of a formulation as possible with what I know, and also try to gauge what they are looking for!

In this instance I thought that maybe the panel just wanted interviewees to be honest about their limits of knowledge, which is how I responded.. but now I'm not so sure!
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Re: What to do if asked about an unfamiliar issue or diagnos

Postby BlueCat » Tue Apr 17, 2018 6:13 pm

Still.....I'd argue that as psychologists we don't organise our interventions according to diagnoses, we organise our interventions according to our formulations. So the answer could still be about how you think and apply your knowledge rather than later in keeping ng for a "correct" response.
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Re: What to do if asked about an unfamiliar issue or diagnos

Postby MissK » Wed Apr 18, 2018 8:16 pm

Interesting question from Pianohead, I think, especially if something is asked about that is less common, I would be tempted to reply with questions I may want to ask the client such as 'how diagnosis x impacts them and their daily functioning, and then to ask about how this makes them feel. What do they make of their relationship with diagnosis x, does the term fit for them? what is helpful about them thinking of themselves under this label etc. I would then think about relationship with others, who this is a problem for etc, and probably then let the panel know that hypothesising with the client could help us co-construct a formulation, which may lead to interventions...this could be wrong, but what I would do in said situation.
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Re: What to do if asked about an unfamiliar issue or diagnos

Postby ell » Wed Apr 18, 2018 8:54 pm

It's tricky, cos the question isn't 'what would you do', but 'what models would you use'. I'd then be tempted to talk about the broad cognitive model (hot cross bun etc) perhaps. Or maybe apply a psychodynamic model (specifically Milan's triangles) and talk about the hidden feelings, anxiety, and defences. But even so, without a formulation it would all be speculative, so I think I would try and explain how I would use the model to inform what I would ask about at assessment, and how I might then conceptualise the case from there.
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