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Royal College of Psychiatrists - Celebrating 180 years
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  • Become a psychiatrist

    Become a psychiatrist

    • Choose Psychiatry

      Choose Psychiatry

      • What is psychiatry?
      • How to become a psychiatrist
      • Why choose psychiatry?
      • Career essentials
      • What next?
    • Sixth formers and school students
    • Medical students

      Medical students

      • Becoming a student associate
      • Psychiatry attachments
      • Awards, prizes and bursaries
      • PsychSocs
      • National conference
      • Summer and autumn schools
      • FuturePsych – the student associate magazine
    • Foundation doctors

      Foundation doctors

      • Foundation doctor associates
      • Making the most of your psychiatry placement
      • Opportunities for foundation doctors
      • FuturePsych - the associate magazine
    • Help us promote psychiatry

      Help us promote psychiatry

      • How can I help?
      • Ideas to inspire you
      • Resources to help you promote psychiatry
      • Our strategy
    • Choose Psychiatry: Guidance for Medical Schools
    • Choose Psychiatry
      • What is psychiatry?
      • How to become a psychiatrist
      • Why choose psychiatry?
      • Career essentials
      • What next?
    • Sixth formers and school students
    • Medical students
      • Becoming a student associate
      • Psychiatry attachments
      • Awards, prizes and bursaries
      • PsychSocs
      • National conference
      • Summer and autumn schools
      • FuturePsych – the student associate magazine
    • Foundation doctors
      • Foundation doctor associates
      • Making the most of your psychiatry placement
      • Opportunities for foundation doctors
      • FuturePsych - the associate magazine
    • Help us promote psychiatry
      • How can I help?
      • Ideas to inspire you
      • Resources to help you promote psychiatry
      • Our strategy
    • Choose Psychiatry: Guidance for Medical Schools
  • Training

    Training

    • Curricula and guidance

      Curricula and guidance

      • GMC approved curricula
      • Curricula review project
      • Specialty guides
      • Dual Training
    • Your training

      Your training

      • Psychiatric Trainees Committee: supporting you
      • Time out of training
      • Training resources
      • Run-through training
      • Prizes and bursaries for trainees
      • Leadership and management training
      • Training less than full time
      • Routes to Registration
      • Cost of Training
    • Exams

      Exams

      • Can I take an exam?
      • Contact the exams team
      • Preparing for exams
      • Applying for your exam
      • Exam results
      • Special notices
      • Exam FAQs
      • A fair exam
      • MRCPsych examinations and COVID-19
      • Webinar: MRCPsych Exam - Changes to exam delivery this autumn
      • Capacity reached for September 2020 CASC
    • Neuroscience in training

      Neuroscience in training

      • About the project
      • Neuroscience events
      • Who is on the commission?
      • Latest news from the neuroscience project
      • Neuroscience history
      • Neuroscience videos
      • Neuroscience resources
    • Information for Local Education and Training Boards (LETBs)
    • Medical training initiative (MTI)
    • Undergraduate education forum
    • International Medical Graduates

      International Medical Graduates

      • Shortage Occupation List
    • Quality Assurance in Training
    • Curricula and guidance
      • GMC approved curricula
      • Curricula review project
      • Specialty guides
      • Dual Training
    • Your training
      • Psychiatric Trainees Committee: supporting you
      • Time out of training
      • Training resources
      • Run-through training
      • Prizes and bursaries for trainees
      • Leadership and management training
      • Training less than full time
      • Routes to Registration
      • Cost of Training
    • Exams
      • Can I take an exam?
      • Contact the exams team
      • Preparing for exams
      • Applying for your exam
      • Exam results
      • Special notices
      • Exam FAQs
      • A fair exam
      • MRCPsych examinations and COVID-19
      • Webinar: MRCPsych Exam - Changes to exam delivery this autumn
      • Capacity reached for September 2020 CASC
    • Neuroscience in training
      • About the project
      • Neuroscience events
      • Who is on the commission?
      • Latest news from the neuroscience project
      • Neuroscience history
      • Neuroscience videos
      • Neuroscience resources
    • Information for Local Education and Training Boards (LETBs)
    • Medical training initiative (MTI)
    • Undergraduate education forum
    • International Medical Graduates
      • Shortage Occupation List
    • Quality Assurance in Training
  • Members

    Members

    • Supporting you

      Supporting you

      • Psychiatrists Support Service
      • New consultants (StartWell)
      • Mentoring and coaching
      • Revalidation
      • Assessing and managing risk of patients causing harm
      • Leadership and management
      • Working less than full time
      • If a patient dies by suicide
      • Writing clinic letters
    • Submitting your CPD

      Submitting your CPD

      • CPD Submissions FAQs
      • Alterations to CPD during coronavirus pandemic
    • CPD Online
    • Membership

      Membership

      • Members login
      • Receipts
      • Pay Your Subscription
      • Direct Debit
      • Your subscription
      • Grades of membership
      • Benefits of membership
      • Fellowship and other Honours
      • Applying for Fellowship
      • Nominations for Honorary Fellows
      • Nominations for National Honours
    • Your Faculties

      Your Faculties

      • Academic psychiatry
      • Addictions psychiatry
      • Child and adolescent psychiatry
      • Eating disorders psychiatry
      • Forensic Psychiatry Faculty
      • General adult psychiatry
      • Intellectual disability psychiatry faculty
      • Liaison psychiatry faculty
      • Medical psychotherapy faculty
      • Neuropsychiatry faculty
      • Old age psychiatry faculty
      • Perinatal psychiatry faculty
      • Rehabilitation and social psychiatry faculty
      • Faculty job descriptions
    • Devolved Nations

      Devolved Nations

      • RCPsych in Scotland
      • RCPsych in Wales
      • Coleg Cymraeg
      • RCPsych in Northern Ireland
      • Executive Committee job descriptions
    • English Divisions

      English Divisions

      • Eastern
      • London
      • Northern and Yorkshire
      • North West
      • South Eastern
      • Trent
      • West Midlands
      • South West
      • Executive Committee job descriptions
      • NW and NY mentorship
    • International members

      International members

      • International strategy
    • Special Interest Groups

      Special Interest Groups

      • How to join a SIG
      • Adolescent forensic psychiatry
      • Arts psychiatry
      • Evolutionary psychiatry
      • History of psychiatry
      • Neurodevelopmental psychiatry
      • Occupational psychiatry
      • Philosophy
      • Private and independent practice PIPSIG
      • Rainbow SIG
      • Spirituality
      • Sport and exercise psychiatry (SEPSIG)
      • Transcultural psychiatry
      • Volunteering and international
      • Women and mental health
      • Special Interest Group Job Descriptions
      • Digital psychiatry
    • Committees of Council
    • RCPsych Insight magazine
    • Publications and books
    • Your monthly eNewsletter

      Your monthly eNewsletter

      • Members' update 8 April 2021
      • RCPsych eNewsletter March 2021
      • Members' update 11 March 2021
      • RCPsych eNewsletter February 2021
      • Members' update 11 February 2021
      • RCPsych eNewsletter January 2021
      • Members' update 14 January 2021
      • RCPsych eNewsletter December 2020
      • RCPsych eNewsletter November 2020
      • Members' update 12 November 2020
      • RCPsych eNewsletter October 2020
      • Members' update 8 October 2020
      • RCPsych eNewsletter September 2020
      • Members' update 11 September 2020
      • Members' update 1 September 2020
      • Members' update 14 August 2020
      • RCPsych eNewsletter July 2020
      • Members' update 10 July 2020
      • RCPsych eNewsletter June 2020
      • Update 12 June 2020
      • COVID-19 Update 29 May 2020
      • RCPsych eNewsletter May 2020
      • COVID-19 Update 7 May 2020
      • COVID-19 Update 1 May 2020
      • RCPsych eNewsletter April 2020
      • COVID-19 Update April 2020
      • RCPsych eNewsletter February 2020
      • RCPsych eNewsletter January 2020
      • RCPsych eNewsletter December 2019
      • RCPsych eNewsletter November 2019
      • RCPsych eNewsletter October 2019
      • RCPsych eNewsletter September 2019
      • RCPsych eNewsletter July 2019
      • RCPsych eNewsletter June 2019
      • RCPsych eNewsletter May 2019
      • RCPsych eNewsletter April 2019
    • Posts for members
    • Public members list
    • Jobs board
    • Specialist and Associate Specialty Doctors

      Specialist and Associate Specialty Doctors

      • A message from the Chair
      • Who are SAS Doctors?
      • How to enter the SAS grade
      • SAS career development
      • SAS doctors resources
      • College SAS training and events
    • President's lectures

      President's lectures

      • Declaration of competing interests (President's lectures)
      • List of president's lectures competing interests
      • Past President's lectures
    • Retired members
    • New Members Ceremonies
    • Obituaries

      Obituaries

      • Submit an obituary
      • Remembering Dame Fiona Caldicott
    • About CPD Online - elearning
    • Supporting you
      • Psychiatrists Support Service
      • New consultants (StartWell)
      • Mentoring and coaching
      • Revalidation
      • Assessing and managing risk of patients causing harm
      • Leadership and management
      • Working less than full time
      • If a patient dies by suicide
      • Writing clinic letters
    • Submitting your CPD
      • CPD Submissions FAQs
      • Alterations to CPD during coronavirus pandemic
    • CPD Online
    • Membership
      • Members login
      • Receipts
      • Pay Your Subscription
      • Direct Debit
      • Your subscription
      • Grades of membership
      • Benefits of membership
      • Fellowship and other Honours
      • Applying for Fellowship
      • Nominations for Honorary Fellows
      • Nominations for National Honours
    • Your Faculties
      • Academic psychiatry
      • Addictions psychiatry
      • Child and adolescent psychiatry
      • Eating disorders psychiatry
      • Forensic Psychiatry Faculty
      • General adult psychiatry
      • Intellectual disability psychiatry faculty
      • Liaison psychiatry faculty
      • Medical psychotherapy faculty
      • Neuropsychiatry faculty
      • Old age psychiatry faculty
      • Perinatal psychiatry faculty
      • Rehabilitation and social psychiatry faculty
      • Faculty job descriptions
    • Devolved Nations
      • RCPsych in Scotland
      • RCPsych in Wales
      • Coleg Cymraeg
      • RCPsych in Northern Ireland
      • Executive Committee job descriptions
    • English Divisions
      • Eastern
      • London
      • Northern and Yorkshire
      • North West
      • South Eastern
      • Trent
      • West Midlands
      • South West
      • Executive Committee job descriptions
      • NW and NY mentorship
    • International members
      • International strategy
    • Special Interest Groups
      • How to join a SIG
      • Adolescent forensic psychiatry
      • Arts psychiatry
      • Evolutionary psychiatry
      • History of psychiatry
      • Neurodevelopmental psychiatry
      • Occupational psychiatry
      • Philosophy
      • Private and independent practice PIPSIG
      • Rainbow SIG
      • Spirituality
      • Sport and exercise psychiatry (SEPSIG)
      • Transcultural psychiatry
      • Volunteering and international
      • Women and mental health
      • Special Interest Group Job Descriptions
      • Digital psychiatry
    • Committees of Council
    • RCPsych Insight magazine
    • Publications and books
    • Your monthly eNewsletter
      • Members' update 8 April 2021
      • RCPsych eNewsletter March 2021
      • Members' update 11 March 2021
      • RCPsych eNewsletter February 2021
      • Members' update 11 February 2021
      • RCPsych eNewsletter January 2021
      • Members' update 14 January 2021
      • RCPsych eNewsletter December 2020
      • RCPsych eNewsletter November 2020
      • Members' update 12 November 2020
      • RCPsych eNewsletter October 2020
      • Members' update 8 October 2020
      • RCPsych eNewsletter September 2020
      • Members' update 11 September 2020
      • Members' update 1 September 2020
      • Members' update 14 August 2020
      • RCPsych eNewsletter July 2020
      • Members' update 10 July 2020
      • RCPsych eNewsletter June 2020
      • Update 12 June 2020
      • COVID-19 Update 29 May 2020
      • RCPsych eNewsletter May 2020
      • COVID-19 Update 7 May 2020
      • COVID-19 Update 1 May 2020
      • RCPsych eNewsletter April 2020
      • COVID-19 Update April 2020
      • RCPsych eNewsletter February 2020
      • RCPsych eNewsletter January 2020
      • RCPsych eNewsletter December 2019
      • RCPsych eNewsletter November 2019
      • RCPsych eNewsletter October 2019
      • RCPsych eNewsletter September 2019
      • RCPsych eNewsletter July 2019
      • RCPsych eNewsletter June 2019
      • RCPsych eNewsletter May 2019
      • RCPsych eNewsletter April 2019
    • Posts for members
    • Public members list
    • Jobs board
    • Specialist and Associate Specialty Doctors
      • A message from the Chair
      • Who are SAS Doctors?
      • How to enter the SAS grade
      • SAS career development
      • SAS doctors resources
      • College SAS training and events
    • President's lectures
      • Declaration of competing interests (President's lectures)
      • List of president's lectures competing interests
      • Past President's lectures
    • Retired members
    • New Members Ceremonies
    • Obituaries
      • Submit an obituary
      • Remembering Dame Fiona Caldicott
    • About CPD Online - elearning
  • Events

    Events

    • Conferences and training events

      Conferences and training events

      • Faculty of intellectual Disability Spring Conference 2019
      • Faculty of Forensic Psychiatry Annual Conference 2020 - Register your interest
      • Section 12 and AC – Update for Trainers - Training Day Course Resources
      • Resilience & Wellbeing Course for SAS Doctors
      • Present State Examination Course 17 April - Register your interest
      • Present State Examination Course 1 September - Register your interest
      • Section 12 and Approved Clinician Training
      • Perinatal Psychiatry Masterclasses
      • Women and Mental Health Special Interest Group Annual Conference
      • Faculty of Medical Psychotherapy Annual Conference 2021 - Register your interest
      • Register your interest - Clinical and Educational Supervisor Training future dates
      • Register your interest - Leadership & Management Fellow Scheme 2021/22 (Trainee)
      • Register your interest - Leadership & Management Fellow Scheme 2021/22 (Trust)
      • Register your interest - Leadership & Management Fellow Scheme 2021/22 (Trust)
    • Events held by other organisations
    • Terms and conditions
    • In house training

      In house training

      • In house training: working with us
      • Health of Nation Outcome Scales
      • Competing interests
    • Highlights from International Congress 2020 - Webinar Series

      Highlights from International Congress 2020 - Webinar Series

      • Registration
      • Programme
      • FAQs
    • Accommodation List
    • Recruitment events
    • Claiming Expenses
    • International Congress 2021

      International Congress 2021

      • Congress FAQs
      • Exhibition Opportunities 2021
      • Registration
      • IC21 Keynote speakers
      • Programme
      • Presenter information
      • Your guide to Congress
    • Free webinars

      Free webinars

      • Free webinars for members
    • Speaker guidance for online events
    • Conferences and training events
      • Faculty of intellectual Disability Spring Conference 2019
      • Faculty of Forensic Psychiatry Annual Conference 2020 - Register your interest
      • Section 12 and AC – Update for Trainers - Training Day Course Resources
      • Resilience & Wellbeing Course for SAS Doctors
      • Present State Examination Course 17 April - Register your interest
      • Present State Examination Course 1 September - Register your interest
      • Section 12 and Approved Clinician Training
      • Perinatal Psychiatry Masterclasses
      • Women and Mental Health Special Interest Group Annual Conference
      • Faculty of Medical Psychotherapy Annual Conference 2021 - Register your interest
      • Register your interest - Clinical and Educational Supervisor Training future dates
      • Register your interest - Leadership & Management Fellow Scheme 2021/22 (Trainee)
      • Register your interest - Leadership & Management Fellow Scheme 2021/22 (Trust)
      • Register your interest - Leadership & Management Fellow Scheme 2021/22 (Trust)
    • Events held by other organisations
    • Terms and conditions
    • In house training
      • In house training: working with us
      • Health of Nation Outcome Scales
      • Competing interests
    • Highlights from International Congress 2020 - Webinar Series
      • Registration
      • Programme
      • FAQs
    • Accommodation List
    • Recruitment events
    • Claiming Expenses
    • International Congress 2021
      • Congress FAQs
      • Exhibition Opportunities 2021
      • Registration
      • IC21 Keynote speakers
      • Programme
      • Presenter information
      • Your guide to Congress
    • Free webinars
      • Free webinars for members
    • Speaker guidance for online events
  • Improving care

    Improving care

    • College Centre for Quality Improvement (CCQI)

      College Centre for Quality Improvement (CCQI)

      • What we do in the CCQI
      • Quality Networks and Accreditation
      • National Clinical Audits
      • Multi-source feedback
      • Using quality improvement
      • CCQI resources
      • CCQI Who we are
      • Research and evaluation
    • Campaigning for better mental health policy

      Campaigning for better mental health policy

      • The Mental Health Act (MHA)
      • Five Year Forward View
      • Integrated care and mental health
      • Children and young people's mental health Green Paper
      • RCPsych in Parliament
      • Join our Research Panel
      • College Reports
      • Position statements
      • Process for College publications
      • Other policy areas
      • Mental Health Watch
      • COVID-19: Guidance for clinicians
      • The Mental Health Act White Paper 2021
    • Planning the psychiatric workforce

      Planning the psychiatric workforce

      • What we do
      • Job planning and recruitment
      • Our workforce census
      • Campaigning for the mental health workforce of the future
      • Workforce strategy
    • Physician Associates

      Physician Associates

      • About Physician Associates
      • Employing Physician Associates
      • Becoming a Physician Associate
      • Support for Physician Associates
      • Physician Associates network
    • National Collaborating Centre for Mental Health

      National Collaborating Centre for Mental Health

      • About the NCCMH
      • Mental health care pathways
      • Mental health quality improvement programmes
      • Other programmes
      • Reducing restrictive practice
      • National suicide prevention programme
      • Sexual Safety Collaborative
      • COVID-19 Mental Health Improvement Network
      • RCPsych Enjoying Work Collaborative
    • Invited Review Service
    • Public Health and its role in mental heath
    • Sustainability and working sustainably

      Sustainability and working sustainably

      • In your community
      • In your practice
      • In your trust
      • Green care
      • Sustainability scholars
      • About sustainability in mental health care
      • Sustainability resources
      • Working sustainably (old)
    • RCPsych Course Accreditation

      RCPsych Course Accreditation

      • Apply for accreditation
    • College Centre for Quality Improvement (CCQI)
      • What we do in the CCQI
      • Quality Networks and Accreditation
      • National Clinical Audits
      • Multi-source feedback
      • Using quality improvement
      • CCQI resources
      • CCQI Who we are
      • Research and evaluation
    • Campaigning for better mental health policy
      • The Mental Health Act (MHA)
      • Five Year Forward View
      • Integrated care and mental health
      • Children and young people's mental health Green Paper
      • RCPsych in Parliament
      • Join our Research Panel
      • College Reports
      • Position statements
      • Process for College publications
      • Other policy areas
      • Mental Health Watch
      • COVID-19: Guidance for clinicians
      • The Mental Health Act White Paper 2021
    • Planning the psychiatric workforce
      • What we do
      • Job planning and recruitment
      • Our workforce census
      • Campaigning for the mental health workforce of the future
      • Workforce strategy
    • Physician Associates
      • About Physician Associates
      • Employing Physician Associates
      • Becoming a Physician Associate
      • Support for Physician Associates
      • Physician Associates network
    • National Collaborating Centre for Mental Health
      • About the NCCMH
      • Mental health care pathways
      • Mental health quality improvement programmes
      • Other programmes
      • Reducing restrictive practice
      • National suicide prevention programme
      • Sexual Safety Collaborative
      • COVID-19 Mental Health Improvement Network
      • RCPsych Enjoying Work Collaborative
    • Invited Review Service
    • Public Health and its role in mental heath
    • Sustainability and working sustainably
      • In your community
      • In your practice
      • In your trust
      • Green care
      • Sustainability scholars
      • About sustainability in mental health care
      • Sustainability resources
      • Working sustainably (old)
    • RCPsych Course Accreditation
      • Apply for accreditation
  • Mental health

    Mental health

    • Problems and disorders

      Problems and disorders

      • ADHD in adults
      • Alcohol and depression
      • Alcohol and older people
      • Anorexia and bulimia
      • Anxiety, panic and phobias
      • Bereavement
      • Bipolar disorder
      • Cannabis
      • Club drugs
      • Coping after a traumatic event
      • Debt and mental health
      • Delirium
      • Depression
      • Depression in older adults
      • Depression and men
      • Eating well and mental health
      • Feeling on the edge
      • Feeling overwhelmed
      • Feeling stressed
      • Hoarding
      • Learning disabilities
      • Medically unexplained symptoms
      • Memory problems and dementia
      • Obsessive-compulsive disorder (OCD)
      • Perinatal OCD
      • Perinatal OCD for carers
      • Personality disorder
      • Physical illness
      • Postnatal depression
      • Postnatal depression key facts
      • Postnatal depression: information for carers
      • Postpartum psychosis
      • Postpartum Psychosis in Carers
      • Post Traumatic Stress Disorder (PTSD)
      • Problem gambling
      • Schizoaffective disorder
      • Schizophrenia
      • Seasonal Affective Disorder (SAD)
      • Self harm
      • Shyness and social phobia
      • Sleeping well
    • Support, care and treatment

      Support, care and treatment

      • Alzheimers drug treatments
      • Antidepressants
      • Antipsychotics
      • Being sectioned
      • Benzodiazepines
      • Bipolar medications
      • Cognitive Behavioural Therapy (CBT)
      • Complementary and alternative medicines: herbal remedies
      • Complementary and alternative medicines: physical treatments
      • Depot medication
      • Deprivation of Liberty Safeguards
      • Electroconvulsive therapy (ECT)
      • Electronic health records in mental health services in England
      • Guide to mental health tribunals
      • Liaison psychiatry services
      • Mental capacity and the law
      • Mental health rehabilitation services
      • Mental health services and teams in the community
      • Planning a pregnancy
      • Psychotherapies and psychological treatments
      • Spirituality and mental health
      • Stopping antidepressants
      • Talking to your GP
      • What to expect of your psychiatrist in the UK
      • Antipsychotics in Pregnancy
      • Lithium in Pregnancy and Breastfeeding
      • Mother and Baby Units (MBUs)
      • Children's Social Services and Safeguarding
      • Valproate in women and girls who could get pregnant
      • What are Perinatal Mental Health Services?
      • Mental health in pregnancy
      • Medication for mental health and COVID-19
      • Remote consultations and COVID-19
      • Attending hospital and COVID-19
      • Monitoring health at home and COVID-19
      • Alcohol and COVID-19
      • Eating disorders and COVID-19
      • Perinatal care and COVID-19
      • COVID-19: Self-harm in young people 
      • COVID-19: Self-harm and suicide 
      • COVID-19: Looking after your mental health – for young people and their parents and carers 
      • COVID-19: Using drugs
      • COVID-19: ASD
    • Young people's mental health
    • Translations

      Translations

      • Arabic عربى
      • Bengali বাঙালি
      • Bulgarian български
      • Chinese 中文
      • French Français
      • German Auf Deutsch
      • Greek Ελληνική γλώσσα
      • Gujurati ગુજરાતી
      • Hindi हिंदीहिंदी
      • Italian italiano
      • Japanese 日本語
      • Lithuanian Lietuvių kalba
      • Pashto پښتو
      • Persian (Farsi) فارسی
      • Polish Polski
      • Punjabi ਪੰਜਾਬੀ
      • Romanian Română
      • Russian Pусский
      • Somali
      • Spanish Español
      • Turkish
      • Tamil தமிழ்
      • Urdu اردو
      • Welsh Cymraeg
    • Mental health FAQs
    • Order mental health leaflets
    • About our mental health information
    • Disclaimer about our mental health information
    • Choosing Wisely - a national campaign
    • BSL translations
    • MindEd: web tools for those working with young people
    • Order mental health packs for schools
    • Audio resources
    • Problems and disorders
      • ADHD in adults
      • Alcohol and depression
      • Alcohol and older people
      • Anorexia and bulimia
      • Anxiety, panic and phobias
      • Bereavement
      • Bipolar disorder
      • Cannabis
      • Club drugs
      • Coping after a traumatic event
      • Debt and mental health
      • Delirium
      • Depression
      • Depression in older adults
      • Depression and men
      • Eating well and mental health
      • Feeling on the edge
      • Feeling overwhelmed
      • Feeling stressed
      • Hoarding
      • Learning disabilities
      • Medically unexplained symptoms
      • Memory problems and dementia
      • Obsessive-compulsive disorder (OCD)
      • Perinatal OCD
      • Perinatal OCD for carers
      • Personality disorder
      • Physical illness
      • Postnatal depression
      • Postnatal depression key facts
      • Postnatal depression: information for carers
      • Postpartum psychosis
      • Postpartum Psychosis in Carers
      • Post Traumatic Stress Disorder (PTSD)
      • Problem gambling
      • Schizoaffective disorder
      • Schizophrenia
      • Seasonal Affective Disorder (SAD)
      • Self harm
      • Shyness and social phobia
      • Sleeping well
    • Support, care and treatment
      • Alzheimers drug treatments
      • Antidepressants
      • Antipsychotics
      • Being sectioned
      • Benzodiazepines
      • Bipolar medications
      • Cognitive Behavioural Therapy (CBT)
      • Complementary and alternative medicines: herbal remedies
      • Complementary and alternative medicines: physical treatments
      • Depot medication
      • Deprivation of Liberty Safeguards
      • Electroconvulsive therapy (ECT)
      • Electronic health records in mental health services in England
      • Guide to mental health tribunals
      • Liaison psychiatry services
      • Mental capacity and the law
      • Mental health rehabilitation services
      • Mental health services and teams in the community
      • Planning a pregnancy
      • Psychotherapies and psychological treatments
      • Spirituality and mental health
      • Stopping antidepressants
      • Talking to your GP
      • What to expect of your psychiatrist in the UK
      • Antipsychotics in Pregnancy
      • Lithium in Pregnancy and Breastfeeding
      • Mother and Baby Units (MBUs)
      • Children's Social Services and Safeguarding
      • Valproate in women and girls who could get pregnant
      • What are Perinatal Mental Health Services?
      • Mental health in pregnancy
      • Medication for mental health and COVID-19
      • Remote consultations and COVID-19
      • Attending hospital and COVID-19
      • Monitoring health at home and COVID-19
      • Alcohol and COVID-19
      • Eating disorders and COVID-19
      • Perinatal care and COVID-19
      • COVID-19: Self-harm in young people 
      • COVID-19: Self-harm and suicide 
      • COVID-19: Looking after your mental health – for young people and their parents and carers 
      • COVID-19: Using drugs
      • COVID-19: ASD
    • Young people's mental health
    • Translations
      • Arabic عربى
      • Bengali বাঙালি
      • Bulgarian български
      • Chinese 中文
      • French Français
      • German Auf Deutsch
      • Greek Ελληνική γλώσσα
      • Gujurati ગુજરાતી
      • Hindi हिंदीहिंदी
      • Italian italiano
      • Japanese 日本語
      • Lithuanian Lietuvių kalba
      • Pashto پښتو
      • Persian (Farsi) فارسی
      • Polish Polski
      • Punjabi ਪੰਜਾਬੀ
      • Romanian Română
      • Russian Pусский
      • Somali
      • Spanish Español
      • Turkish
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Music therapy

Cultural blog, Minds in music blog

01 March, 2017

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Need for a critical perspective

I recently came across  this excellent article in the Lancet (co-authored by Professor Desmond O’Neill, who I also plan to interview soon). It calls for a need for a reflective and critical perspective on the role of the humanities in healthcare.

This very point has been on my mind of late. As someone with a strong interest in music in particular and the arts more widely, I realise that I am not without bias in exploring the potential applications of music and arts therapies in clinical settings.

These interventions are mostly viewed by the public and doctors as benign and harmless at worst, and as potentially wondrous and life-changing by some. Yet, like all interventions in healthcare settings, they need to be subject to scrutiny for effectiveness, cost analysis and, importantly, potential unwanted outcomes.

What works for some may not work for others and pressurising anyone into a potential form of therapy raises ethical questions.

Benefits of music therapy in mental health

I have touched on some evidence base in the blog before, but mostly the blog has been speculative on this front. With this in mind, I did some further digging on the benefits of music therapy in mental health settings.

I was mostly interested in high-quality evidence, from systematic review and metanalysis. I recall having read a 2008 Cochrane review, which suggested that while music therapy may have some benefits, the number of quality studies was very small and caution was required.

I was pleasantly surprised then to find that more recent work in this area, at the level of RCT or systematic review, has suggested benefits not only in depression, but also in other mental disorders including psychosis, dementia, autism, acquired brain injury.

As a forensic psychiatrist, I was encouraged to read of work in correctional settings, where high rates of mental disorder are common. Further, music therapy appears to be well tolerated by almost all patients, and no specific adverse effects have been reported on, though it is not always clear if these have been considered.

So the current state of the field looks more promising, thanks to what seems like an increase in better quality research in this area over the last decade or so.

Gaps remain however in our knowledge about precisely how these interventions work, what components may be especially useful, and which patients will respond less well.

These areas warrant further exploration.

A music therapist’s perspective

I thought readers might also be interested in what music therapy specifically entails. The British Association of Music Therapists website gives an overview, including an historic perspective. 

Mind’s website provides some useful information also, stating ‘you do not need to have any artistic skill or previous experience of dance, drama, music or visual art to find arts therapies helpful.

The aim isn't to produce a great work of art, but to use what you create to understand yourself better.’ This echoes Carl Jung’s view of art therapy, which he quite clearly delineated from actual works of art.

Interview - Hannah Smith, Music Therapist

To further our understanding, I spoke with music therapist, Hannah Smith, who has experience across a range of mental health settings.

How did you develop an interest in music therapy? Are you a musician yourself? What qualifications did you pursue?

My personal background stems from having a musical family of sisters playing music, and growing up wanting to be part of the groups they played in having seen them perform and the friendships they made through their music.

I learnt violin and bassoon through my school years, and was always motivated by playing with others.

As I got older, I wanted to maintain my music and had a keen interest in psychology and counselling/therapy - someone then uttered the term 'Music Therapist' at a careers evening in my GCSE years, and I looked in to the profession.

I started by meeting a Music Therapist in a local hospice, volunteered there and in numerous other relevant settings, and studied Psychology and Music for my Undergraduate Degree, before applying to the Masters in Music Therapy at Guildhall School of Music and Drama. I still play in an orchestra for my own enjoyment and musicianship.

To be a Music Therapist, it is also imperative that you play at least one instrument to a high level (usually diploma or above is required), the psychology and therapy theory and techniques are what are taught and developed during training.

Can you tell us a little about your current work in this area?

I currently work two days a week in secure and forensic services for the NHS, and previously worked in an acute mental health hospital, also for the NHS.

In both settings, I have provided a mixture of group and individual sessions, both on and off ward. Sessions are tailored to client need, with thoughts around timing, context, duration, and therapeutic aims.

In forensic services, there is also consideration of a client's index offence – both in terms of work to be done in therapy, and aspects of safety and risk.

Some group sessions are open to all patients on a given ward – I run drumming groups to promote engagement in accessible group music, active participation, group cohesion and the widely evidenced benefits that drumming is known to have upon mental and physical health.

Others are closed, by referral only, and involve a more ‘classic’ approach of engaging clients in improvised music making, for self-expression, rehabilitation, emotional regulation, building insight and developing relationships with others.

I also work in children’s services for another NHS Trust, three days per week.

What are the main challenges you face as a music therapist?

The most common questions asked of Music Therapists, are ‘What is Music Therapy?’ and ‘Does it work?’.

I used to find this very frustrating in the early days, feeling like I was constantly having to justify my chosen career, until a colleague made the valid point that as a relatively small profession, for most people we meet in life, we will be the first Music Therapist they have ever met.

Realising the weight of this, changed my view, to consider the importance of these questions, and the importance of being open to them in order to nurture individual and societal understanding of the work we do, how, why, and the developments our clients make.

What aspects do you find most interesting and rewarding?

I find group music making with adults can be incredibly rewarding.

To facilitate a group of individuals, who may initially be unsure about attending and reticent of making music together, and to support them grow and come together, engaging in improvisation, to share the moment that they may discover or rediscover their own creative capacity, take risks to express themselves authentically, can be very special.

To offer an alternative means of interacting, to gain insight into parts of a person which may not be accessed or observed by other professionals, is a privilege. When these groups ‘let go’ and are able to ‘be’ in the music, in that moment, the significance in the room is palpable.

This may take many weeks to achieve, or occur within a single session. At times I can go a step further and break from my own music making, when I am no-longer essential to holding the group sound, and the group has the strength and confidence to maintain its own music.

I love to sit out and listen, observe and re-join the music once my clients have hopefully realised what they have achieved together.

Any particular success stories you would like to share?

I would say that the moments of success are what matter to me – the group coming together, the individual managing to stay in the room for the full session time without their anxieties overwhelming them, the individual holding a CD that we have recorded together of songs they may have written or covered which having meaning to them.

Even the client that initially couldn’t bear to identify an instrument to play but who manages to be at ease within the room and explore items with a sense of curiosity and trust for the therapeutic space.

Blog Author
Dr John Tully

Forensic psychiatrist and researcher at the Institute of Psychiatry, Psychology and Neuroscience, London

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