iiinova — where your digital self keeps evolving

Dr Sarah @sarahpsyc.bsky.social · 20/06/2026

See you next year BIGSPD ❤️ Sorry for the lack of tags 🤦🏻‍♀️ hopefully you see the #BIGSPD26 @bigspd.bsky.social

Dr Sarah @sarahpsyc.bsky.social · 20/06/2026

That’s what is lovely about BIGSPD; we all come from different backgrounds, yet it’s the shared views & connections that mean we have these helpful & difficult conversations. I leave sad (that it’s over), yet enthused to go back to my job & continue to drive for change.

100

Dr Sarah @sarahpsyc.bsky.social · 20/06/2026

And so, another BIGSPD comes to an end 😢 what have I learnt? It’s pretty simple really; you can have all these fancy treatments but without the relationship & seeing people as people then it’s pretty pointless.

100

Dr Sarah @sarahpsyc.bsky.social · 20/06/2026

I loved her dialectics - that two opposing things can be true at the same time. Whether you can study medicine & have this diagnosis: “it’s not a yes, it’s not a no; it’s a why not?!” Loved this!

200

Dr Sarah @sarahpsyc.bsky.social · 20/06/2026

Lastly, Dr Erin McCabe talked as the “Borderline Doctor”. She shared her reflections & experiences of training to be a doctor whilst having this label. The duality of roles was discussed, as well as her views on medical training in the area of personality disorder (basically it’s not good enough).

100

Dr Sarah @sarahpsyc.bsky.social · 20/06/2026

Trainees appeared to show more change then their more established counterparts. I feel that shows hope for the future, but leaves me with concerns about people’s ongoing experience with GP’s when they be a main port of call. It also shocked me that GPs don’t get supervision?!

100

Dr Sarah @sarahpsyc.bsky.social · 20/06/2026

The second was a session by Grace Wood from CUSP, about a evaluation of brief training for GPs in London. She outlined what they’d done & what the training involved. Interestingly there were improvements but these had been skewed by GP trainees.

100

Dr Sarah @sarahpsyc.bsky.social · 20/06/2026

There was a strong feeling of anger & wanting to improve care, as well as a reflection of the gap between clinical language & the person’s experience - what is intended v what is felt! It was clear that when support was made available it made a huge difference. Again themes of being human were key!

100

Dr Sarah @sarahpsyc.bsky.social · 20/06/2026

The last sessions of the day were 3 oral presentations. My goodness, these sessions were powerful! Jo Greenwood, Sarah Lemon, Laura Price, Rosie Clements & Martin & Jim from Gloucestershire CEN service described a qualitative evaluation of a group of families & carers who support those with CEN.

100

Dr Sarah @sarahpsyc.bsky.social · 20/06/2026

There were passive & active mechanisms considered. Ultimately it came back to relational experiences (can you see the ongoing pattern). Was really nice to see that ideas we’re implementing in MHIST have this evidence to back us up, & shows the value of our OTs & healthy lifestyle coaches.

100

Dr Sarah @sarahpsyc.bsky.social · 20/06/2026

Final day of BIGSPD reflections. In the morning Peter Coventry discussed nature based interventions. I noticed it mirroring CHIME. The results of these interventions held up to psychological therapies in a population where talking therapies struggles to reach.

100

Dr Sarah @sarahpsyc.bsky.social · 20/06/2026

And a line from Mary - “life outed me” really stuck with me. We might all be patients, but some of us are privileged to be able to hide it whilst others are outed by circumstances. Day 2 was tiring & inspiring all in one. Ultimately relationships & seeing people as people really shone through ❤️

100

Dr Sarah @sarahpsyc.bsky.social · 20/06/2026

The way they shared their own experiences of different roles - some of this provided similarity & the idea that we are all patients & clinicians going between vulnerability & containment - really got me thinking about relationships & roles.

120

Dr Sarah @sarahpsyc.bsky.social · 20/06/2026

I only went to one of the plenary talks in the afternoon, which was delivered by Dr Rachel Gibbons & Mary Ryan. Titled “The patient-clinician relationship: helpful illusion or hard delusion.” It was a really thought provoking space that Rachel & Mary delivered.

100

Dr Sarah @sarahpsyc.bsky.social · 20/06/2026

In the afternoon I went to another workshop facilitated by Vicky Baldwin & Julia Blazdell. This was called “If anyone can do it, then why can’t we? Putting the relational into learning about Personality Disorder.” Lots of reflections & activity linked to the work in the relational practice movement.

100

Dr Sarah @sarahpsyc.bsky.social · 20/06/2026

All facilitators talked about where & how they work, which led to discussions - & disagreements - but all handled politely (as is the way of BIGSPD). This was a session that really got me reflecting on the responses in our systems & whether we actually create more harm because of our own fears.

100

Dr Sarah @sarahpsyc.bsky.social · 20/06/2026

The space allowed open & honest reflections that linked with Dan’s session on the Action/Consequences model. Risk was defined - the chance of losing something of value. But should this only be about death? It led to discussions about fear & what leads us to restrict people over helping them live.

100

Dr Sarah @sarahpsyc.bsky.social · 20/06/2026

Next, I went to a workshop facilitated by Dr Dan Warrender, Jorge Zimbron, David Kingsley, Hollie Berrigan & Keir Harding titled “When safe practice creates new risk: restriction, blame & clinical outcomes.”

100

Dr Sarah @sarahpsyc.bsky.social · 20/06/2026

I loved the other stories from the lived experience network. And Raf summed up what was fast becoming a theme of the conference - less about a specific treatment & more about relationships & factors that I associate with CHIME.

100

Dr Sarah @sarahpsyc.bsky.social · 20/06/2026

Day 2 started with Raf Hamaizia from Cygnet, talking about lived experience & co-production. Raf’s warmth, humour & honesty shone through. In the talk he named interaction between a “medical gaze” & “inverted gaze” - this fascinated me as it identified the loss of a human view from both sides.

100

Dr Sarah @sarahpsyc.bsky.social · 20/06/2026

Ok, here we go…my day 2 & day 3 #BIGSPD26 summary & reflections. Plus overall conference reflections ❤️

100

Dr Sarah @sarahpsyc.bsky.social · 18/06/2026

Oh I know! I was rubbish at catching up with everyone. Also was looking after 2 staff from my team who’d never been before, so was very mindful of not just ditching them 🤣

010

Dr Sarah @sarahpsyc.bsky.social · 18/06/2026

My #BIGSPD26 silence is a reflection of how jam packed the days have been & how enthralled I was with it all. Now processing it & I will share my day 2 & day 3 experiences & reflections. What a great conference!! Always filling my cup (to steal the line from @elliewildbore.bsky.social 😊)

241

Reposted by Dr Sarah

Ad de Jongh @adjongh.bsky.social · 16/06/2026

People who are interested in the underlying research and want to download and read the papers can follow this link (use the password: interweave): www.psycho-trauma.nl/persoonlijkh...

psycho-trauma.nl

Persoonlijkheidsstoornissen – Centrum voor Psychotherapie en Psychotrauma

Deze inhoud is beschermd met een wachtwoord. Voer hieronder je wachtwoord in om het te bekijken:

043

Dr Sarah @sarahpsyc.bsky.social · 17/06/2026

#BIGSPD26 day 2 done…always forget how exhausting the Wednesday is when there’s so many things you want to join. A lot of food for thought. Thanks to those who came for a chat about my poster at lunch too 😊 Reflections of the day coming later, although it’s the gala meal tonight, so who knows 🤷🏻‍♀️

030

Dr Sarah @sarahpsyc.bsky.social · 16/06/2026

And that concludes day 1 of my #BIGSPD26 reflections. Looking forward to day 2 😊

A scene showing Blackpool tower in the distance

020

Dr Sarah @sarahpsyc.bsky.social · 16/06/2026

Linda then went on to discuss how she’s moved it to practice & noted how self-reflection is a key aspect. What’s driving our decisions? Lastly, the group came together for a discussion & something that really stood out to me was the idea that “positive risk taking” can now often equal neglect 😢

120

Dr Sarah @sarahpsyc.bsky.social · 16/06/2026

Whilst he’s had the challenge (from some) of this not having an evidence base, Dan reflected that “we don’t need an evidence base to think” - which is all this model encourages. Interesting challenge from someone when many of our services are not following evidence base day in day out 🤷🏻‍♀️

120

Dr Sarah @sarahpsyc.bsky.social · 16/06/2026

We heard Dan describe the model (see post I shared where Dan spends time explaining the model) & encourage us to view risk like “holding jelly”.

A slide showing pictures of 3 jelly’s. 1 is a jelly on its own, 1 shows hands gently round a jelly, the 3rd shows a jelly being squashed in a hand

120

Dr Sarah @sarahpsyc.bsky.social · 16/06/2026

Final session of the day & I chose to attend a symposium with Dr Dan Warrender @danwarrender.bsky.social, Linda Pert, Hollie Berrigan @hoppypelican.bsky.social, Ellie Wildbore @elliewildbore.bsky.social & Marilyn Rutter. The focus was on the Action/Consequences Model developed by Dan.

132

Dr Sarah @sarahpsyc.bsky.social · 16/06/2026

But evidence doesn’t seem to agree - 1/2 do not respond to treatment & 1/3 drop out. Ad de Jongh instead, described a short, yet intensive, prolonged exposure & emdr approach of just a few sessions over a few days - which included therapist rotation(!). An interesting concept for me.

100

Dr Sarah @sarahpsyc.bsky.social · 16/06/2026

@adjongh.bsky.social gave the second keynote. This considered a brief trauma-focussed treatment for “personality disorder”. Reflections were made about NICE guidance - it tells us that specialised therapies are best & treatment shouldn’t be short term.

100

Dr Sarah @sarahpsyc.bsky.social · 16/06/2026

I wonder if it may be hard for systems (often driven by targets) to see that feedback, from people using the service, was their experience of treatment by staff, not the skills? Probably not a surprise to many that it’s the relationships & consistent approach to care that result in lasting change.

A slide showing quotes from service users for their feedback of ATS

100

Dr Sarah @sarahpsyc.bsky.social · 16/06/2026

First day #BIGSPD26 done ✅ The first keynote was from Dr Annette Jones (LSCFT). It got the room thinking about how to create system learning from a successful service (ATS). What is it about ATS that works? The data/outcomes say it works well.

A slide showing outcomes for the ATS service in LSCFT

111

Dr Sarah @sarahpsyc.bsky.social · 16/06/2026

BIGSPD Blackpool is now on until Thursday. Follow #BIGSPD26 to keep up to date. There will be far better posts than mine, & hopefully they give you a flavour of the conference. I will be doing a summary of each day with a thread of posts & my reflections. Stay tuned for my first day posts 😊

030

Dr Sarah @sarahpsyc.bsky.social · 16/06/2026

Highlight of day 1 was a symposium linked to this #BIGSPD26

032

Dr Sarah @sarahpsyc.bsky.social · 11/06/2026

I’ve been super quiet on here (sorry). My use of social media has massively reduced in the last 12 months; however, I will be posting here over the next week for #BIGSPD26 in Blackpool! Keep an eye on the hashtag, as lots of others will be posting too. Can’t wait ❤️

111

Reposted by Dr Sarah

The Mental Elf @thementalelf.bsky.social · 03/09/2025

Mental Elf Monthly for August 2025 is now LIVE Catch August’s most-read blogs, from trauma to CBT harms, and book your free spot at our difficult-to-treat depression webinar. national-elf-service.kit.com/posts/mental...

national-elf-service.kit.com

What practitioners read most in August; plus a free depression webinar

The Mental Elf Monthly - Your monthly dose of mental health research, evidence, and impact.

033

Reposted by Dr Sarah

BiteSize Therapy @bitesizetherapy.bsky.social · 30/06/2025

In psychotherapy, there are principles and there are preferences. People tend to mistake their personal preferences for principles. We have 400+ therapeutic modalities because of preferences, not principles.

3348

Reposted by Dr Sarah

Keir Harding @keirwales.bsky.social · 20/06/2025

What if unknown male members of staff watching female survivors of sexual violence sleep wasn’t as therapeutic or reassuring as it sounds?

072

Dr Sarah @sarahpsyc.bsky.social · 17/06/2025

🤦🏻‍♀️ really??? Do they read what they’ve written before they send it out? With the wider experience I’m also interested in the pay scale too

120

Dr Sarah @sarahpsyc.bsky.social · 13/06/2025

Yes!! Had a couple of bits where I was trying to go between sessions as I just couldn’t decide. Or then got FOMO for seeing people’s comments about ones I’d missed!

020

Reposted by Dr Sarah

Oh Tea Suz @ohteasuz.bsky.social · 12/06/2025

My #BIGSPD25 poster contribution, challenging the “BPD” diagnosis & current practice of using OOA placement. If you fancy a chuckle at my poor presentation skills give the central QR code a scan & I’ll talk at you for about 15 minutes 😉

0136

Dr Sarah @sarahpsyc.bsky.social · 12/06/2025

Interesting to hear about the brief intervention clinic they’d set up, meeting people where they’re at (crisis point) & working with them/sitting with them for a small number of sessions including family/carer one. The outcomes showed 50% didn’t need to access more, ⬇️ bed days & ⬇️ costs #BIGSPD25

021