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One on one… with Caroline Foster

We dip into the Society member database and pick out Caroline Foster, Consultant Clinical Psychologist, Surrey and Borders Partnership NHS Foundation Trust.

01 July 2019

One book I would recommend
Small Great Things by Jodi Picoult. This profoundly written fiction book provides an illuminating social psychology narrative, exploring power and prejudice as this relates to racism. It’s a reminder to be curious and inquisitive about what we don’t know, while speaking to the most unpleasant and the most admirable qualities we have as human beings. Picoult also weaves in poignant lessons on fallibility, grief and love, so it would be difficult not to be touched by or learn from this book.

One place
I have fond recollections of travelling to Yangshuo in China while I was completing my undergraduate psychology degree. This was more than 20 years ago now, so I don’t know to what extent the area has changed, but the ethereal beauty of the mountain scape created an impression which has stayed with me. More recently, I trekked up Adam’s Peak in Sri Lanka which is known for the Sri Pada, ‘sacred footprint’. You can enjoy the stunning sunrise from the top. I found the gentle ambience on the climb awe-inspiring, and the change in climate at the summit is quite something. 

One enjoyable thing about my job
In my current role as the Psychology Lead for the Adult Eating Disorders Service, one of the most enjoyable and challenging aspects relates to working with the Management Steering Group to develop the interface care pathways. Eating disorders is a dynamic and diverse field, ranging from managing transitions across care settings, to working with often severe physical and mental health co-morbidities. Physically this includes management of the risks associated with starvation and purging behaviours, but also meeting the particular needs of specific client groups such as those with eating disorders and type-1 diabetes. Psychologically the breadth of co-morbidities is also eye-opening.

One thing I would change
I think it would be wonderful to see parity for adult eating disorder services alongside that of eating disorder services for children and young people. This is something that the recent Parliamentary Ombudsman has called for, and it’s something I hope won’t be overlooked in the allocation of promised monies from the NHS Long Term Plan for the transition age group (18- to 25-year-olds).

One inspiration
The story of Paul Kalanithi, Neurosurgeon and author of When Breath Becomes Air. His courage in the face of the adversity and his positive resolve for life is more than humbling.

One piece from The Psychologist
Matthew Pugh’s article ‘Pull up a chair’ (July 2017) is a comprehensive and accessible overview of the history of the development of chair-based interventions, and their empirical basis. What I find enthusing is the scope for creating belief change at emotional as well as at intellectual levels; the potential for broadening the repertoire of the experiential techniques at our disposal. There is increasing appreciation that the more we can effectively use multi-sensory techniques, the greater the prospect for consolidating behavioural change, and for sustainably diminishing people’s emotional distress.

One hope
That we can get more people better, or enjoying an improved quality of life, quicker. We must all make our own small contributions to balancing research and advances in treatment, with the management of day-to-day service demands; particularly in settings where service need is high, and responsiveness is crucial. It’s a challenge we’re well placed to further rise to.

One thing about the Society
I find the opportunities for networking, sharing ideas and problem-solving invaluable. Whether we are deliberating gaps in service provision or our training requirements, the informed reflective space and peer support I think makes all the difference; particularly in clinically challenging times.

One career highlight
The current highlight for me is the recent completion of the Faculty for Eating Disorders Good Practice Guidelines for Trainee Clinical Psychologists and Qualified Clinical Psychologists Working with People with Eating Disorders (publication pending). This has been a significant piece of work which we’ve co-produced with experts by experience. Our hope is that the guidance is not only comprehensively informative, but also that it enthuses more trainees and qualified psychologists to consider working in this rewarding field.

One thing psychologists should be proud of
The competencies we develop during training around formulation. In Clinical Psychology these skills aid us in providing consultation, in optimising adherence to evidence-based treatment, and most fundamentally in ensuring the people we work with feel understood and heard. We typically describe the formulation as our road map for treatment. A good formulation also allows us to consider when we need to work integratively across models, or in a stepped care fashion to promote recovery. The hypotheses we develop from these formulations help us to highlight the gaps in the existing treatment evidence base, and this means crucially there is the potential to drive research forward and to improve people’s outcomes.