Multiple issues that impact service delivery, such as changing student demographic characteristics, educational law and policy, and an increased focus on accountability for services, require school psychologists to adapt and acquire new professional skills in order to meet the needs of students and families. Continuing professional development (CPD) could help school psychologists expand their repertoire of professional skills so that they can engage in effective service delivery. The present study examined the CPD subject areas endorsed by practicing school psychologists and the relationship of those areas with selected demographic characteristics, professional practices, and employment conditions. Secondary analyses were performed using the existing 2004-2005 National Association of School Psychologists (NASP) national database. The total sample size included the responses from 1,155 practitioners. Descriptive analyses revealed that the most commonly endorsed CPD subject areas were behavioral interventions and standardized psychoeducational assessment. Logistic regression analyses indicated that selected demographic characteristic variables helped to predict participation in academic interventions and consultation/problem-solving CPD subject areas. However, no one demographic characteristic variable made a significant unique contribution to either model. Selected professional practice variables helped to predict participation in standardized psychoeducational assessment, social/emotional interventions, consultation/problem-solving, and response to intervention CPD subject areas. School psychologists who engaged in non-traditional CPD subject areas (i.e., social/emotional interventions, consultation/problem-solving, and response to intervention) were less likely to engage in professional practices related to special education (i.e., initial evaluations). Selected employment condition variables helped to predict participation in academic screening/progress monitoring and social/emotional interventions CPD subject areas. School psychologists who reported lower ratios were more likely to participate in social/emotional interventions CPD as compared to those who reported higher ratios. A statistically significant association was found between region and participation in academic screening/progress monitoring, behavioral assessment, social/emotional assessment, social/emotional intervention, response to intervention, and crisis intervention CPD. Implications of the findings are discussed within the context of previous research. Suggestions are offered for areas of future study related to the CPD activities of school psychologists.

No / The number of children in the UK with life-limiting conditions and the demand for home-based palliative care is increasing. Children's hospices remain a dominant provider of palliative care. This study aimed to determine the approaches taken by children's hospices across the UK in meeting the planned and unplanned health needs of children and their families who receive palliative care at home. In addition, the survey aimed to identify the professional composition of community teams and the number of children and families supported by each service. An internet-based questionnaire survey was sent to all children's hospices in the UK, comprising ten questions exploring the size of the team, geographical areas covered, workforce composition, services offered and approaches to managing unplanned, out of hours care. Responses were received from 14 (26%) of the hospices. A total of 1,618 children and their families were being cared for by these hospices, of whom 825 received care at home. Registered nurses constituted the greatest proportion of staff and were employed by all teams. Care provided at home was broadly split into two categories: planned short breaks and responsive palliative nursing. The latter comprised advance care planning, anticipatory prescribing and active symptom control. Out of hours care was usually offered in the form of telephone support. Models of community-based care are evolving to include nurses practising at specialist and advanced levels, allowing more children with increasingly complex conditions to be cared for at home.

Yes / The adoption of digital technology by nurses accelerated during the coronavirus disease 2019 (COVID-19) pandemic. However, not all nurses were familiar with the various digital systems used in their organisations and there were reports of digital technology not being fit for purpose. This article describes a service evaluation that used an online survey to obtain nurses' feedback on the digital systems used to support patient care during the pandemic. Fifty-five respondents provided details about 85 separate digital systems. The usability of these systems varied significantly across technology types, while barriers to their use included nurses' lack of digital literacy and inadequate access to IT infrastructure. However, most of the nurse respondents felt that digital technology had supported effective patient care during the COVID-19 pandemic.

Yes / Care after the death of a child and support of their bereaved family is an important element of the services offered by children’s hospices in the United Kingdom. The study aims to explore the emotional challenges of those delivering care to families of children in hospice cool rooms. An internet-based questionnaire was sent to all practitioners to explore their perspectives of providing care to bereaved families whilst the child’s body was in the hospice, as well as caring for a child’s body after death. In total, 94.9% (n=56) of staff responded. Two key themes were identified that represent the emotional challenges perceived by staff: the impact of deterioration of a child’s body; and witnessing the acute grief of families. Practitioners seek to provide care that recognises the importance of family and demonstrates family-centred care, as well as supporting families to deal with the changes that occur after death. Organisations can support practitioners to deliver care in cool rooms by providing training and education on anticipating and managing the pathophysiological changes that occur after death as well as training in grief and loss, and how to support a bereaved family. / Research Development Fund Publication Prize Award winner, May 2021.

Aim: According to the existing evidence-base, the experience of the death of a therapy client (from a cause other than suicide) for Clinical Psychologists is substantially under researched. Moreover, previous studies into the experience of patient or client death for healthcare professionals indicate this may be an important focus for research. The present study aimed to explore the often unheard, lived experiences of client death for Clinical Psychologists at the beginning of their career. It was hoped that these research findings may assist training courses, clinical supervisors and other Psychologists of all grades to make sense of this experience in greater depth. Method: A qualitative approach was adopted for this study. Semi-structured interviews were conducted with nine female junior Clinical Psychologists (Trainee, Newly Qualified) who had experienced the death of a client. The accounts were analysed using IPA, which attempts to illuminate the lived experience of a phenomenon for small samples of individuals. Results: The analytic procedure highlighted three main themes as emerging from participants’ accounts in the context of their client’s death: Connected and affected: Being unprepared for initial reactions to the client's death; "we do it so why can't you?" facing institutional denial and avoidance; "It's not something I've forgotten about", The lasting impact of client death: Learning reluctant lessons and experiencing continuing bonds. Implications: This study highlights the importance of recognising the impact of client death on Clinical Psychologists in particular, and healthcare professionals in general. Client death, by all causes, appears much overlooked within the current research base, which may have led to a self-perpetuating cycle of hidden and unspoken stories. The findings indicate death needs to be on the research and teaching agenda within the institution of Clinical Psychology. As a result we may be able to begin to break the current cycle of silence which has served to potentially disservice us as professionals, our teams and most importantly our clients.

Objective: Criminal liability for the sexual-transmission of HIV raises complex questions for both clinicians and service-users regarding their responsibilities and legal obligations to disclose information to others. This is the first research study to address the impact of these issues upon everyday clinical and professional management in the UK. The prevalence and incidence of clinical and HIV-legal issues reported by the 107 psychologists sampled are reported. Design: A cross-sectional approach comprising two components was utilised: Firstly, questionnaire survey (Response rate 22%) scoping the experiences of practice issues among psychologists from sexual-health and generic settings. Attitudes towards HIV-prosecutions and various measures of professional self-efficacy were also collected. Secondly, three focus groups (N=15) exploring the impact of practice issues upon clinicians’ likely confidentiality breaking behaviours. Methods: Clinical and legal issues are presented. Further statistical analyses explored the interaction of various demographic, clinical and attitudinal variables upon clinician’s perceived self-efficacy. Focus Group transcripts analysed using Thematic Analysis (Data-driven approach) with eight emergent themes. Results: Although no direct involvements in police investigations reported, two instances of psychology notes being subpoenaed plus multiple ‘near miss’ clinical experiences described. High proportions of sexual-health psychologists experienced HIV-clients disclosing problematic behaviours, including intentional transmission (9%; N=5) and/or ‘reckless’ behaviour (72%). Focus groups expressed high levels of anxiety regarding these scenarios associated to multiple influences (interpersonal, clinician, professional and service factors). Quantitative and qualitative results were triangulated to provide a detailed analysis of how psychologists manage the clinical impact of the issues. Conclusions: Psychologists broadly supported HIV-prosecutions for intentional transmission (81%) but only limited support around ‘reckless’ cases (44%), particularly among those sexual-health experienced. Those ‘critical’ attempted to mitigate the impact of legal issues by proactively raising awareness among HIV-clients and resisting overly-defensive service changes; whereas those ‘less-critical’ were more accepting. Clinical, training and therapeutic implications are briefly considered.