Psychiatry trainee experience of working in a child and adolescent eating disorder program.

OBJECTIVES: Eating disorders are serious psychiatric conditions that affect people of all ages. Many psychiatry trainees' first and only experience with eating disorders during training is their Child and Adolescent Psychiatry (CAP) rotation. This study aimed to explore the learning experience of psychiatry trainees working within an Eating Disorder Program (EDP) during their CAP rotation. METHODS: Fifteen trainees who participated in the EDP were recruited to complete an online survey and focus groups; a thematic analysis design was used to identify themes emerging from their responses. RESULTS: Themes emerged from the trainee learning experience of working in the EDP around what they found they learnt, what aided that process, what was difficult, and recommendations for future improvement. CONCLUSIONS: This study provided insight into the trainee experience in an EDP as one example of how trainees can learn about eating disorders and one way that could inform future workforce and training initiatives.

Single session family therapy for beginners: what difference does it make to psychiatry registrars to participate in family sessions in front of and behind the screen?

OBJECTIVE: Current competencies required for fellowship of the RANZCP require psychiatry registrars to have experience in working with clients across all age groups, as well as working with families and the client's wider network, however gaining this experience is not always easy for trainees. This paper reports on the experience of participating in Single Session Family Therapy (SSFT) during registrar training as a different modality for learning. METHOD: An online survey was conducted with fourteen registrars who had participated in SSFT during their child and adolescent rotation. Qualitative and simple quantitative data were collected and analysed. RESULTS: Participating in SSFT during training was initially daunting, but had a positive effect on trainees, including influencing some towards focussing their future sub-specialisation in the child and youth area. Experience came through learning by doing, and seeing change. Registrars learnt about: understanding the role of the family; teamwork; technical skills; and gained confidence. CONCLUSIONS: Opportunities for trainees to participate in SSFT enables powerful learning beyond what can be taught in the classroom. Such opportunities may enhance registrars' perceptions of family work, and may positively influence decision about future sub-specialisation.

Suicide, misappropriation and impulsivity.

OBJECTIVE: To describe a patient who survived a suicidal act in which lethal means were used and who subsequently cooperated with psychiatric examination. METHOD: Case report. RESULTS: A 22-year-old man jumped from a bridge into the water 49 m below and survived. He was admitted to hospital for assessment. No psychiatric diagnosis could be made on either Axis I or II. He had misappropriated money and lost it gambling, and detection was imminent. He described his jumping as being the result of a sudden impulse. While he was falling he changed his mind and assumed an appropriate diving posture with the intention of preventing his death. CONCLUSIONS: This is an example of a person performing a highly lethal suicide act, in the absence of Axis I or II disorder. Threat of disgrace and possible prosecution; and impulsivity were significant factors.