Genetic conditions and neurological conditions

Throughout my career I have worked with people with a variety of genetically determined conditions including fragile X syndrome, trisomy 21 (Down syndrome), Huntington's disease, Prader-Willi Syndrome, Angelman syndrome, and other rare genetic conditions. 

Some of these conditions come with behavioural and emotional phenotypes (characteristic behavioural and emotional patterns) as well as typical mental health profiles.

My work with people may be traditional 1:1 therapy, but could also include supports such as person-centred planning, training and education of support staff (e.g active support), consultation with other psychologists and allied health staff, and well as family-based consultations.   

Neurological conditions, such as epilepsy and seizures, multiple sclerosis, cerebral palsy, dementia(s), head ache and migraine, and other conditions involving the nervous system can severely impact a person's quality of life. 

Dealing with the uncertainty of the future can be frightening for many, causing a pre-occupation with 'then' and 'if', stealing and hijacking the person's focus away from 'now' and the experience of the present moment. I also work with people who have Functional Neurological Symptom Disorder. 

My approach often involves validating the person as the only real expert in their life, teaching and demonstrating how to experience this moment (at times referred to as mindfulness or being present), and focusing on coping skills to deal with symptoms. 

Prior to my work in Camden, earlier in my career I worked  in a slow-stream rehabilitation unit for several years, and the topic of my doctoral dissertation was the assessment of depression in people who had suffered brain injury. Emotional disorders and other mental health conditions are common following brain injury, even after many years post injury. 

Typical presentations include behavioural issues, disinhibition, personality changes, depression and anhedonia (inability to experience pleasure), as well as psychotic-like symptoms (in the absence of psychosis or schizophrenia more broadly). 

Despite common and negative (and pessimistic) beliefs about treatment, in my experience people with TBI often benefit from therapy. I have found that with the right modifications to the traditional CBT approach (such as less focus on abstract cognitions and thinking problems caused by impacted executive functioning) people can and do improve in relation to mental health symptoms.