Clinical case discussion

The case I wish to present is a long term piece of work that was multi-faceted in the type of work we did and, for me, indicates the need for an integrated and timely pathway of care to avoid crisis management.

Case looks back at the work completed by H an 18 year old young person diagnosed with Androgen Insensitivity Syndrome who was 12 at the time of referral to psychology. Issues to explore around the circumstances of the referral

● No commissioned service- part of good will work done in the department.

● An attempt to build expertise- limited numbers of psychologists picked up endocrine referrals to try for continuity.

● Such work is not just case work, includes MDT liaison and support.

Clinical issues explored in this case have been multi-faceted;

● Adjustment to diagnosis (aged 11- late diagnosis) and management of significant changes in mood and behaviour at this time. Also a developmental process. ● Liaison with and support offered to the systems around the child, first and foremost the family, but also the school as well as MDT.

● Decisions about surgery

● Exploration of sex, gender and sexuality.

Finally I will reflect on how this work could have been different if I had been an integrated part of the care team.