I have been working in developmental psychiatry since 1999, and in psychiatry since 1988, apart from a period in the late 1990’s when I trained and qualified as a General Practitioner.
After undergraduate medical studies at Cambridge University and Guy’s Hospital Medical School, I started psychiatry training in Bradford and Manchester: my trainers included Professor Sir David Goldberg, Professor David Taylor, Dr Mary Eminson, Professor Digby Tantam, and Professor Philip Thomas. Following higher training in Developmental Psychiatry in Leeds, including a specialist registrar post with Professor Stephen Read, I obtained my certificate of completion of training (CCT), and moved to Kent in 2002 to take up a substantive NHS consultant post, which I left in January 2008.
I was a visiting consultant to The Priory Ticehurst House from 2007 to 2008, and I worked with The Priory Group on their adult developmental disorder inpatient and residential services for a year up to the end of 2008.
My clinical approach has always involved a joint discussion with my patients about the best treatment or combination of treatments, which might involve counselling, psychotherapy, medication – or no treatment.
Counselling and Psychotherapy
I have gained experience in a wide range of psychotherapies, including cognitive and behavioural therapies, psychodynamic psychotherapy, the "conversational model", cognitive-analytic therapy, and systemic (family) therapy. In my view any form of psychotherapy can be helpful in any developmental disorder, depending on the individual and his or her particular problems and strengths.
Medication
I have initiated and monitored prescription of the whole range of antidepressant, mood stabilising, antipsychotic, and ADD / ADHD treatments used in UK psychiatry over the last twenty years. All of these classes of medications have seen several new introductions, so that the choice available is now very wide (see also my comments on "Developmental Disorder treatments and the Pharmaceutical Industry" at the bottom of this page).
Academic Interests
I have lectured on the psychiatry of developmental disorders, and on child development, for the University of Kent Masters degree program, 2005-8. My academic interests are in conceptual, cultural and historical issues in developmental psychiatry, and I have regularly given clinical and research presentations, including many at national and international conferences. A small part of this work has appeared in the journal Philosophy, Psychiatry and Psychology, and I am co-author of a clinical study in the European Journal of Psychiatry. I have acted as a peer reviewer for the British Journal of Psychiatry and the Journal of Affective Disorders, and have reviewed books for the British Medical Journal, the Journal of Intellectual Disability Research, and the Journal of Mental Health
Developmental Disorder treatments and the Pharmaceutical Industry
I have a degree of sympathy with the concerns of some patients and relatives about medication and the marketing activities of pharmaceutical companies and I try to form my own opinions about medications by using a range of information sources. However, I believe that over the last few decades the pharmaceutical industry has introduced many products which can be very helpful for people with developmental disorders, and although the current system might not be perfect, it is important that new medications continue to appear.
I also value a significant number of medical specialists having links with the pharmaceutical industry, ranging from full employment to short-term consultancies. Given that my own clinical interests have tended to be more at the interface between biological and psychological factors, I have never had such links, and I have always relied on professional colleagues for more detailed information, and specialist opinions, on medications. Therefore, as an NHS consultant, I did not make myself available for individual meetings with pharmaceutical company representatives, primarily because of the time involved: however, I did regularly have briefer discussions with representatives in the context of sponsored meetings. I have not accepted funding for attending or presenting at meetings.
(There is a further discussion of these issues in the text and notes of my April 2009 presentation on the NICE ADHD guidelines: see the bottom of the "News and Links" page for a summary).
