Take better care of the emotional needs of social workers and they'll take better care of clients

The pioneering work of psychoanalyst Isabel Menzies Lyth demonstrated how individuals and organisations protect themselves - by denial and repression - against anxiety when the primary task is unrelentingly full of anxiety. Another worrying consequence is seriously impaired judgment and decision-making - what Professor Eileen Munro has referred to as "errors of reasoning".

I saw a powerful example of this a couple of weeks ago. I am developing with a colleague, Dr Jane Reeves, innovative ways to develop social workers' skills using virtual reality and filmed scenarios of complex family situations using actors. We visited the clinical skills unit at the School of Medicine at Imperial College, London, where trainee surgeons are prepared for the difficult situations they face in A&E departments. One scene involved an actor taking the role of an aggressive patient (the trainee surgeon does not expect this). The trainee's task is to insert a drip into the patient's arm. To do this safely involves performing a number of key procedures, such as taking blood pressure readings and sterilising the entry site for the drip.