- The family have moved areas 

- Penny has lost weight from when she attended her transfer in visit, however appears well presented

- Penny during the appointment is interacting with Luke positively and is being caring and affectionate 

- Luke’s development is appropriate in all other areas other than he is not mobile yet. Following discussion, it is apparent that Penny holds Luke most of the time and when it is suggested that he is put on the floor to play she reports she is worried about the germs on the floor. She reports she bleaches her floor everyday

Issues are the areas that you will need to know in depth to be able to manage this situation effectively.
 - For Luke to develop appropriately he needs to be put down on the floor however Penny will not put him on the floor to play and develop mobilisation due to the germs 

-  I would want to explore Penny’s mental health history and current mental health. Has she been diagnosed with OCD previously? Has she experienced any conditions such as anxiety/depression if so, what treatment has she had before? Are these new symptoms, behaviours and thoughts or was she experiencing worries throughout pregnancy 

- What are the current signs and symptoms used to diagnose OCD and what are the available treatment options for women in the perinatal period? It is important that Penny understands the importance of Luke’s development and supporting him to mobilise and understands how her current thoughts may affect this 

-  I would want to explore how Penny was feeling and what support mechanisms she has in place to support her with a new area, new job and new role as a mother. Does she feel she is coping ok? Has she got a support network?

- I would want to explore Penny and Gerald’s relationship and explore as he is a builder and will not sit down in his work uniform, does Penny struggle with him being a builder and sitting down at home, does she allow him to be involved in Luke’s care when coming back from work as a builder who will surrounded by mud and building materials. How does Gerald feel? Does he think this is normal behaviour for Penny or has she recently changed? What is his mental health like at present and in the past?

What subject areas are you thinking about that you know about, have a good depth of knowledge and which areas do you know less about?

-    I would like to have a better understanding on how OCD is diagnosed? What the risks are in the perinatal period for women who experience OCD? What puts people are higher risk of development OCD?  What treatment options are available to women? How OCD can affect the child’s development and family relationships.  What support is available for women 

What information do you want to know have to help you with managing this situation effectively?
 - Has Penny been diagnosed with a mental health condition before? If so, what treatment did she have? What is Penny’s family history?  What was Penny’s mental health like in pregnancy and in the postnatal period, is this new thoughts and behaviour? 

-  Does Penny recognise herself that she may have signs and symptoms of OCD and this may affect Luke’s development if she does not let him mobilise and play?  How is Penny feeling in herself – GAD-7 and depression scales can be used as suggested in the national guidance along with open questions to assess how Penny is feeling. 

-          How does Gerald feel? How is this affecting their relationship? 

Develop some questions that you need to answer

-          Who is at higher risk of developing OCD?

-          How is OCD diagnosed, what are the signs and symptoms used to diagnose the condition?

-          What treatment/management options are available for women with OCD? 

-          How can OCD affect women in the perinatal period, how can unmanaged OCD affect the baby and the family relationships?