•Imagine everyone has a bucket, this represents your predisposition or vulnerability to stress.

•The water entering the bucket represents stress. This may trickle in gradually from one source, or may rush in from several sources (e.g. family arguments, finances, exam stress).

• In the bucket to the left there are no valves or taps to allow the water to exit, so once it is full, the bucket will tip over (i.e. into psychosis).

•If the bucket did have taps or valves, this would allow some of the water to be realised and so the bucket would not tip over (i.e. protective factors / coping strategies).

•Now imagine that instead of a bucket you only have a pint glass, or an egg cup? How long will it take for your pint glass or eggcup to overflow compared to a bucket?

•Everyone's “bucket” (i.e. vulnerability) is a different size and this is likely to be due to a number of complex and interacting variables (e.g. genetics, parenting style, past experiences)

•Imagine a couple (lets unimaginatively call them Mr and Mrs Adams) attend the A and E department.

•Mr Adams tells you that Mrs Adams is not herself, he has overheard her talking to herself and she believes that her work colleagues are conspiring against her to make her appear incompetent at work.

•She has admitted to Mr Adams that she is hearing voices.

•Mr Adams tells you that Mrs Adams has been working long days to try to keep on top of her work and that she has not been sleeping well.

•Bearing the stress-vulnerability model and the stress bucket in mind, what else would you need to know? how would you approach your assessment? what questions would you ask each of them? How might Mrs Adams feel? How might Mr Adams feel?

•Consider biological / psychological and social factors in terms of vulnerability, stressors and protective factors.

•Also consider how you would demonstrate compassion and dignity to both Mr and Mrs Adams.