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Before and after Ofsted: The emotional and professional journey of children’s social care senior leaders who received an Ofsted judgement of inadequate
Full text linkThis is a unique small-scale study that explores the experiences of senior leaders who received an Ofsted judgement of inadequate. For the first time and through their own words it tells their stories of their lived experience in the period up to, during and post Ofsted inspection. The study frames these stories, which are rich in detail, from both a professional and emotional perspective and draws out the similarities of the experiences of the participants. The study explores the unconscious processes behind the actions and decisions taken and the individual and organisational defences against anxiety. The study lays bare the career defining impact of an inadequate Ofsted inspection judgement. A hybrid of Hollway and Jefferson’s Free Association Narrative Interview (FANI) method was used to capture the participants’ lived experience. These were explored using thematic analysis. Further consideration was applied to these themes using psychoanalytic theories and constructs, ‘going beneath the surface’ to explore the conscious and unconscious processes at play. The study focused upon outcomes of Ofsted inspections that were undertaken in each English local authority with responsibilities for children’s services between 2013 and 2018. The findings are contextualised in relation to how the participants experienced responses to the Ofsted inspection process. This study contributes to an emerging body of knowledge that goes beneath the surface of the emotional impact of inspection activity for those in positions of responsibility and accountability. Through a psychoanalytic lens, the study points out that responses to a poor inspection outcome can be extremely damaging to managers on an emotional level, with participants outlining feelings of blame, isolation, scapegoating and impotence in the wider organisation and system. Professionally, almost all participants described their experience of the inspection as career limiting, indicating that they did not wish to expose themselves to a similar experience in the future. These findings impact directly on how senior managers are recruited, developed and supported in the complex task of delivering safe and effective children’s social care services
How do we even talk about Palestine and Israel? One group's experience in unspoken territory
No full textThe world changed on 7th October 2023 when Hamas made incursions into Israeli territory, resulting in 1200 deaths and 251 hostages. The response by Israel’s government and military has since brought terrible destruction to Gaza, killing over 60,000 people, with 2.3 million forced from their homes. How have we allowed it to happen? What can we say?
One group of twelve child psychiatrists, psychologists and psychotherapists – with children’s welfare much in mind – met fortnightly to discuss the insurmountable difficulties of the Palestine-Israel conflict and their feelings about the horror streaming daily on their media. Can such matters be discussed in a group? Can minds be changed? Deep disagreement and pain – yet nothing near the pain experienced in Gaza. Silence can’t be the response.
Some of the collection’s contributors come from Palestinian or Jewish heritage, others from different but divided, conflicted backgrounds. Their history goes back to the Balfour Declaration and to the Holocaust. A mother who lived through Kristallnacht; a father from Jaffa with shrapnel head injuries during the Nakba. The group shares memories, reflections, essays and poems in a courageous effort to urge us all towards sense, empathy and a more complex understanding of the catastrophe before our very eyes
Gender Identity Profiles in Autistic and Non-Autistic Cisgender and Gender Diverse Youth, and Their Caregivers
No full textThis preregistered study examined whether the gender identity phenotype differs between autistic and non-autistic children and adolescents, as well as whether gender identity traits aggregate similarly within their families. Study 1 involved four matched groups of autistic and non-autistic gender diverse youth referred to a UK specialist gender clinic, as well as cisgender autistic and non-autistic youth (n = 45 per group). Participants completed measures of gender typicality, discontentedness, anticipated future identity, and (parent-reported) dysphoria. Despite large and significant differences between cisgender and gender diverse youth across all gender-related measures, there were no significant differences between autistic and non-autistic participants within either gender group. Study 2 assessed recalled childhood gender behaviors and current gender dysphoria in the caregivers of participants from each group (N = 203). Caregivers of gender-referred youth, regardless of autism status, reported higher current dysphoric traits than caregivers of cisgender youth, but no differences were observed in recalled childhood gender-related behavior. Overall, the findings indicate that the gender phenotype of autistic youth is comparable to that of non-autistic youth within the same gender identity group, challenging the assumption that gender diversity in autism arises from different underlying mechanisms. Clinically, these results support equitable access to gender-related care for autistic and non-autistic gender diverse youth
Trauma and mourning: containment and interpretation
No full textThis paper describes an understanding of complex developmental trauma and the movement that is needed from containment to mourning. The type of activity of the therapist within the therapeutic frame is dependent on the capacity of the patient to be available for interpretation. Trauma disrupts symbolic capacity, leaving the patient in a world of timeless concretism. In order to penetrate this closed system, the therapist will be required to actively work to contain the powerful anxieties of the paranoid-schizoid position, to support the development in the patient of the capacity to make use of interpretations. Loss is inevitable in trauma, and mourning the losses is the essence of working through and processing the traumatic experience
"It’s better to be quiet than share”: Perspectives of secondary-aged students of British Pakistani background in seeking support for Social, Emotional & Mental Health
Full text linkThis research explores the perspectives of British Pakistani adolescents on seeking support for Social, Emotional, and Mental Health (SEMH) issues. The study aims to understand the cultural and gender-specific barriers and facilitators that influence help-seeking behaviours in this demographic. Utilising a qualitative methodology, data were collected through semi-structured interviews with adolescents aged 16-18 attending post-16 educational settings. The findings highlight significant cultural barriers, such as stigma, the importance of maintaining family honour, and gender-specific expectations, which inhibit open discussions about mental health and seeking professional support. Female participants reported a relatively higher inclination towards seeking help compared to their male counterparts, who often faced cultural pressures to conform to traditional masculine norms. The research underscores the need for culturally sensitive mental health interventions and greater mental health literacy within the British Pakistani community. It also suggests the importance of collaboration between educational institutions, mental health services, and community organisations to effectively address the mental health needs of British Pakistani adolescents
Psychoanalytic consultation frameworks in Forensic CAMHS: Approaches to supporting professionals working with justice-involved youth
Full text linkThis thesis explores the use and application of psychoanalytic principles in a Forensic Child and Adolescent Mental Health Service (FCAMHS) consultation model, presented through three distinct yet interrelated research articles. The first paper is a systematic review using narrative synthesis analysis to amalgamate existing literature conducted in the last ten years on mental health consultations with professionals working with at-risk or high-risk youth. The review identified significant gaps in the literature that call for more research on consultation structure to inform better guidance and practice. The second article is a qualitative research study using Interpretive Phenomenological Analysis (IPA) to explore consultant (n=6) and consultee (n=3) experiences of either delivering or receiving a psychoanalytically informed FCAMHS consultation. Findings underscore the importance of psychoanalytic attention to relational dynamics, such as containment in the consultant-consultee relationship and understanding the child’s relationships to contextualise their forensic risk, in delivering meaningful forensic mental health consultations. The final article presents a thematic analysis of consultants’ (n=6) conceptualisation of forensic consultation and how 2 psychoanalytic principles inform its practice. The study identified distinct phases of consultation and explored how psychoanalytic thinking shaped each stage. The three articles contribute to a more comprehensive understanding of how psychoanalytic thinking can be applied in various contexts, particularly in consultation. It further argues how the use of psychoanalytic concepts can be valuable to supporting professionals working with high-risk or justice-involved youth, a population that does not usually access mental health services
Qualitative Health Research: A Practical Guide for Clinical Practitioners
No full textThis accessible text supports health practitioners undertaking qualitative research to inform clinical practice, guiding readers through the decision-making process from planning and proposing, through data collection, to dissemination and impact. Qualitative research makes an important contribution to the health evidence base, including improving service provision, practitioner communication, and patient safety, as well as informing policies, generating important knowledge about health, and providing populations with a voice in the health context.
Balancing the need for practitioners to operate in an evidence-informed way, the increasing role of a research culture in the health service, and the everyday clinical demands faced in practice, this book includes strategies for managing the reality of undertaking qualitative research while working in clinical practice and includes a wide range of “bite size” chapters on topics such as:
Quality improvement;
Evidence-based practice and practice-based evidence;
Managing dual roles;
Planning a project;
Working with stakeholders;
Ethics;
Data collection methods;
Conducting digital research;
Recruitment and sampling;
Data management;
Analytical approaches;
Thematic approaches;
Research with vulnerable groups;
Dissemination:
Translating research into practice.
This book is a practical resource for clinical researchers, designed to support the application of learning. Each chapter opens with learning objectives, and ends with a reflection on the chapter, integrating case examples and highlighting core issues. Practitioner experience boxes and reflective activities bring an invaluable real-world perspective to each chapter.
Qualitative Health Research is the ideal text for all healthcare practitioners and trainees new to qualitative research, including those from medicine, nursing, midwifery, psychology, allied health, and public health
Mapping the Landscape: Explorations in Psychoanalysis
No full textMapping the Landscape: Explorations in Psychoanalysis offers an overview and exploration of Priscilla Roth’s unique contribution to psychoanalysis over the course of her long and distinguished career.
This book takes the reader on a journey through psychoanalytic clinical practice and the significance of themes such as identity, identification, idealization and reparation. This collection shows a variety of Roth’s interests but also the continuity of her approach – the unconscious thread, which links thoughts and memories together. Through close examination of the moment-to-moment psychoanalytic work, she emphasizes how unconscious processes influence both patient and analyst without either of them becoming aware of it. In this sense, each analysis is unique. The second part of the book allows for reflection on lessons drawn from her work, and how psychoanalysis poses the question of what it means to be oneself for the analyst and the patient.
Reflecting her strong compassion for patients and depth of understanding of the nature of psychoanalysis, this is key reading for psychoanalysts, psychotherapists and anyone interested in the experiences underpinning humanity in each of us
Understanding the journeys of Black Caribbean parents who have children with autism.
Full text linkThis qualitative study explores the journeys of Black Caribbean parents (BCPs) living in the UK who have children with autism. It focuses on the experiences, thoughts, and processes surrounding their child’s autism diagnosis, and how cultural factors intersect with them. This study contributes to a small but growing body of knowledge exploring both autism and culture. It elevates the voices of BCPs who have not yet been exclusively represented in autism research. It also presents the perspectives of a group widely reported in educational statistics (e.g., school exclusion and attainment rates), but often not heard from themselves. Six BCPs, who collectively had ten children with autism, were interviewed using semi-structured interviews. The data was analysed using a grounded theory methodology (Corbin and Strauss, 2015), resulting in the development of the essential super-advocacy theory. The essential super-advocacy theory proposes that BCPs who have children with autism are required to become ‘super-advocates’ to provide the essential, fervent, and persistent advocacy that their children will need. It presents three ‘essential super-advocacy factors’ needed to do this, which are a) enhanced autism awareness and ongoing learning, b) the ability to overcome stigma and inner conflict, and c) connection and collaborative support. The essential super-advocacy theoretical model illustrates how these factors are developed over time and across three stages. These stages involve a series of events and processes shaped by the BCP’s socio-cultural contexts and experiences. The implications of these findings consider how Black Caribbean parents and their children with autism can best be supported by professionals who work with them, including educational psychologists
Bion’s Vertices: On Truth and Lies
No full textBion’s Vertices: On Truth and Lies is the inaugural book of the Contemporary Bion series. It raises many key questions, such as: What is the place of truth and lies in psychoanalytic discourse? What are the consequences in terms of collusion and communication? How can a ‘lie’ carry a meaning? The book features penetrating insights from Nicola Abel-Hirsch, Joseph Aguayo, David Bell, Avner Bergstein, Ronald Britton, Robert Caper, Roosevelt Cassorla, Judy K. Eekhoff, Denis Flynn, Tomasz Fortuna, Antònia Grimalt, Alberto Hahn, R. D. Hinshelwood, Monica Horovitz, Dimitris J. Jackson, Paulo Cesar Sandler, Carlos Tabbia, and Margot Waddell. Their inspiration and starting point is Bion and his work but the vertices are dynamic and involve free expression of their personal perspectives, communication styles, and approaches, including Freudian, Kleinian, mathematical, philosophical, scientific, and poetic.
Their chapters are divided into three parts, which investigate the truth/lie domain, emotional change and growth, and creativity in relation to truth and lies. The wide-ranging discussions include chapters on aesthetic processes in poetry and psychoanalytic thought, the protective function of lying, misunderstandings, chaos, the analyst’s mind, knowledge, representation, perversions, and propaganda. These powerful contributions are essential reading for practising clinicians, academics, and students