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The lived experiences of masking black Autistic girls in UK education: “Before people see the autism, they see my race.”
Full text linkThis paper explores the lived experiences of masking and camouflaging among Black Autistic girls in UK education, addressing a significant gap in autism research and educational psychology practice. Semi-structured interviews were conducted with four participants aged 16–17, centring voices rarely represented in literature or policy. A novel framework, Kaleidoscope Analysis, was developed to interpret the data. Combining Interpretative Phenomenological Analysis (IPA), Intersectionality Theory, and Disability Critical Race Theory (DisCrit), this approach offers layered insight into how individual experiences are shaped by wider structural inequalities. Five key themes were identified: acceptance and belonging; navigating social expectations; the intersection of race, gender, and autism; sensory overload; and the importance of relational support. The findings highlight how masking emerges as a strategy for navigating environments shaped by neurotypical, racialised, and gendered expectations rooted in societal norms of Whiteness and ability. This study recommends educational psychologists (EPs) and related professionals adopt intersectional, neuro-affirming approaches in their practice, highlighting the importance of pupil voice, critical reflection, and anti-oppressive practice in creating inclusive learning environments. Future research is required to explore a wider range of intersecting identities and include Autistic individuals who use diverse forms of communication
What knowledge and skills do early career social workers need to practice effectively with children and families?
Full text linkThere is an extensive literature base about the knowledge and skills required by social workers to work effectively with children and their families. However, making sense of how best to translate this into direct practice can be challenging, particularly when newly qualified. The paper is based on a wider rapid evidence assessment (REA) of the post-qualifying knowledge and skills required by early career social workers (ECSWs) to practice effectively with children and their families. The REA involved searching for relevant English language literature (2012–2023) in ASSIA, Social Care Online, SocINDEX and PsycInfo and specialist journals. However, it was soon apparent that the literature was not segmented by career stage and wider searches relating to knowledge and skills needed to be undertaken. In total, 51 papers were included for review. Studies identified were largely qualitative, exploring the knowledge and skills required through observations of direct practice and self-report studies from the perspectives of social workers and children and families themselves. Where knowledge and skills were identified, relationship building and good authority skills were associated with some improved outcomes for family members. The review presents findings through practice-near descriptions of what works to build early career expertise with children and their families
Grace and correspondence in ethnography and psychotherapy
No full textFor all the ways in which anthropologists have addressed relations during the history of the discipline, from kinship to the contemporary focus on comparison, it is surprising that anthropologists rarely write about the pragmatics of the messy dynamics of relating between interlocutors themselves and between interlocutors and ethnographers. This is despite some anthropologists having highlighted the work of these relations and our approach to them as crucial for the discipline. In this paper I argue that the inquiry practiced in one particular psychotherapeutic approach, namely systemic psychotherapy, is relevant to this micro practice of anthropology. I will present a transcription of a piece of systemic psychotherapeutic work. I will make three points, inspired by work in systemic psychotherapy as well as anthropology. My first point concerns plurality, my second point refers to second-order observation or the use of reflexivity, and my third to the temporal dimension of the inquiry as a process. I suggest that considering these three points will enhance methods of inquiry in both disciplines
Incidence of gynaecological (pre-)malignancies and endometrial activity in transmasculine and gender diverse individuals using testosterone: a retrospective, single-centre cohort study
No full textBackground:
The number of transmasculine and gender diverse (TMGD) individuals that choose to postpone or refrain from surgical intervention to remove their internal gynaecological organs has been increasing. However, the safety of exogenous testosterone use in the presence of the reproductive organs, i.e. the risk of gynaecological malignancies remains unclear. This study aims to evaluate the incidence of gynaecological (pre-)malignancies in a nationwide cohort of TMGD individuals using testosterone treatment.
Methods:
This retrospective cohort study conducted at the Amsterdam University Medical Centre in the Netherlands, included transmasculine and gender diverse (TMGD) individuals receiving testosterone at our clinic between February 17, 1972 and December 3, 2018. Data from medical records were linked to the national pathology database to acquire diagnoses related to gynaecological cancer or gynaecological pathologies with malignant potential. TMGD individuals assigned female at birth who received testosterone were included, excluding those last seen before 1991. Based on observed and expected cases, age-adjusted standardised incidence ratios (SIR) were calculated to assess relative risk compared to the general population assigned female at birth.
Findings:
The cohort comprised 1955 TMGD individuals. Median age at start of gender-affirming hormone therapy was 21 years (interquartile range [IQR] 18–29). Prior to testosterone treatment 21·1% (413/1955) had used puberty suppression. Median duration of testosterone usage was 1·7 years (IQR 1·4–2·4) before hysterectomy and oophorectomy and 3·1 (2·3–5·4) before vaginal and/or vulvar surgery or biopsy. Median age at time of surgery or biopsy was 24 years (IQR 20–33) for uterine and ovarian histopathology acquisition and 29 (IQR 22–39) for vaginal and vulvar histopathology acquisition. No gynaecological malignancies were found, precluding SIR calculation. Expected incidence was 0·26 or less for all cancer types. One ovarian borderline tumour, one case of simple endometrial hyperplasia and one case of vulvar intraepithelial neoplasia III (VIN3) were detected. Based on the expected number of >VIN2 cases in our cohort (4·4) the age-adjusted standardised incidence ratio for > VIN2 was 0·23 (95% CI: 0·01–1·12).
Interpretation:
This is the largest cohort to date reporting on gynaecological histopathologic findings in TMGD individuals using testosterone. Based on these findings we can conclude that the risk of gynaecological malignancies is not increased in TMGD individuals using testosterone for a relatively short period of time compared to the general population assigned female at birth. However, to determine the long-term effects of testosterone on gynaecological organs, and counsel patients appropriately, studies with longer follow-up of individuals retaining these organs are needed.
Funding:
None
Diagnosis and management of complex post-traumatic stress disorder (C-PTSD)
No full textComplex post-traumatic stress disorder (C-PTSD) is a new diagnosis in the International Classification of Diseases (ICD) 11.1 It is not currently recognised in the Diagnostic and Statistical Manual of Mental Disorders (DSM) 5.2 Caused by recurrent, chronic, or sustained trauma, C-PTSD has the clinical features of PTSD and symptoms that reflect the prolonged impact of sustained trauma on self-organisation, encompassing affect regulation, negative self-concept, and difficulties sustaining interpersonal relationships. Here we explain what C-PTSD is, how to recognise it, and the fundamentals of management, acknowledging that the evidence base continues to grow and evolve
Psychoanalysis, criminology and delinquency: The early history of the Portman Clinic
No full textFounded in 1933, the Portman Clinic, now part of the Tavistock and Portman NHS Foundation Trust, in London UK, is a nationally funded out-patient clinic providing psychoanalytic psychotherapy to children, adolescents and adults who present with delinquency, violence, and problematic sexual behaviours. The Portman Clinic came into being during the interwar years, a fertile time in which psychoanalytic theories became influential within criminology. This article describes the foundation and early history of the Clinic within the wider social and political context of the early and mid-twentieth century, including the impact of the second world war and the dawn of the welfare state. It explores the ideas of the psychoanalysts Grace Pailthorpe, Edward Glover, Kate Friedlander, and Melitta Schmideberg, which were based on their work with patients at the Portman Clinic but were also shaped by the internal war within the British psychoanalytic community, the so-called Controversial Discussions. The review draws on previously unpublished clinical material from archived records of patients seen at the Portman Clinic since 1933, providing a fascinating glimpse into the profile of these patients, and how their psychopathology and offending behaviours were influenced by changing societal norms and significant historical events
Supporting health and social care students stay and stay well: A conceptual framework for implementing integrated care into higher education
No full textIntegrated care demands a workforce that is confident, capable and compassionate. This is dependent on a willingness to work inter-professionally and understand the roles, standards and values of other professional groups. However, there are few examples of integrated care initiatives within higher education that aim to build the knowledge and skills required to support effective integrated, people-centred care.
While satisfying, working in the helping professions is emotionally challenging and for students’ these challenges are often underestimated. Some students struggle through their studies with many failing to complete and others drop out in the early years of their careers. Understanding what supports students to thrive in their professional roles is essential to retention of a highly skilled integrated workforce.
To address this challenge, this paper outlines a conceptual framework designed to promote a pedagogical environment focused on creating the conditions for integrated working. The framework is based on the “student lifecycle”, from starting to see the benefits of a career in the helping professions, developing a sense of belonging through to thriving and succeeding as future practitioners. It outlines how students are supported to develop emotional resilience, inter-professional empathy and reflexivity to help them stay and stay well in their careers
A literature search of psychological trauma related outcome measures for adult mental health services
No full textIt is important to measure the impact of psychological trauma within mental health services designed to treat individuals after traumatic experiences. However, there are challenges in capturing the impact of trauma and the recovery from it accurately whilst also considering patient preferences and expectations. This study aims to explore the range of pre-existing outcome measures of trauma symptomatology and determine the relative prevalence of these measures within related research. This is addressed through systematically searching literature for outcome measures available in the assessment of psychological trauma symptomatology across adult mental health populations. Databases Medline, CINAHL and PsychInfo were searched to find papers that described the use of measures within psychological trauma-specific outcome research. 228 articles were found after the exclusion criteria were applied. The most prevalence trauma-specific outcome measures utilised within the evidence base were versions of the Post-Traumatic Disorder Checklist (PCL) and the Clinician Administered PTSD Scale (CAPS). Non-trauma specific measures were also identified within this sample. This paper lists both trauma-specific and non-trauma specific measures found in order of prevalence. Consideration is given to the most frequent measures found. These findings provide insight into gold-standard measures for services wishing to implement outcome measures that will meaningfully capture recovery amongst trauma survivors
‘Naming the unnameable’: A service evaluation of a reflective practice group for foster carers
No full textThis study evaluated a reflective practice group designed to support foster carers and promote secure attachments with their foster children. Eight foster carers in South East England participated in the evaluation. A mixed-methods approach was employed: quantitative measures assessed reflective functioning, parental self-efficacy and parental stress pre- and post-intervention; qualitative data were collected through semi-structured interviews with five participants and analysed using thematic analysis. Results indicated improvements in one domain of reflective functioning. Qualitative findings highlighted themes such as the group providing a safe and therapeutic space, enhanced emotional wellbeing, and strengthened carer–child relationships. Overall, participants found the group beneficial and appropriate. The evaluation suggests that reflective practice groups may positively impact foster carers’ reflective capacities and caregiving experiences. Further research with a larger sample is recommended to substantiate these findings.
Skills in Psychodynamic Counselling & Psychotherapy
No full textThis is a step-by-step guide to the key skills and techniques of the psychodynamic approach used at each stage of the therapeutic process.
Updated in a third edition, the book includes the latest thinking on countertransference and transference; new content on issues of difference and diversity in the therapeutic relationship; online therapy; new case studies; and updates on the evidence base for psychodynamic therapy