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Sustaining relationships: Working with strong feelings: Part II: Hopelessness, depression and despair
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New ways of working and learning can grow resilient children’s social workers. Recruitment and retention are key issues for employers in a sector where the average career span is put at eight years
No full textWe expect a great deal from children’s social workers – they work with chaotic families, they have to look into the darkest parts of society, juggle large caseloads and hold huge amounts of emotional collateral. When things go well, their work often goes unnoticed; when things go wrong, the sky falls on their head.
It is perhaps unsurprising that this story plays out in the numbers too; the vacancy rate for children’s social workers was 17% last September, according to new data published by the Department for Education. The same data suggests more than two-thirds of vacancies are covered by agency staff. A third of social workers leave the profession within two years, and the average career span is just eight years. With all this considered, workforce must be a priority for the What Works Centre for Children’s Social Care.
The DfE data also raises critical questions about how we improve recruitment, resilience and retention of this essential workforce, and points us to places to learn from. Last year Ofsted published its verdict on Camden children’s services where my trust, the Tavistock and Portman, works in partnership with the council and its schools. The trust supports social workers by providing expertise and training and our staff are integrated in frontline social work and early help teams
The neglected role of distress in pain management: qualitative research on a gastrointestinal ward
No full textBackground and aims: Pain management for hospital inpatients remains suboptimal. Previously identified barriers to optimal pain management include staff communication difficulties, confusion around pain management roles and a lack of suitable resources for clinical staff. The emotional, relational and contextual complexities of gastrointestinal (GI) pain create particular challenges for frontline clinical staff attempting to implement a biopsychosocial approach to its management. The current study took place over 2 years, comprised an ethnographic and a feedback phase, and aimed to examine pain management processes with clinical staff in order to generate hypotheses and initiatives for improvement. This paper focuses on two overarching themes identified in the ethnographic phase of the study, centred on the neglected role of both staff and patient distress in GI pain management.
Methods: Grounded theory and thematic analysis methods were used as part of action research, which involves collaborative working with clinical staff. The study took place on a 60 bed GI ward in a university hospital in London. Participants were clinical staff who were either ward-based or involved in the care of particular patients. This latter group included doctors, nurses, psychologists and physiotherapists from the Acute and Complex Pain Teams. Qualitative data on pain management processes was gathered from staff interviews, consultation groups, and observations of patient-staff interactions. Recruitment was purposive and collaborative in that early participants suggested targets and staff groups for subsequent enquiry. Following the identification of initial ethnographic themes, further analysis and the use of existing literature led to the identification of two overarching pain management processes. As such the results are divided into three sections: (i) illustration of initial ethnographic themes, (ii) summary of relevant theory used, (iii) exploration of hypothesised overarching processes.
Results: Initially, two consultation groups, five nursing staff and five junior doctors, provided key issues that were included in subsequent interviews (n=18) and observations (n=5). Initial ethnographic themes were divided into challenges and resources, reflecting the emergent structure of interviews and observations. Drawing on attachment, psychodynamic and evolutionary theories, themes were then regrouped around two overarching processes, centred on the neglected role of distress in pain management. The first process elucidates the lack of recognition during pain assessment of the emotional impact of patient distress on staff decision-making and pain management practice. The second process demonstrates that, as a consequence of resultant staff distress, communication between staff groups was fraught and resources, such as expert team referral and pharmacotherapy, appeared to function, at times, to protect staff rather than to help patients. Interpersonal skills used by staff to relieve patient distress were largely outside systems for pain care.
Conclusions: Findings suggest that identified “barriers” to optimal pain management likely serve an important defensive function for staff and organisations.
Implications: Unless the impact of patient distress on staff is recognised and addressed within the system, these barriers will persist
The heart of the matter: Music and art in family therapy
No full textThe Heart of the Matter invites therapists from all disciplines to consider the use of music and art in their work with families. It introduces systemic music and art ideas, giving clinical examples from practice, and a rationale for using each technique. Conversations with therapists who have explored and incorporated the techniques into their work are shared, and include both personal and professional responses to incorporating new methods in practice. Through a back drop of exploration into what creativity is, the history of the arts in therapy, and consideration of what happens when we use words, the case for music and art to be part of practice with families is presented. This book is more than a handbook of techniques; it explores who we are as therapists, our challenges and our resourcefulness, as we operate in multiple systems to bring about positive chang
An Interpretative Phenomenological Analysis (IPA) study of Eastern European migrants' experiences of arriving at and sense of belonging to a mainstream secondary school in the UK
Get PDFThe UK is a highly diverse country which over the last 10 years has seen a vast increase in immigration with the majority of migrants being from Eastern Europe. The aim of this research was to increase our understanding of Eastern European, migrant students' experiences of transition from their home country to the UK and their experiences of starting secondary school here. The research also aimed to explore how these students experienced a sense of belonging to secondary school. By conducting this research, I hope to add to the psychological understanding of the experiences of this specific group of young people, by giving them a voice that may not otherwise be heard. Semistructured interviews were carried out with five Key Stage 4 students, from four different Eastern European countries. All students were first generation migrants and
had arrived in the UK from their home country within the last three years. Interpretative Phenomenological Analysis was used to analyse the interview data. This led to the emergence of subordinate and superordinate themes for each participant. This was followed by the development of six overarching themes: 'adjusting to change'; 'a journey towards a sense of belonging'; 'a time of vulnerability'; 'the power of self-belief'; 'identity in a new place' and 'a need for support'. Findings are discussed in relation to previous research and relevant psychological theory. Implications of the findings for Educational Psychologists and school staff are also considered
Laverne Antrobus on Newsnight. Girl Gangs. 25 July 2018, BBC2 [Starts at 34:24]
No full textDiscussion of girls in gangs
Has education lost sight of children?
Get PDFThe reflections presented in this chapter are informed by clinical and personal experiences of school education in the UK. There are many challenges for children and young people in the modern education system and for the professionals who support them. In the UK, there are significant gaps between the highly selective education provided to those who pay privately for it and to the majority of those educated in the state-funded system. Though literacy rates have improved around the world, many children, particularly boys, do not finish their education for reasons such as boredom, behavioural difficulties or because education does not ‘pay’. Violence, bullying, and sexual harassment are issues faced by many children in schools and there are disturbing trends of excluding children who present with behavioural problems at school whose origins are not explored. Excluded children are then educated with other children who may also have multiple problems which often just make the situation worse. The experience of clinicians suggests that school-related mental health problems are increasing in severity. Are mental health services dealing with the consequences of an education system that is not meeting children’s needs? An education system that is testing- and performance-based may not be serving many children well if it is driving important decisions about them at increasingly younger ages. Labelling of children and setting them on educational career paths can occur well before they reach secondary schools, limiting potential very early on in their developmental trajectory. Furthermore, the emphasis at school on testing may come at the expense of creativity and other forms of intelligence, which are also valuable and important. Meanwhile the employment marketplace requires people with widely different skills, with an emphasis on innovation, creativity, and problem solving. Is education losing sight of the children it is educating