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A partnership of two therapeutic models: the development of mentalization based treatment—couple therapy (MBT–CT) within a psychoanalytic framework
No full textThe paper outlines the origin of Tavistock Relationship’s development of a mentalization-based treatment for dysregulated, high-conflict couples. This couple population is often unable to avail themselves of insight based psychodynamic/psychoanalytic couple psychotherapy. The paper examines how the two models, MBT–CT and a psychoanalytic understanding of the couple relationship, interact theoretically within the area of highly troubled couple relationships, withparticular emphasis on containment, projective identification, transference, and countertransference
Functional gastrointestinal disorders: A biopsychosocial approach
No full textThis book brings together world experts in the field of Functional Gastrointestinal Disorders (FGIDs) who practice an integrated and holistic approach in their care for patients to provide an up-to-date and comprehensive evaluation of a range of issues associated with the biopsychosocial treatment of FGIDs. Examining topics such as neurological and biological aspects of FGIDs, common concerns faced in relation to diagnosis, and ongoing medical decisions and interventions, each chapter provides crucial practical recommendations, as well as future directions of psychosocial work in multi-team environments.
Functional Gastrointestinal Disorders considers individual conditions in detail, including the current Rome IV diagnostic criteria for FGIDs required to make a positive diagnosis, the role of psychological and other biopsychosocial and biofeedback aspects of treatment, and general recommendations with regard to diet and medications. Each chapter also provides an up-to-date consolidation and evaluation of the current literature as well as practical recommendations, which can then be applied by the reader in their own interaction with FGID patients. Topics covered include:
The common concerns and issues faced by individuals with FGIDs in relation to pre-and post-diagnosis, ongoing medical decisions and interventions.
A review of current evidence-based biopsychosocial treatment practices for each FGID condition.
The differences and challenges associated with FGIDs across individual life stages.
Special topics such as the relationship with eating disorders and the role of psychotropic medications.
Modern patient centred initiatives such as patient empowerment, distance and e-therapies.
The future challenges facing FGID treatment.
Throughout the entire book, common themes and practical recommendations are described. Functional Gastrointestinal Disorders, has broad applicability across multiple spheres, including treatment, research and teaching and is accessible to those working in gastroenterology and primary care alike
We need to talk about doing social care differently. Of course the money matters. But the debate about social care should be about meaning and purpose as well as who pays
No full textA new year and a new minister will pick up the social care reform baton. But how far will they get before they pass it on or drop it?
This year offers little prospect of short-term relief for the social care sector. I hope I am wrong, but the absence of any new funding in the November budget makes further cash unlikely. That means all eyes will be on the green paper and the 2018 budget to pave the way for a sustainable funding settlement.
While 2017 saw greater public awareness of social care, there remains little understanding of the sector. Most people don’t know that social care is means tested or where it ends and the NHS begins.
Before any funding reform can succeed, the veil of ignorance must be lifted.
But funding for what? In 2018, the debate about social care must be more than a question of funding and who pays. Of course the money matters, the current offering from our state-subsidised system is limited, offers little innovation, compromises quality and is focused on task at the expense of relationships and connection.
Social care in 2018: time to think about the future workforce
Sharon Allen
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In 2018, we need to talk about doing care differently. A new report by Independent Age is clear that there isn’t a one-size-fits-all solution
Narrative matters: The eternal triangle - a century of family psychology for clinicians
No full textThe article discusses family psychology for clinicians. Topics discussed include problem solving therapy, ethological and anthropological studies that show the key innovations in human evolution, and enmeshed relationship that forms in the early life of child that links the mother's problems relating with deficits in her own childhood, as explained by Bowlby vignette
Re-uniting families in the chaos of the refugee crisis: medico-legal assessment of unaccompanied refugee minors in the Calais Jungle (mental health and legal perspectives)
No full textPurpose - In total, 90,000 of the 1.26 million people applying for asylum in the EU in 2015 were unaccompanied children. The Dublin III Regulations provided a unique legal situation where unaccompanied young people in the Calais Jungle potentially had the right to be reunited with family in the UK. The purpose of this paper is to explore the substantial challenges presented by carrying out medico-legal assessment of this group in the Calais Jungle. Design/methodology/approach - The authors consider the refugee crisis from a mental health and legal perspective. The authors provide two case examples to contextualise and describe the work. The authors draw from the observations and the literature to discuss the impact of living in the Calais Jungle on young people, the challenges the authors overcame to carry out the assessments and the needs of refugees following settling in the UK. Findings - The authors conclude that the Calais Jungle was a toxic environment not suitable for young refugees’ continued emotional development or recovery from trauma. The current legal process to relocate a young person to the UK is time consuming and labour intensive. The authors note that these concerns are not unique to the Jungle, nor have they ended with its demolition. The difficulties young refugees face with mental illness continues following their arrival to the UK. Originality/value - This was the first successful attempt since the Dublin III Regulations to seek a legal route to bring unaccompanied refugee minors from France to the UK. This paper was co-written by both the legal and mental health professionals involved in the cases providing a broad opinion across both disciplines
Existential support needs following cancer treatment with curative intent
No full textAims
Research in recent years reveals that people can experience a range of existential difficulties following the end of cancer treatment. However, few studies have examined how to best support people with these needs. The aim of this study is to explore what support may be required to help people manage their existential concerns following the end of treatment. It is the second part of a study that examined the existential concerns of the same participants (Lagerdahl, Moynihan and Stollery 2014).
Method
Eight participants recounted their post-treatment experiences through qualitative methods, and inductive thematic analysis was used to systematically organise those experiences.
Results
Participants wished for greater continuity of care and information following the end of treatment, and requested mandatory and holistically focused follow-up appointments, as well as specialised psychological support.
Conclusion
In accord with National Cancer Survivorship Initiative goals, there is a need to establish holistic support in hospitals with follow-up consultations that acknowledge existential experiences, to effectively aid patients in their transition to life beyond cancer
Coming into intensive psychotherapy for adolescents and young adults: An exploration of clinical decision-making
Get PDFThis qualitative study focused on the process of clinical decision-making when making recommendations for intensive psychotherapy for adolescents and young adults. In order to a) learn about which adolescents and young adults come into intensive treatment and b) how they are chosen, the study was separated into two parts. In Study 1, an audit described the population coming into intensive psychotherapy in an adolescent mental health service in a given time period. In Study 2, a case study explored the clinical decision-making process at intake and assessment in the same service. Interpretative phenomenological analysis (IPA), psychoanalytic group theory and thematic analysis were used to analyse the data. The study explored how decisions were made from the point of the referral through to the decision regarding which treatment to recommend and it sought to identify determining factors of the clinical decision-making process. The focus on how a clinical judgement is made, aimed to contribute to the learning about the actual process. The study found evidence for an implicit framework for clinical decisionmaking about intensive psychotherapy for adolescents and young people. There was consideration of a developmental dimension to the presenting problem as well as the potential impact of trauma. The patient's state of mind was assessed and their motivation was explored. The level of need for containment and the level of intensity needed to challenge resistance were assessed. The quality and level of support from the environment, including parents and network were explored. The study found that the clinicians were looking for movement in the patient's capacity to engage with the assessment process. The research highlighted idiosyncratic features when working with adolescents: the inherent difficulties in the engagement process, the foci on ambivalence and on parental involvement. The study also showed that clinical decision-making is affected by the clinician's subjectivity, while the team's decisionmaking is affected by case dynamics, the team's own group dynamics and the service's capacity. Acknowledgements I would like to thank Emil Jackson and Nick Midgley for supervising and helping me with this project. I would also like to thank Jocelyn Catty as head of research at the Tavistock for her advice. In addition I would like to thank the intake team and the clinicians who participated in this study, for the time and thought given and for their support and interest in this project. Thank you to my friends Georgina Taylor and Millie Jenkins for their comments and support. Thank you also to Richard Meier for his patient proof-reading. Finally I would like to express my gratitude to the NHS Trust in which this research took place, for their support of this project
The curse of domestic violence: An in-depth qualitative study based on biographical interviews of British Pakistani women to understand the dominant psycho-social factors which influence women's decisions when it comes to leaving or staying in an abusive relationship
Get PDFThis thesis highlights the domestic abuse of Pakistani/Bangladeshi women living in the UK and
highlights the constant challenge for professionals and agencies to protect those “hard to reach” sections of the community; a group of women who feel their circumstances are beyond the help of agencies. This qualitative study is an
attempt to peek behind this veil in order to answer the
rather elusive question of why victims of domestic abuse do not leave their abusive partners. The analysis of the research attempts to i) Identify key themes that lead to the ongoing cycle of abuse; ii) identify reasons why, in light of the widest range of policy interventions and practice
guidance to tackle forced marriage and domestic abuse, many women will still prefer to suffer in silence; iii) make future recommendations to help prevent further domestic abuse in the Pakistani diaspora in the UK
