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‘Every ending requires us to begin anew’: Endings and beginnings in supervisory relationships
No full textAim(s): Supervision has been characterised as a ‘signature pedagogy’ in the helping professions and an integral component of pre-service training for applied psychologists. Regulatory and professional standards for trainee and qualified Educational Psychologists (EPs) emphasise engagement in supervision as part of our discipline’s orientation towards learning and growth, as well as in enhancing safety and effectiveness for service users. This paper aims to provide a reflective account of evaluation and endings in supervisory relationships. Method/Rationale: There is an increasing interest in the place of supervision as a core component of lifelong professional learning and development. In contrast to beginnings, the evaluation and ending of supervisory relationships (SR) have received less attention in the literature and can be left unattended to in practice. This may reflect some uncomfortable feelings associated with giving and receiving feedback within professional relationships, as well as the multiple meanings endings may have for supervisee and supervisor. The Relational Model of Supervision for Applied Psychology Practice (RMSAPP) and associated supervisory process in evaluation and endings may support practice in this area. This paper outlines the model’s framework for evaluation and ending, and a reflective account of the ending and beginning of supervisory relationships is provided. The supervisee provided feedback on the SR to the original supervisor and this informed the ending made in that supervisory dyad. The supervisee then established a new SR with a different supervisor and the paper’s reflective accounts are from three perspectives: the supervisee, the former and new supervisors. Findings: A critically reflective account of evaluating, ending and new beginnings between a supervisee and two different supervisors is offered, with attention paid to the power differentials between supervisee and supervisors. The account illustrates some of the meanings made of evaluation, endings and beginnings. The benefits of the approach are highlighted, and some tentative ideas about how further developments could be made included. Limitations: The meanings derived from the authors’ experiential learning arose within particular SRs and are unique to these relationships. Conclusions: There are opportunities for development of reflective EP practice in this area, and for further research. The reflective accounts provided may be a stimulus for further reflection on personal and professional development of supervisory practice
A qualitative exploration of psychoanalytic psychotherapists' experiences working with young people who have perverse sexual fantasies and/or engage in harmful sexual behaviour.
Get PDFObjective: This study explores psychoanalytic psychotherapists’ (CPTs) experiences of working with young people (aged 14-25) who have perverse sexual fantasies, and/or engage in harmful sexual behaviour. Methods: Semi-structured interviews were conducted with five qualified CPTs working at the Portman Clinic. Interpretative Phenomenological Analysis (IPA) was employed to analyse the transcribed data. Results: IPA revealed 5 superordinate themes: 1. CPTs view perversion as an entrenched solution to emotional pain; 2. ''…it’s very, very disturbing to get hold of the aggressive, perverse part of the patient''; 3. In CPTs’ views, starting psychotherapy significantly increases the risk of harm to self and others, and it cannot be contained individually; 4. CPTs' gender matters; and 5. “an antidote to the disturbance” Conclusions: These findings have significant implications for clinical practice, emphasising the need to structure services with an awareness of the high risk involved, and the need for supervision and team support. They also highlight the benefits of long-term, open-ended treatment for these patients. Finally, it was revealed that having expertise in how to work with the aggressive part of these patient was another major necessity for all professionals working with these patients
The Tavistock First-Time Parent Study: a pilot randomised controlled feasibility trial of a brief couple-focused perinatal intervention to reduce inter-parental discord
No full textNumerous studies report that some first-time parents experience a decline in relationship quality and an increase in conflict after the birth of a first baby. Inter-parental discord that is frequent, intense, and poorly resolved increases the likelihood of relationship breakdown and adversely impacts child development. We investigated the feasibility of a brief preventative couple-focused psychotherapeutic intervention in the perinatal period in a general population sample. Sixty couples expecting their first baby were recruited from the Royal Free Hospital, London. Thirty were randomly assigned to treatment (TMT, a newly developed five-session couple-focused intervention), and 30 to usual care (TAU). Outcomes were collected at 28 weeks into pregnancy, 6–8 weeks after birth, and when the baby was 6 months old. The intervention was feasible and acceptable, evidenced by 100% attendance. However, no change in relationship quality or inter-parental discord was detected in either TMT or TAU groups across the transition to parenthood. The intervention did not improve outcomes vs. TAU. Depression assessed by the Hospital Anxiety and Depression Scale increased across the cohort and mood symptoms assessed by the Edinburgh Postnatal Depression Scale decreased in mothers but not fathers. The absence of a decline in relationship quality could reflect sample attributes: couples were older than average UK first-time parents, had high levels of educational qualifications, and low discord. Even in this low-risk sample, only 20 out of 30 TAU couples completed all three assessments, vs. 29 out of 30 TMT couples. Larger-scale RCTs of perinatal couple-focused psychosocial interventions may be hampered by selection effects and attrition. They may benefit from co-design with stakeholders and active control conditions
Child and adolescent mental health and social psychiatry
No full textThis article stages a discussion on the role of social psychiatry in present-day child and adolescent mental health care. Taking a broad perspective, it considers the growing demand for mental health services for children and young people and how social psychiatry can be situated in the current framework of psychiatry as a medical specialty as well as within child and adolescent mental health care provision more widely. Avenues available to expand social psychiatry’s reach and impact in the field of child and adolescent mental health are also addressed
The developmental importance of forgiveness in psychoanalysis and Buddhism
No full textThe author discusses the importance of the state of forgiveness for the development of human minds that is essential to reach reparation proper. He brings in his own clinical experience in order to describe what hampers the development towards forgiveness in terms of both the unbearable sense of guilt caused by the damage to the objects and the early trauma. Referring to the Buddhist tale of Ajātashatru, he moves on to look at how the objects of compassion and forgiveness can facilitate the subject’s forgiveness. Finally, he discusses how compassion can alleviate pain, distress and agony, and help hate, hostility, destructiveness and murderousness become less violent and guilt less persecutory. Forgiveness can facilitate guilt. Yet for those who cannot bear guilt, forgiveness can only exacerbate the omnipotent demand for reparation and entitlement. It is therefore crucial for the analyst to sustain a firm and robust attitude in describing the dynamics to the patient while keeping compassion in mind. The discussion of compassion and forgiveness is really important to understand the facilitating factors for the development of human minds
“Thinking about what makes you you”: An exploration of the experience of care leavers in engaging with collective narrative practice through the Tree of Life
Get PDFOver 10,000 young people in the UK transition from being in care to being a care leaver each year (Department for Education, 2021). Despite the prevalence of mental health difficulties among this group, available emotional support is argued to be inadequate (Ofsted, 2022). The Tree of Life is an arts-based collective narrative practice intervention rooted in narrative therapy; utilising the metaphor of a tree as a platform from which to reflect upon, develop and share personal narratives (Ncube, 2006). This has been found to be positively experienced by a range of groups. To date, no research has explored the Tree of Life with care leavers. This research aims to explore how the Tree of Life is experienced by this group. Individual semi-structured interviews were conducted with six care leavers who had engaged in the Tree of Life and the data was analysed using Interpretative Phenomenological Analysis. Findings revealed five Group Experiential Themes which summarised the participants’ experiences: Uncertainty and discomfort, individual barriers and facilitators, developing identity, connecting with others and hope and motivation for the future. This research provides insight into how the Tree of Life is experienced by care leavers, thus providing valuable information as to how the emotional wellbeing of this group can be supported, by not just Educational Psychologists, but a range of stakeholders with a responsibility to this group. Findings may also be of interest to those involved in the designing and implementation of therapeutic interventions in a range of settings
Location, Dislocation, Relocation (LDR): A New Framework To Work With Young People Who Have Experienced Multiple Traumas
No full textThis paper uses a narrative approach from which a clinical understanding of trauma is made by using the geographical metaphor of location, dislocation, and relocation. These descriptors encompass the idea of life as a journey where individuals find their sense of being located, dislocated and relocated depending on where they are at. Often with people who have experienced multiple traumas there is a dominant sense of feeling dislocated and therefore the need to think about location and relocation from a clinical perspective.
The location, dislocation and relocation framework is an innovative intervention that enhances clients’ wellbeing by improving the therapeutic abilities for all who support and care for them. As well as creating a wider understanding of working with trauma responses and offering coherence for practitioners wanting to use this approach. It creates a common language that is multi-disciplinary and has the potential to create coherence, coordination, and an excellence of care abilities within the whole system
How do Child and Adolescent Psychotherapists work with silent patients? An exploration of some meanings and functions of patient silence in sessions: An interpretative phenomenological analysis
Get PDFThis study explores the experience of child psychotherapists that work with the silent child. I conducted semi-structured interviews with a purposive sample of four child and adolescent psychoanalytic psychotherapists, and used interpretative phenomenological analysis (IPA) to examine the unique meaning that participants attribute to their work with the silent child. Four superordinate themes emerged from the data: formulations of the silent child—‘just different’; technique and cautious adaptation—'I needed to try something different’; the therapist’s feelings; and the tension between the need for support, and resistance to accessing it. This study aims to highlight the value of long-term work with the silent child, and strengthen understanding of the need for a mixed approach, which includes psychoanalytic technique and its cautious adaptation, to enliven the withdrawn child. As the first known qualitative study that investigates the experience of therapists working with silent patients, it reveals accounts of participants’ experiences that working with the silent patient can be a long and painful process, but that psychoanalytically trained child psychotherapists have a good foundation for work of this kind. The child psychotherapist’s skill of working with nonverbal communication based on infant observation is central, but flexibility is also required. A finding that was hitherto unexplored in the literature is the therapist’s feelings of shame when working with the silent patient, tied to a feeling of being deskilled and the apparent lack of progress, which leads to difficulties in accessing the necessary supervisory support. This study’s findings can be used for future research and can hopefully benefit the clinical practice of child psychotherapy with the silent child
‘Does it do what it says on the tin?’ – An exploratory case study into how an additional resource provision in a mainstream secondary school facilitates inclusion for young people with autism spectrum disorder (ASD)
Get PDFThe drive toward inclusion for autistic children and young people, has led to the majority of these students being educated within mainstream schools (DfE, 2021/22). School placement decisions for these students are generally based on individual needs and resources available. One option that is slowly growing in popularity based on parental satisfaction and aimed at promoting inclusion in mainstream education is that of additional resource provisions (ARPs) (Fredrickson et al., 2010). Currently there is little research on ARPs and even less eliciting the views of autistic students who access support from these ARPs. Therefore, the aim of this research was to conduct an exploratory case study of an ARP attached to a secondary mainstream school and aimed to explore the available support through observations and a staff focus group. The research also aimed to elicit the views of 7 autistic students through semistructured interviews on their experiences of being supported by an ARP, including what they found helpful and what they experienced as being barriers to effective support. Reflexive Thematic Analysis was used to analysis the data collected and indicated that the ARP in this study offers several benefits that supports students to access the mainstream school, including keyworkers being central to facilitating individualised packages of support. However, findings also highlighted areas of improvement, including developing the wider school ethos and culture, through training and attention to school policies. Furthermore, findings called for more collaborative working between the ARP staff and mainstream teachers with the aim of having a shared understanding of how best to support this population of students. The unique insight into student’s experiences of available support aims to inform future thinking on what students may find works well and what might need further consideration to supporting these students to access the mainstream setting
Next gens leadership conundrum: The emotional experience of taking up leadership roles and claiming authority in family-owned businesses
Get PDFThis study provides a systems psycho-dynamic exploration of leadership development in next generation members of family-owned businesses. Utilising biographic narrative interpretive method (BNIM) and grounded theory, it analyses five self-narrated life stories of family business successors. The research uncovers how the interplay between family dynamics, family and business systems, and societal context shapes leadership development. Key findings reveal that the family system, often reflective of the business’s emphasis on efficiency, success, and competition, profoundly influence the leadership trajectories of the next generation. Three distinct relational patterns emerge. Firstly, those who are seen as “natural successors” are required to conform to family expectations, enclose subjectivity, and renounce authorship (“the restrained”). Other patterns suggest that if an adequate facilitating environment is offered, rivalry and competition can encourage intellectual and creative capacities and foster a desire to later join the business (“self-authorised competitors”). However, if not being seen as a potential successor is seen as rejection, this may trigger unresolved feelings of envy and jealousy, which in turn spur a narcissistic need to “prove the world wrong” (“the rebellious”). These three patterns are understood as transitory states of mind, or momentary related positions, that are dynamic in nature. The concept of “virtuous betrayal” underscores the need for next generation leaders to challenge and transcend established familial norms and covert agreements, fostering personal growth, differentiation, and the development of personal authority whilst preserving a sense of interdependence amongst family members. The research suggests that successful succession and the assertion of authority by the next generation are contingent upon resolving the Oedipal complex and providing adequate reflective space within the family system. Additional findings connect leadership development to the capacity to disentangle oneself from unconscious group alliances, which enables next generations to challenge the meritocratic ideal and maintain a more realistic perspective of the wider social context