Tavistock and Portman E-Prints Online
Not a member yet
2774 research outputs found
Sort by
Parents’ views on their children’s sleep difficulties and their approach to help seeking: An exploratory study
Full text linkBackground: The impact of sleep on physical and mental health is significant. This is evidenced through a wide range of literature (Williamson et al., 2020). This includes educational and personal outcomes for young people (Konen et al, 2015). The patterns and habits that children form in early life can support them to develop positive sleep habits and routines into adulthood (Sutton et al., 2019). Research has shown that parents can be reluctant to seek support for children’s sleep difficulties (Cook et al., 2020). In a longitudinal study by Williamson et al. (2020), 5107 children were recruited at birth and monitored for sleep difficulties up to the age of 11; almost half the children had some form of reported sleep difficulty. This high prevalence provides further rationale for the current exploratory study. Despite how well-established the importance of sleep is, there is little research into what specifically parents would seek or use in terms of support. Aims and objectives: This research aimed to establish what support parents would like or have sought for sleep difficulties of children aged 3-11 in mainstream primary schools in England. Further aims were to find out what parents consider when deciding whether to seek such help. Methods: The study used a mixed-methods design. Data was collected using an online questionnaire for parents to explore help desired and sought. Semi-structured interviews were used to explore parents’ views, experiences and considerations on their help-seeking journeys. The questionnaire data was analysed using descriptive statistics and content analysis; and the interview data was analysed using reflexive thematic analysis (RTA). Results and Conclusions: Analysis of quantitative data is presented alongside key themes identified from qualitative data: Losing Sleep; Weighing it Up; Experiences of Support; Family Matters; What about me? The findings are reviewed in relation to existing literature and implications for educational psychology (EP) practice are highlighted. The strengths and limitations of the study are discussed alongside recommendations for future research. The main implications are the consideration, going forward of the unique position of EPs and how they could be utilised to best support families in which children struggle with the important area of a human’s existence, sleep
A qualitative exploration of psychoanalytic psychotherapists' experiences working with young people who have perverse sexual fantasies and/or engage in harmful sexual behaviour.
Full text linkObjective: 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
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
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
Alone (together): becoming a parent in the pandemic
No full textThis paper draws on the author’s own experience of becoming a parent during the Covid-19 pandemic as a starting point from which to explore, and consider, how the experience of new parenthood was profoundly affected by the unusual and challenging circumstances created by the pandemic. Using a psychoanalytic lens, the author considers the legacy effects of Covid-19 restrictions and the atmosphere of heightened anxiety and danger, on the families who welcomed their first child in 2020 or 2021. The paper brings into focus the simultaneous experience of increased isolation and the withdrawal of support that would ordinarily be offered to new parents, along with the increased opportunities for closeness and early bonding this might bring, and considers how these factors might interrelate. It considers the changes to fatherhood that the pandemic created, and examines the benefits as well as pitfalls of the unusual circumstances brought about by successive lockdowns in the UK. The paper also explores the role that child psychotherapy has, as a profession, to examine and understand this experience for new parents and children born in the pandemic
“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
Full text linkOver 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
Full text linkThis 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)
Full text linkThe 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