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Personalised interventions for subgroups of children with conduct problems. Protocol Intervention
No full textThis is a protocol for a Cochrane Review (Intervention). The objectives are as follows:
To assess the effects of personalised, psychosocial interventions for subgroups of children with conduct problems
The compassionate mind workbook: A step-by-step guide to developing your compassionate self
No full textThere is good and increasing evidence that cultivating compassion for one's self and others can have a profound impact on our physiological, psychological and social processes. In contrast, concerns with inferiority, shame and self-criticism can have very negative impacts on these processes and are associated with poorer physical and mental health.
The Compassionate Mind Workbook is for anyone who is interested in how compassion - in the form of ideas and practices derived from Compassion Focused Therapy (CFT) and other approaches - may help us to engage with, understand and ultimately, try to alleviate suffering.
CFT utilises both Buddhist practices and Western psychological science. It draws on neuroscience, insights into emotion regulation and identity formation, interpersonal psychology and a range of psychotherapeutic models. CFT-based interventions can help people with a range of mental health problems develop compassion for themselves, be open to the compassion of others and develop compassion for others.
This workbook is a step-by-step guide to CFT, in which the chapters build your understanding of yourself, the skills that give rise to a compassionate mind, and ways to work with whatever difficulties you're struggling with in life. The exercises, prompts and case stories in this book provide an understandable and practical way to develop compassion
Parents’ experience of child contact within entrenched conflict families following separation and divorce: A qualitative study
No full textChild contact arrangements with parents following separation and divorce are strongly endorsed for children in both public policy and law where safe, but can be difficult to sustain. Entrenched high-conflict post-separation relationships between parents can cause substantial emotional risks to children as well as impacting severely on parents’ mental health. This paper describes a qualitative study, aimed at examining parents’ experiences of contact arrangements post-separation, undertaken within a mixed methods random allocation study of therapeutic outcomes for parents in entrenched conflict over their children. Two established semi-structured interviews with 22 parents were jointly subjected to thematic analyses. A thematic analysis across interviews revealed three main themes: ‘Dealing with contact evokes extreme states of mind’ for parents; when speaking of contact, the child is ‘everywhere and nowhere’ in the parents’ minds; ‘the hardest thing about contact is dealing with my ex-partner’. These findings indicate the immense strain children and parents are under and shed much light on the desperate states of mind for parents, particularly the anxieties driving relentless child contact disputes. This paper may contribute to the understanding of parents’ experiences of contact arrangements post-separation, potentially providing important information which can inform best practice for professionals working with this population
The economic cost of treatment-resistant depression in patients referred to a specialist service
No full textBackground: Patients with treatment-resistant depression (TRD) suffer very significant morbidity and are at a disadvantage concerning optimal clinical management. There are high associated societal costs.
Aims: A detailed analysis of health economic costs in the United Kingdom in a group manifesting a severe form of TRD in the 12 months before their participation in a major randomized controlled treatment trial.
Methods: The sample consisted of 118 participants from the Tavistock Adult Depression Study. Recruitment was from primary care on the basis of current major depression disorder of at least 2 years' duration and two failed treatment attempts. Service utilization was assessed based on self-report and general practitioner (GP) medical records. Generalized linear models were used to identify predictors of cost.
Results: All participants used GP services. Use of other doctors and practice nurses was also high. The mean total societal cost was £22 124, 80% of which was due to lost work and care required of families. Level of general functioning was found to be the most consistent predictor of costs.
Conclusions: Severe forms of TRD are associated with high costs in which unpaid care and lost work predominate. Treatments that improve functioning may reduce the large degree of burden
To investigate the emotional impact of sibling bone marrow donation
No full textThis thesis reports on a study of the emotional impact on sibling bone marrow donors. It considers in particular donation that takes place during their adolescence and was prompted by the concern of medical and nursing colleagues managing the treatment of young people with cancer. The study interviewed five donors and discusses these interviews using the lens of psychoanalytic theory to offer a deeper understanding of these donors’ experiences. Understood in this way, particularly using the psychoanalytic concept of projective identification, a main finding of the study is that whilst these donors would not have refused to donate, based on the love and duty of a filial relationship, the donation evoked complex emotions arising from the sense of the physiological merging of two people. The study makes some recommendations to change current practice within the hospital where I work in order to improve the psychological management and care of sibling bone marrow donors
Terrorism and mental disorder, and the role of psychiatrists in counter-terrorism in the UK
No full textIn this paper, we review the extant research on the links between terrorism and mental disorder in the light of evolving theoretical frameworks and new empirical evidence, examine the role of the psychiatrist in terrorist prevention as detailed in recently published guidance from the Royal College of Psychiatrists in response to government policy and legislation, and explore the contribution of contemporary psychoanalytic perspectives on existing empirical findings characterising the lone-actor terrorist
Viva voce - the trainee-supervisor voice - collaborative examination? The Tavistock Centre experience
Get PDFHow observational material might be used in a collaborative consultation with teachers to further their understanding of their pupils
Get PDFThe project was a feasibility study into the usefulness of a collaborative consideration of observational material in an early years special education provision. Children were referred, often for only two terms before returning to their mainstream schools where there was an expectation that the concerns would have been improved or resolved. A Child Psychotherapist observed the classes from behind a screen. These were filmed and then written up later in the tradition of Tavistock young child observation. This material was discussed with the teachers in an exploratory session and then a month later there was a review of this process to see if it had been helpful to the teacher’s thinking about the children. The whole process was repeated to allow for some learning from the first phase to be carried forward. A secondary aim of the study was to explore the aspects of the teacher-pupil relationship that promote learning. This study encompasses the use of observation and video along with consultation in schools to assist work with teachers in early years settings. The themes drawn from the data revealed a passive and active interaction between conscious and unconscious processes as they occurred in the classroom as well as in the discussion of the observations. These themes describe the progression of learning as it was observed. There emerged a preference among the teachers for the filmed material which yielded a rich data set. It highlighted the importance of the relationship between teacher and child and the extent of the non-verbal nature of this communication. The written observations worked as a foil to the acceptability of video and provoked discussion in post observation sessions. Whilst technically and ethically demanding the use of video here revealed an increasing desire and orientation toward visual media and its application in work with vulnerable children
Experiences of shame, social rank and violence amongst male offenders
Get PDFBackground: Theory associates shame with violence but research is inconsistent. The Compassion Focused Therapy shame concept distinguishes internal shame, other shame and social rank, offering a novel research approach. Adverse and traumatic experiences have been associated with violence in adulthood.
Aims: This study aimed to distinguish between internal, other and social rank shame with the intention of introducing a relational and social understanding of shame and violence. Secondly, it aimed to explore developmental psychopathology theories of violence by profiling the central and traumatic features of male offenders’ shame memories.
Method: Drawing on a pragmatist philosophy, this study adopted a cross sectional, quantitative approach. Male offenders (N = 121) in a young offenders prison were recruited via the healthcare suite. Participants were invited to complete a series of established self-report questionnaires via one to one interview. Two questionnaires required responses with reference to a strong shame memory.
Results: Multiple regression analysis found proactive aggression was predicted by other shame, social rank and shame memory avoidance. Only other shame and participant age were independent predictors of proactive aggression. Reactive aggression was predicted by internal shame, other shame, shame memory avoidance and hyperarousal, however only age independently predicted reactive aggression. MANCOVA found no differences between groups with and without physical violence risk alerts in terms of shame when controlling for age. Structural Equation Modelling identified social rank and other shame as mediators of proactive aggression. Black and Asian/Other ethnic groups had significantly higher levels of social rank but not aggression.
Conclusion: Although physically violent and nonviolent groups did not differ in terms of shame, different shame variables predicted proactive and reactive aggression in the whole population. The structural equation model is a novel analysis of proactive aggression. Ethnic differences in social rank are discussed in terms of BME overrepresentation in the criminal justice system