Tavistock and Portman E-Prints Online
Not a member yet
2774 research outputs found
Sort by
“The shadow falls”: Understanding the factors involved in decision-making in local authority children’s services.
No full textThis research explores outcomes for 31 children in 17 families, from parenting assessment work undertaken by the author in her role as an independent social worker, for a local authority between 2006 and 2008. The data collected in the course of the work was used in order to identify themes and patterns across cases, to form an understanding of the common difficulties faced by families in complex child protection cases. The assessments were followed up with interviews with the social workers to find out what had happened to the child or family. The themes arising from these two sets of data are presented as case studies, highlighting common themes about the psychodynamic factors affecting decision making in child protection work and the emotional impact of the work. The study describes a process whereby the social worker can lose sight of the child’s needs due to the overwhelming needs of the parents. The findings advocate a process of containment through a model of reflective supervision, which takes account of the emotional impact of the work, bringing the child back into focus whilst not losing sight of the parent’s needs. A process of reconnection with the tragedy behind the cases is also described. This study demonstrates how difficult it is for one lone social worker to keep the parent and child’s needs in mind and therefore advocates for a team approach to complex child protection work
Exploring the lived experiences of pastoral staff identifying and supporting pupil mental health needs in mainstream secondary schools
No full textThe prevalence of children and young people with mental health needs is of national and local concern. Changes in legislation have explicitly made the identification and support of pupil mental health needs a role for schools. Research indicates the identification of pupil mental health needs has a multitude of barriers meaning said needs are frequently unidentified. This is of concern given it is estimated that half of mental health needs have their onset during adolescence and are related to negative outcomes such as poor educational attainment and in some cases, suicide. School staff are tasked with performing a Tier 1 (Universal Services) mental health professional role. However, there is considerable variation in the support school staff receive when performing this pastoral role and routine pastoral care has received little attention in the literature. The purpose of this research was to explore the lived experiences of lead pastoral staff identifying and supporting adolescent pupil mental health needs in mainstream secondary schools. Semi-structured interviews were conducted with four purposively selected members of secondary school staff performing lead pastoral roles. The interview transcripts were analysed using Interpretative Phenomenological Analysis (IPA) and the following four overarching themes were found to be relevant for all participants: Multiple Conceptualisations of Role, A Myriad of Emotion, Constraints and Conflict, and Remit. These findings are discussed in the context of existing literature and the limitations of this research are considered. Implications for educational psychology practice are proposed, relating to the different levels at which educational psychologists work: individual, group and organisational. Suggestions for future research related to pastoral leads identifying and supporting adolescent pupil mental health needs are provided
Switching the light on: Can intensive psychoanalytical psychotherapy enable a child diagnosed with developmental delay to become unstuck?
Get PDFThis research is a qualitative single-case study focusing on a child diagnosed
with global developmental delay who was ‘stuck’ in their development. The aim
of the research was to investigate whether they could be moved along the
developmental trajectory by receiving an intervention of intensive thrice-weekly
psychoanalytical psychotherapy treatment. The research question was: can intensive psychoanalytical psychotherapy enable a child diagnosed with developmental delay to become unstuck?
The data was collected from the therapist’s observations of sessions as
recorded in the detailed write-up of their process notes. Ten sessions were
selected for analysis from the first year of treatment, and three sessions from
the second year. The main methods employed for data analysis were thematic
analysis and matrix methodology. Three themes were identified by this indepth
analysis. The first was ‘finding a voice: language development’, the
second ‘play and space – peekaboo’, and the third and final theme was ‘the
body: feelings, evacuation and physical holding’.
The research results demonstrated that development did shift, and that the
patient became less stuck and was able to move along their developmental
trajectory. More specifically, the findings showed that language developed
substantially, from only six words in the first analysed session and one-word
sentences to sentences of four, five or more words and interactional
conversational language. It was evident that the development of language
opened up the patient’s world relationally, and that they were much more able
to communicate and get their emotional needs met. The research illustrated
increased awareness of others, a growing sense of time and place in which the
present, past and future were more understood, and a place in which
sequencing and linking began to occur.
Thus the patient was able to shift from a flat, two-dimensional world to a livelier,
curious, three-dimensional world in which the notion of a third began to exist
and the beginnings of Oedipal development emerged. The development
enabled the patient to look around more; the world became a bigger and more
interesting and accessible place. The patient began to manage other
developmental issues such as anxiety about separation and object constancy,
and to develop an understanding that the therapist would return after a gap or
break. A more reliable object relationship developed. Holding another in mind
during absences was achieved, and anxiety was alleviated. There was a clear
shift from using non-verbal communication such as acting out and projective
identification to being able to use their language acquisition, to stay with a
thought and use thinking. The results showed an increased sense of self and a
stronger identity. There was evidence of mental growth and of more of an
internal psychic structure, as well as of a notion of play and a developed use of
symbolism, and developmental milestones were negotiated and worked
through.
The conclusion reached is that the research has provided evidence of the
benefit of long-term intensive psychoanalytical psychotherapy for this patient
group that supports other work in the field of global developmental delay
Working in the dark: Understanding the pre-suicide state of mind
No full textWorking in the Dark focuses on the authors’ understanding of an individual’s pre-suicide state of mind, based on their work with many suicidal individuals, with special attention to those who attempted suicide while in treatment. The book explores how to listen to a suicidal individual’s history, the nature of their primary relationships and their conscious and unconscious communications.
Campbell and Hale address the searing emotional impact on relatives, friends and those involved with a person who tries to kill themself, by offering advice on the management of a suicide attempt and how to follow up in the aftermath. Establishing key concepts such as suicide fantasy and pre-suicidal states in adolescents, the book illustrates the pre-suicide state of mind through clinical vignettes, case studies, reflections from those in recovery and discussions with professionals.
Working in the Dark will be of interest to social workers, probation officers, nurses, psychologists, counsellors, psychotherapists, psychoanalysts and doctors who work with those who have attempted suicide or are about to do so
Balint group leadership: Conceptual foundations and a framework for leadership development?
No full textThis article is based on a talk given at the International Balint Federation leadership congress in Warsaw (September 2016). It explores the conceptual foundations of Balint group leadership and starts by emphasizing the mutuality between psychoanalysts and medical practitioners working together. The parallel process between consulting room and group, and subsequently from group back to the consulting room, is delineated as the central construct in understanding the role of the leader. Having proposed a conceptual model for thinking about leadership interventions, the article discusses developments in some contemporary approaches to leadership: coleadership, the use of role play, psychodrama, pushback, and morale. It concludes by introducing Keats' notion of negative capability as a way of thinking about creativity in Balint group leadership
Navigating the medical humanities: My route
No full textWhile health and illness have been the subjects of artistic exploration and scholarly thought since ancient times, the field of medical humanities is relatively young. Indeed, this journal was only founded at the turn of the 21st century. Many interested in, and contributing to, the broad field of medical humanities, are working in small groups or even alone. Although the health humanities community is broad and inclusive, it remains something of a minority pursuit in many university departments. Beyond the academy, clinicians, artists and practitioners are engaging with, and contributing to, the field in wide-ranging and creative ways, but again, these pursuits can be relatively invisible to their professional peers.
The inherent inter-disciplinary character and diversity of the medical humanities community are, for many, its greatest strengths. It does mean, however, that it can be difficult to discern how to begin and progress a career in the medical humanities. Talking to friends and colleagues working in the health humanities, one realises that there are many ways to engage with, and forge a path, in the field. Those conversations also reveal what many readers will know: that it can be a challenging and sometimes isolating journey, but it can also be liberating to realise the scope for creative and original ways of developing one's interests and forming a career.
One of the many privileges of being the editor of this journal is having the opportunity to engage with a wide range of people working in, and engaging with, the medical humanities. It is a privilege that also gives permission to ask impertinent questions about why and how individuals came to be where they are and about their reflections on, and assessments of, the medical humanities as a field of inquiry and practice. There is much to learn from, and be inspired
The effect of cross-sex hormonal treatment on gender dysphoria individuals' mental health: A systematic review
No full textCross-sex hormonal treatment represents a main aspect of gender dysphoria health care pathway. However, it is still debated whether this intervention translates into a better mental well-being for the individual and which mechanisms may underlie this association. Although sex reassignment surgery has been the subject of extensive investigation, few studies have specifically focused on hormonal treatment in recent years. Here, we systematically review all studies examining the effect of cross-sex hormonal treatment on mental health and well-being in gender dysphoria. Research tends to support the evidence that hormone therapy reduces symptoms of anxiety and dissociation, lowering perceived and social distress and improving quality of life and self-esteem in both male-to-female and female-to-male individuals. Instead, compared to female-to-male individuals, hormone-treated male-to-female individuals seem to benefit more in terms of a reduction in their body uneasiness and personality-related psychopathology and an amelioration of their emotional functioning. Less consistent findings support an association between hormonal treatment and other mental health-related dimensions. In particular, depression, global psychopathology, and psychosocial functioning difficulties appear to reduce only in some studies, while others do not suggest any improvement in these domains. Results from longitudinal studies support more consistently the association between hormonal treatment and improved mental health. On the contrary, a number of cross-sectional studies do not support this evidence. This review provides possible biological explanation vs psychological explanation (direct effect vs indirect effect) for the hormonal treatment-induced better mental well-being. In conclusion, this review indicates that gender dysphoria-related mental distress may benefit from hormonal treatment intervention, suggesting a transient reaction to the nonsatisfaction connected to the incongruent body image rather than a stable psychiatric comorbidity. In this perspective, timely hormonal treatment intervention represents a crucial issue in gender dysphoria individuals' mental health-related outcome