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The map of competencies in systemic therapy: A qualitative study of the systemic competencies in child and adolescent mental health that target the associated abnormal psychosocial situations
No full textThe overarching aim of this research project is to identify a comprehensive and detailed outline of the systemic therapist competences in the Norwegian child and adolescent mental health (BUP) that target the psychosocial difficulties that are categorized as associated abnormal psychosocial situations in the multiaxial classification of child and adolescent psychiatric disorders/axis 5 (ICD-10). The project is based on twelve qualitative in-depth interviews with six experienced systemic family therapists, fieldwork observations of the therapists (participants) in practice and an analysis of the Norwegian Directorate of Health’s guidelines for child and adolescent mental health institutions. The specific research questions for this research project are: 1. In the context of child and adolescent mental health, what are the different competences in a systemic family therapy approach that address the associated abnormal psychosocial situations? 2. What are the legally binding requirements in the Norwegian Directorate of Health’s (2008) guidelines for child and adolescent mental health? 3. How does systemic family therapy interconnect with the Norwegian Directorate of Health`s (2008) guidelines for child and adolescent mental health? Grounded theory (GT) was chosen as the main methodology for this study. During the analysis, the following six overarching categories were identified: (1): legally binding requirements; (2) the importance of ethical and contextual awareness in systemic therapy; (3) the systemic therapist’s stance; (4) therapeutic processes; (5) therapeutic practices; and (6) session-specific features. Challenges, such as limiting the systemic approach to six overarching competences, are discussed alongside this study’s strengths and limitations, and suggestions for future research are presented. The detailed outline of the systemic therapist competences and the legally binding requirements in the Norwegian Directorate of Health’s guidelines was compiled into a “map of competences”. The findings show that the legally binding requirements interconnect and overlap with the identified systemic competences, although their wording and their inclusion of diagnosis can challenge the systemic ideas of using a non-pathologizing language. The map of competences is intended to be applied as a tool for clinical supervision, clinical practice, education and training in family therapy. This research may also facilitate a “bridge-building process” between mental health and postmodern systemic ideas
‘Back to our Roots?’ Re-visiting psychoanalytically-informed baby and young child observation in the education of student social workers
Get PDFWhile there is a well-established literature on psychoanalytically-informed baby and young child observation in social work education, little has been published recently. This paper reviews the rationale for its use, evaluating its impact on students’ learning in the light of contemporary policy and practice contexts facing social work education. Analysis of feedback gained from a recent cohort, identifies three ways in which learning through baby and young child observation contributes: firstly, students encounter and learn about the complexity of child development from the direct experience of observing and secondly, observing facilitates the development of important skills for practice; students’ ‘use of self’. Thirdly, through observing, students describe how they develop the capacity to take-up and sustain a professional role. Well-structured teaching and learning through observation is therefore shown to provide a rigorous, theoretically-grounded contribution to the training of university-based social work students entering this complex and challenging professional field
An investigation into perinatal psychotherapy as a treatment for first-time mothers with anxiety disorders
Get PDFIt is widely recognised that the perinatal period brings an increased risk of mental health problems for women, with more than one in ten women in the UK developing a mental disorder during pregnancy or within the first year of having a baby. Perinatal mental disorders are potentially far-reaching in terms of the negative impact they can have on the lives of childbearing women and the foetus or infant. For example a mother’s disturbed mood can have an adverse influence her child’s emotional development and psychosocial outcomes, and can affect the parent-infant relationship.
In the UK, perinatal treatment usually takes place on an outpatient basis although in extreme cases, for example where psychosis is diagnosed, a woman may be admitted to a psychiatric unit. In either case, sometimes the use of psychotropic medication may be needed. However, women’s fears about harm to their babies as a result of using psychotropic medication, plus concerns about their own possible dependency, mean that many women prefer psychological intervention to treat their perinatal mental disorder. Psychoanalytic psychotherapy is one type of psychological intervention used in the UK NHS in the treatment of perinatal disorders. However there tends to be little attention from research and literature on the role and effectiveness of psychoanalytic psychotherapy in working with mothers, and on the sorts of things that can lead to mental disorders in the perinatal period. Hence it is the aim of this study to explore these issues through a qualitative case study of three patients attending one outpatient perinatal service for psychotherapy treatment with a male therapist, specifically for anxiety disorders. Drawing on the material from the three individual case studies, the fear of being judged a bad mother is illuminated as each patient tries to adjust to the transition to motherhood when suffering from complex psychological conflicts. Observations are made of their conscious and unconscious identifications with the vulnerability and dependency of their babies and the interrelated anxiety arising when faced with the primary responsibility of care. A range of factors which have serious implications for the mothers feeling emotionally capable of being the primary caretaker come to light as the case studies unfold. Attention is paid to the transference in the patient-therapist relationship and the technical challenges for psychotherapeutic technique in relation to the gender dynamic. The case examples show a working through of psychological dilemmas in the setting of a perinatal service focussed on strengthening mother-baby relationships at risk of being damaged
Turbulent family and organisational dynamics in the context of succession in a family business: A joint intervention to contain and work through destructive Oedipal forces
No full textThis paper is an account of an intervention in a pharmaceutical company faced with the challenge of navigating the succession of leadership in a family-owned and run business from the founding parents to the adult children. The consultants—a man and a woman—are long-time colleagues who bring a systems psychodynamic approach to bear on this engagement, which includes their use of transference and countertransference data identified between them and the client system. At the outset, the dynamics within the family—both in the personal and work spheres—are understood by all to be dysfunctional and a threat to the succession. The ensuing engagement is explored through the lens of potentially destructive oedipal forces identified in the system
The Care Act is failing to support carers. Legislation gave new rights to carers but its potential is far from being realised
No full textHave carers noticed any difference since the Care Act came in? That is the question the Carers Trust asked me to try to answer. Over the past six months, I’ve been working with a small team of experts by experience and professionals to take the first snapshot of the impact of the act.
Carers provide the bulk of care in our country. Three in five of us will become carers at some point in our lives. Without carers, our already stretched NHS and social services would be overwhelmed. But many carers pay a heavy price for their role in both their health and their wealth.
During our inquiry, we were told by many of those who contributed that the Care Act is an important piece of social reform but its potential is far from being realised. The Care Act puts carers on an equal footing with those who have care needs. This parity in law is new, some even say revolutionary. Councils have a duty to promote the wellbeing of carers and to prevent burnout and crisis
Childhood and society
Get PDFProReal’s work with clinicians continues to contribute to the field of young people’s mental health.
ProReal was featured in Dr Richard Graham’s talk at the ICT Coalition for Children Online at its biannual gathering in Brussels which addressed current and future challenges of young people’s use of online technologies. Dr Graham, Consultant Child and Adolescent Psychiatrist at the Tavistock and Portman NHS Foundation Trust, talked about building young people’s resilience online and highlighted ProReal as a way of doing this.
ProReal was also featured at Identity, Radicalisation and The Future of Mankind, one of a series of Tavistock Digital Lives conferences at the Tavistock Centre. It was a stimulating day of talk focused around the ways in which young people maintain online identities. At the conference delegates were able to experience the ProReal software, including a touch-screen version
Was kann uns die psychoanalytische arbeit mit autistischen kindern über das körperbild lehren? [What can psychoanalytic work with autistic children teach us about the body image?]
No full text'Graphic Medicine’ as a mental health information resource: Insights from comics producers
No full textRecent literature suggests that a growing number of comics are being published on health-related topics, including aspects of mental health and social care (Williams 2012; Czerwiec et al 2015) and that comics are increasingly being used in higher education settings as information resources.
This article offers insights from comics creators and disseminators and explores the wider context of comics production and distribution (with a focus on 'Graphic Medicine' or health-related comics) as part of a larger examination of the interface between these documents and potential academic audiences. Original data was gathered through semi-structured interviews with 15 participants actively involved in comics creation and production. Elements of domain analysis (Hjørland 2002) were used to obtain insights into attitudes to the creation, dissemination and use of mental health-related comics.
Though potentially useful comics material is being produced in the mental health domain, significant challenges remain for producers in enabling their work to be accessed within higher education settings. This paper suggests that comics producers need to make a concerted effort to reach academia, and academia - including information professionals - need to embrace new types of material to enhance teaching