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The feasibility of delivering group family nurse partnership
No full textPurpose:
To evaluate the feasibility of delivering the Group Family Nurse Partnership (gFNP) programme, which combines elements of the Family Nurse Partnership programme and Centering Pregnancy and is offered from early pregnancy to 12 months postpartum to mothers under 25.
Design/methodology/approach:
A mixed method descriptive feasibility study. Quantitative data from anonymised forms completed by nurses from November 2009 to May 2011 (pilot 1) and January 2012 to August 2013 (pilot 2) reporting referrals, attendance and client characteristics. Qualitative data collected between March 2010 and April 2011 (pilot 1) and November 2012 and November 2013 (pilot 2) from semi-structured interviews or focus groups with clients and practitioners.
Findings:
There were challenges to reaching eligible clients. Uptake of gFNP was 57% to 74%, attendance ranged from 39% to 55% of sessions and attrition ranged from 30% to 50%. Clients never employed attended fewest sessions overall compared to those working full time. The group format and the programme’s content were positively received by clients but many struggled to attend regularly. FNP practitioners were positive overall but involving community practitioners (pilot 2) placed more stress on them.
Research limitations/implications:
Further feasibility and then cost and effectiveness research is necessary to determine the optimal staffing model.
Practical implications:
The content and style of support of the home-based FNP programme, available only to first time mothers under 20, could be offered to women over 20 and to those who already have a child.
Originality/value:
This new complex intervention lacks evidence. This article documents feasibility, the first step in a thorough evaluation process
Introduction to the practice of psychoanalytic psychotherapy (2nd ed.)
No full textThis is a practice-oriented textbook which aims to demystify psychoanalytic psychotherapy. Teaching and learning psychoanalytic therapy is a less clear-cut process than for other therapies, and it is easy for students to feel overwhelmed. This accessible guide is based on the author's own long experience of teaching trainee practitioners, and is built on the core premise that psychoanalysis is not so much skill-based as dependent upon development of the analytic attitude, guided by principles of technique that are used in the clinical situation. The book provides step-by-step guidance and useful pointers in key areas such as how to make interpretations, how to carry out assessments, how to formulate cases in psychodynamic terms and how to approach endings. It presents critical information in an accessible way with case studies and practice guidelines, explaining the processes which underpin psychoanalytic psychotherapy as clearly and simply as possible. The Second Edition is updated throughout, with notable new material on findings from neuroscience and the increasing evidence base for psychoanalytic psychotherapy, the US relational school and the development of Dynamic Interpersonal Therapy, and recent studies in transference
The infant citizen: Mean societies produce mean people. Though often disappointed a baby is born to expect some kind – a rather conservative kind – of socialism
No full textBabies haven’t changed much for millennia. Give or take a few enzymes this perfectly designed little bundle of desires and interests has not needed to evolve. Of all primates, the human is the most immature at birth, after which brain growth accelerates and is ‘wired’ according to the kinds of experience the infant has. Provided there are a few familiar and affectionate people there to care continuously for him or her, baby will be fine. If not, evolution has taken care of that too. You live in a cruel world and treat him
roughly? He will develop into a compulsively self-reliant and ruthless individual with little concern for others. Mean societies produce mean people. Through attentive care in the early years we may hope to produce thoughtful, curious and confident young people1 but our social arrangements are essentially hostile and competitive. Having a baby is regarded as an expensive undertaking rather than as a contribution to the future of society.
Encouraged by successive governments our world is geared to markets. "It's the economy,stupid" means you can't do anything without considering the immediate cost. The more this idea takes hold the stupider we become. The current government’s dedication to continuous welfare cuts hits children disproportionately. Neoliberalism is the enemy of children
Comics as mental health information resources: Understanding the graphic medicine community
No full textThe following post is a short summary of the article ‘‘Graphic Medicine’ as a Mental Health Information Resource: Insights from Comics Producers’ published on 6 February 2016 on The Comics Grid: Journal of Comics Scholarship
The making of an abuser
No full textThis paper investigates how it is that a child has become an abuser, and by what means that process may be deconstructed. We know that abusers generally have a childhood history of abuse, though not necessarily sexual. Since not all children who have been traumatised repeat those patterns, and inflict abuse on others, then something must have happened for these particular children in response to their abuse. The author elaborates the view that there is no such thing, to paraphrase Winnicott, as ‘an abused child’ – no such child, that is, separate from the world of the relationships that formed him. He draws on the conceptualisation by Bentovim of an interlocking set of roles described as a ‘trauma organised system’; this notion reflects the fact that the child is a product not just of his specifically traumatic experiences but of a milieu in which power and control is exerted by someone who has typically succeeded in neutralising any caring function in a family in order to bring about the exploitation of a child. Clinical material is presented from the intensive psychotherapy of a nine-year-old boy, who happened also to be a refugee, for whom abusive family dynamics dominated his internal world. He was found to have identified with the abuser, his own father, in order to escape the pain of his victim self and was threatening to act this out in the treatment, making the therapist into a victim. Management of the treatment setting by the inclusion of a benign parental figure enabled the acting out to be contained. Symbolisation of the child’s inner conflicts became possible through play. As the abuser self was contained so the child’s victim experiences could be processed. The conclusion is drawn that engaging therapeutically with the residues of trauma from the beginning of treatment is essential in working with young people who have abused
Nurturing natures: Attachment and children’s emotional, social and brain development
No full textThis new edition of the bestselling text, Nurturing Natures, provides an indispensable synthesis of the latest scientific knowledge about children’s emotional development. Integrating a wealth of both up-to-date and classical research from areas such as attachment theory, neuroscience developmental psychology and cross-cultural studies, it weaves these into an accessible enjoyable text which always keeps in mind children recognisable to academics, practitioners and parents.
It unpacks the most significant influences on the developing child, including the family and social context. It looks at key developmental stages from life in the womb to the pre-school years and right up until adolescence, covering important topics such as genes and environment, trauma, neglect or resilience. It also examines how children develop language, play and memory and, new to this edition, moral and prosocial capacities. Issues of nature and nurture are addressed and the effects of different kinds of early experiences are unpicked, creating a coherent and balanced view of the developing child in context.
Nurturing Natures is written by an experienced child therapist who has used a wide array of research from different disciplines to create a highly readable and scientifically trustworthy text. This book should be essential reading for childcare students, for teachers, social workers, health visitors, early years practitioners and those training or working in child counselling, psychiatry and mental health. Full of fascinating findings, it provides answers to many of the questions people really want to ask about the human journey from conception into adulthood.
Clinical commentary by Sue Coulson, child and adolescent psychotherapist
No full textComments on an article (see record 2016-31144-011). The commentator analyzes the therapeutic interaction between Abigail and her therapist in a psychotherapy session with a new situation, a new therapy room. The change of room and the recent visit to the pediatrician seem to feature significantly in the session. The patient communicates powerfully her dislike of discomfort, physical and psychic, and her ways of protecting herself from any such experience. Abigail lets her therapist know that she does not feel understood or taken care of at school. There is a problem about how to manage upset and anger. She indicates there is a mismatch between what is expected of her and what she can manage. Abigail does not expect her therapist to be able to accept and reflect upon her difficult feelings about the changes, and her failures in understanding. Ending the session, like other changes, is difficult. The hug in the waiting room suggests Abigail is anxious that she may have damaged her therapist by her hostility and is unsure if she can survive
How some systemic practices might help young women with autistic spectrum conditions, and their families
No full textThis article gives a description of some of the author's systemic practices when working with young women who have autism spectrum conditions and their families
Making room for madness in mental health: The psychoanalytic understanding of psychotic communication
No full textIn this book, Marcus Evans argues that in addition to providing a helpful treatment for patients who suffer from serious psychological difficulties, psychoanalytic thinking can also help mental health staff develop a better understanding of their patients and complement other ways of thinking about mental disturbance. Mental health professionals need to be receptive to their patients’ projections and communications, but these powerful projections can become overwhelming, especially for clinicians who are in direct contact with their patients for long periods of time. A psychoanalytic model which puts the understanding of the relationship between the clinician and patient at the centre of its preoccupations can also give mental health professionals a language for describing their experiences of, and interactions with, their patients. This model is developmental and provides a dynamic picture of the ways in which different parts of the patient’s self wrestle for control of the patient’s mind over time. Evans argues that this framework for understanding can help in the day-to-day management of these changes and fluctuations.
Evans believes that the diagnosis and active interventions employed by psychiatry need to be accompanied by a receptive approach to treatment and care. Mental health professionals need to be interested in the meaning of their patient’s symptoms and verbal and physical communications. These may convey important information about the patient’s internal world and underlying conflicts. This receptive approach requires mental health professionals to make a switch from the active state of mind demanded by active interventions, to the receptive state of mind required by the need to take in the patient’s emotional state and underlying personality structure.
Making Room for Madness in Mental Health draws on the author’s extensive experience of working psychoanalytically with people with severe and enduring mental illness, as well as providing psychoanalytic supervision and consultation in a range of mental health settings to show how psychoanalytic ways of thinking may complement other approaches to mental disturbance by highlighting the communication and meaning of such disturbance. This is illuminated by lively clinical vignettes, supported by accessible accounts of key psychoanalytic theory.
Working with people with mental illness can be rewarding and enlightening. It can also be disturbing, frightening, boring, frustrating, anxiety provoking and stupefying. Evans argues that we need to provide room and space for mental health professionals to reflect upon and think about their experiences on a day-to-day basis, and to train clinicians to senior levels in order that they can offer clinical supervision to front-line staff, which can help them develop ideas about the meaning of their patients’ symptoms and behaviours. Psychoanalysis offers a model for thinking about and providing meaning for, the anxieties that drive us ‘out of our minds’, and this can reduce the risk of thoughtless action. To some extent this involves putting the madness back into mental health