Tavistock and Portman E-Prints Online
Not a member yet
2774 research outputs found
Sort by
Clarifying an approach to consultation: The impact of a systemic consultation training for schools-based child and adolescent mental health services clinicians
No full textDespite the importance of consultation in early intervention of mental health difficulties, there has been little consideration of the specific competencies needed nor a model underpinning this intervention. Eleven schools- and children’s centre-based child and adolescent mental health services clinicians were interviewed with semi-structured interviews before and after a systemic consultation training. Four main themes emerged; participants gained: (1) a better understanding of organisational and multi-agency contexts, (2) a clear theoretical basis for practice, consistent with a destigmatising understanding of mental wellbeing, (3) clarity on the role, remit, and process of consultation, and (4) confidence and skills to carry out the role. The skills gained were in line with systems-level competencies. These findings suggest that the systemic consultation training increased the confidence of clinicians to work with complex networked systems in schools and communities. Future research can further understand the impact of this approach on other stakeholders, such as schools and families
Psychoanalysis and homosexuality: A contemporary introduction
No full textThis important book examines the ways in which same sex desire, or 'homosexuality' has been theorized by psychoanalysis during its history to date and the impact of that on clinical practice. The authors explore a brief history of the developing social attitudes which influenced the evolution of psychoanalysis, from Freud's radical questioning of psychosexuality to the later developments that assumed a moral high ground for heteronormativity and led to the diagnosis of other forms of sexual expression as perversions requiring treatment. The book elucidates contemporary developments in psychoanalytic thinking about sexuality from a post-heteronormative standpoint, including an examination of how heteronormative bias has relegated lived sexual experience to the sidelines. The book challenges this bias and introduces new ways of using psychoanalytic ideas as well as illustrating their relevance to clinical practice. Drawing on vignettes, the authors describe current challenges that clinicians face and discuss the dilemmas that these challenges present, both for qualified clinicians as well as those in training. By approaching 'homosexuality' from a contemporary post heteronormative position, the authors advocate a more flexible encounter in the consulting room in a way that can illuminate an understanding of all sexualities, including heterosexuality
The Distress Screening Tool: An Outcome Measure in the Work with Looked after Children and Unaccompanied Asylum Seeking Minors
No full textIn the UK a third of young people have experienced traumatic events (TE) and 7% of them develop PTSD. Early trauma experiences are also linked with changes in the brain structure and its pathways. Unaccompanied asylum seeker children (UASC), care leavers and looked after children (LAC) are among those who experienced a majority of ongoing traumatic events throughout their lives.
The Distress Thermometer (DT) was first introduced by NCCN as a screening for patients who were diagnosed with cancer. Recently, Draper and Marcellino described the use of the Distress Screening Tool (DST) in their clinical work with unaccompanied asylum seekers children (UASC). In this work the tool helps to assess the emotional health of young people during times of potential distress in a non-pathologizing way. Our results clearly highlighted that, in a situation of ongoing trauma, the DST had the efficacy to
decrease the level of distress and to capture any change
Acupuncture increases parasympathetic tone, modulating HRV − Systematic review and meta-analysis
No full textIntroduction: An increasing number of studies have demonstrated that acupuncture can influence Autonomic Nervous System functions. Heart Rate variability (HRV) is one widely used marker of autonomic activity. The main objective of this systematic review is to critically assess the evidence from randomized clinical trials (RCTs) regarding the effect of acupuncture on HRV as compared to placebo methods.
Method: EMBASE, Pubmed, The Cochrane Library, Web of Science, Scopus electronic databases were searched until 9 September 2020 for RCTs in which human subjects were treated with needle acupuncture using acupoints of the body without electric stimulation.
Results: The searches identified 1698 potentially relevant articles, 9 RCTs were included. The statistical analysis of the available data showed that the changes between pre and post treatment HF (high frequency) and LF/HF (high frequency/low frequency) values in Verum group were significant, while there were no significant changes in these parameters in Sham groups.
Conclusion: the results of this meta-analysis suggest that real acupuncture has superior effect over placebo acupuncture in increasing parasympathetic tone and in this way may improve physical well-being. Due to the quality of primary studies and degree of heterogeneity the results should be interpreted cautiously.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper
Substance misuse, trauma and domestic abuse perpetration: The perspective from Family Drug and Alcohol Courts
Full text linkDomestic abuse is one of the key drivers of child protection involvement in the UK. But there is a real lack of evidence around effective ways to with domestic abuse perpetrators. Recent research has highlighted the importance of substance misuse and the experience of trauma amongst perpetrators, and suggests that interventions which take these three issues together may be more effective than many of the current strategies.
This project aims to contribute to our understanding of how to effectively work with perpetrators of domestic abuse by focussing on Family Drug and Alcohol Courts (FDACs), a non-adversarial, trauma-informed alternative to standard care proceedings which works with many domestic abuse perpetrators. Parents within FDAC proceedings receive therapeutic support from a multidisciplinary team and have regular review hearings with a dedicated judge.
This report compares the lessons learned from a systematic review of the evidence around the links between abuse, trauma and perpetration of abuse with the way that these three issues are understood and responded to by FDAC teams and judges
From Less to More: The clinician’s experience of the transition from non-intensive to intensive psychoanalytic psychotherapy with looked-after and adopted children
Full text linkThe aim of this study is to explore the clinician’s experience of the transition from non- intensive (once-weekly) to intensive (three-times-weekly) psychoanalytic psychotherapy with looked-after and adopted children (referred to as LAAC) in the NHS Child and Adolescent Mental Health Services (referred to as CAMHS). The study aims to understand more about the processes involved in this transition when it takes place with children who have experienced early and often traumatic discontinuity, as well as the possible impact upon the therapy of this transition. The literature review reveals that the subject of transitions across session frequencies with LAAC has not yet been studied, despite its prevalence and significance as a clinical practice, confirming this to be a new and valid piece of research. The data for this study was collected through semi-structured interviews and analysed using Reflexive Thematic Analysis. The results offer insight into the complexity and challenges involved in this transition, raising questions about the process and arguing for greater understanding of the meaning for each patient of this change in session frequency. The findings conclude that moving LAAC patients out of once-weekly psychotherapy and into intensive treatment is a vastly more complex undertaking than is often acknowledged; attention is drawn to the difference between a successfully managed transition and an unsettling disruption, cautioning that change to the care plan requires significant preparation and understanding of the patient’s object relationship so that the risk of enacting early, traumatic discontinuities may be minimised. This study suggests that increasing session frequency may not always enable hoped-for developments and that, for some children, once-weekly frequency may be preferable. The findings indicate areas for further research while highlighting the need for greater understanding of this practice to enhance clinical judgement when considering this move and its possible implications for the therapy
Complex PTSD: The Wellbeing Lab with Will Young
No full textThis week I welcome back the excellent Jo Stubley. She's a Consultant Psychiatrist in Psychotherapy at the Tavistock Clinic and an expert on trauma, so I invited her back to talk to me about complex post-traumatic stress disorder. We talk about diagnosis, treatment, some of the problems around the naming of these experiences and of course have a few jokes along the way
Difficult conversations around Suicide with consultant psychiatrist in psychotherapy Dr Jo Stubley
No full textTalking about suicide is never easy, yet it's essential. In this difficult episode both Dr Stubley and I bring personal experiences to the conversation in the hope that it might facilitate your own conversations.
Dr Jo Stubley is a consultant psychiatrist in psychotherapy and leads the adult section of the trauma service at the NHS Tavistock Centre. Jo is a member of the British Psychoanalytic Society. Regular listeners will recognise that Jo is a returning conversationalist - this is our third episode together. The first one, on trauma in series one, would make a good listening companion piece to this one
A question of trust with psychoanalyst Dr Stephen Blumenthal
No full textThis is our first listener requested episode. "Joanne" (not her real name) asked us if we could do an episode on trust, after her husband had an affair. Although Joanne asked some specific questions ("how do I get the trust back/is it good to talk about it"), Dr Blumenthal and I discuss this but also what trust is at its core, beyond romantic relationships, what it means to trust, how do we trust, is it necessary to trust someone to love them, and how to get trust back when it's been lost.
Dr Blumenthal spoke so eloquently in series 2, on Intimacy, and that is a great companion piece to this one
Thesis Abstracts: Professional Doctorate in Social Work & Social Care (from 2008 to Spring 2024)
Full text linkPrevious Professional doctoral students present abstracts of their research in Social Work and Social Care and a professional update.
Compiled by Dr Katharine Scanlan with an introduction by Dr Louise Grant and containing tributes to Professor Andrew Cooper.
Previously compiled by Dr Judy Foster