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Does community CAMHS miss a trick? A F.A.S.T approach to preventative work in the community
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An investigation into the implementation of CYP-IAPT routine outcome measures in their first year of integration into child psychotherapy practice
No full textThis thesis examines the impact on child and adolescent psychotherapists within CAMHS of the introduction of routine outcome measures (ROMs) associated with the Children and Young People’s Improving access to Psychological Therapies programme (CYP-IAPT). All CAMHS therapists working within a particular NHS mental health Trust1 were required to trial CYP-IAPT ROMs as part of their everyday clinical practice from October 2013-September 2014. During this period considerable freedom was allowed as to which of the measures each therapist used and at what frequency. In order to assess the impact of CYP-IAPT ROMs on child psychotherapy, I conducted semi-structured interviews with eight psychotherapists within a particular CAMHS partnership within one NHS Trust. Each statement was coded and grouped according to whether it related to initial (generic) assessment, goal setting / monitoring, monitoring on-going progress, therapeutic alliance, or to issues concerning how data might be used or interpreted by managers and commissioners. Analysis of interviews revealed greatest concern about session-by session ROMs, as these are felt to impact most significantly on psychotherapy; therapists felt that session-by-session ROMs do not take account of negative transference relationships, they are overly repetitive and used to reward / punish the therapist. Measures used at assessment and review were viewed as most compatible with psychotherapy, although often experienced as excessively time consuming. The Goal Based Outcome Measure was generally experienced as compatible with psychotherapy so long as goals are formed collaboratively between therapist and young person. There was considerable anxiety about how data may be (mis)used and (mis)interpreted by managers and commissioners, for example to end treatment prematurely, trigger change of therapist in the face of negative ROMs data, or to damage psychotherapy. Use of ROMs for short term and generic work was experienced as less intrusive and contentious
A child’s loss becomes a young man’s violence
No full textThis paper describes the contribution of earlier traumatic loss to the later violent eruptions, with fatal consequences, of two young men, one who killed his mother and one who killed an unknown woman. Their developing personalities became disordered during their disturbed childhoods and the link between these developing personality disorders and psychoses is referred to. The need for long-term treatments is emphasised, as well as the importance of communication between therapist and clinical team
Brief psychoanalytic therapy
No full textIn recent years, there has been a drive to develop briefer and more focal psychodynamic interventions, with the hope of satisfying the ever-increasing need for mental health support. This book outlines the principles and practice of Brief Psychoanalytic Therapy. It starts with an introductory chapter that distils those aspects of psychoanalysis that provide a basis for the approach. This is followed by an overview of themes and variations in six forms of brief psychodynamic therapy. The remainder of the book is focused on clinical practice.
Treatment and Adherence Manuals detail the specifics of therapist orientation and technique, and a formal research study that compares the approach with Interpersonal Therapy is described. Case histories of individual treatments unfolding over time are complemented by detailed examination of short sequences of patient-therapist dialogue from transcribed sessions. The result is a picture of a psychoanalytic treatment that, while brief, is disciplined and coherent in its concentrated focus on analyzing the transference and countertransference in the therapeutic relationship
Medical psychotherapy
No full textMedical psychotherapy draws together succinct descriptions of the major models of psychotherapy, written by specialists who offer an accessible, theoretical, and evidence based depiction of each therapy and its clinical role for patients. Written by the foremost voices on psychotherapy in the UK, this handbook will appeal to specialist trainees in psychiatry and consultants working in psychotherapy, along with psychologists, and allied health professionals