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The crisis in CAMHS: Can I-Thrive provide a solution?
No full textAnna Moore identifies the problems besetting the provision of mental health services to young people, and assesses the role of i-Thrive as a new needs-based model of prevention and promoting mental heaalth and wellbeing. With contributing authors
Clinical characteristics associated with the prescribing of SSRI medication in adolescents with major unipolar depression
No full textUnipolar major depressions (MD) emerge markedly during adolescence. National Institute for Health and Care Excellence (NICE) UK recommends psychological therapies, with accompanying selective serotonin reuptake inhibitors (SSRIs) prescribed in severe cases only. Here, we seek to determine the extent and rationale of SSRI prescribing in adolescent MD before entering a randomised clinical trial. SSRI prescribing, together with their clinical characteristics was determined in 465 adolescent patients with MD prior to receiving a standardised psychological therapy as part of the Improving mood with psychoanalytic and cognitive therapies (IMPACT) clinical trial. Overall, 88 (19 %) had been prescribed antidepressants prior to psychological treatment. The clinical correlates varied by gender: respectively, depression severity in boys and self-harming behaviours in girls. Prescribing also differed between clinical research centres. Medical practitioners consider severity of depression in boys as an indicator for antidepressant prescribing. Self-injury in girls appears to be utilised as a prescribing aid which is inconsistent with past and current revised UK NICE guidelines
Relationship based social work practice: The case for considering the centrality of humour in creating and maintaining relationships
No full textRelationship based social work practice has received increasing attention in recent years. The use of humour has infrequently been considered in relation to social work, and humour use is a neglected aspect in examining relationships in social work. As humour conveys humanity, is grounded in our earliest attachments and in the management of emotions, the purpose of this paper is to consider how humour operates in social work relationships. Importantly humour can help facilitate relationships with service users, and become a tool to help service users, social workers and their colleagues establish relationships
Adaptation: A contemporary view, revisiting Crichton-Miller’s 1925 paper
No full textIn this paper I discuss a contemporary 'take' on the concept of adaptation in light of Crichton-Miller's original 1926 paper. I look briefly at some of the ways that contemporary thinking is both similar to and different from ideas of 90 years ago. In particular I think about how recent neurobiological findings, epigenetic research and attachment theory have cast new light on our understanding of the ways humans adapt to social and emotional environments. It looks at how psychiatric presentations which are seen as maladaptive might well have an adaptive origin in early life. In this account I emphasise how a more modern version of evolutionary theory can be developed, particularly one influenced by life history theory, and suggest that such ideas have powerful explanatory power as well as being based solidly in good research
Does the computer say no? Considering the evidence for computerised working memory training programmes in paediatric populations
No full textSome comments on 'Autistic processes' by Frances Tustin
No full text‘Autistic processes’, Frances Tustin tells us, is the revised version of a paper that she presented in March 1969 at what was then still called the ACP Study Weekend. Three years previously the Journal of Child Psychology and Psychiatry had published her description of her little autistic patient John (Tustin, 1966 Tustin, F. (1966) ‘A significant element in the development of autism: a psycho-analytic approach’. Journal of Child Psychology and Psychiatry, 7: 56–67.): something one cannot imagine happening today. Tustin describes the two publications as companion papers that should be ‘read in conjunction with each other’. Both concern what she calls the ‘hole’ type of depression, but ‘Autistic processes’ delineates ‘primitive processes which become excessive in order to protect against its catastrophic effects’. This statement foreshadows her later formulation that children with autism made use of self-protective strategies in order to deal with catastrophic, and sometimes psychotic, anxieties; a view that found expression in the title of her last book: The Protective Shell in Children and Adults (Tustin, 1990a Tustin, F. (1990a) The Protective Shell in Children and Adults. London: Karnac
'Working together...it doesn't go far enough actually for what the relationship becomes' - An IPA study exploring the experiences of primary school SENCOs working with parents/carers through the EHCP process
No full textSeptember 2015 marked the start of a system-wide change to the SEND system. The Children and Families Act 2014 and the Special Educational Needs and Disability code of practice: 0 to 25 years (CoP) (2015) have given greater emphasis to parental involvement in the decisions that involve their children and on the expectations of schools. Government research has predominately focussed on the experiences of parents, but the experiences of Special Educational Needs Co-ordinators (SENCOs) in the new process has not yet been greatly explored. Therefore my research has aimed to explore the experiences of primary school SENCOs working with parents/carers through the new Education, Health, and Care Plan (EHCP) process. The purpose of this research was to provide knowledge of the SENCO experience to a relatively new research area in order to increase the awareness and understanding of those who work with and support SENCOs. Semi-structured interviews were conducted with five, purposefully selected, primary SENCOs. Interpretative Phenomenological Analysis was used to analyse the data. Superordinate themes for each of the five SENCOs emerged from the interpretative analysis which led to four overarching themes across the whole sample. Three overarching themes were shared by all five SENCOs: ‘Inner turmoil of the SENCO’, ‘Feeling adrift, in need for an anchor’, and ‘Differing roles, intimacy and professionalism’, and the fourth over-arching theme was shared by three of the SENCOs: ‘Varying expectations of the SENCO role’. Potential implications of these findings for professionals working with SENCOs, such as Educational Psychologists (EPs) could be: offering supervision for SENCOs: personal and/or peer to provide support and guidance for SENCOs, psychological training to provide SENCOs with greater understanding of the reasons behind parents actions/behaviours and their own emotional responses, and EPs approach towards working with SENCOs on a day-to-day basis to reduce SENCOs’ feelings of isolation
