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Exploring the process of change: Developing the use of nurturing approaches in a secondary school for young people with social, emotional and mental health needs
No full textNurture Groups (NGs), an intervention designed for use with primary aged children with ‘Social, Emotional and Mental Health Difficulties’ (SEMHD), has been adapted for use in secondary schools and schools for children with special educational needs. Existing research suggests that the NG approach can be an effective intervention with secondary aged pupils however very little research has studied the use of the approach in specialist settings. This research explored the use of nurturing approaches and the establishment of a nurture unit in a specialist secondary school for young people with SEMHD.
The explorative study used grounded theory approach to data collection and analysis, aiming to explore the process of change which was occurring within the school and the impact of this change on the young people, staff group and the wider school context.
Findings suggest that the establishment of a year seven Nurture Group alongside whole school nurturing approaches was having a positive impact. It seemed that the young people within the group were building trusting relationships with their teachers and feeling safe within the smaller setting. The whole school was thought to have a calmer atmosphere, attributed largely to the use of “wondering aloud” interactional techniques. Nonetheless, the approachhad not impacted all pupils equally, needing to be balanced with other approaches and adapted to meet individual needs as well as the adolescent population .
The implementation of the NG approaches was facilitated by a number of factors including a motivated management team, shared ownership of the project, availability of resources, support from outside professionals, whole school training and an on-going process of reflection and adaptation. Furthermore, there was a need for sufficient time for teachers to prepare, plan and reflect. Limitations to this study and implications for practice are discussed
That joke isn't funny anymore: Humour, jokes and their relationship to social work
No full textHumour can be seen as trivial, peripheral and even
an affront to some people in relation to the solemn business of social work. This thesis makes an original contribution to social work practice and thought, by exploring the relationship between jokes, humour and social,work. Jokes are worthy data in themselves to study, and humour is intrinsic to social life. This thesis draws on the extensive body of literature on
humour and the history of joke telling. Neither have been studied together in relation to social work.
Exposing contradictions in complex social phenomena has a track record as a creative way of knowing. The methodological approach taken reflects the qualitative nature of humour and jokes, and the analysis employed combined psychoanalytic and thematic approaches, in which “thematized meanings” were found across data sets. Social work and social workers occupy a contradictory position in society. The findings here indicate that humour and jokes provide a transitional space which helps social workers manage the contradictions and ambivalences of their work. The jokes made about social workers reflect a profession under attack, and the humour and jokes made by social workers reveal the desire to convey their humanity and to create relationships. Importantly my research shows that whilst there is a danger in humour being used unethically, humour can help social workers attach to their teams and their colleagues, and help build resilience, as a culture of humour within teams creates a nurturing environment, with social workers who will be more likely to stay in the job. Importantly as well humour can help facilitate relationships with service users, and become a tool for service users and social workers to bond
Psychosocial concerns and individual anxieties for fathers with testicular cancer
No full textThe purpose of this qualitative study was to explore the major areas of psychosocial concerns, individual anxieties and coping responses for fathers with testicular cancer. While numerous studies have been carried out with mothers with cancer, research from the perspective of fathers with cancer is sparse. This study attempts to identify and explore their specific concerns and priorities.
The study was approved by the Royal Marsden Hospital (RMH) Committee for Clinical Research (CCR) and the Local Research Ethics Committee (LREC). Men were recruited from the RMH Testicular Clinic. All of the men had two or three school age children and were from a range of ethnic backgrounds, professions and education levels.
The Biographical Narrative Interpretive Method (BNIM) of interviewing was used and the Interpretative Phenomenological Analysis (IPA) method was employed to analyze the data. Psychodynamic concepts were utilized as the theoretical framework to develop interpretations for each participant. Theories of masculinity were also incorporated.
A set of themes emerged which was supported by the current literature. The psychosocial concerns included: lack of adequate medical information, concerns for children and wife and work concerns. The individual anxieties included: concerns around self concepts and masculinity, physical changes and self-image, challenges to faith and finding meaning, fear of recurrence, fear of death and annihilation. The participants employed specific coping responses including: intellectualization, minimizing, maintaining stoic façade and idealization which helped them to cope with the impact of their disease AND allowed them to maintain their sense of masculinity. This phenomenon was labeled “The Masculine Way of Handling Illness”. Additionally, the men split their cancer into the “good one to get”.
The findings suggest that men need more reliable information, preferably on a reputable UK site, about talking to their children, the physical effects of treatment and the options of having a prosthesis
Deception and delusion: The relational aspect of supervision explored through Greek mythology
No full textThe aim of this paper is to explore the relational aspect of supervision from a psychoanalytic perspective. Rationale: In keeping with a psychoanalytic approach, the relational aspect of supervision has been explored through experiential learning and recourse to the literature. Greek mythology has been used to stimulate reflection. Findings: The theoretical concepts of an internal supervisor, projective identification and containment have been used to describe how the supervisory relationship can support development and tolerating complexity and uncertainty. Limitations: This paper describes the author's experiential learning, informed by psychoanalytic theory, in reference to a particular supervisor-supervisee relationship. The argument is developed within this context. Conclusion: It is argued that, trans-theoretically, the relational aspect of supervision merits a greater emphasis in research, practice and professional guidelines
PATHS to teach children with autism about emotions and emotional regulation: Challenges and opportunities in implementation
No full textAnxiety and school refusal: Helping children back to school
No full textBatul Al-khatib introduces the subject of school refusal and its links to anxiety, with a discussion on how the issue develops and what can be done to address it
Helping triumph over phobia
No full textWhen a colleague asked if I would be interested in running a support group for people with phobias, I was enthusiastic to find out more. Aware of long NHS waiting times, I was keen to get involved in a group that helps provide almost instant access to support. From my first meeting at TOP (Triumph Over Phobia) Kentish Town, I was hooked. This UK charity helps individuals with phobias, OCD and other anxiety disorders find ways to overcome their fears. The groups follow a self-help model of cognitive behaviour therapy (CBT) and exposure therapy. Working as an assistant psychologist in the NHS I have experience using CBT with patients and was interested to transfer these skills to a self-help group.
Often the group leaders are past group members. I strongly value the different skills and viewpoints that my colleague and I bring to the sessions, myself from a therapeutic background and my colleague bringing experience as an ex-sufferer having once attended the group herself. Our role is to provide a warm and encouraging space where we help members set and monitor goals and work through weekly tasks to face their fears.
The range of difficulties brought to the groups is varied with emetophobia (fear of vomit) agoraphobia, claustrophobia, OCD, hoarding and social anxiety to name just a few. Through structured sessions, homework tasks and a supportive environment, members work through their anxieties step by step. The exposure is graded and guided by the individuals' goals and what they feel comfortable working towards.
Each week we discuss how they got on with their homework. Rating their anxiety before, during and after each task helps us monitor progress. We then help them decide their next step, often reviewing their short- and long-term goals to assist with decision making. We are also creative in developing ideas for exposure within sessions. We have written plays for a member with social anxiety to perform to the group and found recordings of vomit sounds to help with emetophobia. If members are struggling with what to do next we come up with different ideas and they chose what they feel ready for. We recently revisited the vomit audio and it was so rewarding to see the member laughing along, when previously this task would have been almost intolerable.
A particular challenge I have faced was moving away from the more directive role of a therapist to the motivational approach required of a group leader. Welcoming new members can also be challenging, as you are engaging individuals in something completely new and asking a lot by requesting that they put themselves in situations that are very anxiety provoking.
After a recent new member observed the first session and gave a detailed history of their difficulties, we explained the group would focus on the present. The next session they soon went off topic and I had to be firm, bringing them back to the focus of our discussion. Balancing empathy with structure can be difficult, and it can feel uncomfortable being assertive, but this structure and focus enables members to target a specific problem and achieve their goals.
Members soon become independent with their goals and homework setting, and it is rewarding to see how quickly people make progress. Endings can be difficult, and part of my role is helping members recognise when it might be time for them to start working towards leaving the group.
This new role as Group Leader for TOP-UK has expanded my clinical knowledge and experience. Not only has it given me insight into the part clinical psychology can play outside of the NHS, it has also given me experience with a new clinical population. Watching more experienced group members share their insight and advice to help the newer members of the group has been valuable; the whole group collaborates and works together. TOP-UK value their volunteers and I have benefited from training days where evidence-based theories are discussed alongside real-life experiences to help our learning. Discussions about our own fears and anxieties highlighted for me how we all have fears and anxieties, but it is how they affect us that can be very different.
I am so pleased to be given this opportunity to help people help themselves. It has been a pleasure to work alongside these individuals and watch them achieve their goals. It has also been a valuable learning experience for me; I have already learned so much more about these difficulties through my time at the group and look forward to continuing my work with TOP-UK
Reviving therapeutic social work
No full textWhat has happened
to the relationship
between social work
and psychoanalytic
psychotherapy? Twenty years ago social
work trainings rooted in psychoanalytic
casework flourished in several parts of the
UK, and certain social work agencies like
the Family Welfare Association and
Family Service Units were a key part of
the ‘supply chain’ for psychoanalytic
training institutions. I myself left front
line social work practice in 1987 to work
in a social work training school that was
part of this network of interconnections
between psychoanalysis and social work.
But the decade that followed saw a radical
decline in the fortunes of
psychoanalytically informed social work
practice and training. By the time I moved
to the Tavistock in 1996 to lead the social
work discipline, there was a sense that the
Tavi was a final frontier for clinical social
work in this country. Key training
programmes had closed, the casework
model came under attack in the context of
‘care management’ approaches, and
psychiatric social work as a speciality had
lost its leadership and organisational footing
Enclaves autistiques, somatisation et contre-transfert corporel [Autistic enclaves, somatisation and the bodily counter-transference]
No full textL’auteur propose une réflexion sur le symptôme psychosomatique à partir du récit détaillé de la psychothérapie d’un enfant âgé de 5 à 9 ans, qui présente des ulcères buccaux. Cette manifestation psychosomatique est interprétée à la lumière des travaux de J. Mc Dougall, portant sur l’incapacité à faire face à des vécus d’anéantissement, ainsi que des travaux de F. Tustin et S. Klein sur la somatisation d’angoisses autistiques et existentielles enclavées, en rapport avec la séparation corporelle de la figure maternelle. L’auteur s’interroge sur la signification de certains aspects corporels du contre-transfert et la manière dont son interprétation permet au patient de sortir de son retrait profond, laissant place au symptôme psychosomatique.
[The author offers a detailed description of the psychotherapy of a child from the ages of 5 to 9 years old, reflecting on psychosomatic symptomatology, in this case mouth ulcers. Psychosomatic expression is here considered through the work of Joyce McDougall, on the incapacity to face the feelings in relation with the experience of annihilation, as well as the work of Frances Tustin and Sidney Klein, on somatization of enclosed autistic and existential anxieties, in relation to bodily separation from the maternal figure. The author wonders about the significance of particular bodily aspects of the counter-transference and the way which its interpretation allows the patient to come out of his deep retreat, making way for psychosomatic symptom.
THRIVE elaborated
No full textIntroduction to THRIVE Elaborated:
Since we published the THRIVE framework a year ago in November 2014 it has generated a lot of
interest. We are delighted by this.
We want to take this opportunity to clarify and elaborate as relevant, including addressing areas of
potential confusion, as well as updating the document in light of our emerging thinking and elaboration
of elements of the framework.
It is important to note that nothing relating to the central ideas of the framework has
been changed