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Victims of violence
No full textThis chapter provides an overview of violence and victimisation. This includes consideration of the complex relationship between mental health and violence, highlighting the increased risk of violent victimisation experienced by individuals suffering from mental illness. The developing impact of the COVID-19 pandemic and associated health measures such as lockdown orders on violence (and, in particular, domestic abuse) is explored. We describe the history and development of legal protections and statutory services for victims in the United Kingdom. This includes the 2021 Victims’ Code. The authors discuss public health strategies in the conceptualisation and prevention of violence, and there is consideration of future developments within this field. Current resources available for victims of violence are outlined, alongside a detailed list of organisations that individuals who have been victimised can contact for advice and support
Making sense of experience: tools for collaboration with children and young people with social, emotional and mental health needs at points of school transition
No full textMany teachers, pastoral care staff, counsellors, psychologists and others from related disciplines who support children and young people’s (CYP’s) personal, social and emotional development are concerned by declining well-being and the increased demand for pastoral care and counselling for students with social, emotional and mental health (SEMH) needs. For practitioners to meet these SEMH needs effectively requires both an understanding of them and, more importantly, how CYP themselves make meaning from them. Psychological theories, especially those applicable to exploring experiences that evoke strong emotions, are vital. This paper outlines one such theory-informed approach: a collaborative approach to SEMH assessment at times of school transition. Specifically, it examines a novel use of projective techniques (PTs), where CYP are asked to provide a free-flow response to a stimulus [Content] and then think together with the practitioner about this response [Dialogue]. Reflective accounts of the method are provided to outline how it can support CYP’s engagement in assessment; enhancement of shared insights in formulation and personalisation of interventions. These are critical case study vignettes of using this new approach in applied practice, and there is a priority need for further empirical research. Other limitations and strengths of using PTs are outlined, and implications for future developments provided. Finally, an argument is made that system level transformation may be required if the necessary support for school-based staff to make effective use of these tools is to be realised
The Role of Early Trauma in the Formation of Belief in Reptilian Conspiracy Theories: A Psychoanalytic Perspective
No full textThis paper investigates whether conspiracy theories arising during the COVID-19 pandemic are linked to early trauma or a specific organization of the mind. Using the Reptilian conspiracy theory as an example, the paper proposes that belief in conspiracy theories can activate unresolved memories of trauma and serve as a mediator between the psyche and intrusive content. Classic psychoanalytic concepts, as well as more modern ideas from Britton and Steiner, are explored to understand the role of early trauma and inner object relations dynamics in the development of Belief in Reptilian Conspiracy Theories (BiCT). The concept of après-coup is introduced to explain how newer responses to familiar psychic experiences may shape beliefs in conspiracies. Additionally, the paper proposes that belief in conspiracy theories can function as a psychic retreat. Two clinical cases are presented to illustrate these ideas while maintaining anonymity
Race, ethnicity and culture: What happens to these contexts when Family Therapists work with childhood eating disorders?
Get PDFRace, ethnicity and culture (REC) influence the meaning of food and eating. This research examines how attention and reflexivity of family therapists towards REC are influenced by the NICE guidelines (manualised, family-based treatment- FBT) when working in childhood eating disorders services. The guidelines position clinicians to focus on psycho-education and weight gain. Hence, the opportunity to reflect on differences and similarities when meeting families is often deemed unnecessary in the initial phase of treatment. This sets up a dilemma between saving life and being reflexive. The study employs a qualitative, exploratory, multi-method approach based on online, semi-structured interviews with six individuals and two small focus groups of family therapists. Narrative Analysis (Dialogical/ Performance Analysis) was used to interpret the data from which structure, themes, identities, and contexts were drawn to address the research questions. The analysis illuminated the participants’ internal contexts and their connections with cultural practice. It also highlighted their external contexts such as team dynamics, FBT adherence, cost and efficiency. Wider societal influences were identified: the control of bodies, food and eating; the conceptualisation of risk and blame in modern society and in the NHS. Some unexpected narratives were elicited which showed the complexity of racism and the challenges present when addressing race, ethnicity and culture in this clinical context. My findings show that the degree of adherence to FBT by family therapists, depends on their personal experience, resonance to emotional distress, confidence, team priority and team support. Some participants demonstrated that therapists can save lives and be reflexive. Those who did not adapt FBT prefer the authority and certainty of the medical discourse. Nevertheless, as a systemic therapist, I believe FBT would benefit from adaptation in order for attention to reflexivity and inclusion of REC to be encouraged throughout the treatment process
‘It has got to be dynamic assessment’: An exploration into trainee Educational Psychologists learning and application of dynamic assessment practice in the UK
Get PDFAssessment of children and young people is essential to Educational Psychologists’ work (BPS, 2015). Criticisms of traditional psychometric assessments and hopes for a person-centred way of working with children and young people have led to dynamic assessment (DA) methods becoming a more popular form of assessment. In the UK, DA is less commonly used than standardised tests; there is an ongoing exploration of why this is and how DA practice can be enhanced. This research aimed to describe and explore Trainee Educational Psychologists’ (TEP) DA practice, including how they develop their understanding of DA and apply DA. The study employed a mixed methods design combining a nationwide questionnaire to present an overview of TEPs’ experiences and interviews to gain an in-depth understanding of TEPs' experiences of learning about DA and using DA in their practice. The questionnaire received 190 responses from TEPs, with 175 analysed using descriptive statistics. The researcher interviewed nine TEPs, and a Reflexive Thematic Analysis was used. Overall the findings have been able to provide an overview of TEPs experiences of learning about DA in the UK. The findings indicate a high amount of TEPs are trained to use DA tools, and many have enhanced their understanding of DA using other means (e.g. discussions, reading and additional training). Furthermore, the research provides in-depth insight into the experiences of using DA with children and young people. Many TEPs used a range of DA tools in their practice. TEPs were keen to use DA but were aware of the challenges of using this assessment tool; for example, using DA could be anxiety-provoking for the TEP and they were aware that others have an expectation of EP assessment methods. The TEPs' Educational Psychology Service placement, university and supervisor play key parts in supporting them to learn and use DA
A fall from the stars: a critical psychoanalytic reading of James Gray’s film ‘Ad Astra (to the stars)’
No full textThis reading of James Gray’s science fiction film ‘Ad Astra’ explores, largely from a post-Kleinian perspective, phantasised restrictions on object relations that may result in a developmental arrest in late adolescence. The phantasy of omnipotence, with its dominating impact on the mind, is considered, including how this may link with socio-contextual impingements on boys’ developing masculine identities, especially where a father is absent during their late adolescent years
Fast Feet Forward: A sports group for looked-after children and unaccompanied asylum-seeking children as an early intervention to process trauma and reduce distress
No full textLooked-after children (LAC) and unaccompanied asylum-seeking children (UASC) are likely to have experienced adverse childhood experiences (ACEs) in their developmental years, leading to poorer outcomes in their health and psychosocial development. A novel, exercise-based early intervention utilising bilateral movements for UASC and adoptive children (An early intervention framework for the emotional health and wellbeing of unaccompanied minors, 2020) called Fast Feet Forward (FFF) has shown promise in providing relief from trauma symptoms. This study seeks to replicate the effectiveness of FFF and extend it to a new population of traumatised children. Two groups of FFF occurred with 18 children participating. Results revealed a statistically significant decrease in distress and an increase in positive cognitions for UASC, showing effective processing of trauma-related hotspots. The LAC cohort also demonstrated a statistically significant decrease in distress and disturbance. Support is demonstrated for the efficacy of FFF as a cost-effective and resiliency-building early intervention treatment utilising bilateral movements for traumatised populations, especially UASC
The role of containment and holding in Psychoanalytic Psychotherapy with children in care
Get PDFThis thesis is an evaluation comprised of two studies exploring the implementation of
a new pathway for Children in care (CiC), and the experience of Psychoanalytic
Psychotherapists from the same CAMHS who deliver treatment to children in care. In
2018, the CQC gave a rating of ‘requires improvement’ for safety to the CAMHS due
to long waiting times. In response, a Children and Young People Joint Agency
Pathway (CYPJAP) was implemented in April 2019 to replace the previous Looked
After Children’s pathway.
Routinely collected clinical data were used to examine waiting times for first
appointment and length of treatment for the historical LAC pathway (2018 –2019),
the new CYPJAP (2019 – 2020) and Core CAMHS (2018-19/ 2019-20) as a control.
It was hypothesised that there would be a significant difference in waiting times for
first appointments between the two pathways for children in care. A Mann Whitney U
test indicated a significant reduction in waiting times on the CYJAP (p<0.0001).
The interview study aimed to explore the Psychotherapists’ experience of
containment (Bion, 1962b) and holding (Winnicott, 1963) in work with CiC and how
this may present in the clinical work. Four Psychotherapists were interviewed, and
thematic analysis used to analyse the data. The themes which emerged described
the child’s journey through Psychotherapy. This included ‘holding and containing the
network’. The second stage of the journey explored children’s communications
related to their early life in ‘projections, enactment and the depriving therapist’. In the
third theme ‘being in touch with what’s missed’, the children recognised experiences
they had missed. The final theme, ‘journey to integration’ described children’s
improved emotional regulation, indicative of a more integrated state of mind.
The new pathway significantly improved CiC’s access to a specialist treatment, and
psychotherapists demonstrated a shared understanding of CiC’s need for
containment and holding to improve mental functioning
What issues do school staff describe as important when introducing a whole school attachment-based approach? A Reflexive Thematic Analysis
Get PDFResearch demonstrates that supporting children’s emotional needs promotes better learning outcomes (Geddes, 2018). In the United Kingdom, hundreds of schools are trained in whole school approaches that have a basis in attachment theory. These approaches emphasise the relational needs of pupils and prioritise their sense of safety. They are often referred to by schools and in the limited literature as ‘attachment aware’ approaches. The current study took place in a deprived inner East London borough. It has one of the highest proportions of children with social, emotional, and mental health needs in the country. Reflexive Thematic Analysis (Braun & Clarke, 2019) was used to provide an answer to the following research question: “What issues do school staff describe as important when introducing a whole school attachment-based approach?” Eight semi-structured interviews were conducted in three schools with a range of staff including senior leaders, teachers and support staff. The researcher constructed five overarching themes to organise 13 themes that reflected patterns in participant experience. These five overarching themes were ‘Context Affects Delivery’, ‘Training Must Resonate’, ‘Scope and Remit of School and School Staff Widens’, ‘Permission to Feel’ and ‘Not Running Alone with Them’. In the current climate, emotionally focused “approaches could be referred to as an addon to the real business of education” (Parker & Levinson, 2018: 9). This research argues that emotionally focused approaches such as whole school attachment-based approaches are well placed to meet the needs of the entire school community and promote increased pupil engagement. This study adds to the exponentially growing body of research on whole school attachment-based approaches. The research has implications for local and national practice due to the priority given to trauma-based approaches in recent government guidance
On Redescribing the Indescribable: Trauma, Psychoanalysis and Psychedelic Therapy
No full textThe psychedelic state can be thought about as an interdependent intrapsychic, somatic, interpersonal and spiritual happening which encourages, perhaps both to the relief and dismay of those participating in the experience, the shocking and impressive emergence of one's unconscious desires and traumata's; a state which may be experienced as cathartic or healing, and as anxiety-provoking and confusing. Often, in clinical trials investigating psychedelics in mental health conditions, these go hand in hand. Amid a renewed, at times hyperbolic, interest in psychedelics as a potential treatment for mental ill health, significant gaps of knowledge remain. Additional studies exploring the impact of the extra-pharmacological factors and adjunct therapeutic models on treatment outcomes are needed. Drawing from psychoanalytic perspectives, this paper explores points of intersectionality between psychedelic therapy under investigation and psychoanalysis in the context of traumatic stress. To that end, the psychedelic state will be considered an attempt to make the unconscious conscious by immersing self in a bewildering waking-dream to better tolerate reality; immersing self in a wilful state of vulnerability, to develop trust in one's agency and capacity to trust others; immersing self in an indescribable experience to learn how to redescribe, to self and to others the traumatic past