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A qualitative study using Interpretative Phenomenological Analysis to explore the experiences of young people presenting with gender dysphoria within a Child and Adolescent Mental Health Service
Get PDFFocus of the Study: Young people presenting with gender dysphoria or who are questioning, will be interviewed using a semi-structured approach. Their hopes, expectations, and experiences of using a child and adolescent mental health service will be captured and explored. This will contribute towards the body of knowledge in the field, and the information may then be used to inform planning of CAMHS provision to further understand and meet the needs of this vulnerable group. Gap: Although gender dysphoria is not a new presentation, there is limited body of knowledge in this field particularly regarding treatment. Service user participation or more recently termed as ‘experts by experience’ is part of the NHS long-term plan and is defined as young people who have personal knowledge of services, through their own use of those services (CQC, 2023). However, most of the studies do not reflect this and particularly, transgendered and non-binary young people’s voices are under-represented. Methodology: A qualitative service evaluation sought to evaluate the service user experience of a Child and Adolescent Mental Health Service (CAMHS). A small number of young people with gender dysphoria or who are questioning their gender were interviewed using a semi-structured approach over the telephone. The interviews were analysed by using an Interpretative phenomenological analysis (IPA). Countertransference reflections were incorporated as an integral part of the process providing an extra layer of analysis and understanding. Conclusion: The use of semi-structured interviews in conjunction with the interviewer’s countertransference enabled participants to share their experiences of accessing a CAMHS service. The use of interpretative phenomenological analysis (IPA) provided unique insights into the participant’s world and experiences offering significant contributions to our understanding of gender dysphoria and helping to shape the services gender variant young people access
Clinical studies on parent–infant psychotherapy pre- and post-COVID-19 pandemic ‘Making the best of a bad job’ (1)
No full textIn his last writing in 1979, Bion, aged 81, described how ‘when two personalities meet, an emotional storm is created’ and the way that psychotherapy can only ever aim to ‘make the best of a bad job’ by turning that storm between the two people in the room to good account. This paper, whose title refers to Bion’s famous statement, complements a publication by Micotti and Pozzi, on a literature review regarding this topic. The paper describes clinical vignettes from psychoanalytic psychotherapy with parents, infants and children underfive seen in person, then online, in a Specialist National Health Service. Some technical issues in the move from in-person to online work as well as its impact on families and therapists are highlighted here
A Psychoanalytic Approach in the British Secret Service – Henry Dicks: child of the revolution
No full textHenry Dicks is mostly remembered as a Tavistock Clinic man. He did after all write the book on the Clinic, but there is much more to him - he was a man who traversed the shadowy undercurrents of 20th century history
Between hope and horror: Complex trauma in refugees and asylum seekers
No full textMajid’s work within a small specialized service in the Tavistock that offers court reports to asylum seekers is vividly described, with case examples that illuminate the careful, thoughtful, and often painful process. She uses a psychoanalytic understanding of trauma to conceptualize the difficulties her clients face, as well as describing the journey within the asylum process for the clients and the ways in which her reports may be received by the system
Complex trauma in a time of crisis: The Covid-19 pandemic
No full textThe impact of the COVID-19 pandemic was evolving as this book was being written. Stubley writes from the early months of the pandemic to describe the re-traumatization that the threat of the virus and the realities of lockdown and social distancing were causing in some of the patients in the service
Endings in the work with patients with complex trauma
No full textUsing clinical and literary examples, Dennis explores what makes endings with traumatized patients potentially so problematic and painful. She emphasizes how guilt can impede the capacity to mourn and the complexity of what needs to be borne as part of the grieving process that is required to allow a separation and acknowledgement of the realities of life, including limits of time
Undoing the cycle of violence
No full textTwo presidents, two contrasting approaches to managing violence. There are lessons in this for all of us in how to deal with conflict.
On the one hand, there is Joe Biden with his unscripted, incendiary remarks that Vladimir Putin ‘cannot remain in power’. On the other, Volodymyr Zelesnky, statesman-like in the face of severe provocation, asserting his nation’s resolve against the Russian behemoth, whilst refusing to be drawn in to rubbing Putin’s nose in his failures.
Zelensky knows the two lessons that 30 years of working with violent states of mind has taught me – first, shame is intimately interwoven with perpetrating aggression and second, the worst way of ameliorating violence is to aggravate the offender’s sense of humiliation. Violence begets violence; the shamed becomes the shamer. In W.H. Auden’s immortal words from September 1, 1939, ‘Those to whom evil is done, Do evil in return.