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Aggression in the consulting room: An Interpretative Phenomenological Analysis of the ways aggression is experienced and understood by Child and Adolescent Psychoanalytic Psychotherapists
Get PDFChild and Adolescent Psychoanalytic Psychotherapists (CPTs) regularly encounter and work with different expressions of aggression in their consulting rooms. This is an important aspect of clinical practice because aggression can be found in the work with most patients. This study aims to investigate the CPT’s lived experience and understanding of aggression in the room. The findings of this study suggest that CPTs attempt to experience their patient’s expressions of aggression with the aim to attribute meaning and develop understanding as part of the therapeutic process, which separates them from professionals from other disciplines. This dynamic and an awareness of the CPT’s own relationship to aggression impact on the containment of patients and their development. CPTs can also express aggression in form of enactment or retaliation as part of projective identification. An awareness of this potential dynamic can prevent enactment and retaliatory responses. Some expressions of aggression can be understood as an important and creative aspect of therapy. Interpretative Phenomenological Analysis (IPA) was used to analyse the data from seven semi-structured interviews of CPTs. The findings are discussed in relation to psychoanalytic literature
How might young people communicate their expectations of relationships during ADOS assessments?
Get PDFRecent national developments have seen the rise of distinct Autism Assessment Teams
(AAT) within NHS Child and Adolescent Mental Health Services (CAMHS) as a way of
managing the increasing prevalence of autism amongst young people (Newschaffer et al.,
2007, p. 151). Young people (YP) with autistic symptomology are referred into the AAT for
assessment and diagnosis. Currently, under Nice guidelines (NICE, 28 September 2011), the
AAT does not include Child and Adolescent Psychoanalytic Psychotherapists (CAPPTs).
This study aimed to explore possible CAPPT contributions to the AAT, YP and wider
network, through asking the question ‘How might YP communicate their expectations of
relationships (EoR) during the Autism Diagnostic Observational Schedule (ADOS)?’, which
is one assessment conducted by the AAT.
Participants included 5 AAT clinicians, 7 YP (4 females and 3 males) aged between 9 and 15.
Data was gathered from 7 transcribed video and audio-recorded ADOS assessments.
Discourse Analysis, specifically ‘Subject Positioning (SP) Theory’, was then applied to
analyse the data, revealing fifteen SPs. Psychoanalytic understandings of communication and
EoR were then applied to the SPs. Four main EoR were identified, demonstrating
expectations that relationships would be characterised by:
1. Intrusion and exclusion;
2. Aggression and destruction;
3. Criticism, judgement, unreliability and untrustworthiness;
4. Sameness;
Findings suggested the ADOS assessment to be an emotionally saturated and meaningful
experience for YP, which evoked various unconscious EoR, and primitive survival anxieties. The assessing ADOS Clinician (AC) unconsciously contributed to the EoR and anxieties
communicated.
These findings suggest a CAPPT could provide valuable understanding of the unconscious
emotional world of the YP undertaking the ADOS, and the possible impact on the assessment
outcome, the AAT and wider network surrounding the YP
Inclusive approaches for children at risk of exclusion: Supporting mental health in primary schools
No full textEducation has a long history of managing children with identified behavioural difficulties through behaviourist approaches that rely on learning through reinforcement and may include systems of rewards or punitive consequences such as detentions or exclusions. School policies may advocate for zero tolerance of specific behaviours but such one-size-fits-all policies deprive practitioners from taking steps to understand the individual experiences of children. This chapter argues that behaviourist interventions are limited, as they generally do not consider the emotional experiences of the children or supporting adults. It offers a number of practical tools by which practitioners can take steps to reduce learning barriers for children identified with mental health needs through planning, assessment and analysis of response to intervention
Exploring mainstream secondary school leaderships' views and practices on the inclusion and permanent exclusion of students with social, emotional and mental health needs: A tension between performative pressures and inclusive practice
Get PDFIn the academic year 2019/2020, 6,500 children and young people (CYP)
were permanently excluded from school; almost one-third of this population were
identified with social, emotional and mental health (SEMH) needs (Department for
Education [DfE], 2021a). For many, this disciplinary sanction leads to academic,
social, health and financial disadvantages in addition to exacerbating their mental
health needs (DfE, 2021a; Ford et al.,2018; Gill et al.,2017). The responsibility for
decisions made to permanently exclude rests mainly with school leadership (DfE,
2012, 2017; Kulz, 2019).
Therefore, this research explored the views and practices of senior leadership
teams (SLTs) concerning the inclusion and permanent exclusion (PEX) of students
with SEMH needs, using focus groups from three mainstream secondary schools in
a local authority (LA) with a high PEX rate (DfE, 2016a, 2021b). A thematic analysis
identified the overarching theme that 'SLTs grapple with their sense of agency over
the inclusion and PEX of students with SEMH needs'. The discussion has been
framed within Bronfenbrenner's (1979) ecological systems theory and has
highlighted the tension between performativity and inclusion at various levels in the
ecosystem. Within the macrosystem and exosystem, inclusion is inhibited by
academic pressures, covert deficit discourses of disability and limited distribution of
LA funding. Nevertheless, members of SLTs seek to promote inclusion within the
mesosystem and microsystem by pursuing collaborative inter-organisational
relations and facilitating containing relationships between the young people (YP) and
significant others. Implications highlight that complex interactions within the
ecosystem affect senior leaders sense of collective agency to promote the inclusion
of students with SEMH needs, contributing to PEXs (Bandura, 1985, 2018).
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Recommendations include the DfE to perhaps acknowledge the systemic causes of
PEX then provide policy and funding to support inclusion. At the school level, SLTs
may wish to share effective strategies and utilise educational psychologist support
for training, supervision and the development of inclusive systems
Mourning and metabolization: Close readings in the psychoanalytic literature of loss
No full textBy bringing together perspectives from psychoanalysis and literary studies and considering the reciprocal relation between ideas about mourning and our internal worlds, this book provides a guide to thinking theoretically about loss and how we deal with it.
Rael Meyerowitz conceptualizes the work of psychic internalization required by loss in terms of bodily digestion and metabolization. In this way, successful mourning can be likened to the proper processing of physical sustenance, while failed mourning is akin to indigestion, as expressed in various forms of melancholia, mania, depression, and anxiety. Borrowing from the methodology of literary criticism, the book conducts a detailed treatment of these themes by drawing on a series of psychoanalytic works, including those of Freud, Ferenczi, Karl Abraham, Klein, Loewald, Torok, Nicolas Abraham, and Green, while paying close critical attention to a selection of literary works such as those by William Faulkner, Wallace Stevens, and Sylvia Plath.
Aimed at clinicians as well as readers with a more academic interest in psychoanalytic theory and language, the close-reading format offered by this book will also enable students in psychoanalytic and psychotherapy courses to engage deeply with some central texts and key concepts in psychoanalysis
Bystanders and whistleblowers: A study of the systemic forces driving the journey from denial to action in the face of wrongdoing within organizations
Get PDFThis study examines how a member of an organization comes to recognize and react to
wrongdoing in their workplace. The impact on an individual of perceived systemic processes
at the level of the organization and the wider culture which encourage silence or grant voice
is analysed within a social constructionist framework.
This focus allowed a more holistic understanding of the decision to speak out or remain
silent in the context of organizational wrongdoing. The aim was to produce a plausible and
explanatory account of bystanding and whistleblowing, acknowledging that those processes
are complex and co-constituted from the interplay of social and psychological processes. In
a small way, I hoped to generate testable hypotheses about key processes which explain
how people situated within a specific set of norms, faced with organizational wrongdoing
construct meaning and make choices about ethical practice.
Nine participants, drawn from a range of organizational contexts, who had raised concerns
about wrongdoing within their employing organization were interviewed individually. They
were asked to narrate their biographies up to and including the process of speaking out
about their concerns. Two further participants, who were bystanders in two of the
whistleblowers’ incidents were interviewed using the same approach. The interview data
was analysed using grounded theory. The research procedure gave participants space and a
process which provoked reflection and some newfound perspectives.
Initially an analytic account of the stages and processes leading up to speaking out or
remaining silent was obtained. Then the data was re-analysed, using the Transforming
Experience Framework (Long, 2016) to explore in greater depth how the organization-in-the-mind was composed in each case. The goal was not to develop a causal explanation but
to reach an understanding of how self, role and system interact in shaping a whistleblowing
episode.
Investigating the complexity of the full situation of inquiry requires that discourses at the
cultural level, should also be examined. Therefore, I conducted a supplementary study of representation of whistleblowers in film. I explored the relationship between historical
contextual factors and the changes to the portrayal, of the whistleblowing act, to draw out
how discursive concepts construct the subject of the whistleblower. Popular films featuring
whistleblowers were sampled across decades and their narratives were scrutinized using
situational analysis.
Findings showed that the pathway to speaking out has shared stages and processes, but
that the route to speaking out or keeping silent is both iterative and highly individual.
Systemic factors were found to inform the process at every stage. Whistleblowers
attachment to a contested version of the primary task, when they perceived the alternative
version of task to be associated with perversity led them towards raising concerns.
Experiences of occupying roles in their earlier life were reflected in how they managed their
attachment to organization. Being let down was also formative. Those experiences
collectively pushed them towards a new attachment to a parrhesiastic self and to attempts
to rescue the organization. The bystanders were aware of the same problems within their
organizations but, helped by an allegiance to an alternative professional discourse, were
acquiescent. The cultural context of the ‘market civilization’ shaped the discourses and
practices operating within the organizations in the study and contributed to the
construction of what was recognizable behaviour within the organization.
The implications of these findings for professional practice were discussed. The results
point to the value of enabling consultants and other change agents to understand the
systemic constraints which make wrongdoing invisible or deter staff from challenging what
they see and to develop strategies to empower people within organizations to reach a
position where they are prepared to speak out
How does parenting self-efficacy develop? A grounded theory study of the influences on parents’ feelings and beliefs about themselves in role
Get PDFParents’ beliefs about their ability to perform effectively as a parent, referred to as ‘parenting self-efficacy’, are associated with child behaviour, socio-emotional functioning and academic achievement, as well as parenting competence and functioning (Jones & Prinz, 2005). Research has shown that the most significant neural development takes place during the period between birth and three years and that early experiences can have a lifelong impact on children’s mental and emotional health, language and communication, and other key skills (Music, 2017). This research adopted a Constructivist Grounded Theory approach to explore how parenting self-efficacy emerges and develops in first-time parents. Nine participants engaged in a single semi-structured interview with the researcher via a virtual platform. Demographic information relating to the parents and their children was collected and used to inform theoretical sampling to ensure a range of perspectives and experiences were reflected in the data. Three cycles of data collection, coding and analysis were conducted; use of NVivo qualitative data analysis software supported the coding and analysis process. The findings offer new ideas to existing conceptualisations of parenting self-efficacy by presenting a transactional model for how the construct emerges and develops. Through applying a qualitative methodology that generates theory based on parents’ own perspectives, the study provides a unique offering that has relevance for both theory and practice. This research will be of interest to services and practitioners that support young families; researchers and professionals who are interested in early child development or the transition to parenthood; and parents themselves
Complex trauma: The initial consultation
No full textThis is a detailed introduction to the theoretical underpinnings of the service and how these are brought into the initial consultation that a traumatized individual will attend. The emphasis is on a flexible approach that focuses on engagement of the patient rather than assessment for suitability for therapy
Unequal impact – The links between environment racism and climate change
No full textWe will examine connections between those who profit from racism and those who profit from the destruction of the world's natural resources.
About this event:
The International Federation of Social Workers (IFSW) theme for World Social Work Day 2022 is Co-building a New Eco-Social World - Leaving No One Behind. The theme reflects a vision of new global values, policies and practices that develop trust, security and confidence for all people around the world – as well as the sustainability of the planet.
World Social Work Day 2022 will be a highlight opportunity for the social work profession to engage all our networks and the community we work within to make contributions to the values and principles which enable all people to have their dignity respected through shared futures.
The Tavistock and Portman and The British Association of Social Workers (BASW) are proud to stand together with social workers across to the world to mark World Social Work Day, which falls on Tuesday 15 March 2022.
This lunchtime event entitled: ‘Unequal Impact – The links between Environment Racism and Climate Change’ will examine the connections between those who profit from racism, colonialism and exploitation and those who cause and profit from the destruction of the world’s natural resources, from a UK perspective. We will conclude by asking - how do we co-build a new eco-social world where no one is left behind?’
Shantel Thomas, is the Anti-Racism Lead at BASW UK and Course Lead for the MA Social Work programme at the Tavistock and Portman NHS Trust. Shantel is a qualified social worker, senior academic and doctoral researcher interested in Anti-Racist Leadership in Social Work. Her role involves working collaboratively with members, colleagues and senior stakeholders to support the delivery of BASW’s equality, diversity and inclusion (EDI) strategy - alongside exploring how anti-racist practice can be developed and implemented across the social work sector.
Anna Harvey is a senior lecturer in social work at the Tavistock and Portman. She has taught on the professional doctorate in social work and the MA in Social work for the past six years. She is a children and families social worker who qualified 25 years ago. She worked with homeless people in therapeutic communities in Glasgow for seven years prior to qualifying. Her original degree was in political philosophy and developmental politics and this is where she learned about colonialism and exploitation. She recently became aware of the threat to children and families from ecological and climate disaster and began addressing the issues from a psychosocial position. She is interested in developing the dialogue about climate change within the social work profession in the UK