Tavistock and Portman E-Prints Online
Not a member yet
2774 research outputs found
Sort by
Beginnings, endings and transitions. Work with families in the perinatal period: the value of observation
No full textThis paper focuses on the lifelong significance of beginnings, endings and transitions and the way in which early experience affects the individual's capacity to manage change, separation and loss. It draws on examples from infant observation and from a postgraduate course for the perinatal mental health workforce. It underlines the value of observation and reflects on the importance of beginnings and endings in professional practice
Trajectories of transgender adolescents referred for endocrine intervention in England
No full textObjectives: Some gender-diverse young people (YP) who experience clinically significant gender-related distress choose to pursue endocrine treatment alongside psychotherapeutic support to suppress pubertal development using gonadotropin-releasing hormone analogues (GnRHa), and then to acquire the secondary sex characteristics of their identified gender using gender affirming hormones (GAH). However, little is known about the demographics of transgender adolescents accessing paediatric endocrinology services while under the specialist Gender Identity Development Service (GIDS) in England.
Design: Demographics of referrals from the GIDS to affiliated endocrinology clinics to start GnRHa or GAH between 2017 and 2019 (cohort 1), with further analysis of a subgroup of this cohort referred in 2017–2018 (cohort 2) were assessed.
Results: 668 adolescents (227 assigned male at birth (AMAB) and 441 assigned female at birth (AFAB)) were referred to endocrinology from 2017 to 2019. The mean age of first GIDS appointment for cohort 1 was 14.2 (±2.1) years and mean age of referral to endocrinology post assessment was 15.4 (±1.6) years. Further detailed analysis of the trajectories was conducted in 439 YP in cohort 2 (154 AMAB; 285 AFAB). The most common pathway included a referral to access GnRHa (98.1%), followed by GAH when eligible (42%), and onward referral to adult services when appropriate (64%). The majority (54%) of all adolescents in cohort 2 had a pending or completed referral to adult services.
Conclusions: This study highlights the trajectories adolescents may take when seeking endocrine treatments in child and adolescent clinical services and may be useful for guiding decisions for gender-diverse YP and planning service provision
An exploratory study investigating the experience of a group of Irish social workers undertaking an applied training in mentalization-based thinking and practice
Get PDFThis qualitative study explored the potential relevance of mentalization-based theory (MBT) and its corollary reflective functioning (RF) within social work practice. A bespoke MBT-informed psychoeducational programme emphasizing a novel tripartite model, comprising MBT, Attachment Theory and Regulation Theory was delivered in two hourly groups over twelve weeks. In addition to the provision of psychoeducational information, the groups incorporated a Tavistock style Work Discussion Group to support the participants’ applied use of MBT to one of their own cases. The study aimed to explore the participants’ own experience of engaging with and acquiring a working knowledge of mentalization, its relevance, both personally and professionally, as well as garnering any learnings from this first attempt to research the provision of introductory MBT training to a group of social worker practitioners. Nine of the eleven social workers, recruited from a large metropolitan area in Ireland completed the programme. Utilizing a thematic analysis in conjunction with a psychoanalytic lens, the transcriptions of the groups were analyzed within a critical realist world view, using Braun and Clarke’s six-stage model. The case studies were subjected to close scrutiny and reflexive considerations from which three central themes emerged for further analysis. The study advances our knowledge by indicating a strong consensus amongst the participants that MBT was a relevant and beneficial theoretical and practice gyroscope to support the social work task. Participants warmly welcomed the new language and ‘Thinking Tools’ of MBT which supported their ability to conceptualize and articulate a level of complexity of their clients and their own intersubjective process which they had previously struggled to enunciate. This novel tripartite model offers significant potential as a centralizing theoretical and practice framework; as such, it warrants further development and research. Future social work practice development could be beneficially advanced in light of these findings
The contribution of Child Psychotherapy to work with parents and infants in the baby clinic of a GP Practice
Get PDFPerinatal mental illness affects up to 20% of mothers and their babies (NHS
England 2022). GPs and health visitors are often the first port of call for parents
and infants in distress. For over 40 years, the GP practice in this study has been
home to a child and parent-infant psychotherapy service, supporting parents and
infants with emotional and mental health needs and providing consultation to the
GPs and health visitors who provide vital support to these families.
The aim of this research project was to explore the contribution that a child and
parent-infant psychotherapy service in a GP practice makes to supporting
parents and infants. This was a qualitative research study. The literature review
examined literature on consultation and clinical work by psychotherapists in
primary care and in parent-infant psychotherapy, policy and training for GPs and
health visitors in the areas of perinatal and infant mental health.
The research was conducted using semi-structured interviews and analysing the
psychotherapy session notes from sessions with parents and babies. Three
interviews and three session notes were analysed using Interpretative
Phenomenological Analysis (IPA). The main findings of this study are that parents
and infants in distress can be supported by primary care clinicians when they are
able to: provide continuity, encourage agency, develop, and use their observation
skills, pay attention to unconscious and emotional communication, be interested
and receptive and take a holistic view.
This thesis offered recommendations for future research and future practice in
child psychotherapy in primary care with GPs and health visitors
Changing minds and evolving views: a bio-psycho-social model of the impact of trauma and its implications for clinical work
No full textThis paper summarises my current understanding of relevant neuroscience and trauma therapy concepts, and discusses the implications for psychoanalytic psychotherapy with traumatised patients. It also explores the new social constructivist theory of ‘How emotions are made’ which has deep resonances with the psychoanalytic theory of thinking. These bio-psycho-social models and ideas challenge our existing traditional techniques and ways of working with trauma, and places the necessity of addressing body states at the forefront of our work. Some guidelines on working with traumatised children are discussed which take account of the newer findings of the impact of trauma on the body/brain
Helping the heroes: Psychoanalytic work with military veterans
No full textIn partnership with a charitable organization, Swinburne, as part of the Trauma Service, spent several years working with homeless veterans within a therapeutic community. He describes, with clinical examples, the presentations of complex trauma and the ways in which the individual’s difficulties were also played out within the dynamics of the community. Oedipal issues around the hatred of authority and problems with receptivity are explored
An exploration of school leaders' decision-making to exclude a student from school: What can we learn from their experiences?
Get PDFExclusion from school is an acknowledged problem. Outcomes for children and young people (CYP) who are excluded from school are poor, with over-representation in the criminal justice system, involvement with substance misuse, poorer health and anti-social behaviour. The aim of this study was to explore experiences of school leaders (SLs) decision-making to exclude a student from secondary schools, including what considerations and learning they take into account. The study was conducted with SLs from seven schools in one Local Authority in the South-East of England. Semi-structured interviews were conducted and analysed using Thematic Analysis. Three key themes were found: challenges with creating cultural change; challenges with meeting the needs of CYP at risk of exclusion; and the need for specific personal and leadership skills. The findings suggest: i) decision-making to exclude is strongly influenced by organisational culture and, therefore, SLs need to engage at a whole school level to create an environment where the need to exclude is reduced. ii) Systems to support decision-making were often implemented too rigidly. When SLs were able to use these systems flexibly it led to greater consideration of alternatives to exclusion. A lack of alternatives to exclusion was also a key finding. iii) Specific leadership skills and personal qualities are identified that SLs utilised to help with their decision-making. Implications from the findings include: the need for schools to regularly review their whole school culture/ethos; regular professional development on intervention with, and responses to, CYP at risk of exclusion; greater co-ordination with special educational needs systems; policy guidance focusing on preventative approaches; greater support for SLs in their roles and the use of systemic theory to understand organisational change. The implications for educational psychology practice are also considered
Fast Feet Forward: Early intervention protocol using bilateral movements to reduce stress and increase positive cognitions in adopted children with complex trauma presentation
No full textAdopted children are a vulnerable group that have often experienced multiple traumatic events such as maltreatment, neglect and the perpetuation of abuse. These early traumatic experiences can result in compromised resilience which impacts both psychological and biological development (Cicchetti & Banny, 2014). This study used the systemic model approach, method and technique to gain an understanding of the complexity of presentation and formulation being made (Harris & Burnham, 1985). It also expanded on an early intervention sports protocol, named fast feet forward, that was previously used with unaccompanied asylum‐seeking minors with significant results. The use of running as a bilateral stimulus resulted in a rise in VOC (validity of cognition) and a reduction in SUD (subjective units of distress) scores, both after a single session and after 12 sessions. The data reported from this study replicated the previous findings of Draper et al., 2020) and showed the benefits of using fast feet forward with adopted children. The results further evidence the potential efficacy of this protocol for adopted children displaying complex trauma and show promising results for future enquiry. Future research should aim to replicate these findings with a larger sample size