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Tavistock child psychotherapy in schools: A brief history of a long relationship
No full textThis chapter gives a short history of the relationship between Tavistock child psychotherapy approaches and education, looking at how child psychotherapists and teaching staff have worked together in different and evolving ways since the 1930s when child psychoanalytic psychotherapy came into practice. It looks at how many child psychotherapists started out as teachers and then returned to schools to work with staff and children in a different capacity and how, over the years, child psychotherapists and teachers have found creative ways to work together, through Tavistock courses and in-school services providing staff consultation, work discussion groups, individual and group therapy. It shows how child psychotherapists have at times been based in education services, at others in health services, but have always been dual citizens, taking their thinking and services out of clinics and into school communities
Personal perspectives across education and mental health in a therapeutic school
No full textIn this chapter, three senior staff at a specialist, therapeutic school—head teacher, lead nurse/clinical lead and child psychotherapist— talk about their experiences of working together to support children who have experienced severe deprivation and trauma. They discuss what child psychotherapy brings to the school and how it works alongside teaching and psychosocial nursing in a “therapeutic milieu”. They describe how, as well as providing individual and group therapy, the school’s child psychotherapists join together with other staff to think about what children are communicating through often challenging behaviour, how they try to make sense of difficult group dynamics that distressed children inevitably create and “get psychoanalytic thinking into the school in a very practical and accessible way”
Therapists’ responses to young people’s anger: A Conversation Analysis approach
Get PDFObjective: The exploration of negative feelings is one of the core principles of psychoanalytic psychotherapy, yet anger experienced towards the therapist may lead to increased risk, ruptures in the therapeutic relationship and dropout. This study aimed to investigate the therapists’ immediate responses to patients’ anger in Short Term Psychoanalytic Psychotherapy (STPP) Method: This study used Conversation Analysis (CA) to analyse 10 patient-therapist conversations in extracts extrapolated from 4 different patient-therapist couples. The four treatments were audio-recorded as part of the STPP arm of the IMPACT study, a randomised controlled trial, investigating the efficacy of three types of therapy in the treatment of adolescent depression. Results: The CA analysis found six patterns of response that were produced following patients’ expressed anger. Therapists responded in highly emotion-laden ways, they created space from addressing anger in the here-and-now interaction, they used their epistemic authority to support their point of view, they asked questions about patients’ anger and they shifted their focus to moments of agreement. In one case, the therapist named the patient’s annoyance and anger towards her. In all other three cases latent feelings of anger were named but evaded when those became explicit in the therapeutic interaction. Conclusions: Expressions of anger can be seen as moments of increased emotionality which temporarily affect the therapist’s reflective stance and neutrality. Whilst anger indicates misalignment in the patients’ and therapists’ views and goals, strong emotional alignment on a non-verbal, procedural level seems to be at play. Pragmatic research in naturally-occurring data can inform psychoanalytic technique for STPP and bring awareness of factors likely to impact upon the therapeutic alliance
‘Will to survive’: The lives of young people with ‘no papers’ in the UK
Get PDFThis thesis explores the everyday lives, life histories, hopes and dreams of young people
(aged 17 – 25 years old) with irregular/undocumented immigration status. The project
grew out of 15 years’ experience of working with young refugees and migrants in an
urban context and a desire to understand more about the lives of those without
authorised status in the UK. Drawing on in-depth qualitative interviews with seven young
people, the findings suggest that undocumented youth survive on a continuum moving
between life and death; their aliveness or closeness to death impacted by multiple
psychological and socio-political factors.
This thesis has three main objectives. Firstly, it seeks to document and honour the
participants’ stories in ways which represent not only their struggles but also their
capacity to continue living in the face of adversity and to hold hope for the future.
Secondly, it delineates the ways practitioners in social care, health, education, youth and
community work, might help this group of young people to construct their everyday lives
safely. Thirdly, building on a psychosocial relational ontology informed by black
feminism and decolonial thinking, the thesis looks to advance critical reflexive
scholarship grounded in principles of respect, kindness and justice.
Overall, the results of this empirical enquiry confirm that individual lives cannot be
understood through attending only to that which is spoken and speakable. Rather, any
attempts to understand lived experience must also consider that which may be unspoken
or unspeakable. From this perspective, attention to emotions and a willingness to
embrace embodied ways of knowing and learning can offer deeper insights into the lives
of others. Interweaving participant testimonies, empirical research and theory, with
poetry and prose, this thesis attempts both to represent the lives of young people with ‘no
papers’ and to speak to the complexity of such an endeavour
Learning remote lessons in the year of lockdown
No full textAt the time of writing this we are all beginning to emerge from the second national lockdown. I have been discussing this with a friend and realising, in true systemic fashion, a lot more about my position by hearing his. He spoke very certainly that the period of COVID-19 could only be advantageous in its ending. I felt differently; that there may be parts I would miss and that I had valued. As I have worked as a newly-qualified family therapist through this lockdown, often remotely, Burnham's (2017) work around 'problems – possibilities, resources – restraints' often came to mind: strongly defined problems could be seen as possibilities, and restraints seen as resources. Moving so suddenly to remote working with no prior training or experience seemed beset only with problems. In this article, I will examine dilemmas and difficulties that I experienced during the lockdown and in remote working as well as the opportunities and resources that have grown from them
Shah Alam on BBC Asian Network. How to get Bangladeshi men talking about mental health. 11 May 2021. BBC
No full textBangladeshi men have been hit hard by the pandemic – in terms of higher death rates compared to other communities, shut down industries and job losses. But with lockdown easing, many fear that the impact of the pandemic on their mental health may be overlooked.
Imran Khan lost his father earlier this year to coronavirus. While he reached out to this GP for support, other Bangladeshi men are less likely to do so, says psychologist Shah Alam. He believes Islam could play a key role in getting men to open up and reducing the stigma around mental health issues. Imam Sheikh Abdullah Hasan has been exploring this – he has been providing mental health toolkits to more than 200 imams and scholars around the UK
Black men and mental health recovery: An intersectionalities approach
No full textIn 2017/2018, black men were four times more likely to be detained under the Mental Health Act than their white counterparts. The risk of psychosis in the black Caribbean population is estimated to be nearly seven times higher than in the white population. These inequalities may be the result of many connected factors, including racism, economic inequality and poverty, and mental health stigma, and should be of concern to any practitioner working in the mental health system.
This session will explore the inequalities that exist for black, Asian and ethnic people accessing the mental health system – particularly black African and Caribbean men and will present findings from a study to explore black men’s perspectives on mental health recovery
Complex post-traumatic stress disorder
No full textIn this chapter, the focus will be on the newly emerging diagnosis of Complex Post-traumatic Stress Disorder (C-PTSD). Following a brief overview of the history of the concept and some diagnostic issues that arise, a description will be given of common symptoms and presentations in C-PTSD. A case history will be used to illustrate these points. The chapter ends with a brief outline of some of the principles of treatment
Confidentiality at the interface of an adolescent psychotherapy service
Get PDFAims: Aims included to explore how, within a London trust, staff at the interface between patients, relatives and access to services view their understanding of confidentiality, and to determine ways to improve knowledge if needed.
Background: Confidentiality is essential to the trust and development of clinician-patient relationships. National policies set guidance on how confidential information should be recorded, secured and shared. However, confidentiality breaches are reportedly common within health professions. Working with adolescent patient groups brings additional issues regarding confidentiality. Care-givers who contact services, often desiring containment, may experience a sense of uncertainty when confidentiality policy prevents details being shared about a young person's clinical experience.
Method: Stakeholders were identified from the multidisciplinary team, with a collaborative rather than ‘top-down’ approach. Administrators in patient-facing roles were surveyed to ascertain current understanding and frequency of involvement in confidentiality issues. Based on feedback, a flowchart prompt was designed, ensuring it reflected best practice. Qualitative and quantitive data were collected before and after a two month implementation period.
Result: All respondents (n = 10) dealt with confidentiality issues at work, with 50% experiencing issues daily. 33% respondents did not feel confident dealing with confidentiality queries at work. The majority (60%) had received confidentiality training, but all respondents thought extra information would be useful. Of possible interventions, 70% supported a flowchart. Following an implementation period, 100% respondents re-surveyed agreed they felt confident dealing with issues related to confidentiality at work. The majority of respondents had used the flowchart and found it useful (83%). Qualitative data gathered suggested rolling-out the project elsewhere.
Conclusion: A lack of confidence surrounding issues with confidentiality, including information sharing, was identified. This can negatively impact patient engagement and delivery of care. The introduction of the confidentiality flowchart demonstrated improved understanding of, and confidence in, patient confidentiality issues. The small sample size means there are limitations in extrapolating findings to wider contexts. However, it is likely that more confidentiality training and practical information for NHS staff at the interface between patients, clinicians and services would reduce the risk of confidentiality breaches and reinforce positive relationships with services
Exploring the challenges for the care network of providing therapeutic support for unaccompanied asylum-seeking minors
Get PDFComplexities limiting therapeutic engagement with unaccompanied minors observed in one
CAMHS team, prompted a qualitative and explorative study into how these young people’s
needs were attended to by their care networks. An overarching Psychoanalytic framework and
the use of Thematic Analysis was applied to data collected from audio recorded group
discussions held over six weeks with foster carers, and from semi-structed interviews with a
variety of professionals who have had experience of working with unaccompanied minors. The
research question was to look at what the challenges were for these two groups in the care
network with the aim to highlight the complexities and difficulties within these relationships,
whilst at the same time enhancing understanding of the intricacies of their interactions,
including positive experiences.
Findings from the foster carer group suggested they often took a “Detective Mother” stance,
attempting to understand and make connections when faced with multiple uncertainties and
unknowns. However, this instigated fear, mistrust, and caution of what might be internalised
or enlivened within relationships resulting in the need for distance. Professionals emphasised
their struggles with time pressures and the feeling of ‘trying to get it right’ in terms of provision
offered and their communication, which ultimately ignited feelings of guilt and shame. The
flight to normalise behaviours and position themselves in the shoes of the ‘other’ dulled down
the ambiguity and trauma they often faced.
Overall, these findings highlighted that one of the greatest challenges was identifying and
remaining in touch with a young person’s needs when there were significant traumas and
multiple layers of deprivation to contend with. In addition, difference and diversity had an
impact upon the ability and availability to offer care which it is argued became laced with
unconscious animosity and institutional racism which was perpetuated within the system. It
concludes care networks would benefit from detailed and specific training, as well as safe, nonjudgemental spaces to engage in conversations about the challenges and successes of
supporting unaccompanied minors. The study also suggests that a consideration of unconscious
biases and racism, including those at a societal and political level as well as how trauma
becomes enlivened within relationships can be advantageous in understanding how therapeutic
engagement can be obstructed and obfuscated