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Developing digital approaches for adolescents and young adults with autism and learning disabilities: Tools to facilitate access and shared decision-making
No full textAims: Digital living is now an integral part of many children and young people's (CYP) everyday experience. Practitioners who work with them are increasingly focused on effectively deploying technology to help those with social, emotional and mental health (SEMH) needs. Throughout all aspects and phases of work, practitioners must adhere to legal and professional best practice standards in involving service users, person-centred working and in enhancing accessibility for all. Methods: Measures introduced to reduce the spread of Covid-19 triggered significant service delivery change in a specialist multi-disciplinary child and adolescent mental health service (CAMHS) team. The majority of assessment and intervention work moved to an online audio and web conferencing platform. A shared decision-making approach was developed to support service user understanding of online appointments and to giving informed consent, in line with the i-THRIVE Framework for system change (Wolpert et al., 2019). Three Guides were developed and distributed ahead of online appointments: written, easy-read and video. Findings: Data collected within a Quality Improvement (QI) framework indicated that the Guides supported practitioners to prepare service users, as well as themselves, for digital working. The Guides supported service access, collaborative decision-making and increased CYP autonomy. Their introduction also led to conversations about equity and cultural responsiveness, as well as serving as a model for the development of aids to support shared decision-making for autism diagnostic assessments. Limitations: This paper outlines the first phase of the QI project with a small participant sample and requires further engagement with service users to review the use of Guides and shared decision-making decision aids. Conclusions: Digital approaches present new possibilities and are rapidly changing service delivery across CAMHS. The importance of involving service users in shared decision-making when developing digital practices must be held in mind as part of this change process
‘Half alive, half dead’ boys: sexuality and censorship in Wilfred Bion’s ‘The long weekend’
No full textThis paper traces Wilfred Bion’s disrupted sexual development from young child in India to schoolboy in England, as described in his autobiography ‘The long weekend’. It discusses the meaning of Bion’s baffling descriptions of sex at his Hertfordshire boarding school, where he puts the topic front and centre, yet affords it a peculiar kind of censorship, via an understanding of the moral and religious way that boys’ sexuality in segregated boarding schools was viewed and dealt with during the Edwardian era. The paper explores the stifling impact this had on Bion’s creativity. It also describes how Bion’s personal qualities of courage, his capacity to observe and his interest in the truth, helped to counterbalance the destructiveness that had led him to reject relationships. The emotional deprivation, bleakness and aggression he recalls are viewed as being of interest to child psychotherapists working with contemporary adolescent sexual difficulties
Taking stock and looking to the future: a discussion of the findings of, and tensions within, a multimethod research study with a view to how it might be taken forward
No full textThis paper presents an overview of the author’s doctoral research project, a two-pronged study using both qualitative and quantitative methods. Excerpts of observation material based on video-recorded interactions between mother and infant are presented and discussed, in relation to a psychoanalytic framework with a focus on infantile phantasy. The author also describes the process of developing an assessment scale that attempts to render the rich qualitative data of the observation transcripts as numerical data for comparison with other available quantitative clinical assessments, for the mother-infant pairs studied. The author reflects on some of the challenges of the project and explores possible new directions it could take
Joey Essex: Grief and me. 16 Jun 2021. BBC2
No full textAfter ten years in the reality TV spotlight, it might appear that everything in Joey Essex’s life is ‘reem’. But fame and a luxury lifestyle haven’t been able to heal the grief he has kept inside for 20 years. Now, as he turns 30, Joey wants to embark on a deeply personal journey to take stock of his life and, for the sake of his future, finally confront his past. Every year, 41,00 young people lose a parent in the UK. At the age of just ten, Joey’s world was ripped apart when his mum tragically took her own life. Unable to comprehend the loss, Joey has spent the next 20 years of his life burying his grief. He has kept his emotions hidden, rarely spoken about his mother and avoided having pictures of her in his home. But now, as he leaves his twenties behind, he is ready to confront his trauma so he can move forward with his life. With the help of a clinical psychologist, Dr Stephen Blumenthal
How trauma can affect everyday life with consultant psychiatrist in psychotherapy Jo Stubley
No full textI used to think of trauma in terms of war and soldiers but actually trauma can affect anyone and impact every day life. Its effects can be felt in the brain and the body.
In this episode I talk to Dr Jo Stubley, who leads the adult section of the Trauma Service at the NHS's Tavistock Centre. Find out what trauma and PTSD is and what might make some people more susceptible to it. We also talk about how trauma memories are stored in different way to normal memories and perhaps most important of all, how to recognise trauma and begin to heal
Bourdieu’s contribution to psychoanalytic thinking in the context of research
No full textThis article explores the added value that the application of the conceptual tools of French sociologist, Pierre Bourdieu (1930–2002), has the potential to bring to psychoanalytic thinking. Drawing on evidence derived from our individual studies, we aim to demonstrate how Bourdieu’s theories can contribute to our understanding of workers’ occupational choices and add to our knowledge of the way organisational cultures combine with personal attributes to either sustain people in their jobs or drive them out. Given we have practice backgrounds informed by psychoanalytic and psychosocial theory and undertook our Professional Doctorates in Social Work at the Tavistock Centre in London, which strongly promotes psychoanalytic ideas, it may seem surprising that we chose to utilise sociological concepts with which we were largely unfamiliar. However, upon studying Bourdieu’s key concepts of habitus, field, capital and practice we recognised their relevance and ability to bring fresh insights to our research findings
Child psychoanalytic psychotherapy in primary schools: Tavistock approaches
No full textThis book investigates the experiences of severely troubled children and their families, teachers, and child psychoanalytic psychotherapists working together in primary schools.
The book begins by looking at children’s emotional life during the primary school years and what can disrupt ordinary, helpful social development and learning. It examines what child psychoanalytic psychotherapy is, how it works, and why it is offered in primary schools. The following chapters intersperse accounts of creative child psychoanalytic approaches with interviews with parents, carers, teachers, and clinicians. A section focusing on mainstream primary schools presents parent–child interventions for a nursery class; child group psychotherapy with children from traumatized families; and consultation to school staff, with personal accounts from parents, a kinship carer, a family support worker, a deputy head, and a child psychotherapist. Chapters then focus on alternative educational settings, featuring a school for children with severe physical and cognitive disabilities; a primary pupil referral unit; and a therapeutic school. These chapters show psychotherapy with a non-verbal boy with autism; therapy groups with children who have missed out on the building blocks of development alongside reflective groups for school staff; and child psychotherapy approaches at lunchtime and in breaks, with insights from a parent, a clinical lead nurse, a head teacher, and a child psychotherapist. Finally, there is an evaluation of evidence about the impact of child psychotherapy within primary schools.
Recognizing the increasing importance of attending to the emotional difficulties of children whose relationships and learning are in jeopardy, this book will be invaluable to all those working in primary schools, to commissioners of child mental health services, to parents and carers, and to experienced and training clinicians
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