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The Tavistock approach to autism: Development and uncertainty
No full textJoin us for a talk on our ground-breaking work with people with autism and their families.
This event will explore the rich clinical work and innovative thinking around Autism Spectrum Condition at the Tavistock over the past five decades. We are delighted to welcome Child Psychotherapists, Sue Reid and Anne Alvarez who will describe their early ground-breaking work within the multidisciplinary Tavistock Autism Team and Workshop. Their experiences yielded clinical observations that there were some children with the condition who made significant gains in therapy, leading to developments in psychoanalytic techniques for this group. They also provided detailed insights into the nature of the condition and the role of personality. Their work underlined the importance of providing support for parents and siblings, and working with schools and wider networks.
We will also be joined by current members of the service, who will discuss the continuing influence of psychoanalytic and systemic perspectives on the Tavistock approach. It is an approach which at the same time is firmly rooted in the research around Autism’s neurodevelopmental basis. The parallels and differences in work with individuals with Learning Disabilities will be explored - in particular the stigma and marginalisation that individuals with these conditions unfortunately still face.
In recent years in the service, there has been an increasing focus in the service on supporting young adults with autism, particularly as they face the complexities of transition to adulthood. The team has also developed a diagnostic assessment service that predominantly sees adolescents. This has brought to the fore questions around the young person’s consent, giving voice to their experience and exploring the meaning of a diagnosis and concepts of neurodiversity.
The contribution of other disciplines including social work, clinical and educational psychology, speech and language therapy and psychiatry have been vital. But the most important has been the work of those who have collaborated and drawn from ideas across disciplines, true to the Tavistock tradition. We hope that we will be joined by both professionals from a range of backgrounds, and those with lived experience of Autism Spectrum Condition in our discussion of how we can continue to best support individuals and their families in the future.
For 100 years, the Tavistock and Portman has proudly been at the forefront of exploring mental health and wellbeing. From attachment theory and infant observation, to applying psychoanalytic and systemic approaches in varied settings, our ideas have led to changes in care, education, how organisations work and beyond.
Our Centenary Festival is celebrating our history and exploring contemporary issues in relation to identity, relationships and society. It is considering how we continue to draw on our heritage to provide valuable responses to contemporary and future problems from the perspective of equality and inclusion.
This event will support The Tavistock Clinic Foundation. This charity shares the fundamental aim of The Tavistock and Portman NHS Foundation Trust, which is to highlight the importance of relationships from the earliest years throughout all our lives. The Foundation supports innovative approaches to improving mental health and preventing ill-health. Read more about its work on the Tavistock Clinic Foundation website
A qualitative study of the parental perspective on the problems of children attending a Primary Pupil Referral Unit
No full textIn the academic year of 2017/2018, there were 1210 permanent exclusions and 66,105 fixed term exclusions across all UK primary schools (DfE, 2019), whilst the number of primary school aged children in Pupil Referral Units (PRU) in England has more than doubled since 2011 (Weale, 2019). It is the most vulnerable children in society who experience school exclusion (DfE, 2019). There is limited research on the experiences and views of parents of primary aged children attending a Pupil Referral Unit and this small-scale study attempts to address this gap in the literature. The aim is to both explore and understand the problems of children attending a PPRU from the perspective of their parents and their perception of the sources from which these problems emanate. Seven mothers of primary aged children attending a PRU took part in semi-structured interviews. Data was analysed using Thematic Analysis and findings were presented as key themes that arose from hearing the experiences of the mothers: Understanding the problem, No one cares and Exclusion, isolation and loneliness. This study highlighted important difficulties the mothers identified in their children, including mental health issues. Furthermore, the study also shows how the mothers had an overall negative experience with their children’s previous educational setting. Finally, the study also indicates another layer in how parents’ own difficulties impact upon their children. With the primary focus on parental views, the study’s implications for mental health professionals working in Alternative educational Provisions (including PRUs) are discussed. It is proposed that empowering parents by enhancing their own understanding and increasing their involvement will be significant in promoting wellbeing for this vulnerable population
Tatton-Brown-Rahman syndrome: Cognitive and behavioural phenotypes
No full textThe aim of this case series was to assess and characterize cognitive abilities, autistic traits, and adaptive behaviour in Tatton-Brown-Rahman syndrome (TBRS). The sample included 18 individuals with a clinical and genetic diagnosis of TBRS (11 males, seven females; mean age 17y 7mo, SD 9y 5mo, range 7y 2mo–33y 10mo). The British Ability Scales, Third Edition and the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) were administered to all participants. The Social Responsiveness Scale, Second Edition and the Vineland Adaptive Behaviour Scales, Third Edition were completed by a parent/caregiver. The majority of participants (n=15) had intellectual disability and General Conceptual Ability scores ranged from 39 to 76 (mean 53.17, SD 12.13). Participants displayed a profile of better verbal ability compared with non-verbal reasoning ability and spatial ability. Autistic traits were prevalent and eight participants scored above the cut-off on the ADOS-2, although symptoms were less pronounced in older individuals. Adaptive functioning was impaired but commensurate with intellectual ability. Overall, TBRS is associated with an uneven cognitive profile and a high prevalence of autistic traits. This has implications for identifying appropriate services and support that may be beneficial for individuals with TBRS
Lockdown and adolescent mental health: reflections from a child and adolescent psychotherapist
Get PDFThe author, a child and adolescent psychoanalytic psychotherapist working in the UK NHS, ponders the varied impacts of ‘lockdown’ on adolescents, their parents and the psychotherapists who work with them, during the COVID-19 pandemic. She asks, particularly, how psychological therapies are positioned during such a crisis, and whether the pressures of triage and emergency can leave time and space for sustained emotional and psychological care. She wonders how psychoanalytic time with its sustaining rhythm can be held onto in the face of the need for triage on the one hand and the flight to online and telephone delivery on the other. Above all, the author questions how the apparent suspension of time during lockdown is belied by the onward pressure of adolescent time, and how this can be understood by, and alongside, troubled adolescents
Laverne Antrobus on ITV News. Discussion on the psychological aspects of returning to the classroom in the midst of the Coronavirus crisis. 28 May 2020, ITV [Starts at approximately 10:39]
No full textLaverne Antrobus on BBC Breakfast. The launch of Tiny Happy People, a five-year initiative backed by Her Royal Highness The Duchess of Cambridge, to support parents and carers in developing the language and communication skills of 0-4-year-old children. 14 July 2020, BBC. [Story begins from approximately 1:12:30 with interview at approximately 1:15:23]
No full textAt the heart of the initiative is a simple message - talk to children from as early an age as possible. Laverne spoke about the important role parents can play
Exploring how a trainee child and adolescent psychoanalytic psychotherapist generates clinical formulations when undertaking assessment work: A qualitative study
Get PDFBackground information: Assessment forms a significant and important component of a child psychotherapist’s work. Petit and Midgley’s (2008) small-scale, qualitative study found that assessment equated to 45% of their work within a five-year period. Despite this, child psychotherapy assessment continues to be relatively neglected in the research literature. Focus of the study The research study explores how a trainee child psychotherapist generates formulations within their psychotherapy assessment work. This will involve the systematic analysis of the assessment encounter, incorporating an understanding of the unfolding transference and countertransference relationship and the technical approach of the assessing psychotherapist. Gap: This research study is the first to use template analysis in order to examine how clinical formulations arise as a result of child psychotherapy assessments. Methodology: A qualitative approach was used. Detailed descriptive commentaries of assessment sessions for three different case studies form the data to be analysed. This was facilitated using the hierarchical coding structure of Template Analysis. Conclusion: The application of template analysis enabled a systematic exploration of assessment data. Coding of the session data allowed for the fine detail of the communications between the child and assessing psychotherapist to be illustrated and tracked. The research demonstrates how close and detailed observation of a child can facilitate an expression of their inner world. This allowed the origin and validity of the trainee child psychotherapists formulations to be captured and evaluated. This included evidence of clinical understanding in relation to the unfolding transference-countertransference relationship. It has also provided evidence of the technical approach to undertaking assessment work
