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When called to a Coroner’s court
Get PDFDr Gabrielle Pendlebury follows last month’s advice on how to prepare for an inquest by looking at the different ways you could be involved in an inquest hearing and what to expect on the day
100 years of promoting mental health resilience
No full textDiscussion of the psychological impact of Covid-19 and pressures on the mental health workforce, as well as the history of the Tavistock and Portma
“Searching for an answer to make it all better”. A grounded theory study exploring parental drive for diagnosis; is it really autism, or a misinterpretation of behaviour?
Get PDFThe number of children being referred for an autism assessment is increasing significantly (Ballaro & Griswold, 2019). However, many children referred for assessment are not receiving a diagnosis (Monteiro et al. 2015). This is creating an extra burden on services which are already pressured, leading to increased waiting times for all. In light of scarce research into the reasons why parents think that their child’s behaviour is attributable to autism, this explanatory and exploratory study answers the research question: “What are Educational Psychologists’ views on the contexts and mechanisms that lead to parents thinking their child has autism, in cases when their child does not receive a diagnosis based on results of the ADOS?” Using qualitative methodology and a semi-structured interview design, data from interviews with six Educational Psychologists (EPs) working in a local authority was analysed, utilising critical realist grounded theory (Corbin and Strauss, 2008). The grounded theory developed from the data suggests that parents think their child’s behaviour is symptomatic of autism due to an unconscious psychological response against ideas, that they may in some way be responsible for their child’s challenging behaviour. This unconscious psychological response is sustained through confirmation bias, enabling the parent to regard their child’s difficulties as attributable to organic rather than contextual factors. Challenges which go beyond what parents feel able to cope with combined with parental anxiety; can result in thoughts about alternative explanations to autism being intolerable and therefore avoided. This grounded theory suggests a number of environmental contextual factors which contribute to these unconscious mechanisms taking place, including: the impact of technology, effects on parenting within societal change, adverse Childhood Experiences (ACEs), and socio-economic factors. Implications for EPs are explored in the discussion
Parents’ understanding and motivation to take part in a randomized controlled trial in the field of adolescent mental health: a qualitative study
No full textBackground: Little is known about why parents agree to take part in randomized controlled trials for adolescent mental health. This study aimed to investigate parents’ perspectives on participating in a trial for psychological treatment of depression. The study explored parents’ motivations, understanding of the trial and perspectives on the acceptability of the trial.
Methods: Sixty-five parents took part in this qualitative study. Their adolescent children had been randomly allocated to one of three active psychological treatments for depression as part of the IMPACT trial and were interviewed about their experiences of participating in the study. Semi-structured interviews were analysed using framework analysis.
Results: For seven of the sixty-five parents, their experience of taking part in the trial was not covered in their interview so they were excluded from the analysis. The analysis was therefore based on the data from the parents of 58 adolescents taking part in the trial. The most commonly cited motivation for taking part in the study reported by parents was a desire to help others going through similar difficulties. Parents generally reported finding trial participation acceptable, although there were aspects that some reported finding less acceptable, including randomization and the burden of research assessments. Others spoke positively about the experience of trial participation and found it enjoyable or even therapeutic. Importantly, some did not appear to have a good understanding of the trial design, including randomization and treatment allocation.
Conclusions: This study indicates that trial participation can be a positive experience for parents, yet it raises concerns about how trialists can ensure that consent is fully informed, given that some parents appeared to have a poor understanding of the trial. Future studies should seek to explore how communication with trial participants can be improved, to ensure that trial participation is fully informed. Patient and public involvement will be crucial in ensuring this communication is accessible to stakeholders
Literary reflections on creativity and despair: Meaning, mourning, and mortality in Freud, Yeats, and Auden
No full textThis paper explores the relations between the inevitability of loss and the counter-responses of creativity in psychoanalysis and poetry – particularly in Freud’s short literary essay, “On transience”, written during the First World War, and poems by W. B. Yeats and W. H. Auden. It first notes and details the structural and thematic similarities between the Freud essay and the Yeats poem “Adam’s Curse”, using the close reading methods of literary criticism or Freud’s dream-analysis. Both men achieved their lasting fame and success during the conflict-ridden first half of the twentieth century, and both died in 1939, the year in which the Second World War began. The second part of the paper focuses on three Auden poems of that year, the ominous anticipations of “September 1, 1939” and his elegiac tributes to Yeats and Freud, each of whom was a major influence on his own work and life. What connects all these texts is the issue of how creative endeavours struggle to make and preserve meaning when faced with the twin adversaries of destruction and despair
Beginnings: On being and becoming a family therapist
Get PDFThis article considers personal reflections on 'beginnings' as a tri-lensed experience amongst three systemic family therapy colleagues based in a CAMHS team: Paula, a lead family therapist; Marianne, a more recently qualified family therapist in the first year of a professional systemic doctorate and Sam, a foundation-level systemic trainee. We hope to bring forth experiences of 'beginnings' across the lifecycle of family therapy, holding in mind individual and shared narratives from personal, professional and training contexts
Trans and non-binary gender healthcare for psychiatrists, psychologists, and other health professionals
No full textGender diversity is now recognised as simply part of human diversity, rather than being pathological. This shift calls for a need for mental health professionals to adapt their practice when working with trans and non-binary people. Written by two clinicians with significant experience in this field, this book provides practical, everyday advice on what to do when seeing gender-diverse people in both inpatient and outpatient settings. It avoids focusing on academic theory or being overly political and, instead, offers straightforward, useful guidance on common issues clinicians may face, such as which ward to accommodate someone on or which name to use when. Topics include common drug interactions, differential diagnoses, complex case formulation, autistic spectrum conditions, the spectrum of sexualities, surgeries, legal and religious matters, forensic assessment, psychotherapy and mental health diagnoses. Fully relevant to contemporary practice, this is a much-needed guide for busy clinicians seeking immediate, practical and authoritative answers
Service for under-fives in the child and family department at the Tavistock: Short-term applications of psychoanalytic practice
No full textIn the footsteps of Bick: Continuing the legacy of infant observation
No full textEsther Bick was intensely passionate about her work, which she pursued with a single minded focus and dedication. Her best-known contribution to psychoanalysis was her development of infant observation, which still underpins child psychotherapy training not just at the Tavi but around the world.
Esther Bick’s pioneering legacy continues. In this 100 years of the Tavistock and Portman talk, Dilys Daws and Alexandra de Rementeria shared their first-hand experience of learning and teaching infant observation. Dilys Daws was taught by Esther Bick and Alexandra by Dilys. The two presenters talked about the central role observation plays in their clinical work and in their writing for parents. This talk will appeal to students and practitioners of child and adolescent psychotherapy and all those working with children and families. This event was chaired by Kathryn Fenton.
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