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The haunting melody of loss in the racist imagination
No full textThis article aims to explore the appeal of racist narratives and how they are used in populist politics to manipulate and exploit, leading to a rise in xenophobia and race hate crimes. Beneath the surface of the rhetoric is a predictable constellation of thoughts and feelings that create a racist imagination whose emotional atmosphere is melancholic and potentially murderous. The entangling of grief with racism is exploited through political messaging which aims to create false narratives of hope that attempt to bring to life a regressive fantasy of a return to an idealised past, into the material reality of the present by racialising others and treating them with impunity. I consider the extent to which we can learn about the challenges of engaging with these forces by turning to the experience of working clinically with these states of mind to translate a psychoanalytic sensibility to the political, one that is sensitive to the complexity and conflation of race, class and biography
The challenges of working with child sexual exploitation and how a psychoanalytic understanding can help
No full textSexual exploitation is becoming endemic in our society. It involves victims being coerced to enter abusive sexual relationships with individuals or gangs. It can occur with children from care homes – or from more privileged backgrounds. Sexual exploitation is so addictive that it is really difficult to extract the victims. This is the first book that we are aware of that examines exploitation using a psychoanalytic framework which makes the behaviour and motives of victims and, in some cases, exploiters comprehensible. The book looks at a range of situations from care homes to refugee camps and elite schools.
We expect this book to become indispensable for social workers, psychotherapists, counsellors, and care workers who have to tackle child sexual exploitation. Giving up an addiction is a struggle. Our clinical examples show how much and what kinds of work are needed to start to release girls from their addiction to their exploiters.
The roots of vulnerability lie in an attack on the maternal function. This is reflected in the huge expansion of day-care taking children from as little as three months old. Care for mothers and children can be transformed. We demonstrate how powerful properly organised maternal-type care can be, to give young people a sound start to their lives
The voices of Looked After Children: Care leavers reflect on their experiences of placement transitions
Full text linkThis qualitative study explores the perspectives of care leavers who have experienced three or more placement moves while under the care of the Local Authority in England. The study investigates the participants’ memories of the experience of moving, whether their voices were heard by the professional network, and their perceptions of the impact of frequent placement changes. Three participants aged between 18-25 were recruited from care leavers’ services and interviewed using a semi-structured format. The data was analysed using Interpretative Phenomenological Analysis with a psychoanalytic lens to explore the lived experiences of the participants and the meanings attributed to those experiences. By exploring the first-hand experiences and perspectives of care leavers, this study aims to offer a nuanced understanding of the multifaceted impacts that frequent placement changes can have, including separations, the need for stability, loss of identity, a sense of belonging, psychological difficulties, and the impact on relationships. The findings emphasise the importance of emotional support, positive relationships, and the inclusion of young people in preparation, decision-making, and advocacy to improve services. This study aims to address a gap in qualitative research in the UK and to contribute to ongoing efforts to improve policy and practice for looked after children and care leavers
Measuring quality of life of adults with intellectual disabilities: Psychometric evaluation of the personal outcomes scale in the United Kingdom
Full text linkBackground - The Personal Outcomes Scale (POS) is a scale developed to measure quality of life of adults (18+) with intellectual disability. Previous studies have reported good fit for Spanish and Portuguese language versions of POS.
Aims - This study aimed to evaluate the factor structure of the English language version of POS when used to measure the quality of life of adults (18+) with intellectual disability in the UK.
Materials and Methods - Analysis was conducted on POS data from 310 adults with an intellectual disability. First and second order factor models and multi-level models were used to assess fit.
Results - There was poor fit to the data for all tested models. We estimated that 23% of variance in POS scores was accounted for by interviewer cluster.
Discussion - This was the first UK-based evaluation of POS and our data did not confirm the factor structure of the POS measure. The identification of systematic variability within the dataset indicates that inter-rater reliability is a potential limitation of the POS tool.
Conclusion - Further research is needed to investigate inter-rater reliability of POS interviewers and to explore factor structure
Service evaluation of a training initiative in participatory practice with children and young people for early help professionals
No full textPurpose: The purpose of this paper is to report findings from a service evaluation of a training initiative in participatory practice with children and young people (CYP) for early help (EH) professionals. The training was based on the Lundy model of child participation. Design/methodology/approach: A questionnaire-based survey was undertaken of staff completing the training. Within the sample of professionals surveyed, various work contexts were represented. Findings: Reported benefits arising from the training included increased understanding of the utility of the tenets of the Lundy model, as well as changes in practice with CYP. Barriers and issues encountered in seeking to work in a participatory way were identified in relation to time for relationship-building, resources and interprofessional and interagency working. Originality/value: The evaluation findings provide insight into ways training in participatory practice with CYP is experienced by EH professionals. The role of networks of practitioner champions in influencing participatory practice is also addressed, as well as the interface between participatory and relationship-based practice
A virtual frame – how does forensic psychotherapy work remotely?
No full textPsychotherapy has been practised via remote technology since the mid-1990s and has grown in mainstream popularity; yet, it remains controversial, particularly for psychoanalytically informed treatment, and limited research in this area has been published. However, COVID-19 provoked a necessary transition to online working across the psychotherapy profession, including clinicians providing psychoanalytic treatment to a unique forensic outpatient group remotely for the first time. This qualitative research study sought insights from this sample via grounded theory interviews and analysis to inform hypothetical future practice of remote psychotherapy via videoconferencing to forensic populations with limited access to treatment. This generated a substantive theory about how forensic psychotherapy works remotely: In the context of a forced transition to remote working, forensic psychotherapists make attempts to substitute for real by establishing an alternative frame; noticing how differently contact is mediated; adapting technique; and evaluating suitability for remote treatment. An implication of these findings may be that developing a new Virtual Frame for forensic psychotherapy, supported by specialist training and supervision, could increase its reach within settings that provide sufficient containment for the work. Further research is encouraged to support this undertaking and consider which patients, and/or clinicians, might work effectively this way
Health and wealth: A systems psychodynamic exploration of the migrant professional experience in Switzerland’s pharmaceutical industry
Full text linkLittle is known of the professionals who dedicate their careers to advancing science in the pharmaceutical industry: What might it mean for them to leave home and join this industry with its double focus on health and wealth? This qualitative research explores the experiences of migrant professionals who go to work in Switzerland’s highly regarded pharmaceutical industry, considering the question of how they take up their role given the concerns of health and wealth - easing suffering and creating profit. The question arose from my coaching work with migrant professionals where I noticed a pattern of addressing issues regarding role, power and authority through exploring the younger self whilst bracketing off the present self. This study’s research data draws from qualitative depth interviews with migrant professionals who work with or adjacent to the science. The lack of extant research opens up an opportunity for new ideas to be created using Biographic-Narrative Interpretive Method for data generation and Grounded Theory for analysis, and finally distilled into 3 ideas. The study looks at the research data through the lens of systems-psychodynamics, which, like a microscope, examines the less visible material, including unconscious communication. The ideas are: 1. A permanent state of temporality: competition and entry being regulated as migrant professionals contend with the tensions of health and wealth. 2. The bonding of migrant professional and molecule: the industry’s health and wealth focus creating an intense relationship between migrant professional and molecule. 3. Emotional refugeeism: a social defence against projections into the migrant professional and focusing on the task’s ‘uncontestable’ good. The implication for practice is a deepening view of social defences amongst migrant professionals in this industry. It may have relevance to sectors reliant on migrant professionals with a double humanitarian and financial task
Are adolescent boys from African and Caribbean heritage underrepresented in CAMHS referrals, and what are clinicians' experiences working with this group?
Full text linkResearch on Black boys and young men in the UK has been limited. At 11, Black and White boys have the same chance of being diagnosed with a mental health disorder, but when they reach adulthood, Black men are many times more likely to have severe mental health disorders. Therefore, this study was interested in what happens during adolescence, whether they are referred to mental health services, and, if so, what it is like working with them. This study completed an audit to understand the representation of Black adolescent boys (BABs) aged 11-15 in referrals to an inner-city Child and Adolescent Mental Health Service (CAMHS) in 2019. Semi-structured interviews were conducted thereafter with four CAMHS clinicians to understand their experience working with this patient group. Using local population data, the audit found that BABs were underrepresented in referrals to CAMHS. CAMHS received more than expected referrals for adolescent boys who identified as ‘White’, Mixed’, and ‘Other’. These results are limited due to the lack of specific data on ethnicity for adolescents 11-15. However, these results indicated discrepancies in referrals to CAMHS based on ethnicity. Interviews analysed using a Reflective Thematic Analysis method highlighted the need for professionals to be curious about the behaviours of BABs to understand their needs and for intersectionality to be part of clinical thinking and practice. The findings highlight the importance of supervision for clinicians to reflect on their unconscious biases and the significance of working flexibly within one’s therapeutic frame when working with differences. Building trust was found necessary when working with BABs and their families to increase engagement and accessibility. The study recommends areas for further research and highlights the responsibility of services to BABs and their families and the community
Stories of absence: Experiences of parental and familial rejection among gender-diverse children and young people
No full textPrevious research has demonstrated the positive associations with parental support with better mental health outcomes in gender-diverse young people. However, less is known about what happens within a family structure if an unsupportive parent or family member leaves the family unit and sees the child only on the condition that they present in a way that conforms to their birth gender. This paper will focus on the first interviews with nine families within the wider sample of 39 families in the LOGIC-Q (Longitudinal Outcomes of Gender Identity in Children – qualitative) study who reported they had experienced rejection by a parent or family member after the young person had disclosed their gender non-conformity. These families’ narratives are examined through two themes: How rejection impacts visitation, and Moving past the loss of rejection. The families all spoke about how they had adapted to the loss of their family members. They described how any negative impact would have been worse had they stayed living together, or were in contact with, the rejecting family member. Here, it becomes important then to understand the context of why a gender-diverse young person may choose to no longer see a parent or family member