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    Balint groups

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    Alexis Brook: The contribution of a psychotherapist in primary care

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    A foothold in paediatrics

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    Autonomic countertransference: The psychopathic mind and the institution

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    The emotional experiences of Teaching Assistants, working 1:1 with a child

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    Government policy has identified the role of schools in the support and development of emotional wellbeing of children, specifically highlighting the contribution of Teaching Assistants (TAs) to children’s welfare. Whilst previous research has focused on the instructive role of TAs, and the impact of 1:1 learning support from TAs on children with Special Educational Needs and Disability (SEN/D), there has been limited exploration of the role of TA beyond the pedagogical, when working 1:1. There is also a paucity of research considering the experience of TAs, and the emotional experience of working closely with individual children. This qualitative research sought to explore the emotional experiences of TAs engaging in 1:1 work with a child. In this study, the emotional experience of working on a 1:1 basis with a child was understood in the context of austerity and cuts within education, the changing expectations and roles of TAs, as well as the individual contexts of the TAs. Using a psychosocial approach (Hollway & Jefferson, 2013), two Free Association Narrative Interviews were completed with four TAs working at mainstream primary schools in London. All of the TAs worked on a 1:1 basis with the same child, regularly. A Reflexive Thematic Analysis (Braun & Clarke, 2019) approach was used to understand and interpret the data, using a case-study approach to consider each individual’s data as a ‘whole’. Themes drawn from each case-study were presented in the findings, then considered collectively, with pertinent psychoanalytic concepts applied. The implications of the study, for educational psychology practice and for the role of Educational Psychologists in supporting TAs with the emotional impact of their work is discussed, through the use of reflective and supervisory spaces

    The Tavistock Clinic Series

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    The Tavistock Gazette, pantomimes and books

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    What can be learned from an understanding of the lived experience of treatment journeys into psychotherapy through interviews with adolescents and their carers?

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    Exploring young people and families’ lived experiences prior to encountering a child psychotherapist in Child and Adolescent Mental Health Services (CAMHS) is a scarce area of research. Previous studies have sought to explore specific characteristics in lived experiences rather than a naturalistic phenomenological view. Alongside this, the challenges faced by NHS CAMHS services in the current socio-economic climate include underfunding and a scarcity of resources, which then result in effects such as long waiting times and increased entry criteria for services. The public are likely to view CAMHS negatively and is exacerbated by the media depicting CAMHS as a ‘failing service’, unable to effectively meet the needs of the population they serve; young people struggling with their mental health. This study explored the lived experiences of three young people and three parental figures prior to their contact with a child psychotherapist within CAMHS. Each participant took part in a single semi-structured interview which was then analysed using interpretative phenomenological analysis (IPA) to gather pertinent themes. The themes were grouped into two data sets; parental figures and young people. The IPA highlighted predominantly negative experiences in all participants regardless of data set. The experiences conveyed were characterised by some hopeful connections, but mainly involved persistent struggle and psychological deterioration which resulted in the participants using fractious and compartmentalised ways of relating in order to survive. All participants found themselves inevitably reaching a crisis point in their functioning. The discussion utilised various psychoanalytic theories in order to further highlight the negative and fractious ways of relating the participants employed. Further to this, it could be understood that the participants entered a ‘crisis state of mind’, where disturbances are not recognised as such until they reach crisis point. This is heavily influenced by current socio-economic factors and the impact that this has on NHS provision. Broader research is required to more conclusively identify the individual characteristics that may influence young people’s lived experience and help-seeking

    Usage and acceptability of the ibobbly App: A pilot trial for suicide prevention in Aboriginal and Torres Strait Islander youth

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    Background: The proliferation of mental health apps purporting to target and improve psychological wellbeing is ever-growing and also concerning: Few apps have been rigorously evaluated, and, indeed, the safety of the vast majority of them has not been determined. Over 10,000 self-help apps exist but most are not used much after being downloaded. Gathering and analyzing usage data and the acceptability of apps are critical to inform consumers, researchers, and app developers. Objective: This paper presents pilot usage and acceptability data from the iBobbly suicide prevention app, an app distributed through a randomized controlled trial. Methods: Aboriginal and Torres Strait Islander participants from the Kimberley region of Western Australia completed a survey measuring their technology use in general (n=13), and data on their experiences with and views of the iBobbly app were also collected in semistructured interviews (n=13) and thematically analyzed. Finally, engagement with the app, such as the number of sessions completed and time spent on various acceptance-based therapeutic activities, was analyzed (n=18). Both groups were participants in the iBobbly app pilot randomized controlled trial (n=61) completed in 2015. Results: Regression analysis indicated that app use improved psychological outcomes, although only minimally, and effects were not significant. However, results of the thematic analysis indicated that the iBobbly app was deemed effective, acceptable, and culturally appropriate by those interviewed. Conclusions: There is a scarcity of randomized controlled trials and eHealth interventions in Indigenous communities, while extremely high rates of psychological distress and suicide persist. In this environment, studies that can add evidence from mixed-methods approaches are important. While the regression analysis in this study did not indicate a significant effect of app use on psychological wellbeing, this was predictable considering the small sample size (n=18) and typically brief app use. The results on engagement with the iBobbly app were however positive. This study showed that Indigenous youth are early and frequent users of technology in general, and they regarded the iBobbly app to be culturally safe and of therapeutic value. Qualitative analyses demonstrated that iBobbly app use was associated with self-reported improvements in psychological wellbeing, mental health literacy, and reductions in shame. Importantly, participants reported that they would recommend other similar apps if available to their peers

    “It depends on the individual”: A psycho-social exploration of designated teachers’ and virtual school advisory teachers’ experiences of supporting looked after children in education

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    In 2019, there were 78,150 (DfE, 2019) looked after children (LAC) in the United Kingdom. According to national statistics they are underachieving by at least 28% (DfE, 2017), across all key stages of education in comparison to the general population. LAC pupils are four times more likely to have a special educational need or an education, health and care plan (EHCP). Within education there are two key organisations, schools and the virtual school, whose legal responsibility it is to coordinate and monitor the education of LAC pupils. This study is a psycho-social exploration of VSAT and DT’s experiences of supporting LAC pupils within education, both academically and emotionally. Eight interviews were conducted, four with VSATs and four with their link DTs in primary and secondary schools. Unstructured interviews were conducted applying a Free Associative Narrative Method (FANI) and each participant was interviewed once. An Activity Theory Diagram was included in the interview as an initial task, providing a conceptual map of the participants construction of the systems surrounding LAC children. Interviews were analysed using a reflexive inductive thematic analysis approach, with an additional psycho-analytic lens to explore participants unconscious emotional responses to supporting LAC pupils. Three main themes were identified: the ‘emotional labour’ of supporting LAC pupils, systemic issues within the network and the participants perspectives on LAC pupils achievement. The findings highlight the challenges for educational professionals providing educational and emotional support and implications for Educational Psychologists are discussed

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