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Can the Parent Development Interview (PDI-RF) inform assessment in a CAMHs Parent-Infant Psychotherapy service? A qualitative study using Thematic Analysis
Get PDFThe assessment is a core component of the process used by Parent-Infant Psychotherapists to ascertain the presenting issues, risks and needs of the parent/s and their infant to help decide if treatment is indicated or to make further recommendations. This study aims to determine how feasible and acceptable the Parental Development Interview (PDI) is within the routine assessment and to understand its potential as an assessment tool in the service. By applying the PDI (Aber, Slade, Berger, Bresgi, Kaplan 1985), the parent’s capacity for reflective functioning could be measured to ascertain if they can hold in mind their infant's thoughts and feelings. The objective is to incorporate the validated, manualised PDI (Aber et al. 1985) within the standard outcome measure sets currently used in NHS Child and Adolescent Mental Health Service Early Years Service. It is proposed that the PDI could provide a sensitive, nuanced qualitative measure to capture key information on parental reflective functioning and the relationship between the parent and infant. Thematic analysis was used to analyse data from six semi-structured interviews of parent participants. Findings show that parents found the PDI useful and accessible to provide insight into their relationship with their infant
Difficult encounters in psychoanalytic parent work: Exploring the clinical experiences of child and adolescent psychotherapists through qualitative enquiry.
Get PDFPsychoanalytic parent-work is a routine intervention offered by Child and Adolescent Psychotherapists in the UK. However, there remains a disjointedness in clinical approaches to this complex area, and it is described as a neglected area of practice. This study explored parent-work encounters which a group of Child and Adolescent Psychotherapists found more difficult than usual, and why. Four therapists spoke about their difficult encounters in psychoanalytic parent-work, during semi-structured interviews. Data was analysed qualitatively, using Interpretative Phenomenological Analysis. Participant encounters were formulated as including contact with something threatening, linked with Klein’s “bad” object, Bion’s “nameless dread”, and concepts of vicarious trauma. These were associated with collapses of thinking or meaning making, and distress experienced at the compromised or lost ideal self. This linked with a loss of meaning or disillusionment, including inner conflict arising from the wish to avoid knowing. Whilst participant experiences offer phenomenological universality, they appeared to be exacerbated by a profession-wide reluctance to think about trauma as it presents in the external world, rather than the playroom. Idealised expectations of psychoanalysts were noted, meaning experience of professional shame and inadequacy were more likely in situations of difficulty. Lastly, containing parental experience appeared more difficult for practitioners lacking a sturdy, integrated theoretical parent-work framework to draw upon. Overall, it is suggested participants had come to a complex, multi-layered and difficult work theoretically and practically unprepared. The Child Psychotherapy profession may benefit from further thinking around psychoanalytic parent-work as it is theorised and trained for. Without this, psychoanalytic practitioners may continue to find themselves overwhelmed as they draw upon primarily dyadic models of working, within a non-dyadic ‘external’ space
Paternal PTSD or depression, adolescent mental health, and family functioning: A study of UK military families
Get PDFLimited research has explored the relationships between paternal mental health, adolescent offspring mental health, and family functioning in United Kingdom military populations. The authors investigated this in a study of 105 serving and ex-serving members of the United Kingdom Armed Forces, with adolescent offspring ages 11 to 17 years. It was found military fathers with symptoms of PTSD or depression had more family difficulties, particularly around communication. Their adolescent offspring were also more likely to meet criteria for mental health disorders. These findings demonstrate the importance of supporting military fathers and their families with mental health and well-being
Moments as a form of leadership
No full textIn this article, we want to explore leadership in the context of interactions and conversations we have had together across the three domains of aesthetics, production and explanation (Maturana, 1985; Penn, 1987; Lang et al., 1990). Our primary focus is in the domain of aesthetics from which what we explain and produce is shaped. The domain of aesthetics refers to "the emotion in the happening of living you recognise as aesthetics". Therefore, this refers to such notions as elegance, beauty, harmony, desirability, consistency, morality and ethics (Maturana, 1985)
One hour a week observing the baby. A lot or a little?
No full textThe author aims to show that observers learn a lot from presenting the idea of an observation to parents, and that, while everyone is self-conscious at the start of an observation, research suggests that many parents find that they enjoy and benefit from the weekly visits. On very rare occasions observers need to think about risk and child safeguarding with the support of teachers. Research suggests that many parents enjoy the observer's visits and enjoy observing their baby more themselves. Observers learn a lot about themselves and, in their seminars, about other babies' development. Each observation is unique as observers discover week by week about their own observed baby and the other babies' developing minds and imagination
Exploring the views of child and adolescent psychotherapists on psychoanalytic remote work carried out during the COVID-19 pandemic: A reflexive thematic analysis study
Get PDFThe COVID-19 pandemic changed the way that child and adolescent psychoanalytic psychotherapists worked, almost overnight, by requiring the vast majority of therapy to be offered remotely, using telephone or video call. As the restrictions of the pandemic have been lifted, the interest in remote psychotherapy remains as an option that could widen access to treatment. There is a need to develop guidelines on best practice for on-going remote work. Prior to the pandemic very little psychoanalytic remote work was offered to children and adolescents. The literature regarding adult patients suggests a relatively high prevalence of psychoanalytic remote work taking place in recent years. This work with adults has received a mixed reception, with questions arising on how a psychoanalytic setting and approach can be maintained remotely. This research aimed to explore the views of a team of NHS child and adolescent psychotherapists working during the pandemic. Seven members of the psychotherapy team took part in a semi-structured interview, exploring their thoughts on the scope and limitations of remote work in child psychoanalytic psychotherapy. I used Reflexive Thematic Analysis (Braun and Clarke, 2006; 2022) to generate themes that represent the participants’ views. The findings of this study suggest that there are fundamental differences between in-person and remote child psychotherapy. Most significantly the absence of the patient and therapist being physically together appears to change the nature of communication and containment in the dyad. This study tentatively suggests that young patients with significant disturbance or impoverished capacities might struggle to make good use of remote work. Minimum requirements in the young person’s physical and family environment are also described. Recommendations for further research into specific aspects of remote work are made
An exploration of the uncanny and mystical influences developing leadership thinking, in the context of rising technological complexity and declining organisational certainty
Get PDFThis thesis is based on a research study conducted into understanding the uncanny and mystical influences developing leadership thinking. Using biographical interviews, the study examines how leaders use such alternative perspectives during periods of rupture and uncertainty in their professional careers. I will also consider how personal and professional biography is convergent in participants' understanding of the need for irrational thinking in response to the increasing logic of work. The thesis will go on to explore how the formation of superordinate objects may provide containment when other complex systems appear unable to do so
Walking a tightrope without a safety net: A systems and psychodynamic exploration into the experiences of Black women in senior leadership roles in the UK
Get PDFThis study employed a systems psychodynamic approach to explore the experiences of Black
women in senior leadership roles within UK organisations. A constructivist phenomenological
enquiry was undertaken, using a psychoanalytically informed method, Free Association
Narrative Interview (FANI) - which involved semi-structured interviews with a purposive
sample of six Black women of African and African-Caribbean heritage across various sectors
in the UK. The data was analysed using Grounded Theory, with a systems psychodynamic
lens applied to augment the findings.
The study revealed that Black women in senior leadership often struggle to fully take up
authority, and their experiences can be metaphorically described as “walking a tightrope with
no safety net.” Five key themes emerged: systemic racism enacted through microaggressions;
playing it safe; a projected sense of inadequacy; masking emotions; negative stereotype
threats.
Drawing from these findings, the study proposes three theoretical ideas for organisations to
explore in order to better understand the complex dynamics shaping these challenges. It
concludes with a set of recommendations for interventions aimed at creating environments in
which Black women in senior leadership roles feel seen, safe, and authorised to lead with
confidence and authenticity.
The three theoretical ideas proposed in this study to explain the difficulties faced by Black
women in senior leadership are:
1. Black women in senior leadership roles find it difficult to take up authority because
of systemic racism enacted in overt and covert microaggressions. They experience
the system as too dangerous, prompting the use of coping strategies to survive in
role.
2. Through unconscious group processes Black women may identify with negative
projections of failure and incompetence from the dominant groups, resulting in a
sense of inadequacy in role and failure to perform in authentic ways and take up
authority.
3. Black women often draw upon internalised personal defences. These defences
influence how they take up leadership roles. If personal defences fail, they will resort
to quitting to protect themselves
Consultation to Adoptive Parents and Adoption Professionals in Child and Adolescent Mental Health: Findings From a Quality Improvement Project Analysis
No full textThe mental health vulnerability of children and young people in foster and adoptive families is well recognised, which has led to the development of dedicated posts and care pathways in mental health care provision. This article reports on learning resulting from local quality improvement work in a single child and adolescent mental health service team. This work was concerned with the ‘front door’ of access to care for these groups and specifically addresses initial consultations with adoptive parents and adoption professionals, reporting findings from an analysis of reports from consultations undertaken over a 13-month period between April 2021 and May 2022. The analysis highlights that support can be sought by these parents and professionals for diverse issues relating to mental health which is also indicative of a high level of need amongst children and young people involved with specialist mental health provision. The analysis also has wider implications for practice in demonstrating the benefits of attending to clinical data to contribute meaningfully to practice-based scholarship in this type of specialist setting
Holding the vanishing organisation: Can an 'agile' work environment facilitate emotional containment?
Get PDFOver recent decades, ‘lean’, ‘activity based’ and ‘agile’ working environments
characterised by a non-proprietorial use of space and resources, networked
communication, and porosity between experience in public, private and
organisational contexts have proliferated within organisations. As this
transformation of the physical territory for office work has taken place, the
concept of the ‘vanishing organisation’ was proposed (Cooper and Dartington,
2004; Cooper and Lousada, 2005) to provide an account of how in a networked
society, established mechanisms for sustaining emotional containment in
organisations, through the maintenance of concrete and symbolic boundaries,
appear to no longer function or even exist.
The research explores the extent to which the contemporary workplace might
be supportive of or deleterious to emotional containment in organisations and its
implications for theory, practice and research within the systems
psychodynamic approach to consulting. Social photo matrix focus groups were
convened at four organisations which deployed elements of ‘lean’, ‘activity based’ or ‘agile’ workplace design to record narratives of the felt experience of
place at work, with further data gathered from detailed case notes covering the
researcher’s engagement with each organisation and personal reflexivity, in part drawing upon their personal memory of place in a transient institutional,
organisational and domestic context as a military child.
In-case analysis was carried out using a grounded theory exercise where social
photo matrix transcript text was used to develop axial codes which for each
workplace abductively invoked Freud’s exclamation in the Aetiology of Hysteria
of “saxa loquuntur!” [the stones speak] (Freud, 1896), as well as its
manifestation of ‘murality’ (Cox, 1995; Adshead, 2019), a concept developed
within forensic psychotherapy to refer to the experience of an instrumentally
derived and beneficial experience of ‘wallness’ realised through the pairing of a
bounded perimeter with an emotionally containing organisational and
institutional culture. This exercise generated rich and emotionally evocative data
for each site relating to the felt experience of place, as well as tentative
indications of the manifestation of patterns of emotional attachment (Bowlby,
1969; Ainsworth et al., 1978), basic assumption function (Bion, 1962) and
‘commensal’, ‘symbiotic’ and ‘parasitic’ forms of containment (Bion, 1970).
Further cross-case analysis of the gathered grounded theory axial codes helped
develop the hypothesis that rather than instrumentally facilitating emotional
containment, the workplaces served to both reflect the particular forms and
levels of containment arising within each organisation’s already-existing culture,
and in certain circumstances, to reinforce them