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Facilitating work discussion groups with staff in complex educational provisions
No full textThis paper presents findings from an exploratory study of ‘work discussion groups’ (WDGs) conducted with groups of staff in three complex educational provisions (a special needs setting and two alternative provisions) facilitated by two Educational Psychologists (EPs) using Action Research. The objective was to give the group members tools to understand and develop their own emotional wellbeing and resilience. Four themes emerged from data analysis: ‘Group readiness’ – how the structure of a WDG was initially hard to follow; ‘Being heard’ – wanting to be listened to within the school; ‘Physical space’ – how the schools were physically positioned and located, and ‘Staff wellbeing’ – how the staff were able to consider their own needs. In each group, the facilitators used an ‘adapted WDG model’ to support the group members. This way of working was recognised by participants as a helpful way to come together and share ideas and reflect on practice. This suggests that the findings could have implications for staff wellbeing across complex educational settings
Parenting a child with toileting issues
No full textToileting issues in children and young people who are past the age of toilet training are a particularly sensitive, taboo subject. However, they are not uncommon, particularly in fostered and adopted children, where they are the most commonly reported physical problem. For this group, the physical explanations that can often solve the issue in the general population frequently do not address the deep-seated reasons or possible solutions to this distressing condition. Children and families can be left distressed and exhausted, while underlying emotional or psychological issues are missed.
This new title in the Parenting Matters series provides authoritative, clinical guidance for carers and adopters on why this issue can occur and what can be done about it. In straightforward language, it explains how children’s difficult early experiences can affect their behaviour, the various physical, emotional and psychological causes, how to engage with social work and health professionals to explore this difficulty, and what solutions may be offered. In the second half of the book, a range of case studies describe what it is like to parent an affected child, how families have managed the situation, and how solutions were found for the children’s problems.
This book is part of CoramBAAF’s Parenting Matters series which explores many of the health conditions commonly diagnosed in looked after children
Parenting strategies used by caregivers of children with ASD: Differential links with child problem behaviour
Get PDFHere, we explored the structure of the ‘Parenting Strategies Questionnaire’, a new scale designed to measure parenting strategies for problem behaviour in ASD. We then examined links between child behaviour and parenting in a sample of 222 predominantly-UK parents of ASD children exhibiting behaviour found difficult or challenging. Analysis revealed three parenting subscales: Accommodation, Reinforcement Approaches and Reducing Uncertainty. Both Accommodation and Reducing Uncertainty were linked to child problem behaviour. Child factors explained up to 29% of the variance in Accommodation, with Socially Inflexible Non-compliance the strongest predictor, and up to 24% of the variance in Reducing Uncertainty, with Intolerance of Uncertainty the strongest predictor. Child factors were not related to Reinforcement Approaches. Longitudinal studies investigating these relationships are needed
The measurement of adult pathological demand avoidance traits
Get PDFPathological (“extreme”) demand avoidance (PDA) involves obsessively avoiding routine demands and extreme emotional variability. It is clinically linked to autism spectrum disorder (ASD). The observer-rated EDA Questionnaire (EDA-Q) for children was adapted as an adult self-report (EDA-QA), and tested in relation to personality and the short-form Autism Screening Questionnaire (ASQ). Study 1 (n = 347) found the EDA-QA reliable, univariate, and correlated with negative affect, antagonism, disinhibition, psychoticism, and ASQ scores. Study 2 (n = 191) found low agreeableness, greater Emotional Instability, and higher scores on the full ASQ predicted EDA-QA. PDA can screened for using this tool, occurs in the general population, and is associated with extremes of personality. Future studies will examine if PDA occurs in other clinical populations
Disinhibited attachment behavior among infants of mothers with borderline personality disorder, depression, and no diagnosis.
No full textDisinhibited attachment behavior is related to early institutional rearing and to later social maladaptation. It is also seen among infants reared at home whose mothers have histories of child maltreatment or psychiatric hospitalization. However, little is known about the maternal psychiatric diagnoses that might be associated with disinhibited behavior or the mechanisms through which maternal diagnosis might influence infant behavior. In the current study (N = 59), 2 maternal diagnoses, borderline personality disorder (BPD; n = 13) and depression (n = 15), were compared with a no diagnosis group (n = 31) on extent of infant disinhibited behavior. Disinhibited infant behavior was assessed at infant age of 12–18 months using the validated Rating of Infant–Stranger Engagement. Mother–infant interaction was coded using the Atypical Maternal Behavior Instrument for Assessment and Classification. Results indicated that infants of mothers with BPD were significantly more likely to be rated as disinhibited in their behavior toward the stranger compared with infants of mothers with depression and with no diagnosis. Disinhibited behavior was further related to the quality of mother–infant interaction, and maternal frightened/disoriented interaction partially mediated the effect of maternal BPD on infant disinhibited behavior. Disinhibited behavior among previously institutionally reared infants is relatively resistant to intervention after toddlerhood and is associated with maladaptation into adolescence. Therefore, high priority should be placed on understanding the developmental trajectories of home-reared infants with disinhibited behavior and on providing early assessment and early parenting support to mothers with BPD
Personality and outcome in individuals with treatment-resistant depression—Exploring differential treatment effects in the Tavistock Adult Depression Study (TADS).
No full textObjective: Although research over the past decades has investigated the impact of the personality dimensions of dependency and self-criticism on treatment outcome, little is known of how these personality features influence responsiveness to treatment in patients with severe, chronic forms of depression. Method: The present study uses data from the Tavistock Adult Depression Study, a randomized controlled trial investigating the effectiveness of long-term psychoanalytic psychotherapy (LTPP) compared with treatment as usual (TAU) for individuals diagnosed with treatment-resistant depression. Patients were rated with the Anaclitic-Introjective Depression Assessment Q-sort, which distinguishes between two more maladaptive (Submissive and Dismissive) and two less maladaptive (Needy and Self-Critical) subdimensions of dependent or anaclitic and self-critical or introjective depression. Multilevel modeling was used to compare individuals’ growth curves of depression severity as measured by the Hamilton Rating Scale for Depression over the 18-month treatment period and 2-year follow-up. Rates of clinically significant change were also determined. Results: As expected, depressed patients with more maladaptive dependent and self-critical features did not benefit from LTPP or TAU. Patients with less maladaptive self-critical features benefited from both LTPP and TAU, while those with less maladaptive dependent features showed considerable gains from LTPP but not from TAU, with medium to large effect sizes. Conclusions: Findings of this study are consistent with existing research suggesting the need to modify and tailor treatments in accordance with individuals’ pretreatment personality features. Given the time and cost-intensive nature of longer-term treatment, this may be particularly important in patients with treatment-resistant depression
What do babies know? An exploration of the experience of Bangladeshi mothers and their infants
No full textThis chapter presents a selective account of a research journey that takes into the lived experience of a group of Bangladeshi parents, mostly mothers, reflecting on their beliefs about what they know about their babies, including in utero, and young children. It describes the setting for the research, which took place in selected Children’s Centres in the East London Borough of Tower Hamlets, and the rationale behind this. The chapter focuses on the value that the psychoanalytic perspective and receptive practice of child psychotherapists can bring to the research process and the research community. The research took place in the north-eastern part of Tower Hamlets, where the community was predominantly Bangladeshi, mostly originating from the rural Sylhet region. The research method involved six focus groups and three individual semi-structured interviews to generate the data. Each group took place in a Children’s Centre; the interviews took place in the women’s home, and all were tape-recorded
‘Don’t tell me the risks’
No full textGetting informed consent is at the forefront of doctors’ minds – but how can you best manage a scenario where a patient doesn’t want to know the risks