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Co-ordinating meaning within a gender identity development service: What can the theory of the co-ordinated management of meaning offer clinicians working with young people, and their families, exploring their gender identities
No full textWorking with young people who present with diverse gender identifications and their families requires consideration and acknowledgement of a range of contexts (including relationship, family, social and cultural) as well as the influences of prior experience and language. Family members often present with diverse understandings and hopes from their referral to the Gender Identity Development Service and look to us to meet these. This article considers the contribution of Cronen and Pearce who introduced the theory of the co-ordinated management of meaning (CMM). We focus on their ideas about communication, the complexities of communication, meaning, context and multiple perspectives. This article relates to our practice as well as considers useful ways to work with families and young people, within a highly contested field. Clinical examples are used to illustrate how we have made use of the theory and models of CMM to facilitate engagement, build therapeutic rapport, facilitate understanding and support those we see in a way which takes into account the many contexts of their lives
Recording without consent
No full textAdvances in technology mean that it is now possible for patients to record and video consultations on their mobile phones with ease. This can be done overtly with prior discussion with the doctor or covertly without permission
What do adolescent natal males choose to tell us about self-harm: A thematic analysis of self-harm vlogs
Get PDFSelf-harm has been described as a national health crisis amongst young people in the United Kingdom. It has become an area of growing interest in response to reports of increasing prevalence. Despite evidence that the behaviour is not solely restricted to females, the study of self-harm has been largely restricted to adolescent female samples, meaning that what is known about them is often extrapolated to provide an understanding of self-harm amongst adolescent males. In order to expand the limited evidence base on adolescent males and self-harm, this research investigated what natal males chose to share about their experiences in the vlogs they posted on You Tube. 14 vlogs were selected and analysed using thematic analysis to identify commonalities across the posts. The findings were represented in terms of six themes: Motives & Methods, Concealment, Addiction & Intensification, Emotional Expression, Thoughts about Help and Sharing Knowledge & Expertise. The study found that vloggers wanted to use their first hand experiences of self-harm to be a source of information, encouragement and support for those engaged in self- harm or those wanting to find out more about it. They wanted to let others who might be heading in the same direction as them know about the more obscure aspects of the experience which makes it difficult to stop. They spoke about how they managed the consequences of self-harming in order to maintain outward normalcy. The vlogs were delivered in a context of candour and emotional expressiveness. The limitations and implications of the study were discussed, as well as suggestions for future research
A psychosocial study exploring children’s experience of their parents’ divorce or separation
Get PDFAccording to the Office of National Statistics (2018) an estimated 42% of marriages in England and Wales now end in divorce, with half involving children under the age of 16. Despite growing evidence of the impact of divorce and separation on children’s happiness, self-esteem and behaviour there has been a paucity of research within the UK, which looks at children’s experience of their parents’ divorce or separation. This psychosocial study aimed to explore the experiences of children and young people whose parents have divorced or separated. Four children and young people who had experienced the separation of their parents’ (three males, one female) aged between 8 and 13 years old were interviewed twice about their experience using two psychoanalytically informed, free associative methods; the Grid Elaboration Method (GEM) and the Free-Association Narrative Interview (FANI). Data was analysed using Thematic Analysis. A subsequent psychosocial layer of analysis was then applied, using researcher field notes, to support an exploration of the dynamic, intersubjective and unconscious processes present during the interviews. Five themes emerged from the data and these are discussed alongside existing research and psychological theory. Unconscious processes observed through the interview process are also explored. Implications for Educational Psychologists (EPs), as well as schools and other professionals, when working with similar populations of children and young people are considered. The studies limitations and thoughts about future research are presented
Understanding more about how young people make sense of their siblings changing gender identity: How this might affect their relationships with their gender-diverse siblings and their experiences
No full textThe gender roles and identity of siblings have been found to be an important factor in the nature and quality of sibling relationships. With an increasing number of young people identifying as gender-diverse or transgender, this research aimed to develop a greater understanding of how young people make sense of their siblings’ gender diversity. Semi-structured interviews explored the experiences of eight sibling participants (aged 11–25 years) who have a sibling identifying as gender-diverse. Five overarching themes emerged from the thematic analysis of their transcribed interviews. These themes encapsulated commonalities and nuances within the sibling participants’ experiences and revealed a process of adjustment. Developing an increased understanding of transgender issues appeared to enable young people to embrace supportive roles, and as a consequence, they reported that their relationships with their gender-diverse siblings were enhanced. However, the sibling participants’ increased understanding of transgender issues also generated significant fears and concerns about their siblings’ well-being and their sibling relationships. From understanding more about these eight young people’s experiences, suggestions are given for how specialist services might best support siblings of gender-diverse young people along their processes of adjustment
Finding a place of one's own: A grounded theory approach to reviewing the developmental impact of child psychotherapy with a looked-after 2-year-old child
No full textThis chapter focuses on a single-case research study in which grounded theory methodology was applied for a retrospective analysis of the clinical material from an intensive psychotherapy treatment. It presents a brief outline of the case followed by a summary of the methodologies applied in the analysis, prior to a discussion of the material. As child psychotherapy has had a long history in the field of looked-after children, it seemed important to further the understanding of the treatment of this particular population with a focus on early development. Given that a psychotherapist’s work is so often focused on the slow and intimate development of a relationship, it is difficult to imagine what kind of research method could effectively clarify or accurately follow its finer contours. The grounded theory approach gave an opportunity to develop greater understanding about some of the themes and phenomena that lie at the heart of many child psychotherapy cases of very young looked-after children
Working with MAPPA: ethics and pragmatics
No full textMulti-agency public protection arrangements (MAPPA) have been in operation for around 18 years in England and Wales. The primary purpose is for the sharing of information between agencies regarding the risk management of offenders returning to the community from custodial and hospital settings. The legal framework regarding information by psychiatrists is not dealt with in one single policy or guidance document. Psychiatrists must use their clinical and professional judgement when engaging with the MAPPA process, mindful of guidance available from professional bodies such as the Royal College of Psychiatrists, General Medical Council and British Medical Association
Family dramas: Intimacy, power and systems in Shakespeare's tragedies
No full textMost of Shakespeare’s tragedies have a family drama at their heart. This book brings these relationships to life, offering a radical new perspective on the tragic heroes and their dilemmas. Family Dramas: Intimacy, Power and Systems in Shakespeare's Tragedies focusses on the interactions and dialogues between people on stage, linking their intimate emotional worlds to wider social and political contexts.
Since family relationships absorb and enact social ideologies, their conflicts often expose the conflicts that all ideologies contain. The complexities, contradictions and ambiguities of Shakespeare’s portrayals of individuals and their relationships are brought to life, while wider power structures and social discourses are shown to reach into the heart of intimate relationships and personal identity. Surveying relevant literature from Shakespeare studies, the book introduces the ideas behind the family systems approach to literary criticism. Explorations of gender relationships feature particularly strongly in the analysis since it is within gender that intimacy and power most compellingly intersect and frequently collide.
For Shakespeare lovers and psychotherapists alike, this application of systemic theory opens a new perspective on familiar literary territory
Body positive: Bodies, minds, trauma and becoming easeful
No full textThis paper focuses on trauma and the body. It describes mistakes made earlier in the author’s career in over-emphasising the importance of helping to bear pain and suffering. It was learnt that focusing on traumatic incidents too quickly could be profoundly unhelpful, re-triggering PTSD, dissociation and flashbacks. Recent trauma theory teaches the importance of facilitating a sense of safety before processing traumas, including using the thinking of Van der Kolk on the importance of body-awareness in trauma work. Attention is paid to autonomic nervous system states, and in particular of developing ventral vagal capacities and reducing sympathetic nervous system activity and dorsal vagal shut-down. The central role of the embodied countertransference is emphasised