Psychotherapeutic work with Families with Life-threatening Maternal Illness

This exploratory research study describes a child and adolescent psychotherapeutic clinical service offered to children/adolescents and their families with mothers with a life-threatening illness. The clinical service itself was also exploratory in nature. The research objectives of the study were (i) to explore whether this form of clinical work could be beneficial for such families in relieving distress and supporting their development; (ii) to discover the factors at play within and between the family members using an adaptation of Grounded Theory research methodology; and (iii) to add to the knowledge base for adults – family members and professionals – relating to, and dealing with, such children and adolescents. Descriptions and discussion of the therapeutic input and research study are given. Symptoms, which included emotional, behavioural, psychological, learning, and interpersonal difficulties, decreased in all the children/adolescents who were offered clinical treatment within an outpatient multidisciplinary Tier 3 Child and Adolescent Service (CAMHS). Six Themes were identified across the cases and these were named: Engagement, Parental Concern, Impact of Mother’s Illness, Defences, Sustaining Factors and Feeling Different. These Themes are discussed in the light of relevant published research. A literature review was undertaken and focuses on: epidemiological context; children’s understanding of death; impact of parental bereavement in childhood; the mourning process; anticipatory grief; psychoanalysis: mourning and trauma; children’s play and drawings as communication; and psychosocial therapeutic services. The thesis has particular relevance for child and adolescent psychotherapists and other mental health professionals who work within hospital and hospice settings.

Psychotherapeutic work with Families with Life-threatening Maternal Illness

This exploratory research study describes a child and adolescent psychotherapeutic clinical service offered to children/adolescents and their families with mothers with a life-threatening illness. The clinical service itself was also exploratory in nature. The research objectives of the study were (i) to explore whether this form of clinical work could be beneficial for such families in relieving distress and supporting their development; (ii) to discover the factors at play within and between the family members using an adaptation of Grounded Theory research methodology; and (iii) to add to the knowledge base for adults – family members and professionals – relating to, and dealing with, such children and adolescents. Descriptions and discussion of the therapeutic input and research study are given. Symptoms, which included emotional, behavioural, psychological, learning, and interpersonal difficulties, decreased in all the children/adolescents who were offered clinical treatment within an outpatient multidisciplinary Tier 3 Child and Adolescent Service (CAMHS). Six Themes were identified across the cases and these were named: Engagement, Parental Concern, Impact of Mother’s Illness, Defences, Sustaining Factors and Feeling Different. These Themes are discussed in the light of relevant published research. A literature review was undertaken and focuses on: epidemiological context; children’s understanding of death; impact of parental bereavement in childhood; the mourning process; anticipatory grief; psychoanalysis: mourning and trauma; children’s play and drawings as communication; and psychosocial therapeutic services. The thesis has particular relevance for child and adolescent psychotherapists and other mental health professionals who work within hospital and hospice settings.

Live Work: The Impact of Direct Encounters in Statutory Child and Family Social Wor

The aim of this research project was to examine the impact of direct work on practitioners in the field of statutory child protection. The author’s premise was that this work was anything but straightforward and that surprisingly, given the intense scrutiny on Children’s Services following a child death, there was little research into the day-to-day practice of front line staff. The aim was to explore whether psychoanalytic theory could be useful in understanding and making sense of the social work task. Data was collected through observation and semi-structured interviews in one Local Authority Child in Need team over a period of six months. The findings indicated that practitioners experienced direct work with some individuals and families as profoundly disturbing and that this affected them physiologically as well as psychologically. These effects persisted over time and appeared very difficult for the workers to process or articulate. This could be expressed through embodied or non-verbal communication in the interview. Practitioners appeared to be ‘inhabited’ by particular clients, suggesting phenomena such as projective identification were in operation. The intensity and persistence of the impact on the practitioners appears to be directly related to the quality, nature and intensity of the psychic defences functioning for the particular client. Significantly, the research indicated that when practitioners were dealing with the negative and disturbing projections from the (adult) clients it seemed from the data that the focus on the child would slip so that the child appeared to recede from view. Symptoms experienced by the practitioners were akin to trauma and research and theory on primary and secondary trauma were considered. Other issues raised included shame, which affects the clients, practitioners and the organisation and the meaning and implications of this are explored. Links between neuroscience and projective identification are addressed as well as the role of the organisation, particularly as a container for these toxic and disturbing encounters.

How Do Young People Talk About Relationships?

Interpersonal relationships are important for young people’s social, emotional and mental wellbeing. Educational Psychologists in their work with children, young people and families play a role in promoting the social, emotional and mental wellbeing of young people. A review of previous literature suggested that young people’s voice is missing from much of the research about relationships. This research is positioned within an ontological perspective of social constructionism. It aimed to explore ways in which a group of Year 8 students used their language to talk about relationships; what meaning they drew from them, who they have relationships with and what is important about them. 13 Year 8 students participated in the study and their views were explored using semi-structured interviews. Data gathered was then scrutinised using a discourse analysis technique. Three broad discourses were drawn upon by participants: ‘Social Contract’, ‘Interpersonal Aspects’ and ‘Relationship Diversity’. Within each of these there were smaller sub-discourses and interpretive repertoires drawn upon by participants to convey action and function within their talk. Participants considered relationships as very important, though they rejected the notion of a single construct of relationships, choosing instead to draw upon relationships with different people as different types of relationship. Friendship was the primary type of relationship which young people spoke about, however, they often constructed their discourse to undermine the importance of these friendships. The research findings were incorporated within the wider literature and relevant links have been drawn between the study and psychological theories. Implications for the work of Educational Psychologists were also discussed, in terms of utilising relationships for interventions and supporting those working with young people to consider young people’s views and meaning making about relationships.