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.

What is the Role of Attachment in Contemporary Psychotherapy? A Grounded Theory Exploration of the Perspective of Experienced Psychologists

Since Bowlby devised his theory of attachment, originally for clinical purposes, refinements and extensions have developed its clinical utility. The research question asked how experienced contemporary clinicians now perceive the role of attachment in the formulation and treatment of distress by reference to their clinical work. Using grounded theory methodology, underpinned by a relativist, moderate social constructionist epistemology, initial sampling consisted of 16 in-depth interviews with experienced clinicians. The tentative theoretical categories that emerged were then developed in theoretical sampling in further interviews with 5 of the initial interviewees. The final theoretical categories to emerge concerned the prevalence of caregiver-related problems, the provision of safety together with the prioritisation of the relationship with self as attachment-related treatment strategies, and attachment theory’s provision of understanding in problem formulation. Whilst this suggests that attachment-related ideas are integrated in contemporary practice, it also suggests that the clinical utility now offered by attachment theory, as established in the literature, has not found broad appeal amongst clinicians despite the commonness of attachment-related presenting problems. The implications of this are manifold. To begin with, attachment theorists have largely failed to bring the potential now offered by attachment-related therapeutic interventions to the market. This situation makes it incumbent on the next generation of attachment researchers to more clearly articulate techniques with which clinicians, of whatever theoretical orientation, can better leverage attachment-related knowledge in their clinical work. In this enterprise, perhaps the knowledge and experience of expert clinicians could be harvested, as this research has done. Moreover, researchers must expand the evidence base that such interventions actually work. Beyond the implications for clinical utility and efficacy, the findings strengthen counselling psychology’s influence on society’s perception and treatment of attachment-related problems.

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.

Context-Based Sound and the Ecological Theory of Perception

This paper aims to investigate the ways in which context-based sonic art is capable of furthering a knowledge and understanding of place based on the initial perceptual encounter. How might this perceptual encounter operate in terms of a sound work’s affective dimension? To explore these issues I draw upon James J. Gibson’s ecological theory of perception and Gernot Böhme’s concept of an ‘aesthetic of atmospheres’. Within the ecological model of perception an individual can be regarded as a ‘perceptual system’: a mobile organism that seeks information from a coherent environment. I relate this concept to notions of the spatial address of environmental sound work in order to explore (a) how the human perceptual apparatus relates to the sonic environment in its mediated form and (b) how this impacts on individuals’ ability to experience such work as complex sonic ‘environments’. Can the ecological theory of perception aid the understanding of how the listener engages with context-based work? In proposing answers to this question, this paper advances a coherent analytical framework that may lead us to a more systematic grasp of the ways in which individuals engage aesthetically with sonic space and environment. I illustrate this methodology through an examination of some of the recorded work of sound artist Chris Watson.

An Interview with Tony David Sampson: Author of Virality: Contagion Theory in the Age of Networks

We are delighted to have the opportunity to talk with Tony about how his work touches on issues of imitation and contagion—a loaded term unpacked within his 2013 book.