Le script de l'intervention policière auprès des personnes en état mental perturbé : déroulement et facteurs de l'usage de force par les policiers

Travail dirigé présenté à la Faculté des études supérieures et postdoctorales en vue de l’obtention du grade de maîtrise ès sciences (M.SC) en criminologie, option sécurité intérieure

Las representaciones construidas por estudiantes universitarios acerca del modelo científico de membrana citoplasmática. Diagnóstico y relevancia en el proceso de enseñanza aprendizaje

Aprender ciencia requiere aprender modelos y reconstruirlos en el aula. Los docentes que enseñan ciencia utilizan habitualmente en sus clases modelos científicos, los cuales constituyen una forma de representar la realidad. Se les atribuye a los modelos diferentes funciones: representar estructuras y fenómenos, ayudar en la visualización de entidades abstractas o microscópicas, asistir en la interpretación de resultados experimentales, entre otras. Los modelos científicos requieren un elevado nivel de abstracción, esto hace que muchas veces el alumnado encuentre dificultad en la comprensión e interpretación de los mismos. El presente trabajo se propone caracterizar las representaciones construidas por alumnos universitarios de la carrera de Psicología sobre el modelo de membrana citoplasmática y analizar su utilidad en las clases de Biología y su relevancia en el proceso de enseñanza aprendizaje. Para este fin se utilizó como instrumento una encuesta, elaborada ad hoc, que fue procesada a través de una estrategia metodológica mixta, estableciendo categorías. A partir del análisis del modelo explícito de la membrana citoplasmática expresado por los alumnos en las respuestas, se pondrán de manifiesto las características de los modelos mentales elaborados por ellos. De los resultados se desprende que aquellas investigaciones que se propongan interpretar la manera en que las personas construyen sus representaciones sobre determinados fenómenos, aportarán a la didáctica de las ciencias para mejorar el aprendizaje de los estudiantes; por otro lado se concluye que la analogía del modelo de membrana como mosaico fluido resulta poco significativa para los alumnos, que a menudo incorporan estos conceptos memorísticamente, representando un modelo que no es completamente científico. El trabajo con imágenes exige la mediación didáctica; resulta por eso necesario que los docentes comprendan que el razonamiento basado en modelos es una habilidad altamente deseable, pero requiere extenso entrenamiento y práctica dentro del ámbito áulico

Las representaciones construidas por estudiantes universitarios acerca del modelo científico de membrana citoplasmática. Diagnóstico y relevancia en el proceso de enseñanza aprendizaje

Aprender ciencia requiere aprender modelos y reconstruirlos en el aula. Los docentes que enseñan ciencia utilizan habitualmente en sus clases modelos científicos, los cuales constituyen una forma de representar la realidad. Se les atribuye a los modelos diferentes funciones: representar estructuras y fenómenos, ayudar en la visualización de entidades abstractas o microscópicas, asistir en la interpretación de resultados experimentales, entre otras. Los modelos científicos requieren un elevado nivel de abstracción, esto hace que muchas veces el alumnado encuentre dificultad en la comprensión e interpretación de los mismos. El presente trabajo se propone caracterizar las representaciones construidas por alumnos universitarios de la carrera de Psicología sobre el modelo de membrana citoplasmática y analizar su utilidad en las clases de Biología y su relevancia en el proceso de enseñanza aprendizaje. Para este fin se utilizó como instrumento una encuesta, elaborada ad hoc, que fue procesada a través de una estrategia metodológica mixta, estableciendo categorías. A partir del análisis del modelo explícito de la membrana citoplasmática expresado por los alumnos en las respuestas, se pondrán de manifiesto las características de los modelos mentales elaborados por ellos. De los resultados se desprende que aquellas investigaciones que se propongan interpretar la manera en que las personas construyen sus representaciones sobre determinados fenómenos, aportarán a la didáctica de las ciencias para mejorar el aprendizaje de los estudiantes; por otro lado se concluye que la analogía del modelo de membrana como mosaico fluido resulta poco significativa para los alumnos, que a menudo incorporan estos conceptos memorísticamente, representando un modelo que no es completamente científico. El trabajo con imágenes exige la mediación didáctica; resulta por eso necesario que los docentes comprendan que el razonamiento basado en modelos es una habilidad altamente deseable, pero requiere extenso entrenamiento y práctica dentro del ámbito áulico

Las representaciones construidas por estudiantes universitarios acerca del modelo científico de membrana citoplasmática. Diagnóstico y relevancia en el proceso de enseñanza aprendizaje

Aprender ciencia requiere aprender modelos y reconstruirlos en el aula. Los docentes que enseñan ciencia utilizan habitualmente en sus clases modelos científicos, los cuales constituyen una forma de representar la realidad. Se les atribuye a los modelos diferentes funciones: representar estructuras y fenómenos, ayudar en la visualización de entidades abstractas o microscópicas, asistir en la interpretación de resultados experimentales, entre otras. Los modelos científicos requieren un elevado nivel de abstracción, esto hace que muchas veces el alumnado encuentre dificultad en la comprensión e interpretación de los mismos. El presente trabajo se propone caracterizar las representaciones construidas por alumnos universitarios de la carrera de Psicología sobre el modelo de membrana citoplasmática y analizar su utilidad en las clases de Biología y su relevancia en el proceso de enseñanza aprendizaje. Para este fin se utilizó como instrumento una encuesta, elaborada ad hoc, que fue procesada a través de una estrategia metodológica mixta, estableciendo categorías. A partir del análisis del modelo explícito de la membrana citoplasmática expresado por los alumnos en las respuestas, se pondrán de manifiesto las características de los modelos mentales elaborados por ellos. De los resultados se desprende que aquellas investigaciones que se propongan interpretar la manera en que las personas construyen sus representaciones sobre determinados fenómenos, aportarán a la didáctica de las ciencias para mejorar el aprendizaje de los estudiantes; por otro lado se concluye que la analogía del modelo de membrana como mosaico fluido resulta poco significativa para los alumnos, que a menudo incorporan estos conceptos memorísticamente, representando un modelo que no es completamente científico. El trabajo con imágenes exige la mediación didáctica; resulta por eso necesario que los docentes comprendan que el razonamiento basado en modelos es una habilidad altamente deseable, pero requiere extenso entrenamiento y práctica dentro del ámbito áulico

Degree classification and recent graduates’ ability: Is there any signalling effect?

Research across several countries has shown that degree classification (i.e. the final grade awarded to students successfully completing university) is an important determinant of graduates’ first destination outcome. Graduates leaving university with higher degree classifications have better employment opportunities and a higher likelihood of continuing education relative to those with lower degree classifications. This article investigates whether one of the reasons for this result is that employers and higher education institutions use degree classification as a signalling device for the ability that recent graduates may possess. Given the large number of applicants and the amount of time and resources typically required to assess their skills, employers and higher education institutions may decide to rely on this measure when forming beliefs about recent graduates’ abilities. Using data on two cohorts of recent graduates from a UK university, results suggest that an Upper Second degree classification may have a signalling role.

Diagnóstico del rendimiento académico de estudiantes de una escuela de educación superior en México

El objetivo del artículo es realizar un diagnóstico sobre la percepción de los factores que intervienen en el rendimiento académico de los estudiantes de cinco carreras universitarias en una escuela de educación superior en México, para así reconocer las áreas de oportunidad que permitan sugerir políticas y estrategias para elevar su rendimiento. Se utilizó una muestra de 1651 estudiantes, se obtuvieron los datos a partir de un cuestionario con treinta preguntas que estudian la percepción del rendimiento académico en escala tipo Likert. Se realizó un análisis factorial exploratorio que permitiera reducir los datos, facilitar la interpretación y validar el instrumento. Se identificaron tres factores: a) el rol de los profesores, b) la evaluación y c) la motivación de los estudiantes. Se llevó a cabo un análisis comparativo por carrera. Se encontró que los estudiantes perciben que la mayoría de los maestros no se preocupan por la condición de los jóvenes en situación de reprobación. Además, casi no motivan y carecen de expresiones de sentimientos de orgullo por los logros académicos de los estudiantes. La mitad de los participantes piensa que los docentes no cubren el temario en su totalidad. Se detectó que los estudiantes poseen una alta motivación siendo esto positivo porque son alumnos dedicados y responsables. Se concluye realizando una serie de sugerencias y explicando las implicaciones que tiene este trabajo para las instituciones de educación superior.

Buenas prácticas de los centros de rehabilitación laboral (CRL) para personas con enfermedad mental grave de la Comunidad de Madrid a tener en cuenta para el diseño de un nuevo modelo de gestión de los servicios de empleo

El presente artículo tiene como objetivo principal identificar las variables que explican por qué los Centros de Rehabilitación Laboral (CRL) para personas con enfermedad mental grave y duradera de la Comunidad de Madrid consiguen tasas de inserción sociolaboral cercanas al 50%, siendo un colectivo que presenta unas tasas de desempleo superiores al 80%. La metodología empleada en la investigación del recurso (documental, cualitativa y cuantitativa) demuestra que estos resultados son posibles gracias a la conjunción de varios elementos: financiación sostenible, método de trabajo, fuerte liderazgo político, trabajo con el tejido empresarial (presentando a las empresas, perfiles profesionales basados en un certero análisis de las competencias), trabajo en red, plazo de intervención marcado por la persona y la composición de los equipos multiprofesionales, entre otros factores.

Do Individual Differences in Emotion Regulation Mediate the Relationship Between Mental Toughness and Symptoms of Depression?

Mental Toughness (MT) provides crucial psychological capacities for achievement in sports,
education, and work settings. Previous research examined the role of MT in the domain of
mental health and showed that MT is negatively associated with and predictive of fewer
depressive symptoms in non-clinical populations. The present study aimed at 1) investigating
to what extent mentally tough individuals use two emotion regulation strategies: cognitive
reappraisal and expressive suppression; 2) exploring whether individual differences in
emotion regulation strategy use mediate the relationship between MT and depressive
symptoms. Three hundred sixty-four participants (M = 24.31 years, SD = 9.16) provided
self-reports of their levels of MT, depressive symptoms, and their habitual use of cognitive
reappraisal and expressive suppression. The results showed a statistically significant
correlation between MT and two commonly used measures of depressive symptoms. A small
statistically significant positive correlation between MT and the habitual use of cognitive
reappraisal was also observed. The correlation between MT and the habitual use of
expressive suppression was statistically significant, but the size of the effect was small. A
statistical mediation model indicated that individual differences in the habitual use of
expressive suppression mediate the relationship between MT and depressive symptoms. No
such effect was found for the habitual use of cognitive reappraisal. Implications of these
findings and possible avenues for future research are discussed.

Implications of coping strategies and community cohesion for mental health in Colombia

In the face of mass human rights violations and constant threats to security, there is growing recognition of the resilience of people and communities. This paper builds on such work by investigating the effects of individual coping strategies, perceived community cohesion, and their interaction on mental health symptoms in Colombia. The study was conducted five years after the mass demobilisation of the former paramilitaries and takes an exploratory quantitative approach to identify two distinct forms of coping approaches among participants living in the Caribbean coast of Colombia. A constructive coping approach included active engagement, planning behaviours, emotional support, acceptance and positive reframing of daily stressors. A destructive coping approach in this study entailed denial of problems, substance use and behavioural disengagement from day-to-day stress. In addition, the strength of perceived community cohesion, or how close-knit and effective the individuals feel about the community in which they live, was examined. Structural equation modelling revealed that a constructive coping approach was significantly related to lower depression, while a destructive coping approach predicted more symptoms of depression. Although there was not a significant direct effect of perceived community cohesion on mental health outcomes, it did enhance the effect of constructive coping strategies at the trend level. That is, individuals who used constructive coping strategies and perceived their communities to be more cohesive, reported fewer depression symptoms than those who lived in less cohesive settings. Implications for promoting constructive coping strategies, as well as fostering cohesion in the community, are discussed.

Vergonha e Solidão na Doença Mental Crónica: contributo de um estudo exploratório

Este estudo pretende explorar a natureza da vergonha, enquanto vivência emocional, e a sua relação com a solidão nos doentes mentais crónicos. Foi avaliada a vergonha interna e externa, a solidão, e estados emocionais negativos, nomeadamente a depressão, ansiedade e stress. Nesta investigação participaram 41 utentes com diagnóstico de perturbação mental. Para avaliar as variáveis psicológicas pretendidas foi utilizada a Escala de Vergonha Interna (ISS), a Escala de Vergonha Externa (OAS), A Escala de Solidão UCLA e a Escala de Depressão, Ansiedade e Stress (DASS-21). Os resultados indicaram que os doentes mentais da nossa amostra apresentam maiores níveis de vergonha comparativamente à população geral. São as mulheres que apresentam valores mais elevados de vergonha interna, enquanto os divorciados apresentam maiores índices de vergonha externa e de solidão. Os doentes que têm uma actividade laboral manifestam menores níveis de solidão e de depressão. Quanto mais elevadas as habilitações literárias dos participantes, menor é o nível de ansiedade. No estudo de comparação entre doentes institucionalizados e não-institucionalizados, verificou-se que os primeiros apresentam níveis significativamente mais elevados de ansiedade, não se distinguindo relativamente à percepção de solidão e de vergonha (interna e externa). A análise da relação entre as variáveis evidenciou que os valores de vergonha interna e de solidão estavam associados de forma positiva e elevada à depressão e de forma moderada à ansiedade e stress. Não obstante as limitações reconhecidas, o presente estudo contribuiu para um melhor conhecimento dos estados emocionais negativos nos doentes mentais. / This study aims to explore the nature of shame, while emotional experience and its relationship with loneliness in the chronic mentally ill. We evaluated the internal and external shame, loneliness, and negative emotional states, including depression, anxiety and stress. 41 users participated in this investigation with a diagnosis of mental disorder. To assess the psychological variables was intended to use Internal Shame Scale (ISS), the Foreign Shame Scale (OAS), the UCLA Loneliness Scale and the Scale for Depression, Anxiety and Stress (DASS-21). The results indicated that the mentally ill in our sample have higher levels of shame compared to the general population. They are women who have higher levels of internal shame, while the divorced have higher rates of external shame and loneliness. Patients who have a work activity demonstrate lower levels of loneliness and depression. The higher the educational level of participants, the lower the level of anxiety. In the comparative study of institutionalized patients and non-institutionalized, it was found that the former have significantly higher levels of anxiety, not distinguishing relation to the perception of loneliness and shame (internal and external). The analysis of the relationship between the variables showed that the values of internal shame and loneliness were positively associated with depression and high and moderately to anxiety and stress. Despite the recognized limitations, this study contributes to a better understanding of negative emotional states in the mentally ill.

Influence des traits et troubles de personnalité sur l’intégration au travail de personnes aux prises avec un trouble mental grave

Bien que le travail soit bénéfique et souhaité par une majorité de personnes aux prises avec un trouble mental grave (TMG), les études réalisées auprès de cette clientèle montrent des taux d’emploi d’environ 10 à 20%. Parmi les services visant le retour au travail, les programmes de soutien à l’emploi (PSE) se sont montrés les plus efficaces avec des taux de placement en emploi standard oscillant entre 50 et 60%, sans toutefois garantir le maintien en emploi. Plusieurs études ont tenté de cerner les déterminants de l’obtention et du maintien en emploi chez cette population sans toutefois s’intéresser à la personnalité, et ce, bien qu’elle soit reconnue depuis toujours comme un déterminant important du fonctionnement des individus. De plus, peu de questionnaires d’évaluation de la personnalité selon le modèle de la personnalité en cinq facteurs (FFM) ont été utilisés auprès d’une clientèle avec un TMG et ceux-ci ont montré des propriétés psychométriques ne respectant pas des normes reconnues et acceptées. Cette thèse porte sur les liens entre la personnalité et l’intégration au travail chez les personnes avec un TMG. La première partie vise la validation d’un outil de mesure de la personnalité selon le FFM afin de répondre aux objectifs de la deuxième partie de la thèse. À cet effet, deux échantillons ont été recrutés, soit 259 étudiants universitaires et 141 personnes avec un TMG. Des analyses factorielles confirmatoires ont mené au développement d’un nouveau questionnaire à 15 items (NEO-15) dont les indices d’ajustement, de cohérence interne et de validité convergente respectent les normes établies, ce qui en fait un questionnaire bien adapté à la mesure de la personnalité normale dans des contextes où le temps d’évaluation est limité. La deuxième partie présente les résultats d’une étude réalisée auprès de 82 personnes aux prises avec un TMG inscrites dans un PSE et visant à identifier les facteurs d’obtention et de maintien en emploi chez cette clientèle, particulièrement en ce qui concerne la contribution des éléments normaux et pathologiques de la personnalité. Les résultats de régressions logistiques et de régressions de Cox (analyses de survie) ont démontré que l’historique d’emploi, les symptômes négatifs et le niveau de pathologie de la personnalité étaient prédictifs de l’obtention d’un emploi standard et du délai avant l’obtention d’un tel emploi. Une autre série de régressions de Cox a pour sa part démontré que l’esprit consciencieux était le seul prédicteur significatif du maintien en emploi. Malgré certaines limites, particulièrement des tailles d’échantillons restreintes, ces résultats démontrent la pertinence et l’importance de tenir compte des éléments normaux et pathologiques de la personnalité dans le cadre d’études portant sur l’intégration au travail de personnes avec un TMG. De plus, cette thèse a permis de démontrer l’adéquation d’un nouvel instrument de mesure de la personnalité auprès de cette clientèle. Des avenues futures concernant la réintégration professionnelle et le traitement des personnes avec un TMG sont discutées à la lumière de ces résultats.

Comprometimento Organizacional, Autocriticismo e Autocompaixão em Profissionais/Cuidadores Formais que Trabalham com Pessoas com Deficiência/Doença Mental

Introdução: Alguns estudos internacionais e nacionais têm-se dedicado a estudar as caraterísticas psicológicas de profissionais/cuidadores que trabalham na área da prestação de cuidados a pessoas com doença e deficiência mental. Porém, segundo temos conhecimento são escassos ou mesmo inexistentes os estudos que abordem os níveis de autocriticismo, autocompaixão e comprometimento organizacional destes profissionais/cuidadores. Foram nossos objetivos: caraterizar uma amostra de cuidadores formais/profissionais que trabalham com pessoas com doença e deficiência mental em diferentes variáveis sociodemográficas e profissionais; analisar os níveis de autocriticismo, autocompaixão e comprometimento organizacional destes cuidadores formais/profissionais, bem como explorar as associações entre todas estas variáveis (entre si e com as variáveis sociodemográficas e profissionais). Metodologia: 55 cuidadores formais de pessoas com doença/deficiência mental (sexo feminino/n = 49, 84,5%; idade média de 45,21; DP = 10,92; variação = 22-65) preencheram um questionário sociodemográfico, o Questionário de Comprometimento Organizacional, a Escala das Formas do Autocriticismo e Autotranquilização e a Escala de Autocompaixão. Resultados: O Eu inadequado apresentou um valor médio bastante maior que o Eu detestado. O valor médio do Eu tranquilizador foi superior a qualquer dimensão de autocriticismo. O Calor-Compreensão (autocompaixão) apresentou o valor médio mais elevado e a Autocrítica o valor médio mais baixo. O Eu inadequado e detestado associaram-se positivamente às dimensões negativas de autocompaixão e o Eu tranquilizador às dimensões positivas de autocompaixão. O Comprometimento Afetivo associou-se positivamente ao Autocriticismo total. O Comprometimento Calculativo associou-se positivamente ao Eu detestado, que foi seu preditor. O Comprometimento Normativo associou-se de forma positiva ao Eu detestado, Autocriticismo total e idade negativamente ao Mindfulness. A idade foi o seu preditor. O Comprometimento Afetivo associou-se positivamente aos meses de trabalho na instituição, que foram seus preditores. Os cuidadores com um familiar com deficiência mental tiveram um valor mais baixo de Eu inadequado. Discussão: No geral, esta amostra de cuidadores formais apresentou caraterísticas psicológicas que nos tranquilizam quanto ao papel que desempenham junto de pessoas com doença/deficiência mental, mas as instituições devem sempre encontrar formas de estimular os níveis de comprometimento e autocompaixão dos seus profissionais. / Introduction: Some international and national studies have focused on studying the psychological characteristics of professionals/caregivers working with people with mental disease and intelectual disability. However, to our knowledge, the studies exploring levels of selfcriticism, self-compassion and organizational commitment in these professionals are scarce or even nonexistent. Our goals were to: characterize a sample of formal caregivers/professionals who work with people with mental illness and intellectual in different sociodemographic and professional variables; analyze the levels of selfcriticism, self-compassion and organizational commitment of these formal caregivers/professionals, as well as explore the associations between all these variables (with each other and with the sociodemographic and professional variables and professionals). Methodology: 55 caregivers of people with mental disease/intelectual disability (female/n = 49, 84.5%; mean age of 45,21; DP = 10,92; variation = 22-65) completed a sociodemographic questionnaire, the Organizational Commitment questionnaire, the Forms of Self Criticism Rating Scale and the Self- Compassion Scale. Results: Inadequate Self had na higher mean value than the Hated Self. The mean value of the Reassuring Self was higher than any dimension of selfcriticism. Self-Kindness was the one with a higher mean value (of self-compassion) and Self-Judjment the one with the lowest mean value. The Inadequate Self and the Hated Self were positively associated with the negative dimensions of selfcompassion and the Reassuring Self with the positive dimensions of selfcompassion. The Affective Commitment was positively associated to total selfcriticism. The Continuance Commitment was associated with the Hated Self (positively), being its predictor. The Normative Commitment was positively associated to the Hated Self, the total selfcriticism and age and negatively to Mindfulness. Age was its predictor. The Affective Commitment was positively associated to months of work at the institution. This variable was its predictor. Professionals with a family member with intellectual disability had a lower value of Inadequate Self. Discussion: In general, this sample of formal caregivers presented psychological characteristics that reassure us about the role that they have while working with people with mental disease/intellectual disability, but the institutions must always find ways of stimulating the commitment and selfcompassion levels of their professionals.

Blurred Lines: Performance Enhancement, Common Mental Disorders and Referral in the U.K. Athletic Population

Through the awareness-raising efforts of several high-profile current and former athletes, the issue of common mental disorders (CMD) in this population is gaining increasing attention from researchers and practitioners alike. Yet the prevalence is unclear and most likely, under-reported. Whilst the characteristics of the sporting environment may generate CMD within the athletic population, it also may exacerbate pre-existing conditions, and hence it is not surprising that sport psychology and sport science practitioners are anecdotally reporting increased incidences of athletes seeking support for CMDs. In a population where there are many barriers to reporting and seeking help for CMD, due in part to the culture of the high performance sporting environment, anecdotal reports suggest that those athletes asking for help are approaching personnel who they are most comfortable talking to. In some cases, this may be a sport scientist, the sport psychologist or sport psychology consultant. Among personnel in the sporting domain, there is a perception that the sport psychologist or sport psychology consultant is best placed to assist athletes seeking assistance for CMD. However, sport psychology as a profession is split by two competing philosophical perspectives; one of which suggests that sport psychologists should work exclusively with athletes on performance enhancement, and the other views the athlete more holistically and accepts that their welfare may directly impact on their performance. To add further complication, the development of the profession of sport psychology varies widely between countries, meaning that practice in this field is not always clearly defined. This article examines case studies that illustrate the blurred lines in applied sport psychology practice, highlighting challenges with the process of referral in the U.K. athletic population. The article concludes with suggestions for ensuring the field of applied sport psychology is continually evolving and reconfiguring to ensure that it continues to meet the demands of its clients.

Psychology and Social Work: Applied Perspectives

Successful social work practice is underpinned by knowledge, theories and research findings from a range of related disciplines, key amongst which is psychology. This timely book offers a grounded and engaging guide to psychology s vital role at the heart of contemporary social work practice. The book skilfully addresses some of the central theoretical developments in psychology from an applied perspective, and explains how these make essential contributions to the methods and theory base of social work in ways that foster critical evaluation and promote best practice. Written by two authors with extensive backgrounds in psychology and social work respectively as well as a deep understanding of the intersections of the two this book delivers a unique synthesis of perspectives and approaches, focusing on their application to the lives of individuals and families. Each chapter contains reflective points and case studies based on contemporary practice realities which are related to the Professional Capabilities Framework for Social Workers and also to the Health and Care Professions Council s Standards of Proficiency. Times have never been more challenging for social work and this book will be an invaluable source of professional support within the ever-more complex psychological worlds where social work takes place. Table of Contents 1. Introduction: The place of psychological knowledge and research in social work training and practice 2. Signposts from Developmental Psychology on Human Development over the Life Course 3. Perspectives from Clinical and Counselling Psychology on Mental Health and Illness 4. Perspectives from Social and Community Psychology: Understanding values, attitudes, diversity and community change 5. Health Psychology: Understanding health, illness, stress and addiction 6. Organizational Psychology: Understanding the individual and the organization in the social work structure 7. Forensic Psychology: Understanding criminal behaviour and working with victims of crime 8. Conclusion References Index

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.