Pub Date : 2023-10-10DOI: 10.53841/bpscypf.2023.1.8.16
Andrew Horan
Children, young people, and families who seek support from community CAMHS have experienced a disproportional number of childhood adverse experiences. Many families continue to endure uncertainty and adversity due to global events and political context (e.g. racism, poverty, and gender-based violence). Building trust within this context requires therapists to work in trauma-informed ways that focus on establishing effective therapeutic relationships. Cognitive analytic therapy (CAT) is an approach that mainly focuses on relationship patterns to help people overcome psychological distress and develop positive ways of relating that encourage emotional wellbeing. Whilst offering therapy within a child and adolescent mental health service, I have extended the use of CAT to focus on both the young person’s relationships and the relationship between caregiver-child; also referred to as a child-caregiver ‘dyad’. Theoretically, working dyadically offers advantages over individual therapy including providing opportunities to influence and overcome transgenerational patterns that may not be possible within individual sessions with young people. I have termed this way of working ‘Dyadic CAT’ and propose that there are several adaptations to individual CAT that therapists may consider when offering a dyadic intervention including: (a) identifying what to work on within therapy, (b) exploring ways of factoring in power imbalances, and (c) balancing the needs of three learners to promote discovery within therapy. CAT with dyads may also benefit from an additional phase focused on creating a ‘safe base’ prior to the reformulation phase. Early outcomes and anecdotal evidence indicate that CAT can be a successful intervention for caregiver-child dyads in promoting change and healing from transgenerational trauma. Further practice-based research is needed to develop the structure and practice of Dyadic CAT including the integration of other relational theories.
{"title":"Working together towards overcoming transgenerational trauma – Using cognitive analytic therapy with child-caregiver dyads","authors":"Andrew Horan","doi":"10.53841/bpscypf.2023.1.8.16","DOIUrl":"https://doi.org/10.53841/bpscypf.2023.1.8.16","url":null,"abstract":"Children, young people, and families who seek support from community CAMHS have experienced a disproportional number of childhood adverse experiences. Many families continue to endure uncertainty and adversity due to global events and political context (e.g. racism, poverty, and gender-based violence). Building trust within this context requires therapists to work in trauma-informed ways that focus on establishing effective therapeutic relationships. Cognitive analytic therapy (CAT) is an approach that mainly focuses on relationship patterns to help people overcome psychological distress and develop positive ways of relating that encourage emotional wellbeing. Whilst offering therapy within a child and adolescent mental health service, I have extended the use of CAT to focus on both the young person’s relationships and the relationship between caregiver-child; also referred to as a child-caregiver ‘dyad’. Theoretically, working dyadically offers advantages over individual therapy including providing opportunities to influence and overcome transgenerational patterns that may not be possible within individual sessions with young people. I have termed this way of working ‘Dyadic CAT’ and propose that there are several adaptations to individual CAT that therapists may consider when offering a dyadic intervention including: (a) identifying what to work on within therapy, (b) exploring ways of factoring in power imbalances, and (c) balancing the needs of three learners to promote discovery within therapy. CAT with dyads may also benefit from an additional phase focused on creating a ‘safe base’ prior to the reformulation phase. Early outcomes and anecdotal evidence indicate that CAT can be a successful intervention for caregiver-child dyads in promoting change and healing from transgenerational trauma. Further practice-based research is needed to develop the structure and practice of Dyadic CAT including the integration of other relational theories.","PeriodicalId":471563,"journal":{"name":"The Child & Family Clinical Psychology Review","volume":"177 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136357932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-10DOI: 10.53841/bpscypf.2023.1.8.24
Lawrence Howells
Children and Young People are being labelled with psychiatric diagnoses at higher rates than ever before (e.g. NHS Digital, 2022). This is despite significant concerns with the diagnostic model in mental health, including that it locates problems within individuals, can lead to stigmatisation and can seem insufficiently curious about their voices and experience. There are good examples of non-diagnostic approaches that are non-blaming, trauma-informed and put the voices of children, young people and families at their heart. This article describes three: Adverse Childhood Experiences, Power Threat Meaning Framework and Emotion-Based Cognitive Behaviour Therapy, showing how they can apply to clinical practice.
{"title":"Children’s mental health and diagnosis: Time for alternatives?","authors":"Lawrence Howells","doi":"10.53841/bpscypf.2023.1.8.24","DOIUrl":"https://doi.org/10.53841/bpscypf.2023.1.8.24","url":null,"abstract":"Children and Young People are being labelled with psychiatric diagnoses at higher rates than ever before (e.g. NHS Digital, 2022). This is despite significant concerns with the diagnostic model in mental health, including that it locates problems within individuals, can lead to stigmatisation and can seem insufficiently curious about their voices and experience. There are good examples of non-diagnostic approaches that are non-blaming, trauma-informed and put the voices of children, young people and families at their heart. This article describes three: Adverse Childhood Experiences, Power Threat Meaning Framework and Emotion-Based Cognitive Behaviour Therapy, showing how they can apply to clinical practice.","PeriodicalId":471563,"journal":{"name":"The Child & Family Clinical Psychology Review","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136357065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-10DOI: 10.53841/bpscypf.2023.1.8.47
Sara O’Curry, Eliane Young
Children and young people may enter a hospital system for a number of reasons including for a diagnosis of a long term, lifelimiting or life-threatening condition, a change in health status or a hospital admission for medical management of a mental health condition. All of which can be conceived of as potential traumatic stressors. For parents and families the subsequent medical investigations and treatments themselves can be traumatic to witness in a loved-one, often accompanied with a high sense of threat, and a low sense of self-efficacy and control, with outcomes often uncertain. Children, young people and families who come to the hospital come with a full range of histories and experiences, from all walks of life and all kinds of cultural backgrounds, that can impact on their ability to trust healthcare staff or to cope with the feelings evoked in this setting. Similarly, hospital staff come to their chosen careers with a range of experiences that can lead to intense emotional responses, are impacted by repeated exposure to traumatic events, and by vicarious trauma from witnessing the trauma of children, young people and families. As well as working directly with children, young people and families, a key role of the psychologist in the paediatric setting is to help contain this anxiety by helping them and staff make sense of and respond to the challenges they face, through sharing a psychological formulation, collaboration, teaching and contributing to the development of policies and procedures that enable the system to prevent, identify and respond effectively to trauma.
{"title":"Identifying and responding to trauma in children, young people and families in a hospital setting","authors":"Sara O’Curry, Eliane Young","doi":"10.53841/bpscypf.2023.1.8.47","DOIUrl":"https://doi.org/10.53841/bpscypf.2023.1.8.47","url":null,"abstract":"Children and young people may enter a hospital system for a number of reasons including for a diagnosis of a long term, lifelimiting or life-threatening condition, a change in health status or a hospital admission for medical management of a mental health condition. All of which can be conceived of as potential traumatic stressors. For parents and families the subsequent medical investigations and treatments themselves can be traumatic to witness in a loved-one, often accompanied with a high sense of threat, and a low sense of self-efficacy and control, with outcomes often uncertain. Children, young people and families who come to the hospital come with a full range of histories and experiences, from all walks of life and all kinds of cultural backgrounds, that can impact on their ability to trust healthcare staff or to cope with the feelings evoked in this setting. Similarly, hospital staff come to their chosen careers with a range of experiences that can lead to intense emotional responses, are impacted by repeated exposure to traumatic events, and by vicarious trauma from witnessing the trauma of children, young people and families. As well as working directly with children, young people and families, a key role of the psychologist in the paediatric setting is to help contain this anxiety by helping them and staff make sense of and respond to the challenges they face, through sharing a psychological formulation, collaboration, teaching and contributing to the development of policies and procedures that enable the system to prevent, identify and respond effectively to trauma.","PeriodicalId":471563,"journal":{"name":"The Child & Family Clinical Psychology Review","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136358553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-10DOI: 10.53841/bpscypf.2023.1.8.100
Katherine Miller Brunton, Kirsty Kitchen
Children’s social care (CSC) involvement during pregnancy and the first two years of a child’s life – the period known as the ‘1001 critical days’ – can have a significant impact on the mental health and wellbeing of both mothers and infants. By putting bonding and attachment between mothers and their babies at risk, this can pose long-term implications for children’s emotional and psychological development. Drawing on findings from Birth Companions’ recent projects with women with lived experience of CSC involvement, this article offers insight into the mental health impacts of assessment and/or care proceedings during the first 1001 days. The article also outlines key principles for all those working with women in these circumstances, published in the form of the Birth Companions Birth Charter for women with involvement from children’s social care (2023c). This aims to embed improved practice across all systems and services working with women with CSC involvement. Key recommendations focus on the significance of trauma-informed care for women, and the centralisation of pregnancy and early motherhood in multi-agency practice. Birth Companions is calling for this to be driven forward in the form of a joint national health and social care pathway for pregnant women and mothers of infants who are subject to pre-birth or parenting assessment, or child protection proceedings, to guide the care and support they receive up to their child’s second birthday.
{"title":"Working with women affected by children’s social care involvement in pregnancy and early motherhood: Insights from recent Birth Companions work","authors":"Katherine Miller Brunton, Kirsty Kitchen","doi":"10.53841/bpscypf.2023.1.8.100","DOIUrl":"https://doi.org/10.53841/bpscypf.2023.1.8.100","url":null,"abstract":"Children’s social care (CSC) involvement during pregnancy and the first two years of a child’s life – the period known as the ‘1001 critical days’ – can have a significant impact on the mental health and wellbeing of both mothers and infants. By putting bonding and attachment between mothers and their babies at risk, this can pose long-term implications for children’s emotional and psychological development. Drawing on findings from Birth Companions’ recent projects with women with lived experience of CSC involvement, this article offers insight into the mental health impacts of assessment and/or care proceedings during the first 1001 days. The article also outlines key principles for all those working with women in these circumstances, published in the form of the Birth Companions Birth Charter for women with involvement from children’s social care (2023c). This aims to embed improved practice across all systems and services working with women with CSC involvement. Key recommendations focus on the significance of trauma-informed care for women, and the centralisation of pregnancy and early motherhood in multi-agency practice. Birth Companions is calling for this to be driven forward in the form of a joint national health and social care pathway for pregnant women and mothers of infants who are subject to pre-birth or parenting assessment, or child protection proceedings, to guide the care and support they receive up to their child’s second birthday.","PeriodicalId":471563,"journal":{"name":"The Child & Family Clinical Psychology Review","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136358399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-10DOI: 10.53841/bpscypf.2023.1.8.5
Rachel Bradley
{"title":"Introduction to the review","authors":"Rachel Bradley","doi":"10.53841/bpscypf.2023.1.8.5","DOIUrl":"https://doi.org/10.53841/bpscypf.2023.1.8.5","url":null,"abstract":"","PeriodicalId":471563,"journal":{"name":"The Child & Family Clinical Psychology Review","volume":"253 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136358699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-10DOI: 10.53841/bpscypf.2023.1.8.41
Jack Griffiths, Elizabeth Harrhy, Marielle Wilcox
This article is a reflective piece written by the Intensive Positive Behaviour Support Service (iPBS) in South Wales. The iPBS team works with children and young people with learning disabilities and/or autism spectrum conditions, that communicate their unmet needs in ways that may challenge and are at risk of their support networks breaking down. The team works within the Positive Behaviour Support Framework and is shaped by attachment and trauma-informed research and practice. The main aims of the service are to understand unmet needs and to improve quality of life. The iPBS team completed a 1-hour reflection considering ‘hear me, don’t blame me’ and what this means to them, their roles and the service as a whole. Three key overarching themes were identified using thematic analysis: service structure, skills, and approach. The team hopes that the themes identified through this exercise will influence future iPBS processes and service delivery. The reflections explored in this article may also be beneficial for parents/carers and professionals working with a united aim of meeting the needs of children and young people presenting with behaviours of concern; beyond words. Clinical implications of the reflective piece are discussed and recommendations for other services to have their own reflections are provided.
{"title":"Beyond words: A reflection from health professionals around the meaning of ‘hear me, don’t blame me’ in relation to meeting the needs of young people with learning disabilities and autism spectrum conditions","authors":"Jack Griffiths, Elizabeth Harrhy, Marielle Wilcox","doi":"10.53841/bpscypf.2023.1.8.41","DOIUrl":"https://doi.org/10.53841/bpscypf.2023.1.8.41","url":null,"abstract":"This article is a reflective piece written by the Intensive Positive Behaviour Support Service (iPBS) in South Wales. The iPBS team works with children and young people with learning disabilities and/or autism spectrum conditions, that communicate their unmet needs in ways that may challenge and are at risk of their support networks breaking down. The team works within the Positive Behaviour Support Framework and is shaped by attachment and trauma-informed research and practice. The main aims of the service are to understand unmet needs and to improve quality of life. The iPBS team completed a 1-hour reflection considering ‘hear me, don’t blame me’ and what this means to them, their roles and the service as a whole. Three key overarching themes were identified using thematic analysis: service structure, skills, and approach. The team hopes that the themes identified through this exercise will influence future iPBS processes and service delivery. The reflections explored in this article may also be beneficial for parents/carers and professionals working with a united aim of meeting the needs of children and young people presenting with behaviours of concern; beyond words. Clinical implications of the reflective piece are discussed and recommendations for other services to have their own reflections are provided.","PeriodicalId":471563,"journal":{"name":"The Child & Family Clinical Psychology Review","volume":"253 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136358393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-10DOI: 10.53841/bpscypf.2023.1.8.74
Amy Toolis, Sarah Parry
Team formulation can provide opportunities for integrating interprofessional perspectives, leading to a rich consensus of how to support someone. Such an approach can be particularly important when working in complex environments, where it is essential that a range of professional perspectives inform a trans-professional approach to care. Youth Forensic Services are one such setting, supporting young people who face intersectional vulnerabilities and have often experienced multi-type traumas. A trauma-informed approach to team formulation facilitates a compassionate perspective to inform decision-making and care planning, encapsulating an understanding of how a young person’s past experiences of trauma may be influencing how they interact with their environment and in relationships in the here-and-now. Additionally, some therapeutic modalities may feature more dominantly within trauma-informed formulation, which may reinforce a greater theoretical basis to the formulation process, offering further opportunities for tailored, evidence-based, person-centred care.
{"title":"The role of trauma-informed formulation in increasing compassionate and person-centred care within youth forensic services","authors":"Amy Toolis, Sarah Parry","doi":"10.53841/bpscypf.2023.1.8.74","DOIUrl":"https://doi.org/10.53841/bpscypf.2023.1.8.74","url":null,"abstract":"Team formulation can provide opportunities for integrating interprofessional perspectives, leading to a rich consensus of how to support someone. Such an approach can be particularly important when working in complex environments, where it is essential that a range of professional perspectives inform a trans-professional approach to care. Youth Forensic Services are one such setting, supporting young people who face intersectional vulnerabilities and have often experienced multi-type traumas. A trauma-informed approach to team formulation facilitates a compassionate perspective to inform decision-making and care planning, encapsulating an understanding of how a young person’s past experiences of trauma may be influencing how they interact with their environment and in relationships in the here-and-now. Additionally, some therapeutic modalities may feature more dominantly within trauma-informed formulation, which may reinforce a greater theoretical basis to the formulation process, offering further opportunities for tailored, evidence-based, person-centred care.","PeriodicalId":471563,"journal":{"name":"The Child & Family Clinical Psychology Review","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136358556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-10DOI: 10.53841/bpscypf.2023.1.8.85
Sarah Beadle, Ruth Payne, Serk Suleyman, Nicola Print, Daniel Edge, Victoria Wallis, Amy D’Sa, Stephanie Harradine
This article provides an overview of some of the psychologically informed practice of supporting young people, their families and the people supporting them within Children and Young People’s Services (CYPS) in Suffolk County Council (SCC). The overview outlines the approach and experiences of the Psychology Support Service (PSS; formerly known as Suffolk Family Focus Psychology Service). The PSS enables practitioners and managers across CYPS to access specialist psychological support to enable practitioners to support children, young people, and families with a range of needs. The PSS works closely with stakeholders including frontline practitioners, managers, and workforce development. The article, therefore, also includes reflections from practice management (Early Help) and workforce development management about psychological and trauma informed practice within CYPS. It is clear from the evidence, and from our own work within PSS, that working in a psychologically and trauma-informed way is important to meet the needs of vulnerable children and young people and those who are supporting them. The Psychology Support Service: Who we are, Why we do it and What we do.
{"title":"Embedding psychological thinking within a local authority children and young people’s service; supporting, developing, and nurturing the workforce to work in a trauma informed way from the inside out","authors":"Sarah Beadle, Ruth Payne, Serk Suleyman, Nicola Print, Daniel Edge, Victoria Wallis, Amy D’Sa, Stephanie Harradine","doi":"10.53841/bpscypf.2023.1.8.85","DOIUrl":"https://doi.org/10.53841/bpscypf.2023.1.8.85","url":null,"abstract":"This article provides an overview of some of the psychologically informed practice of supporting young people, their families and the people supporting them within Children and Young People’s Services (CYPS) in Suffolk County Council (SCC). The overview outlines the approach and experiences of the Psychology Support Service (PSS; formerly known as Suffolk Family Focus Psychology Service). The PSS enables practitioners and managers across CYPS to access specialist psychological support to enable practitioners to support children, young people, and families with a range of needs. The PSS works closely with stakeholders including frontline practitioners, managers, and workforce development. The article, therefore, also includes reflections from practice management (Early Help) and workforce development management about psychological and trauma informed practice within CYPS. It is clear from the evidence, and from our own work within PSS, that working in a psychologically and trauma-informed way is important to meet the needs of vulnerable children and young people and those who are supporting them. The Psychology Support Service: Who we are, Why we do it and What we do.","PeriodicalId":471563,"journal":{"name":"The Child & Family Clinical Psychology Review","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136357249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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