Clinical Child Psychology and Psychiatry current issue

Editorial: Organizational Matters

Brazier, A., Wren, B. — Wed, 16 Sep 2009 03:38:32 PDT

Enough's Enough: Conversations with Myself and Other Practitioners

Southall, A. — Wed, 16 Sep 2009 03:38:32 PDT

Amidst considerable media focus on the stresses and strains on health services personnel who choose to leave the service, the author interviewed child mental health colleagues about how they coped with organizational stress in the UK National Health Service (NHS). The themes that emerged suggest that clinical staff feel senior managers have lost touch with what is described as the primary task — that of caring for the children and families that use the service. Practitioners feel undervalued and overwhelmed by nonclinical activities. Although stressed, the kinds of coping mechanisms described are likely to maintain high levels of stress, rather than reduce them. It is suggested that the cognitive dissonance paradigm explains both the stressful nature of practitioner experience and the tendency for clinical staff to work even harder in circumstances of perceived oppression. Perceptual Control and general systemic theories may help provide a framework in which to understand the dynamic forces at work that maintain the clinical and senior management groups in a state of perpetual conflict.

Working Appreciatively to Improve Services for Children and Families

Onyett, S. — Wed, 16 Sep 2009 03:38:32 PDT

Service improvement approaches are described that specifically focus on appreciating the positive that individuals bring to contexts related to children and family services. This includes application of Solution-Focused approaches, Appreciative Inquiry and other approaches that promote a positive emotional climate and focus on what works. Their conceptual foundations are explored and particularly their value in supporting working well with complex adaptive systems. Specific applications described include leadership and management practice, work in school settings, engaging clinicians in healthcare improvement, establishing clinical networks, work with homeless youth, child protection and approaches to drawing out best practice and community development. The theme that unites is a focus on developing effective relationships at all levels and a pragmatic focus on what works so that we can find opportunities to do more of it.

Do Unconscious Processes Affect Educational Institutions?

Hinshelwood, R.D. — Wed, 16 Sep 2009 03:38:32 PDT

In this article I discuss the way that aspects of school and teaching have unconscious roots. Where anxiety about the process, for teachers and children, is high then there is the risk that unconscious defensive processes may occur resulting in institutionalized phenomena. These take the form of cultural attitudes and common practices which may not necessarily enhance the work and in some cases may actively interfere.

Test of Time: A Case Study in the Functioning of Social Systems as a Defence Against Anxiety: Rereading 50 Years On

Lawlor, D. — Wed, 16 Sep 2009 03:38:32 PDT

In this paper I revisit Isabel Menzies’s classic ‘nursing paper’ (I.E.P. Menzies [1960]. A case-study in the functioning of social systems as a defence against anxiety: A report on a study of the nursing service of a general hospital. Human Relations, 13, 95—121). I outline the main findings of the paper and connect it to the major theoretical developments made by the Tavistock Institute of Human Relations and consider the current relevance of the paper in the contemporary field of health and social care.

Soapbox: Interprofessional Working: Choice or Destiny?

Cooper, A. — Wed, 16 Sep 2009 03:38:32 PDT

This article suggests that there may be profound obstacles to our capacity to work together effectively across professional or disciplinary boundaries. These problems are rooted in our love of ourselves and our professions and our dislike of those not like us, dynamics which are also central to the production of our positive professional identities. Such a thickly textured notion of professional identity is at odds with contemporary health and welfare policy trends which stress ‘role performance’ as the start and finish of professional activity. Such shallow concepts of identity are an affront to the real ethical difficulties facing us as we struggle to move beyond professional narcissism and engage with the different professional ‘other’.

Visiting the Native Land

Sands, E. — Wed, 16 Sep 2009 03:38:32 PDT

A Controlled Clinical Evaluation of the Parents Plus Children's Programme: A Video-based Programme for Parents of Children Aged 6 to 11 with Behavioural and Developmental Problems

Coughlin, M., Sharry, J., Fitzpatrick, C., Guerin, S., Drumm, M. — Wed, 16 Sep 2009 03:38:32 PDT

This article describes the development and the clinic-based evaluation of the Parents Plus Children’s Programme (PPCP), a group-based video-modelling-assisted programme for parents of children aged 6 to 11 referred to a Child Mental Health Service with significant behavioural problems both with and without associated developmental difficulties. In evaluating the programme, a sequential block design was used to assign 74 parents of children referred to the service to the PPCP group (n = 42) or the Treatment as Usual (TAU) Comparison Group (n = 32). Assessment took place before and immediately following the 8-week intervention for both groups and at 5-month follow-up for the PPCP Group. Compared to the TAU Group postprogramme, the PPCP Group displayed significant reductions in total difficulties and conduct problems as measured by the Strengths and Difficulties Questionnaire, decreased parental stress, increased parental confidence and significant improvements in parent-defined problems and goals. These positive changes were maintained at 5-month follow-up for the PPCP group, in addition to further significant improvements in peer problems and prosocial behaviour. The analysis also suggests that the programme is more effective for parents of children with behavioural problems only, than for those with associated developmental difficulties. The strengths and limitations of the study are discussed, as well as the difficulties of conducting practice-based research.

Attachment Research and Eating Disorders: A Review of the Literature

O'Shaughnessy, R., Dallos, R. — Wed, 16 Sep 2009 03:38:32 PDT

The aim of this article is to review the clinical literature which examines the association between attachment patterns and eating disorders with a focus on anorexia nervosa, and to examine the varieties of methods and measures employed in attachment research. A literature review was carried out and the relevant articles are examined in terms of their contribution to this area. The literature indicates a number of important considerations when working with this group, including extreme separation anxiety and unresolved loss and trauma, and discusses the implications of these findings for treatment. The results also indicate conflicting evidence regarding associations between attachment style and eating disorder subgroup suggesting that severity of disorder matters more than eating disorder subtype. The different ways of investigating attachment patterns and experiences are explored in this paper. It is suggested that the attachment classification system runs the risk of reducing complex human experience to typologies and that qualitative research might help to address this problem.

Medically Unexplained Physical Symptoms in Children: Exploring Hospital Staff Perceptions

Furness, P., Glazebrook, C., Tay, J., Abbas, K., Slaveska-Hollis, K. — Wed, 16 Sep 2009 03:38:32 PDT

Many children present at GP surgeries with debilitating symptoms with no obvious physical cause and are then referred to acute settings for investigation. Research with GPs suggests caring for this group of patients presents a significant challenge, however, the impact upon the range of hospital staff with whom they have contact has been little studied. This study aimed to explore perceptions and experiences of caring for children with medically unexplained physical symptoms (MUPS) and their families among the paediatric staff at one large UK hospital Trust. Data demonstrated staff awareness that children affected by MUPS have complex needs and the perception that those needs resulted in extra demands and anxieties, especially regarding time management, care protocols and communication. There was a clear desire by general paediatric staff for more information and training from psychiatric services to help them care for this group. Results also revealed staff perceptions of the quality of current MUPS care and suggestions as to how this could be improved.

Understanding and Knowledge of Psychiatric Treatment Among Adolescents and Adults

Wed, 16 Sep 2009 03:38:32 PDT

We evaluated the level of adolescent psychiatric patients’ knowledge and understanding of their treatment in light of their competency to participate in decision-making processes related to their receiving treatment, and compared the adolescents’ levels of understanding and knowledge to those of adult psychiatric patients. The study group consisted of 30 adolescents and 30 adults who were randomly selected from the inpatients of our mental health center. Consenting participants were interviewed and their objective knowledge of psychiatric treatments was evaluated by a specially designed questionnaire. Adolescents knew significantly more about adverse effects of treatment and showed a higher level of comprehensive general knowledge. These data indicate that adolescents are no less knowledgeable than adults and should be regarded as competent partners in the process of therapeutic decision making.

A Qualitative Exploration of Children's Understanding of Indiscriminate Friendliness

Bennett, J., Espie, C., Duncan, B., Minnis, H. — Wed, 16 Sep 2009 03:38:33 PDT

Eight young people (aged 9—14) were interviewed about indiscriminately friendly behaviour. The majority of the sample had a history of maltreatment and placements within foster and care settings. These young people were described as indiscriminately friendly by clinicians, guardians and via the Relationships Problems Questionnaire. Interview transcripts were analysed using Interpretative Phenomenological Analysis, a qualitative methodology. Emergent themes were drawn from interview data which highlighted the young people’s experiences of rejection and feelings of insecurity within their social interactions. While being aware of the risks associated with speaking to strangers and the efforts of adults attempting to protect them from the potential danger associated with indiscriminate friendliness, this group of young people demonstrated a trust of new people and a craving for kindness from others. Evidence was also collected which showed that these children attempted to exert control over others during social contact. These findings offer clinicians an insight into the social interactions of this vulnerable group of children and offer considerations for clinical practice.

Letter to the Editors

Lask, B. — Wed, 16 Sep 2009 03:38:33 PDT

Book Review: Tiffany Field, The Amazing Infant: Touch Research Institute at the University of Miami School of Medicine. Oxford: Blackwell, 2007, 272 pp. ISBN 140515392X, {pound}18.99 (pbk)

Edge, J. — Wed, 16 Sep 2009 03:38:33 PDT

Book Review: Celia A. Brownell & Claire B. Kopp (Eds.), Socioemotional Development in the Toddler Years, Transitions and Transformations. New York: Guilford Press, 2007. 481 pp. ISBN 9781593854966, {pound}37.50 (hbk)

Bacon, H. — Wed, 16 Sep 2009 03:38:33 PDT

Book Review: E. Storch, G. Geffken, & T. Murphy (Eds.), Handbook of Child and Adolescent Obsessive-compulsive Disorder. Abingdon: Routledge, 2007. 432 pp. ISBN 0805862544. {pound}47.50 (pbk)

Gallop, C. — Wed, 16 Sep 2009 03:38:33 PDT

Book Review: Kim S. Golding, Nurturing Attachments: Supporting Children Who Are Fostered or Adopted. London: Jessica Kingsley, 2008, 239 pp. ISBN 9781843106142

Rushton, A. — Wed, 16 Sep 2009 03:38:33 PDT

Book Review: Lorraine Bell & Jenny Rushforth, Overcoming Body Image Disturbance: A Programme for People with Eating Disorders. Abingdon: Routledge, 2008, 146 pp. ISBN 9780415423304

Titley, M. — Wed, 16 Sep 2009 03:38:33 PDT

Book Review: Cathy A. Malchiodi (Ed.), Creative Interventions with Traumatized Children. London: Guildford Press, 2008, 332 pp. ISBN 9781593856151, {pound}25.95

Davies, J. — Wed, 16 Sep 2009 03:38:33 PDT

Book Review: Stephen J. Bagnato, Authentic Assessment for Early Childhood Intervention: Best Practices (Guilford School Practitioner Series). London: The Guilford Press, 2007. 315 pp. ISBN 1593854749. _27.00

Eaton, J. — Wed, 16 Sep 2009 03:38:33 PDT

Book Review: Evelyn M. Field, Bully Blocking: Six Secrets to Help Children Deal with Teasing and Bullying. London: Jessica Kinglsey Publishers, 2007, 254 pp. ISBN 9781--843105541. {pound}12.99

Farr, N. — Wed, 16 Sep 2009 03:38:33 PDT

Book Review: Keith Hawton, Karen Rodham, and Emma Evans, By Their Own Young Hand: Deliberate Self-harm and Suicidal Ideas in Adolescents. London: Jessica Kingsley, 2006. 264 pp. ISBN 1843102307. {pound}17.00 (pbk)

Hill, K. — Wed, 16 Sep 2009 03:38:33 PDT

Book Review: Patricia Crittenden, Raising Parents: Attachment, Parenting and Child Safety. Cullompton: Willan, 2008. 381 pp. ISBN 9781843924982. {pound}29.95

Peile, L. — Wed, 16 Sep 2009 03:38:33 PDT

Book Review: L. Seiler, Cool Connections with Cognitive Behaviour Therapy: Encouraging Self-Esteem, Resilience and Well-Being in Children and Young People Using CBT Approaches. London: Jessica Kingsley Publishers, 2008

Gallop, C. — Wed, 16 Sep 2009 03:38:33 PDT

Book Review: J. Derisley, I. Heyman, S. Robinson and C. Turner, Breaking Free from OCD: A CBT Guide for Young People and Their Families. London: Jessica Kingsley, 2008

Gallop, C. — Wed, 16 Sep 2009 03:38:34 PDT

Book Review: E. Tronick, The Neurobehavioral and Social-Emotional Development of Infants and Children. London: Norton, 2007. 571 pp. $55.00

Davies, J. — Wed, 16 Sep 2009 03:38:34 PDT