"It’s better to be quiet than share”: Perspectives of secondary-aged students of British Pakistani background in seeking support for Social, Emotional & Mental Health

This research explores the perspectives of British Pakistani adolescents on seeking support for Social, Emotional, and Mental Health (SEMH) issues. The study aims to understand the cultural and gender-specific barriers and facilitators that influence help-seeking behaviours in this demographic. Utilising a qualitative methodology, data were collected through semi-structured interviews with adolescents aged 16-18 attending post-16 educational settings. The findings highlight significant cultural barriers, such as stigma, the importance of maintaining family honour, and gender-specific expectations, which inhibit open discussions about mental health and seeking professional support. Female participants reported a relatively higher inclination towards seeking help compared to their male counterparts, who often faced cultural pressures to conform to traditional masculine norms. The research underscores the need for culturally sensitive mental health interventions and greater mental health literacy within the British Pakistani community. It also suggests the importance of collaboration between educational institutions, mental health services, and community organisations to effectively address the mental health needs of British Pakistani adolescents

Qualitative Health Research: A Practical Guide for Clinical Practitioners

This accessible text supports health practitioners undertaking qualitative research to inform clinical practice, guiding readers through the decision-making process from planning and proposing, through data collection, to dissemination and impact. Qualitative research makes an important contribution to the health evidence base, including improving service provision, practitioner communication, and patient safety, as well as informing policies, generating important knowledge about health, and providing populations with a voice in the health context. Balancing the need for practitioners to operate in an evidence-informed way, the increasing role of a research culture in the health service, and the everyday clinical demands faced in practice, this book includes strategies for managing the reality of undertaking qualitative research while working in clinical practice and includes a wide range of “bite size” chapters on topics such as: Quality improvement; Evidence-based practice and practice-based evidence; Managing dual roles; Planning a project; Working with stakeholders; Ethics; Data collection methods; Conducting digital research; Recruitment and sampling; Data management; Analytical approaches; Thematic approaches; Research with vulnerable groups; Dissemination: Translating research into practice. This book is a practical resource for clinical researchers, designed to support the application of learning. Each chapter opens with learning objectives, and ends with a reflection on the chapter, integrating case examples and highlighting core issues. Practitioner experience boxes and reflective activities bring an invaluable real-world perspective to each chapter. Qualitative Health Research is the ideal text for all healthcare practitioners and trainees new to qualitative research, including those from medicine, nursing, midwifery, psychology, allied health, and public health

Supporting health and social care students stay and stay well: A conceptual framework for implementing integrated care into higher education

Integrated care demands a workforce that is confident, capable and compassionate. This is dependent on a willingness to work inter-professionally and understand the roles, standards and values of other professional groups. However, there are few examples of integrated care initiatives within higher education that aim to build the knowledge and skills required to support effective integrated, people-centred care. While satisfying, working in the helping professions is emotionally challenging and for students’ these challenges are often underestimated. Some students struggle through their studies with many failing to complete and others drop out in the early years of their careers. Understanding what supports students to thrive in their professional roles is essential to retention of a highly skilled integrated workforce. To address this challenge, this paper outlines a conceptual framework designed to promote a pedagogical environment focused on creating the conditions for integrated working. The framework is based on the “student lifecycle”, from starting to see the benefits of a career in the helping professions, developing a sense of belonging through to thriving and succeeding as future practitioners. It outlines how students are supported to develop emotional resilience, inter-professional empathy and reflexivity to help them stay and stay well in their careers

‘Naming the unnameable’: A service evaluation of a reflective practice group for foster carers

This study evaluated a reflective practice group designed to support foster carers and promote secure attachments with their foster children. Eight foster carers in South East England participated in the evaluation. A mixed-methods approach was employed: quantitative measures assessed reflective functioning, parental self-efficacy and parental stress pre- and post-intervention; qualitative data were collected through semi-structured interviews with five participants and analysed using thematic analysis. Results indicated improvements in one domain of reflective functioning. Qualitative findings highlighted themes such as the group providing a safe and therapeutic space, enhanced emotional wellbeing, and strengthened carer–child relationships. Overall, participants found the group beneficial and appropriate. The evaluation suggests that reflective practice groups may positively impact foster carers’ reflective capacities and caregiving experiences. Further research with a larger sample is recommended to substantiate these findings.

Diagnosis and management of complex post-traumatic stress disorder (C-PTSD)

Complex post-traumatic stress disorder (C-PTSD) is a new diagnosis in the International Classification of Diseases (ICD) 11.1 It is not currently recognised in the Diagnostic and Statistical Manual of Mental Disorders (DSM) 5.2 Caused by recurrent, chronic, or sustained trauma, C-PTSD has the clinical features of PTSD and symptoms that reflect the prolonged impact of sustained trauma on self-organisation, encompassing affect regulation, negative self-concept, and difficulties sustaining interpersonal relationships. Here we explain what C-PTSD is, how to recognise it, and the fundamentals of management, acknowledging that the evidence base continues to grow and evolve

Learning and Unlearning through the Clinical Encounter: Becoming a Psychoanalytic Psychotherapist

This book examines the learning process involved in becoming a psychoanalytic practitioner and presents training experiences at the Tavistock and Portman NHS Foundation Trust through the lens of both teachers and trainees. The book describes the relevant history at the Tavistock and how psychoanalytic knowledge is acquired through a process of learning from experience and the fostering of a culture of enquiry. The contributors also present their interpretations of what is meant by analytic learning and how this is acquired for a psychoanalytic attitude to become possible. The book includes a mix of chapters by more experienced clinicians setting out what can be useful in training, balanced by other chapters from more recent trainees who reflect on their development and experience of that training. Other important sections focus on the experience and importance of supervision and on how to respond to clinical challenges in training and practice, specifically public-sector-based trainings. With rich clinical vignettes and personal reflections on training experiences, this book is key reading for all psychoanalysts and psychotherapists involved or interested in training

Ethnic disparities as potential indicators of institutional racism in inpatient care within acute mental health wards: A rapid review

Purpose: Previous reviews suggest minoritised ethnic patients face inequalities in aspects of inpatient care including involuntary admission and forced medication. This rapid review aimed to identify ethnic disparities in acute adult mental health care and explore to what extent these provide evidence of institutional racism, as defined by the Macpherson report. Methods: Ovid MEDLINE, Cochrane Library, Ovid PsycINFO, Web of Science and Ovid EMBASE were searched for studies published from January 2018 to August 2024. Quality of evidence was assessed using the Joanna Briggs Critical Appraisal Tools. A synthesis of the studies was performed. Results: Quantitative studies (n = 34) revealed ethnic disparities in involuntary admission, psychiatric diagnoses, forced medication, physical restraint, seclusion, length of stay and access to appropriate services/facilities. Qualitative data (n = 2) revealed experiences of disempowerment, confusion and loss of autonomy. Collectively these findings mapped onto components identified as underlying institutional racism as defined by the Macpherson report. Conclusion: Our current evidence can be used to understand the genesis and perpetuation of insitutional racism in health care settings. This will enable us to better target intervention or change management to address issues where they arise. Further research and analyses are needed however, in order to verify whether ethnic disparities in inpatient services and treatment reflect or are themselves exacerbated or contributed to by institutional racism

Gender Identity Profiles in Autistic and Non-Autistic Cisgender and Gender Diverse Youth, and Their Caregivers

This preregistered study examined whether the gender identity phenotype differs between autistic and non-autistic children and adolescents, as well as whether gender identity traits aggregate similarly within their families. Study 1 involved four matched groups of autistic and non-autistic gender diverse youth referred to a UK specialist gender clinic, as well as cisgender autistic and non-autistic youth (n = 45 per group). Participants completed measures of gender typicality, discontentedness, anticipated future identity, and (parent-reported) dysphoria. Despite large and significant differences between cisgender and gender diverse youth across all gender-related measures, there were no significant differences between autistic and non-autistic participants within either gender group. Study 2 assessed recalled childhood gender behaviors and current gender dysphoria in the caregivers of participants from each group (N = 203). Caregivers of gender-referred youth, regardless of autism status, reported higher current dysphoric traits than caregivers of cisgender youth, but no differences were observed in recalled childhood gender-related behavior. Overall, the findings indicate that the gender phenotype of autistic youth is comparable to that of non-autistic youth within the same gender identity group, challenging the assumption that gender diversity in autism arises from different underlying mechanisms. Clinically, these results support equitable access to gender-related care for autistic and non-autistic gender diverse youth

Trauma and Recovery: The Aftermath of Violence – From Domestic Abuse to Political Terror, by Judith Herman

Trauma and Recovery by Judith Herman was published in 1992. This article explores its relevance and legacy for today in the trauma field, particularly with the new ICD-11 diagnosis of complex post-traumatic disorder

The lived experiences of masking black Autistic girls in UK education: “Before people see the autism, they see my race.”

This paper explores the lived experiences of masking and camouflaging among Black Autistic girls in UK education, addressing a significant gap in autism research and educational psychology practice. Semi-structured interviews were conducted with four participants aged 16–17, centring voices rarely represented in literature or policy. A novel framework, Kaleidoscope Analysis, was developed to interpret the data. Combining Interpretative Phenomenological Analysis (IPA), Intersectionality Theory, and Disability Critical Race Theory (DisCrit), this approach offers layered insight into how individual experiences are shaped by wider structural inequalities. Five key themes were identified: acceptance and belonging; navigating social expectations; the intersection of race, gender, and autism; sensory overload; and the importance of relational support. The findings highlight how masking emerges as a strategy for navigating environments shaped by neurotypical, racialised, and gendered expectations rooted in societal norms of Whiteness and ability. This study recommends educational psychologists (EPs) and related professionals adopt intersectional, neuro-affirming approaches in their practice, highlighting the importance of pupil voice, critical reflection, and anti-oppressive practice in creating inclusive learning environments. Future research is required to explore a wider range of intersecting identities and include Autistic individuals who use diverse forms of communication