"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

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

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

Trauma and mourning: containment and interpretation

This paper describes an understanding of complex developmental trauma and the movement that is needed from containment to mourning. The type of activity of the therapist within the therapeutic frame is dependent on the capacity of the patient to be available for interpretation. Trauma disrupts symbolic capacity, leaving the patient in a world of timeless concretism. In order to penetrate this closed system, the therapist will be required to actively work to contain the powerful anxieties of the paranoid-schizoid position, to support the development in the patient of the capacity to make use of interpretations. Loss is inevitable in trauma, and mourning the losses is the essence of working through and processing the traumatic experience

Understanding the journeys of Black Caribbean parents who have children with autism.

This qualitative study explores the journeys of Black Caribbean parents (BCPs) living in the UK who have children with autism. It focuses on the experiences, thoughts, and processes surrounding their child’s autism diagnosis, and how cultural factors intersect with them. This study contributes to a small but growing body of knowledge exploring both autism and culture. It elevates the voices of BCPs who have not yet been exclusively represented in autism research. It also presents the perspectives of a group widely reported in educational statistics (e.g., school exclusion and attainment rates), but often not heard from themselves. Six BCPs, who collectively had ten children with autism, were interviewed using semi-structured interviews. The data was analysed using a grounded theory methodology (Corbin and Strauss, 2015), resulting in the development of the essential super-advocacy theory. The essential super-advocacy theory proposes that BCPs who have children with autism are required to become ‘super-advocates’ to provide the essential, fervent, and persistent advocacy that their children will need. It presents three ‘essential super-advocacy factors’ needed to do this, which are a) enhanced autism awareness and ongoing learning, b) the ability to overcome stigma and inner conflict, and c) connection and collaborative support. The essential super-advocacy theoretical model illustrates how these factors are developed over time and across three stages. These stages involve a series of events and processes shaped by the BCP’s socio-cultural contexts and experiences. The implications of these findings consider how Black Caribbean parents and their children with autism can best be supported by professionals who work with them, including educational psychologists

Psychoanalysis, criminology and delinquency: The early history of the Portman Clinic

Founded in 1933, the Portman Clinic, now part of the Tavistock and Portman NHS Foundation Trust, in London UK, is a nationally funded out-patient clinic providing psychoanalytic psychotherapy to children, adolescents and adults who present with delinquency, violence, and problematic sexual behaviours. The Portman Clinic came into being during the interwar years, a fertile time in which psychoanalytic theories became influential within criminology. This article describes the foundation and early history of the Clinic within the wider social and political context of the early and mid-twentieth century, including the impact of the second world war and the dawn of the welfare state. It explores the ideas of the psychoanalysts Grace Pailthorpe, Edward Glover, Kate Friedlander, and Melitta Schmideberg, which were based on their work with patients at the Portman Clinic but were also shaped by the internal war within the British psychoanalytic community, the so-called Controversial Discussions. The review draws on previously unpublished clinical material from archived records of patients seen at the Portman Clinic since 1933, providing a fascinating glimpse into the profile of these patients, and how their psychopathology and offending behaviours were influenced by changing societal norms and significant historical events

Learning and unlearning through the clinical encounter: On 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

Effects of the Family Nurse Partnership on all eligible mothers: a data linkage cohort study in England

Background: An intensive programme of home visiting, the Family Nurse Partnership (FNP), is received by around one in four first-time adolescent mothers in selected areas in England. During home visits, nurses support mothers to make choices about healthy pregnancies, improving child development, and fulfilling their own aspirations and ambitions. Evidence is needed of the wider effects of the FNP, including for mothers not enrolled in the programme (who might experience unintended effects). We evaluated child and maternal outcomes for all eligible mothers giving birth before, during, and after the period in which FNP was active in local areas. Methods: We created a linked cohort of 237,185 eligible mothers, aged 13-19, who gave birth between April 2010 and March 2019, and who had a first antenatal booking appointment (or a date of 28 completed weeks of gestation, if missing) when FNP was active in their area. We used administrative hospital data to identify unplanned maternal/child hospitalisations up to 2 years after birth for children born and mothers delivering before, during and after FNP was active. Generalised linear models were used to adjust for background regional time trends, maternal characteristics, and clustering of outcomes within residential areas. Results: We found no evidence of differences in unplanned hospital admissions for children born during the FNP period (36.9% versus 36.0%, relative risk [RR] 1.01; 95% CI 0.99-1.02), or after FNP was active (37.1%, RR 1.0; 95% CI 0.95-1.06), compared with those born before FNP was active. There was no evidence of differences in child admissions for maltreatment/injury-related diagnoses or for maternal admissions for adversity-related diagnoses. Conclusion: Child and maternal outcomes were similar before, during and after FNP active periods, suggesting that the FNP did not have a wider impact on outcomes in all eligible mothers, including those not participating in the FNP

Complex trauma: the Tavistock model. A phase based multi-modal service held within a psychoanalytic frame

In this paper I hope to offer an understanding of the different kinds of complex trauma presentations we see in the Tavistock Trauma Service and will use amalgated clinical examples to illustrate these. We work in a trauma-informed manner using a phase-based approach of stabilisation and safety, trauma processing, and reintegration and reconnection. All of this is held within a psychoanalytic frame