'Forensic group psychotherapy': Estela Welldon's contribution to working with groups at the Portman Clinic.

In this paper the author gives a summary of the contributions made by Dr Estela Welldon to the Group Psychotherapy at The Portman Clinic. He describes how clinicians working at the Portman Clinic have evolved and adapted the principles and practices from group psychotherapy in order to work with perverse, violent, delinquent, transsexual and other specialist patient groups in what is described as `forensic group psychotherapy'. Attention is drawn to the selection of patients, composition of the group, particular differences of dynamic administration of the group, the style of the conductor, and the observed and expected group processes. The author describes his personal experience as a specialist registrar in forensic psychotherapy at the Portman Clinic working with Dr Welldon, and his continued work there as a consultant, and the continual development and evolution of forensic group psychotherapy

‘Parallel processes’: Observed in the patient, therapy and organization

In this theoretically informed clinical study the author introduces the term ‘parallel process’. Five parallel processes of ‘confusion’, ‘genital-centrality’, ‘binary rigidity’, ‘rejection’, and the ‘questioning of authenticity’ are observed in the analytic material presented by trans-gender patients in specialist small group psychotherapy, and observed similarly in the organizational context in which the group takes place. The author provides a theoretical explanation for the occurrence of such parallel processes. The author concludes that the term ‘parallel processes’ describes a phenomenon currently without definition in the existing group-analytic vocabulary and suggests it should be added as a group-analytic term to describe the processes that are clinically and theoretically detailed in this article

Study Protocol for a randomized controlled trial of mentalization based therapy against specialist supportive clinical management in patients with both eating disorders and symptoms of borderline personality disorder

The NOURISHED study: Nice OUtcomes for Referrals with Impulsivity, Self Harm and Eating Disorders.Eating Disorders (ED) and Borderline Personality Disorder (BPD) are both difficult to treat and the combination presents particular challenges. Both are associated with vulnerability to loss of mentalization (awareness of one's own and others' emotional state) In BPD, Mentalization Based therapy (MBT) has been found effective in reducing symptoms. In this trial we investigate the effectiveness and cost-effectiveness of MBT adapted for Eating disorders (Mentalization Based Therapy for Eating Disorders (MBT-ED))compared to a standard comparison treatment, Specialist Supportive Clinical Management SSCM-ED) in patients with a combination of an Eating Disorder and either a diagnosis of BPD or a history of self-harm and impulsivity in the previous 12 months

Deconstructing gender in trans-gender identities

In this theoretically informed clinical study the author draws upon the psychoanalytic and group therapeutic literature in addition to the works of Judith Butler and his own clinical group analytic work with trans-gender in order to discuss the author’s hypothesis that binary gender rigidity stands at the core of trans-gender states. The author suggests that the analytic task is to deconstruct gender and trans-gender constructions in working with these patients. In addition to working towards greater analytic understanding such an endeavour may also be considered as a social, political and cultural exercise in working towards shifts in our societal foundation matrix. Small group psychotherapy is used as a medium for these observations and as the basis for this study

Understanding violence when the perpetrator has an intellectual disability: The perceptions of professionals

From Crossref via Jisc Publications RouterHistory: epub 2017-12-18, issued 2017-12-18Aim: The research sought to enhance professional understanding of the violence perpetrated by some people with an intellectual disability. Background: The violent behaviour exhibited by some people with intellectual disabilities remains poorly understood, particularly with regard to a clear and informative definition. Design: A qualitative study investigated the views and perceptions of professionals working directly with people with an intellectual disability in different settings. Methods: Twenty-two semi-structured interviews were undertaken with professionals from a variety of backgrounds, and four themes were generated through data analysis. Findings: Themes produced comprised the degree of intellectual disability, impulsivity, intentionality and unpredictability. Findings indicated tension between understanding violence as purposeful and explaining it in relation to the intellectual disability and/or additional conditions. Conclusion: Intellectual disability is central to understanding the impact of the other three themes, though there is a professional reluctance to use such knowledge as evidence to inform practice