A qualitative evaluation of reflective practice groups on acute adult mental health inpatient units

Working on inpatient psychiatric wards requires the ability to maintain a calm and compassionate demeanour in the face of patient distress. This article considers the role of flexible Reflective Practice Groups (RPGs) as a means of supporting staff to manage the impact of this distress on their own wellbeing, whilst maintaining an ethically sound practice.Peer reviewe

Across the Great Divide: reflecting on dual positions in Clinical Psychology to enhance equality and inclusion between those working in and those referred to services

In the United Kingdom there are guidelines and policies to facilitate boundaries within professional interactions which recognise power differences between those employed in services and those referred to them. However, perhaps we must acknowledge that these boundaries may have indirectly resulted in an unbridgeable division between professionals and those that use services in current professional policies. This paper considers what it means to be a Clinical Psychologist and user of services or carer with the complexity that surrounds this dual position. Through incorporating personal reflections, it seeks to highlight how hard it can be to break down ‘them and us’ barriers despite the best intentions of the profession and policy makers. The suggestion is that to be truly equal and inclusive we must shift from relating differently to service users, professionals and professionals who may use services by acknowledging our personal positions; otherwise breaking down barriers will remain an ideal rather than a reality. When it comes to our overall well-being breaking down these barriers could shift us from direct or oblique misunderstandings, judgements and stigma towards understanding, tolerance and acceptance within and between all of us.Peer reviewedFinal Accepted Versio

The psychological impact of the secondary school transition on families of autistic children

© 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/The transition from primary to secondary school is a stressful period for autistic individuals. However, less isknown about parental experiences of the school transition, and its impact on the family. This study exploredmothers’perspectives on the psychological impact of the transition to secondary school for their autistic chil-dren and their families. Using Interpretative Phenomenological Analysis, semi-structured interviews were ana-lysed to explore the experiences of eight mothers of autistic children at the end of their child’s first year insecondary school. The analysis revealed two superordinate themes: lack of available support and detrimentalpsychological impact on the family. Mothers reported the negative impact the transition had on themselves,their child, and the wider family. The importance of pre- and ongoing transition support was highlighted toreduce the concerns of children and their parents throughout the transition process. The findings highlightedthe need for autism-specific individualized guidance, as well as considering the potential for transition issuesto impact on siblings.Peer reviewe

The hardest part is knowing I will survive: The use of music and creative mediums to enhance empathy and facilitate life-long distance learning in professionally qualified clinicians

© Redfame Publishing Inc.Music is an experience that can cross personal and professional domains alongside cultural, gender, age and generational boundaries; it can also enhance the learning process through emotional processing and connection. This paper focuses on the learning experience of qualified clinical psychologists (CPs) working in the United Kingdom. This group of CPs had experience of undertaking experiential learning and reflective writing during their professional training. It considers the potential to continue a learning process, 3 years post qualification, through long distance methods using vignette-based material. Empathising with, and understanding, the position of others from differing backgrounds is an important competency within the therapeutic work of CPs and this comes alongside acknowledging and understanding ones‟ own experiences, both past and present. CPs work with difficult life experiences and complex issues; connecting constantly can be exhausting and, perhaps, unrealistic. Yet, to truly empathise one must connect with, and understand, the lived experiences of others. We will consider what helps and hinders this process, and how music and other creative mediums can be effectively used in learning even via long distance methods. We will further consider how CPs may be well placed to enhance the learning about, and processing of, difficult emotional experiences for themselves, other clinicians and the people they might work with.Peer reviewe

Emotional earthquakes in the landscape of psychosis: : an interpretative phenomenology

This document is the Accepted Manuscript version of the following article: Jonathan Hutchins, John Rhodes, and Saskia Keville, 'Emotional earthquakes in the landscape of psychosis: an interpretative phenomenology', Vol. 9, e30, January 2016. The Version of Record is available online at DOI: https://doi.org/10.1017/S1754470X16000167. COPYRIGHT: © British Association for Behavioural and Cognitive Psychotherapies 2016. Published by Cambridge University Press.Traditionally studies have neglected emotion in psychosis, possibly as a consequence of psychiatry’s emphasis on psychotic symptoms rather than individuals’ lived experience of emotions before, during and after psychotic episodes. This study sought to investigate how individuals experienced their emotions and delusions in the context of psychosis. A qualitative Interpretative Phenomenological Analysis (IPA) research methodology was used. Semi-structured interviews were conducted with a purposively sampled group of eight participants recruited from a local Early Intervention in Psychosis service. Four themes were generated by the analysis. The first highlighted emotional experiences prior to the onset of psychosis: ‘struggling with life distress’. The second highlighted the intense emotional experience within psychotic experiences: ‘transformed world and intense emotion’. The third theme highlighted self-critical tendencies in the post-onset phase of psychosis: ‘blame and guilt after the breakdown’. The final theme highlighted a mixture of emotions in the post-onset phase: ‘confusion, despair and hope’. There were many clinical implications highlighted in the study including the value of normalizing participants’ emotional experiences in order to promote engagement in services and of assessing for self-criticism, despair and hope following the psychotic experience, alongside therapeutically addressing the varying levels of emotional experiences before, during and after a psychotic breakdown.Peer reviewedFinal Accepted Versio

Mothers’ Perspectives of Co-occurring Fatigue in Children with Autism Spectrum Disorders

© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/4.0/).Background: Fatigue seems deeply associated with Autism Spectrum Disorders (ASD) as reflected by the preferred terms ‘autistic fatigue’ and ‘autistic burnout’. In ASD there is also a greater prevalence of sensory and cognitive demands, and medical conditions where persistent fatigue can be a symptom. This may contribute to some of the debilitating levels of fatigue evidenced, impacting on children with ASD and families. Objective: As parents caring for a child with ASD experience high levels of stress this study aimed to provide a deeper understanding of the lived experiences of parenting a child with ASD with co-occurring fatigue. Design: An interpretative phenomenological analysis was used to analyse semi-structured interviews from six mothers of children with ASD aged 4 to 19 who also had severe levels of co-occurring fatigue. Results: Four superordinate themes were generated: The experience of fatigue; Making sense of their child’s fatigue; Managing fatigue; Accepting needs and limitations. Mothers developed understanding of their child’s fatigue, guiding their child to self-regulate. As mismanagement increased meltdowns and emotional outbursts, managing fatigue was perceived to be a key aspect of living with the phenomenon. Conclusion: The findings reflect the impact of extreme fatigue on a child with ASD and families, supporting recent recommendations which state managing energy levels and reducing stressors is essential to prevent burnout in those with ASD and co-occurring fatigue. Better understanding, recognition and diagnosis would support parents, as would greater flexibility in schools to help children with ASD to better manage the demands of the school day.Peer reviewe

British Teachers’ knowledge and awareness of Tourette Syndrome in children attending mainstream school

© 2022 The Authors. This is an open access article under the terms of the Creative Commons Attribution License, https://creativecommons.org/licenses/by/4.0/Mainstream primary and secondary schools are increasingly committed to the inclusion of students with Tourette Syndrome (TS). This qualitative study explores teachers' perceptions of factors that have contributed to, or hindered, their success in creating an inclusive environment for children with Tourette Syndrome (TS). Eight teachers (2 males, 6 females) from mainstream primary and secondary schools in the United Kingdom (UK) took part in semi-structured interviews to ascertain their knowledge, training and experience of TS during their professional careers in the UK. Thematic analysis of the transcripts revealed three main themes: Teachers’ lack of real knowledge and awareness of Tourette Syndrome; Training provision and marginalisation of Tourette Syndrome; and finding solutions and building alliances. While many of the teachers described their mainstream school as an inclusive environment, many still believed they lacked the professional training to adequately understand the disorder. By enhancing teacher training related to TS, improvements may be seen in the communications between the teachers and parents, and opportunities to educate children and the wider community will also result in a more inclusive environment, reducing specific and generic stressors for children with TS.Peer reviewe

Mothers’ Experiences of Accessing Mental Health Care for their Child with an Autism Spectrum Disorder

© 2020 Springer. This is the accepted manuscript version of an article which has been published in final form at https://dx.doi.org/10.1007/s10826-019-01662-8Objectives: Despite the recognition that a high proportion of individuals with an Autism Spectrum Disorder (ASD) will also reach the diagnostic threshold for at least one other mental health condition, many families struggle to access the appropriate mental health support. This study aimed to systematically explore the lived experiences of raising a child with an Autism Spectrum Disorder (ASD) and comorbid mental health condition and describes their attempts to access support via mental health services in the UK. Methods: Seven mothers of children aged between 11 to 15 years with ASD and who were referred for mental health issues, took part in semi-structured interviews. Interpretative Phenomenological Analysis (IPA) of the transcribed interviews revealed gaps and inconsistencies within the process of gaining access to mental health services, in addition to the impact it had on the mothers’ own mental health. Results: The themes generated were psychological impact on caregiver; negative experience accessing mental health services, and breakdown in relationships with professionals. Managing the impact of their child’s mental health condition, including suicidal ideation and self-harm, alongside their child’s neurological condition, commonly led to feelings of isolation, self-blame, guilt and powerlessness; impacting on the mother’s own mental health. Conclusions: The themes emphasised the importance of ensuring appropriate referrals are made, enhancing the therapeutic alliance with both the child and parent during the referral process, and in providing continuity of care.Peer reviewe

Anxiety in female adolescents with autism spectrum disorder: Lessons for healthcare professionals

This is an open access article distributed under the Creative Commons Attribution License, to view a copy of the license, see: https://creativecommons.org/licenses/by/4.0/Despite awareness of the high prevalence of anxiety in females with autism spectrum disorders (ASD), females report high unmet service needs regarding mental health concerns. Aim: This study explored experiences of anxiety in female adolescences with ASD, their management of it, and their experiences of mental health services in the United Kingdom. Methods: Utilising an Interpretative Phenomenological Analysis, six females with ASD, aged between 13 to 15 years and referred to mental health services, took part in semi-structured interviews. Results: The analysis generated the following themes: the central experience of anxiety; the impact of the surrounding world; mismatch between needs and support; and the value of self-management. The themes emphasised a need for a more general acceptance of ASD-related anxiety triggers such as sensory overload and uncertainty to change. Discussion: Adolescents raised concerns around the appropriateness of support provided for their anxiety, including awareness raising initiatives around ASD which only served to heighten their anxiety. Conclusions: Healthcare professionals need to have a better understanding of ASD-related anxiety in females. To improve outcomes, better service knowledge and communications around ASD-related anxiety are important for the assessment of anxiety as well as tailored ASD interventions.Peer reviewe

Exploring mothers’ experiences of accessing an Education, Health and Care Plan (EHCP) for an autistic child attending mainstream school in the United Kingdom

© 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/Many autistic children are educated in mainstream settings, yet despite the benefits it can present challenges for the children and their parents. A legal framework for accessing support for school age children in England are Education, Health and Care Plans (EHCP). Whilst there are anecdotal accounts on accessing EHCPs for autistic children, research is limited. To expand knowledge, six mothers (aged between 31 and 44) of autistic children (aged between 6 and 15) were interviewed about their EHCP experiences. A reflexive thematic analysis resulted in the following themes: Barriers for accessing educational support; the process of obtaining an EHCP; impact on mothers; trying to find glimmers of hope. The main finding was an intimidating and overwhelmingly difficult process mothers had to navigate to access an EHCP. The ensuing battle left them with feelings of isolation, anxiety, and hopelessness; alongside a sense that the systems set up to help were found to work against them. Nevertheless, some mothers were determined to find glimmers of hope for the benefit of their child’s development. For autistic children to access the benefits of mainstream education, wider systemic changes are urgently needed. This would also vicariously support parental wellbeing.Peer reviewe