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Article
Publication date: 14 October 2024

Isobel Moore, Philip John Archard and Sarah Simmonds

The process of ending mental health support is often not well-attended to in practice or research, and clinicians in UK mental health services lack focused clinical guidance in…

61

Abstract

Purpose

The process of ending mental health support is often not well-attended to in practice or research, and clinicians in UK mental health services lack focused clinical guidance in this area. This paper aims to report on a service evaluation that sought to understand from clinicians working in a single adult community mental health team (CMHT) their experiences of discharge and issues arising in the process, factors considered in decision-making and what constitutes “good” endings and what support could be helpful to them in navigating this with clients.

Design/methodology/approach

Semi-structured interviews were completed with six members of the multi-disciplinary team and analysed thematically.

Findings

Clinicians described a range of criteria considered in discharge decision-making. Collaboration, planning and preparation were represented as key ingredients for “good” endings. Factors viewed as complicating discharge included complexity and changes in presentation, psychosocial contexts and re-referrals. Perceptions of clients’ feelings (resistance and dependence, fear and anger, relief and gratitude) and varying feelings evoked for clinicians (from little or no reported impact, to pride and confidence, sadness and worry) at the ending of the working relationship were reported. Suggested organisational supports for clinicians with endings and discharges involved opportunities to consult with colleagues, psychological formulation and advice and reflective supervision.

Originality/value

There has been limited empirical attention to practitioner experiences of discharge in the work of CMHTs in a UK context; this practitioner-led evaluation explored clinician perspectives.

Details

Mental Health Review Journal, vol. 29 no. 4
Type: Research Article
ISSN: 1361-9322

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Article
Publication date: 14 March 2024

Philip John Archard, Michelle O'Reilly and Massimiliano Sommantico

This paper contributes to a dialogue about the psychoanalytic concept of free association and its application in the context of qualitative research interviewing. In doing so, it…

119

Abstract

Purpose

This paper contributes to a dialogue about the psychoanalytic concept of free association and its application in the context of qualitative research interviewing. In doing so, it also adds to wider discussion regarding the relationship between clinical psychoanalysis, psychoanalytic psychotherapy and qualitative research.

Design/methodology/approach

Critical consideration of different perspectives on the application of free association in the qualitative research interview, extending earlier work addressing this issue. Differences and similarities in the way the concept of free association is articulated are examined regarding its framing in psychoanalysis and psychoanalytically oriented psychotherapy.

Findings

Whether researchers see themselves as borrowing, applying or drawing inspiration from free association, there is scope for muddling distinct ways of viewing it as it is conceived in psychoanalysis.

Originality/value

Considerations are outlined for researchers interested in psychoanalytically informed methods to be mindful of.

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Article
Publication date: 4 February 2021

Philip John Archard

This paper is concerned with what intensive family intervention professionals reveal to the parents with whom they work about whether they themselves are parents or not, as a form…

119

Abstract

Purpose

This paper is concerned with what intensive family intervention professionals reveal to the parents with whom they work about whether they themselves are parents or not, as a form of professional self-disclosure in child welfare work. This paper also addresses the act of lying in professional self-disclosure.

Design/methodology/approach

The paper draws on material from a series of narrative interviews completed with practitioners from one family intervention programme in an English local authority as part of a study looking at how children’s services professionals experience the suffering of parents. The study was based on a psychoanalytically informed methodological approach, which is represented in the analysis provided in the paper.

Findings

The overall team ethos regarding parental status disclosure is considered briefly first then two participants’ accounts are explored in depth. These involved, what can be considered as, questionable or unorthodox stances regarding parental status disclosure (and self-disclosure more generally). The exploration illustrates the role that practitioners’ personal lives and histories can play in influencing how the act of professional parental status disclosure is experienced and how particular positions are invested in regarding the role of self-disclosure in working relationships with parents.

Originality/value

Child welfare and family intervention professionals are often asked personal questions by the parents and carers they work with, including questions about whether they are a parent or not. These questions can be difficult to answer and there is a need for dedicated empirical analysis into the ways in which professionals experience, think about and respond to them and what they disclose about themselves when working with families.

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Article
Publication date: 12 March 2018

Steven Lucas, Philip John Archard, James Tangen and David Murphy

The purpose of this paper is to report an analysis of arrangements in English mental health trusts to meet the needs of adult service users who are homeless. Homelessness is…

446

Abstract

Purpose

The purpose of this paper is to report an analysis of arrangements in English mental health trusts to meet the needs of adult service users who are homeless. Homelessness is associated with various forms of mental ill-health, yet homeless people are not always well-served by statutory mental health services. In recent years, practice guidance seeking to improve health outcomes for the homeless has emphasised the need for NHS services to improve care pathways and professional provision for this service user group, in part by collaborating more closely with homelessness organisations.

Design/methodology/approach

Responses to freedom of information requests sent to trusts were analysed. The requests asked trusts for information concerning partnerships with external agencies, particular projects/staff, training available to trust professionals, referral pathways, and intervention models/approaches informing work with homeless service users.

Findings

In total, 49 trusts provided information that could be used in the analysis. Just under half of these had dedicated arrangements or resources, including outreach teams and clinical staff co-located in accommodation and support services for the homeless. The remaining trusts indicated that they either had some limited specific arrangements, such as links between local agencies working with the homeless and existing services, or no dedicated arrangements in place. Training to improve staff awareness around, and knowledge in, working with homeless service users tended to be minimal if provided at all.

Originality/value

This analysis further evidences gaps in the way the needs of the homeless population are addressed by statutory mental health services and adds support to concerns about the homeless having equitable access to care and treatment.

Details

Mental Health Review Journal, vol. 23 no. 1
Type: Research Article
ISSN: 1361-9322

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Article
Publication date: 11 August 2023

Sewanu Awhangansi, Michael Lewis, Khalid Karim, Jibril Abdulmalik, Philip Archard, Adeniran Okewole and Michelle O'Reilly

This paper aims to report a non-randomized control study undertaken to investigate prevalence and correlates of conduct disorder among male secondary education students in…

95

Abstract

Purpose

This paper aims to report a non-randomized control study undertaken to investigate prevalence and correlates of conduct disorder among male secondary education students in South-West Nigeria and to assess the impact of a problem-solving skills and attributional retraining (PSSAR) intervention with this population.

Design/methodology/approach

In total, 787 male students from two schools were screened for conduct disorder. All participants who met criteria for the disorder were allocated to either treatment (n = 55) or control (n = 47) groups. Outcome measures comprised the strengths and difficulties questionnaire (SDQ; teacher and student versions) and the teacher rating of students’ aggressive behaviors.

Findings

Of the sample, 13% were found to present with difficulties that met criteria for conduct disorder. The presence of these difficulties correlated with several demographic variables, including parental conflict and alcohol use. A statistically significant reduction in mean scores was observed for the treatment group in the student rating of the SDQ emotional subscale and total difficulties scores. Teacher ratings were less consistent in that conduct problems, prosocial behavior and total difficulties increased following the intervention, whereas peer problems and aggressive behavior were reported by teachers to reduce. No statistically significant change was found in the outcome measures for the control group.

Practical implications

In resource-constrained settings, school-based interventions are an important means through which treatment gaps in child and adolescent mental health can be addressed.

Originality/value

In resource-constrained settings, school-based interventions are an important means through which treatment gaps in child and adolescent mental health can be addressed. This study’s findings offer some preliminary support for the PSSAR intervention for conduct disorder in this context and indicate areas for further research.

Details

The Journal of Forensic Practice, vol. 25 no. 4
Type: Research Article
ISSN: 2050-8794

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Article
Publication date: 19 November 2024

Bernadette Martin, Julie Fox, Philip John Archard, Steven Lucas, Karima Susi and Michelle O’Reilly

The purpose of this paper is to report findings from a service evaluation of a training initiative in participatory practice with children and young people (CYP) for early help…

27

Abstract

Purpose

The purpose of this paper is to report findings from a service evaluation of a training initiative in participatory practice with children and young people (CYP) for early help (EH) professionals. The training was based on the Lundy model of child participation.

Design/methodology/approach

A questionnaire-based survey was undertaken of staff completing the training. Within the sample of professionals surveyed, various work contexts were represented.

Findings

Reported benefits arising from the training included increased understanding of the utility of the tenets of the Lundy model, as well as changes in practice with CYP. Barriers and issues encountered in seeking to work in a participatory way were identified in relation to time for relationship-building, resources and interprofessional and interagency working.

Originality/value

The evaluation findings provide insight into ways training in participatory practice with CYP is experienced by EH professionals. The role of networks of practitioner champions in influencing participatory practice is also addressed, as well as the interface between participatory and relationship-based practice.

Details

Journal of Children’s Services, vol. 19 no. 4
Type: Research Article
ISSN: 1746-6660

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Article
Publication date: 30 August 2022

Philip John Archard, Emma Giles, Isobel Moore, Sewanu Awhangansi, Siobhan Fitzpatrick, Leanne Kulik and Michelle O’Reilly

The purpose of this paper is to report findings from a service evaluation undertaken within a single specialist child and adolescent mental health service (CAMHS) team. The team…

240

Abstract

Purpose

The purpose of this paper is to report findings from a service evaluation undertaken within a single specialist child and adolescent mental health service (CAMHS) team. The team works closely with local authority children’s services to serve specific populations recognised as experiencing higher levels of mental health need, including children living in alternative care and with adoptive families. The evaluation sought to better understand the experience of this provision during the COVID-19 pandemic and concomitant increase in remote and digitally mediated care delivery.

Design/methodology/approach

Analysis of the accounts of 38 parents, carers and professionals involved with the team gathered via telephone interviews and email and postal questionnaires.

Findings

Similar views were expressed from participants involved with the team before and following the onset of the pandemic. Overall, satisfaction was high; however, changes in care appeared more challenging for those already involved with the team before the pandemic. Differences in experience between groups were also evident. Whereas foster carers’ accounts were generally appreciative of the involvement of clinicians, particularly regarding clinician–patient relationships, amongst adoptive parents and members of children’s birth families there were more mixed and negative impressions.

Originality/value

Locally based service evaluations can help inform care pathway planning in specialist CAMHS provision as part of wider quality improvement initiatives. This is especially relevant considering the repercussions of the COVID-19 pandemic and as the longer-term acceptability of remote working practices is appraised.

Details

Journal of Children's Services, vol. 17 no. 4
Type: Research Article
ISSN: 1746-6660

Keywords

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Abstract

Purpose

This paper aims to focus on concerns unique to international medical graduates (IMGs) and doctors from global majority groups pursuing a career in psychiatry in the UK. It specifically addresses challenges affecting the differential attainment of IMGs in passing the Clinical Assessment of Skills and Competencies (CASC) examination – the final assessment for attaining Membership of the Royal College of Psychiatrists, affording entry to specialty training programmes.

Design/methodology/approach

Reflections are provided on learning from a CASC examination preparatory course specifically developed for IMGs in psychiatry, particularly those from global majority groups. The rationale for the course is set out as well as some of the challenges in designing and developing the course.

Findings

By reflecting on the experience of developing the course, the intersection of medical education, differential attainment and cultural disparities in training is addressed, alongside the role of group practice in exam preparation and support tailored to the needs of IMGs from global majority groups.

Originality/value

The reflections provided illuminate possible means of innovation to support the progression of IMGs and doctors from global majority backgrounds in the CASC, as a high stakes examination in medical training, and to support action to improve overall outcomes for this community in the field of psychiatry.

Details

The Journal of Mental Health Training, Education and Practice, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1755-6228

Keywords

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Article
Publication date: 8 February 2021

Steven Lucas and Philip John Archard

The purpose of this study was to explore early help provision to children and families not reaching the Children Act (1989) child in need threshold, across all 152 English local…

1037

Abstract

Purpose

The purpose of this study was to explore early help provision to children and families not reaching the Children Act (1989) child in need threshold, across all 152 English local authorities in 2017.

Design/methodology/approach

A freedom of information request was used, in September 2017, to obtain information regarding recorded numbers, attributes and referral reasons for Early Help cases, case categorisation, professional groups involved in this provision and models of practice.

Findings

Responses revealed there are no common protocols categorising referrals and identified needs of children and young people. Child behavioural issues were the most frequently occurring category followed by parenting issues and child emotional well-being. The numbers of children engaged by Early Help services varied with a range between Barnsley with 7.8% of children under 18 years old and Richmond on Thames with 0.33% and only exceeded children in need in a 7 out of 71 reporting authorities. Models of practice used were most commonly based on the assessment framework, which operates at all social work thresholds including child protection. The enquiry found a diverse workforce involved in Early Help and sets it within a context of local thresholds for dealing with large increases in referral rates to children’s services departments in recent years.

Originality/value

The study provides a unique insight into the nature and scope of Early Help provision across England. The relationship between existing thresholds of intervention in the child welfare system is underexplored in the social work literature.

Details

Journal of Children's Services, vol. 16 no. 1
Type: Research Article
ISSN: 1746-6660

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Article
Publication date: 6 September 2024

Sewanu Awhangansi, Titilayo Salisu, Oluwayemisi Awhangansi, Adefunke Dadematthews, Eghonghon Abumere, Benazir Siddiq, Eden Phillips, Meera Mogan, Ayoyimika Olushola, Atim Archibong, Adeniran Okewole, Increase Adeosun, Oladipo Sowunmi, Sunday Amosu, Michael Lewis, Philip John Archard, Olugbenga Owoeye and Michelle O'Reilly

This paper aims to examine the role of bullying victimization in predicting psychopathology, encompassing post-traumatic stress disorder (PTSD), risk of developing prodromal…

18

Abstract

Purpose

This paper aims to examine the role of bullying victimization in predicting psychopathology, encompassing post-traumatic stress disorder (PTSD), risk of developing prodromal psychosis and emotional and behavioural problems, among in-school Nigerian adolescents.

Design/methodology/approach

A total of 351 junior secondary students (n = 173 males, 178 females; age range: 9–17 years) were recruited from five randomly selected public secondary schools in Nigeria. Students completed a variety of self-report measures, including a socio-demographic questionnaire, the prodromal questionnaire – brief version, the strengths and difficulties questionnaire (SDQ) and the multidimensional peer victimization scale. They were also interviewed using the PTSD module of the Mini International Neuropsychiatric Interview-Kid Version.

Findings

Although bullying victimization was not found to predict the presence of PTSD, it predicted the risk of developing prodromal psychosis. All SDQ subscales also held significant positive associations with bullying victimization. This indicates that higher levels of victimization are associated with increased behavioural and emotional difficulties among adolescents.

Practical implications

The study findings add support to whole system approaches involving relevant stakeholders in health, education, social and criminal justice sectors via protective policies to address the problems of bullying in schools.

Originality/value

The study contributes to evidence demonstrating a need for improved understanding regarding the role of exposure to bullying victimization in predicting various forms of psychopathology. Furthermore, there is specifically a need for research with this focus in developing countries in sub-Saharan Africa and the Nigerian education system.

Details

The Journal of Forensic Practice, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2050-8794

Keywords

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