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Introduction: The aim of this study was to gain consensus among young people with a stoma due to inflammatory bowel disease (IBD) on the priorities for the content of an intervention for the self‐management of stoma‐related distress. The current identification and management of distress in young people with a stoma is often suboptimal in clinical settings and there is a need for improved support resources. Methods: Two consensus group meetings were carried out via online video conferencing, using nominal group technique. Participants generated, rated on a Likert scale and discussed, topics for inclusion in a future self‐management intervention. Results: Nineteen young people, aged 19–33, with a stoma due to IBD took part in one of two group meetings. Participants were located across England, Scotland, and Northern Ireland. Twenty‐nine topics were generated by participants, seven of which reached consensus of ≥80%, that is, a mean of ≥5.6 on a 7‐point Likert scale. These were: receiving advice from young people with lived experience of stoma surgery; advice on/addressing concerns about romantic relationships, sex and intimacy; information about fertility and pregnancy related to stoma surgery; stoma 'hacks', for example, useful everyday tips regarding clothing, making bag changes easier and so forth; reflecting on and recognising own emotional response to surgery; tips on managing the stoma during the night; and processing trauma related to the illness and surgery journey. Conclusions: Findings extend previous research on young people's experiences of stoma surgery, by generating consensus on young people's priorities for managing distress related to surgery and living with a stoma. These priorities include topics not previously reported in the literature, including the need for information about fertility and pregnancy. Findings will inform the development of a self‐management resource for young people with an IBD stoma and have relevance for the clinical management of stoma‐related distress in this population. Patient or Public Contribution: Three patient contributors are co‐authors on this paper, having contributed to the study design, interpretation of results and writing of the manuscript. The study's Patient and Public Involvement and Engagement advisory group also had an integral role in the study. They met with the research team for four 2‐h virtual meetings, giving input on the aims and purpose of the study, recruitment methods, and interpretation of findings. The group also advised on the age range for participants. The views of young people with a stoma are the central component of the study reported in this paper, which aims to gain consensus among young people with an IBD stoma on their priorities for the content of a resource to self‐manage distress related to stoma surgery. [ABSTRACT FROM AUTHOR]

There is growing recognition, in the UK and internationally, of the huge costs of recurrent appearances of parents in local authority care proceedings. This paper contributes to pressing policy and practice concerns to reduce recurrence. It presents qualitative longitudinal data from the first study of fathers' experiences of recurrent care proceedings in England. Demonstrating the emotional impact of repeat proceedings and successive loss of children on fathers, in terms of grief, loss and shame, we highlight the trauma and abuse in their developmental histories. We consider complex connections between anger and shame for these fathers, including within the arena of family justice. With the use of literature on complex trauma, shame and parental disengagement, we explore ideas for re‐framing fathers', and professionals', resistance to engagement and for better understanding fathers' intense emotions. We suggest that the link between shame and complex trauma and the value of shame reducing, dignity promoting practice in response provide a valuable way forward for working with fathers. As is recognized to be the case for mothers, without holistic, empathic interventions to address the vulnerabilities of such fathers, the risks for children, mothers and fathers are unlikely to reduce. [ABSTRACT FROM AUTHOR]

This article reports findings from a study which sought to offer primacy to the voice of the child, using narrative approaches to encourage children and young people to share their lived experiences of neglect. Using a constructivist approach, this paper explores the relationship between the voice of the child and their narrative of neglect. Drawing on the notion of 'family narrative', the discussion examines how children's views are constructed and reconstructed through the process of telling. This research documents that whilst practitioners seek to present the authentic voice of the child, our understanding of 'voice' should be problematized to take account of the fact that it is mediated through a number of filters and lenses. By attending to the voice of the child in the context of their narrative, practitioners may move closer to understanding the lived experience of the individual by exploring feelings, motivations and the myriad of factors which may influence how and for what purpose voice is shared. Engagement with the voice of their child in the context of their narrative, facilitates the development of a social work meta‐narrative to inform effective intervention. [ABSTRACT FROM AUTHOR]

The voluntary sector acts as the last line of defense for some of the most marginalized people in societies around the world, yet its capacities are significantly reduced by chronic resource shortages and dynamic political obstacles. Existing research has scarcely examined what it is like for voluntary sector practitioners working amidst these conditions. In this paper, we explore how penal voluntary sector practitioners across England and Scotland marshaled their personal and professional resources to "keep going" amidst significant challenges. Our analysis combines symbolic interactionism with the concept of story‐lines. We illuminate the narratives that practitioners mobilized to understand and motivate their efforts amidst the significant barriers, chronic limitations, and difficult emotions brought forth by their work. We position practitioners' story‐lines as a form of emotion work that mitigated their experiences of anger, frustration, overwhelm, sadness, and disappointment, enabling them to move forward and continue to support criminalized individuals. Our analysis details three story‐lines—resignation, strategy, and refuge—and examines their consequences for practitioners and their capacities to intervene in wicked social problems. [ABSTRACT FROM AUTHOR]

This paper examines the impact of disruptions to the organisation and delivery of healthcare services and efforts to re‐order care through emotion management during the COVID‐19 pandemic in the UK. Framing care as an affective practice, studying healthcare workers' (HCWs) experiences enables better understanding of how interactions between staff, patients and families changed as a result of the pandemic. Using a rapid qualitative research methodology, we conducted interviews with frontline HCWs in two London hospitals during the peak of the first wave of the pandemic and sourced public accounts of HCWs' experiences of the pandemic from social media (YouTube and Twitter). We conducted framework analysis to identify key factors disrupting caring interactions. Fear of infection and the barriers of physical distancing acted to separate staff from patients and families, requiring new affective practices to repair connections. Witnessing suffering was distressing for staff, and providing a 'good death' for patients and communicating care to families was harder. In addition to caring for patients and families, HCWs cared for each other. Infection control measures were important for limiting the spread of COVID‐19 but disrupted connections that were integral to care, generating new work to re‐order interactions. [ABSTRACT FROM AUTHOR]

Background: A new diagnosis of complex post‐traumatic stress disorder, CPTSD, has been agreed by the World Health Organization, WHO, and evidence is needed for what psychological treatment might be effective, particularly from those with experience of the disorder. We used a novel participatory approach to explore patient views and simultaneously studied the impact on the patient researchers of the research process itself. In this paper, we report on the latter section of the study how the involvement in research of patients with CPTSD affected their mental health. Symptoms of CPTSD may include emotional dysregulation, feelings of self‐worthlessness and difficulties in relationships. Objective: The aim of this study section was to explore whether patients' mental health could be promoted through empowering them to participate in research on CPTSD. Design: The study had a qualitative, participatory design. The clinician who led the research (first author) held group meetings with patient researchers to explore the impact of the research process. The clinician also kept notes on the process in a reflective log. Setting and participants: Six patient researchers participated in research with other patients with lived experience of CPTSD in an NHS outpatient unit in a London hospital. Intervention studied: The research process itself was analysed in group meetings with researchers which the clinician recorded and transcribed. Findings: Participation in research may promote increased self‐confidence and social inclusion for those with CPTSD. Conclusion: Involvement in research may be seen as an empowering intervention because patients felt it contributed to recovery. [ABSTRACT FROM AUTHOR]

Keeping children safe and keeping children free from worry are usually tasks that parents do without any sense of cross-purpose. In times of threat and very real danger, these two parental goals come into conflict. This article articulates the confusion of intentions amidst the pandemic. It alludes to previous crises such as happened in both World Wars to protect children including Operation Pied Piper to evacuate them from London in World War 2. The aim of this paper is to give parents and clinicians an awareness of the child's and young person's point of view, in particular, the worry of children for parents. The burden on children of fearing that they may infect parents, grandparents and loved ones generally is considerable. Parents who deny what is happening lack credibility. Parents who fail to manage their own anxieties burden their children with burdens they themselves cannot bear. Honesty about the need for safety and courage as parents to promote calm are what good parents have been doing throughout history. Telling children what they are doing that is right helps them to know what 'the right' is. The possibility is considered that we will come through the pandemic with a greater sense of what matters to our children and what should matter to us. [ABSTRACT FROM AUTHOR]

Objectives Young people in the public care system ('looked-after' young people) have high levels of self-harm. Design This paper reports the first detailed study of factors leading to self-harm over time in looked-after young people in England, using sequence analyses of the Card Sort Task for Self-harm (Ca TS). Methods Young people in care (looked-after group: n = 24; 14-21 years) and young people who had never been in care (contrast group: n = 21; 13-21 years) completed the Ca TS, describing sequences of factors leading to their first and most recent episodes of self-harm. Lag sequential analysis determined patterns of significant transitions between factors (thoughts, feelings, behaviours, events) leading to self-harm across 6 months. Results Young people in care reported feeling better immediately following their first episode of self-harm. However, fearlessness of death, impulsivity, and access to means were reported most proximal to recent self-harm. Although difficult negative emotions were salient to self-harm sequences in both groups, young people with no experience of being in care reported a greater range of negative emotions and transitions between them. For the contrast group, feelings of depression and sadness were a significant starting point of the self-harm sequence 6 months prior to most recent self-harm. Conclusions Sequences of factors leading to self-harm can change and evolve over time, so regular monitoring and assessment of each self-harm episode are needed. Support around easing and dealing with emotional distress is required. Restricting access to means to carry out potentially fatal self-harm attempts, particularly for the young persons with experience of being in care, is recommended. Practitioner points Self-harm (and factors associated with self-harm) can change and evolve over time; assessments need to reflect this., Looked-after young people reported feeling better after first self-harm; fearlessness of death, access to means, and impulsivity were reported as key in recent self-harm., Underlying emotional distress, particularly depression and self-hatred were important in both first and most recent self-harm., Looked-after young people should undergo regular monitoring and assessment of each self-harm episode and access to potentially fatal means should be restricted., The CaTS would have clinical utility as an assessment tool, Recruiting participants can be a significant challenge in studies with looked-after children and young people., Future research with larger clinical samples would be valuable. [ABSTRACT FROM AUTHOR]

Disgust is a complex phenomenon that pervades a number of social situations. To date, disgust has primarily been understood as an individually experienced emotion or as a way of defining boundaries between people or objects; the detailed social practices through which disgust is choreographed, however, have yet to be fully explored. The social implications of disgust are particularly apparent when food and eating are involved, as it is in such settings that individuals, objects, and social boundaries coincide. In this paper, I argue that the enactment of disgust is an inherently social event, and that we can evidence it as such through the way in which it is produced and oriented to in everyday interaction. The setting for this paper is family mealtimes, as a situation in which children and parents explore the boundaries of what is, and what is not, disgusting. A large corpus of video and audio recordings of mealtimes in England and Scotland were analysed using a discursive psychological approach, with a focus on explicating the sequential and prosodic features of disgust markers (DMs), such as 'eugh' and 'yuck'. The analysis demonstrates that DMs are typically preceded by a 'noticing' by speakers and that 'eugh' is usually uttered alone and at the start of a turn in talk. It is argued that, regardless of their putative status as emotions or cultural concepts, DMs work as assessments of food and eating practices in everyday interaction. They orient others to a trouble source and attend to people's entitlements to 'know' disgust. The implications for our understanding of disgust as a social psychological concept are further explored. [ABSTRACT FROM AUTHOR]

ABSTRACT Popular representations of crowd behaviour in disasters are often characterised by irrationalist discourses, in particular 'mass panic' despite their rejection by current scientific research. This paper reports an analysis of four survivors' accounts of the 1989 Hillsborough disaster to investigate if and how they used the term 'panic'. Reference to 'panic' occurred frequently, but more detailed analysis found that their accounts did not match the classic criteria for 'mass panic' (e.g. uncontrolled emotion and selfish behaviour). Indeed, participants referred to 'orderly' behaviour, and cooperation, even when they said the threat of death was present. 'Panic' was therefore being used as a description of events that was not consistent. A discourse analysis of usage suggests that participants used 'panic' not only to convey feelings of fear and distress but also to apportion culpability towards the actions of the police who they considered responsible for the tragedy (as indeed recent independent research has confirmed). It is concluded that the term 'panic' is so deeply embedded in popular discourse that people may use it even when they have reason to reject its irrationalist implications. Alternative discourses that emphasise collective resilience in disasters are suggested. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

There has been little research into the association of shame and other self-conscious emotions in bipolar disorder, although there is evidence linking shame to various psychopathologies. Objectives: This research investigates the levels of shame in individuals with bipolar disorder. Design and Methods: A cross-sectional design was used to compare 24 individuals with a diagnosis of bipolar disorder to a clinical control group of 18 individuals with unipolar depression, and 23 age-matched non-psychiatric controls on measures of mood (Beck Depression Inventory [BDI] and Self Report Manic Inventory [SRMI]) and of self-conscious emotions (Internalized Shame Scale and Test of Self-Conscious Affect). Results: Higher levels of trait shame and lower guilt-proneness were found in the bipolar group. Higher levels of shame-proneness were found in the unipolar group in comparison to the bipolar and control groups. BDI scores positively correlated with trait shame and shame-proneness, and accounted for a large proportion of the variance in these scores. SRMI scores positively correlated with trait (internalized) shame and negatively correlated with guilt-proneness. Conclusions: There was evidence for the presence of shame within bipolar disorder, but this differed to the evidence for shame in individuals with unipolar depression. Clinical implications are discussed. Copyright © 2009 John Wiley & Sons, Ltd. Key Practitioner Message: • Evidence suggests that cognitive–behavioural therapy is not effective in individuals with bipolar disorder with more than 12 illness episodes. • Shame has been elucidated as a factor is some chronic mental health problems, including depression. • Compassionate mind training has recently been developed to address experience of shame and is designed as an adjunct to cognitive–behavioural approaches. • This paper finds evidence for the presence of shame within bipolar disorder, but with a different manifestation than that found in individuals with depression. • This suggests that clinicians should consider shame as a factor for exploration within therapy, possibly using compassionate mind therapy, and its inclusion may improve on therapeutic outcome. [ABSTRACT FROM AUTHOR]

Accessible Summary •This paper looks at the history of self advocacy in England. • Self advocacy has helped many people with learning difficulties to speak up and gain more confidence. • But now it is associated with Government policy. After Valuing People, people expect self advocacy organizations to speak up for everyone with learning difficulties. • This might mean there is less time and space to help new people learn about speaking up as individuals. • It is important to find ways to support self advocacy groups, especially those run by people themselves, to avoid this happening. [ABSTRACT FROM AUTHOR]