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In this paper, I determine how body psychotherapists can support clients' recognition of belonging to the natural world to support greater resilience and healing. The research begins by determining what multidisciplinary fields are saying about the importance of the relationship between humans and Earth. It then researches approaches from body psychotherapy that support resilience and healing, and highlights ways this overlaps with the research from multidisciplinary fields. From here, the Seasonal Attunement model was created. A case study shows the Seasonal Attunement model supporting a client in reclaiming her anger and the potential this suggests for bigger societal change. This leads to a discussion of possible implications of this research for the field of body psychotherapy, including why supporting clients' relationship to the natural world is imperative for well-being. [ABSTRACT FROM AUTHOR]

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Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The idea that the therapeutic relationship is at the core of psychotherapy is shared by most therapeutic approaches. Also, an increasing variety of therapeutic approaches, consider experiential techniques as central tools to promote effective therapeutic change. Commonly, it is argued that the creation of a positive, empathic, safe, and solid therapeutic alliance should be a prerequisite for administering these techniques. However, recent evidence is beginning to challenge this cautious stance showing that the introduction of experiential work early in therapy can be safe and effective. So, the quality of the therapeutic relationship may either facilitate or hinder the use of experiential techniques, but the use of these techniques may also strengthen or cause ruptures in the therapeutic alliance. So how do we balance the attention to the therapeutic relationship and the use of active, emotionally arousing techniques? In this paper, we present an issue of the Journal of Clinical Psychology: In Session exploring the complex interplay between therapeutic relationship and experiential practices in light of different psychotherapeutic approaches. We do so by first providing an initial overview of the topic. Next, we introduce the five papers of the issue along with some thoughts on how authors from diverse psychotherapeutic orientations contributed to illustrate and reflect on this multifaceted "dance" between therapeutic relationship and techniques. [ABSTRACT FROM AUTHOR]

A systematic review is presented which aims to synthesize relevant literature focused on the influence of Meaning in Life (MiL) and Reasons for Living (RFL) on Suicidal Behaviour (SB). It also aims to elucidate the utility of meaning-centred practices for psychological treatment and risk assessment of suicidality. Thirteen papers of suitable quality were sourced through a rigorous search strategy and a narrative synthesis was performed. The findings present encouraging indications that both RFL and MiL play a role as protective factors against SB. Nevertheless, additional in-depth research is imperative to establish these associations with greater certainty. Additional findings also allude to a cultural universality of the protective aspects of MiL and RFL on SB and provide further insights into the subcomponents of life meaning: search for MiL and presence of MiL. Associated risk factors of SB such as hopelessness, life regard and mental pain are also discussed in relation to MiL and RFL. Overall, this study paves the way for further research on the topic and draws attention to something that is frequently neglected in the psychiatric community, namely, the consideration of the transcendental aspects of human nature. [ABSTRACT FROM AUTHOR]

Background: Self‐harm is a major public health concern. Lifetime prevalence is high, and rates of self‐harm are rising; however, available interventions do not benefit everyone, and engagement with therapy can be low. Qualitative accounts allow for a greater understanding of what is helpful to individuals. This study aimed to synthesize the experiences of interventions for self‐harm, from participants who have participated in these themselves. Methods: Participants had self‐harmed at least once and undergone an individual psychotherapeutic intervention for self‐harm. Papers not written or translated to the English language were excluded. Four databases (Medline, CINAHL, Web of Science and PsycINFO) were systematically searched and each paper was assessed using the CASP quality appraisal tool. A meta‐ethnographic approach to the synthesis was taken. Results: Ten studies encompassing 104 participants were included. Four overarching themes were developed and the importance of recognizing the person beyond the self‐harm emerged through a line of argument synthesis. Building a trusted, therapeutic relationship founded on patience and without judgement was essential for the perceived success of therapy, which was unique to each person and often went beyond reducing self‐harming behaviours. Limitations: Papers included in the study showed a lack of diversity with regard to ethnicity and gender. Conclusions: The findings illustrate the importance of the therapeutic alliance when working with self‐harm. Clinical implications of this paper include the importance of utilizing key therapeutic competencies which should be considered fundamental to change within psychotherapeutic interventions for self‐harm, with the uniqueness of each patient recognized throughout. [ABSTRACT FROM AUTHOR]

Objective: Despite calls to increase the 'cultural competence' of health care providers, racially minoritised people continue to experience a range of problems when it comes to health care, including discrimination. While relevant qualitative meta-syntheses have suggested better ways forward for health care for racialised minorities, many have lacked conceptual depth, and none have specifically investigated the relational dimensions involved in care. We set out to investigate the social and cultural influences on health care interventions, focusing on psychological approaches and/or cancer care to inform the trial of a new psychological therapy for those living with or beyond cancer. Method: A meta-ethnography approach was used to examine the relevant qualitative studies, following Noblit and Hare, and guided by patient involvement throughout. Papers were analysed between September 2018 and February 2023, with some interruptions caused by the Covid pandemic. The following databases were searched: Ovid MEDLINE, EBSCO CINAHL, Ovid Embase, EBSCO PsycINFO, Proquest Sociology Collection (including Applied Social Sciences Index & Abstracts (ASSIA), Sociological Abstracts and Sociology Database), EBSCO SocINDEX, Ovid AMED, and Web of Science. The systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) (ID: CRD42018107695), and reporting follows the eMERGe Reporting Guidance for meta-ethnographies (France et al. 2019). Results: Twenty-nine journal papers were included in the final review. Themes (third-order constructs) developed in the paper include the centrality of the patient-practitioner relationship; how participants give meaning to their illness in connection to others; how families (rather than individuals) may make health decisions; how links with a higher power and spiritual/religious others can play a role in coping; and the ways in which a hierarchy of help-seeking develops, frequently with the first port of call being the resources of oneself. Participants in studies had a need to avoid being 'othered' in their care, valuing practitioners that connected with them, and who were able to recognise them as whole and complex (sometimes described in relational languages like 'love'). Complex family-based health decision-making and/or the importance of relations with non-human interactants (e.g. God, spiritual beings) were frequently uncovered, not to mention the profoundly emergent nature of stigma, whereby families could be relatively safe havens for containing and dealing with health challenges. A conceptual framework of 'animated via (frequently hidden) affective relationality' emerged in the final synthesis, bringing all themes together, and drawing attention to the emergent nature of the salient issues facing minoritised patients in health care interactions. Conclusion: Our analysis is important because it sheds light on the hitherto buried relational forces animating and producing the specific issues facing racially minoritised patients, which study participants thought were largely overlooked, but to which professionals can readily relate (given the universal nature of human relations). Thus, training around the affective relationality of consultations could be a fruitful avenue to explore to improve care of diverse patients. [ABSTRACT FROM AUTHOR]

School mental health (SMH) services are widespread but are often not well integrated into school settings, based on evidence for effectiveness, or efficiently delivered. This paper presents results of a pilot study of a brief (4 session) assessment, engagement, triage, and initial intervention strategy for SMH clinicians working in high schools. The study included n = 29 students served by five clinicians trained on the Brief Intervention for School Clinicians (BRISC), compared to n = 37 students served by 10 similar clinicians providing school-based services as usual. Clinicians implemented BRISC elements with good fidelity and reported the strategy was feasible and aligned with student needs. BRISC students reported greater satisfaction and therapeutic alliance. No differences were found for overall behavioral functioning; however, BRISC students showed greater reduction in depression and anxiety symptoms. Academic outcomes were not associated with condition. After four sessions, the majority of BRISC students were discharged without need for continued services, suggesting it could promote efficiency. Results indicate that BRISC is a promising approach that merits further research.

Foucault's invitation to the subject is to become free of themselves by learning to think differently. Such a project has as its goal the mastery of the self, and can be understood as a Foucaultian 'politics of ourselves'. Foucault's ethical turn is an invitation for subjectivity to undertake its own radical education. Whilst this invitation has characteristics unique to Foucault's philosophical discipline, I argue that it sheds light upon a diversity of practices of subjectivity from the psychotherapeutic and mystic traditions. By seeing these currently available technologies of self in the Foucaultian lens we are given the opportunity to appreciate their work on subjectivity as necessarily political and social, a radical education not limited to the realm of individualistic aspiration and narcissistic temptations. The paper concludes by drawing attention to some implications for education, and for a teacher education that embraces the 'radical reflexivity' of some psycho-spiritual practices.

This paper argues that the field of counselling and psychotherapy needs to find values-congruent ways of managing, and creatively engaging with, the challenging tension between accountability and diversity in therapy work. The authors strongly support the preservation of pluralism and diversity in therapy practice, in the face of the increasingly urgent, anxiety-driven demands for audit, regulation and accountability typifying Late Modernity. It is argued that if accountability itself is to be "evidence-based", then incorporating a relational dimension is essential; for if relationship factors are central to successful therapy, then accountability frameworks must themselves be founded on/in "relationship". The arguments against formal institutional regulation of the psychological therapies in relation to the ineffectiveness of systems are rehearsed, and alternative, more values-congruent approaches considered. In making a case for "pluralistic accountability", a detailed case-study of Bristol's developing local directory of therapists is offered, illustrating how local initiative can deliver good-enough accountability, avoiding the many negative side-effects of more didactic, centralised systems. The paper concludes that innovation and diversity in the field are more likely to be preserved if approaches can be found that hold and embrace the tensions between accountability and diversity, rather than seeking "solutions" that prematurely and inappropriately resolve them. (Contains 1 note.)

In this interview by email, Ann Scott, Editor‐in‐Chief of the British Journal of Psychotherapy from 2009 to 2022, is in conversation with Brett Kahr, responding to questions put to her by him and the Journal's Editorial Board. The interview focuses on Scott's background and its influence on her work; her early role at Free Association Books and her role as Deputy Editor of the BJP. She identifies papers from the Journal, on her watch as Editor‐in‐Chief, that have resonated particularly powerfully for her, commenting that all convey a sense of urgency and immediacy. She is asked to comment on the relationship between clinical and research approaches; current debates about informed consent; the Journal's title; the impact of online as well as print publication; whether published topics have changed over time; and the Journal's international standing. She describes the editorial principles that have governed her approach to the editorship, drawing on work by Britton, Turquet, Rey and Gabbard. She comments on some challenges she has faced as an editor, and shares the highlights of her tenure. Lastly, she is asked whether the editorship has impacted on her clinical practice, whether she has any regrets, and how she would like to be remembered in relation to her editorial work. [ABSTRACT FROM AUTHOR]

In this paper I develop my contention that reality is experienced polymorphically at different levels along a concrete-abstract continuum. At the more abstract and psychic level the internal representations of primary reality are, to varying degrees, verbally labelled. However, for various reasons, this verbal symbolisation is rarely adequate or complete--even in adulthood, and hence the persistent recourse to somatisation, acting out, projection and other psychological strategies and defences. This paper also examines, using both constructivist and psychodynamic models, how verbalisation can be helpful in clinical practice with somatoform disorders as both models are concerned with the "talking cure". Drawing on our understanding of meditation and mindfulness, the role of our psychological defences in limiting our consciousness is examined, in contrast to the practice of non-verbal mindfulness which aims at expanding our awareness. Potential problems with meditation are discussed, as well as limitations to the "talking cure"--as verbalisation can also be used as a higher order defence. However, it is concluded that all awareness expanding practices, such as mindfulness and psychotherapy, reduce the need to resort to somatisation and other primitive awareness distorting strategies. In this paper constructivist (Kellian) and psychodynamic (both Freudian and post-Freudian) perspectives are employed to develop my contention that reality is experienced polymorphically at different levels of cognitive awareness along a concrete-abstract continuum. At a more abstract (or largely psychic) level the internal representations of primary reality become, to varying degrees, verbally labelled as we develop and mature from infancy. However, this verbal symbolisation is rarely sufficient or complete--even in adulthood, and hence the persistent need for somatisation, acting out, acting in, and primitive forms of communication and psychological defence, such as hysterical identification, projective identification and/or other forms of basic communication typically found at the lower levels of awareness. This paper further goes on to examine, especially using constructivist, but also psychodynamic models, how verbal symbolisation can be helpful in practice with psychosomatic and hysterical disorders. Drawing on our understanding of concentrative and mindfulness meditation the workings of our psychological defences are examined. Constructivist and psychodynamic models are used to describe the distortion of consciousness by these defences--albeit from different perspectives. Both of these psychotherapy approaches are also concerned with the issue of increased awareness via insight, and are therefore complementary to the Eastern notion of enhanced awareness through the practice of meditation and mindfulness. Potential problems with meditation are discussed, as well as limitations to the "talking cure"--as verbalisation can also be used as a higher order cognitive defence, as observed in rationalisation--as well as in the higher service of the expansion of awareness.

This article shares an author's perspective with regards to the contributions of Trigant Burrow in the field of group psychoanalysis. Furthermore, this article deals with how Burrow's influence is kept alive by his loyal followers. In addition, the author also talks about the similarity between his own thinking with that of Burrow's specifically in the aspect of species-connectedness and the organismic foundations of an individual's existence on the nature of dreaming consciousness.

This paper explores further the vast topic of child neuropsychiatric disorders--ADHD in particular. It refers to and expands on issues debated in an earlier paper "Ritalin for whom?". In that paper, it was argued that those who benefitted most from children taking Ritalin were parents and teachers struggling with uncontained and out-of-control children under five, as well as doctors constrained by scarce resources and long waiting lists in NHS child services. This paper looks at the complex, inextricable and still somewhat mysterious interaction between genetic and environmental factors and what is meant by "genetic disorder" when, for example, the diagnosis of autism, Asperger's syndrome, ADHD is made. The author explores various avenues of research and focuses on the contribution of the psychological perspective offered by psychoanalytic thinking and attachment theory to understanding hyperactivity. This paper is mostly a review of theories, research and formulations, which help us explain some of the underlying factors in hyperactive children. Brief vignettes from infant observation, parent-infant psychotherapy and psychoanalytic treatment of children are used to support the main hypothesis that ADHD results from the interweaving of neuropsychological factors from birth onwards and can be treated by psychological interventions. (Contains 1 note.)

This paper explores the idea of possible proto-experiences of the prenatal child in the context of Bion's model of container/contained. The physical configuration of the embryo/foetus contained in the maternal uterus represents the starting point for an enquiry into the unborn child's possible experiences of its state of being contained in a container. The paper takes into consideration the sensory dimensions of auditory, tactile and kinaesthetic levels of awareness of the prenatal child in relation, respectively, to the maternal voice and the uterine environment. The author's hypothesis is that concrete prenatal experiences of containment may have their mental counterpart in the development of a proto-mental container and memory, the existence of which can be observed in the newborn infant. It is also suggested that prenatal proto-experiences of containment may prepare the child for further postnatal realisations of the pre-conception of containment and represent the experiential basis for the encounter with the breast. Observations of newborn babies in an obstetric ward, as well as the observation of a prematurely born child, seem to confirm the idea that the intrauterine experience of container/contained plays a role in the child's prenatal development. The meaning of prenatal thumb-sucking is explored in terms of the model of container/contained at a part-object level. An observation of the play of a three-year-old child offers material for further thought about the meaning and function of the introjected configuration of container/contained for the development of a sense of identity and symbolic thinking. The clinical case of an autistic child who survived a threatened miscarriage shows how the emotional containment in psychotherapy allowed the formerly inaccessible nameless dread to re-emerge and be represented and shared. (Contains 2 notes.)

This paper describes a systematic thematic analysis of one particular latency-aged children's group and includes a discussion about potentially helpful outcomes measures. The impetus for our small, practice-based qualitative research project came from the two papers by Reid (1999) and Canham (2002) about children's psychotherapy groups, particularly Canham's (2002) paper, "Group and gang states of mind". Canham and Reid used Bion's theories of group functioning as the basis of their technique with children's groups. We felt that it would be an interesting follow-on from Reid and Canham's findings to explore in some detail the specific therapeutic factors involved in a shift from paranoid-schizoid to depressive functioning in group therapy. We hoped that this might give us some helpful clinical indications as to the circumstances in which group rather than individual psychotherapy and parallel parent work should be considered as the treatment of choice. The paper concentrates exclusively on group work with latency-aged children, therefore referring mainly to the limited number of papers published about psychoanalytic group therapy with this age group. (Contains 1 figure.)

This paper draws on psychoanalytic and socio-political perspectives of trauma and emotion to examine how "critical emotional praxis" may serve as a pedagogical tool for reconciliation education. A major challenge for teachers in traumatized societies struggling to enact reconciliation education is that emotions of trauma are often appropriated by social and political institutions, including schools, to justify particular collective narratives and ideologies. The prospects of critical emotional praxis are explored through two vignettes from an on-going ethnographic research in Cyprus, a country of protracted ethnic conflict. The first vignette focuses on how emotions of trauma are politically appropriated in a classroom while the second shows how one teacher manages to enact critical emotional praxis with her students to undermine the political appropriation of emotions of trauma. The paper concludes with a discussion of the pedagogical implications and recommendations for future research. (Contains 5 notes.)

This paper describes the use of play in the psychotherapy of a latency child from a severely traumatised background. It considers the meaning of play in relation to the role of the psychotherapist and to psychotherapeutic technique and explores its functions in terms of the child's development. The paper documents the psychotherapist's learning experience about the difficulty of trying to make the "right" interpretations and her consequent realisation of the intrinsic value of play in psychotherapy. In considering these themes, the author explores how, by placing interpretation secondary to play, the therapy enabled the development of the child's creativity and self-agency, facilitating a movement from primarily paranoid-schizoid defences towards the beginnings of a depressive position.

This paper takes Betty Joseph's concept of "addiction to near death," which describes a clinical situation in which sadism and masochism dominate the relationships of a particular group of patients, and applies it specifically to the case material of a girl in adolescent psychotherapy treatment. A link is made between the patient's retreat from mature genital sexuality as she approaches adulthood and the use of sadism and masochism towards this aim. The paper concludes with a discussion on the increase in strength and potency of sadism and masochism in adolescence as contributing to the high risk of destructive and self-destructive behaviour present in this age group.

This paper charts the journey made towards verbal communication with Mackenzie, a boy who was three years old at the start of treatment and diagnosed with pervasive developmental disorder. In this paper, I bring together diverse areas of research and demonstrate how they inform my clinical practice. Together, these ideas created a multimodal and synergistic way of working that enabled Mackenzie to make connections between the internal and external world, moving towards self-agency, thus allowing him to start to enter the world of verbal communication. The research that I applied to practice included: the role of prediction in Theory of Mind (TOM), "dynamic systems" theory of emotions, affect regulation and interactive regulation, embodied perception and entrainment. (Contains 1 figure.)

In this paper, I explore how we might link ideas about clinical facts to current issues in child psychotherapy research. I consider what our understanding of clinical facts might contribute to our research methods and how our research methods might better represent the clinical facts. The paper introduces a selection of psychoanalytic writers' formulations of the concept and describes some of the debates about the shortcomings of the traditional style of case reporting. The importance of keeping emotional experience central in our research is discussed. I describe a research method that I believe has the potential to capture and describe some of the complicated processes of change in psychotherapy. This is the concept of the "turning point" session. Introducing the paradigm of complexity theory, I briefly explore how we might think about and understand the relationship between processes revealed through detailed analysis of a single session and change over a longer period of therapy.

Ethical approaches to practice and research in counselling and arts/psychotherapies demand an urgent attention to body politics. Bodies are not neutral; gender, sexuality, ethnicity and class are socio-political aspects that shape our mental, emotional and physical selves and inform our ethical values. Drawing from the author's embodied practice as interdisciplinary practitioner-researcher, the aim of this paper is to examine the inseparability of ethics and bodies and explore how autobiographical, relational and political aspects of our selves-in-motion give rise to and build upon "ethically important moments". The paper concludes with expanding possibilities; that highlighting ethical tensions within the lived experiences of bodies-in-motion allows for politically progressive approaches to practice that reflect the emerging paradigm shift of a post-Cartesian and interdisciplinary age. (Contains 3 figures and 2 notes.)

This paper describes work with two children, placed for late adoption who have suffered relational trauma. The paper explores the long-term consequences of such trauma, which includes problems with affect regulation, difficulties in generalising from one experience to another and shifts between phantasies of omnipotent control and sudden helplessness. Using drawings from one boy's therapy, it is argued that many children adopted at a later age live in two worlds, both internal and external, and internal objects and memories from the past vie with new experiences and representations for ascendancy within the child's mind. Which is more real: the world of the past or the present? The paper describes how these children experienced sudden and troubling shifts in focus as they were catapulted from feeling states belonging to one world to the other. The paper ends with a consideration of how findings from neuroscience may help us to understand these sudden shifts and overall argues for a pulling together of psychoanalytic thinking and child development research findings to support the child in psychotherapy. (Contains 4 figures and 1 note.)

This paper examines the relationship between therapeutic progress and the patient's family or residential situation with reference to the intensive treatment of an adolescent boy who had a severe learning disability and moved placement five times within four years. The idea is explored that the capacity to be thoughtful about emotional distress and to be engaged in learning about one's own mental processes is dependent in part on the human context surrounding the individual. It is illuminated by detailed clinical material using in particular Winnicott's concept of the facilitating environment and Sinason's concept of secondary handicap. The paper also discusses the dilemma for the therapist of whether a thoughtful state of mind and emotional connectedness are always in the interest of the patient's mental health when the external context is so at odds with this and whether retreating into psychic "suspended animation" may sometimes be an adaptive response. Despite this, the author hopes that the paper will contribute to a growing understanding of the potential of psychoanalytic psychotherapy as an intervention for children and young people with severe learning disabilities. (Contains 2 notes.)

This paper draws on the theory and method of free association in psychoanalysis to frame an investigation of the content, structure, and function of the thinking expressed in conversations about sexuality and sexual health. The investigation emerges from an ongoing three-year study of the way adolescents, teachers, and peer sex educators negotiate and interpret the language of abstinence and the emotional terrain of sexuality in everyday speech and interaction. Through close readings of a film and related focus group data, the paper calls for attention to free associative movements of thought in sex education conversations. It argues that fostering free association in sex education will make room for the translation of sexuality into thought about the contours of sexuality in experience.

The paper describes the psychoanalytic psychotherapy of a patient who had originally been referred at the age of 15 because of his social isolation. In fact, he suffered from high-functioning Asperger's syndrome and lived in an almost delusional world populated by a number of imaginary companions, which he used to counteract a deep void and sense of deadliness within him. After five years of therapy, the patient was able to move on, allowing him to be successful in his academic studies, and to abandon his imaginary friends. This paper focuses on a subsequent phase of the therapy when the patient, as a young man, began to show an interest in and attraction to the world of intimate relationships. The paper is grounded in Meltzerian theory, especially his ideas about the role of beauty in the mother-child relationship, and about the world of intimate links as opposed to conventional ones. (Contains 2 notes.)

This paper traces the analytic work with a severely traumatised two-and-a-half-year-old girl Phoebe, whose early life was marked by chronic abuse and a violent murder she witnessed a few months prior to the beginning of treatment. Bringing the trauma in the room in a dissociative form, in line with post-traumatic stress disorder presentation, was Phoebe's unconscious means of communicating her pre-verbal encounters by projecting onto me the rage, shock and helplessness of her predicament. Thus, countertransference responses were a helpful window into her internal world, which was governed by cataclysmic losses and primitive states of fear. The importance of containment of the complex feelings aroused in the work and protecting against potential re-enactment of the abusive elements the patient, the family and often the professional network brought in the therapy is highlighted. The author hopes that this paper will encourage the offering of psychoanalytic psychotherapy to traumatised children particularly the under fives.

Following evidence based literature, the Birmingham Clinical Psychology Service for People with Learning Disabilities ran a Loss and Bereavement Psychotherapy Group. The group consisted of five adults with mild learning disabilities, who met for 8 consecutive weeks. This paper reports the process of setting up a bereavement group for people with learning disabilities, detailing the development of session plans and structure of the group. The authors encourage allied health professionals to consider setting up similar groups within their learning disabilities services, bearing in mind reflections on practical issues highlighted within this paper. (Contains 1 table.)

In this paper, the concept of expertise as defined in various professions is applied to psychotherapy and more specifically to the field of childhood sexual abuse. Given the dearth of research in this area, exploration of the issue is accompanied by reviewing the curriculum vitae of a number of recognized experts in the field. The paper concludes with a call for the recognition of childhood sexual abuse as a specialized field requiring specialized training both at the graduate level and in continuing postgraduate education. (Contains 3 notes.)

This paper describes the once-weekly psychoanalytic psychotherapy of a girl, called Ellie, aged eight at the start of her treatment. Ellie had a learning disability and displayed difficult behaviour at school and at home. In her therapy, Ellie grew in emotional intelligence, more in touch with and able to express her feelings. Her behaviour improved and so did her capacity to learn. In the therapy there were certain limitations to progress and this is discussed in terms of how Ellie's disability affected the basic achievements of emotional development, including a mind with a solid "reality ego", able to contain anxiety, and able to maintain depressive functioning. The importance of parallel parent work, to share observations and understanding of the child's functioning is discussed. Difficulties for both child and parents in dealing with the pain of difference and how this limits emotional intelligence are discussed. The author hopes that this paper will encourage the offering of psychoanalytic psychotherapy to children and young people with learning disabilities, who are significantly more likely to suffer from mental health problems than their peers. (Contains 1 figure.)

This paper sets out the case for the manualization of sex offender treatment. The movement towards evidence-based practice in psychotherapy has led to strongly voiced opposing views on the value of manualization. However, "what works" evidence, i.e. the meta-analytical research behind the Risk-Needs-Responsivity model of offender rehabilitation, as well as the broader psychotherapy literature, demonstrates that manualized treatment is usually more effective. Manualized treatment is also more likely to be replicable and focused upon criminogenic targets. Arguments against manualization include the claim that it restricts therapeutic artistry, but this is not necessarily a bad thing. This paper also proposes some important characteristics of a good manual, which will ensure that treatment is structured and targeted appropriately, but which will not override the importance of a constructive therapeutic relationship between treatment provider and offender. The review concludes that carefully designed manuals are essential for sex offender treatment to be demonstrably successful, and for successful treatment to be replicated.

A response from the author of an article The Beyond Mind Papers: Transpersonal and Metatranspersonal Theory. It replies the objection that synthesizes the piece published in "Integral World" and the most relevant parts of the initial draft of the original reply to Abramson. It argues that the critique continued to incur on an error pointed out in papers.

Counselling and psychotherapy has been influenced by technology for over 50 years. During this time, the rate at which ways that technology of one kind or another can assist therapists and counsellors has seemed to increase exponentially. This paper introduces and summarises contributions to the subject of technological enhancements or extensions of routine practice. While the variety of technologies referred to is far from exhaustive, the paper offers a representative sampling of the range available to practitioners from the now relatively familiar email, internet chat and video conferencing through to the cutting edge of developments in virtual reality, mood influencing packages and services that, like Web 2.0, can be based upon the needs and designs of the users themselves.

Introduction Many children fail to receive the mental health treatments they need, despite strong evidence demonstrating efficacy of brief and low-intensity psychological interventions. This review identifies the barriers and facilitators to their implementation. Sources of Data PsycInfo, EMBASE and Medline were searched and a systematic approach to data extraction using Normalization Process Theory highlighted key mechanisms and contextual factors. Areas of Agreement Ten interventions from 9 papers, including 371 young people, were included. Studies identified organizational demands, lack of implementation strategy and stigma as barriers to implementation, and clear training and plans for implementation as facilitators. Areas of Controversy No standardized implementation outcomes were used across papers so meta-analysis was not possible. Growing Points Barriers and facilitators have been clearly identified across different settings. Areas Timely for Developing Research Longitudinal studies can identify methods and processes for enhancing long-term implementation and considers ways to monitor and evaluate uptake into routine practice. [ABSTRACT FROM AUTHOR]

This paper gives an account of the developments in the intensive psychotherapy of a seven-year-old boy with global development delay. It also describes the adaptations to technique and the changes in the setting that were required to support the work, which was undertaken in a special school. The importance of the regularity of sessions in helping to establish object constancy; physical and mental boundaries in relation to me/not me; inside and outside is also explored. A central theme of the paper is how close observation can inform the understanding of the emotional states of disabled children, particularly those with little language. The paper draws links between the early communications of mothers and infants and the therapeutic relationship, with reference to music therapy. It describes banging as a form of communication and traces the development of banging into more coherent nursery rhymes arguing that this development is an internalisation of the rhythm of the therapy and of the growing understanding between the child and therapist.

This paper is an account of the intensive psychotherapy of a young girl on the autistic spectrum. It describes her confusing presentation and how this suggested a tendency to oscillate between mainly unintegrated states of mind. Important themes that emerged included the phantasy of inhabiting a claustrum; the use of adhesive identification to defend against the bodily felt terror of separation; and fear of damage to the maternal object. The paper also discusses the trans-generational aspects of her difficulties and considers how her therapy helped growth to take place.

This paper describes the first two years of intensive psychotherapy with a six-year-old boy diagnosed with autism. I explore the many ways in which he retreated from reality, most frequently by taking refuge inside the maternal body or flying off into an imaginary space world. He fragmented his identity and that of his objects by using the discourse of fictional characters. Everything was externalised; there was little transmutation of material available for thought. I consider his dilemma--the wish to fuse with the object and the fear of being engulfed; the omnipotent denial of the need for an object and of the parental relationship, leading to an inability to make links. The paper discusses working with a child who experienced any "paternal" firmness as persecuting and destructive. The softer, receptive maternal mind of the therapist was more easily tolerated. He gradually began to internalise a more benign combined object, as he became more able to bear separateness from the other.

This paper describes the application of child psychotherapy, its theory and practice, in a Pupil Referral Unit (PRU). It examines the importance of a flexible approach to outreach work and the implementation of interventions that take into consideration both the internal and the external world of the adolescent. Furthermore, the process of development of a psychodynamic group with PRU students is described and illustrated. Additionally, it explores the importance of developing psychodynamic models of working with allied professionals in supervision and collaborative efforts in general. The paper explores the usefulness of the concept of mentalisation when working in the context of schools as well as the need to develop an accessible psychodynamic language that enables multidisciplinary collaboration. Overall, this paper reflects on the importance of holding in mind the challenge of balancing the needs of the external and the internal world, which becomes very evident in the process of outreach work. (Contains 1 figure and 1 note.)

This paper discusses how the child psychotherapist's core skills can be usefully applied in a school setting. It outlines some of the important policy changes that have necessitated a move towards delivering therapeutic work in community settings such as schools. It is argued that the role of the child psychotherapist in schools has much in common with the role played by the psychotherapist in a therapeutic community. The paper suggests that therapy in schools is in many ways less simple than therapy in clinic settings, and in particular it is often unclear who exactly the client is and at what level to intervene when a referral is made. The referred patient is not necessarily the "problem", so that the child psychotherapist must be prepared to tackle issues in the system to ensure that splitting and projection are reduced, and systems around children can become more containing. Clinical vignettes and one main clinical illustration are used to try to illustrate these points. ["From Scapegoating to Thinking and Finding a Home: Delivering Therapeutic Work in Schools" was written with Becky Hall.]

Suicide is currently the third leading cause of death among youth; it has been named a public health concern. A number of programs have been developed to prevent suicide; many of these involve intervening with youth who are known to be at-risk because of their depression, expressed suicide ideation, or previous suicide attempts. This paper serves as a qualitative review of existing interventions for adolescent suicide. Long-term outcome data on existing programs are relatively scarce. However, promising current interventions include strategies to help youth tolerate intense negative affect and maintain emotional regulation. Individual psychotherapy for suicide prone youth is often conducted in conjunction with pharmacological treatments. Other noteworthy suicide interventions address the family dynamics surrounding suicidal youth, often by including the family in treatment. Interventions that increase the adolescent's motivation for treatment and likelihood of treatment compliance are also under current investigation. Modes of delivery for suicide interventions may also be changing with the inclusion of technology in service access and provision. Essential elements of effective suicide prevention programs and concerns with existing suicide-related interventions are also summarized.

This paper aimed to highlight the process of therapist direct contingent responding to shape client behavior in two Child Behavior Analytic Therapy (CBAT) cases using transitional probabilities. The Functional Analytic Psychotherapy Rating Scale (FAPRS) was used to code client behaviors and the Multidimensional System for Coding Behaviors in Therapist-Client Interaction (SiMCCIT) was used to code therapist behavior. Measures of behavior duration and transitional probability were taken from nine sample sessions for Client 1 and 10 sample sessions for Client 2. The first treatment was successful and lasted 18 sessions, while the second treatment was unsuccessful. In the first case, coding results showed that problem behaviors (CRB1) decreased, and improvement behaviors (CRB2) increased. In the second case, CRB1 predominated through seven sessions, and CRB2 did not show stability. Transitional probabilities indicated regularities in therapist responding to the client's clinically relevant behaviors, especially with approval after CRB2. It is concluded that contingent responding with approval functioned to shape client improvements in the first case, but not in the second case. (Contains 2 tables, 2 figures, and 1 footnote.)

Problems with intimacy and interpersonal issues are exhibited across most psychiatric disorders. However, most of the targets in Cognitive Behavioral Therapy are primarily intrapersonal in nature, with few directly involved in interpersonal functioning and effective intimacy. Functional Analytic Psychotherapy (FAP) provides a behavioral basis for working on intimacy and interpersonal functioning. The current paper describes how intimacy concerns are addressed by FAP and provides evidence for the need to assess and understand the role of intimacy across a number of disorders. There are several justifications for support for including attempts to measure intimacy and design treatments to increase clients' effectiveness in intimacy. In conclusion, there appears to be a need to empirically determine the extent to which intimacy should be a therapeutic target of interest across many psychiatric disorders and FAP may be an important part of therapeutic change in these areas.

The Experiencing of Self Scale (EOSS) was created for the evaluation of Functional Analytic Psychotherapy (Kohlenberg & Tsai, 1991, 2001, 2008) in relation to the concept of the experience of personal self as socially and verbally constructed. This paper presents a reliability and validity study of the EOSS with a Spanish sample (582 participants, 18 to 70 years old; 198 men and 384 women), gathered from different cities, universities and clinical centers. The clinical sample consisted of 162 people undergoing psychological or psychiatric treatment and 420 people without problems. Standard questionnaires (Eysenk Personality Questionnaire-Revised, Rosenberg Self-Esteem and Dissociative Experiences Scale) which measure similar self-concepts were used to explore the validity of the EOSS. The results show high internal reliability (Cronbach's alpha = 0.935) and both high and significant correlations with the "neuroticism" scale of the EPQ-R (0.212, p less than 0.001), "dissociation" of the DES (r = 0.483, p less than 0.001) and negative self-esteem of the RSES (r = -0.544, p less than 0.001). The partial and total scores of EOSS also differentiated the clinical sample with high scores from the standard sample (t = 7.78, p less than 0.001). In conclusion, the EOSS has high internal reliability, high validity with similar self-concept scales, and it is also useful for evaluating people with psychological problems of self. (Contains 4 tables.)

Depression and cigarette smoking are recurrent, interacting problems that co-occur at high rates and--especially when depression is chronic--are difficult to treat and associated with costly health consequences. In this paper we present an integrative therapeutic framework for concurrent treatment of these problems based on evidence-based practices and Functional Analytic Psychotherapy (FAP). We report the results of a pilot study in which clients (n = 5) received the integrated treatment. Case material is presented to illustrate the integration of interventions within a FAP framework.

This paper presents a clinical case study of a depressed female, treated by means of Functional Analytic Psychotherapy (FAP) based on the theory and techniques for treating an "unstable self" (Kohlenberg & Tsai, 1991), instead of the classic treatment for depression. The client was a 20-year-old college student. The trigger for her problems was a sentimental break-up in addition to a degree of academic failure. She reported difficulty knowing how she felt, what she wanted, what she thought. At pretreatment, her scores on self-report questionnaires (the BDI, AAQ, and EOSS) were high, indicating moderate depression, no acceptance of feelings, and a high level of public control of self. The treatment lasted 23 sessions, with a follow-up 13 months later. Results showed the elimination of diagnostic criteria based on her behaviors in and out of sessions, and a considerable decrease in her scores in questionnaires, suggesting that FAP techniques targeting problems with the self may be clinically useful. (Contains 1 figure.)

Functional Analytic Psychotherapy (FAP) is a form of therapy grounded in behavioral principles that utilizes therapist reactions to shape target behavior. Despite a growing literature base, there is a paucity of research to establish the efficacy of FAP. As a general approach to psychotherapy, and how the therapeutic relationship produces change, FAP does not specify a disorder construct as a dependent variable. In addition, because of its functional, idiographic nature FAP is also challenging to specify as an independent variable. The present paper suggests interpersonal relating as a domain of focus for a line of FAP research and describes four levels of FAP application to contribute to specifying FAP as an independent variable for use in research. Illustrative data from an ongoing study comparing FAP to supportive listening for interpersonal difficulties demonstrates an application of these suggestions for promoting FAP efficacy research. (Contains 1 figure.)