This paper is a reflective account of a personal experience of mental distress and the journey through mental health services that resulted. It is written from the perspective of a professional who had been working with children and their families for over 40 years, latterly as the director of children’s social care in a large local authority. Her working life was dedicated to assisting vulnerable children, young people and their families. The account demonstrates how quickly the mental health of a confident and highly competent professional can unravel without warning. The piece is written in the first person with no attempt to disguise how it felt but also reflects the considerations of a more ‘detached’ professional observer. The account emphasises the negative consequences of a diagnostic and medicalised view of mental distress which lacks an adequate awareness of the role of trauma in instigating mental health difficulties. Implications for the support of staff, self–care and a wider psycho social formulation of mental health distress are discussed.
This study aimed to qualitatively evaluate the unique lived experience of adoptive fathers, specifically their mental health and support needs. Following participation in a community peer-support group, adoptive fathers were interviewed, and interview data was combined with adoptive fathers’ contributions to a series of community workshops focusing upon the lived experience, mental health, and support needs of adopters. Data was thematically analysed, and four themes were identified, highlighting the multiple marginalisation of adoptive fathers, the reduction in mental health experienced by a change of role, the stigmatisation and silence around male mental health, and the importance of peer-support for adoptive fathers. Results are discussed in the context of social barriers and facilitators to male mental wellbeing and the wider literature on adoption and parenting, and recommendations are made for improvements to policy, practice, and adoptive fathers’ mental health.
We share our personal and professional journeys through different identity discourses that have shaped our practice as clinical psychologists and systemic psychotherapists working with children, adults and older people within public physical and mental health services. Through examples of our work with children affected by illness and disability, we track the development of our understandings of identity from ‘internal states of self’ to understandings that are relational, distributed, performed, and fluid. Integrating the practical theory of Coordinated Management of Meaning (CMM), Michael White’s Narrative approach, in particular the reauthoring map and Outsider Witnessing with a systemic constructionist approach to identity, we offer a therapeutic approach, the We-dentity Daisy Method, to provide an antidote to some of the more individualised and potentially pathologizing ways of describing young people’s experiences.
This project explored the relational context between parents and their autistic children in middle childhood. Familial, parental and child factors may significantly impact outcomes for autistic children, and represent a vital area for research. Specifically, the influence of the caregiver representations, child attachment patterns and parent–child interactions upon each other were investigated. All three constructs were separately assessed in 11 parent–child dyads (22 participants), with children aged 6–11 years who had received a diagnosis of autism. The study employed a multiple case-study methodology utilising Miles and Huberman’s abductive method of data reduction, display and conclusion development, to explore the complexity and connections in the data. The project highlighted high levels of adversity in the backgrounds of parents of the autistic children; an elevated level of unbalanced caregiving representations amongst the parents; and evidence of high-risk attachment patterns identified in the autistic children. Looking at the interaction of these factors, the study showed: 1. The relational nature of the behaviour of the autistic children; 2. mutual difficulties with emotional engagement, intimacy and co-regulation of affect; 3. the irreducibly unique nature of the relationships between autistic children and their parents, suggesting a need for bespoke, idiographic understanding of them rather than one size fits all explanations; and 4. that security and sensitivity can co-exist with an autism diagnosis, highlighting the limits of attachment theory to explain all difficulties experienced by these families. We suggest that a systemic attachment framework may broaden clinical and research enquiry, revealing the multiple challenges these families are facing, and the significant strengths and resources possessed, offering new avenues of support.
This paper is based on my experiences of becoming a systemic family therapist, reflecting on how my identity and Greek cultural narratives have shaped my practice. A historical overview of first-, second-, and third-order approaches illustrates the evolution of the self of the therapist in systemic therapy through self-reflexivity. Reflecting on my experiences in a multicultural context, I explore the significance of curiosity in understanding how my cultural narratives influence my practice. I examine how my identity is formed and re-formed based on context. To achieve this, I provide practice examples where I attended to my internal dialogues, used supervision, and applied reflective tools such as the cultural genogram. Expanding on these reflections, I propose the Culturally Permissioned Reflexivity Map (CPRM) framework, which integrates insights from the Location, Dislocation, and Relocation (LDR) framework (Draper, Marcellino & Thomson 2023), reflexive mapping approaches, including the Social Identity Map (Jacobson & Mustafa, 2019), the cultural genogram (Laszloffy & Hardy, 1995), and conceptual work on mapping emotional reflexivity (MacKian, 2004). The CPRM framework aims to deepen further our understanding as to how cultural contexts shape which emotions and professional positions feel permitted, silenced or tolerated within the therapeutic and supervisory relationships. The core argument of this paper is that, in therapeutic relationships, therapists should integrate all aspects of their selves to establish meaningful connections with clients. This integration is central to the therapeutic process and facilitates change.
