Background: Research suggests that there are differences in the problems that are referred to Child and Adolescent Mental Health Services (CAMHS) by White British and Asian families as well as differences in how these services are accessed. There is a need for more information about how different ethnic communities perceive and access CAMH services. Method: White British or Pakistani mothers of children between 0–20 years at an urban health centre were invited to complete a study‐specific questionnaire written in English (with verbal translation provided when needed). Data were collected on awareness and experience of, and willingness to use CAMH services; severity of problems before referral is considered and additional factors that influence service use. Results: In comparison to White British mothers, Pakistani mothers were found to be less likely to consider a referral for problems judged as mild or moderate. There was no difference for severe problems. Qualitative factors that would enhance the use of CAMH services by Pakistani mothers include the availability of culture and gender matched therapists, and better access to translation facilities. Conclusions: The study highlights service needs and expectations of mothers of Pakistani origin, and emphasises the need for relevant, inclusive and culturally sensitive services.
It is important to differentiate between the mystical and religious experiences, as transcendent moments of spirituality are not automatically equatable with religious undertakings. The basic human dimensions of spirituality derive from instinctual archetypal roots and should not be given religious overtones as if they prove the factual existence of God. This results, as has happened in so many religions, in an anthropomorphic model of God in which a dead or imagined object is animated and endowed with human attributes in order to be worshipped in a very structured and ritualized manner. These objects are chosen specifically because they are dead or imaginary, as thoughts or feelings attributed to them cannot be either proved or disproved. By localizing individual or social thoughts and feelings in a God who confers an authoritative sense of the truth, the human craving for validation is satisfied.
ABSTRACT Enuresis is a common childhood problem which, although it causes considerable distress to both children and parents, nearly always responds to at least one of the available treatment modalities. These treatment options include behavioural techniques, cognitive therapy, medication and psychotherapeutic interventions. However, both behavioural treatment and pharmacotherapy have high relapse rates. In spite of the general acknowledgement that enuresis (especially secondary enuresis)indicates underlying psychological problems, few cases are described in the literature where a psychodynamic approach was used successfully. This is especially noticeable given the growing acceptance that enuresis is related to sub‐optimal parenting, poor child‐rearing practices and disruption of maternal care. The clinical vignette described is a case of secondary enuresis in a 10‐year‐old boy which responded favourably to psychodynamic input after behavioural, cognitive and family therapies failed to resolve the problem. The dynamic formulation postulated a desire for intimacy, following failed mother‐infant bonding due to maternal depression, which was obtained through enuretic symptoms and interpersonal conflict. This quest for intimacy through replication of early pleasurable somatic sensations and the utilization of conflict for attention‐seeking may rapidly develop into a repetitive cycle involving delinquency, crime and sexual perversions later in life. In such cases, a psychodynamic understanding is most likely to succeed as the enuresis represents an ego‐syntonic solution to possible ego‐fragmentation, or an attempt at preventing pending psychological breakdown.
Abstract An NHS Trust set up groups to teach social skills to children and adolescents using a cognitive behavioural framework. One group of seven children (five boys and two girls) is described. Parents were invited to a parallel parents' group. Each group lasted for 90 minutes and ran weekly for 6 weeks. Extensive liaison with parents and teachers took place before, during and after the group. Analysis of pre- and postgroup questionnaires sent to parents and teachers indicated improved social functioning, outside the group, for most of the children. Parents valued the dialogue with professionals and often felt supported by them for the first time. Therapists' contact with teachers ensured full knowledge of children's behaviour and the transfer of skills to schools. Cognitive behavioural techniques with children under-going group work require intensive liaison to facilitate generalization of skills learnt.
Introduction Enid Balint Irma Brenman Pick Fiona Caldicott Janine Chasseguet-Smirgel Peter Fonagy Michael Fordham William Gillespie Rosemary Gordon Robert Hinshelwood Robert F Hobson Mario Jacoby David Malan Joyce McDougall Anton Obholzer Malcolm Pines Charles Rycroft.
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