Fast Feet Forward: A sports group for looked-after children and unaccompanied asylum-seeking children as an early intervention to process trauma and reduce distress

Looked-after children (LAC) and unaccompanied asylum-seeking children (UASC) are likely to have experienced adverse childhood experiences (ACEs) in their developmental years, leading to poorer outcomes in their health and psychosocial development. A novel, exercise-based early intervention utilising bilateral movements for UASC and adoptive children (An early intervention framework for the emotional health and wellbeing of unaccompanied minors, 2020) called Fast Feet Forward (FFF) has shown promise in providing relief from trauma symptoms. This study seeks to replicate the effectiveness of FFF and extend it to a new population of traumatised children. Two groups of FFF occurred with 18 children participating. Results revealed a statistically significant decrease in distress and an increase in positive cognitions for UASC, showing effective processing of trauma-related hotspots. The LAC cohort also demonstrated a statistically significant decrease in distress and disturbance. Support is demonstrated for the efficacy of FFF as a cost-effective and resiliency-building early intervention treatment utilising bilateral movements for traumatised populations, especially UASC.     

From scapegoating to thinking and finding a home: delivering therapeutic work in schools

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.     

Further considerations of theory,technique, and affect in child psychoanalysis: Two prelatency cases

The analyses of two young boys, 4½ and 5 years old, are presented. One child was severely inhibited and nearly mute; the other was disorganized, frenetic, and violent. In the context of these treatments, the author raises several questions related to clinical theory and technique, including the use of early interpretation of affect with such children; the possible benefit of verbalizing primary affects in this early interpretive work; and the roles of verbalization and affect in work with caregivers and adult patients.     

Homelessness and strategies of identity maintenance: a participant observation study

In order to investigate identity maintenance strategies used by a low status group, a covert participant observation study was conducted in a shelter for the homeless. From Social Identity Theory and previous research on the homeless, it was hypothesized that the identity maintenance strategies used would differ as a function of longevity of homelessness: the short‐term homeless (<2 years) would be less likely to identify themselves as homeless (social mobility), while the longer‐term homeless (>2 years) would identify themselves as homeless but engage in various types of social creativity to mitigate their situation. In addition to the strategies described in SIT, it was conjectured that some of the longest‐term homeless would have given up making any intergroup or other social comparisons. Of the various strategies found, some were beyond SIT. The pattern of strategy use was best interpreted mainly as a function of longevity of homelessness, but this was moderated by both experience and personality. A trajectory of change in identity strategies with longevity of homelessness was offered as a plausible frame of reference for further research. Methodological limitations, implications for Social Identity Theory and recommendations for improving the situation of the homeless were discussed. Copyright © 1999 John Wiley & Sons, Ltd.     

A place within the heart: finding a home with parental objects

For adopted and Looked After children with compromised early experiences, there can be troubling phantasies and anxieties associated with parental objects. These internal object relations can seriously restrict the development of secure intimate relationships with new parental figures. Adoptive parents and foster carers bear the brunt of the associated difficulties. Clinical work with the child, parents/carers, family, or network, may help processes of containment, differentiation, working through, mourning, and integration. This paper is based on thinking derived from clinical work with children who are adopted or Looked After, and with adoptive parental couples, carers, and networks. The primary focus is on how the child needs to find a ‘psychic home’ in the minds of others for their damaged internal parental objects, and the emotional capacities required in adoptive parents to provide this. I describe some of the complexities for adoptive parents and others in providing what is needed to enable the child to experience their internal parental objects in a fuller way. This process can allow the child to introject, identify with, and re-imagine their internal parental objects, and through this develop a more realistic relationship to their adoptive parents and to their birth parents. It promotes trust, freedom, and emotional depth in the relationship with parental figures.     

Intergenerational Transmission of Trauma-Related Distress: Maternal Betrayal Trauma,Parenting Attitudes,and Behaviors

The purpose of this study was to elucidate mechanisms involved in the intergenerational transmission of trauma-related distress. This study investigated whether betrayal trauma (BT; abuse by a person close to the victim) and specific parenting attitudes and behaviors among mothers with child abuse histories predicted internalizing and externalizing symptoms in their children. Mothers and children (ages 7–11) were recruited for a project on parenting and stress (N = 72). Maternal betrayal trauma predicted both internalizing (β = 0.33, p < .01) and externalizing symptoms (β = 0.25, p < .05) even when controlling for mothers’ trauma-related symptoms. Negative attitudes toward limit setting predicted externalizing symptoms (β = ?0.33, p < .05). Poorer communication (β = ?0.39, p < .05) but higher parenting satisfaction (β = 0.38, p < .01) predicted internalizing symptoms. These findings demonstrate the importance of assessing maternal trauma and parenting characteristics as part of interventions with symptomatic children.     

Homelessness Is Traumatic: Abuse,Victimization, and Trauma Histories of Homeless Men

Homelessness is traumatic, and trauma-informed care is an emerging best practice. Using structured interviews with day shelter clients (N = 152), this study examined trauma among homeless men. The PTSD Checklist (PCL–C) was used to assess for posttraumatic stress disorder (PTSD). Participants’ pattern of PCL–C responses suggested that 23% to 30% screened positive for PTSD. Those with positive PTSD screens had been homeless longer and were more likely to have met time criteria for chronic homelessness. They were significantly more likely to be veterans and to report violent attacks, abuse histories, and mental health problems. Importantly, only 69% of those with positive PTSD screens acknowledged current mental health problems. These individuals were much less likely to report mental health counseling in the prior year.     

Treating Multitraumatized,Socially Marginalized Children: Results of a Naturalistic Treatment Outcome Study

Although early-onset, repeated trauma is relatively common in socially marginalized populations and related to numerous negative outcomes, most empirically validated interventions are not especially well tailored to meet the complex and individualized needs of child and adolescent trauma survivors in such contexts. Integrative treatment of complex trauma (ITCT) was developed as a specialized treatment that is empirically informed, culturally sensitive, extendable beyond the short term, and customized to the specific social and psychological issues of each child. This article examines the potential effectiveness of ITCT in assisting 151 traumatized children living in an economically deprived environment. Results indicate significant reductions in anxiety, depression, posttraumatic stress, anger, dissociation, and sexual concerns as a function of time in treatment.     

Children’s representations of facial expression and identity: Identity-contingent expression aftereffects

This investigation used adaptation aftereffects to examine developmental changes in the perception of facial expressions. Previous studies have shown that adults’ perceptions of ambiguous facial expressions are biased following adaptation to intense expressions. These expression aftereffects are strong when the adapting and probe expressions share the same facial identity but are mitigated when they are posed by different identities. We extended these findings by comparing expression aftereffects and categorical boundaries in adults versus 5- to 9-year-olds (n = 20/group). Children displayed adult-like aftereffects and categorical boundaries for happy/sad by 7 years of age and for fear/anger by 9 years of age. These findings suggest that both children and adults perceive expressions according to malleable dimensions in which representations of facial expression are partially integrated with facial identity.     

Multidimensional Profiles of Welfare and Work Dynamics: Development, Validation, and Associations with Child Cognitive and Mental Health Outcomes

This prospective longitudinal study addresses the research gap in the literature regarding multidimensional variation in welfare use and employment patterns, and relationships of such variation with parent earnings and child development outcomes. This study also aims to address the limitations of welfare dynamics studies that do not examine how multiple dimensions of welfare receipt and employment co-occur. Cluster analysis was utilized, using monthly welfare and employment data from the National Longitudinal Survey of Youth, to examine variation within the welfare population in their welfare and work patterns across the first 5 years of children's lives. Six cluster profiles of welfare and work dynamics were found: Short-Term, Short-Term Work Exit, Working Cyclers, Nonworking Cyclers, Cycle to Long-Term Exit, and Long-Term. The clusters were validated using mother's 6th-year earnings as the criterion. The clusters' associations with child development outcomes in the cognitive and mental health domains (at ages 6 and 7) were then explored. Work following short-term welfare use was associated with higher child reading scores than that following long-term use (a moderate-size effect). Cycling on and off welfare in the context of high levels of employment was associated with higher child internalizing symptoms than cycling accompanied by low levels of employment (a moderate-size effect). Implications for evaluation of TANF welfare-to-work policies are discussed.     

Evolution of the wealth gap in child development and mediating pathways: Evidence from a longitudinal study in Bogota,Colombia

Large gaps in cognition and language on the Bayley‐III between the top and bottom household wealth quartiles in 1,330 children aged 6–42 months in a representative sample of low‐ and middle‐income families in Bogota were previously shown. Maternal education and the home environment mediated these wealth effects, whereas height‐for‐age mediated a small amount of the language deficit only. At ages 6–8 years, we relocated 72% of the children and assessed their IQ on the WISC‐V, school achievement, and behavior to investigate the evolution of the wealth gaps and potential mediators. The wealth gap in IQ at 6–8 years was significantly larger than that in a factor combining Bayley‐III language and cognition at 6–42 months; whereas the gap in achievement was larger but not significantly. Moreover, in cross‐sectional analysis, the IQ gap increased from 6 to 8 years reaching over 1 SD. In contrast, the gap in behavior was not significant in either childhood stage. Parental education and early home environment remained major mediators of the wealth gap in IQ and achievement at 6–8 years; later home environment and attending private education also had an effect; and early height‐for‐age was no longer significant. The home environment partly mediated the effect of parental education on wealth. All mediators combined explained most of the variance in the wealth gap; the remaining gaps being not significant. Results highlight the importance of the early home environment and suggest that interventions focusing on that should have long‐term benefits. Also, continued intervention through to 8 years may be desirable. A video abstract of this article can be viewed at https://youtu.be/_U53iXNww3I .     

网络词语与非网络词语的知觉差异:时间知觉、空间距离知觉与知觉范围

根据具身认知理论,人们的认知会受到身体活动的影响。网络环境下人的身体活动受到限制,因而其认知活动与非网络环境存在很大的差异。本研究目的在于考察人们对网络词语与非网络的日常词语的时间知觉,空间距离知觉与知觉范围是否有差异。结果发现被试对网络词语的时间知觉更长;网络词语的空间距离感与日常词语没有显著差异;在启动网络词语之后,被试的知觉范围缩小,对中心刺激的反应显著快于边缘刺激。本研究发现了网络词语加工在时间知觉和知觉范围上的变化。     

Borderline personality disorder,complex trauma,and problems with self and identity: A social-communicative approach

Borderline personality disorder (BPD) is a relatively highly prevalent psychiatric disorder that is associated with very high personal and socioeconomic costs. This paper provides a state-of-the-art review of the relationship between complex trauma and key features of BPD, with a focus on problems with self-coherence and self-continuity. We first review evidence for the high prevalence of complex trauma in BPD patients. This is followed by a discussion of emerging knowledge concerning the biobehavioral mechanisms involved in problems related to self and identity in BPD. We emphasize three biobehavioral systems that are affected by complex trauma and are centrally implicated in identify diffusion in BPD: the attachment system, mentalizing or social cognition, and the capacity for epistemic trust—that is, an openness to the reception of social communication that is personally relevant and of generalizable significance. We formulate a new approach to personality and severe personality disorders, and to problems with self and identity in these disorders, rooted in a social-communicative understanding of the foundations of selfhood. We also discuss how extant evidence-based treatments address the above-mentioned biobehavioral systems involved in identity diffusion in BPD and related disorders, and the supporting evidence. We close the paper with recommendations for future research.     

The Voices of Therapists and Children Regarding the Inclusion of Children in Family Therapy: A Systematic Research Synthesis

In 1970, Nathan Ackerman challenged the field of marriage and family therapy to actively involve young children in the family therapy process. How has the field of marriage and family therapy responded to his challenge? Using a systematic research synthesis to review and critique the non-empirical and empirical literature in the area of children in family therapy, the author discovered that the field of marriage and family therapy has not responded to Ackerman's challenge in the way he may have hoped for nearly three decades ago. A summary of the literature's findings is provided and recommendations for future research, as well as implications, for the field of marriage and family therapy are discussed.     

Developing cognitions about race: White 5‐ to 10‐year‐olds' perceptions of hardship and pain

White American adults assume that Blacks feel less pain than do Whites, but only if they believe that Blacks have faced greater economic hardship than Whites. The current study investigates when in development children first recognize racial group differences in economic hardship and examines whether perceptions of hardship inform children's racial bias in pain perception. Five‐ to 10‐year‐olds (N = 178) guessed which of two items (low versus high value) belonged to a Black and a White child and rated the amount of pain a Black and a White child would feel in 10 painful situations. By age 5, White American children attributed lower‐value possessions to Blacks than Whites, indicating a recognition of racial group differences in economic hardship. The results also replicated the emergence of a racial bias in pain perception between 5 and 10. However, unlike adults', children's perceptions of hardship do not account for racial bias in pain perception.     

Some thoughts on the diffusion of psychoanalysis: the group dimension, ethics and the sense of identity

In this paper the author questions some of the ways in which psychoanalysis is passed on to the wider public, one of which is sometimes evocative of the sales promotion of a consumer product in contemporary society. This methodology does not give sufficiently deep prior thought to the eventual consequences of side effects. The detailed exposition of clinical cases, for example, raises sensitive ethical issues, even when anonymity is preserved. Although it is true that making information about Freud's theories more widely available may indeed encourage people to think about training as psychoanalysts, it is noticeable that this process is sometimes considered to be a form of training in itself. Some participants feel that acquiring a psychoanalytical vocabulary and reading clinical reports form a sufficient basis for practising thereafter as psychotherapists, both in institutional contexts and in private practice. The absence of group work on the part of the organizers might explain why closer study is not made of the methodologies of transmission and the different levels that it involves. This is sometimes due to the absence of a common object, formed within and by the group, and to the emergence of manic defences in the group.     

Testing the concurrent and predictive relations among articulation accuracy, speech perception, and phoneme awareness

The relations among articulation accuracy, speech perception, and phoneme awareness were examined in a sample of 97 typically developing children ages 48 to 66 months. Of these 97 children, 46 were assessed twice at ages 4 and 5 years. Children completed two tasks for each of the three skills, assessing these abilities for the target phoneme /r/ and the control phoneme /m/ in the word-initial position. Concurrent analyses revealed that phoneme-specific relations existed among articulation, awareness, and perception. Articulation accuracy of /r/ predicted speech perception and phoneme awareness for /r/ after controlling for age, vocabulary, letter-word knowledge, and speech perception or phoneme awareness for the control phoneme /m/. The longitudinal analyses confirmed the pattern of relations. The findings are consistent with a model whereby children's articulation accuracy affects preexisting differences in phonological representations and, consequently, affects how children perceive, discriminate, and manipulate speech sounds.     

Child psychotherapy with looked after and adopted children: a UK national survey of the profession

Relatively little empirical data is available about the range of work undertaken by child psychotherapists in the UK; however, previous surveys have shown high levels of complexity amongst children referred to child psychotherapists and an increasing proportion of work with children in foster or adoptive placements. Aims: We sought to examine child psychotherapists’ working practices with looked after and adopted children (LAAC), including the types of activities undertaken and their views on this work. Method: An online survey was designed to elicit this information from the members of the Association of Child Psychotherapists (ACP), the regulatory body for child psychotherapists in the UK. The survey included a number of categorical and open-ended questions, which were analysed quantitatively and qualitatively. Findings: 215 responses were received (24.5% of the eligible ACP membership). The vast majority of the sample were working with LAAC in some context (87.9%). Respondents were conducting a range of work: the most frequently conducted activities were assessment (83.7%), direct psychotherapy (82.3%), work with foster carers and adoptive parents (80.9%) and consultation with the professional network (76.7%). Thematic analysis of qualitative data suggested the complexity of problems amongst the children attending psychotherapy, as well as the perceived need for long-term work with these children. Many respondents placed emphasis on the importance of working with the professional network around the child, including foster carers and adoptive parents, despite feeling that this was often an under-resourced area of child and adolescent mental health services. The implications of the survey for practice and future research are discussed.     

Biographical truths and their clinical consequences: Understanding ‘embodied memories’ in a third psychoanalysis with a traumatized patient recovered from severe poliomyelitis

The relationship between ‘narrative’ and ‘historical–biographical truth’ in psychoanalytic treatment has become the subject of many controversial debates in recent years. Findings of contemporary memory research have lead to great scepticism as to whether therapists are able objectively and reliably to reconstruct biographical events on the basis of their observations in the therapeutic situation. Some authors even claim that psychoanalysts should concentrate exclusively on observing the here and now of the patient′s behaviour within the transference relationship to the analyst. In this paper it will be discussed whether the baby has been thrown out with the bathwater in this debate. Centred around the insights from a third psychoanalysis with a patient who suffered from a severe case of childhood polio, the hypothesis will be discussed that working through the traumatic experience in the transference with the analyst, as well as the reconstruction of the biographical–historical reality of the trauma suffered, prove to be indispensable for a lasting structural change. Integration of the trauma into one′s own personal history and identity is and remains one of the main aims of a psychoanalytic treatment with severely traumatized patients. The reconstruction of the original trauma is indispensable in helping the patient to understand the ‘language of the body’ and to connect it with visualizations, images and verbalizations. The irreversable wounds and vulnerability of his body as the ‘signs of his specific traumatic history’ have to be recognized, emotionally accepted and understood in order to live with them and not deny them any longer. Another important aspect in psychoanalysis is to develop the capability to mentalize, in other words, to understand the intentions of central (primary) objects related to the trauma. The concept of ‘embodied memory’ might be helpful in understanding precisely in what way ‘early trauma is remembered by the body’. Observing in detail the sensory‐motor coordinations in the analytic relationship enables one to decode the inappropriate intensity of affects and fantasies which match the original traumatic interaction and are revealed as inappropriate reactions in the present, new relationship to the analyst.