Social support for women with chronic pelvic pain: what is helpful from whom?

Eight women with Chronic Pelvic Pain (CPP) were asked, by means of semi-structured interview, what had been helpful and unhelpful in terms of social support from their partners, families, friends, acquaintances, doctors, nurses and other women with CPP. Firstly, thematic analysis employing a pre-defined social support category system revealed that particular forms of tangible support were preferred from specific support providers but emotional and informational support was appreciated from the whole support network. Secondly, interpretative phenomenological analysis revealed three major additional themes: ‘Pain and Suffering’ described the trauma suffered by these patients and the anger and anxiety surrounding their experience; ‘Ideal Social Support’ revealed a picture of desired support consisting of enduring emotional and practical support which did not undermine individual autonomy; ‘Shortfalls in Social Support’ had subsidiary themes entitled ‘Lack of empathy’ and ‘Lack of engagement’. These themes were described and discussed in relation to each other, extant research and their clinical implications.     

Reviews

Gorbachev, Glasnost and The Gospel by Michael Bourdeaux. Hodder and Stoughton, 1990. 226 pp. Hardback, £13.95. Paperback, £8.99.

The Lutheran Church and the East German State: Political Conflict and Change under Ulbricht andHonecker by Robert F. Goeckel. Cornell University Press, 1990. 328 pp.

With God, For the People by Laszlo Tokes with David Porter. London: Hodder and Stoughton, 1990. Paperback, 226 pp., £3.50.

In the Eye of the Romanian Storm by Felix Corley and John Eibner. Old Tappan, New Jersey: Fleming H. Revell Company, 1990. Paperback, 272 pp., $6.95.     

Can Giving Clients a Choice in Food Selection Help to Meet Their Nutritional Needs?: Investigating a Novel Food Bank Approach for Asylum Seekers

The aim of this research was to investigate whether a foodbank working directly with people seeking asylum and incorporating client choice, located in Melbourne Australia, can meet the nutritional requirements of asylum seekers. A structured process of direct observation was used to document each item selected from the foodbank in a single basket. The food baskets of 116 asylum seekers, all over the age of 18, who were wholly reliant on the foodbank were analysed for nutritional content. Analysis revealed that an average basket was deficient in almost all micronutrients including vitamins A, C, D and E, folate, calcium and zinc. Baskets were found to have higher than recommended levels of sodium and fat. Despite the foodbank allowing clients to individually select the food they wish to consume, the food baskets remained nutritionally inadequate. This may be due the structure of the foodbank, the nature of relying on community donations of food and complexities surrounding healthy food choice among asylum seekers. Providing choice around food acquisition is one way to promote dignity in the refugee determination process; however, this may not be the best way to provide a nutritionally adequate diet. In addition to donor guidelines that highlight the need for nutritionally and culturally appropriate foods, further supplementary nutritional education may be required to encourage healthy food choices where they exist.     

Reversibility and chiasm: false equivalents? An alternative approach to understanding difference in Merleau-Ponty’s late philosophy

The chiasm is usually considered the key notion for Merleau-Ponty’s later philosophy. I argue against a common conclusion, namely that ‘the chiasm’ is equivalent to ‘reversibility’. Even when the two terms are not taken as interchangeable, the precise nature of their relation has not been adequately established. Focusing exclusively on ‘reversibility’ has implications for a range of philosophical issues, including relations between self and other. The danger of substituting one term for the other is that existential relations are construed as inversions, rather than as genuine exchanges. I examine two trajectories that can be discovered in ‘The Intertwining—The Chiasm’. The first is the inclusion of difference within a peculiar, extended sense of ‘reversibility’. The second is the development of a plurality of expressions, among which ‘reversibility’ is necessary but not sufficient. I go on to argue that Merleau-Ponty secures difference within the chiasm by supplementing the notion of reversibility with ‘imminence’, the idea that something has not yet occurred. I also propose that the figure of a threshold illuminates how the chiasm operates as a transition where both joining and differentiation occur.     

Mothers’ Experiences of Parent-Reported and Video-Recorded Observational Assessments

Rigorous evaluation of early childhood interventions requires accurate and efficient measurement. Researchers commonly use parent-reported surveys or direct observations; both of which have inherent strengths and limitations. Existing attempts to understand the correspondence between these methods have been primarily quantitative in design. Little is known about parents’ unique, subjective experiences of parent-reported surveys and direct parent-child observations. In this paper, we describe the experiences of ten mothers of children aged 24 months, recruited from a randomised controlled trial of a nurse home visiting program for mothers at risk of experiencing social adversity. After completing both a survey and video-recorded parent-child observation, mothers participated in in-depth semi-structured interviews which were analysed thematically. Mothers voiced concerns about how researchers may view their parenting skills, and their child’s behaviour and development. Contrary to previous quantitative evidence, mothers reported parent and child behavioural change, which they attributed to the researcher’s presence. Mothers described how the structured requirements of the observation contributed to forced and unnatural interactions. The survey was viewed as a welcome opportunity to reflect on parenting skills, the parent-child relationship and the child’s development. Mothers identified practical strategies for minimising parent-child discomfort during video-recorded observations, such as the researcher averting their gaze or stepping out of the room. We highlight opportunities for enhanced data validity in research and clinical settings, strengthened participant engagement, and minimisation of participant discomfort. Given the exploratory nature of this study, we do not claim that results are necessarily generalisable to other parent or general populations. Further research is warranted to build the evidence regarding parent participation in early childhood research.     

The Role of Children��s Appraisals on Adjustment Following Psychological Maltreatment: A Pilot Study

Little is known about the cognitive mechanisms involved in the development of psychopathology following psychological maltreatment in children. This study therefore examined the role of thinking styles on children's outcomes following this subtype of maltreatment. Children who had experienced past maltreatment (n?=?24) and a control group (n?=?26) were assessed using self-report questionnaires. Maltreatment history, cognitive styles and psychological outcomes, such as depression, posttraumatic stress disorder (PTSD) and self-esteem were assessed. Parents/caregivers also completed a measure of child internalizing and externalizing behaviours. Psychological maltreatment made a significant contribution to children's self-reported depression and low self-esteem, and parent reported internalizing and externalizing problems, even after controlling for other abusive experiences. This was not the case for PTSD symptoms. Further, children's cognitive styles were associated with self-reported depression, self-esteem and PTSD. They did not, however, predict parent-rated emotional and behavioural problems. This study provides preliminary support for a cognitive model of adjustment following psychological maltreatment. The results indicate the need for enhanced community awareness about the impact of psychological maltreatment, and suggest a direction for therapeutic intervention.     

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.