A fertile matrix: the birth of the Forensic Psychotherapy Society

This paper traces some aspects of the fertile matrix within which, over many years, the application of a psychoanalytic perspective to clinical work with the most severely mentally ill, difficult and at times frightening patients in secure and community settings has evolved and now led to the recent inauguration of the Forensic Psychotherapy Society (FPS), a new Member Institution of the British Psychoanalytic Council. The Society provides both a framework for a national, multidisciplinary professional training in psychodynamic forensic psychotherapy and the potential launching pad for an active post-qualification organisation supporting CPD and all other forms of professional development. The particular contributions to the birth of the FPS of the Forensic Psychotherapy Department at West London Mental Health NHS Trust, partly because we know it best but also because it is part of the largest forensic psychiatric service in the United Kingdom, are described.     

Mediation in Health Care Settings: Some Theoretical and Practical Concepts

Selected topics are discussed that may be relevant to psychologists in medical mediation and bioethical consultations, such as family conflict and DNR (do not resuscitate) orders. The premise is that psychologists will be more involved in these disputes than ever before. This article includes some relevant theoretical issues and practical procedures for conducting mediation disputes in health care settings.     

Will the Mother-Group Have a Face? The Future of the Facilitating Environment

The author predicts that maintaining the responsible practice of group psychotherapy in the coming years will require attention to three areas of professional life. The training of group therapists must include group-as-a-whole, in addition to intrapsychic and interpersonal, theoretical constructs. A supportive network of professional colleagues must be available to provide consultation and continuing education. Finally, a culture that values the necessary components of group psychotherapy practice must be encouraged and supported.     

School-Based Mental Health Services: Definitions and Models of Effective Practice

ABSTRACT

School-based mental health services are those delivered by school-employed and community-employed providers in school buildings. With the implementation of provisions of the Patient Protection and Affordable Care Act (2010) that funds school-based health centers, school-based mental health services could become more broadly available in communities throughout the United States. Playing a pivotal role in promoting models for school-based services that maximize benefits to children and adolescents while making efficient use of communities' mental health resources are school psychologists. School psychologists, who recognize and respect the separated development of school and community mental health professions, can foster school–agency partnerships to coordinate children's mental health services that are comprehensive, child centered, family focused, and culturally competent. In this article, we provide three case examples using the Participatory Culture-Specific Intervention Model (B. K. Nastasi, R. B. Moore, & K. M. Varjas, 2004 Nastasi, B. K., Moore, R. B., & Varjas, K. M. (2004). School-based mental health services: Creating comprehensive and culturally specific programs. Washington, DC: American Psychological Association. [Google Scholar]) as exemplars for the implementation of community partnerships providing comprehensive culturally and contextually relevant school-based mental health services.     

Supervisory countertransferences and impingements in evaluating readiness for graduation: Always present,routinely under‐recognized

Utilizing detailed, in‐depth material from supervisory hours from around the world (explored in End of Training Evaluation groups), this paper shows that supervisors are subject to multiple, diverse and, at times, ongoing intense countertransferences and impingements on their ability to evaluate candidates’ progress. Multiple external and internal sources of these impingements are explored. It is suggested that supervisory countertransferences and their manifestation in parallel enactments remain under‐recognized, their impact underappreciated, and the information they contain underutilized. It is argued that the recognition, containment, and effective use of the parallel process phenomena and supervisory countertransferences are essential in order to evaluate candidates’ progression and readiness to graduate. Common signals of such entanglements in the supervisor's evaluative function are identified. Three remedies, each of which provides a ‘third,’ are offered to assist supervisors in making effective use of their countertransference: self‐supervision, consultation, and institutional correctives.     

Is there a place for individual subjectivity within a social constructionist epistemology?

The epistemological turn towards social constructionism has become well established within the field of family systemic therapy. Social constructionism has provided therapists with a theoretical rationale for the concentration upon the social context within which individuals and families live their lives. This is a philosophical position that pushes to the margins the positivist premise that individuals have fixed and measurable personalities in favour of a discourse which proposes that the person is encountered differently within different social contexts. Prompted by the growing interest in systemic practice with individuals and by the rediscovery of the psychoanalytic canon within family therapy literature, the adequacy of this position is examined and an attempt is made to open up a space within social constructionist discourse for a theory of individual subjectivity. Findings from a research project are the starting point for this venture. These findings are understood through the lens of psychoanalytic theory, with particular reference to the work of Jacques Lacan.     

Ethics Consultation and Autonomy

Services of ethics consultants are nowadays commonly used in such various spheres of life as engineering, public administration, business, law, health care, journalism, and scientific research. It has however been maintained that use of ethics consultants is incompatible with personal autonomy; in moral matters individuals should be allowed to make their own decisions. The problem this criticism refers to can be conceived of as a conflict between the professional autonomy of ethics experts and the autonomy of the persons they serve. This paper addresses this conflict and maintains that when the nature of both ethics consultation and individual autonomy is properly understood, the professional autonomy of ethics experts is compatible with the autonomy of the persons they assist.     

The profession of ferryman: Considerations on the analyst's internal attitude in consultation and in referral1

Psychoanalytic consultation is an interview with a patient who will not be taken in treatment by the consultant analyst, but who will be sent to another, perhaps specifi cally chosen, colleague after one or more assessment sessions. This practice is becoming increasingly important since, besides traditional private relationships between consultant and patient, it is now common in many specialized centres affi liated to offi cial psychoanalytical institutions. The author explores some fundamental aspects of the analyst's internal attitude in consultation: motivation to know; a ‘concave’ attitude to listening; responsibility in proposing suitable technical choices and referral to a further specialist; empathy and partial identifi cation; the balance between authentic experience in the consultation and risks of seduction; internal links within the community of colleagues; the technique for sending patients on. He presents a clinical example, specifi cally aimed at reproducing the internal attitude of the analyst, together with the necessary work that allows a diffi cult patient to initiate psychoanalytic treatment.     

Taking Cognitive-Behavior Therapy to School: A School-Based Mental Health Approach

This paper offers an overview using cognitive-behavior therapy (CBT) within a school system. In addition to providing services to individual students, this article provides an overview of implementing CBT into a system of school-wide mental health services. Interventions are discussed at three levels—universal school-wide interventions, target interventions with at-risk students, and intensive interventions with students in need. Examples of specific programs or intervention are given for each level.     

Exploring the Relationship Between School Counselors’ Perceived ASCA National Model Implementation,Supervision Satisfaction,and Burnout

The authors investigated the relationship between perceived American School Counselor Association (ASCA) National Model implementation, supervision satisfaction, and burnout in a sample of 208 practicing school counselors, of whom all were members of ASCA. After school district type, grade level, and consultation hours were controlled, results showed that increases in perceived ASCA National Model implementation and supervision satisfaction were related to decreases in burnout. Implications for the school counseling profession are discussed.