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Purpose This study aims to establish the perspectives of community providers on challenges and enablers in developing child mental health capacity in disadvantaged communities in South Africa. Design/methodology/approach The authors involved 29 community providers operating in a large urban-deprived area in the Gauteng Province, east of Johannesburg. Community providers had educational, social and health care backgrounds. Their perspectives were captured through three focus groups, two participatory workshops and reflective diaries. Data were integrated and subjected to inductive thematic analysis. Findings Three interlinked themes were identified. Community mobilization was viewed as pre-requisite through mental health awareness and strategies to engage children, youth and parents. Service provision should take into consideration contextual factors, predominantly inequalities, lack of basic needs and gender-based issues (domestic violence, teenage pregnancy and single motherhood). Participants referred to severe mental health needs, and related to physical health conditions, disabilities and impairments, rather than to common mental health problems or wellbeing. They proposed that capacity building should tap into existing resources and integrate with support systems through collaborative working. Practical implications Child mental health policy and service design in Majority World Countries (MWCs), should involve all informal and structural support systems and stakeholders. Contextual factors require consideration, especially in disadvantaged communities and low-resource settings, and should be addressed through joined up working. Originality/value Children’s mental health needs are largely unmet in MWC-disadvantaged communities. These findings capture the experiences and perspectives of various community providers on how to enhance mental health provision by mobilizing communities and resources.

To date, the study of how health and wellbeing are actualized in organizations and how an organization’s interactional practices shape an environment that is potentially harmful to health is understudied. Much of the research around this topic has centered on personality and individual differences, as well as health and safety or ergonomics. Little understanding exists of how interactional practices might serve to prioritize health and wellbeing. In this paper, we introduce discursive psychology (DP) – a qualitative approach to studying talk and text that focuses on examining what is accomplished through people’s interactional practices. We provide an overview of DP and discuss its underlying assumptions, analytic process, and quality measures. To illustrate the application of DP to HRD, we include data extracts that highlight the impact of question design. To conclude, we point to how DP might afford HRD scholars opportunities to generate new theoretical understandings about organizational practices.

Ayres et al's (2021) reflective account published in this journal discusses Ayres' experience of undertaking a doctoral study concerned with how mental health nurses who had been assaulted by patients in secure settings make sense of this experience. This commentary recognises the importance of extending the dialogue initiated by Ayres' account, specifically regarding intersubjectivity in research relationships and research beneficence. An emphasis is placed on how practitioner participation in research interviews, whether as the interviewer or interviewee, can be a cathartic experience and foster practice reflection. However, engagement in more sensitive research may also present additional risk considerations for the insider researcher, such as emotional safety risks.

This article adds to literature addressing research beneficence from a psychoanalytic perspective, providing reflections focussing on notions of containment and container-contained dynamics as derived from the Kleinian/post-Kleinian tradition of psychoanalysis. It does so by reference to the accounts of participants in a study which explored how professionals working in local authority children’s services in England experience the suffering of parents. In this research, a psychoanalytically informed interview approach was used, and space was provided for participants to reflect on the experience of participation. The variable representation of this experience is considered along with the experience of the researcher carrying out the interviews. Questions are raised about using the language of containment in the context of this research approach and whether this may say more about a researcher’s desire to be helpful to participants and less about participants’ actual experiences (and a genuinely psychoanalytically based understanding of them).

This article focuses on approaches to qualitative research interviewing that draw direct inspiration from psychoanalytic therapy. The reflective discussion piece provides a critical spotlight on this method to promote reflection and ethical application.To provide clarity regarding the meaning of psychoanalytically informed, psycho-social research and the interpretive nature of qualitative interviews and of therapy, and to reflect on nurse researchers' partiality for using quasi-dynamic interpretative comments and the sharing of formulations in interviews.The authors review relevant literature, and comment on the apprehension and uncertainty researchers may experience with this type of research approach.Researchers should consider how they conduct themselves as interviewers and what to share of the analysis of participants' accounts based on the specifics of the research, including their or their team's experience of conducting psychotherapy and their and participants' expectations about what may be therapeutic about interviews.Psychoanalytically informed research interviewing should be used in a reflective way by nurse researchers with attention paid to the limitations and possibilities of parallels between psychotherapeutic and research interview dialogue.

Purpose The purpose of this paper is to report findings from a service evaluation undertaken within a single specialist child and adolescent mental health service (CAMHS) team. The team works closely with local authority children’s services to serve specific populations recognised as experiencing higher levels of mental health need, including children living in alternative care and with adoptive families. The evaluation sought to better understand the experience of this provision during the COVID-19 pandemic and concomitant increase in remote and digitally mediated care delivery. Design/methodology/approach Analysis of the accounts of 38 parents, carers and professionals involved with the team gathered via telephone interviews and email and postal questionnaires. Findings Similar views were expressed from participants involved with the team before and following the onset of the pandemic. Overall, satisfaction was high; however, changes in care appeared more challenging for those already involved with the team before the pandemic. Differences in experience between groups were also evident. Whereas foster carers’ accounts were generally appreciative of the involvement of clinicians, particularly regarding clinician–patient relationships, amongst adoptive parents and members of children’s birth families there were more mixed and negative impressions. Originality/value Locally based service evaluations can help inform care pathway planning in specialist CAMHS provision as part of wider quality improvement initiatives. This is especially relevant considering the repercussions of the COVID-19 pandemic and as the longer-term acceptability of remote working practices is appraised.

Adolescents are spending significant time online. Consequently, concerns are consistently raised about potential negative impacts on their mental health. Potentially, these concerns minimise their autonomy and reify the construction of the vulnerable adolescent. Using template analysis, we explored adolescents’ perspectives ( N = 54) of the relationship between social media and mental health. We centrally considered the wide array of uses made of different social media by the participants, focusing on their understandings of the potentially positive effects these might have. Focus group discussions showed social media could be used to reduce stress, have value for social connectivity, were an important source of information about mental health, and provided a platform for peer-to-peer support. Our conclusion indicated adolescents are generally socially competent online and are often experimenting with their emergent sense of agency.

Of interest across the domains of sport, education and health in the UK and internationally is the challenge of engaging girls in physical activity. There has been increasing support for novel approaches that take seriously the notion of ‘co-design’: i.e. involving girls in decision-making processes that directly and indirectly affect their engagement with physical activity. Given this approach is still in its infancy, this study set out to explore pupils’ experiences of a co-designed school-based physical activity programme–the UK Youth Sport Trust’s Girls Active programme–and offers suggestions for enhancing future co-design interventions. We report analysis of 22 focus groups conducted with 143 pupils from eight of the ten schools that engaged in the Girls Active programme. Seeking to explore how co-design can be optimised, the analysis arrived at a conceptualisation grounded in comfort theory, articulated here across three sources of comfort and discomfort: material, social and practical. We discuss how orienting future co-design interventions around these sources of discomfort may be a useful way of avoiding several significant reasons why girls might disengage from physical activity in schools. Crucially, we suggest that pupils are uniquely placed to offer insight and foresight about experiences of discomfort, making a co-design approach a potentially powerful way to help navigate what can be a complex, changing and context-sensitive issue. Finally, important distinctions between co-design and co-production are discussed to encourage researchers in the field to carefully consider which of these approaches are most appropriate for their own work.

Child mental health assessments are complex and involve the analysis of data from multiple sources to inform treatment decisions. Question sequences are central to mental health assessments; however, little research has examined the functions of questions in child mental health interactions, particularly questions that aim to elicit information from children that might be used to inform diagnosis and treatment. In this study, we utilize a large corpus of video-recorded child mental health assessments to examine the use and function of a particular kind of wh-question—circular questions—that is, questions that seek clients’ views on other family members’ feelings, actions, and thoughts. Using conversation analysis, we identified three “broad” functions of circular questions in child mental health assessment. Our findings provide clinicians with clinically relevant examples for using circular questions to more fully involve children in the assessment process and acquire valuable information for diagnosis.

Approaching qualitative interviews using principles drawn from psychoanalytic therapy can assist nurse researchers in developing nuanced accounts of participants' and their own subjectivity. Yet, doing so means confronting questions about the use of psychoanalytic concepts and techniques outside the traditional clinical context of the consulting room.To consider the researcher's interpretive involvement when a psychoanalytically informed interview approach is used with specific reference to email correspondence as a form of interpretive intervention.The authors describe the experience of completing a study involving a psychoanalytically informed interview approach. The interpretive quality of email correspondence is illustrated via reference to the case of one study participant for whom this correspondence appeared to help in the level of insight afforded overall.When using a psychoanalytically informed interview approach, researchers should consider emails delineating topics for discussion in follow-up interviews as a form of interpretive intervention.Nurse researchers interested in this type of method should reflect on the interpretive function of email correspondence. Pre-participation and pre-interview dialogue with participants may be used to explore participants' views on the potentially therapeutic aspects of participation and what might be related to them of the researcher's understanding.

PurposeThe paper aims to explore the anxiety of university students. The authors note that the rhetoric of the snowflake is frequently invoked in lay discourse to characterise a generation of young people as overly sensitive. This misleading conceptualisation is potentially stigmatising.Design/methodology/approachInterviews were conducted with tweleve young women (18–25 years) about anxiety during their transition through university and into adulthood.FindingsThe authors identified three themes: (1) students in a modern world, (2) gendered demands and (3) anxiety of adulting. Analysis demonstrated numerous, transecting and discourse-informed anxieties about modern life.Practical implicationsUniversity professionals may benefit from understanding the gendered dimensions of anxiety associated with transitions to adulthood, including the increased pressures to succeed and achieve.Originality/valueThe arguably pejorative label of “snowflake” could negatively impact the social progress made in recognising the importance of taking care of mental health and help-seeking. This is especially concerning for females, as they have higher prevalence of anxiety conditions than males.

This research note explores two inter-connected ideas. First, that the category of ‘vulnerable’ groups has expanded and has sometimes been used to exclude seldom heard groups from research. The underpinning protectionist polemic, whilst well-intended, has arguably led to disempowerment of the very groups they intended to safeguard. Learning lessons from advances in research with children can be utilised to develop a more inclusive and empowering approach with adults while simultaneously addressing safeguarding. Second, the note values the potential of using naturally occurring data as a mechanism for including vulnerable groups in research. An example is offered attending to frequently excluded inpatient voices in healthcare studies. The practical and ethical benefits of using naturally occurring data are explored for countering arguments against the inclusion of vulnerable groups using an example of autistic inpatient research from the UNITE study. Researchers are invited to make practical adjustments to maximise involvement opportunities, and a reminder that capacity to take part in research activity may be facilitated by these modifications. Naturally occurring data offer the possibility of understanding complex hospital practices without additional burdens of researcher-generated methods.

The objective was to establish how stakeholders in low- and middle-income countries (LMIC) conceptualize child mental health impact. Semi-structured interviews were conducted with 18 stakeholders from disadvantaged urban communities in Kenya, South Africa, Turkey and Brazil. Participants represented education, welfare and health care agencies; as well as community and religious groups. Data were analysed through a thematic approach and three related themes were identified. Impact was defined as a process of change, with child-centred outcomes and measures that were broader than mental health symptoms improvement. Beneficiaries were identified at child, family, community and service level. Participants wished to see strategies that ensured sustainability of impact, namely child mental health policy, stakeholder engagement, interdisciplinary working, and capacity-building for all stakeholder groups. Child mental health service transformation in LMIC, especially in areas of deprivation, needs to build on existing resources and strengths by co-producing psychosocial outcomes with a range of professional and community stakeholders. Impact on children’s mental wellbeing can be achieved through a co-ordinated strategy that involves designated policy, capacity-building, and interdisciplinary networks with meaningful community involvement.

Debates regarding quality in qualitative research are longstanding. There are continued calls for additional quality indicators that account for the heterogeneity of qualitative methodologies. In t...

Dear Professor HarveyWe write to your journal to illustrate the importance of suicide response and prevention, and to illustrate the value of a new model of police practice which has translatable p...

Suicide is a global public health challenge. We explore the benefits and challenges of operationalizing strategic objectives of national suicide prevention policies locally. To implement policy effectively, local resources must be mobilized, and we investigate a real-time surveillance, principles-based model led by the police through a multiple case-study design. We found current data collected on deaths by suicide is limited and more localized responses are necessary. Multi-agency communication, utilization of existing local support systems, and emotional support for frontline practitioners is essential. Police are on the frontline for suicide and are uniquely placed to collect data and support families.

With the prevalence of child mental health conditions rising, the role of the initial mental health assessment is crucial in determining need. Utilising a critical discursive analytic framework, we explored the ways in which parents during these mental health assessments constructed the child’s difficulties as medicalised and doctorable as opposed to systemic and familial. Through this discursive positioning, we examined the ways in which parents mitigated blame and accounted for the child’s behaviours and emotions. Parents engaged in three accounting practices to construct the child’s problems as dispositional and to mitigate against an alternative familial system interpretation. First, they drew upon normative cultural repertoires of parenting. Second, they mediated ways whereby normative practices were deviated from in the best interest of the child. Third, they rhetorically positioned overcoming systemic difficulties by illustrating cooperative parenting in separated families. Our findings have implications for how parents build a case for the need for medical intervention in assessment settings.

open access article This paper offers an illustrative example to demonstrate one way of combining qualitative methods. The context for the study was a UK inpatient psychiatric hospital. Data set one was collected from weekly ward rounds where inpatient staff met with autistic patients to review medication, listen to patient concerns and make plans or adjustments in light of this. Data set two was reflective discursive interviews with patients and staff. The research objective was to critically consider the potential reasons for discrepancies in dissatisfaction reports from patients in the interviews, compared to relative compliance exhibited by patients in the ward rounds. Utilising a video‐reflexive design and critical discursive psychology approach, both data sets were analysed together. It is possible to simultaneously analyse two different data sets, one naturally occurring and one researcher generated because of the epistemological congruence in the overall design. We have presented an argument for the benefits of mixing two qualitative methods, thereby extending the mixed‐methods evidence base beyond the traditional discussions of quantitative and qualitative paradigms.

Despite evidence identifying bullying as leading to severe distress, few studies have focused on bullied adolescents with existing mental health conditions. With increasing prevalence rates, it is ...

This paper introduces quality markers common to Discursive Psychology (DP) – a qualitative approach for examining talk and text. We offer a guide for researchers using DP and reviewers evaluating D...

© The Author(s) 2020. A distinction has been drawn between basic (pure) conversation analysis (CA) and applied CA. Applied CA has become especially beneficial for informing areas of practice such as health, social care and education, and is an accepted form of research evidence in the scientific rhetoric. There are different ways of undertaking applied CA, with different foci and goals. In this article, we articulate one way of conducting applied CA, that is especially pertinent for practitioners working in different fields. We conceptualise this as Reflective Interventionist CA (RICA). We argue that this approach to applied CA is important because of its emphasis on the reflective stance that is valuable to an understanding of research data, its commitment to collaboration with practitioners, and its inductive style. In this paper, we outline the core premises and benefits of this approach and offer empirical examples to support our argument. To conclude, we consider the implications for evidence-based practice.

Despite the considerable potential of qualitative approaches for studying the systemic and constructionist therapy process due to shared theoretical and epistemological premises, to date there is lack of a comprehensive qualitative synthesis of how change process is experienced and conceptualized by clients and therapists. To address this evidence gap, we performed a systematic meta-synthesis review of 30 studies reporting clients' and therapists' retrospective narratives of change process across systemic and constructionist models and across a range of client configurations, including individuals, couples, families, and groups. The studies were identified following a systematic search in PsycINFO and MEDLINE resulting in 2,977 articles, which were screened against eligibility criteria. Thematic analysis led to the identification of four main themes: (1) navigating through differences, (2) toward nonpathologizing construction of problems, (3) navigating through power imbalances, and (4) toward new and trusting ways of relating. Findings illustrate the multifaceted aspects of systemic and constructionist change process, the importance for their reflexive appraisal, and the need for further research contributing to the understanding of the challenges inherent in the systemic and constructionist therapeutic context.A pesar del potencial considerable de los enfoques cualitativos para estudiar el proceso de la terapia sistémica y construccionista debido a premisas teóricas y epistemológicas compartidas, hasta la fecha hay una escasez de síntesis cualitativas completas de cómo los pacientes y los terapeutas viven y conceptualizan el proceso de cambio. Para abordar esta falta de datos, realizamos una revisión sistemática de la metasíntesis de 30 estudios que informan historias retrospectivas de los pacientes y los terapeutas del proceso de cambio entre modelos sistémicos y construccionistas y entre una variedad de configuraciones de pacientes, entre ellas, individuos, parejas, familias y grupos. Los estudios se identificaron después de una búsqueda sistemática en PsycINFO y MEDLINE, de donde se obtuvieron 2,977 artículos, que se analizaron según los criterios de elegibilidad. El análisis temático condujo a la identificación de cuatro temas principales: 1) orientarse entre las diferencias, 2) hacia una construcción no patologizante de los problemas, 3) orientarse entre los desequilibrios de poder, 4) hacia formas nuevas y confiables de relacionarse. Los resultados ilustran los aspectos multifacéticos del proceso de cambio sistémico y construccionista, la importancia para su valoración reflexiva y la necesidad de más investigaciones que contribuyan a la comprensión de los desafíos inherentes en el contexto terapéutico sistémico y construccionista.尽管由于理论和认识论的共同存在，研究系统性和建构性治疗过程的定性方法具有相当大的潜力，但到目前为止，来访者和治疗师对改变的过程和概念化缺乏全面的定性综合。 为了解决这一证据缺口，我们对30项研究进行了系统的文献综述，报告了来访者和治疗师在系统和构建主义模型和一系列来访者配置(包括个人、夫妻、家庭和群体)对变化过程的回顾。 研究是在对PsycINFO和MEDLINE进行系统搜索后确定的，结果得出了2977篇文章，这些文章是根据相关的标准进行筛选的。 主题分析后识别出四个主题：1)在差异中找到方向，2)对问题的非病理学构建，3)在权力失衡中找到方向，4)关于新的和信任的关系。 研究结果说明了系统和建构主义改变过程的多方面，和对其反射性评价的重要性。也指出了进一步研究的需要，对理解系统和建构主义治疗环境中固有的挑战有帮助。.

Through empirical work we conceptualise a framework of an ethics of care philosophy with digital media, coining the notion, a ‘digital ethics of care’. Increasing focus on the potential of social m...

Child mental health services are in rising demand, but increasingly overstretched and difficult for families to access. This article examines rhetorical techniques used by parents seeking a mental health diagnosis for their child. Using recordings of consultations from a child mental health clinic (UK) with 28 families, analysis focuses on the use of ‘epistemic corroboration’, a strategy by which third-party candidate diagnoses are reported to support the parents’ case. That is, parents draw upon the expertise of non-present professional persons to strengthen their proposed diagnostic claims. Conversation analysis shows how this epistemic corroboration is reported by parents and received by mental health practitioners. Conclusions illustrate that mental health diagnosis for children is actively pursued by parents as they navigate labelling. This has implications for understanding the dilemmas created for families of possible medicalisation of their child to achieve the levels of support being sought.