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- PublicationA review of Boyne, E. (1993) Psychotherapy in Ireland(The Irish Society for the Prevention of Cruelty to Children, 1993)Up until now there has been no consumer's guide to psychotherapy in Ireland. Nor has there been a psychotherapy textbook with a uniquely Irish orientation. Edward Boyne's new volume, therefore, is an important book for both prospective psychotherapy clients and students of psychotherapy.
- PublicationThe Waterford mental health surveyThe primary objective of the Waterford Mental Health Survey was to document the prevalence of co-morbid personality disorders in a sample of inpatients and outpatients attending the HSE mental health service in Waterford and outline the implications of this for service development. Between July 2011 and June 2014, 100 inpatients and 99 outpatients were evaluated with the Structured Clinical Interviews for DSM-IV axis I and II disorders, the Childhood Trauma Questionnaire, the Global Assessment of Functioning rating scale, the SCORE family assessment instrument, the Camberwell Assessment of Need Short Appraisal Schedule, and the Readiness for Psychotherapy Index. Participants were consenting, consecutive referrals who were not too unwell to engage with the study. The sample interviewed was probably slightly higher functioning than all cases attending the service. With regard to the primary objective of the study, we found that 98.4% of cases had DSM-IV axis I psychiatric disorders and 39.3% of these had comorbid axis II personality disorders. Between approximately a half and three-quarters of cases with personality disorders had comorbid anxiety, depressive or alcohol and substance use disorders. Compared to those without personality disorders, cases with personality disorders had experienced more child maltreatment; had poorer personal and family functioning and more severe presenting problems; and reported greater unmet service needs and motivation for psychotherapy. In terms of service development, approximately 2 out of 5 patients attending the public mental health services in Waterford require specialist psychological therapy for personality disorders which addresses low levels of personal and family functioning and past history ofchild maltreatment. Specialist psychological therapies include dialectical behaviour therapy (Linehan, 1993. 2014), schema therapy (Young et al., 2007), cognitive behaviour therapy (Beck et al., 2004) and brief psychodynamic psychotherapy such as mentalization-based treatment (Bateman & Fonagy, 2006; Clarkin et al., 2010). A review of psychology staffing levels is required to determine the number of psychologists required to provide this type of service in line with recommendations in the national mental health policy - Vision for Change (Department of Health & Children, 2006) - and the HPSI Psychology briefing paper for the HSE mental health division (Heads of Psychology Services Ireland, 2014). Intensive initial staff training and ongoing supervision are required for psychologists to provide these specialist evidence-based interventions.
- PublicationA national survey of clinical psychologists in Ireland(Edwin Mellen Press, 2000)The results of a 1993 survey of 111 clinical psychologists practising in Ireland are presented in this paper.
- PublicationHarassment of clinical psychologists by clientsIn this survey conducted in 1997 and 1998 it was found that over two thirds of 137 clinical psychologists working in Irish Health Boards and Voluntary Bodies had experienced at least one sexual, physical and verbal potentially negative interaction with a client. The frequency with which particular negative interactions occurred differed across specialities. Seeking support from colleagues, addressing the issues raised by the negative interaction with the client, and taking self-protective measures were the most commonly used problem-solving coping strategies. Reframing negative interactions as therapeutic issues rather than sexual, physical or verbal aggression was the most common reappraisal strategy. Problem-solving based coping strategies were perceived to be the most effective. Negative interactions with clients and harassment by clients were unrelated to clinical psychologists stress levels as assessed by the GHQ-28.
- PublicationA study of the differential effects of Tomm's questioning styles on therapeutic allianceThis study examined the impact of Tomm’s (1988) four questioning styles on the therapeutic alliance in family therapy using an analogue method devised by Dozier in which families viewed videotaped scenes from simulated family therapy sessions portraying each of Tomm’s questioning styles and rated the alliance between the therapist and family.
- PublicationUrban public attitudes to the treatment of psychological problems and depression in general practiceA previous national study of public attitudes to depression indicated that only 17% spontaneously mentioned their general practitioner as someone who could help with depression, in contrast to 79% of respondents being willing to consult their G.P. in a similar U.K. survey. The present study undertook to examine the public perception of an urban sample to the treatment of depression in general practice and the factors associated with expressed unwillingness to consult. A random sample from the electoral register was drawn and 54 (89%) of 61 subjects selected were interviewed. While 85% of respondents were satisfied with their general practice care, only 24% to 52%, depending on the context and wording of the question, said that they would seek help from their general practitioner for depression. Factors associated with an expressed reluctance to consult were being male, dissatisfied with general practitioner care and believing that general practitioners were not qualified to treat depression.
- PublicationHistory of family therapy in Ireland. 1. A bird's-eye view(Family Therapy Association of Ireland, 2013-01)This paper presents an overview of the history of family therapy in Ireland. Profiles of key figures in the development of family therapy in Ireland are contained in a companion paper. In Ireland family therapy is a small profession, with under 200 registered therapists. The Irish family therapy movement began in the mid-1970s. By 1980 the Family Therapy Network of Ireland in the Republic of Ireland and the Northern Ireland Branch of the UK Association Family therapy had been founded. At present there are three main family therapy training centres in Ireland: two in the south (the Mater Hospital, affiliated to University College Dublin and Clanwilliam Institute) and one in the north (at Queen’s University Belfast). These centres run professional family therapy training programmes accredited by national and European psychotherapy associations, with which family therapists register. Accredited professional family therapy programmes in Ireland are 4-year part-time courses culminating in masters level qualifications. A primary degree in medicine, nursing, psychology, social science or education is a prerequisite for entry. The curriculum includes academic tuition and research, clinical practice, and personal development. Family therapists in Ireland work in both private practice and the public health service. Most family therapists in the public sector are employed as social workers, psychologists, psychiatrists or nurses, and conduct family therapy as part of their broader professional roles. Couple therapy in Ireland is provided by family therapists, and also by voluntary couple counsellors based in networks of local centres, some of which were established by religiously affiliated organizations, without a formal connection to national family therapy associations. The three major future challenges for Irish family therapy are creating a research infrastructure, developing a career structure in the public health service, and introducing statutory registration.
- PublicationPrevalence of CSA in IrelandProfessionals involved in working with victims or perpetrators of childhood sexual abuse (CSA) require a basic understanding of the nature of this problem in our society. The purpose of this article is to aid such an understanding from an Irish perspective by attempting a synthesis of two excellent and comprehensive research studies. Although these studies first appeared in the literature some time ago their findings remain relevant and in need of dissemination.
- PublicationThe Clonmel Project. Mental Health Service Needs of Children and Adolescents in the South East of Ireland: Final ReportThe aim of this project was to determine the prevalence of mental health problems among children and adolescents in the South East of Ireland and make recommendations for service development.
- PublicationThe clinical assessment of young people with sexually abusive behaviourThis chapter outlines some basic ideas that can be used to plan and conduct a clinical assessment for a young person referred for problems with sexually abusive behaviour. It begins by considering key characteristics that reflect a good approach to clinical assessment with this population. It then considers aspects of motivation that are important in planning such assessments. It will outline the main areas usually covered during a clinical assessment and concludes with ideas on formulating information from the assessment, report writing, and contracting for intervention. We use fictional case material to illustrate key points made regarding assessment throughout. The ideas contained in this chapter are drawn from a variety of sources including Beckett (1994), Graham, Richardson and Bhate (1997), Becker, (1998), APA Task Force (1999), Will (1999), and Sheerin and O’ Reilly (2000), and O’ Reilly (2001). Each of these authors provide useful information and ideas on conducting clinical assessments with young people who sexually abuse.