ISSUE 6 5 Spring/Summer 2012
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CHAIR’S WELCOME This issue of The Bridge highlights and reports on this year’s Emanuel Miller conference – which was successful and well attended, particularly by our members from disciplines concerned with education. The combination of clinical, research and educational speakers and delegates was a fine example of what this Association is for. At our AGM I will be welcoming Professor Kathy Silva as the next Chair of the Association, and I am sure that her appointment will be another step in the involvement of all the disciplines connected with young people’s mental health. The Jack Tizard Conference on 22 June will be highlighting social aspects, with a focus on inequalities and adversities that challenge children’s development. Everything we are doing - from our publications to our branch meetings, national conferences, master classes, special interest groups, encouragement to young researchers, and our current development of a really useful website is designed to help our members to help children better. And, of course, monthly and quarterly issues of our journals, JCPP and CAMH, always targeted, always expert, always considered, always balanced. Your continuing support for the Association will be continually, and fittingly, rewarded; new ideas, thoughts and proposals always welcome!
EDITOR’S OVERVIEW This edition of The Bridge presents a healthy balance of international, national and local content - from the National Emanuel Miller Conference to the North East Branch’s Dyadic Developmental Psychotherapy, to a summary of work carried out by an ACAMH member in India. A list of forthcoming ACAMH events features prominently - please take a look and see if any of them capture your interest and address your CPD needs. Some conferences are now so popular that early application is your only guarantee of a place. There are currently discussions underway to develop The Bridge into the kind of format you would find most helpful, perhaps to expand into more of a magazine format. However, it’s your resource, so please do share your views and suggestions: bridge@acamh.org.uk. We will potentially be looking for more contributions so do submit any articles that you think may be of interest to the wider readership.
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ACAMH Emanuel Miller National Conference: Speech, Language, Communication and Child and Adolescent Mental Health Highlights: recognised for its academic quality, relevance and international reputation of its presenters, this conference was designed to build on 2011’sYear of Communication and re-inforced both the importance for children and young people to develop good c-ommunication skills as well as the necessity to strengthen provision for those with speech, language and communication problems. Presenters were without exception passionate about their particular areas of expertise and keen to continue their excellent work – hugely encouraging at a time of government austerity – measure cutbacks. Opening Addressee: the Rt Hon John Bercow MP, Speaker of the House of Commons, began with a statement that would be a resounding theme throughout the day: communication is crucial! Central to his 2008 Bercow Report – still as relevant today as then – he highlighted other key themes which remain vital to providing support for those with speech and language needs, namely the importance of early identification and subsequent intervention, the need for a long-term view of ‘spend to save’, and the need requirement for extra surveillance during the transition to secondary school when provision can sometimes fall by the wayside.The addressee’s powerful concluding refrain, that in today’s financially-strained climate it is doubly important to protect the delivery of care for those with speech, language and communication difficulties, inspired each attendee to speak up for those who cannot speak up for themselves. Bercow Report: (Bercow Review of Services for Children andYoung People (0-19) with Speech, Language and Communication Needs) was published in July 2008 as the result of an independent cross-government review chaired by John Bercow, MP and RCSLT vice-president. It was the culmination of a major consultation process over ten months, gathering evidence and analysis, and including a questionnaire which received over 2,000 responses, meetings with groups of parents and visits to children's centres, nurseries, primary and secondary schools across England. It was commissioned as a response to the current arbitrary access to services for children and young people with speech, language and communication needs and the failure to meet their needs, despite the hard work and commitment of many professionals in health and children’s services.The report attempts to chart a course to enable speech, language and communication services to improve educational outcomes, promote public health, tackle anti-social behaviour and bolster the skills of the workforce. It makes recommendations to Government about the steps it should take to transform provision for and the experiences of children and young people with speech, language and communication needs and their families to facilitate improved educational outcomes, promote public health, tackle anti-social behaviour and bolster the skills of the workforce. Five key themes were identified – issues that need to be addressed for real change and improvement to occur – linked with which are a number of recommendations: • • • • •
communication is crucial; early identification and intervention are essential; a continuum of services designed around the family is needed; joint working is critical; and the current system is characterised by high variability and a lack of equity.
For a copy of the complete report, please see http://www.johnbercow.co.uk/pdf/Bercow_Report_Final.pdf Emanuel Miller Memorial Lecturer, Professor Dorothy Bishop, Professor of Neurodevelopmental Psychology, University of Oxford, based her presentation on a premise that Emanuel Miller would assuredly have fully supported, namely that behavioural data should be at the forefront of language intervention studies. With research increasingly focusing on measuring effects in the brain, often in an attempt to add authority to interventions, particularly commercial ones which frequently publish colourful images of brains pre- and post-treatment and publish these alongside pseudoscientific explanations to enhance the credibility of what might that would otherwise be judged as poor scientific accounts. Studies show that such strategies can enhance their credibility, even among scientists! Professor Bishop explained the importance of adequate control groups to confirm whether an intervention has been effective at the behavioural level, only then being able to be applied to find out what is going on in the brain. However, more behavioural studies are required on the process of language learning, the presenter’s own current work adding valuably to this resource. A couple of future directions of research, such as transcranial direct-current
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ACAMH Emanuel Miller National Conference: Speech, Language, Communication and Child and Adolescent Mental Health stimulation (tDCS) and smart drugs were highlighted which are useful in furthering our understanding, but development of more neuropsychological intervention studies around solid behavioural evidence are still lacking. Professor Karen Bryan (University of Surrey) focused on speech, language and communication disorders as a risk factor for re-offending.The incidence of young offenders with speech and language difficulties is all too high with a prevalence of around 60% of those in Young Offenders Institutes (YOI); given that such impairments are a risk factor for re-offending, urgent recognition of the need to reduce the risk factors is critical. Frequently masked by behavioural problems or the reluctance of those suffering communication disorders to admit it, early identification is not always easy. However, an intervention study which incorporatesd speech and language therapy with a more general programme of surveillance and supervision (ISSP) for those recently released from YOIs, found that the additional focus on speech and language was useful and that those individuals were better able to re-engage with education and with the community. Professor Maggie Snowling (University of York) stressed the importance of good early language skills in positively influencing later educational success. The presence of early language difficulties can influence attainment even if speech problems resolve themselves; such children often experience poorer literacy in later development in spite of normal language, achieving fewer high grade GCSEs than their typically developing peers.An early intervention targeting reading skill worked especially well when combined with phonology training, highlighting pointing to the prominence of oral language skill in underpinning reading ability. A subsequent intervention, which focused on improving oral language ability, did see some positive effects but did not seem to benefit reading. A targeted approach with younger children in nursery and the early school years (Language4Learning) also yielded improvements, with a combined approach training oral language, narrative and phonological skills being most successful. Although such interventions are often effective in the short term, there is a more limited understanding of the longer term benefits. Such studies indicate that oral language training in young children can significantly improve their reading comprehension, this being especially effective when combined with intensive vocabulary learning. Guest Lecturer Sheena Reilly, Professor of Paediatric Speech Pathology at the University of Melbourne, presented data from the Early Language inVictoria Study (ELVS), a largescale prospective population study focusing on identifying early predictors of poor language in later life and tracking trajectories. Despite language being central to everyday communication and functionalit, language impairments remain underresearched compared with other prevailing conditions such as diabetes or autism, in spite of their higher prevalence. Preliminary findings from ELVS suggest that trajectories are very moveable and language levels at two years are not necessarily a good predictor of later language ability. A parent-led intervention given to those assessed to have poor language skills at 12 months surprisingly found no differences between intervention and control groups, which could be caused by due to screening such young children being problematic due to sensitivity of measures, the low intensity of the intervention or its reliance on parental enthusiasm and commitment, or it could simply be ineffective in children this young or effective but with benefits only seen later in development.To conclude, rather than focusing on ‘red flags’ at particular ages, trajectories should receive more attention with a focus placed on surveillance and not screening. Professor James Law discussed the mediating effect of communication on behaviour, and the potential implications for intervention. Data from the Avon Longitudinal Survey of Parents and Children (ALSPAC) demonstrated that early social risk was associated with behaviour problems as measured on the Strengths and Difficulties questionnaire at age 13 and the Children’s Communication Checklist (CCC)
showed pragmatics at 8 years to be a partial mediator of the behaviour score. Professor Law explained that identifying such mediators is crucial for the effective design of interventions; interventions that act on a mediator give positive results, even with small sample sizes. With this is mind, the Social Communication Intervention Project (SCIP), a language-based intervention, was designed for children with pragmatic and social communication problems. School-aged children took part in up to 3 one-hour speech and language therapy sessions a week. Parent report data found that children who took part in this intervention had significantly improved in measures of language skills, social communication, social situations, and peer relations compared to a control group, leading to the conclusion that further work on the impacts of such interventions; most importantly on behaviour, is urgently required. Maggie Johnson, speech and language therapist advisor, focused on the importance of defining selective mutism accurately. Defined as the failure to speak in specific situations where speaking is expected, it is frequently misinterpreted as the child choosing not to speak, ; the term ‘specific mutism’ may therefore more accurately capture the true nature of the condition.The Diagnostic and Statistical Manual of Mental Disorders (DSM) intends to put selective mutism under social anxiety in its next version, though many children who have selective mutism are not socially anxious and can be happy playing in a social situation but just not want to speak. Under the wrong category in the DSM may lead children to be referred to services which do not best meet their needs, and the presenter advocated that a more useful classification in would be specific phobia.Without the correct diagnosis and referral, selective mutism can lead to isolation, low self-esteem and social anxiety, even though there is gathering evidence that these effects can be avoided and selective mutism completely overcome with the right treatment; the preferred method being cognitive behavioural therapy (CBT). However, the DSM proposed change in definition, may mean that these children cannot access the help they require. Conclusion: an informative, engaging and interactive day, bringing alive the day’s important theme and reinforcing that communication is crucial, in particular helping children to communicate from a young age and throughout childhood thus setting them up for later life; without such resources and time, children with speech, language and communication problems frequently go on to encounter academic, behavioural, social, and mental health problems. The expert presenters showed that it is possible to help these children, and that we should endeavour to create the best possible interventions to do so. Annie Brookman and Nicki Gratton, Research Assistants, University of Oxford Researcher Perspective: in keeping with its aim to support those still in training or in the early years of professional CAMH life, the Association was once again delighted to be able to offer complimentary attendance for a number of such trainees. Below is an overview from one such trainee, a first year PhD student: “My research will explore the relationship between child mental health and exclusion from school, and will involve a systematic review of the literature, secondary analyses of two epidemiological studies and a case control study of children who have been excluded from school or at risk of the outcome. The aim is to see whether there are specific difficulties that could be systematically assessed should a child have repeated disciplinary crisis, particularly relevant given that there is currently no set systematic assessment to identify children who are struggling with school. Attending this conference has helped me to reflect upon my own research and given me a great opportunity to listen to experts in the field presenting relevant and up to date perspectives and experiences around this area. I hope my PhD work will enable more understanding and clarity about the children that are being excluded from our schools and may could potentially minimise or remove the risk of exclusion from school. Claire Parker Peninsula College of Medicine and Dentistry in Exeter
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IT’S ALL ABOUT AUTISM Revised DSM-5 proposed changes … Publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in May 2013 marks one the most anticipated events in the mental health field. As part of the development process, the preliminary draft revisions to the current diagnostic criteria for psychiatric diagnoses were made available for public review - proposed changes as well as its history, impact, and developer: www.dsm5.org Autism Redefined – new diagnostic criteria more restrictive: Getting an autism diagnosis could be more difficult in 2013 - proposed DSM-5 changes may affect the proportion of individuals who qualify for a diagnosis of autism spectrum disorder, according to preliminary data presented by Yale School of Medicine researchers: "Given the potential implications of these findings for service eligibility, our findings offer important information for consideration by the task force finalizing DSM-5 diagnostic criteria," said Yale Child Study Center (CSC) director Fred Volkmar MD, who conducted the study with colleagues Brian Reichow and James McPartland. They found that in a group of individuals without intellectual disabilities who were evaluated during the 1994 DSM-IV field trial, it was estimated that approximately half might not qualify for a diagnosis of autism under the proposed new definition.Volkmar stressed that these preliminary findings relate only to the most cognitively able and may have less impact on diagnosis of more cognitively disabled people: "Use of such labels, particularly in the United States, can have important implications for service," he said. "Major changes in diagnosis also pose issues for comparing results across research studies." Volkmar and colleagues will publish full study results in the April print edition of the Journal of the American Academy of Child and Adolescent Psychiatry. Source: Yale University (20 January 2012) Autism redefined; ScienceDaily Autism Rates Rise: Federal health authorities in Los Angeles, have significantly raised their estimate of the prevalence of autism in children, concluding in a new study of 8-year-olds that 1 in 88 has some form of the disorder (previous estimate in 2006, 110). For the analysis, researchers sourced tens of thousands of health and special education records in 14 states, looking for an autism diagnosis or the symptoms that would add up to one. Opinion is divided as to reliability of the data – Dr Bryan King of the Seattle Children’s Autism Center is not surprised by the results:“we’re up against a tidal wave of need”, whereas other experts, such as Dr David Mandell of the University of Pennsylvania, question the validity of relying on records to estimate the disorder’s true prevalence: “. As does likewise Dr Daniel Geschwind, autism expert at UCLA: “what we’re looking at is mostly due to practices and infrastructure and culture, rather than some underlying biological phenomenon”.Whilst the CDC acknowledge the shortcomings, they hope that the study will draw attention to the need for more vigorous screening early in children’s lives, particularly given that early intervention offers autistic children the best long-term prospects. Source: Seattle Times News Higher Maternal Age Predicts Risk of Autism: In a recent study led by Mr. Sven Sandin, of the Karolinska Institutet, Sweden and King's College London, researchers analyzed past findings (25,687 cases of autism spectrum disorder and over 8.6 million control subjects, drawn from the 16 epidemiological papers that fit inclusion criteria for the study as defined by the investigators) to investigate possible associations between maternal age and autism. All studies controlled for paternal age which is an independent risk factor for autism. While much research has been done to identify potential genetic causes of autism, this analysis suggests that non-heritable and environmental factors may also play a role in children's risk for autism.The researchers compared the risk of autism in different groups of material age (under 20, 24-29, 30-34, and 35+) and found that children of mothers older than 35 years had 30% increased risk for autism, that c hildren of mothers under 20 had the lowest risk of developing autism, and that the association between advancing maternal age and risk for autism was stronger for male offspring and children diagnosed in more recent years. The researchers identified and discussed several potential underlying causes of the association between maternal age and risk for autism such as increased occurrence of gene alteration during the aging process and the effects of exposure to environmental toxins over time. Sandin said of the study, "The study makes us confident there is an increased risk for autism associated with older maternal age, even though we do not know what the mechanism is. It has been observed in high quality studies from different countries, including the US..This finding adds to the understanding that older age of the parents could have consequences to the health of their children." Source: www.sciencedaily.comJAACAP JCPP Contribution - Annual Research Review: re-thinking the classification of autism spectrum disorders: a recently published article (JCPP,April 2012) by Catherine Lord and Rebecca Jones, discussed the nosology of ASD, highlighting that the field has reached a critical point as it seeks to better define dimensions of social-communication deficits and restricted/repetitive behaviours on an individual level for both clinical and neurobiological purposes.These different dimensions also suggest an increasing need for quantitative measures that accurately map their differences, independent of developmental factors such as age, language level and IQ. Psychometric measures, clinical observation as well as genetic, neurobiological and physiological research from toddlers, children and adults with ASD are reviewed and the question of how to conceptualize ASDs along dimensions versus categories is discussed within the nosology of autism and the proposed changes to the DSM-5 and ICD-11, and differences across development are incorporated into the new classification frameworks. The authors conclude that it is crucial to balance the needs of clinical practice in ASD diagnostic systems, with neurobiologically based theories that address the associations between social-communication and restricted/repetitive dimensions in individuals. Clarifying terminology, improving description of the core features of ASD and other dimensions that interact with them and providing more valid and reliable ways to quantify them, both for research and clinical purposes, will move forward both practice and science. To read the full article, please visit http://bit.ly/I3g119:
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Forthcoming National Events, Conferences and Meetings
ACAMH Master Classes
Autumn 2012, full day, Dublin Mindfulness Professor Susan Bogels ter: sen Pre Class eill, Clinical Psychologist, Glasgow hiatr y, University of Glasgow;Yvonne McN Psyc cial hoso Psyc of ssor Profe , ams Chris Willi
3 September 2012, full day, Scotland Attention Deficit Hyperactivity Disorder Class Presenters: Professor Eric Taylor and Dr Jody Warner-Rogers Emeritus Professor of Child and Adolescent Psychiatry / Chartered Clinical Psychologist and Child Neuropsychologist
ACAMH International Travelling Speaker Fellowship 2012 7 June 2012; Dublin Tics and Tourettes Fellowship Speaker: Professor James Leckman James Leckman, Neison Harris Professor, Professor of Pediatrics & Psychiatry and Director, Research at Child Study Center,Yale University, US
ACAMH Jack Tizard Lecture and Confere nce
22 June 2012, full day, London Inequalities and Children’s Mental Health Named Memorial Speaker: Professor Robert McCa ll Professor, Department of Psychology and Co-Director , Office of Child Development, University of Pittsburgh, US Guest Lecturer: Dr Lynne Jones OBE Honorary Research Associate in Developmental Psychi atry, University of Cambridge Opening Addressee: Professor Christopher Bentl ey Sheffield Hallam University; Former Head, National Suppo rt Team for Health Inequalities Department of Health Conference Presenters Enver Solomon, Director of Policy and Public Affairs, The Children's Society, London Dr Tamsin Ford, Clinical Senior Lecturer, Peninsula Medica l School, University of Exeter and Devon Partnership Trust Dr Matthew Hodes, Senior Lecturer in Child and Adole scent Psychiatry, Imperial College, London
Co-hosted ACAMH-YoungMinds Conference November 2012, full day, London Theme: The Changing NHS Landscape with particular focus on practice and service delivery
3rd Egyptian Child and Adolescent Psychiatry Conference early December 2012, Giza, Egypt National Conference Keynote and Pre-Conference Master Class Trauma-Focused CBT Model and Treatment Presenters: Emeritus Professor William Yule and Dr Patrick Smith Institute of Psychiatry, Kings College London
For further details, please visit our website or contact Ingrid King: ingrid.king@acamh.org.uk, +44 20 7403 7458
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Forthcoming Local Events, Conferences and Meetings ” “MULTI – DIMENSIONAL TREATMENT FOSTER CARE 21 June 2012 ence Confer y Half-da : Midlands Branch
Venue: Parkview Clinic, Birmingham
Speakers: Maureen Moss, Dr Michael Slowik
AL HEALTH” “CRISIS IN CHILD MENT ting Mee day Half : North West Branch Speakers: Craig Mearns, Vicky Oldfield
20 June 2012 Venue: Warrington
: WHY FEELINGS MATTER” 27 June 2012 “EMOTIONAL LITERACY ting Welsh Branch: Half - day Mee Training and Consultancy Support Speakers: Cris Hoskin, C H Consultancy,
Venue: Cardiff
“ADHD: RECENT DEVELOPMENTS IN RESEARCH AND PRACTICE”
Southern Branch: Day Conference Speakers: Professor Eric Taylor and Professor Edmund Sonuga-Barke
29 June 2012 Venue: Southampton
“THE USE OF INTENSIVE INTERACTIONS WITH CHILDREN AND ADOLESCENTS WITH AUTISM” 19 July 2012 Venue: Innovation Centre York
Yorkshire Branch: Day Conference Speakers: Phoebe Caldwell
“WHY ATTACHMENT MATTERS – IN EDUCATION” Scottish Branch: Day Conference Speakers: Louise Bomber, SAIA Conference supported by ACAMH
14 September 2012 Venue: The Thistle Hotel, Glasgow
” “TRAUMA AND IMMIGRATION: A PRESSING PROBLEM FOR CAMHS r 2012
27 Septembe Venue: Leeds
Yorkshire Branch: Day Conference Speakers: David Trickey and Lynne Fordyce
“EATING DISORDERS”
Midlands Branch: Day Conference Speakers: Dr Agnes Ayton
11 October 2012 Venue: SIMTR Solihull
“ATTACHMENT THEORY AND ITS CLINICAL IMPLICATIONS”
North Wales and Merseyside Branch: Day Conference 8 November 2012 Speakers: TBC Venue: Ellesmere Port, Liverpool
“AMBIT AND OTHER THERAPIES” East Anglia Branch: Day Conference Speakers: TBC
9 December 2012 Venue: Peterborough
DREN” “THE EFFECT OF PARENTAL MENTAL HEALTH ON7 CHIL December 2012 Scottish Branch: TBC Speakers: TBC
Venue: TBC
“EATING DISORDERS” Southern Branch: Day Conference Speakers: TBC
“ASD”
ference Devon and Cornwall Branch: Day Con TBC : Speakers
9 December 2012 Venue: Southampton
10 December 2012 Venue: Totnes Devon
“BEHAVIOURAL DISORDERS” Scottish Branch: Day Conference Speakers: TBC
Q4 2012/Q1 2013 Venue: TBC
“CYBERBULLYING”
Scottish Branch: Twilight Meeting Speakers: Respectme and ChildLine (TBC)
TBC Venue: TBC
For further details, please visit our website or contact Charlotte Edge: charlotte.edge@acamh.org.uk, 020 7403 7458
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Dyadic Developmental Psychology Conference Overview: Putting Theory into Practice Highlights: A dynamic ACAMH North East event, led by internationally acclaimed Dan Hughes, a popular and renowned presenter, for his conceptualisation of dyadic developmental psychology (DDP). Launching his presentation with an immediate invitation to delegates to share his world of PACE: Playfulness, Acceptance, Curiosity and Empathy, he eloquently described the therapeutic practice, important role of engagement in tune with the young person’s experiences and emotions, and necessity of sensitive progress towards re-experiencing traumatic events. Greater success if practised in an adequately contained environment with scope to explore care giving and attachment processes was highlighted.
Helen Minis followed, framing her presentation on maltreatment, the brain and social development within the relevant social and cultural context. Raising the question of what constituted ‘good enough’ care giving, she drew attention to the neuro-biological changes which occur when neglect is present and the stress responses which deregulate when care giving is not successful. The potential for physiological problems to persist with age, resulting in reactive attachment disorder was highlighted. The plasticity of the physiological stress system was considered, in particular the ability of this system to ‘heal’ in later life through careful attention to the management of stress and stimulations through relationships which might otherwise be known as ‘attunement principles’.
John Sands, in his discussion of attachment focused work in practice, spoke about the need for flexibility in the therapeutic setting for attachment work including the proximity of parents and young people in the therapy room. Eloquent case examples were given from a DDP perspective, and a series of questions raised about the application of theory to practice, eloquently responded to by Dan Hughes. Conclusion: A valuable conference spanning theoretical, biological and pragmatic issues of attachment focused interventions which could be readily taken and used in clinical work.
Intervention Overview: Dan Hughes Dyadic developmental psychotherapy (DDP) is a treatment approach to trauma, loss, and/or other dysregulating experiences, based on principles derived from attachment theory and research and also incorporating aspects of treatment principles that address trauma. It is a specialised form of attachment-focused family therapy which is utilised for all families. It involves creating a safe setting in which the child can begin to explore, resolve, and integrate a wide range of memories, emotions, and current experiences, that are frightening, shameful, avoided or denied. Safety is created by insuring that this exploration occurs within an intersubjective context characterized by nonverbal attunement, reflective dialogue, acceptance, curiosity, and empathy. As the process unfolds, the client is creating a coherent life-story which is crucial for attachment security and is a strong protective factor against psychopathology. Therapeutic progress occurs within the joint activities of co-regulating affect and co-creating meaning. Primary intersubjective experiences between a parent and infant contain shared
affect (attunement), focused attention on each other in a way such that the child’s enjoyable experiences are amplified and his/her stressful experiences are reduced and contained, and a congruent intention to understand the other/be understood by the other. This is done through contingent, nonverbal (eye contact, facial expressions, gestures and movements, voice prosody and touch) communications. These same early parent-child experiences, fundamental for healthy emotional and social development, are utilized in therapy to enable to the child to rely on the therapist and parents to regulate emotional experiences and to begin to understand these experiences more fully. Such understanding develops further through engaging in affectivereflective (A-R) dialogue about these experiences, without judgment or criticism. The therapist will maintain a curious attitude about past and present events and behaviors, facilitating the client’s ability to explore them to better understand their deeper meanings in his life and gradually develop a more coherent life-story. This process may be stressful for the client, so the therapist will frequently “take a break” from the work, go slower, provide empathy for the negative affect that may be elicited, and repair the treatment relationship.
Routine features of DDP include: • playful interactions, focused on positive affective experiences, are never forgotten as being an integral part of most treatment sessions, when the client is receptive. When the client is resistant to these experiences, the resistance is met with PACE. • shame is frequently experienced when exploring many experiences of negative affect. Shame is always met with empathy, followed by curiosity about its development, organization, exceptions, management, and impact on the narrative. • emotional communication that combines nonverbal attunement and reflective dialogue and is followed by relationship repair when necessary, is the central therapeutic activity. All communication is “embodied” within the nonverbal. • resistance is addressed and met with PACE, rather than being confronted. • treatment is directive and clientcentered. Directives are frequently modified, delayed, or set-aside in response to the child’s response to the directive.
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ACAMH members working to develop Cognitive Behaviour Therapy in India Cognitive Behaviour Therapy is very rarely available within child and adolescent or adult mental health services in India. Though there has been one excellent randomised control study of CBT for anxious adults published five years ago a recent review identified only 40 papers on Behaviour or Cognitive Behaviour Therapy written in the Indian Journal of Psychiatry since the 1940s. Pockets of expertise do exist amongst therapists generally trained in the UK or USA, but there is no structure of accreditation, supervision or training for therapists or dedicated CBT training
courses although it is included in some psychiatry and psychology training programmes. Over the past 6 months staff from the CAMHS team in the Central Manchester Foundation Trust and the Salford Cognitive Therapy Training Centre have been working with Dr Virudhagirinathan and colleagues at the CARE Institute of Behaviour Science in Chennai to develop a modular training programme using UK trainers with a view towards making India self-sufficient in CBT practice, supervision and training within five years. Around half of the 50 participants who have taken part in training there so far
have been from a child and adolescent mental health background including clinical psychologists, psychiatrists and college counsellors. Highlights: A dynamic, interactive day, with a well-balanced programme of expert speakers Morning Keynote: Phoebe Caldwell, specialist in learning disabilities gathered over 40 years local, national and international professional life, she focussed on “Can we Talk: emotional engagement with non-verbal people with autism�, illustrating that reality is different for everyone and judgements are subjective, based on personal experiences.Through the use of videos showing her own working with children, delegates shared
Conference Overview: When Words are Not Enough: working with children with learning disabilities and autism In July 2010 ACAMH member Dr Andrew Beck, Consultant Clinical Psychologist at CMFT and trainer at the Salford Cognitive Therapy course, ran two introductory days on CBT for over 40 mental health staff in Chennai in collaboration with the CARE Institute of Behaviour Science. Initial feedback was very good and there was a consensus amongst participants that there was a clear need for further training and that the CBT as a therapy suited the child and adult Indian mental health context. In March 2012 a five-day foundation workshop was run in Chennai, the first part
of a modular programme based on the curriculum developed by the Salford Cognitive Therapy training centre and including specific teaching on parenting programmes and adapting CBT for younger children. Over the next five years several staff from the Salford training centre and Manchester and Salford CAMHS will volunteer their time to provide week long training courses with the intention to enable Indian colleagues work towards international standards of training and qualification
ACAMH Board Members 2012 Chair Chair Elect Academic Secretary Branch Liaison Officer Editorial Representative (JCPP) Editorial Representative (CAMH)
Professor Eric Taylor Professor Kathy Sylva Dr Paul Ramchandani Dr Mark Lovell Professor Edmund Sonuga-Barke Dr Tamsin Ford
Dr Eilis Kennedy Dr Daphne Keen
Board Members Professor Michael Kerfoot Mrs Cathy Laver-Bradbury
Psychiatry Paediatrics
Psychiatry Education Psychiatry Psychiatry Psychology Psychiatry Social Work Nursing
Dr Kapil Sayal Psychiatry Dr Jody Warner-Rogers Psychology
Jack Tizard Lecture and Day Conference
Please visit www.acamh.org.uk for full details
The Jack Tizard National Conference is one of two prestigious ACAMH memorial events and is designed to appeal to both the academic and clinical worlds. It is named in memory of Professor Jack Tizard (1919-1979), an avid supporter of ACAMH and contributor to the development of social justice, community care and child and adolescent mental health, particularly the relationship between policy, management and practice; and improvement of services. His immense work was recognised internationally and he was awarded both the Kennedy International Scientific Award (1968) and the Research Award of the American Association on Mental Deficiency (1973)
The Emanuel Miller Lecture was established in 1972, in memory of Emanuel Miller, one of
Professor Robert McCall
Jack Tizard Memorial Lecturer :
CHILD AND ADOLESCENT MENTAL HEALTH
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INEQUALITIES
Friday 22 June 2012; Institute of Physics, 76 Portland Place, London W1B 1NT
Afternoon Tea and Conference Close
The Association for Child and Adolescent Mental Health St Saviour’s House, 39/41 Union Street, London SE1 1SD Tel: 020 7403 7458 Fax: 020 7403 7081 Website: www.acamh.org.uk Email: acamh@acamh.org.uk
A Company Limited by Guarantee Registered in England and Wales No.2990385 Registered Charity Number 1042760
Whilst every effort is made by ACAMH to see that no inaccurate or misleading data, statement or opinion is expressed at this meeting, the Association wish to make clear that data and opinions given at this particular meeting are the sole responsibility of the contributor or speaker[s] concerned and accordingly, ACAMH accepts no responsibility for the consequences of any inaccurate/misleading data, opinion, statement.
1600
Registration WELCOME: Conference Chair (Morning), Professor Eric Taylor, Outgoing Chair, ACAMH OPENING ADDRESS: GIVING EVERY CHILD THE BEST START WE CAN - Professor Chris Bentley JACK TIZARD MEMORIAL LECTURE: THE CONSEQUENCES OF EARLY INSTITUTIONALIZATION: CAN INSTITUTIONS BE IMPROVED? SHOULD THEY? Professor Robert McCall 1100 Morning Coffee 1130 THE GOOD CHILDHOOD REPORT 2012: A REVIEW OF OUR CHILDREN’S WELL-BEING - Enver Solomon 1215 CASE COMPLEXITY AND OUTCOMES: WHAT DO WE KNOW AND WHAT DO WE NEED TO KNOW? Dr Tamsin Ford 1300 Lunch and Annual General Meeting for ACAMH Members; POSTER DISPLAY OF RESEARCH 1400 AFTERNOON OVERVIEW - Conference Chair, Professor Kathy Sylva, Incoming Chair, ACAMH 1405 GUEST PRESENTER: RESPONDING TO THE NEEDS OF WAR AND DISASTER AFFECTED CHILDREN - Dr Lynne Jones OBE 1500 INEQUALITIES AND MENTAL HEALTH OF UNACCOMPANIED ASYLUM SEEKING CHILDREN - Dr Matthew Hodes 1545 ACAMH NATIONAL RESEARCH PRIZE CEREMONY
0900 0930 0935 1000
CONFERENCE PROGRAMME
DR MATTHEW HODES Senior Lecturer in Child and Adolescent Psychiatry, Imperial College, London
DR LYNNE JONES OBE Honorary Research Associate in Developmental Psychiatry, University of Cambridge
DR TAMSIN FORD Clinical Senior Lecturer, Peninsula Medical School, University of Exeter and Devon Partnership Trust
ENVER SOLOMON Director of Policy and Public Affairs, The Children's Society, London
PROFESSOR ROBERT MCCALL Co-Director, University of Pittsburgh Office of Child Development; Professor of Psychology, University of Pittsburgh, USA
PROFESSOR CHRISTOPHER BENTLEY Sheffield Hallam University; Former Head, National Support Team for Health Inequalities Department of Health
SPEAKERS
www.acamh.org.uk
The Association for Child and Adolescent Mental Health
1. To record those present 2. To approve the minutes of the Annual General Meeting held on 6 June 2011 3. To receive and approve the annual financial statements for the year ended 31 December 2011 4. To receive the reports of the Honorary Officers 5. Elections to the Board 5.1 To note the following: 5.1.1 Professor Eric Taylor will complete his term of office as Chair of the Association and will be succeeded by Chair Elect Professor Kathy Sylva 5.1.2 Dr Jane Akister will be retiring as Honorary Treasurer of the Association and will be succeeded by Dr Jo Fletcher 5.1.3 Dr Paul Ramchandani will be standing for re-election to a second term of office as Honorary Academic Secretary of the Association 5.1. 4Professor Edmund Sonuga-Barke will be standing for re-election to a second term of office as Journal of Child Psychology and Psychiatry Editorial Representative 5.1. 5 Dr Jane Akister will be standing for re-election to a second term of office as Board Member 5.2 To elect the Board of the Association for the year 2012-2013 6. To appoint the Auditor for the year 2012-2013 7. To transact such other business as the Board shall determine: 7.1 To approve amendments to the Association’s Constitution (Memorandum and Articles) to enable: 7.1.1 Diversification of membership categories 7.1.2 Identification of additional Honorary Officer position and appointment thereto 7.1.3 Required new and amended wording to facilitate the above 7.1.4 Additional required revisions to clauses within Constitution to reflect legislative changes 7.2 To agree the membership subscription fees for 2013 7.3 To confirm ACAMH’s membership of the following: • IACAPAP • Young Minds • National Children’s Bureau • NCVO 8. To transact any other business
Notice is hereby given that the Association’s Annual General Meeting will be convened Friday 22 June 2012, 1.00pm, Institute of Physics, 76 Portland Place, London W1B 1NT for the purpose of transacting the following business
ANNUAL GENERAL MEETING: 2012
39-41 Union Street, London SE1 1SD; telephone 020 74037458; facsimile 020 74037081 email: acamh@acamh.org.uk; website www.acamh.org.uk
ASSOCIATION FOR CHILD AND ADOLESCENT MENTAL HEALTH