The Munro Review of Child Protection, Interim Report: The Child's Journey. Professor Eileen Munro

The review of child protection is part of a national drive to improve the quality of child protection services. The aim of this report was to set out for discussion the struction of an effective child protection system, and the reforms that might help create this. To encourage the change, the review has been working with five authorities who have requested greater flexibility when assessing the needs of children and young people, with the aim of delivering improved outcomes and more fixed interventions. The Secretary of State for Education is considering using his powers to allow them to model the responsible improvement this review wants to encourage. These local authorities will be granted temporary suspension from certain requirements in statutory guidance for a six month period (subject to their agreement with Ministers to the conditions of the trial). The review highlights the crucuial role that inspection can play in improving services for children, and we will be working with Ofsted to develop an inspection process that drives child-centred practice, focuses on the effectiveness of help provided and assesses the quality of learning across local organisations, rather than compliance with process. Serious Case Reviews (SCR's) have failed to identify or explain the factors that have contributed to poor practice. The review is therefore considering adopting the systems approach used in the health sector, which explores these factors and therefore offers the potential for deeper lessons and improved learning. Early identification and provision of help is in the childs best interests and multiagency services which give support for families are important in promoting childrens well-being. The review looks at the efforts to improve family support services in the community such as Sure Start Childrens Centres. All who come into contact with families have a part to play in identifying those children whose needs are not being met. Some of these needs can be helped by early intervention services, while others may need more specialist services, including children's social care. Evidence submitted to the review shows strong support for the current policy where, with the family's agreement, an assessment is made, using a system common to all local agencies, that can be shared with other professionals. It is imporant to minimise dependency and empower families, giving them ownership of their own assessment. This review is taking place at a time of major reform in all of the relevant public services, where there are financial contraints being applied and with major workforce issues particularly in the field of social work. It is essential that the protection of children still remains the priority within these reforms. It is in this context that the review is seeking the help of each profession within the sector to develop the reforms proposed in this report and work with a range of groups to develop its thinking before producing a final report and recommendations to the Government in April. To see the full report please visit this link: http://www.education.gov.uk/munroreview/downloads/Munrointerimreport.pdf

MP Graham Allen Highlights the Importance of Early Years Intervention

The government- commissioned report recommends regular assessments of pre-school children which focus on their social and emotional development. This type of early intervention will improve the lives of vulnerable children, which will help break the cycle of "dysfunction and under-achievement". It also calls for a national parenting programme in the UK. Previous interventions have been too late and major social problems have become worse not better. MP Graham Allen was asked to assess how children who are from disadvantaged backgrounds could be given the best start in life.

His report highlights that success or failure in early childhood has "profound economic consequences", and calls for more private money to be channelled into early intervention schemes to help set children on the right path in life.

Society is failing to equip young children with the social and emotional skills they need in life, he says. "If we continue to fail, we will only perpetuate the cycle of wasted potential, low achievement, drink and drug misuse, unintended teenage pregnancy, low work aspirations, anti-social behaviour and lifetimes on benefits, which now typifies millions of lives and is repeated through succeeding generations".

Mr Allen's report details the impact of poor parenting and says very few parents-to-be understand how to build the social and emotional capability of a baby or small child. All parents need to know how to "recognise and respond to a baby's cues, attune with infants and stimulate them from the very start, and how to foster empathy", it says. The report highlights American research that shows the early years are the greatest period of growth in the human brain. This is why Mr Allen is stressing the importance to intervene in the early years, rather than later when the basic architecture, or wiring, of the brain is formed for life.

To read the full article and listen to Mr Allen on Radio 4 view the link below

http://www.bbc.co.uk/news/education-12216967

An interesting development in a Criminal Law case.

I thought I'd like to share this interesting piece of Law I came across recently during a trial, in which I was instructed by the Crown Prosecution Service in a Murder case to do an assessment of personality. It may be of interest to psychologists who get involved in criminal work.

Here's the scenario: First an expert (psychiatrist) produced a report for the defense, suggesting that the defendant did not have a personality disorder but did have "abnormal personality traits," (histronic) which he claimed could have influenced the defendant's decision making during the week of the alleged murder of his wife. The psychiatrist did not use any psychometrics.

In my report, I also suggest that there's not a personality disorder but agree there are some personality traits (though not histronic) but say it is unclear what relevance they have, if any. I based my conclusions on my review of the evidence, clinical interviews, STAXI-2, MCMI-III, PAI, WTAR and WASI.

At trial, the question that was raised was: should the jury judge even hear and consider the experts' evidence re personality traits if there is no disorder? A Voir Dire was held to consider this question. It was decided that they should not. This judgement was based on the following pieces of Law: R V Turner (1975): "where no mental abnormality is involved, such matters are within the 'common knowledge and experience' and can be understood by a jury. An Expert's opinion is only admissible to furnish the court with scientific information which is likely outside the experience and knowledge of judge/jury." This decision was upheld in Weightman (1991) and Cole (1995). That is, unless there's an Abnormality of Mind (which translates into a Mental Disorder), the jury can be confused by hearing scientific jargon that seeks to explain a defendants behaviour. They were considered to be perfectly capable of understanding that people with different personality styles will act differently and there can be more than one explanation for someone's behaviour under duress, without resorting to experts.

The judge pronounced the defense psychiatrist's evidence in this case "superfluous, and it trespasses upon matters which are within the jury's normal experience." Consequently, therefore, none of the expert psychiatric or psychological evidence was admissible and the general feeling was the defense psychiatrist should have just concluded No PD, full stop.

The outcome was that the defendant was found Guilty and given a 19 year sentence.

The barrister became aware of this piece of Law only at the very last moment (the night before we were due to testify). It has been very interesting to think how things might have progressed if the experts' testimony had been allowed. The whole area is a fascinating one: for example, in future, will there be less distinction made in Criminal law between Abnormality of Mind (i.e., when a serious disorder is present) and less serious mental/emotional conditions? Is it really within the jury's experience to understand how personality features (though not personality disorder) can account for inappropriate behaviour? Should there be different standards in Criminal v other proceedings? Don't we talk about significant personality feature and their impact on behaviour all the time in child & family work?

Please let us hear your thoughts on this?

Posted on Behalf of Dr Susan Jones by Gareth Nightingale

Meditation Training Promotes Positive Psychology and Better Cellular Health

Researchers at the University of California, Davis, and the University of California, San Francisco have discovered links between the positive psychological changes that occur from meditation and greater Telomerase activity. Telemerase is an enzyme which is important for cellular health and helps rebuild and lengthen telomeres.

Participants in the study also had numerous psychological benefits from meditation training at the same time as decreasing negative emotionality. The effect is attributable to psychological changes that increase the ability for a person to deal with stress and maintain their feelings of well-being.
Clifford Saron an associate research scientist at the University of California, Davis centre for Mind and Brain said "We have found that meditation promotes positive psychological changes and that meditators showing the greatest improvement on various psychological measures had the highest levels of telemerase". The research findings are not suggesting that meditation directly increases telomerase activity and therefore a persons health. But rather that mediation improves a person's psychological well-being and that these changes are connected to telomerase activity in immune cells, which then has the potential to endorse longevity in those cells. Activities that increase a person's sense of well-being will have a huge effect on the most primary aspects of their physiology.

To read the article in full visit: http://clinicallypsyched.com/meditation-positive-psychology-improved-cellular-health-research/

Intensive care diaries

Intensive care patients are particularly vulnerable to one of the key risk factors for post-traumatic stress disorder (PTSD); failing to fully process a traumatic experience, this is due to the sedation, sleep deprivation and delirium.

One in ten patients who are in intensive care for longer than 48 hours later develop PTSD according to a recent estimate. A new study has suggested that an effective way to reduce this risk could be through the use of a daily text and photo diary. This diary would be kept by the patients nurse and family. Christina Jones at the University of Liverpool and her colleagues recruited 352 intensive care patients. They were randomly allocated to receive the diary one month after discharge (a doctor or nurse explained its contents but not how to use it), or in the control group.

PTSD symptoms were recorded at the one month stage and two months, the controls also at this point received their diaries. The main findings were that 5% of patients in the diary group developed PTSD between one and three months after their discharge compared with 13% of patients in the control group. The comments of the patients were also very positive.

When compared with providing formal therapy to all patients struggling to cope with what they have experienced, diaries are likely to be cost-effective at the same time as being effective in helping intensive care patients. However two new studies by Dr Alex Mitchell, a consultant psycho oncologist at Leicestershire Partnership Trust, suggest that nurses involved with patient care struggle very often to detect depression in patients. Most receive very little training in mental health, therefore it may be unrealistic to expect nurses to remember complex criteria to enable them to detect depression and apply lengthy screening tools.

To read more this article can be found in The Psychologist, November 2010 issue. Vol 23 no 11.

Commitment to Psychological Therapies in the Spending Review 2010

The Spending Review 2010 Presented to Parliament by the Chancellor of the Exchequer (see this link for full review) states that despite vast cuts across other departments the Department of Health settlement includes a commitment by the government to “expanding access to psychological therapies”. George Osborne speaking in the House of Commons stated “We will expand access to psychological therapies for the young, elderly and those with mental illness."

This commitment has been welcomed by many including Professor Peter Kinderman, a Clinical Psychologist and Member of the British Psychological Society; the Royal College of Psychiatrists and the mental health charities, Mind, Rethink and Young Minds, particularly because previous expansion of psychological therapies via the Improving Access to Psychological Therapies Programme, has focussed on working age adults with difficulties that could be classified as mild to moderate depression or anxiety.

At this stage no further information has been provided on the form this expansion will take, or the timescale for the changes, but the Spending Review highlights the Government’s position “that while it should continue to fund important services, it does not have to be the default provider. This stifles competition and innovation and crowds out civil society”. Therefore the Spending Review announces that to address this and create new opportunities for non-state providers “the Government will pay and tender for more services by results”. Again, at this stage, there is no further information about how results will be measured and therefore how services will tender for mental health or psychological therapies contracts, but this is likely to be an important time for innovation and development within the private sector.

Psychoanalysis: The Unconscious in Everyday Life

A new exhibition entitled Psychoanalysis: The Unconscious in Everyday Life opened yesterday, 13th October 2010, at the Science Museum in London. The exhibition uses historical artefacts and contemporary artworks to explore the workings of the unconscious and its influence on everyday life. The exhibition is free and open until 2nd April 2011.

See www.sciencemuseum.org.uk for further information and the exhibition catalogue.