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Are children in care offered effective therapeutic support?Aim - This thesis aims to answer the question as to whether or not the therapeutic support offered to children in care in the U.K. is effective. There are two parts to the question: ascertaining what the actual offer of therapy consists of; the quality of that offer in terms of therapeutic effectiveness. Background - children in care are significantly more likely than their peers to be involved in offending behaviour, substance misuse, and to be unemployed DfE (2019). There is evidence to suggest that unresolved developmental trauma can contribute to these outcomes (National Audit Office, 2015). It is unclear how focused the government is on supporting effective therapeutic recovery from developmental trauma. Method - Questionnaires were distributed to every local authority in the country, with approval from the Directors’ of Children’s Services. Interviews were attempted. A Foucaultian Discourse Analysis of key pieces of legislation in the field was then completed, and a Thematic Analysis of 28 studies into therapeutic recovery from complex developmental trauma was achieved. Key Findings- The study found that children in care are not systematically offered effective therapeutic support. In fact, there are multiple issues according to the quality of therapies on offer: there is a legal/political/organisational system that is dysfunctional: the offer of therapy is impossible to ascertain across the country; the way in which therapists research their own provision is laden with methodological, political, and ethical issues. However, the evidence supports the idea that we are aware of some key factors that help therapeutic recovery. Implications for Practice - The evidence provided a range of factors to support future development of therapeutic support to children in care, and supported a mapping out of the way in which therapies could usefully be developed in the future. The evidence led to the development of a model of best practice. Conclusion - The thesis ends with some recommendations as to how the profession of psychotherapy and counselling could begin to develop both their knowledge base and way of working with children care to support more effective therapeutic recovery.
Attitudes to marriage and sexual behaviors: A survey of gender and culture differences in China and United KingdomThis article discusses a study which examined gender and cultural differences in China and the UK in terms of attitudes to marriage and sexual behaviours.
Cancer patients’ respect experiences in relation to perceived communication behaviours from hospital staff: analysis of the 2012-2013 National Cancer Patient Experience SurveyPurpose: Respect experiences are poorly understood despite respect being central to professionalism in healthcare and patient well-being, and needed for optimal patient care. This study explores which patient-perceived communication behaviours from hospital staff contribute most to cancer patients’ respect experiences and account for variation in their experience by socio-demographic and clinical characteristics. Methods: Secondary analysis of data from the 2012-2013 National Cancer Patient Experience Survey of 45191 patients with a primary cancer diagnosis treated in English National Health Service trusts providing adult acute cancer services who provided data on experienced respect and dignity. Results: Both autonomy-supportive and caring/emotionally sensitive behaviours were associated with reported respect, although the latter showed stronger associations and accounted for most differences in reports of respect between patient groups. Differences in respect were found by gender, race/ethnicity, age, the presence of long-standing conditions, treatment response, time since first treated for cancer (p<.001), employment and type of cancer (p<.05). Conclusions: The study questions the tendency to conceptualise respect primarily in terms of autonomy-supportive behaviours and shows the relative contribution of autonomy-supportive and caring/emotionally sensitive behaviours in explaining disparities in respect experiences. More attention should be paid to affective communication behaviours from hospital staff to reduce disparities in respect experiences.