BackgroundAttention‐Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder starting in childhood that may persist into adulthood. It can be managed through carefully monitored medication and nonpharmacological interventions. Access to care for children at risk of ADHD varies both within and between countries. A systematic literature review was conducted to investigate the research evidence related to factors which influence children accessing services for ADHD.MethodStudies investigating access to care for children at risk of ADHD were identified through electronic searches of the international peer‐reviewed and grey literature. Databases were searched from inception till 30th April 2012. This identified 23,156 articles which were subjected to three levels of screening (title, abstract and full text) by a minimum of two independent reviewers. Due to the heterogeneity in the study designs, a narrative approach was used to present the findings.ResultsTwenty‐seven papers met the inclusion criteria; these were grouped into four main themes, with some papers being included in more than one. These were wider determinants (10 papers); identification of need (9 papers); entry and continuity of care (13 papers) and interventions to improve access (4 papers). Barriers and facilitators to access were found to operate at the individual, organisational and societal level. Limited evidence of effective interventions to improve access was identified.ConclusionThis review explored the multilayered obstacles in the pathway to care for children at risk of ADHD and the lack of evidence‐based interventions designed to address these issues, thereby indicating areas for service development and further evaluative research.
Psychoanalysis today is largely a psychology of consciousness: post-and neo-Freudians form a marginalized community within North America in comparison to contemporary relational and intersubjective theorists who emphasize the phenomenology of lived conscious experience, dyadic attachments, affective attunement, social construction, and mutual recognition over the role of insight and interpretation. Despite the rich historical terrain of theoretical variation and advance, many contemporary approaches have displaced the primacy of the unconscious. Notwithstanding the theoretical hair-splitting that historically occurs across the psychoanalytic domain, we are beginning to see with increasing force and clarity what Mitchell and Aron (1999) refer to as the emergence of a new tradition, namely, relational psychoanalysis. Having its edifice in early object relations theory, the British middle school and American interpersonal traditions, and self psychology, relationality is billed as "a distinctly new tradition" (Mitchell & Aron, 1999, p. x). What is being labeled as the American middle group of psychoanalysis (Spezzano, 1997), relational and intersubjective theory have taken center-stage. It may be argued, however, that contemporary relational and intersubjective perspectives have failed to be properly critiqued from within their own school of discourse. The scope of this article is largely preoccupied with tracing the (a) philosophical underpinnings of contemporary relational theory, (b) its theoretical relation to traditional psychoanalytic thought, (c) clinical implications for therapeutic practice, and (d) its intersection with points of consilience that emerge from these traditions. Relational psychoanalysis is an American phenomenon, with a politically powerful and advantageous group of Note that most identified relational analysts are psychologists, as are the founding professionals associated with 1 initiating the relational movement including Mitchell, Greenberg, Stolorow, Aron, and Hoffman, just to name a few. members advocating for conceptual and technical reform. Relational trends are not so prevalent in other parts of the world where one can readily observe the strong presence of Freud throughout Europe and abroad, Klein in England and South America, Lacan in France and Argentina, Jung in Switzerland, the Independents in Britain, Kohut in the Midwestern United States, and the Interpersonalists in the East, among others. Despite such secularity and pluralism, relational thinking is slowly gaining mainstream ascendency. Perhaps this is due in part to the following factors: (a) In the States there is an increasing volume of psychoanalytically trained psychologists who graduate from and teach at many progressive contemporary training institutes and post-doctoral programs, thus exerting a powerful conceptual influence on the next generation of analysts who are psychologically rather than medically trained; (b) There has been a magnitude of books that have embraced the relational turn and are
In this commentary on Bemister and Dobson's (2011) article on recordkeeping, I attempt to show that many of the recommendations they propose are clinically contraindicated. Introducing the details of recordkeeping in the treatment process is particularly ill advised for it may engender distrust, taint the therapeutic alliance, and damage the professional relationship with the client, which could conceivably ruin the treatment. It is the intention of this critique to foster dialogue and debate about the best standards of practice for clinicians working in the private sector. I argue that Bemister's and Dobson's proposals are misguided and belie the real world of private practice. If we condone the teaching of these principles in graduate education and implement these recommendations in professional practice, then this could potentially tarnish the reputation of psychologists in Canada.
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