This study examined implicit and explicit anxiety in individuals with epilepsy and psychogenic nonepileptic seizures (PNESs) and explored whether these constructs were related to experiential avoidance and seizure frequency. Based on recent psychological models of PNESs, it was hypothesized that nonepileptic seizures would be associated with implicit and explicit anxiety and experiential avoidance. Explicit anxiety was measured by the State-Trait Anxiety Inventory; implicit anxiety was measured by an Implicit Relational Assessment Procedure; and experiential avoidance was measured with the Multidimensional Experiential Avoidance Questionnaire. Although both groups with epilepsy and PNESs scored similarly on implicit measures of anxiety, significant implicit-explicit anxiety discrepancies were only identified in patients with PNESs (p b .001). In the group with PNESs (but not in the group with epilepsy), explicit anxiety correlated with experiential avoidance (r = .63, p b .01) and frequency of seizures (r = .67, p b .01); implicit anxiety correlated with frequency of seizures only (r =.56,p b .01). Our findings demonstrate the role of implicit anxiety in PNESs and provide addi-tional support for the contribution of explicit anxiety and experiential avoidance to this disorder.

Although providing psychological consultation to the network around looked after children is a popular intervention within the practice literature, there is little evidence examining its value for social workers. This study utilised mixed methods, integrated through an explanatory sequential design, to explore the extent to which psychological consultation met social workers’ goals and in what way it made a difference. Feedback questionnaires were collated from 48 social workers attending such consultations. Two focus groups were then held with consulting clinicians to gain their perspectives on consultation and the feedback obtained. The survey data demonstrated that social workers wanted a broad range of input and support from consultation, which they reported was largely provided. This reinforced clinicians’ perspectives of consultation as a valuable service. Surprisingly, the survey data implied that consultation had a limited impact in terms of making a difference. This is discussed in relation to the methodology and challenges of gaining feedback. An improved model of evaluation is subsequently proposed

Purpose: Self-esteem (SE), or one's sense of competence and worth, is reduced in many mental and physical\ud disorders. Low SE is associated with perceived stigma and disability and poor treatment outcomes. The present\ud study examined implicit and explicit SE (automatic and deliberate views about the self) in people with epilepsy\ud and people with psychogenic nonepileptic seizures (PNESs). Discrepancies between implicit SE and explicit SE\ud have been found to correlate with psychological distress in disorders often associated with PNESs but are\ud relatively unexplored in PNESs. We hypothesized that, compared with epilepsy, PNESs would be associated\ud with lower self-reported SE and greater discrepancies between implicit SE and explicit SE.\ud Methods: Thirty adults with PNESs, 25 adults with epilepsy, and 31 controls without a history of seizures were\ud asked to complete the Rosenberg Self-esteem Scale as a measure of explicit SE and an Implicit Relational\ud Assessment Procedure as a measure of implicit SE. The State–Trait Anxiety Inventory and Patient Health\ud Questionnaire—15 (a somatic symptom inventory) were also administered.\ud Results: We found significant group differences in explicit (p b 0.001) but not implicit SE. Patients with PNESs\ud reported lower SE than the other groups. No group differences were found in implicit SE. Implicit–explicit SE\ud discrepancies were larger in the group with PNESs than in the other groups (p b 0.001). Higher frequency of\ud PNESs (but not epileptic seizures) was associatedwith lower explicit SE (rs=−.83, p b 0.01) and greater SE discrepancies\ud (i.e., lower explicit relative to implicit SE; rs = .65, p b 0.01). These relationships remained significant\ud when controlling for anxiety and somatization.\ud Conclusion: Patients with PNESs had lower explicit SE than those with epilepsy or healthy controls. In keeping\ud with our expectations, there were greater discrepancies between implicit SE and explicit SE among patients\ud with PNESs than in the other groups. Our results, including the strong relationship between PNES frequency,\ud anxiety, and explicit–implicit SE discrepancies, support the interpretation that PNESs serve to reduce cognitive\ud dissonance, perhaps protecting patients' implicit SE

This paper explores staff attitudes and perceptions of psychological practice within inpatient and outpatient services. On the dawn of the New Horizons for 2020, it examines a remaining gap, and discusses how this can be bridged.