Appreciative Inquiry in Psychiatry Peer Groups.

OBJECTIVE: The purpose of the study was to explore the feasibility of using appreciative inquiry in a peer group of psychiatry residents. METHODS: A peer coaching exercise using appreciative inquiry was modeled to a group of psychiatry residents who practised the approach. The topics discussed in separate sessions 1 month apart were values and identity as a psychiatrist, dealing with conflict and working within the psychiatric system. Following each session, the residents participated in focus group interviews. Transcripts were thematically analyzed and independently coded. RESULTS: Four themes were identified: (i) connectedness, (ii) a structure for dialogue, (iii) reflection, and (iv) generative conversations. CONCLUSION: Appreciative inquiry is a feasible method to facilitate focused and meaningful encounters and develop connection between members of a peer group.

The management of young people who self-harm by New Zealand Infant, Child and Adolescent Mental Health Services: cutting-edge or cutting corners?

OBJECTIVES: Self-harm is common in New Zealand (NZ) young people and can have short-term and long-term consequences, including suicide. This study was undertaken to examine the extent to which evidence-based approaches for addressing self-harm are offered by Infant, Child and Adolescent Mental Health Services (ICAMHS). METHODS: A national survey of ICAMHS practitioners working with young people who self-harm was undertaken between May and July 2016. RESULTS: Responses from 23 out of 30 ICAMHS confirmed self-harm was a familiar presentation and most commonly associated with diagnoses of depression, anxiety and borderline personality disorder. Cognitive behavioural therapy (47.1%, n = 8), dialectical behaviour therapy (47.1%, n = 8) and acceptance and commitment therapy (5.9%, n = 1) were the treatments of choice, but variably delivered. There were significant training gaps for all types of therapy. CONCLUSIONS: Although it is reassuring that many ICAMHS are using evidence-based approaches to address self-harm in young people, there is concerning variability in the way these therapies are delivered. Improvement in training in key modalities, further research into therapist performance and continuous evaluation of workforce development are needed to maximise the effectiveness of proven interventions and provide NZ young people with the state-of-the-art service they deserve.

The infant observation task as a tool in psychiatric practice.

OBJECTIVE: The objective of this study was to describe the method and relevance of infant observation as a unique and powerful learning tool for psychiatrists. CONCLUSION: Infant observation provides a privileged entry into an infant's internal world to observe its earliest mental life. Weekly consecutive observations of the mother-baby dyad, combined with the process of supervision, enable identification of emergent and changing patterns in the relationship. The discipline of observation encourages attunement to the nuances of relationships, which provides a potent tool for application in other clinical settings.