How might young people communicate their expectations of relationships during ADOS assessments?

Scott, Bridget (2022) How might young people communicate their expectations of relationships during ADOS assessments? Professional Doctorate thesis, Tavistock and Portman NHS Foundation Trust/University of Essex. Full text available

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Abstract

Recent national developments have seen the rise of distinct Autism Assessment Teams (AAT) within NHS Child and Adolescent Mental Health Services (CAMHS) as a way of managing the increasing prevalence of autism amongst young people (Newschaffer et al., 2007, p. 151). Young people (YP) with autistic symptomology are referred into the AAT for assessment and diagnosis. Currently, under Nice guidelines (NICE, 28 September 2011), the AAT does not include Child and Adolescent Psychoanalytic Psychotherapists (CAPPTs). This study aimed to explore possible CAPPT contributions to the AAT, YP and wider network, through asking the question ‘How might YP communicate their expectations of relationships (EoR) during the Autism Diagnostic Observational Schedule (ADOS)?’, which is one assessment conducted by the AAT. Participants included 5 AAT clinicians, 7 YP (4 females and 3 males) aged between 9 and 15. Data was gathered from 7 transcribed video and audio-recorded ADOS assessments. Discourse Analysis, specifically ‘Subject Positioning (SP) Theory’, was then applied to analyse the data, revealing fifteen SPs. Psychoanalytic understandings of communication and EoR were then applied to the SPs. Four main EoR were identified, demonstrating expectations that relationships would be characterised by: 1. Intrusion and exclusion; 2. Aggression and destruction; 3. Criticism, judgement, unreliability and untrustworthiness; 4. Sameness; Findings suggested the ADOS assessment to be an emotionally saturated and meaningful experience for YP, which evoked various unconscious EoR, and primitive survival anxieties. The assessing ADOS Clinician (AC) unconsciously contributed to the EoR and anxieties communicated. These findings suggest a CAPPT could provide valuable understanding of the unconscious emotional world of the YP undertaking the ADOS, and the possible impact on the assessment outcome, the AAT and wider network surrounding the YP.

Item Type: Thesis (Professional Doctorate)
Additional Information: Thesis submitted in partial fulfilment of the requirements of the Tavistock and Portman NHS Foundation Trust and the University of Essex for the degree of Professional Doctorate in Child and Adolescent Psychoanalytic Psychotherapy.
Uncontrolled Keywords: Professional Doctorate in Child and Adolescent Psychoanalytic Psychotherapy, Northern School of Child & Adolescent Psychotherapy (NSCAP), Communication, Projective Identification, Expectations of Relationships, Transference, Countertransference, Autism and ADOS
Subjects: Communication (incl. disorders of) > Autism
Communication (incl. disorders of) > Communication
Research, Tests, Assessments > Psychological Research
Department/People: Children, Young Adult and Family Services
Research
URI: http://repository.tavistockandportman.ac.uk/id/eprint/2685

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