This chapter, written for those who work with children and adolescents, summarizes, explains and extends psychoanalytic thinking about young people and climate change. Ambivalence, disavowal, grief, unconscious societal pressures, feelings of betrayal, regression to immature defenses, and interaction of climate concerns with other developmental issues are explored, applying the developmental frameworks of Melanie Klein, Erik Erikson, and Wilfred Bion. Climate change implications within each Eriksonian stage of psychosocial development through young adulthood are described. Specific recommendations are made to promote healthy attachment to the natural world, valuable versions of hope, and alignment with values. The importance of being a “good-enough” “flexible container” in relation to young people is emphasized. Particular considerations in addressing climate change issues with young children and with adolescents are detailed.

‘Forensic psychotherapy’ is a shorthand term for the treatment of offenders with psychodynamic psychotherapy. Over the last decade, a range of psychological therapies for offenders have been developed, often based on improved therapies for personality disorder. The author discusses what distinguishes forensic psychotherapy from other psychological therapies offered to offenders; and which offenders might benefit most from psychodynamically focussed therapy. The author describes how psychological treatments broadly fit within the risk needs responsivity construct and the matched stepped care system. Matched stepped care and an appropriate governance framework ensure services deliver evidence-based practices, targeting underlying needs. Clear treatment pathways exist, low- to high-intensity interventions are provided with good fidelity and the right people skills are in place to deliver these interventions. The requirement to step up in intensity and expertise level of treatment is based on a clinical formulation and risk. Having the right service in the right place at the right time delivered by the right professional is critical to reducing risk among people who are violent.

This chapter explores theories of revolution that propose psychological factors as the main driving force for intergroup change. These theories include social identity theory, psychodynamic theory, justice theories, equity theory, and relative deprivation theory. A number of the theories that also give importance to material conditions, such as system justification theory, also give importance to psychological factors through concepts such as false consciousness. The irrationalist perspective of psychodynamic theory is also integral to a number of the other theories discussed in this chapter because of the pervasive assumption that often people are unaware of what is influencing their participation in collective action and displacement of aggression. The most influential contemporary theory is social identity theory, and the key experiment associated with this theory, the minimal group paradigm, is critically discussed. The complex role of relative deprivation and perceived justice is discussed, with reference to fraternal deprivation and equity theory.

A psychodynamic approach to anxiety is not disorder specific; anxiety can and usually is present to varying degrees in all patients that are seen for psychodynamic psychotherapy. This chapter aims to shed some light on some psychodynamic approaches to thinking about anxieties. Using theory and clinical examples we think about how difficulties in containing processes between caregiver and infant early in the infant’s life may predispose to the persistence of archaic anxieties. We go on to explore the nature of separation and loss in relation to anxiety and finally, we reflect on how internal conflict and the role of a critical internal object can bring about anxiety. The clinical examples illustrate how wider variation in anxieties may present in therapy and the last section focuses on how the therapist may experience and respond to these different anxieties.

The consultation is likely to be the first experience the patient has of a psychodynamic way of thinking and it has the potential to be an experience of being deeply heard and understood. In the consultation period the aim is for the therapist to have an experience of the internal world of the patient and the patient an experience of what the therapy will be like. A consultation over a series of meetings may even give the opportunity of developing a patient’s capacity to undertake therapeutic work. It is a complex process that often starts before the patient even enters the room. There are different approaches to the consultation process and some of these are discussed. Given that the psychodynamic consultation is an encounter which will, in all likelihood, create anxiety and a sense of vulnerability in the patient, we can expect to see defences emerging in the moment-by-moment interaction and these are considered. A tripartite structure of psychodynamic formulation is outlined as a helpful framework for picking out the relational dynamic

Staff in the caring professions often have to contain troubling and unpredictable communications (projections) from those they work with. It is usual and expected for staff to have feelings in response to these communications – this is part of the process of emotional containment. If reflected on, the professional’s feelings and inner responses (countertransference) can be a vital source of information about the relational dynamics the service user carries with them and how the staff member is responding to these. However, if staff members do not reflect on and process their countertransference, there is the potential for increased stress for the staff member, and to inadvertently re-enact the patient’s relational difficulties rather than provide containment for them. A reflective practice (RP) group brings a whole clinical team together with the primary task being to reflect on and process staff-patient, teamm and organisational dynamics, to sustain caring relationships with patients and reduce the stresses of the work for staff. This chapter offers an introduction to psychodynamic RP groups, aimed at both participants and group facilitators. We discuss the theory of RP groups and their intended purpose, outline a process of starting a group, and consider what is expected for both participants and facilitators.

Explains the physiological processes and the medical treatments behind the biological perspective of psychopathology. Defines the psychodynamic perspective and the techniques used in psychodynamic therapy. Describes the behavioral perspective and related techniques. Contrasts the cognitive theories of Beck, Ellis, and the 3rd Wave approaches of ACT and DBT. Describes the sociocultural perspective, and how systems and group therapy utilize this approach. Analyzes how multiperspective approaches to psychopathology integrate various approaches.

From the 1960s to the 1980s, in parallel with societal changes from welfarism to the counterculture, the legacy of the child guidance and psychodynamic approaches gave way to more active, transparent and fast-moving therapies. Family/systemic therapy involved the whole family, training practitioners from all disciplines. Cognitive behavioural therapy (CBT) was developed as an alternative effective psychological treatment. A variety of longitudinal and epidemiological research approaches developed, providing a variety of ways of measuring the presence and impact of mental health problems. Conditions such as anorexia of childhood, self-harming and neurodevelopmental disorders – autism and attention deficit hyperactivity disorder (ADHD) – have been identified. Despite attempts to ‘shrink the state’ in the 1980s, a continuing theme has been the recognition of the hidden yet pervasive traumatic impact of maltreatment many children suffer. There is a lifespan impact of adversity on mental and physical health and the need for a trauma-informed care approach.

In this commentary, the author highlights the contributions from Fonagy and colleagues in their chapter on contemporary psychodynamic treatments. Chief among these contributions are balance between a rich and nuanced historical presentation of the major traditions within the psychodynamic perspective and a focus on contemporary psychodynamic treatments such as Mentalization Based Therapy (MBT) and Transference-Focused Psychotherapy (TFP). Additionally, building on recent findings regarding the equivalence of outcomes for various treatments irrespective of theoretical orientation, Fonagy and colleagues articulate an interesting, timely, and integrative model of personality disorder that is consistent with and integrative of a psychodynamic approach. In an effort to highlight and elaborate the work of Fonagy and colleagues, the author of this commentary focuses on the unique contributions and utility of a psychodynamic approach.