000			03301nam a22003137a 4500
005			20250625151350.0
008			141113s2012 -nz||||| |||| 00| 0 eng d
040			_aAFVC
100			_aSampson, Maria E. _94404
245			_aDo community mental health staff ask about and respond to adverse childhood experiences and attachment histories? _cMaria Elisabet Sampson
246			_aA thesis submitted in partial fulfillment of the requirements for the degree of Doctorate in Clinical Psychology (PhD), The Univeristy of Auckland
260			_c2012
300			_aelectronic document (165 pages); PDF format: 884.15 KB
520			_a"The links between adverse events, attachment, and mental health problems are well documented. However, there has been limited focus on clinicians' enquiry and response behaviour in the literature to date. This project had two main objectives: 1) To add to this limited field of research and 2) to function as a replication of 1997 file audit (Agar & Read, 2002). The current study examined 250 computerised medical files, to see if clinicians working in four community mental health centres (CMHC) in Auckland, New Zealand, routinely asked about adverse events and if they incorporated disclosed information into psychological case formulations and treatment recommendations. All files were read in their entirety, and information regarding adverse events in childhood, adulthood and attachment related experiences was recorded. Results indicate that there have been significant improvements in both enquiry and response behaviours since the last audit. For instance, 20% of the files included recorded disclosures of child sexual abuse in the 1997 audit, compared to 32.4% in 2010. Furthermore, the inclusion of adverse events in clients' case formulations had increased by more than 300% since 1997. Despite these encouraging results, there were also some concerning findings. There had been no improvements in the proportion of individuals referred for psychological therapy or in the number of alleged crimes that had been reported to the authorities. Furthermore, men and individuals with a psychotic disorder diagnosis appear to continue to receive a less than satisfactory service regardless of efforts made by a training programme. Findings from this study suggest that focus needs to be placed on assuring that more individuals are referred to and able to access trauma-focused therapy. Future CMHC training providers would benefit from considering ways to disseminate this information to minimise misunderstandings, misdiagnosis, and ineffective treatment recommendations, especially for males and clients experiencing psychosis. Furthermore, reporting of historical abuse to legal authorities also needs some future attention at policy level." (Author's abstract).
650			_aABUSED MEN _924
650			_aADVERSE CHILDHOOD EXPERIENCES _94089
650			_aATTACHMENT _969
650			_aDISCLOSURE _9199
650			_aMENTAL HEALTH _9377
650			_aMENTAL HEALTH SERVICES _9379
650			_aMENTAL ILLNESS _9380
650			_aTHESES _9606
650		4	_aTRAUMA _9612
650			_aTREATMENT _9613
651		4	_aNEW ZEALAND _92588
650			_9121 _aCHILD SEXUAL ABUSE
856			_uhttp://hdl.handle.net/2292/19790
942			_2ddc _cTHESIS
999			_c4550 _d4550