AMBIT: Working in anxious places

42 Pages·2013·3.55 MB·English

AMBIT:
Working
in
anxious
places
A team-based
mentalizing
approach
to high risk hard to
reach complex youth
Fundación Castilla del Pino
2013
Dr Dickon Bevington
1
Thanks
Peter Fuggle (co-lead)
Peter Fonagy
Mary Target
Eia Asen
Neil Dawson
Rabia Malik
Suzanne Hare
Garry Richardson
Liz Cracknell
Sally Zlotowitz
All the AMBIT-trained teams
2
> 40 teams
AMBIT:
using versions of
A Community of
AMBIT manual
Practice
Wenger and Lave
Derry - Omagh
Edinburgh CAMHS
MAC-UK AMASS - Islington
CASUS
Bexley CAMHS
Education/Training
(Total n = 70)
No. of staff and working experience
“At times I feel anxious working
with complex hard to reach
7 youth.”
“Strongly Disagree”
6
5
4
3
2
“Strongly Agree”
1
“At times I feel anxious working
with complex hard to reach
( n = 67)
youth.”
“Strongly Disagree”
7
6
5
4
3
2
“Strongly Agree”
1
A Definition of Mentalizing
The imaginative activity of making sense of behaviour
•
Of self and of others
•
By reference to present intentional mental states
•
Beliefs, Desires, Fears, Hopes…
•
A ‘bedrock’ neurodevelopmental capacity that is:
Located primarily in the prefrontal cortex
•
Fostered (or rekindled) in the experience of relationship with a
•
trusted other, in which one has repeated experience of
being accurately mentalized (“I find my mind in your mind”)
Easily overwhelmed by powerful stress/arousal/attachment
•
7
Anxiety & the Failure of Mentalization
Genetic & early
environmental The
influence Disorganised
Excessive
demand for Self
excellence
Activation of
INSIDE-OUT thinking
Becoming attachment
adult system
(Psychic Equivalence)
Rejection
ELEPHANT-IN-THE-ROOM
Current Disruption of
‘insurmountable’ mentalization thinking
life challenges
(Pretend Mode)
QUICK FIX thinking
Stress
CSA
reaction (Teleological Mode)
Adverse (fight/flight)
History of
parenting
physical
maltreatment
Genetic & early
environmental
influence
Psychic
Equivalence
“INSIDE-OUT
THINKING”
Certainty about other minds
and the way the world IS…