Petersen, 2014), such as the therapeutic relationship (Shirk & Karver, 2003), may be linked to treatment outcome. For older adolescents, service engagement could be a challenge (Royal College of Psychiatrists, 2012). Alongside experiencing mental distress, they may also be faced with societal (e.g., stigma; Eisenberg, Downs, Golberstein, & Zivin, 2009), familial (YoungMinds, 2006), and developmental (Erikson, 1968) pressures. In addition, 16 to 18 years is a potential time of transition between CAMHS and adult mental health services (AMHS), which may impose its own challenges (

BackgroundBreastfeeding is a public health priority and lack of breastfeeding support a contributing factor to the low initiation and continuation rates in the UK. Online social support groups are being increasingly utilised by breastfeeding mothers and research into this phenomenon is only now emerging.AimTo document and describe the posts made within an online breastfeeding support group.MethodThe posts made to an online breastfeeding social support group between 1st and 7th November 2016 were recorded using an unobtrusive non-participant design, and subject to systematic message content analysis. Themes relating to topics of discussion were deduced from the data and concepts of social support used to analyse the data.ResultsThe group received 501 posts over the week (m = 72, range 20–93 a day) and was accessed 24 hours a day. Eighty-two percent of posts received comments (m = 12, range 0–415, SD = 24) and 93% received likes (m = 11, range = 0–641, SD 42). The group was used from pregnancy and until the child was over two years old. The majority of infants discussed were aged 6 weeks to 6 months. Informational support was the greatest reason for use (65%), followed by esteem support (18%) and emotional support (10%). Thirteen topics of conversations were identified.ConclusionMothers are using online social support groups in their thousands to seek information from people in similar situations. Not only do they pose questions but they discuss a range of parenting and breastfeeding topics in an environment that aims to support and facilitate responses. The impact of this support avenue within the wider context of professional, family and offline support warrants further investigation through a qualitative approach.

Given the high rates of completed suicide and poor help-seeking among young men, this research explored how young men, who had successfully sought help from a Child and Adolescent Mental Health Service (CAMHS), experienced helpseeking. The study focused on the factors that facilitated initial access and ongoing engagement in services. Eight young men between the ages of 16 to 18, who had entered CAMHS following self-harm or suicidal ideation, and who were engaged in ongoing therapy, were recruited. Each young man was interviewed to elicit his personal experiences of help-seeking and help-receiving. Interviews were transcribed and subjected to Interpretative Phenomenological Analysis. Four superordinate themes, which overarched participant's individual experiences, emerged from the data: Role of external adult in recognizing, normalizing, and initiating help-seeking; challenging and renegotiating perception of need for help and meaning behind this need; maintaining an independent self; and mechanisms of engagement. Help-seeking was described as a journey of two stages: (a) initial access and (b) ongoing engagement, during which the presence and timing of external influences (parents, teachers) and internal influences (personal beliefs and attitudes) were crucial. A model of help-seeking in young men who self-harmed was developed, which considered both access and engagement to help, and combined a consideration of internal and external influences on their ability to access help.

Research has highlighted the many challenges that foster carers face in caring for children who have experienced adversity and has charted a growing mismatch between the numbers of children needing placements and the availability of carers. This review synthesises and evaluates the current empirical evidence on the causes and consequences of stress experienced by foster carers and the factors that lessen or increase it. PsychINFO, ASSIA, Web of Science and Google Scholar were searched for relevant studies, 15 of which met the specific inclusion criteria. The factors identified included both system variables, such as working in a wider service framework, and individual ones, such as children’s behaviour. One consequence of this stress was reduced foster carer retention. Scrutiny of the papers also revealed methodological issues related to sampling, research design and cultural variability. Topics for future research were identified, especially an analysis of the perspectives of people involved in the system around foster carers, such as social workers and the carers’ birth children. Clinical implications were also highlighted, most notably the promotion and provision of effective training and support and the development of integrated ways of working with services and foster carers’ families.

Identity formation may be more complex for those who have been in foster care in the face of childhood abuse, difficult relationships, unstable environments, and multiple care contexts but this does not imply there is anything pathological about it. Given the higher levels of mental health difficulties in looked after children and the known role identity has in mental health, whether as a risk or a protective factor, it seems clinically significant to investigate what factors help construct or hinder the formation of identity for those who have been in care. Interpretative Phenomenological Analysis was used to analyze semistructured interviews of eight female care leavers about the understanding of their identity development. Three superordinate themes emerged which encapsulated participants’ identity development. These included Construction of Identity—How I Became Me, Understanding of Identity—Who am I, and Experience of Identity—How My Identity Plays Out. Participants’ construction of identity can be understood in the context of early adverse environments and developmental trauma. This construction of self, in turn, mediates how participants understand and experience their identity. Findings were discussed in relation to previous research, and limitations were outlined. Implications for future research included giving fuller consideration to the role of developmental trauma in identity formation. Clinical implications encourage understanding of looked after children and care leavers in the context of developmental trauma, rather than focusing on symptoms of various diagnoses.