ISRCTN 81605131 http://www.controlled-trials.com/ISRCTN81605131/.

TA is a brief intervention associated with improved treatment engagement. TA training is feasible and is associated with improved quality of self-harm assessment. SFBT-based exit is the most commonly used strategy in TA.

Aims and MethodAdolescents presenting with self-harm have poor adherence to community follow-up. Poor adherence is a principal obstacle to treatment delivery and is associated with poor psychosocial outcomes. Therapeutic assessment is a novel method of assessing adolescents with self-harm. We compared therapeutic assessment with assessment as usual in a pilot study of 38 adolescents referred for psychosocial assessment following self-harm.ResultsSignificantly more adolescents assessed with therapeutic assessment than with usual assessment attended the first community follow-up appointment (75% v. 40%, χ2=3.89, P < 0.05) and engaged with services (62% v. 30% χ2=4.49, P < 0.05).Clinical ImplicationsYoung people assessed using therapeutic assessment may be more likely to engage with community follow-up. A therapeutic intervention at the time of the initial assessment might be necessary to enable future therapeutic work.

No abstract

Dementia is relatively poorly understood from a psychological perspective and current care provisions focus preferentially on pharmacological and social interventions. Although dementia preys on a sufferer's cognitive attributes, this loss does not equate to a loss of emotional attributes in these patients. In dementia, the trajectory of life reverses and a degree of regression occurs. Through observations in an acute dementia ward, this work scrutinizes the potential that infant observation may hold for achieving greater insights into the internal worlds of dementia patients and their external environment. I look at the experience of caring for these challenging patients and examine the psychoanalytical constructs behind it. The findings derived from the platform of infant observation appear to support a more psychological rather than biological stance in approaching the complicated but fragile configuration of care on acute psychiatric units for dementia sufferers.