This article was downloaded by: [George Mason University] On: 24 December 2014, At: 21:18 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK
Journal of Child & Adolescent Mental Health Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/rcmh20
Journal abstracts from current research in the field of child and adolescent mental health Erhabor S Idemudia
a
a
Department of Psychology (Ipelegeng Child & Family Centre) , North West University , Mmbatho Published online: 26 Oct 2012.
To cite this article: Erhabor S Idemudia (2012) Journal abstracts from current research in the field of child and adolescent mental health, Journal of Child & Adolescent Mental Health, 24:2, 177-182, DOI: 10.2989/17280583.2012.735511 To link to this article: http://dx.doi.org/10.2989/17280583.2012.735511
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms
Downloaded by [George Mason University] at 21:18 24 December 2014
& Conditions of access and use can be found at http://www.tandfonline.com/page/ terms-and-conditions
Journal of Child & Adolescent Mental Health 2012, 24(2): 177–182 Printed in South Africa — All rights reserved
Copyright © NISC Pty Ltd
JOURNAL OF CHILD & ADOLESCENT MENTAL HEALTH ISSN 1728-0583 EISSN 1728-0591 http://dx.doi.org/10.2989/17280583.2012.735511
Abstracts
Downloaded by [George Mason University] at 21:18 24 December 2014
Journal abstracts from current research in the field of child and adolescent mental health
Warren JS, Nelson PL, Burlingame GM and Mondragon SA (2012) Predicting patient deterioration in youth mental health services: community mental health vs. managed care settings. Journal of Clinical Psychology 68(1): 24–40 Objective: To examine differences across a community mental health system and a private managed care system in the accuracy of a warning system designed to identify youth at risk for deterioration in mental health services. Design: Longitudinal outcome data from the Youth Outcome Questionnaire (Y-OQ) were examined using multilevel modelling for 2,310 youth ages 4-17 who received outpatient treatment. Results: The warning system correctly identified 69% of cases that ultimately ended in deterioration in the community mental health setting, compared to 61% in the managed care setting. The overall hit rate (overall accuracy in classifying cases as deteriorators/non-deteriorators) was the same in the two settings (75%). Conclusions: Results are consistent with previous research demonstrating that patient-focused warning systems can be reasonably accurate in identifying youth cases at risk for treatment failure Lapatin S, Gonçalves M, Nillni A, Chavez L, Quinn RL, Green A and Alegría M (2012) Lessons from the use of vignettes in the study of mental health service disparities. Health Services Research 47(3pt2): 1345–1362 Objective: To examine the development, feasibility, and use of a vignette approach as an important tool in health services disparities research. Data Source Interviews with vignette developers and qualitative data from a novel mental health services disparities study that used vignettes in two samples: (1) predominantly low-income parents of children attending mental health specialty care who were Latino or non-Latino White and (2) Latino and non-Latino mental health clinicians who treat children in their practice. Study Design We conduct a content analysis of qualitative data from patients and providers in the Ethnic Differences Study to explore the feasibility of vignette methodology in health services disparities research, and we identify lessons learned that may guide future vignette development. Principal Findings Vignettes provide a valuable approach that is acceptable to participants, elicits important insight on participant experience and services, and sheds light on factors that can help optimize study design for exploring health disparities questions. Conclusions Researchers, clinicians, and others should consider a set of factors that help determine when a vignette approach is warranted in research, training, or for other uses, including how best to address identified weaknesses.
Venta A, Kenkel-Mikelonis R and Sharp C (2012) A preliminary study of the relation between trauma symptoms and emerging BPD in adolescent inpatients. Bulletin of the Menninger Clinic 76(2): 130–146 The relation between trauma and borderline personality disorder (BPD) has been studied in great detail with adults, but few studies have examined this link in adolescents. Furthermore, virtually Journal of Child & Adolescent Mental Health is co-published by NISC (Pty) Ltd and Routledge, Taylor & Francis Group
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nothing is known about how different aspects of trauma relate to BPD and whether trauma symptoms reflect actual trauma history in adolescents diagnosed with BPD. Using a sample of 147 adolescent psychiatric inpatients, the authors examined the concurrent link between trauma symptoms, trauma history, and BPD. Findings suggest that adolescents with BPD are more likely than their non-BPD counterparts to have a history of sexual trauma and to report sexual concerns. However, the link between BPD and sexual concerns is not completely explained by increased sexual trauma history in the BPD group, indicating that there is some relation between BPD and sexual concerns independent of trauma history. These findings are discussed within an attachment framework. The preliminary nature of this study is noted and used as the basis for encouraging future research in the area Liang H, Pickles A, Wood N and Simonoff E (2012) Adolescent emotional and behavioural outcomes of nonparental preschool childcare. Social Psychiatry & Psychiatric Epidemiology 47(3): 399–407 Purpose: This study aimed to identify whether nonparental preschool childcare was associated with adolescent mental health outcomes as measured by the strengths and difficulties questionnaire (SDQ). Method: This study was a secondary analysis of data from the Croydon Assessment of Learning Study. From a general population sample of 2,726 adolescents tested for cognitive ability, additional data were collected from a stratified sub-sample of 197 subjects. A semi-structured interview asked parents about preschool childcare and early development concerns. Parent and teacher SDQ and IQ data were collected. Complete data were available from 167 subjects. Using nonparental preschool childcare as the ‘treatment’ effect and parental childcare as the ‘control’, propensity score matching analyses were used to analyse the effect of nonparental childcare on adolescent SDQ outcomes. Results: Nonparental childcare was reported by 49% of the sample and was not significantly associated with conduct, emotional, peer or prosocial SDQ subscales, but was found to have a significant average treatment effect on symptoms of attention/hyperactivity, on average raising the symptom subscale score by 1.8 (95% confidence interval 0.12-3.65). The propensity score analysis ensures the results could not be explained by the available measures that influenced receiving nonparental care. Increased time spent in nonparental childcare was associated with greater attention/hyperactivity symptoms. Conclusions: Nonparental preschool care showed little association with generalized psychopathology but may be associated with hyperactivity and inattention problems. Replication of these findings in prospective studies is required. Cleek EN, Wofsy M, Boyd-Franklin N, Mundy B and Howell TJ (2012) The Family Empowerment Program: An interdisciplinary approach to working with multi-stressed urban families. J. Family Process 51(2): 207–217 The family empowerment program (FEP) is a multi-systemic family therapy program that partners multi-stressed families with an interdisciplinary resource team while remaining attached to a ‘traditional’ mental health clinic. The rationale for this model is that far too often, families presenting at community mental health centres struggle with multiple psychosocial forces, for example problems with housing, domestic violence, child care, entitlements, racism, substance abuse, and foster care, as well as chronic medical and psychiatric illnesses, that exacerbate symptoms and impact traditional service delivery and access to effective treatment. Thus, families often experience fragmented care and are involved with multiple systems with contradictory and competing agendas. As a result, services frequently fail to harness the family’s inherent strengths. The FEP partners the family with a unified team that includes representatives from Entitlements Services, Family Support and Parent Advocacy, and Clinical Staff from the agency’s Outpatient Mental Health Clinic practicing from a strength-based family therapy perspective. The goal of the FEP is to support the
Journal of Child & Adolescent Mental Health 2012, 24(2): 177–182
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family in achieving their goals. This is accomplished through co-construction of a service plan that addresses the family’s needs in an efficient and coherent manner-emphasizing family strengths and competencies and supporting family self-sufficiency.
Downloaded by [George Mason University] at 21:18 24 December 2014
Kirkpatrick SM, Rojjanasrirat W, South BJ, Sindt JA and Williams LA (2012) Assessment of emotional status of orphans and vulnerable children in Zambia. Journal of Nursing Scholarship 44(2): 194–201 Purpose: To describe the emotional status of orphans and vulnerable children (OVC) in two communities in Zambia. Methods: The Health Ed Connect Adaptation Questionnaire (HECAQ) was used to interview 306 OVC and 158 primary caregivers in Zambia in 2010. Findings: Child participants and caregivers reported evidence of emotional distress behaviours in the majority of OVC. Conclusions: More research to evaluate the efficacy of intervention programs for loss and grief, normal and abnormal reactions to grief, and positive coping skills is needed to assist both children and their caretakers. In the population studied, caregivers and OVC could benefit from additional support for promoting emotional health and managing emotional distress in vulnerable children. Clinical Relevance: Healthcare professionals play a key role in promoting the emotional health of OVC through identification of deviant behaviours and the development of interventions to alleviate emotional and psychological distress. Wilson CJ and Deane FP (2012) Brief report: Need for autonomy and other perceived barriers relating to adolescents’ intentions to seek professional mental health care. Journal of Adolescence 35(1): 233–237 The current study examined the relationship between belief-based barriers to seeking professional mental health care and help-seeking intentions in a sample of 1037 adolescents. From early adolescence to adulthood, for males and females, the need for autonomy was a strong barrier to seeking professional mental health care. Help-seeking fears were weaker in the older age groups. Having lower perceived need for autonomy and believing that prior mental health care was helpful was significantly associated with higher intentions to seek future professional mental health care. Implications for prevention and overcoming barriers to seeking mental health care are suggested. Miers D, Abbott D and Springer PRA (2012) Phenomenological study of family needs following the suicide of a teenager. Death Studies 36(2): 118–133 The objective of this phenomenological study was to develop an understanding of family needs following the suicide of a teenager. Six parent units living in the Midwest who lost a teenager to suicide were interviewed. Participants indicated several key themes that describe a parent’s needs following the suicide of a teenager. These needs were organized into 6 main categories: (a) support by listening and responding, (b) support from another suicide survivor, (c) support in finding direction, (d) support when viewing the deceased teen, (e) support in remembering the teen, and (f) support in parents giving back to the community. Sarwer D and Dilks R (2012) Invited commentary: Childhood and adolescent obesity: Psychological and behavioural issues in weight loss treatment. Journal of Youth & Adolescence 41(1): 98–104 The prevalence of childhood and adolescent obesity has tripled in the past three decades. This increase has been accompanied by a dramatic rise in obesity-related health complications among American youth. Thus, many obese youth are now experiencing illnesses that will threaten their life expectancy in the absence of significant weight loss. Despite these concerns, a relatively modest
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body of research has focused on the treatment of adolescent obesity. Results from trials investigating the efficacy of behavioural and pharmacological treatments, like studies of these interventions with adults, suggest that individuals typically lose 5-10% of their initial weight. Unfortunately, weight regain is common. Given the increase in the number of obese adolescents, coupled with the modest results from more conservative treatment approaches, it is not surprising that bariatric surgery for adolescents who suffer from extreme obesity has grown in popularity. The weight losses after surgery are impressive and many adolescents, like adults, experience significant improvements in their physical and mental health postoperatively. However, only a small fraction of adolescents and adults who are heavy enough for bariatric surgery present for surgical treatment. Among those who undergo surgery, a significant minority appear to struggle with a number of behavioural and psychosocial issues that threaten their lifelong success. With all of this in mind, the current obesity problem in the United States and other Westernized countries likely will present a significant challenge to both current and future medical and mental health professionals who work with adolescents and young adults. Hodges S, Ferreira K and Israel N (2012) If we’re going to change things, it has to be systemic: Systems change in children’s mental health. American Journal of Community Psychology 49(3/4): 526–537 Communities that undertake systems change in accordance with the system of care philosophy commit to creating new systems entities for children and adolescents with serious emotional disturbance. These new entities are values-based, voluntary, and cross-agency alliances that include formal child-serving entities, youth, and families. Describing the scope and intent of one such implementation of systems of care, a mental health administrator commented, ‘If we’re going to change things, it has to be systemic’ (B. Baxter, personal communication, December 2, 2005). This paper explores the concept of ‘systemic’ in the context of systems of care. Systems theory is used to understand strategies of purposeful systems change undertaken by stakeholders in established system of care communities. The paper presents a conceptual model of systems change for systems of care that is grounded in data from a national study of system of care implementation (Research and Training Centre for Children’s Mental Health in Case Studies of system implementation: Holistic approaches to studying community-based systems of care: Study 2, University of South Florida, Louis de la Parte Florida Mental Health Institute, Research and Training Centre for Children’s Mental Health, Tampa, FL). The model is based on Soft Systems Methodology, an application of systems theory developed to facilitate practical action around systems change in human systems (Checkland in Systems thinking, systems practice, Wiley, Chichester). The implications of these findings to real world actions associated with systems change in systems of care are discussed. Ramirez R, Hinman A, Sterling S, Weisner C and Campbell C (2012) Peer influences on adolescent alcohol and other drug use outcomes. Journal of Nursing Scholarship 44(1): 36–44 Purpose: To examine the role of family environment and peer networks in abstinence outcomes for adolescents 1 year after intake to alcohol and other drug (AOD) treatment. Design: Survey of 419 adolescents 13 to 18 years of age at consecutive intakes to AOD treatment programs at four sites of a large health system, with telephone follow-up survey 1 year after intake. Methods: Examined association of 1-year abstinence with baseline characteristics. Using logistic regression, we examined characteristics predicting 1-year abstinence and predicting having fewer than four substance-using friends at 1 year. Results: We found that family environment scores related to family conflict, limit setting, and positive family experiences, were not related to abstinence outcomes, but peer networks were related. Adolescents with fewer (less than four) AOD-using friends were more likely to be abstinent than those with four or more AOD-using friends (65% vs. 41%, p = 0.0002). Having fewer than four
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AOD-using friends at intake predicted abstinence at 1 year (odds ratio [OR] = 2.904, p = 0.0002) and also predicted having fewer than four AOD-using friends at 1 year (OR = 2.557, p = 0.0007). Conclusions: Although family environment is an important factor in the development of AOD problems in adolescents, it did not play a significant role in treatment success. The quality of adolescent peer networks did independently predict positive outcomes. Clinical Relevance: For physicians, advanced practice registered nurses, and other primary and behavioural care providers who screen and care for adolescents with AOD and other behavioural problems, our finding suggest the importance of focusing on improving the quality of their peer networks. Kaale A, Smith L and Sponheim E (2012) A randomized controlled trial of preschoolbased joint attention intervention for children with autism. Journal of Child Psychology & Psychiatry 53(1): 97–105 Background: Deficits in joint attention (JA) and joint engagement (JE) represent a core problem in young children with autism as these affect language and social development. Studies of parentmediated and specialist-mediated JA-intervention suggest that such intervention may be effective. However, there is little knowledge about the success of the intervention when done in preschools. Aim: Assess the effects of a preschool-based JA-intervention. Methods: 61 children (48 males) with autistic disorder (29-60 months) were randomized to either 8 weeks of JA-intervention, in addition to their preschool programs (n = 34), or to preschool programs only (n = 27). The intervention was done by preschool teachers with weekly supervision by trained counsellors from Child and Adolescent Mental Health Clinics (CAMHC). Changes in JA and JE were measured by blinded independent testers using Early Social Communication Scale (ESCS) and videotaped preschool teacher-child and mother-child play at baseline and post-intervention. Clinical trials registration: NCT00378157. Results: Intention-to-treat analysis showed significant difference between the intervention and the control group, with the intervention group yielding more JA initiation during interaction with the preschool teachers. The effect generalized to significantly longer duration of JE with the mothers. Conclusions: This is the first randomized study to show positive and generalized effects of preschool-based JA-intervention. Myklestad I, Røysamb E and Tambs K (2012) Risk and protective factors for psychological distress among adolescents: a family study in the Nord-Trøndelag Health Study. Social Psychiatry & Psychiatric Epidemiology 47(5): 771–782 Purpose: The study aimed to investigate potential adolescent and parental psychosocial risk and protective factors for psychological distress among adolescents and, in addition, to examine potential gender and age differences in the effects of risk factors on adolescent psychological distress. Methods: Data were collected among 8,984 Norwegian adolescents (13-19 years) and their parents in the Nord-Trøndelag Health Study (HUNT). The outcome measure was psychological distress (SCL-5). Results: Bivariate regression analysis with generalized estimating equation (GEE) model showed that all parental self-reported variables (mental distress, substance use, social network, economic problems, unemployment and family structure) and adolescents’ self-reported variables (leisure activities, social support from friends, school-related problems and substance use) were significantly associated with psychological distress among adolescents. Results revealed that in a multiple regression analysis with a GEE model, adolescent psychosocial variables, specifically academicrelated problems and being bullied at school, emerged as the strongest predictors of psychological distress among adolescents after controlling for age, gender, and all parental and adolescent variables. The following psychosocial risk factors were significantly more important for girl’s psychological distress compared to boys: problems with academic achievement, conduct problems in
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school, frequency of being drunk, smoking, dissatisfaction in school, living alone and seen parents being drunk. Conclusion: Academic achievement and being bullied at school were the psychosocial factors most strongly associated with psychological distress among adolescents. Parental factors had an indirect effect on adolescent psychological distress, through adolescents’ psychosocial factors.
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Erhabor S Idemudia Department of Psychology (Ipelegeng Child & Family Centre), North West University, Mmbatho e-mail: [email protected] or [email protected]
Journal of Child & Adolescent Mental Health Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/rcmh20
Journal abstracts from current research in the field of child and adolescent mental health Erhabor S Idemudia
a
a
Department of Psychology (Ipelegeng Child & Family Centre) , North West University , Mmbatho Published online: 26 Oct 2012.
To cite this article: Erhabor S Idemudia (2012) Journal abstracts from current research in the field of child and adolescent mental health, Journal of Child & Adolescent Mental Health, 24:2, 177-182, DOI: 10.2989/17280583.2012.735511 To link to this article: http://dx.doi.org/10.2989/17280583.2012.735511
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms
Downloaded by [George Mason University] at 21:18 24 December 2014
& Conditions of access and use can be found at http://www.tandfonline.com/page/ terms-and-conditions
Journal of Child & Adolescent Mental Health 2012, 24(2): 177–182 Printed in South Africa — All rights reserved
Copyright © NISC Pty Ltd
JOURNAL OF CHILD & ADOLESCENT MENTAL HEALTH ISSN 1728-0583 EISSN 1728-0591 http://dx.doi.org/10.2989/17280583.2012.735511
Abstracts
Downloaded by [George Mason University] at 21:18 24 December 2014
Journal abstracts from current research in the field of child and adolescent mental health
Warren JS, Nelson PL, Burlingame GM and Mondragon SA (2012) Predicting patient deterioration in youth mental health services: community mental health vs. managed care settings. Journal of Clinical Psychology 68(1): 24–40 Objective: To examine differences across a community mental health system and a private managed care system in the accuracy of a warning system designed to identify youth at risk for deterioration in mental health services. Design: Longitudinal outcome data from the Youth Outcome Questionnaire (Y-OQ) were examined using multilevel modelling for 2,310 youth ages 4-17 who received outpatient treatment. Results: The warning system correctly identified 69% of cases that ultimately ended in deterioration in the community mental health setting, compared to 61% in the managed care setting. The overall hit rate (overall accuracy in classifying cases as deteriorators/non-deteriorators) was the same in the two settings (75%). Conclusions: Results are consistent with previous research demonstrating that patient-focused warning systems can be reasonably accurate in identifying youth cases at risk for treatment failure Lapatin S, Gonçalves M, Nillni A, Chavez L, Quinn RL, Green A and Alegría M (2012) Lessons from the use of vignettes in the study of mental health service disparities. Health Services Research 47(3pt2): 1345–1362 Objective: To examine the development, feasibility, and use of a vignette approach as an important tool in health services disparities research. Data Source Interviews with vignette developers and qualitative data from a novel mental health services disparities study that used vignettes in two samples: (1) predominantly low-income parents of children attending mental health specialty care who were Latino or non-Latino White and (2) Latino and non-Latino mental health clinicians who treat children in their practice. Study Design We conduct a content analysis of qualitative data from patients and providers in the Ethnic Differences Study to explore the feasibility of vignette methodology in health services disparities research, and we identify lessons learned that may guide future vignette development. Principal Findings Vignettes provide a valuable approach that is acceptable to participants, elicits important insight on participant experience and services, and sheds light on factors that can help optimize study design for exploring health disparities questions. Conclusions Researchers, clinicians, and others should consider a set of factors that help determine when a vignette approach is warranted in research, training, or for other uses, including how best to address identified weaknesses.
Venta A, Kenkel-Mikelonis R and Sharp C (2012) A preliminary study of the relation between trauma symptoms and emerging BPD in adolescent inpatients. Bulletin of the Menninger Clinic 76(2): 130–146 The relation between trauma and borderline personality disorder (BPD) has been studied in great detail with adults, but few studies have examined this link in adolescents. Furthermore, virtually Journal of Child & Adolescent Mental Health is co-published by NISC (Pty) Ltd and Routledge, Taylor & Francis Group
178
Abstracts
Downloaded by [George Mason University] at 21:18 24 December 2014
nothing is known about how different aspects of trauma relate to BPD and whether trauma symptoms reflect actual trauma history in adolescents diagnosed with BPD. Using a sample of 147 adolescent psychiatric inpatients, the authors examined the concurrent link between trauma symptoms, trauma history, and BPD. Findings suggest that adolescents with BPD are more likely than their non-BPD counterparts to have a history of sexual trauma and to report sexual concerns. However, the link between BPD and sexual concerns is not completely explained by increased sexual trauma history in the BPD group, indicating that there is some relation between BPD and sexual concerns independent of trauma history. These findings are discussed within an attachment framework. The preliminary nature of this study is noted and used as the basis for encouraging future research in the area Liang H, Pickles A, Wood N and Simonoff E (2012) Adolescent emotional and behavioural outcomes of nonparental preschool childcare. Social Psychiatry & Psychiatric Epidemiology 47(3): 399–407 Purpose: This study aimed to identify whether nonparental preschool childcare was associated with adolescent mental health outcomes as measured by the strengths and difficulties questionnaire (SDQ). Method: This study was a secondary analysis of data from the Croydon Assessment of Learning Study. From a general population sample of 2,726 adolescents tested for cognitive ability, additional data were collected from a stratified sub-sample of 197 subjects. A semi-structured interview asked parents about preschool childcare and early development concerns. Parent and teacher SDQ and IQ data were collected. Complete data were available from 167 subjects. Using nonparental preschool childcare as the ‘treatment’ effect and parental childcare as the ‘control’, propensity score matching analyses were used to analyse the effect of nonparental childcare on adolescent SDQ outcomes. Results: Nonparental childcare was reported by 49% of the sample and was not significantly associated with conduct, emotional, peer or prosocial SDQ subscales, but was found to have a significant average treatment effect on symptoms of attention/hyperactivity, on average raising the symptom subscale score by 1.8 (95% confidence interval 0.12-3.65). The propensity score analysis ensures the results could not be explained by the available measures that influenced receiving nonparental care. Increased time spent in nonparental childcare was associated with greater attention/hyperactivity symptoms. Conclusions: Nonparental preschool care showed little association with generalized psychopathology but may be associated with hyperactivity and inattention problems. Replication of these findings in prospective studies is required. Cleek EN, Wofsy M, Boyd-Franklin N, Mundy B and Howell TJ (2012) The Family Empowerment Program: An interdisciplinary approach to working with multi-stressed urban families. J. Family Process 51(2): 207–217 The family empowerment program (FEP) is a multi-systemic family therapy program that partners multi-stressed families with an interdisciplinary resource team while remaining attached to a ‘traditional’ mental health clinic. The rationale for this model is that far too often, families presenting at community mental health centres struggle with multiple psychosocial forces, for example problems with housing, domestic violence, child care, entitlements, racism, substance abuse, and foster care, as well as chronic medical and psychiatric illnesses, that exacerbate symptoms and impact traditional service delivery and access to effective treatment. Thus, families often experience fragmented care and are involved with multiple systems with contradictory and competing agendas. As a result, services frequently fail to harness the family’s inherent strengths. The FEP partners the family with a unified team that includes representatives from Entitlements Services, Family Support and Parent Advocacy, and Clinical Staff from the agency’s Outpatient Mental Health Clinic practicing from a strength-based family therapy perspective. The goal of the FEP is to support the
Journal of Child & Adolescent Mental Health 2012, 24(2): 177–182
179
family in achieving their goals. This is accomplished through co-construction of a service plan that addresses the family’s needs in an efficient and coherent manner-emphasizing family strengths and competencies and supporting family self-sufficiency.
Downloaded by [George Mason University] at 21:18 24 December 2014
Kirkpatrick SM, Rojjanasrirat W, South BJ, Sindt JA and Williams LA (2012) Assessment of emotional status of orphans and vulnerable children in Zambia. Journal of Nursing Scholarship 44(2): 194–201 Purpose: To describe the emotional status of orphans and vulnerable children (OVC) in two communities in Zambia. Methods: The Health Ed Connect Adaptation Questionnaire (HECAQ) was used to interview 306 OVC and 158 primary caregivers in Zambia in 2010. Findings: Child participants and caregivers reported evidence of emotional distress behaviours in the majority of OVC. Conclusions: More research to evaluate the efficacy of intervention programs for loss and grief, normal and abnormal reactions to grief, and positive coping skills is needed to assist both children and their caretakers. In the population studied, caregivers and OVC could benefit from additional support for promoting emotional health and managing emotional distress in vulnerable children. Clinical Relevance: Healthcare professionals play a key role in promoting the emotional health of OVC through identification of deviant behaviours and the development of interventions to alleviate emotional and psychological distress. Wilson CJ and Deane FP (2012) Brief report: Need for autonomy and other perceived barriers relating to adolescents’ intentions to seek professional mental health care. Journal of Adolescence 35(1): 233–237 The current study examined the relationship between belief-based barriers to seeking professional mental health care and help-seeking intentions in a sample of 1037 adolescents. From early adolescence to adulthood, for males and females, the need for autonomy was a strong barrier to seeking professional mental health care. Help-seeking fears were weaker in the older age groups. Having lower perceived need for autonomy and believing that prior mental health care was helpful was significantly associated with higher intentions to seek future professional mental health care. Implications for prevention and overcoming barriers to seeking mental health care are suggested. Miers D, Abbott D and Springer PRA (2012) Phenomenological study of family needs following the suicide of a teenager. Death Studies 36(2): 118–133 The objective of this phenomenological study was to develop an understanding of family needs following the suicide of a teenager. Six parent units living in the Midwest who lost a teenager to suicide were interviewed. Participants indicated several key themes that describe a parent’s needs following the suicide of a teenager. These needs were organized into 6 main categories: (a) support by listening and responding, (b) support from another suicide survivor, (c) support in finding direction, (d) support when viewing the deceased teen, (e) support in remembering the teen, and (f) support in parents giving back to the community. Sarwer D and Dilks R (2012) Invited commentary: Childhood and adolescent obesity: Psychological and behavioural issues in weight loss treatment. Journal of Youth & Adolescence 41(1): 98–104 The prevalence of childhood and adolescent obesity has tripled in the past three decades. This increase has been accompanied by a dramatic rise in obesity-related health complications among American youth. Thus, many obese youth are now experiencing illnesses that will threaten their life expectancy in the absence of significant weight loss. Despite these concerns, a relatively modest
Downloaded by [George Mason University] at 21:18 24 December 2014
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body of research has focused on the treatment of adolescent obesity. Results from trials investigating the efficacy of behavioural and pharmacological treatments, like studies of these interventions with adults, suggest that individuals typically lose 5-10% of their initial weight. Unfortunately, weight regain is common. Given the increase in the number of obese adolescents, coupled with the modest results from more conservative treatment approaches, it is not surprising that bariatric surgery for adolescents who suffer from extreme obesity has grown in popularity. The weight losses after surgery are impressive and many adolescents, like adults, experience significant improvements in their physical and mental health postoperatively. However, only a small fraction of adolescents and adults who are heavy enough for bariatric surgery present for surgical treatment. Among those who undergo surgery, a significant minority appear to struggle with a number of behavioural and psychosocial issues that threaten their lifelong success. With all of this in mind, the current obesity problem in the United States and other Westernized countries likely will present a significant challenge to both current and future medical and mental health professionals who work with adolescents and young adults. Hodges S, Ferreira K and Israel N (2012) If we’re going to change things, it has to be systemic: Systems change in children’s mental health. American Journal of Community Psychology 49(3/4): 526–537 Communities that undertake systems change in accordance with the system of care philosophy commit to creating new systems entities for children and adolescents with serious emotional disturbance. These new entities are values-based, voluntary, and cross-agency alliances that include formal child-serving entities, youth, and families. Describing the scope and intent of one such implementation of systems of care, a mental health administrator commented, ‘If we’re going to change things, it has to be systemic’ (B. Baxter, personal communication, December 2, 2005). This paper explores the concept of ‘systemic’ in the context of systems of care. Systems theory is used to understand strategies of purposeful systems change undertaken by stakeholders in established system of care communities. The paper presents a conceptual model of systems change for systems of care that is grounded in data from a national study of system of care implementation (Research and Training Centre for Children’s Mental Health in Case Studies of system implementation: Holistic approaches to studying community-based systems of care: Study 2, University of South Florida, Louis de la Parte Florida Mental Health Institute, Research and Training Centre for Children’s Mental Health, Tampa, FL). The model is based on Soft Systems Methodology, an application of systems theory developed to facilitate practical action around systems change in human systems (Checkland in Systems thinking, systems practice, Wiley, Chichester). The implications of these findings to real world actions associated with systems change in systems of care are discussed. Ramirez R, Hinman A, Sterling S, Weisner C and Campbell C (2012) Peer influences on adolescent alcohol and other drug use outcomes. Journal of Nursing Scholarship 44(1): 36–44 Purpose: To examine the role of family environment and peer networks in abstinence outcomes for adolescents 1 year after intake to alcohol and other drug (AOD) treatment. Design: Survey of 419 adolescents 13 to 18 years of age at consecutive intakes to AOD treatment programs at four sites of a large health system, with telephone follow-up survey 1 year after intake. Methods: Examined association of 1-year abstinence with baseline characteristics. Using logistic regression, we examined characteristics predicting 1-year abstinence and predicting having fewer than four substance-using friends at 1 year. Results: We found that family environment scores related to family conflict, limit setting, and positive family experiences, were not related to abstinence outcomes, but peer networks were related. Adolescents with fewer (less than four) AOD-using friends were more likely to be abstinent than those with four or more AOD-using friends (65% vs. 41%, p = 0.0002). Having fewer than four
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AOD-using friends at intake predicted abstinence at 1 year (odds ratio [OR] = 2.904, p = 0.0002) and also predicted having fewer than four AOD-using friends at 1 year (OR = 2.557, p = 0.0007). Conclusions: Although family environment is an important factor in the development of AOD problems in adolescents, it did not play a significant role in treatment success. The quality of adolescent peer networks did independently predict positive outcomes. Clinical Relevance: For physicians, advanced practice registered nurses, and other primary and behavioural care providers who screen and care for adolescents with AOD and other behavioural problems, our finding suggest the importance of focusing on improving the quality of their peer networks. Kaale A, Smith L and Sponheim E (2012) A randomized controlled trial of preschoolbased joint attention intervention for children with autism. Journal of Child Psychology & Psychiatry 53(1): 97–105 Background: Deficits in joint attention (JA) and joint engagement (JE) represent a core problem in young children with autism as these affect language and social development. Studies of parentmediated and specialist-mediated JA-intervention suggest that such intervention may be effective. However, there is little knowledge about the success of the intervention when done in preschools. Aim: Assess the effects of a preschool-based JA-intervention. Methods: 61 children (48 males) with autistic disorder (29-60 months) were randomized to either 8 weeks of JA-intervention, in addition to their preschool programs (n = 34), or to preschool programs only (n = 27). The intervention was done by preschool teachers with weekly supervision by trained counsellors from Child and Adolescent Mental Health Clinics (CAMHC). Changes in JA and JE were measured by blinded independent testers using Early Social Communication Scale (ESCS) and videotaped preschool teacher-child and mother-child play at baseline and post-intervention. Clinical trials registration: NCT00378157. Results: Intention-to-treat analysis showed significant difference between the intervention and the control group, with the intervention group yielding more JA initiation during interaction with the preschool teachers. The effect generalized to significantly longer duration of JE with the mothers. Conclusions: This is the first randomized study to show positive and generalized effects of preschool-based JA-intervention. Myklestad I, Røysamb E and Tambs K (2012) Risk and protective factors for psychological distress among adolescents: a family study in the Nord-Trøndelag Health Study. Social Psychiatry & Psychiatric Epidemiology 47(5): 771–782 Purpose: The study aimed to investigate potential adolescent and parental psychosocial risk and protective factors for psychological distress among adolescents and, in addition, to examine potential gender and age differences in the effects of risk factors on adolescent psychological distress. Methods: Data were collected among 8,984 Norwegian adolescents (13-19 years) and their parents in the Nord-Trøndelag Health Study (HUNT). The outcome measure was psychological distress (SCL-5). Results: Bivariate regression analysis with generalized estimating equation (GEE) model showed that all parental self-reported variables (mental distress, substance use, social network, economic problems, unemployment and family structure) and adolescents’ self-reported variables (leisure activities, social support from friends, school-related problems and substance use) were significantly associated with psychological distress among adolescents. Results revealed that in a multiple regression analysis with a GEE model, adolescent psychosocial variables, specifically academicrelated problems and being bullied at school, emerged as the strongest predictors of psychological distress among adolescents after controlling for age, gender, and all parental and adolescent variables. The following psychosocial risk factors were significantly more important for girl’s psychological distress compared to boys: problems with academic achievement, conduct problems in
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school, frequency of being drunk, smoking, dissatisfaction in school, living alone and seen parents being drunk. Conclusion: Academic achievement and being bullied at school were the psychosocial factors most strongly associated with psychological distress among adolescents. Parental factors had an indirect effect on adolescent psychological distress, through adolescents’ psychosocial factors.
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Erhabor S Idemudia Department of Psychology (Ipelegeng Child & Family Centre), North West University, Mmbatho e-mail: [email protected] or [email protected]
