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Martin A, DiGiovanni M, Acquaye A, Ponticiello M, Chou DT, Neto EA, Michel A, Sibeoni J, Piot MA, Spodenkiewicz M, Benoit L. Pathways and identity: toward qualitative research careers in child and adolescent psychiatry. Child Adolesc Psychiatry Ment Health 2024; 18:49. [PMID: 38685108 PMCID: PMC11059710 DOI: 10.1186/s13034-024-00738-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 03/28/2024] [Indexed: 05/02/2024] Open
Abstract
OBJECTIVE Qualitative research methods are based on the analysis of words rather than numbers; they encourage self-reflection on the investigator's part; they are attuned to social interaction and nuance; and they incorporate their subjects' thoughts and feelings as primary sources. Despite appearing well suited for research in child and adolescent psychiatry (CAP), qualitative methods have had relatively minor uptake in the discipline. We conducted a qualitative study of CAPs involved in qualitative research to learn about these investigators' lived experiences, and to identify modifiable factors to promote qualitative methods within the field of youth mental health. METHODS We conducted individual, semi-structured 1-h long interviews through Zoom. Using purposive sample, we selected 23 participants drawn from the US (n = 12) and from France (n = 11), and equally divided in each country across seniority level. All participants were current or aspiring CAPs and had published at least one peer-reviewed qualitative article. Ten participants were women (44%). We recorded all interviews digitally and transcribed them for analysis. We coded the transcripts according to the principles of thematic analysis and approached data analysis, interpretation, and conceptualization informed by an interpersonal phenomenological analysis (IPA) framework. RESULTS Through iterative thematic analysis we developed a conceptual model consisting of three domains: (1) Becoming a qualitativist: embracing a different way of knowing (in turn divided into the three themes of priming factors/personal fit; discovering qualitative research; and transitioning in); (2) Being a qualitativist: immersing oneself in a different kind of research (in turn divided into quality: doing qualitative research well; and community: mentors, mentees, and teams); and (3) Nurturing: toward a higher quality future in CAP (in turn divided into current state of qualitative methods in CAP; and advocating for qualitative methods in CAP). For each domain, we go on to propose specific strategies to enhance entry into qualitative careers and research in CAP: (1) Becoming: personalizing the investigator's research focus; balancing inward and outward views; and leveraging practical advantages; (2) Being: seeking epistemological flexibility; moving beyond bibliometrics; and the potential and risks of mixing methods; and (3) Nurturing: invigorating a quality pipeline; and building communities. CONCLUSIONS We have identified factors that can support or impede entry into qualitative research among CAPs. Based on these modifiable findings, we propose possible solutions to enhance entry into qualitative methods in CAP (pathways), and to foster longer-term commitment to this type of research (identity).
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Affiliation(s)
- Andrés Martin
- Child Study Center, Yale School of Medicine, New Haven, CT, USA.
- QUALab, Qualitative and Mixed Methods Lab, a collaboration between the Yale Child Study Center, 230 South Frontage Road, New Haven, CT, 06520, USA.
- CESP, The Centre de Recherche en Épidémiologie et Santé des Populations, Paris, France.
| | - Madeline DiGiovanni
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
- QUALab, Qualitative and Mixed Methods Lab, a collaboration between the Yale Child Study Center, 230 South Frontage Road, New Haven, CT, 06520, USA
- CESP, The Centre de Recherche en Épidémiologie et Santé des Populations, Paris, France
| | - Amber Acquaye
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
- QUALab, Qualitative and Mixed Methods Lab, a collaboration between the Yale Child Study Center, 230 South Frontage Road, New Haven, CT, 06520, USA
- CESP, The Centre de Recherche en Épidémiologie et Santé des Populations, Paris, France
| | - Matthew Ponticiello
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
- QUALab, Qualitative and Mixed Methods Lab, a collaboration between the Yale Child Study Center, 230 South Frontage Road, New Haven, CT, 06520, USA
- CESP, The Centre de Recherche en Épidémiologie et Santé des Populations, Paris, France
| | - Débora Tseng Chou
- QUALab, Qualitative and Mixed Methods Lab, a collaboration between the Yale Child Study Center, 230 South Frontage Road, New Haven, CT, 06520, USA
- CESP, The Centre de Recherche en Épidémiologie et Santé des Populations, Paris, France
- Departamento de Psiquiatria da Faculdade de Medicina da, Universidade de São Paulo, São Paulo, Brazil
| | - Emilio Abelama Neto
- QUALab, Qualitative and Mixed Methods Lab, a collaboration between the Yale Child Study Center, 230 South Frontage Road, New Haven, CT, 06520, USA
- CESP, The Centre de Recherche en Épidémiologie et Santé des Populations, Paris, France
- Departamento de Psiquiatria da Faculdade de Medicina da, Universidade de São Paulo, São Paulo, Brazil
| | - Alexandre Michel
- QUALab, Qualitative and Mixed Methods Lab, a collaboration between the Yale Child Study Center, 230 South Frontage Road, New Haven, CT, 06520, USA
- CESP, The Centre de Recherche en Épidémiologie et Santé des Populations, Paris, France
- Inserm U1018, CESP, Team DevPsy, Paris-Saclay University, Villejuif, France
| | - Jordan Sibeoni
- QUALab, Qualitative and Mixed Methods Lab, a collaboration between the Yale Child Study Center, 230 South Frontage Road, New Haven, CT, 06520, USA
- CESP, The Centre de Recherche en Épidémiologie et Santé des Populations, Paris, France
- Inserm U1018, CESP, Team DevPsy, Paris-Saclay University, Villejuif, France
| | - Marie-Aude Piot
- QUALab, Qualitative and Mixed Methods Lab, a collaboration between the Yale Child Study Center, 230 South Frontage Road, New Haven, CT, 06520, USA
- CESP, The Centre de Recherche en Épidémiologie et Santé des Populations, Paris, France
- Inserm U1018, CESP, Team DevPsy, Paris-Saclay University, Villejuif, France
| | - Michel Spodenkiewicz
- QUALab, Qualitative and Mixed Methods Lab, a collaboration between the Yale Child Study Center, 230 South Frontage Road, New Haven, CT, 06520, USA
- CESP, The Centre de Recherche en Épidémiologie et Santé des Populations, Paris, France
- Department of Psychiatry, McGill University Faculty of Medicine, Montréal, QC, Canada
| | - Laelia Benoit
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
- QUALab, Qualitative and Mixed Methods Lab, a collaboration between the Yale Child Study Center, 230 South Frontage Road, New Haven, CT, 06520, USA
- CESP, The Centre de Recherche en Épidémiologie et Santé des Populations, Paris, France
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Awhangansi S, Okewole A, Archard PJ, O’Reilly M. Perspective on clinical high-risk for psychosis in Africa. Front Psychiatry 2023; 14:1226012. [PMID: 37743999 PMCID: PMC10514491 DOI: 10.3389/fpsyt.2023.1226012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 08/29/2023] [Indexed: 09/26/2023] Open
Abstract
Clinical High Risk for Psychosis has evolved in recent years as a conceptual and clinical entity, representing a shift in focus from the syndromal psychosis state to a recognition of the pre-psychotic state as a period of potential preventive intervention. Much existing evidence has been generated from well-resourced countries, with a more limited body of literature available from Africa and other Majority World countries. Against a backdrop of prevailing systemic challenges, it is necessary to appraise the state of knowledge on Clinical High Risk for Psychosis in Africa. In this perspective article, we cover epidemiology, risk factors, predictors of psychosis conversion, as well as an overview of sociocultural factors, notably stigma, and the barriers to mental health services in African settings. We discuss existing and promising assessment approaches and reflect on preventive and early intervention strategies. We conclude with recommendations including the need for more clinical, longitudinal, and collaborative research anchored in an integrative transdisciplinary approach. We highlight the need for more culturally valid assessment tools and strategies to improve access to and utilization of services while also reducing stigma.
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Affiliation(s)
| | - Adeniran Okewole
- Neuropsychiatric Hospital Aro, Abeokuta, Nigeria
- Pembroke College, University of Cambridge, Cambridge, United Kingdom
| | - Philip John Archard
- Leicestershire Partnership NHS Trust, Leicester, United Kingdom
- University of Leicester, Leicester, United Kingdom
- Tavistock and Portman NHS Foundation Trust, London, United Kingdom
| | - Michelle O’Reilly
- Leicestershire Partnership NHS Trust, Leicester, United Kingdom
- University of Leicester, Leicester, United Kingdom
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Thomas I, Martin A, Wicker A, Benoit L. Understanding youths' concerns about climate change: a binational qualitative study of ecological burden and resilience. Child Adolesc Psychiatry Ment Health 2022; 16:110. [PMID: 36587220 PMCID: PMC9805369 DOI: 10.1186/s13034-022-00551-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/02/2022] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Climate change has been shown to have long-term effects on mental health, yet, to date, there have been few studies on how children and adolescents experience and respond to ecological changes and how and why they engage in climate action. We explored empirically young people's views about climate change and how distinct cultural contexts influence individual climate action. METHODS We invited children and adolescents (ages 7 to 18) and their caregivers from the general population in the United States and France to participate in semi-structured focus groups. We recruited 74 participants, 39 in the U.S. (33 children and adolescents, 6 parents) and 35 in France (32 children and adolescents, 3 parents). Focus groups with participants centered on their emotions, beliefs, and actions around climate change. We analyzed the focus group data and developed themes via grounded theory and symbolic interactionist approaches. RESULTS Many participants described experiencing anger, hopelessness, guilt, and sadness in response to climate change, and a smaller number endorsed significant anxiety symptoms; many described frustration about needing to fix the mistakes of earlier generations. Younger participants frequently misunderstood the purpose of their parents' eco-conscious behaviors unless they were provided with age-appropriate explanations. Participants described a spectrum of experiences when trying to discuss climate change with peers and family, ranging from genuine support to apathy to hostility. Between the two samples, U.S. participants experienced more conflict with adults about climate change than French participants, but French participants described a greater lack of political agency compared to U.S. PARTICIPANTS Participants in both samples expressed a relatively balanced view of climate action, recognizing the significance of individual actions while acknowledging the limits of their power in the face of systemic issues. Some found hope and empowerment through climate action and building communities around it. CONCLUSION Discussing with children and adolescents what adults are doing to mitigate climate change can provide reassurance, model prosocial behaviors, and inspire their own investment in climate action. Adults seeking to support the psychological well-being of young people should both support their concerns and actions around climate change and create avenues for young people to meaningfully engage in climate action.
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Affiliation(s)
- Isaiah Thomas
- Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Andrés Martin
- Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Antoine Wicker
- Xavier Bichat School of Medicine, University of Paris VII, Paris, France
| | - Laelia Benoit
- Yale School of Medicine, Yale University, New Haven, CT, USA.
- CESP, Team DevPsy, Inserm 1178, Maison de Solenn, Hôpital Cochin AP-HP, Université Paris-Saclay, UVSQ, Paris, France.
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Guessoum SB, Minassian S, de Staël P, Touhami F, DiGiovanni M, Radjack R, Moro MR, Benoit L. Multimodal co-therapy for unaccompanied minors: a qualitative study. Child Adolesc Psychiatry Ment Health 2022; 16:81. [PMID: 36344979 PMCID: PMC9641960 DOI: 10.1186/s13034-022-00518-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/11/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Unaccompanied refugee minors-or unaccompanied minors-are children and adolescents who have been separated from parents and other relatives and are not being cared for by an adult. Unaccompanied minors are a vulnerable population, with numerous stressors and complex psychiatric symptoms necessitating specialized mental health care. This study explores patients' experiences of a Multimodal Co-Therapy for Unaccompanied Minors (MUCTUM), which encompasses cultural, biological, narrative & institutional approaches to care. METHODS MUCTUM is a co-therapy program for unaccompanied minors, with a psychiatrist, psychologist, native-language interpreter, and caseworker for each patient. In this qualitative study, we interviewed adolescents about their experiences with MUCTUM and analyzed these semi-structured interviews using a phenomenological framework (Interpretative Phenomenological Analysis). RESULTS Qualitative analysis of 16 interviews discovered that unaccompanied minors felt misunderstood before participating in MUCTUM, describing a sense of strangeness and loneliness in relation to psychiatric symptoms. Several youths experienced triple stigmatization: of being unaccompanied minors, of suffering from psychotrauma, and of being mental health patients. We further describe three overarching domains that inform on MUCTUM support to unaccompanied minors: (1) A safe space for unaccompanied minors; (2) Helpful interventions during therapy; and (3) Narrating one's story can "set us free" if guided carefully by care providers. CONCLUSION This study suggests that MUCTUM therapy may efficiently support unaccompanied minors' mental health by acknowledging their hierarchy of needs. Psychotherapeutic strategies include creating a safe place, providing culturally appropriate care and patient-centered therapy, addressing concrete problems, supporting relationships, and making use of limited reparenting in therapy. Delayed and progressive inquiry about traumatic events may be beneficial. Replication of these findings and their field application is warranted.
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Affiliation(s)
- Sélim Benjamin Guessoum
- Department of Child and Adolescent Psychiatry, Assistance Publique - Hôpitaux de Paris (APHP), Cochin University Hospital, 97 Boulevard Port-Royal, 75014, Paris, France. .,Université Paris Cité, PCPP, Paris, France. .,Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Team DevPsy, Villejuif, France.
| | - Sevan Minassian
- grid.508487.60000 0004 7885 7602Université Paris Cité, PCPP, Paris, France
| | - Pauline de Staël
- grid.411784.f0000 0001 0274 3893Department of Child and Adolescent Psychiatry, Assistance Publique ‐ Hôpitaux de Paris (APHP), Cochin University Hospital, 97 Boulevard Port-Royal, 75014 Paris, France
| | - Fatima Touhami
- grid.508487.60000 0004 7885 7602Université Paris Cité, PCPP, Paris, France
| | - Madeline DiGiovanni
- grid.47100.320000000419368710Child Study Center, Yale School of Medicine, New Haven, USA
| | - Rahmeth Radjack
- grid.411784.f0000 0001 0274 3893Department of Child and Adolescent Psychiatry, Assistance Publique ‐ Hôpitaux de Paris (APHP), Cochin University Hospital, 97 Boulevard Port-Royal, 75014 Paris, France ,grid.508487.60000 0004 7885 7602Université Paris Cité, PCPP, Paris, France ,grid.463845.80000 0004 0638 6872Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Team DevPsy, Villejuif, France
| | - Marie Rose Moro
- grid.411784.f0000 0001 0274 3893Department of Child and Adolescent Psychiatry, Assistance Publique ‐ Hôpitaux de Paris (APHP), Cochin University Hospital, 97 Boulevard Port-Royal, 75014 Paris, France ,grid.508487.60000 0004 7885 7602Université Paris Cité, PCPP, Paris, France ,grid.463845.80000 0004 0638 6872Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Team DevPsy, Villejuif, France
| | - Laelia Benoit
- grid.411784.f0000 0001 0274 3893Department of Child and Adolescent Psychiatry, Assistance Publique ‐ Hôpitaux de Paris (APHP), Cochin University Hospital, 97 Boulevard Port-Royal, 75014 Paris, France ,grid.463845.80000 0004 0638 6872Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Team DevPsy, Villejuif, France ,grid.47100.320000000419368710Child Study Center, Yale School of Medicine, New Haven, USA
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