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Anderson J, Trevella C, Burn AM. Interventions to improve the mental health of women experiencing homelessness: A systematic review of the literature. PLoS One 2024; 19:e0297865. [PMID: 38568910 PMCID: PMC10990227 DOI: 10.1371/journal.pone.0297865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/10/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Homelessness is a growing public health challenge in the United Kingdom and internationally, with major consequences for physical and mental health. Women represent a particularly vulnerable subgroup of the homeless population, with some evidence suggesting that they suffer worse mental health outcomes than their male counterparts. Interventions aimed at improving the lives of homeless women have the potential to enhance mental health and reduce the burden of mental illness in this population. This review synthesised the evidence on the effectiveness and acceptability of interventions which aim to improve mental health outcomes in homeless women. METHODS Five electronic bibliographic databases: MEDLINE, PsycInfo, CINAHL, ASSIA and EMBASE, were searched. Studies were included if they measured the effectiveness or acceptability of any intervention in improving mental health outcomes in homeless women. Study quality was assessed using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool. A narrative summary of the study findings in relation to the research questions was produced. RESULTS Thirty-nine studies met inclusion criteria. Overall, there was moderate evidence of the effectiveness of interventions in improving mental health outcomes in homeless women, both immediately post-intervention and at later follow-up. The strongest evidence was for the effectiveness of psychotherapy interventions. There was also evidence that homeless women find interventions aimed at improving mental health outcomes acceptable and helpful. CONCLUSIONS Heterogeneity in intervention and study methodology limits the ability to draw definitive conclusions about the extent to which different categories of intervention improve mental health outcomes in homeless women. Future research should focus on lesser-studied intervention categories, subgroups of homeless women and mental health outcomes. More in-depth qualitative research of factors that enhance or diminish the acceptability of mental health interventions to homeless women is also required.
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Affiliation(s)
- Joanna Anderson
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Charlotte Trevella
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Anne-Marie Burn
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
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Warren JM, Halpin SA, Hanstock TL, Hood C, Hunt SA. Outcomes of Parent-Child Interaction Therapy (PCIT) for families presenting with child maltreatment: A systematic review. CHILD ABUSE & NEGLECT 2022; 134:105942. [PMID: 36368165 DOI: 10.1016/j.chiabu.2022.105942] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 10/13/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The developmental consequences of childhood trauma for young children are extensive and impact a diverse range of areas. Young children require treatments that consider their developmental stage and are inclusive of caregiver involvement. Parent-Child Interaction Therapy (PCIT), with its dyadic focus and developmental sensitivity, is uniquely positioned to offer therapeutic support to young children and their families. AIM The current study aimed to conduct a systematic review of the current literature on PCIT and trauma and determine treatment outcomes for children and caregivers. METHOD A systematic review of five electronic databases was undertaken. Studies that utilized PCIT to treat a population who had experienced trauma were included in the review regardless of study design. RESULTS PCIT was used to treat a population who had experienced trauma in 40 studies. PCIT was an effective treatment in improving a variety of child and parent outcomes in this population including reduced parenting stress, child behavior problems, child trauma symptoms, parental mental health concerns, negative parenting strategies, and reducing potential risk of recidivism of abuse and neglect. These findings should be taken with caution given attrition rates and potential for bias in the study samples. DISCUSSION Clinicians should consider PCIT as a potential treatment for children who have experienced trauma and their families. Future research should incorporate corroborative sources of information, assessment of caregiver and child trauma symptoms, examination of permanency outcomes, and consider standardization of PCIT modifications for child trauma to determine treatment in this population of children.
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Affiliation(s)
- Jessica M Warren
- School of Psychological Sciences, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
| | - Sean A Halpin
- School of Psychological Sciences, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Tanya L Hanstock
- School of Psychological Sciences, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Carol Hood
- School of Psychological Sciences, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Sally A Hunt
- School of Psychological Sciences, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
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3
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Utilizing Parent-Child Interaction Therapy with Trauma-Directed Interaction in a Young Male in Out of Home Care Who Had Experienced Trauma. Clin Case Stud 2022. [DOI: 10.1177/15346501221130532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Child abuse and neglect in young children can lead to trauma-related stress symptoms that can be challenging to manage. Parent-Child Interaction Therapy (PCIT), a strong evidence-based behavioral parent training program used for young children with behavior issues, has been used in its traditional form with increasing frequency with children and families who have trauma histories, with clinicians tailoring PCIT to use with children who have experienced trauma. Trauma-Directed Interaction (TDI) is a new systematic adaption to the standard PCIT parent training program that has the potential to help treat trauma in younger children. TDI includes several trauma-informed techniques that are added to a course of standard PCIT treatment including psychoeducation regarding trauma, recognition of feelings, and emotional regulation. This case study illustrates the use of a manualized trauma adaptation to PCIT (TDI) with a three-year-old boy who had a history of child maltreatment and his caregiver. This case provides a summary of the progression of this intervention and the results obtained. Results from the case indicated that TDI treatment was effective in not only reducing child trauma and behavioral symptoms but also in reducing mild caregiver mental health concerns. The next steps for TDI treatment and need for further research are discussed.
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Gillespie ML, Rao U. Relationships between Depression and Executive Functioning in Adolescents: The Moderating Role of Unpredictable Home Environment. JOURNAL OF CHILD AND FAMILY STUDIES 2022; 31:2518-2534. [PMID: 36504694 PMCID: PMC9733726 DOI: 10.1007/s10826-022-02296-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/12/2022] [Indexed: 06/09/2023]
Abstract
Although researchers have explored the link between depression and executive functioning (EF), the influence of early-life environmental and relational instability on this association has not been comprehensively assessed in adolescents. This cross-sectional study examined whether unpredictability of home environment in childhood moderated the relationship between depression and EF in adolescents. Participants were 138 adolescents aged 13 to 17 years (72% female; 47.8% White; 47.1% Hispanic). Diagnostic status (major depression versus healthy control) and depression severity were assessed using psycho-diagnostic interviews and self-reports from parents and adolescents. Participants also completed the Questionnaire of Unpredictability in Childhood (QUIC). EF was assessed using self-report (Behavior Rating Inventory of Executive Function, Second Edition; BRIEF2) and a battery of performance-based measures. Results showed that QUIC scores moderated the relationship between depression and BRIEF2 scores, such that high unpredictability was associated with poorer EF for adolescents exhibiting low depression severity. Participants with the highest levels of depression exhibited the poorest EF ratings, regardless of childhood unpredictability. Unpredictability was moderately associated with performance-based measures, but did not interact with depressive symptoms to predict complex performance-based EF. Recommendations include assessing for unpredictable childhood environment and acknowledging this risk factor for poor EF in youth with sub-threshold depression. Treatment implications are discussed with respect to family systems/parenting interventions, as mildly depressed adolescents growing up in unstable homes may be vulnerable to EF difficulties. Further, this study adds to the EF measurement literature by examining associations between self-report and performance-based EF instruments in a diverse sample of adolescents.
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Affiliation(s)
- Marie L Gillespie
- Biobehavioral Research on Adolescent Development (BRoAD) Lab, Department of Psychiatry & Human Behavior, University of California, Irvine, 5251 California Ave., Suite 240, Irvine, CA 92617, USA
| | - Uma Rao
- Biobehavioral Research on Adolescent Development (BRoAD) Lab, Department of Psychiatry & Human Behavior, University of California, Irvine, 5251 California Ave., Suite 240, Irvine, CA 92617, USA
- Department of Pediatrics, University of California, Irvine, 505 S. Main St., Suite 525, Orange, CA 92868, USA
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, 309 Qureshey Research Lab Irvine, CA 92697, USA
- Children's Hospital of Orange County, 1201 W La Veta Ave, Orange, CA 92868, USA
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Dawson-Squibb JJ, Davids EL, Chase R, Puffer E, Rasmussen JDM, Franz L, de Vries PJ. Bringing Parent-Child Interaction Therapy to South Africa: Barriers and Facilitators and Overall Feasibility-First Steps to Implementation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084450. [PMID: 35457315 PMCID: PMC9031323 DOI: 10.3390/ijerph19084450] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 03/24/2022] [Indexed: 12/26/2022]
Abstract
There is a large assessment and treatment gap in child and adolescent mental health services, prominently so in low- and middle-income countries, where 90% of the world's children live. There is an urgent need to find evidence-based interventions that can be implemented successfully in these low-resource contexts. This pre-pilot study aimed to explore the barriers and facilitators to implementation as well as overall feasibility of Parent-Child Interaction Therapy (PCIT) in South Africa. A reflective and consensus building workshop was used to gather South African PCIT therapist (N = 4) perspectives on barriers, facilitators, and next steps to implementation in that country. Caregiver participants (N = 7) receiving the intervention in South Africa for the first time were also recruited to gather information on overall feasibility. Facilitators for implementation, including its strong evidence base, manualisation, and training model were described. Barriers relating to sustainability and scalability were highlighted. Largely positive views on acceptability from caregiver participants also indicated the promise of PCIT as an intervention in South Africa. Pilot data on the efficacy of the treatment for participating families are a next step. These initial results are positive, though research on how implementation factors contribute to the longer-term successful dissemination of PCIT in complex, heterogeneous low-resource settings is required.
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Affiliation(s)
- John-Joe Dawson-Squibb
- Division of Child and Adolescent Psychiatry, Department of Psychiatry & Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa; (E.L.D.); (L.F.); (P.J.d.V.)
- Correspondence:
| | - Eugene Lee Davids
- Division of Child and Adolescent Psychiatry, Department of Psychiatry & Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa; (E.L.D.); (L.F.); (P.J.d.V.)
| | - Rhea Chase
- Judge Baker Children’s Center, Harvard Medical School, Boston, MA 02115, USA;
| | - Eve Puffer
- Department of Psychology & Neuroscience, Duke Global Health Institute, Duke University, Durham, NC 27708, USA; (E.P.); (J.D.M.R.)
| | - Justin D. M. Rasmussen
- Department of Psychology & Neuroscience, Duke Global Health Institute, Duke University, Durham, NC 27708, USA; (E.P.); (J.D.M.R.)
| | - Lauren Franz
- Division of Child and Adolescent Psychiatry, Department of Psychiatry & Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa; (E.L.D.); (L.F.); (P.J.d.V.)
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioural Sciences, Duke Global Health Institute, Duke University, Durham, NC 27708, USA
| | - Petrus J. de Vries
- Division of Child and Adolescent Psychiatry, Department of Psychiatry & Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa; (E.L.D.); (L.F.); (P.J.d.V.)
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Renner LM. The Co-Occurrence of Child Maltreatment and Intimate Partner Violence: A Commentary on the Special Issue. CHILD MALTREATMENT 2021; 26:464-469. [PMID: 34463156 DOI: 10.1177/10775595211034430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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Warren JM, Hanstock T, Hunt S, Halpin S. Parent–Child Interaction Therapy for a 3-Year-Old Girl With Post-Traumatic Stress Disorder: Restoration to Her Father’s Care Following a Period in Out-of-Home Care. Clin Case Stud 2021. [DOI: 10.1177/15346501211047482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Child abuse and neglect in very young children can lead to trauma-related stress symptoms that can be challenging to treat. Children exposed to multiple traumas occurring in the context of a caregiving relationship are sometimes more severely affected, evidenced by diverse negative behavioral, physical, social, and emotional consequences. Some of these children go on to develop post-traumatic stress disorder (PTSD). Parent–child interaction therapy (PCIT) is a dyadic play-based treatment for children with behavior problems and their parents or caregivers. There is limited research relating to the application of PCIT with very young children with PTSD with some studies actively excluding families where PTSD was present (Herschell et al., 2017). Additionally, there are no articles relating to treatment of a child restored to the care of a parent following out-of-home care (OOHC) and fewer still relating to a child restored to the care of her father. This case study illustrates the use of PCIT with a 3-year-old girl with PTSD, recently restored to her father’s care. It highlights how the use of PCIT in this case not only improved behavioral indicators of traumatic stress, but also afforded this child permanency and stability. The case study provides a summary of the progression of this intervention and the results obtained throughout treatment and 4 years post-intervention. The results indicated that PCIT, with trauma-informed tailoring, was an effective treatment in this case and contributed to safe and permanent care for this child.
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Affiliation(s)
- Jessica M. Warren
- School of Psychological Sciences, The University of Newcastle, Callaghan, NSW, Australia
| | - Tanya Hanstock
- School of Psychological Sciences, The University of Newcastle, Callaghan, NSW, Australia
| | - Sally Hunt
- School of Psychological Sciences, The University of Newcastle, Callaghan, NSW, Australia
| | - Sean Halpin
- School of Psychological Sciences, The University of Newcastle, Callaghan, NSW, Australia
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Dell’armi M, Kruck J, Niec L. Prise en charge des troubles du comportement du jeune enfant par le programme Parent-Child Interaction Therapy (PCIT). PRAT PSYCHOL 2020. [DOI: 10.1016/j.prps.2020.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Latzman NE, Casanueva C, Brinton J, Forman‐Hoffman VL. The promotion of well-being among children exposed to intimate partner violence: A systematic review of interventions. CAMPBELL SYSTEMATIC REVIEWS 2019; 15:e1049. [PMID: 37131508 PMCID: PMC8356495 DOI: 10.1002/cl2.1049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
| | | | - Julia Brinton
- RTI InternationalResearch Triangle ParkNorth Carolina
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10
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A Double-Blind Randomized Controlled Trial in Effectiveness of Parent-Child Interaction Therapy on Psychological Indicator and Cortisol Level in Children of Caregiver with Cancer. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2019. [DOI: 10.5812/ijcm.85572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Scudder AT, Taber-Thomas SM, Schaffner K, Pemberton JR, Hunter L, Herschell AD. A mixed-methods study of system-level sustainability of evidence-based practices in 12 large-scale implementation initiatives. Health Res Policy Syst 2017; 15:102. [PMID: 29216886 PMCID: PMC5721589 DOI: 10.1186/s12961-017-0230-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 07/06/2017] [Indexed: 11/10/2022] Open
Abstract
Background In recent decades, evidence-based practices (EBPs) have been broadly promoted in community behavioural health systems in the United States of America, yet reported EBP penetration rates remain low. Determining how to systematically sustain EBPs in complex, multi-level service systems has important implications for public health. This study examined factors impacting the sustainability of parent-child interaction therapy (PCIT) in large-scale initiatives in order to identify potential predictors of sustainment. Methods A mixed-methods approach to data collection was used. Qualitative interviews and quantitative surveys examining sustainability processes and outcomes were completed by participants from 12 large-scale initiatives. Results Sustainment strategies fell into nine categories, including infrastructure, training, marketing, integration and building partnerships. Strategies involving integration of PCIT into existing practices and quality monitoring predicted sustainment, while financing also emerged as a key factor. Conclusions The reported factors and strategies impacting sustainability varied across initiatives; however, integration into existing practices, monitoring quality and financing appear central to high levels of sustainability of PCIT in community-based systems. More detailed examination of the progression of specific activities related to these strategies may aide in identifying priorities to include in strategic planning of future large-scale initiatives. Trial registration ClinicalTrials.gov ID NCT02543359; Protocol number PRO12060529. Electronic supplementary material The online version of this article (doi:10.1186/s12961-017-0230-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ashley T Scudder
- Washington Health System, Family Medicine Residency Program, 95 Leonard Avenue, Washington, PA, 15301, United States of America. .,Chatham University, Graduate Psychology, Woodland Road, Pittsburgh, PA, 15232, United States of America.
| | - Sarah M Taber-Thomas
- University at Buffalo, 171 Park Hall, Buffalo, NY, 14260, United States of America
| | - Kristen Schaffner
- University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street - 506 Bellefield Towers, Pittsburgh, PA, 15213, United States of America
| | - Joy R Pemberton
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR, 72205, United States of America
| | - Leah Hunter
- The Pennsylvania State University, 225 CEDAR Building, University Park, PA, 16802, United States of America
| | - Amy D Herschell
- Psychiatry & Psychology, University of Pittsburgh School of Medicine, 1234 Life Sciences Building, Morgantown, WV, 26506-6040, United States of America.,Psychology & Family Medicine, West Virginia University, 1234 Life Sciences Building, Morgantown, WV, 26506-6040, United States of America
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