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Pereira TLB, Wichaikhum OA, Nantsupawat A, Rajendrana P, Baladram S, Shorey S. Recognising the Parental Caregiver Burden of Children With Mental Disorders: A Systematic Mixed-Studies Review. Int J Ment Health Nurs 2024. [PMID: 39238105 DOI: 10.1111/inm.13417] [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: 02/01/2024] [Revised: 07/22/2024] [Accepted: 08/18/2024] [Indexed: 09/07/2024]
Abstract
This review aims to consolidate and appraise evidence exploring the caregiver burden of parents of children with mental disorders. A mixed-studies review structure was adopted and six electronic databases (PubMed, CINAHL, PsycINFO, Embase, Scopus and ProQuest Dissertations and Theses Global) were searched from each database's inception date until September 2023. Thomas & Harden's thematic analysis framework was utilised for data analysis. Twenty-three studies were included in this review. The results-based convergent integration method identified an overarching theme titled 'hiding behind the walls on fire, engulfed in chaos: dark and alone', three main themes named 'Invisible scars': role of psychological factors on caregiver burden, navigating through social and economic influences on caregiving burden, and influence of illness-related variables and nine subthemes. This review highlighted that the parents perceived insufficient support from healthcare providers and a lack of insight regarding their children's medical condition as the primary contributors to the burden experienced. It is imperative for healthcare professionals to collaboratively engage with parental caregivers, offering accessible treatment options for their children with mental disorders and providing comprehensive educational resources to facilitate a profound understanding of their children's mental health conditions. In addition to addressing caregivers' informational needs, the establishment of an integrated support system is advocated, one involving active participation from healthcare professionals, healthcare institutions, community resources, social services and policymakers. This holistic approach could better meet the multifaceted needs of caregivers, encompassing psychosocial, emotional and financial aspects. Trial Registration: International Prospective Register of Systematic Reviews: PROSPERO ID: CRD42022363420.
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Affiliation(s)
- Travis Lanz-Brian Pereira
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | | | - Priyadharshni Rajendrana
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Sara Baladram
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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2
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Carroll D, Wales M, Rintell LS, Hojlo M, Gonzalez-Heydrich J, Berbert L, Fitzpatrick M, D'Angelo E, Reed MP. Burden Experienced by Primary Caregivers of Children With Psychotic Disorders and at Clinical High Risk for Psychosis. J Am Psychiatr Nurses Assoc 2024; 30:518-531. [PMID: 36475411 DOI: 10.1177/10783903221141883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Despite the existing research exploring caregiver burden in adult psychosis, few studies have examined the experience of providing care to children diagnosed with psychotic disorders (PDs) and those identified as having clinical high risk for psychosis (CHR-P). AIM This study measured the level of burden in caregivers of children with PD and CHR-P and examined associated risk factors, including social support, caregiver-child relationship, severity of illness, and frequency of psychiatric hospitalizations. METHODS A total of 56 caregivers completed validated measures and provided demographic information. Measures included the Zarit Burden Interview, the Multidimensional Scale of Perceived Social Support, the Behavior Assessment System for Children, Third Edition, Parenting Relationship Questionnaire-Child and Adolescent Form (BASC-3 PRQ-CA), and the Clinical Global Impression-Severity scale. RESULTS The majority of caregivers were women (86%), mothers (84%), White (63%), married (66%), working full-time (50%), college-educated (79%), and whose mean age was 45.7 years (SD = 8.09). Nearly half of the caregivers (45%) reported a high level of caregiver burden, 39% rated their burden in the mild to moderate range, and 16% reported little to no burden. There was no significant difference in mean burden between PD and CHR-P groups. Higher caregiver burden was associated with lower levels of social support (r = -.408, p = .002), lower levels of parenting confidence (r = -.514, p < .001), higher levels of relational frustration (r = .612, p < .001), and higher severity of illness (r = .316 p = .025). CONCLUSIONS These findings underscore the critical unmet need for support for caregivers of children with PD and CHR-P. Applications to clinical practice are discussed.
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Affiliation(s)
- Devon Carroll
- Devon Carroll, PMHNP-BC, MSN, Boston Children's Hospital, Boston, MA, USA; University of Rhode Island, Providence, RI, USA
| | - Meghan Wales
- Meghan Wales, RN, BA, Boston Children's Hospital, Boston, MA, USA
| | | | - Margaret Hojlo
- Margaret Hojlo, BA, Boston Children's Hospital, Boston, MA, USA
| | - Joseph Gonzalez-Heydrich
- Joseph Gonzalez-Heydrich, MD, Boston Children's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Laura Berbert
- Laura Berbert, MS, Boston Children's Hospital, Boston, MA, USA
| | - Molly Fitzpatrick
- Molly Fitzpatrick, MA, Boston Children's Hospital, Boston, MA, USA; William James College, Newton, MA, USA
| | - Eugene D'Angelo
- Eugene D'Angelo, PhD, Boston Children's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Mary P Reed
- Mary P. Reed, PhD, RN, ANP, CNRN, NEA-BC, Boston Children's Hospital, Boston, Massachusetts, USA
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Al Omari O, Amandu G, Al-Adawi S, Shebani Z, Al Harthy I, Obeidat A, Al Dameery K, Al Qadire M, Al Hashmi I, Al Khawldeh A, ALBashtawy M, Aljezawi M. The lived experience of Omani adolescents and young adults with mental illness: A qualitative study. PLoS One 2023; 18:e0294856. [PMID: 38011180 PMCID: PMC10681192 DOI: 10.1371/journal.pone.0294856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 11/09/2023] [Indexed: 11/29/2023] Open
Abstract
There is currently limited knowledge about the firsthand experiences of adolescents and young adults with mental health problems and the meanings they ascribe to these experiences, particularly within Arab countries. This study, therefore, aimed to explore the lived experience of Omani adolescents and young adults with a mental health problem. A sample of 15 participants aged 13-22 diagnosed with a range of mental health problems took part in the study. A qualitative interview guide consisting of open-ended questions was used to allow participants to speak in-depth about their experiences. Using the thematic analysis approach to uncover patterns in the data, three major themes emerged: "living in darkness", "perilous journey" and "uncertain future". Results show that the progress of adolescents and young adults with mental health problems is characterized by several challenges; the most significant of which is having insufficient knowledge about their illness, leading to unnecessary delays in their treatment. These findings shed light on the breadth and depth of the experience of adolescents and young adults with mental health problems and lay the groundwork for further examinations. Implications lie in the development of approaches for preventing or mitigating difficulties faced by adolescents and young adults with mental health problems.
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Affiliation(s)
- Omar Al Omari
- College of Nursing, Sultan Qaboos University, Muscat, Oman
- College of Nursing, Yarmouk University, Irbid, Jordan
| | - Gerald Amandu
- College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Samir Al-Adawi
- College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Zubaida Shebani
- College of Education, Sultan Qaboos University, Muscat, Oman
| | | | - Arwa Obeidat
- College of Nursing, Sultan Qaboos University, Muscat, Oman
| | | | - Mohammad Al Qadire
- College of Nursing, Sultan Qaboos University, Muscat, Oman
- Princess Salma Faculty of Nursing Al al-Bayt University, Mafraq, Jordan
| | - Iman Al Hashmi
- College of Nursing, Sultan Qaboos University, Muscat, Oman
| | | | | | - Maen Aljezawi
- College of Nursing, Sultan Qaboos University, Muscat, Oman
- Princess Salma Faculty of Nursing Al al-Bayt University, Mafraq, Jordan
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Gudka R, Kelman C, Bryant E, Farooq B, Berry V, Bjornstad G, Martin F, Glover SL, Russell A. Parent-carer experiences using a peer support network: a qualitative study. BMC Public Health 2023; 23:2007. [PMID: 37845646 PMCID: PMC10577900 DOI: 10.1186/s12889-023-16666-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/30/2023] [Indexed: 10/18/2023] Open
Abstract
INTRODUCTION Parent-carers of children and young people (CYP) with mental health problems are at greater risk of poor outcomes, such as poor physical and mental health. Peer interventions for parent-carers of CYP with disabilities may improve parent-carer outcomes. This qualitative study investigates parent-carer experiences of using Parental Minds (PM), a multi-component peer support service for parent-carers of CYP with disabilities. METHODS Twelve current service-users and four staff/volunteers at PM participated in one-to-one semi-structured interviews. All participants were white females, except for one service-user who was male. All interviews were recorded and transcribed verbatim. Thematic analysis of results was used to explore perceived benefits and disadvantages of PM and possible behaviour change mechanisms. RESULTS Three themes and eight subthemes were identified. Participants identified that internal and external factors influence their self-concept. The identification of themselves as a priority, and empowerment by reassurance and affirmation lead to improved parent-carer self-efficacy and agency to better care for their CYP. Participants described the difficulty of speaking honestly with friends and family about what they experience because it is perceived as different to what "normal" parents experience. From participant accounts, PM enables the construction of a support network and links external services to help manage family circumstances rather than offer curative treatment/intervention. Proactive and immediate advice which is constantly and consistently available was valued by participants. Participants expressed the need for a flexible range of service components which provide holistic support that encompasses both health and social care. CONCLUSIONS PM was perceived to be beneficial as a multi-component peer support service which increases parenting self-efficacy and empowerment, reduces isolation, improves access to services, and is tailored to individual needs. Parent-carers reported benefits in parenting and wellbeing practices. The development of a refined logic model will inform a future study of the effectiveness of PM on parent-carer outcomes.
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Affiliation(s)
- Rebecca Gudka
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Charlotte Kelman
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Eleanor Bryant
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | | | - Vashti Berry
- Children and Young People's Mental Health Research Collaboration, University of Exeter, Exeter, UK
| | - Gretchen Bjornstad
- Children and Young People's Mental Health Research Collaboration, University of Exeter, Exeter, UK
| | | | | | - Abigail Russell
- Children and Young People's Mental Health Research Collaboration, University of Exeter, Exeter, UK.
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Martin F, Dahmash D, Glover S, Duncan C, Turner A, Halligan SL. Needs of parents and carers of children and young people with mental health difficulties: protocol for a systematic review. BMJ Open 2023; 13:e071341. [PMID: 36797023 PMCID: PMC9936057 DOI: 10.1136/bmjopen-2022-071341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 02/09/2023] [Indexed: 02/18/2023] Open
Abstract
INTRODUCTION Having a child or young person (CYP) with mental health problems can be highly distressing for parents/carers. The impact can include parental/carer depression, anxiety, lost productivity and poor family relationships. Currently, there is no synthesis of this evidence, which is needed to provide clarity around what support parents/carers may need, to meet the needs of family mental health. This review aims to identify the needs of the parents/carers of CYP who are receiving mental health services. METHODS AND ANALYSIS A systematic review will be conducted to identify potentially relevant studies that provide evidence concerning the needs and impact on parents/carers linked to their CYP having mental health difficulties. CYP mental health conditions included are anxiety disorders, depression, psychoses, oppositional defiant and other externalising disorders, labels of emerging personality disorders, eating disorders and attention deficit (hyperactive) disorders. The following databases were searched on November 2022 with no date restriction applied: Medline; PsycINFO; CINAHL; AMED; EMBASE; Web of Science; Cochrane Library; WHO International Clinical Trials Registry Platform; Social Policy and Practice; Applied Social Sciences Index and Abstracts; and Open Grey. Only studies reported in English will be included. The quality of the included studies will be assessed using Joanna Briggs Institute Critical Appraisal Checklist for qualitative studies and the Newcastle Ottawa Scale for quantitative studies. Qualitative data will be analysed thematically and inductively. ETHICS AND DISSEMINATION This review was approved by the ethical committee at Coventry University, UK, reference number P139611. The findings from this systematic review will be disseminated across various key stakeholders and published in peer-reviewed journals.
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Affiliation(s)
- Faith Martin
- School of Psychology, Cardiff University, Cardiff, UK
| | - Dania Dahmash
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK
| | | | - Charlie Duncan
- British Association for Counselling and Psychotherapy, Lutterworth, UK
| | - Andy Turner
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK
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Berry KR, Gliske K, Schmidt C, Ballard J, Killian M, Fenkel C. The Impact of Family Therapy Participation on Youth and Young Adult Engagement and Retention in a Telehealth Intensive Outpatient Program: Quality Improvement Analysis (Preprint). JMIR Form Res 2022; 7:e45305. [PMID: 37079372 PMCID: PMC10160927 DOI: 10.2196/45305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/17/2023] [Accepted: 03/27/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Early treatment dropout among youths and young adults (28%-75%) puts them at risk for poorer outcomes. Family engagement in treatment is linked to lower dropout and better attendance in outpatient, in-person treatment. However, this has not been studied in intensive or telehealth settings. OBJECTIVE We aimed to examine whether family members' participation in telehealth intensive outpatient (IOP) therapy for mental health disorders in youths and young adults is associated with patient's treatment engagement. A secondary aim was to assess demographic factors associated with family engagement in treatment. METHODS Data were collected from intake surveys, discharge outcome surveys, and administrative data for patients who attended a remote IOP for youths and young adults, nationwide. Data included 1487 patients who completed both intake and discharge surveys and either completed or disengaged from treatment between December 2020 and September 2022. Descriptive statistics were used to characterize the sample's baseline differences in demographics, engagement, and participation in family therapy. Mann-Whitney U and chi-square tests were used to explore differences in engagement and treatment completion between patients with and those without family therapy. Binomial regression was used to explore significant demographic predictors of family therapy participation and treatment completion. RESULTS Patients with family therapy had significantly better engagement and treatment completion outcomes than clients with no family therapy. Youths and young adults with ≥1 family therapy session were significantly more likely to stay in treatment an average of 2 weeks longer (median 11 weeks vs 9 weeks) and to attend a higher percentage of IOP sessions (median 84.38% vs 75.00%). Patients with family therapy were more likely to complete treatment than clients with no family therapy (608/731, 83.2% vs 445/752, 59.2%; P<.001). Different demographic variables were associated with an increased likelihood of participating in family therapy, including younger age (odds ratio 1.3) and identifying as heterosexual (odds ratio 1.4). After controlling for demographic factors, family therapy remained a significant predictor of treatment completion, such that each family therapy session attended was associated with a 1.4-fold increase in the odds of completing treatment (95% CI 1.3-1.4). CONCLUSIONS Youths and young adults whose families participate in any family therapy have lower dropout, greater length of stay, and higher treatment completion than those whose families do not participate in services in a remote IOP program. The findings of this quality improvement analysis are the first to establish a relationship between participation in family therapy and an increased engagement and retention in remote treatment for youths and young patients in IOP programing. Given the established importance of obtaining an adequate dosage of treatment, bolstering family therapy offerings is another tool that could contribute to the provision of care that better meets the needs of youths, young adults, and their families.
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Affiliation(s)
| | - Kate Gliske
- Charlie Health, Inc, Bozeman, MT, United States
| | | | - Jaime Ballard
- University of Minnesota, St. Paul, MN, United States
| | - Michael Killian
- College of Social Work, Florida State University, Tallahassee, FL, United States
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Protocol for the Implementation and Evaluation of a Mindfulness-Based Intervention for Caregivers of Children with Mental Disorders in a Clinical Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010777. [PMID: 34682519 PMCID: PMC8535239 DOI: 10.3390/ijerph182010777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/08/2021] [Accepted: 10/09/2021] [Indexed: 11/16/2022]
Abstract
Being a parent is complicated in typical circumstances, with a great psychological impact as well as feelings and experiences of great intensity. This impact is greater in families in vulnerable situations, such as those with children with mental health problems, receiving treatment in a clinical setting. Due to these challenges, parenting in these circumstances is often accompanied by experiences of stress. An approach that has shown evidence of effectiveness in mitigating the negative impact of stress is mindfulness-based interventions, including the Mindfulness-Based Stress Reduction intervention program. The Mindfulness-Based Stress Reduction intervention program is designed as a psychoeducational, instructional, multimodal, and structured program whose main objective is to provide strategies for the management, coping, and awareness of stress in order to reduce it. In this paper, a protocol for the implementation and evaluation of the original Mindfulness-Based Stress Reduction intervention program with the added positive parenting component is presented, in order to systematize the incorporation of a parenting component in the Mindfulness-Based Stress Reduction intervention program, analyze its effectiveness for parents whose children have mental health problems (in terms of stress, mindfulness, emotional intelligence, general health, and parental role), explore the mechanisms of change operating in this intervention as perceived by the participants, and examine the application of acquired strategies to daily life.
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8
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Merayo-Sereno B, Fernández-Rivas A, de Oliveira-Silva KL, Sánchez-Andérez FJ, Sesma-Pardo E, Vivanco-González E, González-Torres MÁ. The experience of parents faced with the admission of their adolescent to a child and adolescent psychiatric inpatient unit. A qualitative study with focus groups. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01901-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AbstractThe admission of an adolescent to a child and adolescent psychiatric inpatient unit has a serious impact on the entire family unit. The emotional experience of those primary caregivers has been scarcely studied qualitatively despite being recommended by previous research. This study aims to examine the experience of parents of adolescents with mental health needs that required psychiatric hospitalization in a child and adolescent unit. Qualitative cross-sectional research was carried out under the recommendations of Grounded Theory with three Focus Groups of parents (N = 22) of adolescents who required psychiatric hospitalization in a child and adolescent ward. The COREQ quality criteria were applied. The parental experience implies a high level of emotional suffering modulated by feelings of guilt, stigma, parental awareness of their child’s illness and the passage of time. The use of Prochaska’s and Diclemente’s trans-theoretical model of health behavior change is useful in understanding the parental experience.
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Hawke LD, Thabane L, Wilkins L, Mathias S, Iyer S, Henderson J. Don't Forget the Caregivers! A Discrete Choice Experiment Examining Caregiver Views of Integrated Youth Services. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2021; 14:791-802. [PMID: 33855684 PMCID: PMC8046579 DOI: 10.1007/s40271-021-00510-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/11/2021] [Indexed: 11/21/2022]
Abstract
Background The design and implementation of community-based integrated youth service hubs (IYSHs) is burgeoning around the world. This collaborative model of care aims to address barriers in youth service access by designing services that meet the needs of youth and caregivers. However, heterogeneity across models requires a better understanding of the preferences for key service characteristics. Method A discrete choice experiment was conducted among 274 caregivers of youth aged 14–29 years with mental health challenges. The experiment consisted of 12 attributes with four levels each, representing different service components; additional measures were collected, including demographics and burden assessments. Utility values were calculated, representing the degree of preference for a given level of an attribute. Latent class analysis was conducted to understand subgroups with different service preferences, identifying three latent classes with differing IYSH service preferences. Results The largest class (n = 173, 63.1%), entitled ‘Comprehensive, Integrative Service Access’, strongly valued practical aspects of service design, such as rapid access and support for a wide range of needs. The ‘Service Process Features’ class (n = 67, 24.5%) expressed a relative prioritization of process features of service access, while the smaller ‘Caregiver Involvement’ (n = 34, 12.4%) class most highly prioritized caregiver involvement in their youths’ services. Similar demographic characteristics and caregiver burden were found across classes, although participants in the Caregiver Involvement latent class were supporting younger youth. Discussion and Conclusions Caregivers have diverse youth service preferences and relative priorities that should be taken into account when designing services. System designers and service providers are encouraged to take caregivers’ preferences and priorities into account, alongside youth priorities, whether designing service delivery models or an individual service plan for a youth. Supplementary Information The online version contains supplementary material available at 10.1007/s40271-021-00510-6.
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Affiliation(s)
- Lisa D Hawke
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health; University of Toronto, Toronto, ON, Canada
| | - Lehana Thabane
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Leanne Wilkins
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | | | - Srividya Iyer
- McGill University; ACCESS Open Minds (Youth Mental Health Services Research Network), Montreal, QC, Canada
| | - Joanna Henderson
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health; University of Toronto, Toronto, ON, Canada.
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10
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Boritz TZ, Sheikhan NY, Hawke LD, McMain SF, Henderson J. Evaluating the effectiveness of the Family Connections program for caregivers of youth with mental health challenges, part I: A quantitative analysis. Health Expect 2021; 24:578-588. [PMID: 33580987 PMCID: PMC8077151 DOI: 10.1111/hex.13205] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 01/03/2021] [Accepted: 01/12/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Caregivers of youth with mental health (MH) challenges are often faced with complex problems in relation to caring for their youth. Family Connections™ (FC) is a 12-week skills training program for families of individuals with MH challenges, developed originally for Borderline Personality Disorder. Research is needed to examine the effectiveness of FC for caregivers of youth with diverse MH challenges. OBJECTIVE To examine the effectiveness of FC for caregivers of youth with MH challenges. METHODS A total of 94 caregivers of youth with MH challenges participated in FC, across three sites in Ontario, Canada. Assessments occurred at baseline, 6 weeks, 12 weeks and follow-up. Primary outcomes include the Burden Assessment Scale and The Stress Index for Parents of Adolescents. Secondary outcomes included the caregiver's report of child behaviour, affect, mastery, coping and grief. Linear mixed model analyses were conducted, where time and the time × site interaction were defined as the fixed effects. RESULTS Statistically significant improvements over time were observed across outcome measures, including caregiver burden, grief, coping, and other measures. The time × site interaction was only significant for burden (P = .005). CONCLUSION This study demonstrates the effectiveness of FC for caregivers of youth with MH challenges. Future research should focus on differences across geographical sites and facilitation models. PATIENT OR PUBLIC CONTRIBUTION Caregivers were involved in the facilitation of FC. A person with lived experience was involved in analysing the data, reporting the results, and drafting the manuscript.
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Affiliation(s)
- Tali Z. Boritz
- Centre for Addiction and Mental HealthTorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
| | - Natasha Y. Sheikhan
- Centre for Addiction and Mental HealthTorontoOntarioCanada
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Lisa D. Hawke
- Centre for Addiction and Mental HealthTorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
| | - Shelley F. McMain
- Centre for Addiction and Mental HealthTorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
| | - Joanna Henderson
- Centre for Addiction and Mental HealthTorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
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Skundberg-Kletthagen H, Gonzalez MT, Schröder A, Moen ØL. Mental Health Professionals' Experiences with Applying a Family-Centred Care Focus in Their Clinical Work. Issues Ment Health Nurs 2020; 41:815-823. [PMID: 32401564 DOI: 10.1080/01612840.2020.1731028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Family members play vital roles in supporting their young adults with mental health challenges, implying that professionals are challenged to apply a Family-Centred Care approach (FCC) in community mental health services. By applying a qualitative phenomengraphic approach, this study aimed to explore and describe professionals' experiences of applying a FCC approach. Based on data from 13 individual interviews, the descriptive categories were: Mutual understanding, Facing dilemmas and Dealing with barriers. Despite the professionals' expressed desires to involve the family, individual treatment and follow-up seemed to characterize their daily clinical practice, often due to the young adults' own wishes.
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Affiliation(s)
- Hege Skundberg-Kletthagen
- Faculty of Medicine and Health, Institute of Health Sciences, Norwegian University of Science and Technology (NTNU), Gjøvik, Norway
| | - Marianne Thorsen Gonzalez
- Faculty of Medicine and Health, Institute of Health Sciences, Norwegian University of Science and Technology (NTNU), Gjøvik, Norway.,Faculty of Health and Social Sciences, University of South-Eastern Norway (USN), Notodden, Norway
| | - Agneta Schröder
- Faculty of Medicine and Health, Institute of Health Sciences, Norwegian University of Science and Technology (NTNU), Gjøvik, Norway.,University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Øyfrid Larsen Moen
- Faculty of Medicine and Health, Institute of Health Sciences, Norwegian University of Science and Technology (NTNU), Gjøvik, Norway
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12
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Jansen R, Reid M. Communication Technology Use by Caregivers of Adolescents With Mental Health Issues: Systematic Review. JMIR Mhealth Uhealth 2020; 8:e13179. [PMID: 32663143 PMCID: PMC7468639 DOI: 10.2196/13179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 12/11/2019] [Accepted: 05/14/2020] [Indexed: 11/22/2022] Open
Abstract
Background Caregivers of adolescents with mental health issues experience challenges that may result in the caregivers having a variety of unmet needs. There is a growing need to support these caregivers. Effective support to strengthen positive caregiving behavior in caregivers may address their challenges. Communication technologies offer novel opportunities to assist these caregivers and may contribute to strengthening caregiver behavior. However, little is known about the use of communication technologies among caregivers of adolescents with mental health issues. Objective The study aimed to answer the question: “What is the best evidence available to strengthen positive behavior of caregivers of adolescents with mental health issues using communication technology.” Methods A systematic review of articles published between January 2007 and August 2018 was conducted. Searches included articles of multiple study designs from EBSCO Host and Scopus platforms with prespecified eligibility criteria. Methodological quality was evaluated using the applicable Critical Appraisal Skills Programme and Joanna Briggs Institute assessment tools. Results The search yielded 1746 articles. Altogether, 5 articles met the eligibility criteria and were included in the review for data synthesis. Data analysis and synthesis identified three thematic conclusions reflecting the types of communication technologies used, caregivers as the target population, and strengthening of positive behavior through determinants of the Integrated Model of Behavior Prediction. Conclusions The review reported the usefulness of communication technology by caregivers. Caregivers also demonstrated improvement in self-efficacy, knowledge, parent-child communication, and parental skills reflecting positive behavior. Although the use of communication technology is expanding as a supportive intervention to address caregivers’ needs, the evidence for usefulness among caregivers of adolescents with mental health issues is still scarce. More research and information related to preferred methods of communication delivery among caregivers of adolescents is still needed.
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Affiliation(s)
- Ronelle Jansen
- School of Nursing, Faculty of Health Science, University of the Free State, Bloemfontein, South Africa
| | - Marianne Reid
- School of Nursing, Faculty of Health Science, University of the Free State, Bloemfontein, South Africa
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13
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Hendrickx G, De Roeck V, Maras A, Dieleman G, Gerritsen S, Purper-Ouakil D, Russet F, Schepker R, Signorini G, Singh SP, Street C, Tuomainen H, Tremmery S. Challenges during the transition from child and adolescent mental health services to adult mental health services. BJPsych Bull 2020; 44:163-168. [PMID: 31931898 PMCID: PMC8058856 DOI: 10.1192/bjb.2019.85] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The transition from child and adolescent to adult mental health services for young people with mental health problems is of international concern. Despite the high prevalence of mental disorders during adolescence and their tendency to continue during adulthood, the majority of young people do not experience continuity of care. The aim of this review paper is to unravel the complexity of transitional mental healthcare to clinicians, policy makers and mental health service managers, and to address challenges to a smooth transition process at all levels.
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Affiliation(s)
- Gaelle Hendrickx
- Department of Neurosciences, Centre for Clinical Psychiatry, KU Leuven, Belgium
| | - Veronique De Roeck
- Department of Neurosciences, Child and Adolescent Psychiatry, KU Leuven, Belgium
| | - Athanasios Maras
- Yulius Academy, Yulius Mental Health Organization, The Netherlands
| | - Gwen Dieleman
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, The Netherlands
| | - Suzanne Gerritsen
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, The Netherlands
| | - Diane Purper-Ouakil
- Child and Adolescent Psychiatry Unit, University Hospital of Montpellier, France
| | - Frédérick Russet
- Child and Adolescent Psychiatry Unit, University Hospital of Montpellier, France
| | | | - Giulia Signorini
- Psychiatric Epidemiology and Evaluation Unit, Saint John of God Clinical Research Center, Italy
| | | | - Cathy Street
- Warwick Medical School, University of Warwick, UK
| | | | - Sabine Tremmery
- Department of Neurosciences, Child and Adolescent Psychiatry, KU Leuven, Belgium
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14
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Krysinska K, Curtis S, Lamblin M, Stefanac N, Gibson K, Byrne S, Thorn P, Rice SM, McRoberts A, Ferrey A, Perry Y, Lin A, Hetrick S, Hawton K, Robinson J. Parents' Experience and Psychoeducation Needs When Supporting a Young Person Who Self-Harms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3662. [PMID: 32456022 PMCID: PMC7277421 DOI: 10.3390/ijerph17103662] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 05/19/2020] [Accepted: 05/20/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Self-harm in young people can have a substantial negative impact on the well-being and functioning of parents and other carers. The "Coping with Self-Harm" booklet was originally developed in the UK as a resource for parents and carers of young people who self-harm, and an adaptation study of this resource was conducted in Australia. This paper presents qualitative analysis of interviews with parents about their experiences and psychoeducational needs when supporting a young person who engages in self harm. METHODS The qualitative study drew on semi-structured individual and group interviews with parents (n = 19 participants) of young people who self-harm. Data were analysed using Thematic Analysis. RESULTS The analysis identified six themes: (1) the discovery of self-harm, (2) challenges in the parent-young person relationship, (3) parents' need to understand self-harm, (4) parents' emotional reactions to self-harm, (5) the importance of self-care and help-seeking among parents, and (6) the need for psychoeducational resources. CONCLUSION The study highlights the need for support for parents and carers of young people who engage in self-harm, including development and adaptation of resources, such as the "Coping with Self-Harm" booklet, of which an Australian version has now been developed.
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Affiliation(s)
- Karolina Krysinska
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Sophie Curtis
- North Western Mental Health, Parkville, VIC 3050, Australia
| | - Michelle Lamblin
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Nina Stefanac
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Kerry Gibson
- School of Psychology, The University of Auckland, Auckland 1142, New Zealand
| | - Sadhbh Byrne
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Pinar Thorn
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Simon M Rice
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | | | - Anne Ferrey
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Yael Perry
- Telethon Kids Institute, University of Western Australia, Nedlands, WA 6009, Australia
| | - Ashleigh Lin
- Telethon Kids Institute, University of Western Australia, Nedlands, WA 6009, Australia
| | - Sarah Hetrick
- Orygen, Parkville, VIC 3052, Australia
- Department of Psychological Medicine, The University of Auckland, Auckland 1142, New Zealand
| | - Keith Hawton
- Centre for Suicide Research, University of Oxford, Oxford OX3 7JX, UK
- Oxford Health NHS Foundation Trust, Oxford OX3 7JX, UK
| | - Jo Robinson
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
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15
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Jiménez L, Hidalgo V, Baena S, León A, Lorence B. Effectiveness of Structural⁻Strategic Family Therapy in the Treatment of Adolescents with Mental Health Problems and Their Families. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071255. [PMID: 30965678 PMCID: PMC6479931 DOI: 10.3390/ijerph16071255] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 04/01/2019] [Accepted: 04/04/2019] [Indexed: 11/16/2022]
Abstract
Mental health problems during adolescence constitute a major public health concern today for both families and stakeholders. Accordingly, different family-based interventions have emerged as an effective treatment for adolescents with certain disorders. Specifically, there is evidence of the effectiveness of concrete approaches of systemic family therapy on the symptoms of adolescents and family functioning in general. However, few studies have examined the effectiveness of other relevant approaches, such as structural and strategic family therapy, incorporating parent⁻child or parental dyadic measurement. The purpose of this study was to test the effectiveness of a structural⁻strategic family therapy with adolescents involved in mental health services and their families. For this purpose, 41 parents and adolescents who participated in this treatment were interviewed at pre-test and post-test, providing information on adolescent behavior problems, parental sense of competence, parental practices, parenting alliance, and family functioning. Regardless of participants' gender, adolescents exhibited fewer internalizing and externalizing problems after the treatment. Parents reported higher family cohesion, higher satisfaction and perceived efficacy as a parent, and healthier parental practices (less authoritarian and permissive practices, as well as more authoritative ones). An interaction effect between parenting alliance and gender was found, with more favorable results for the mothers. In conclusion, this paper provides evidence of the usefulness of structural⁻strategic family therapy for improving family, dyadic, and individual facets in families with adolescents exhibiting mental health problems.
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Key Words
- Mental health problems during adolescence constitute a major public health concern today for both families and stakeholders. Accordingly, different family-based interventions have emerged as an effective treatment for adolescents with certain disorders. Specifically, there is evidence of the effectiveness of concrete approaches of systemic family therapy on the symptoms of adolescents and family functioning in general. However, few studies have examined the effectiveness of other relevant approaches, such as structural and strategic family therapy, incorporating parent–child or parental dyadic measurement. The purpose of this study was to test the effectiveness of a structural–strategic family therapy with adolescents involved in mental health services and their families. For this purpose, 41 parents and adolescents who participated in this treatment were interviewed at pre-test and post-test, providing information on adolescent behavior problems, parental sense of competence, parental practices, parenting alliance, and family functioning. Regardless of participants’ gender, adolescents exhibited fewer internalizing and externalizing problems after the treatment. Parents reported higher family cohesion, higher satisfaction and perceived efficacy as a parent, and healthier parental practices (less authoritarian and permissive practices, as well as more authoritative ones). An interaction effect between parenting alliance and gender was found, with more favorable results for the mothers. In conclusion, this paper provides evidence of the usefulness of structural–strategic family therapy for improving family, dyadic, and individual facets in families with adolescents exhibiting mental health problems.
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Affiliation(s)
- Lucía Jiménez
- Faculty of Psychology, University of Seville, Camilo José Cela s/n, 41018 Seville, Spain.
| | - Victoria Hidalgo
- Faculty of Psychology, University of Seville, Camilo José Cela s/n, 41018 Seville, Spain.
| | - Sofía Baena
- Faculty of Psychology, University of Seville, Camilo José Cela s/n, 41018 Seville, Spain.
| | - Antonio León
- Child and Adolescent Mental Health Unit, Virgen Macarena Hospital, C/ Dr. Fedriani, 3, 41009 Seville, Spain.
| | - Bárbara Lorence
- Faculty of Psychology, University of Seville, Camilo José Cela s/n, 41018 Seville, Spain.
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16
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Montoya-Castilla I, Postigo S, Prado-Gascó V, Pérez-Marín M. Relationships between affective states and childhood internalizing disorders. Arch Psychiatr Nurs 2018; 32:591-598. [PMID: 30029753 DOI: 10.1016/j.apnu.2018.03.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 01/31/2018] [Accepted: 03/11/2018] [Indexed: 12/18/2022]
Abstract
Internalizing disorders are mainly defined as psychosomatic, anxiety and depression problems. The aim of this study was to analyze the relationships between dairy affective states and internalizing disorders in early adolescence (10-12 years old), considering the influence of sex. The participants of the study were 367 children aged between 10 and 12 (190 girls and 177 boys). The results showed that fear was the best predictor for all internalizing disorders, and the only common predictor for all of them. The prediction of boys' internalizing disorders was based only in fear, whereas the prediction for girls involved more variables besides fear. An early detection/regulation of these affective states (particularly fear) may be useful for the prevention and treatment of child internalizing disorders.
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Affiliation(s)
- Inmaculada Montoya-Castilla
- Personality, Assesment and Psychological Treatment Department, Faculty of Psychology, Universitat de València, Spain.
| | - Silvia Postigo
- Department of Psychology, Faculty of Health Sciences, European University of Valencia, Spain
| | - Vicente Prado-Gascó
- Social Psychology Department, Faculty of Psychology, Universitat de València, Spain
| | - Marian Pérez-Marín
- Personality, Assesment and Psychological Treatment Department, Faculty of Psychology, Universitat de València, Spain
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