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Steffensen EH, Santoro SL, Pedersen LH, Vogel I, Lou S. Encounters with public and professional understandings of Down syndrome: A qualitative study of parents' experiences. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13221. [PMID: 38440921 DOI: 10.1111/jar.13221] [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: 04/15/2023] [Revised: 10/24/2023] [Accepted: 02/18/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND The meanings of neurodevelopmental conditions are socially and culturally defined. We explored how parents of a child with Down syndrome experienced public and professional understandings of Down syndrome. METHOD Qualitative interviews with 25 parents of a child with Down syndrome living in Denmark. From a reflexive thematic analysis, we developed themes describing understandings (i.e., attitudes or perceptions) of Down syndrome. RESULTS The parents experienced that the Down syndrome diagnosis acted as a 'label'; this had perceived positive and negative consequences for the child. The parents felt others understood Down syndrome as severe and undesirable. This attitude was tied to the existence of prenatal screening. Finally, to the parents, professional support for their child expressed an understanding of children with Down syndrome as valued individuals. CONCLUSIONS Parents encountered ambiguous understandings of Down syndrome. This should be recognised by professionals who may shape such understandings.
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Affiliation(s)
- Ellen H Steffensen
- Center for Fetal Diagnostics, Aarhus University, Aarhus, Denmark
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Stephanie L Santoro
- Division of Medical Genetics and Metabolism, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Lars H Pedersen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Ida Vogel
- Center for Fetal Diagnostics, Aarhus University, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Stina Lou
- Center for Fetal Diagnostics, Aarhus University, Aarhus, Denmark
- Defactum - Public Health & Health Services Research, Central Denmark Region, Aarhus, Denmark
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Van Riper M, Knafl GJ, Knafl KA, do Céu Barbieri-Figueiredo M, Barnoy S, Caples M, Choi H, Cosgrove B, Duarte ED, Honda J, Marta E, Phetrasuwan S, Alfieri S, Angelo M, Deoisres W, Fleming L, Dos Santos AS, da Silva MJR. Family adaptation in families of individuals with Down syndrome from 12 countries. AMERICAN JOURNAL OF MEDICAL GENETICS. PART C, SEMINARS IN MEDICAL GENETICS 2024; 196:e32075. [PMID: 37929633 DOI: 10.1002/ajmg.c.32075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/11/2023] [Accepted: 10/21/2023] [Indexed: 11/07/2023]
Abstract
Our current understanding of adaptation in families of individuals with Down syndrome (DS) is based primarily on findings from studies focused on participants from a single country. Guided by the Resiliency Model of Family Stress, Adjustment, and Adaptation, the purpose of this cross-country investigation, which is part of a larger, mixed methods study, was twofold: (1) to compare family adaptation in 12 countries, and (2) to examine the relationships between family variables and family adaptation. The focus of this study is data collected in the 12 countries where at least 30 parents completed the survey. Descriptive statistics were generated, and mean family adaptation was modeled in terms of each predictor independently, controlling for an effect on covariates. A parsimonious composite model for mean family adaptation was adaptively generated. While there were cross-country differences, standardized family adaptation mean scores fell within the average range for all 12 countries. Key components of the guiding framework (i.e., family demands, family appraisal, family resources, and family problem-solving communication) were important predictors of family adaptation. More cross-country studies, as well as longitudinal studies, are needed to fully understand how culture and social determinants of health influence family adaptation in families of individuals with DS.
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Affiliation(s)
- Marcia Van Riper
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - George J Knafl
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kathleen A Knafl
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | | | - Maria Caples
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | | | - Beth Cosgrove
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | | | - Elena Marta
- Università Cattolica del Sacro Cuore, Milan, Italy
| | | | - Sara Alfieri
- Università Cattolica del Sacro Cuore, Milan, Italy
| | | | | | - Louise Fleming
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Van Riper M, Cosgrove B, Fleming L. Adaptation at the Family Level in Families of Individuals With Down Syndrome: A Scoping Review. JOURNAL OF FAMILY NURSING 2023; 29:324-347. [PMID: 37066798 PMCID: PMC10629249 DOI: 10.1177/10748407231163236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Down syndrome (DS) is a chromosomal disorder associated with intellectual and physical disabilities and has historically been viewed by health care providers through a negative lens when considering the effect the condition has on the individual, family, and community. The purpose of this scoping review was to provide an overview of recent research concerning adaptation in families of individuals with DS with a focus on family adaptation rather than individual or dyadic adaptation. Three literature indexes were searched from 2017 to 2022, with 41 articles included. Foci of the studies included strength/resilience, stress/coping, and negative/challenge. Thirteen studies reported using a family framework. Multiple methodological approaches and family measures were used in the studies and are outlined. Findings from this review show there has been a shift in focus when researching families of individuals with DS from a negative and challenging experience to one of strength and resilience.
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Urbanowicz AM, Shankland R, Rance J, Bennett P, Leys C, Gauchet A. Cognitive behavioral stress management for parents: Prevention and reduction of parental burnout. Int J Clin Health Psychol 2023; 23:100365. [PMID: 36908695 PMCID: PMC9999161 DOI: 10.1016/j.ijchp.2023.100365] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 01/02/2023] [Indexed: 03/07/2023] Open
Abstract
Context Parental burnout increases the risk of deleterious consequences on parents', couples', and children's physical and mental health. Methods The current study (N = 134) aimed to assess the effectiveness of a Cognitive Behavioural Stress Management (CBSM) group programme in terms of parental burnout reduction. In total 67 parents attended the 8-week CBSM intervention groups, and another 67 parents were assigned to the waiting-list control group. We compared the effectiveness of the CBSM intervention with a waiting-list control group directly after the end of the programme and at three-months follow-up. Results The results showed that compared to the control group the CBSM programme contributed to the reduction of parental burnout symptoms with statistically significant and small effect size. Moreover, the contrast analyses showed that the reduction in parental burnout severity was maintained at 3 month-follow-up. The reduction in parental burnout scores was mediated by the decrease in stress and the increase in unconditional self-kindness. Conclusions These results highlight the potential benefits of the CBSM programme for parental burnout prevention and reduction.
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Affiliation(s)
- Agata Maria Urbanowicz
- Grenoble-Alpes University, 621 Avenue Centrale, 38400 Saint-Martin-d'Hères, France
- Swansea University, Singleton Park, Sketty, Swansea SA2 8PP, United Kingdom
| | | | - Jaynie Rance
- Swansea University, Singleton Park, Sketty, Swansea SA2 8PP, United Kingdom
| | - Paul Bennett
- Swansea University, Singleton Park, Sketty, Swansea SA2 8PP, United Kingdom
| | - Christophe Leys
- Université Libre de Bruxelles, Campus du Solbosch, Avenue F.D. Roosevelt, 501050 Bruxelles, Belgium
| | - Aurélie Gauchet
- Savoie Mont Blanc University, 27 rue Marcoz, 73011 Chambéry, France
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Šimunić A, Slišković A, Tokić A, Ombla J, Stewart L. The Roles of Personal and Environmental Resources in Predicting Work-Family Facilitation and Mental Health among Employed Parents of Children with Disabilities in Croatia. Behav Sci (Basel) 2023; 13:710. [PMID: 37753988 PMCID: PMC10525903 DOI: 10.3390/bs13090710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/14/2023] [Accepted: 08/24/2023] [Indexed: 09/28/2023] Open
Abstract
Quantitative research on the positive aspects of work-life integration and the well-being of families with children with disabilities is scarce, especially in the national context. The family can provide gains that enhance work domain functioning (family-to-work facilitation; FWF), and work can provide gains that enhance family domain functioning (work-to-family facilitation; WFF). The aim of this study is to examine the contributions of some personal and environmental resources in explaining WFF and FWF and the mental health of parents of children with disabilities residing in Croatia. The mediational role of WFF and FWF in the relationship between resources and mental health was tested, while controlling for some general socio-demographic variables. A total of 571 employed parents of a child/children with disabilities completed an online self-assessment questionnaire. The results show that higher WFF (19%) was predicted by higher levels of social support at work, a higher level of education, posttraumatic growth (PTG) of personal strength, and recovery management. Higher FWF (46%) was predicted by higher levels of social support in the family, PTG of personal strength, the emotional regulation strategy of reorienting to planning, optimism, a younger age, the male gender, a greater number of children, and a higher level of education. A higher level of mental health (47%) was predicted directly by higher levels of optimism, recovery management, FWF, emotional regulation strategies of positive refocusing and planning, and a greater number of children, and was indirectly predicted by all the predictors of FWF through a higher level of FWF (but not WFF).
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Affiliation(s)
- Ana Šimunić
- Department of Psychology, University of Zadar, 23000 Zadar, Croatia; (A.S.); (A.T.); (J.O.)
| | - Ana Slišković
- Department of Psychology, University of Zadar, 23000 Zadar, Croatia; (A.S.); (A.T.); (J.O.)
| | - Andrea Tokić
- Department of Psychology, University of Zadar, 23000 Zadar, Croatia; (A.S.); (A.T.); (J.O.)
| | - Jelena Ombla
- Department of Psychology, University of Zadar, 23000 Zadar, Croatia; (A.S.); (A.T.); (J.O.)
| | - Lisa Stewart
- Department of Social Work, California State University, Monterey Bay, Long Beach, CA 93955-8001, USA;
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Celik P, Kara Uzun A. Stressful experiences and coping strategies of parents of young children with Down syndrome: A qualitative study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023. [PMID: 37100435 DOI: 10.1111/jar.13108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 02/26/2023] [Accepted: 04/05/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND Previous studies have focused mostly on the negative experiences of parents of children with Down syndrome. We aimed to explore both the stressful experiences and coping strategies of parents from a non-Western country. METHODS Twenty-six parents of children aged 8-48 months with Down syndrome were included. Semi-structured interviews were conducted, and the data were analysed using thematic analysis. RESULTS The main themes of the stressful experiences were emotional burdens, caregiving burdens, struggle against stigma and discrimination, concerns about the future, challenges related to health, education, and financial issues. Parents used a variety of coping strategies to overcome the challenges by seeking support and help, searching for information, accepting and adapting, and adopting optimistic attitudes. CONCLUSION Although being a parent of a child with Down syndrome has many challenges, most parents effectively used coping strategies and adapted their lives to their new parental roles in their child's early years.
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Affiliation(s)
- Pelin Celik
- Department of Pediatrics, Ankara Yildirim Beyazit University, Ankara, Turkey
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Aysun Kara Uzun
- Division of Social Pediatrics, Department of Pediatrics, Ankara Bilkent City Hospital, University of Health Sciences Turkey, Ankara, Turkey
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Coleman J, Thompson T, Riley K, Allen K, Michalak C, Shields R, Berry-Kravis E, Hessl D. The comparison of expressed emotion of parents of individuals with fragile X syndrome to other intellectual disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:394-404. [PMID: 36647196 PMCID: PMC10381095 DOI: 10.1111/jar.13069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 12/14/2022] [Accepted: 12/19/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Parenting children and young adults with intellectual disabilities, including individuals with fragile X syndrome and Down syndrome, is challenging, joyful, and complicated. Exploring how parents talk about their children, and the quality of the parent/child relationship can provide insight into the home environment and interactional patterns of the family. METHOD Expressed emotion (EE) is a measurement of a family's emotional climate based on a parent or caregiver's report of warmth, emotional overinvolvement, hostility, and criticism. The purpose of this study was to describe EE for a sample of parents of individuals with intellectual disabilities and to determine any differences in EE amongst individuals within subgroups. Based on previous research about fragile X syndrome and family systems, we hypothesized that there would be significant differences between the disability groups (higher EE in families with children/young adults with fragile X syndrome). RESULTS Results showed relatively high proportions of EE across groups of individuals with intellectual disabilities, however, there were no significant differences between the subgroups. Null findings suggest that differences in EE may not relate directly to a child's specific genetic condition. Rather, increased EE in caregiver populations may simply reflect well-documented stressors related to stigma, caregiver burden, and limited community supports. Critical statements were infrequent, however, over half of the participants reported dissatisfaction with their situation, and many were categorized as having emotional overinvolvement, as measured by frequent statements of intense worry and self-sacrifice. CONCLUSION Findings point to potential utility in family-level interventions focused on providing structured caregiver therapy to manage excessive worry and grief related to a diagnosis of intellectual disability, and respite care to encourage caregiver independence and pursuit of personal care.
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Affiliation(s)
| | - Talia Thompson
- Department of Pediatrics, Children's Hospital Colorado, School of Medicine, University of Colorado, Aurora, Colorado, USA
| | | | - Korrie Allen
- Morgridge College of Education, University of Denver, Denver, Colorado, USA
| | | | - Rebecca Shields
- Davis Medical Center, Translational Psychophysiology and Assessment Laboratory, MIND Institute, University of California, Sacramento, California, USA
| | | | - David Hessl
- Davis Medical Center, Translational Psychophysiology and Assessment Laboratory, MIND Institute, University of California, Sacramento, California, USA
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Ghim S, Ku B. The prevalence of health problems and their association with physical activity in caregivers of children with disabilities: 2018 National Health Interview Survey. Child Care Health Dev 2022; 48:347-357. [PMID: 34850443 DOI: 10.1111/cch.12934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 10/22/2021] [Accepted: 11/22/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Caregivers of children with disabilities often experience poor health. One way for caregivers to promote their own health may be to participate in physical activity (PA). AIMS The purpose of this study was to examine the association between PA and psychological and physical health problems in caregivers of children with disabilities. METHODS The 2018 National Health Interview Survey (NHIS) data were used, and 890 household representatives were identified as caregivers of children with disabilities. Based on the national PA guidelines, caregivers were classified into three groups: inactive (IA), aerobically active (AA), and aerobically and muscularly active (AMA). RESULTS Multivariable logistic regression indicated that the AMA group had a lower likelihood of reporting depression compared to the IA group (OR: 0.73 [95% confidence interval: 0.54, 0.98]). The AMA group also had a lower likelihood of reporting back pain and obesity compared to the IA group (OR:0.69 [95% confidence interval: 0.56, 0.84] and OR:0.63 [95% confidence interval: 0.52, 0.76], respectively). CONCLUSIONS The results of the current study suggest that caregivers of children with disabilities may benefit from PA, especially from the combination of aerobic and muscle-strengthening PA.
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Affiliation(s)
- Seungbeen Ghim
- Health Management and Policy, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Byungmo Ku
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore, Singapore
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Steffensen EH, Rosvig LH, Santoro S, Pedersen LH, Vogel I, Lou S. Parenting a child with Down syndrome: A qualitative study of everyday practices in Danish families. J Genet Couns 2021; 31:758-770. [PMID: 34939262 DOI: 10.1002/jgc4.1542] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/26/2021] [Accepted: 12/05/2021] [Indexed: 12/14/2022]
Abstract
Genetic counseling about Down syndrome is suggested to include information on a future family life. However, there is an insufficient knowledge on the potential impact of parenting a child with Down syndrome on parents' everyday practices. We aimed to address this gap by exploring the experienced everyday practices of parents in families where a child has Down syndrome. Taking a qualitative approach, we conducted semi-structured interviews with 25 parents of children with Down syndrome aged 4-12 years. Using reflexive thematic analysis, we identified two themes concerned with the parents' practice. The first, 'Supporting our child', describes how the parents perceived their child as a valuable human being and how this perception founded parents' support of the child's development and social interactions. The second, 'Managing our family life', demonstrates how the parents acted to manage a family life that had become the 'new normal' including being alert toward the child, shaping the practical and logistical framework of daily life, and balancing between being at home and away from home. Overall, the analysis presents an everyday practice aimed at a desirable future for the child with Down syndrome and at a management of everyday life on the family's own terms. In conclusion, this study provides specific knowledge on parents' everyday practice, which may inform genetic counseling about Down syndrome and be of value to service providers.
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Affiliation(s)
- Ellen Hollands Steffensen
- Center for Fetal Diagnostics, Aarhus University, Aarhus, Denmark.,Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lena Have Rosvig
- Department of Obstetrics and Gynecology, Horsens Regional Hospital, Horsens, Denmark
| | - Stephanie Santoro
- Division of Medical Genetics and Metabolism, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Lars Henning Pedersen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.,Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Ida Vogel
- Center for Fetal Diagnostics, Aarhus University, Aarhus, Denmark.,Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Stina Lou
- Center for Fetal Diagnostics, Aarhus University, Aarhus, Denmark.,Defactum - Public Health & Health Services Research, Aarhus, Denmark
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Winnard R, Roy M, Butler-Coyne H. Motherhood: Female Perspectives and Experiences of Being a Parent with ASC. J Autism Dev Disord 2021; 52:2314-2324. [PMID: 34106393 PMCID: PMC9021069 DOI: 10.1007/s10803-021-05122-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2021] [Indexed: 12/04/2022]
Abstract
Little is known about the emotional pressures and practical management of daily challenges and, intra and interpersonal demands of raising a child as a parent with a diagnosis of Autistic Spectrum Conditions. The present study utilised a qualitative approach to understand perceptions of females diagnosed on the autistic spectrum of ‘being a parent’. Eight semi-structured interviews were analysed using Interpretative Phenomenological Analysis. Benefits and challenges of being a parent were highlighted alongside population-specific skill and characteristics associated with strength and resilience, love, nurture, routine and sensory considerations. Findings identify the need for population-specific specialist parenting support, provide direction for professionals in clinical settings and expand the paucity of research in this area.
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Affiliation(s)
- Rebecca Winnard
- School of Psychology, University of Central Lancashire, Darwin Building, Preston, PR1 2HE, UK.,Tier 4 CAMHS Inpatients Services, Lancashire Care NHS Foundation Trust, Piccadilly, Lancaster, LA1 4PW, UK
| | - Mark Roy
- School of Psychology, University of Central Lancashire, Darwin Building, Preston, PR1 2HE, UK.,Tier 4 CAMHS Inpatients Services, Lancashire Care NHS Foundation Trust, Piccadilly, Lancaster, LA1 4PW, UK
| | - Hannah Butler-Coyne
- School of Psychology, University of Central Lancashire, Darwin Building, Preston, PR1 2HE, UK. .,Tier 4 CAMHS Inpatients Services, Lancashire Care NHS Foundation Trust, Piccadilly, Lancaster, LA1 4PW, UK.
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