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Koh E, Bruhn C, Ansong D, Budde S, Mann K. Delivery and Impact of Foster Parent Training: Similarities and Differences for Relative and Non-Relative Foster Parents. CHILD MALTREATMENT 2024; 29:309-321. [PMID: 37002699 DOI: 10.1177/10775595231168998] [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
Literature on the delivery and impact of foster parent training, such as the Nurturing Parenting Program (NPP), is sparse, particularly for relative foster parents. This study investigates (a) how NPP referral, initiation, and completion rates vary between relative and non-relative foster parents, (b) reasons for not initiating NPP, and (c) changes in parenting attitudes and behaviors for relative and non-relative foster parents after participating in NPP. The study analyzed data from the Illinois Birth to Three (IB3) study for 722 relative and 397 non-relative foster parents of children ages three and younger. Relative and non-relative foster parents had similar NPP referral and initiation rates, but relatives had significantly lower completion rates. Content analysis of case notes for 498 cases showed that relative foster parents more frequently noted barriers (e.g., childcare, transportation) to NPP initiation. Among NPP completers, both groups reported similar levels of improvements in parenting attitudes and behaviors at the end of NPP, but a pattern of lower scores was observed for relative foster parents. The findings suggest a need for more support for foster parents, particularly relative foster parents.
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Affiliation(s)
- Eun Koh
- National Catholic School of Social Service, The Catholic University of America, Washington, DC, USA
| | - Chris Bruhn
- School of Social Work, Aurora University, Aurora, IL, USA
| | - David Ansong
- School of Social Work, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Kimberly Mann
- Office of Research and Child Well-Being, Illinois Department of Children and Family Services, Chicago, IL, USA
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2
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Jukes LM, Di Folco S, Kearney L, Sawrikar V. Barriers and Facilitators to Engaging Mothers and Fathers in Family-Based Interventions: A Qualitative Systematic Review. Child Psychiatry Hum Dev 2024; 55:137-151. [PMID: 35763177 PMCID: PMC10796537 DOI: 10.1007/s10578-022-01389-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/28/2022] [Indexed: 11/03/2022]
Abstract
The current systematic review examined the similarities and differences between mothers' and fathers' reported barriers and facilitators to engaging in family-based interventions for child and adolescent behavioural problems (aged 2-17 years). Systematic searches of six electronic databases and grey literature alongside a two-way screening process identified twenty eligible qualitative studies from 2004 to 2019. A thematic meta-synthesis identified similarities in major themes of psychological, situational, knowledge/awareness, programme/intervention, co-parenting, practitioner, and beliefs/attitudes factors, alongside group experiences and stages of engagement. However, differences emerged in subthemes related to parental, treatment, and service delivery factors that included individual ideologies of parenting, parental roles, and treatment participation; the role of mothers in facilitating engagement; and individual preferences for treatment content and delivery. Overall, findings suggest that while mothers and fathers experience similar challenges to engagement, they can also experience distinct challenges which need to be addressed at the treatment outset to maximise engagement.
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Affiliation(s)
- Laura M Jukes
- School of Health in Social Science, The University of Edinburgh, Edinburgh, Scotland, UK
- National Health Service (NHS) Lothian, Edinburgh, Scotland, UK
| | - Simona Di Folco
- School of Health in Social Science, The University of Edinburgh, Edinburgh, Scotland, UK
- National Health Service (NHS) Lothian, Edinburgh, Scotland, UK
| | - Lisa Kearney
- School of Health in Social Science, The University of Edinburgh, Edinburgh, Scotland, UK
- National Health Service (NHS) Lothian, Edinburgh, Scotland, UK
| | - Vilas Sawrikar
- School of Health in Social Science, The University of Edinburgh, Edinburgh, Scotland, UK.
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3
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Hambrick E, Lee SK, Weiler L, Collins JO, Rhodes T, Taussig H. Engagement in a Preventive Intervention for Preadolescent Children in Foster Care: Considerations for Intervention Design. Child Psychiatry Hum Dev 2023; 54:1373-1385. [PMID: 35303199 DOI: 10.1007/s10578-022-01341-8] [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] [Accepted: 02/21/2022] [Indexed: 11/03/2022]
Abstract
Engagement in mental health-focused preventive interventions is understudied. Demographic, child, and system-level predictors of engagement were explored in a study with children in foster care (N = 222, Mage = 10.3) who participated in a 30-week intervention. Attendance and engagement in mentor visits and skills groups were rated weekly. Only 4 of 21 predictors showed bivariate associations with attendance/engagement: child sex, IQ, behavior problems, and trauma symptoms. SEM models with these three variables and a measure of adverse childhood experience (ACEs), were used to develop a model of engagement. Males had poorer mentor visit and group engagement. Group attendance was positively associated with trauma symptoms and negatively associated with ACEs. Group engagement was associated with higher IQ and fewer behavior problems. A contextually-sensitive intervention can result in high engagement for a vulnerable and diverse population, yet a few child factors still impacted engagement, and when identified could be ameliorated.Trial Registration ClinicalTrials.gov, Identifiers: NCT00809315 & NCT00810056.
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Affiliation(s)
- Erin Hambrick
- Department of Psychology, University of Missouri - Kansas City, Kansas City, MO, USA.
- Department of Psychology, University of Missouri - Kansas City, 5030 Cherry St, Cherry Hall Room 309, Kansas City, MO, 64110, USA.
| | - Sun-Kyung Lee
- Department of Family Social Science, University of Minnesota - Twin Cities, St. Paul, MN, USA
| | - Lindsey Weiler
- Department of Family Social Science, University of Minnesota - Twin Cities, St. Paul, MN, USA
| | - Jen O Collins
- Department of Psychology, University of Missouri - Kansas City, Kansas City, MO, USA
| | - Tara Rhodes
- Colorado Department of Education, Denver, CO, USA
| | - Heather Taussig
- University of Denver - Graduate School of Social Work, Denver, CO, USA
- University of Colorado - Kempe Center, Aurora, CO, USA
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4
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Evans R, MacDonald S, Trubey R, Noyes J, Robling M, Willis S, Boffey M, Wooders C, Vinnicombe S, Melendez-Torres GJ. Interventions targeting the mental health and wellbeing of care-experienced children and young people in higher-income countries: Evidence map and systematic review. Syst Rev 2023; 12:111. [PMID: 37393358 PMCID: PMC10315047 DOI: 10.1186/s13643-023-02260-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 05/26/2023] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND The mental health and wellbeing of care-experienced children and young people (i.e. foster care, kinship care, residential care) is poorer than non-care-experienced populations. The Care-experienced cHildren and young people's Interventions to improve Mental health and wEll-being outcomes Systematic review (CHIMES) aimed to synthesise the international evidence base for interventions targeting subjective wellbeing, mental health and suicide amongst care-experienced young people aged ≤ 25 years. METHODS For the first phase of the review, we constructed an evidence map identifying key clusters and gaps in interventions and evaluations. Studies were identified through 16 electronic databases and 22 health and social care websites, in addition to expert recommendations, citation tracking and screening of relevant systematic reviews. We charted interventions and evaluations with a summary narrative, tables and infographics. RESULTS In total, 64 interventions with 124 associated study reports were eligible. The majority of study reports were from the USA (n = 77). Interventions primarily targeted children and young people's skills and competencies (n = 9 interventions), the parental functioning and practices of carers (n = 26), or a combination of the two (n = 15). While theoretically under-specified, interventions were largely informed by theories of Attachment, Positive Youth Development, and Social Learning Theory. Current evaluations prioritised outcomes (n = 86) and processes (n = 50), with a paucity of study reports including theoretical descriptions (n = 24) or economic evaluations (n = 1). Interventions most frequently targeted outcomes related to mental, behavioural or neurodevelopmental disorders, notably total social, emotional and behavioural problems (n = 48 interventions) and externalising problem behaviours (n = 26). There were a limited number of interventions targeting subjective wellbeing or suicide-related outcomes. CONCLUSIONS Future intervention development might focus on structural-level intervention theories and components, and target outcomes related to subjective wellbeing and suicide. In accordance with current methodological guidance for intervention development and evaluation, research needs to integrate theoretical, outcome, process and economic evaluation in order to strengthen the evidence base. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020177478.
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Affiliation(s)
- Rhiannon Evans
- DECIPHer, School of Social Sciences, Cardiff University, SPARK, Maindy Road, Cardiff, CF24 4HQ, UK.
| | - Sarah MacDonald
- DECIPHer, School of Social Sciences, Cardiff University, SPARK, Maindy Road, Cardiff, CF24 4HQ, UK
| | - Rob Trubey
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Jane Noyes
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | | | - Simone Willis
- Specialist Unit for Review Evidence, Cardiff University, Cardiff, UK
| | - Maria Boffey
- DECIPHer, School of Social Sciences, Cardiff University, SPARK, Maindy Road, Cardiff, CF24 4HQ, UK
| | | | - Soo Vinnicombe
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - G J Melendez-Torres
- Peninsula Technology Assessment Group (PenTAG), University of Exeter, Exeter, UK
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5
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Alfano CA, Valentine M, Nogales JM, Kim J, Kim JS, Rigos P, McGlinchey EL, Ripple CH, Wolfson AR. How Are the Sleep Problems of Children in the US Foster Care System Addressed? J Dev Behav Pediatr 2022; 43:e525-e532. [PMID: 35507424 DOI: 10.1097/dbp.0000000000001090] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 03/11/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Evidence of poor sleep health among children in foster care continues to mount, but information about whether and how sleep problems are addressed is unavailable. The goal of this study was to begin to fill these significant knowledge gaps. METHODS Four hundred eighty-five foster caregivers from across the United States completed a survey focused on the sleep health of one child, 4 to 11 years ( M = 6.4; SD = 2.2) currently in their care. Caregivers provided quantitative and qualitative responses to questions regarding training, information, and services received in relation to their child's sleep. Caregivers also reported on the factors and strategies they perceived as most important for helping children in their care sleep well. RESULTS Only 13% of caregivers reported receiving any information/education about sleep from agencies or case workers, whereas 55% had sought help from a health provider related to their child's sleep. Nearly half of all caregivers (46%) reported giving their child melatonin. Caregivers reported that a bedtime routine/consistency, reassurance of safety/love, and a calming environment were most important for helping their child sleep well. A recurrent theme in qualitative responses was a need to mitigate child fear/anxiety at night. CONCLUSION Children in foster care face a range of risk factors that increase the likelihood of poor/insufficient sleep, but these findings suggest this critical aspect of health requires greater clinical and research attention. As these data were collected during the initial months of the COVID-19 pandemic, replication studies are necessary.
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Affiliation(s)
| | | | | | - Jinu Kim
- Department of Psychology, University of Houston, Houston, TX
| | - Josephine S Kim
- Department of Psychology, Fairleigh Dickinson University, Teaneck, NJ; and
| | - Priscilla Rigos
- Department of Psychology, Fairleigh Dickinson University, Teaneck, NJ; and
| | | | | | - Amy R Wolfson
- Department of Psychology, Loyola University Maryland, Baltimore, MD
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6
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Abstract
Child trauma is a serious societal problem. At least one trauma is reported by two-thirds of American children and adolescents Despite children's inherent resilience, trauma exposure is associated with increased risk for medical and mental health problems including posttraumatic stress disorder, depression, anxiety, substance abuse, and attempted and completed suicide. Early identification and treatment of traumatized children can prevent these potentially serious and long-term negative outcomes.
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7
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Barnett ML, Lau AS, Lind T, Wright B, Stadnick N, Innes-Gomberg D, Pesanti K, Brookman-Frazee L. Caregiver Attendance as a Quality Indicator in the Implementation of Multiple Evidence-Based Practices for Children. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2020; 49:868-882. [PMID: 31799862 PMCID: PMC7269837 DOI: 10.1080/15374416.2019.1683851] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This study investigated a quality indicator for children's mental health, caregiver attendance in youth psychotherapy sessions, within a system-driven implementation of multiple evidence-based practices (EBPs) in children's community mental health services. METHOD Administrative claims from nine fiscal years were analyzed to characterize and predict caregiver attendance. Data included characteristics of therapists (n = 8,626), youth clients (n = 134,368), sessions (e.g., individual, family), and the EBP delivered. Clients were primarily Latinx (63%), male (54%) and mean age was 11; they presented with a range of mental health problems. Three-level mixed models were conducted to examine the association between therapist, youth, service, EBP characteristics and caregiver attendance. RESULTS Caregivers attended, on average, 46.0% of sessions per client for the full sample and 59.6% of sessions for clients who were clinically indicated, based on age and presenting problem, to receive caregiver-focused treatment. Following initial EBP implementation, the proportion of caregiver attendance in sessions increased over time. Caregivers attended a higher proportion of youth psychotherapy sessions when clients were younger, had an externalizing disorder, were non-Hispanic White, and were male. Further, higher proportions of caregiver attendance occurred when services were delivered in a clinic setting (compared with school and other settings), by bilingual therapists, and the EBP prescribed caregiver attendance in all sessions. CONCLUSIONS Overall, the patterns of caregiver attendance appear consistent with evidence-informed practice parameters of client presenting problem and age. Yet, several improvement targets emerged such as client racial/ethnic background and service setting. Potential reasons for these disparities are discussed.
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Affiliation(s)
- Miya L. Barnett
- University of California, Santa Barbara, Department of Counseling, Clinical, & School Psychology, Santa Barbara, CA
| | - Anna S. Lau
- University of California, Los Angeles, Department of Psychology, Los Angeles, CA
| | - Teresa Lind
- University of California, San Diego, Department of Psychiatry; Child and Adolescent Services Research Center, San Diego, CA
| | - Blanche Wright
- University of California, Los Angeles, Department of Psychology, Los Angeles, CA
| | - Nicole Stadnick
- University of California, San Diego, Department of Psychiatry; Child and Adolescent Services Research Center, San Diego, CA
| | | | - Keri Pesanti
- Los Angeles County Department of Mental Health, Los Angeles, CA
| | - Lauren Brookman-Frazee
- University of California, San Diego, Department of Psychiatry; Child and Adolescent Services Research Center, San Diego, CA
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8
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Powell BJ, Patel SV, Haley AD, Haines ER, Knocke KE, Chandler S, Katz CC, Seifert HP, Ake G, Amaya-Jackson L, Aarons GA. Determinants of Implementing Evidence-Based Trauma-Focused Interventions for Children and Youth: A Systematic Review. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2020; 47:705-719. [PMID: 31813066 PMCID: PMC7275881 DOI: 10.1007/s10488-019-01003-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
A systematic review was conducted to identify determinants (barriers and facilitators) of implementing evidence-based psychosocial interventions for children and youth who experience emotional or behavioral difficulties due to trauma exposure. Determinants were coded, abstracted, and synthesized using the Exploration, Preparation, Implementation, and Sustainment framework. Twenty-three articles were included, all of which examined implementation of Trauma-Focused Cognitive Behavioral Therapy or Cognitive-Behavioral Intervention for Trauma in Schools. This review identified multilevel and multiphase determinants that can be addressed by implementation strategies to improve implementation and clinical outcomes, and suggests how future studies might address gaps in the evidence base.
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Affiliation(s)
- Byron J Powell
- Brown School, Washington University in St. Louis, St. Louis, USA.
| | - Sheila V Patel
- Department of Health Policy and Management, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, USA
- RTI International, Durham, USA
| | - Amber D Haley
- Department of Health Policy and Management, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, USA
| | - Emily R Haines
- Department of Health Policy and Management, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, USA
- RTI International, Durham, USA
| | - Kathleen E Knocke
- Department of Health Policy and Management, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, USA
| | - Shira Chandler
- Department of Health Policy and Management, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, USA
| | - Colleen Cary Katz
- Silberman School of Social Work, Hunter College, City University of New York, New York, USA
| | | | - George Ake
- Duke University School of Medicine, Durham, USA
| | - Lisa Amaya-Jackson
- Center for Child and Family Health, Durham, USA
- Duke University School of Medicine, Durham, USA
| | - Gregory A Aarons
- Child and Adolescent Services Research Center, University of California at San Diego School of Medicine, San Diego, USA
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9
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Shafi RMA, Bieber ED, Shekunov J, Croarkin PE, Romanowicz M. Evidence Based Dyadic Therapies for 0- to 5-Year-Old Children With Emotional and Behavioral Difficulties. Front Psychiatry 2019; 10:677. [PMID: 31620029 PMCID: PMC6759941 DOI: 10.3389/fpsyt.2019.00677] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 08/21/2019] [Indexed: 11/13/2022] Open
Abstract
As many as one in four preschool-aged children are estimated to struggle with psychosocial stress and social-emotional issues; yet, interventions are often postponed until older ages when change is actually more difficult. Reasons for this include limited interventions, paucity of FDA approved medications for young children, as well as the dearth of clinicians adequately trained in psychotherapeutic approaches for young children. This commentary outlines indications of the four most commonly used evidence-based dyadic psychotherapies for young children: Child-Parent Psychotherapy (CPP) and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), used primarily for young children with trauma, and Parent-Child Interaction Therapy (PCIT) and Child Parent Relationship Therapy (CPRT), used mostly for children with behavioral issues. Rooted in attachment theory and further supported by the premise that the quality of the child-caregiver dyad is paramount to psychological wellbeing, these therapies focus on strengthening this relationship. Literature indicates that insecure or disorganized early attachments adversely affect an individual's lifelong trajectory. These therapies have demonstrated efficacy leading to positive behavioral changes and improved parent-child interactions. The major challenges of clinical practice focused on young children and their families include proper diagnosis and determining the best therapeutic strategy, especially for families who have not benefited from prior interventions. At this time, it is still unclear which therapy is best indicated for which type of patients and it mostly has been driven by convenience and provider preference or training. Further research is required to tailor treatments more successfully to the child's needs.
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Affiliation(s)
- Reem M A Shafi
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Ewa D Bieber
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Julia Shekunov
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Paul E Croarkin
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Magdalena Romanowicz
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
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10
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Lancaster C, Ovrebo E, Zuckerman S. Adoption Counselors' Perspectives of Counseling Postadoptive Families. JOURNAL OF COUNSELING AND DEVELOPMENT 2017. [DOI: 10.1002/jcad.12156] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Chloe Lancaster
- Department of Counseling, Educational Psychology and Research; University of Memphis
| | - Elin Ovrebo
- Department of Counseling, Educational Psychology and Research; University of Memphis
| | - Stephanie Zuckerman
- Department of Counseling, Educational Psychology and Research; University of Memphis
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11
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Hambrick EP, Oppenheim-Weller S, N'zi AM, Taussig HN. Mental Health Interventions for Children in Foster Care: A Systematic Review. CHILDREN AND YOUTH SERVICES REVIEW 2016; 70:65-77. [PMID: 28496286 PMCID: PMC5421550 DOI: 10.1016/j.childyouth.2016.09.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Children in foster care have high rates of adverse childhood experiences and are at risk for mental health problems. These problems can be difficult to ameliorate, creating a need for rigorous intervention research. Previous research suggests that intervening with children in foster care can be challenging for several reasons, including the severity and complexity of their mental health problems, and challenges engaging this often transitory population in mental health services. The goal of this article was to systematically review the intervention research that has been conducted with children in foster care, and to identify future research directions. This review was conducted on mental health interventions for children, ages 0 to 12, in foster care, using ERIC, CINAHL, PsycINFO, PubMed, ProQuest's Dissertation and Theses Database, Social Services Abstracts, and Social Work Abstracts. It was restricted to interventions that are at least "possibly efficacious" (i.e., supported by evidence from at least one randomized controlled trial). Studies were evaluated for risk of bias. Ten interventions were identified, with diverse outcomes, including mental health and physiological. Six interventions were developed for children in foster care. Interventions not developed for children in foster care were typically adapted to the foster context. Most interventions have yet to be rigorously evaluated in community-based settings with children in foster care. Little research has been conducted on child and family engagement within these interventions, and there is a need for more research on moderators of intervention outcomes and subgroups that benefit most from these interventions. In addition, there is not consensus regarding how to adapt interventions to this population. Future research should focus on developing and testing more interventions with this population, rigorously evaluating their effectiveness in community-based settings, determining necessary adaptations, and identifying which interventions work best for whom.
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Affiliation(s)
- Erin P Hambrick
- The Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, Departments of Pediatrics and Psychiatry, University of Colorado - School of Medicine
- University of Denver - Graduate School of Social Work
| | - Shani Oppenheim-Weller
- The Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, Departments of Pediatrics and Psychiatry, University of Colorado - School of Medicine
| | - Amanda M N'zi
- Children's Hospital Colorado, University of Colorado - School of Medicine
| | - Heather N Taussig
- The Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, Departments of Pediatrics and Psychiatry, University of Colorado - School of Medicine
- University of Denver - Graduate School of Social Work
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12
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Greiner MV, Ross J, Brown CM, Beal SJ, Sherman SN. Foster Caregivers' Perspectives on the Medical Challenges of Children Placed in Their Care: Implications for Pediatricians Caring for Children in Foster Care. Clin Pediatr (Phila) 2015; 54:853-61. [PMID: 25561697 DOI: 10.1177/0009922814563925] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To investigate, using qualitative methodology, foster caregivers' perspectives related to the medical needs of children placed in their care. STUDY DESIGN Fifteen foster caregivers were individually interviewed using a semistructured open-ended question guide. Data were coded, and the analysis was conducted in an inductive manner, allowing themes to emerge from the interviews. RESULTS The following 4 themes were identified: (1) the fragmented histories provided to foster caregivers and difficulty in obtaining information; (2) the unique medical complications that children in foster care experience; (3) the difference between "doing what is expected" and becoming a proactive foster caregiver; and (4) the support needs of foster caregivers. CONCLUSIONS Foster caregivers receive insufficient information despite the evidence that these children are likely to have complex needs. It is, therefore, necessary for the pediatrician to recognize existing medical problems, identify new medical problems, educate foster caregivers, and communicate with the multidisciplinary team.
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Affiliation(s)
- Mary V Greiner
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jennifer Ross
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Courtney M Brown
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Sarah J Beal
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Susan N Sherman
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
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13
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Cohen JA, Mannarino AP. Trauma-focused Cognitive Behavior Therapy for Traumatized Children and Families. Child Adolesc Psychiatr Clin N Am 2015; 24:557-70. [PMID: 26092739 PMCID: PMC4476061 DOI: 10.1016/j.chc.2015.02.005] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Trauma-focused cognitive behavioral therapy (TF-CBT) is a family-focused treatment in which parents or caregivers participate equally with their traumatized child or adolescent. TF-CBT is a components-based and phase-based treatment that emphasizes proportionality and incorporates gradual exposure into each component. Child and parent receive all TF-CBT components in parallel individual sessions that enhance skills to help the child recognize and regulate trauma responses, express thoughts and feelings about the child's trauma experiences and master avoidance of trauma memories and reminders. Parental participation significantly enhances the beneficial impact of TF-CBT for traumatized children.
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Affiliation(s)
- Judith A. Cohen
- Department of Psychiatry, Allegheny General Hospital, Drexel University College of Medicine, 4 Allegheny Center, 8 Floor, Pittsburgh, PA 15212,
| | - Anthony P. Mannarino
- Department of Psychiatry, Allegheny General Hospital, Drexel University College of Medicine, 4 Allegheny Center, 8 Floor, Pittsburgh, PA 15212,
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14
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Dorsey S, Pullmann MD, Berliner L, Koschmann E, McKay M, Deblinger E. Engaging foster parents in treatment: a randomized trial of supplementing trauma-focused cognitive behavioral therapy with evidence-based engagement strategies. CHILD ABUSE & NEGLECT 2014; 38:1508-20. [PMID: 24791605 PMCID: PMC4160402 DOI: 10.1016/j.chiabu.2014.03.020] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 03/25/2014] [Accepted: 03/29/2014] [Indexed: 05/03/2023]
Abstract
The goal of this study was to examine the impact of supplementing Trauma-focused Cognitive Behavioral Therapy (TF-CBT; Cohen et al., 2006) with evidence-based engagement strategies on foster parent and foster youth engagement in treatment, given challenges engaging foster parents in treatment. A randomized controlled trial of TF-CBT standard delivery compared to TF-CBT plus evidence-based engagement strategies was conducted with 47 children and adolescents in foster care and one of their foster parents. Attendance, engagement, and clinical outcomes were assessed 1 month into treatment, end of treatment, and 3 months post-treatment. Youth and foster parents who received TF-CBT plus evidence-based engagement strategies were more likely to be retained in treatment through four sessions and were less likely to drop out of treatment prematurely. The engagement strategies did not appear to have an effect on the number of canceled or no-show sessions or on treatment satisfaction. Clinical outcomes did not differ by study condition, but exploratory analyses suggest that youth had significant improvements with treatment. Strategies that specifically target engagement may hold promise for increasing access to evidence-based treatments and for increasing likelihood of treatment completion.
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Affiliation(s)
- Shannon Dorsey
- Department of Psychology, University of Washington, 335 Guthrie Hall, Seattle, WA 98195 USA
| | - Michael D. Pullmann
- Psychiatry and Behavioral Sciences, University of Washington School of Medicine, 2815
| | - Lucy Berliner
- Eastlake Avenue East, Suite 200, Seattle, WA 98102 USA, Harborview Center for Sexual Assault and Traumatic Stress, 401 Broadway, Suite 2027, Seattle, WA 98122 USA
| | - Elizabeth Koschmann
- Department of Psychiatry, University of Michigan Medical School, Rachel Upjohn Building, 4250 Plymouth Rd, Ann Arbor, MI 48108 USA
| | - Mary McKay
- Silver School of Social Work, New York University, 1 Washington Square North, Room 205, New York, NY 10003 USA
| | - Esther Deblinger
- Rowan University, School of Osteopathic Medicine, 42 E. Laurel Road, Stratford, NJ 08084 USA
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Cowart-Osborne M, Jackson M, Chege E, Baker E, Whitaker D, Self-Brown S. Technology-Based Innovations in Child Maltreatment Prevention Programs: Examples from SafeCare®. SOCIAL SCIENCES 2014; 3:427-440. [PMID: 25606347 PMCID: PMC4297664 DOI: 10.3390/socsci3030427] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Each year, hundreds of thousands of children in the U.S. are victims of child maltreatment. Experts recommend behavioral, skill-based parent training programs as a strategy for the prevention of child abuse and neglect. These programs can be enhanced using innovative technology strategies. This paper presents a brief history of the use of technology in SafeCare®, a home visiting program shown to prevent child neglect and physical abuse, and highlights current work that takes a technology-based hybrid approach to SafeCare delivery. With this unique approach, the provider brings a tablet computer to each session, and the parent interacts with the software to receive psychoeducation and modeling of target skills. The provider and parent then work together to practice the targeted skills until mastery is achieved. Initial findings from ongoing research of both of these strategies indicate that they show potential for improving engagement and use of positive parenting skills for parents and ease of implementation for providers. Future directions for technology enhancements in SafeCare are also presented.
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Palinkas LA. Qualitative and mixed methods in mental health services and implementation research. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2014; 43:851-61. [PMID: 25350675 PMCID: PMC4212209 DOI: 10.1080/15374416.2014.910791] [Citation(s) in RCA: 152] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Qualitative and mixed methods play a prominent role in mental health services research. However, the standards for their use are not always evident, especially for those not trained in such methods. This article reviews the rationale and common approaches to using qualitative and mixed methods in mental health services and implementation research based on a review of the articles included in this special series along with representative examples from the literature. Qualitative methods are used to provide a "thick description" or depth of understanding to complement breadth of understanding afforded by quantitative methods, elicit the perspective of those being studied, explore issues that have not been well studied, develop conceptual theories or test hypotheses, or evaluate the process of a phenomenon or intervention. Qualitative methods adhere to many of the same principles of scientific rigor as quantitative methods but often differ with respect to study design, data collection, and data analysis strategies. For instance, participants for qualitative studies are usually sampled purposefully rather than at random and the design usually reflects an iterative process alternating between data collection and analysis. The most common techniques for data collection are individual semistructured interviews, focus groups, document reviews, and participant observation. Strategies for analysis are usually inductive, based on principles of grounded theory or phenomenology. Qualitative methods are also used in combination with quantitative methods in mixed-method designs for convergence, complementarity, expansion, development, and sampling. Rigorously applied qualitative methods offer great potential in contributing to the scientific foundation of mental health services research.
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