Interventions for family members of adolescents with disruptive behavior disorders

Interfamily Therapy, a multifamily therapy model settled in infant-juvenile mental health services of Havana (Cuba): A qualitative study from participants' perspectives

Interfamily therapy (IFT) is a specific model for multifamily therapy (MFT) of recent expansion in Latin American and European countries. In IFT a multifamily group becomes a community of learning where professionals and family members establish collaborative relationships and participate in dialogues. This study used a qualitative phenomenological approach to explore the participants' perspective of 14 members and ex-members of two IFT groups conducted in Infant-Juvenile Mental Health Centers in Havana (Cuba). In this study IFT was well accepted and effective, and it was perceived as beneficial due to its positive influence for participants, with benefits on a personal, family and social level. In addition, participants articulated a series of therapeutic elements of IFT that were essential to promote these benefits. In conclusion, IFT seems to be a useful therapeutic model in the treatment of children, adolescents and their families in a Cuban psychiatric setting.

Conflict Resolution and Emotional Expression in Mother-Preadolescent Dyads: Longitudinal Associations with Children's Socioemotional Development

How youth learn to manage emotions during mother-child conflict influences their socioemotional development. Ninety-four mother-preadolescent (aged 9-13, 57.4% female) dyads were observed during conflict discussions and completed questionnaire measures at one prior time-point (Time 1; ages 6-10) and one subsequent time-point (Time 3; ages 11-16) to the observations (Time 2). The temporal associations between individuals' emotional expressions and their own and their partners' verbal conflict behaviors were observed. Mothers and preadolescents were more attacking and assertive when angry, and more conciliatory and avoidant when sad. Neutral affect predicted the most constructive behaviors, while positive affect promoted avoidance. The responses were similar following their partners' emotions. Maternal conflict-escalating responses to anger were associated with difficult characteristics in earlier childhood and socioemotional difficulties in adolescence. Maternal and child de-escalation following sadness predicted socioemotional adjustment in adolescence. These results demonstrate that conflict resolution between preadolescents and their mothers is influenced by the emotional climate of the interaction, and that the management of negative emotions within the dyad is tied to youth's socioemotional development.

Scene-Based Psychodramatic Family Therapy With Troubled Adolescents and Parents: A Pilot Study

Scene-Based Psychodramatic Family Therapy (SB-PFT) is an innovative treatment used with troubled adolescents and their parents to improve family relationships and reduce adolescents' problematic behavior. It integrates the principles of family therapy, psychodrama, and multiple-family group methodology. This research is a pilot study to obtain empirical evidence on the SB-PFT therapeutic process by gauging the perception of change of troubled adolescents and their parents, and assess the perceived helpfulness of its methodology and techniques. Ten multiple-family intervention groups were drawn up, with 110 participants (63 adolescents and 47 parents), and we adopted a qualitative methodology with focus groups, using an inductive analysis of 290 active constructions of participant narratives. Concerning perception of change, the adolescents reported mainly gaining in social support, prosocial attitudes, keys to problem solving, and expression of emotions due to the treatment. The parents perceived improvement in social support, keys for educational practices, emotional well-being, and expression of emotions due to the treatment. Regarding the perceived helpfulness of methodology and techniques, both adolescents and parents highlighted the usefulness of the group methodology for gaining social support, relativizing the problem, and expressing emotions. Additionally, participants referred to role-playing and mirror techniques as the most useful techniques. In conclusion, this first study on SB-PFT presents and describes its treatment for troubled adolescents and their parents. The participants' positive perception of their personal and relational change after treatment should serve to promote further studies with quantitative methodology in order to verify the effectiveness of SB-PFT treatment.

Effectiveness of Structural⁻Strategic Family Therapy in the Treatment of Adolescents with Mental Health Problems and Their Families

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.

Developing a Multiple Caregiver Group for Caregivers of Adolescents With Disruptive Behaviors

This article describes the development of a 6-week multiple caregiver group intervention for primary caregivers of adolescents diagnosed with Oppositional Defiant Disorder or Conduct Disorder in low-income African American families. The intervention is aimed at increasing the primary caregivers' self-efficacy in managing interactions within the family and especially with child serving educational, mental health, juvenile justice, and child welfare systems. Development of the intervention involved seven iterative activities performed in a collaborative effort between an interdisciplinary academic team, community engagement specialists, members of the targeted population, and clinical partners from a large public mental health system. The intervention development process described in this article can provide guidance for teams that aim to develop new mental health interventions that target specific outcomes in populations with unique needs.

Characteristics of Qualitative Descriptive Studies: A Systematic Review

Qualitative description (QD) is a term that is widely used to describe qualitative studies of health care and nursing-related phenomena. However, limited discussions regarding QD are found in the existing literature. In this systematic review, we identified characteristics of methods and findings reported in research articles published in 2014 whose authors identified the work as QD. After searching and screening, data were extracted from the sample of 55 QD articles and examined to characterize research objectives, design justification, theoretical/philosophical frameworks, sampling and sample size, data collection and sources, data analysis, and presentation of findings. In this review, three primary findings were identified. First, although there were some inconsistencies, most articles included characteristics consistent with the limited available QD definitions and descriptions. Next, flexibility or variability of methods was common and effective for obtaining rich data and achieving understanding of a phenomenon. Finally, justification for how a QD approach was chosen and why it would be an appropriate fit for a particular study was limited in the sample and, therefore, in need of increased attention. Based on these findings, recommendations include encouragement to researchers to provide as many details as possible regarding the methods of their QD studies so that readers can determine whether the methods used were reasonable and effective in producing useful findings. © 2016 Wiley Periodicals, Inc.

Raising the Level of Nursing Involvement in the National Precision Medicine Initiative: An Example

PURPOSE

The Precision Medicine Initiative (PMI) goal of ushering in a new and more effective era of health care that benefits all Americans requires two critical and interdependent components: a cohort assembly of 1 million or more Americans who reflect the diversity of the United States of America and an interdisciplinary workforce that includes nursing. The purpose of this article is to provide an example of nursing involvement in PM, specifically as related to gathering biospecimens (saliva) from vulnerable, understudied adolescents with disruptive behavior disorders and their family members.

SOURCE(S)

First, we provide a brief description of important concepts related to PM as well as current roles of nurses in PM. Then, we share lessons learned from our feasibility study aimed at increasing the diversity of our statewide cohort assembly that has provided biospecimens for the Indiana Biobank.

CONCLUSION

Nurses can definitely contribute to biobanks in support of the PMI. This article is a call to action for nurses to take their rightful place in PM.