1
|
Zeanah PD, Steier A, Lim I, Korfmacher J, Zeanah CH. Current approaches and future directions for addressing ethics in infant and early childhood mental health. Infant Ment Health J 2023; 44:625-637. [PMID: 37483087 DOI: 10.1002/imhj.22077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 07/25/2023]
Abstract
In this paper, we consider whether the field of infant and early childhood mental health (IECMH) needs its own code of ethics. We begin by describing unique features of infant and early childhood mental health (IECMH) and the diverse strategies that the field has developed to address complex clinical dilemmas, among them workforce development, clinical supports, policy statements, and statements of ethical values. Because of the field's interdisciplinary nature, we also consider how various contributing professions and organizations address ethical issues. While these are important resources that can inform ethical decision-making, we identify some of the limitations of the current approaches. We argue that it is time for the field of IECMH to take an intentional, systematic approach to directly address the complex and unique ethical dilemmas faced by infant and early childhood mental health practitioners, and we grapple with some of the challenges developing such a code might entail. We suggest several avenues for better understanding the scope of ethical issues and ethical decision-making processes in IECMH that could be used to support developing an ethics code that is responsive to the unique and challenging world of infant and early childhood mental health.
Collapse
Affiliation(s)
- Paula D Zeanah
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | | | - Izaak Lim
- Early in Life Mental Health Service, Monash Health and the Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia
| | - Jon Korfmacher
- Chapin Hall Institute, University of Chicago, Chicago, Illinois, USA
| | - Charles H Zeanah
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
| |
Collapse
|
2
|
Raudenska J, Gumančík J, Raudenský M, Pasqualucci A, Moka E, Varrassi G, Paladini A, Javurkova A. Cognitive-Behavioral Play Therapy and COVID-19 Pandemic Trauma in Preschool Children. Cureus 2023; 15:e44249. [PMID: 37772203 PMCID: PMC10524805 DOI: 10.7759/cureus.44249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 08/28/2023] [Indexed: 09/30/2023] Open
Abstract
Traumatic life events, such as the ongoing COVID-19 pandemic, can be a challenging health emergency, among others. The pandemic can also affect young preschoolers. They can experience negative emotions and behavioral and social difficulties. It can be hard for children to understand on their own what is going on, as well as for their families. This narrative review summarizes the role of psychotherapeutic approaches in working with trauma and aims to manage trauma, such as COVID-19, in preschool children. It focuses on the possibilities of applying cognitive-behavioral play therapy (CBPT) in preschool children who suffer from trauma during the COVID-19 pandemic period. The therapeutic approaches are tailored to specific development in preschoolers. Furthermore, the article provides insights into the relationship between negative emotions, thinking, and behavior, and COVID-19 as a threat, by describing a cognitive model in preschool-aged children. Finally, the article offers possible ways of applying play-based cognitive-behavioral therapy programs in preschool children who are victims of trauma.
Collapse
Affiliation(s)
- Jaroslava Raudenska
- Department of Nursing, Second Medical Faculty of Charles University, Prague, CZE
| | - Jiří Gumančík
- Department of Psychology, Faculty of Health and Life Sciences, University of Northumbria in Newcastle, Newcastle upon Tyne, GBR
| | | | - Alberto Pasqualucci
- Department of Anesthesia and Critical Care, University of Perugia, Perugia, ITA
| | - Eleni Moka
- Department of Anesthesiology, Creta InterClinic, Heraklion, GRC
| | | | - Antonella Paladini
- Department of Life, Health and Environmental Sciences (MESVA), University of L'Aquila, L'Aquila, ITA
| | - Alena Javurkova
- Department of Clinical Psychology, University Hospital Královské Vinohrady, Prague, CZE
- Department of Nursing, Second Medical Faculty of Charles University and Motol University Hospital, Prague, CZE
| |
Collapse
|
3
|
Lowell AF, Suchman NE, Byatt N, Feinberg E, Friedmann PD, Peacock-Chambers E. Parental substance use and home visiting programs: Implementation considerations for relationship-based treatment. Infant Ment Health J 2023; 44:166-183. [PMID: 36859776 PMCID: PMC10050092 DOI: 10.1002/imhj.22041] [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: 05/31/2022] [Accepted: 01/03/2023] [Indexed: 03/03/2023]
Abstract
Home visiting programs can provide critical support to mothers in recovery from substance use disorders (SUDs) and young children prenatally exposed to substances. However, families impacted by maternal SUDs may not benefit from traditional child-focused developmental home visiting services as much as families not impacted by SUDs, suggesting the need to adjust service provision for this population. Given the need to implement tailored services within home visiting programs for families impacted by SUDs, we sought to investigate the implementation barriers and facilitators to inform future integration of a relationship-based parenting intervention developed specifically for parents with SUDs (Mothering from the Inside Out) into home visiting programs. We conducted nine interviews and five focus groups with a racially diverse sample (N = 38) of parents and providers delivering services for families affected by SUDs in the USA. Qualitative content analysis yielded three most prominent themes related to separate implementation domains and their associated barriers and facilitators: (1) engagement, (2) training, and (3) sustainability. We concluded that the home visiting setting may mitigate the logistical barriers to access for families affected by SUDs, whereas relationship-based services may mitigate the emotional barriers that parents with SUDs experience when referred to home visiting programs.
Collapse
Affiliation(s)
- Amanda F. Lowell
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Nancy E. Suchman
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Nancy Byatt
- Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Emily Feinberg
- Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Peter D. Friedmann
- Department of Medicine, University of Massachusetts Chan Medical School-Baystate, Springfield, Massachusetts, USA
| | - Elizabeth Peacock-Chambers
- Department of Pediatrics, University of Massachusetts Chan Medical School-Baystate, Springfield, Massachusetts, USA
- Department for Healthcare Delivery and Population Science, Springfield, Massachusetts, USA
| |
Collapse
|
4
|
Abstract
PURPOSE OF REVIEW As maternal mortality climbs in the USA with mental health conditions driving these preventable deaths, the field of reproductive psychiatry must shift towards identification of women and other birthing individuals at risk and facilitating access. This review brings together recent studies regarding risk of perinatal depression and highlights important comorbidities that place individuals at higher vulnerability to poor perinatal outcomes. RECENT FINDINGS Recent research suggests that identifying risk for perinatal depression including historical diagnoses of depression, anxiety, trauma, and comorbid substance use and intimate partner violence may move the field to focus on preventive care in peripartum populations. Emerging data shows stark health inequities in racial and ethnic minority populations historically marginalized by the health system and in other vulnerable groups such as LGBTQ+ individuals and those with severe mental illness. Innovative models of care using systems-level approaches can provide opportunities for identification and risk analyses of vulnerable peripartum patients and facilitate access to therapeutic or preventive interventions. Utilizing intergenerational approaches and leveraging multidisciplinary teams that thoughtfully target high-risk women and other birthing individuals could promote significant changes to population-level care in maternal health.
Collapse
|
5
|
Abstract
PURPOSE OF REVIEW This review describes clinical management of early-onset severe obesity, defined here as severe obesity in children ≤ 5 years old. It summarizes current information regarding (1) assessment, specifically growth, genetics, cardiometabolic risk, health behaviors, developmental considerations, and psychosocial factors, and (2) treatment, focusing on lifestyle modification including parent training and a brief summary of pharmacotherapy. RECENT FINDINGS Prevalence of severe obesity in young children has remained stable yet most of these children will become adults with obesity. Interventions that address multiple health domains, such as eating habits, physical activity, and parenting skills, are necessary for addressing early-onset severe obesity. Research into pharmacotherapy remains limited but may provide future strategies for management. Early-onset severe obesity significantly influences children's long-term health and management should focus on intervention to promote BMI reduction. Further research into effective strategies is necessary to address the needs of this high-risk population.
Collapse
Affiliation(s)
- Sarah Raatz
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, USA
- Center for Pediatric Obesity Medicine, University of Minnesota, Minneapolis, USA
| | - Amy C Gross
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, USA.
- Center for Pediatric Obesity Medicine, University of Minnesota, Minneapolis, USA.
- , Minneapolis, USA.
| |
Collapse
|
6
|
Navsaria N, Hawkey EJ, Whalen BM, Galvin K. Using social and emotional learning paradigms to inform a therapeutic intervention for preschool-aged children and their parents. EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2020. [DOI: 10.1080/17405629.2020.1811085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Neha Navsaria
- Division of Child & Adolescent Psychiatry, Washington University School of Medicine, Saint Louis, MO, USA
| | - Elizabeth J. Hawkey
- Department of Psychological & Brain Sciences, Washington University in St. Louis, Saint Louis, MO, USA
| | - Blair M. Whalen
- George Warren Brown School of Social Work, Washington University in St. Louis, Saint Louis, MO, USA
| | - Kathryn Galvin
- George Warren Brown School of Social Work, Washington University in St. Louis, Saint Louis, MO, USA
| |
Collapse
|