System-Level Change in Cultural and Linguistic Competence (CLC): How Changes in CLC are Related to Service Experience Outcomes in Systems of Care

As US demographic trends shift toward more diversity, it becomes increasingly necessary to address differential needs of diverse groups of youth in mental health service systems. Cultural and linguistic competence (CLC) is essential to providing the most appropriate mental health services to youth and their families. The successful implementation of CLC often begins at the system level. Though various factors may affect change and system-level factors set the tone for broad acceptance of CLC within systems, there is limited empirical evidence linking culturally competent practices to outcomes. The purpose of the present study was to examine system-level CLC changes over time within systems of care and their associations with service experiences among youth and their families. Participants were 4,512 youth and their families enrolled in the national evaluation of the Children’s Mental Health Initiative (CMHI). Results suggest that implementation of CLC at the system level improves over time in funded systems of care. Further, variation exists in specific system-level components of CLC. In addition, the changes in CLC at the system level are related to family/caregiver participation in treatment. Implications for supporting positive changes in CLC among systems of care communities, and specific strategies for community psychologists, are discussed.     

Indigenous Healing Practices in Australia

ABSTRACT

Indigenous Australian women are among the most disadvantaged women in the world. Over two centuries of colonization have had a damaging impact on perceptions of their gender roles and status as well as many other consequential oppressions. These experiences have affected the social and emotional wellbeing of Indigenous women of all ages, resulting in socio-economic ghettoization, higher suicide rates, psychological distress, illness, and poverty. Generations of women have experienced the forced removal of their children, resulting in complex forms of historical trauma. Despite this, Indigenous women have also maintained strong leadership roles and have kept families and communities intact. In the last few decades, the Australian Indigenous mental health movement has emerged within the context of a broader self-determination movement, restoring and strengthening women’s traditional therapeutic practices. This article offers an overview of the social and emotional wellbeing of Indigenous women within neocolonial Australia and explores women’s relationship to traditional therapeutic practices. Future directions and key issues for the capacity building of Indigenous women’s healing are explored.     

Tales of the Absent Father: Applying the “Story” Metaphor in Family Therapy

Father-absent families often function with a lively father-presence conveyed by stories the family members share. The metaphor of “story” proposed by social constructionist and narrative approaches to therapy helps us to conceptualize the role these family stories play. The story metaphor draws attention to four issues: the rendition of what is said and unsaid about the father; the connections among past, present, and future ideas about father and family; the reciprocal influences of expression and experience, seen in the family's stories and interactions; and the impact on the family and the therapeutic process of dominant narratives about father-absence. Exploration of these issues demonstrates how client and therapist stories about the absent father mediate the impact of father-absence on the family.     

South African International Migration and its Impact on Older Family Members

In this article, we explore the impact of South African families’ emigration on parents/grandparents who must renegotiate their lives in their loved ones’ physical absence. We adopted a transnational perspective in a bigger qualitative project to consider both sides of the migratory spectrum. Here we focus on elderly family members who remain behind—a group largely neglected in prior research. Our findings illustrate the complex emotions and relational changes experienced by elderly people whose families emigrate. New technologies bridge distances, allowing new ways to connect and take care of each other, and of re-imagining transnational relationships and what constitutes family life, but these bridges cannot negate the loss experienced by those remaining. People have to make sense of the emigration and forge new relational bonds with remaining family members. Our findings stress grandparents’ meaningful role in a family system and highlight some gendered and racial differences in families’ experiences.     

Universal Prevention Exposure as a Moderator of the Community Context: Findings from the PROSPER Project

This study examined how participation in a universal family skills‐building program may interact with community risks and resources to produce youth outcomes. Prior research has noted community‐level variability in risk and protective factors, but thus far no study has examined the role that participation on a community‐wide intervention may play in moderating the effects of community risks or resources. The study included 14 communities (seven in Iowa, seven in Pennsylvania) that implemented a family focused evidence‐based program as part of the PROSPER project. Community level variables included both risk factors (percent of low income families, the availability of alcohol and tobacco, norms regarding adolescent substance use, incidence of drug‐related crimes) and community resources (proactive school leadership, availability of youth‐serving organizations, and student involvement in youth activities). The proximal youth and family outcomes included youth perceptions of their parents’ management skills, parent–child activities, and family cohesion. Results indicated that the Strengthening Families Program:10–14 may have moderated the impact of the community risks and resources on community‐level youth outcomes; risk levels meaningfully associated with community‐level change in program participants, though these results varied somewhat by outcome. Generally, higher levels of resources also meaningfully associated with more positive change after participating in the family‐focused intervention. These results suggest that the effect of some evidence‐based programs may be even stronger in some communities than others; more research in this area is needed.     

When a child comes out in the latter-days: an exploratory case study of Mormon parents

Under the modern gay rights movement, cultural and societal values regarding sexuality, marriage, and family have rapidly evolved while the fundamental doctrine of monogamous, heterosexual marriage espoused by The Church of Jesus Christ of Latter-day Saints has not. Questions arise as to how orthodox Mormon families come to terms with their child coming out in light of the Church’s policy on same-sex marriage and families. This article employs an exploratory case-study method to examine the experience of one such orthodox Mormon family whose child came out as gay. The findings herein suggest that it is possible for families and individuals in these circumstances to develop and maintain loving and supportive relationships in spite of religious differences. These findings better equip academics, professionals, clergy, and families to address the mental health concerns of and create inclusive spaces in families, congregations, and communities for youth who identify as sexual minorities.     

Parent Perspectives on Child Health and Wellbeing in Same-Sex Families: Heteronormative Conflict and Resilience Building

Measurable aspects of child health and wellbeing for children in same-sex parented families show that these children develop well, overall. Increasingly however, it is understood that stigma can have a negative impact on their health within a same sex family context. The aim of this study is to understand how child health in same-sex parented families is constructed by same-sex attracted parents and what this teaches us about the impact of stigma on child health in this context. Families from across Australia were sampled from a larger study of child health and wellbeing. We used family interviews, which took place between January and August 2013. Thematic analysis was used to identify themes. We report on the data from 11 parents with 10 children. Families presented stories of heteronormative conflict that arose from their position in society. Through family constructs, gender assumptions, discrimination and challenging interactions with institutions this heteronormative conflict had a significant influence on child health, sometimes through the generation of broader familial stress. Resilience building was used by parents to construct a positive environment for child health by combating the lack of understanding and discrimination seen at a societal level. Resilience that is developed to combat stigma provides significant benefits, particularly in a heteronormative world where traditional assumptions about families dominate. The anticipation of stigma, and heteronormative pressures, can stimulate same-sex attracted parents to prepare their children for potential negativity. This should be supported through appropriate school programs and considered political leadership.     

Family-Centered Care for Military and Veteran Families Affected by Combat Injury

The US military community includes a population of mostly young families that reside in every state and the District of Columbia. Many reside on or near military installations, while other National Guard, Reserve, and Veteran families live in civilian communities and receive care from clinicians with limited experience in the treatment of military families. Though all military families may have vulnerabilities based upon their exposure to deployment-related experiences, those affected by combat injury have unique additional risks that must be understood and effectively managed by military, Veterans Affairs, and civilian practitioners. Combat injury can weaken interpersonal relationships, disrupt day-to-day schedules and activities, undermine the parental and interpersonal functions that support children’s health and well-being, and disconnect families from military resources. Treatment of combat-injured service members must therefore include a family-centered strategy that lessens risk by promoting positive family adaptation to ongoing stressors. This article reviews the nature and epidemiology of combat injury, the known impact of injury and illness on military and civilian families, and effective strategies for maintaining family health while dealing with illness and injury.     

Parenting after Weight Loss Surgery: A Conceptual Model and Two Case Reports

The ways families approach eating, shape, and weight can result in stress for individual family members and challenge the overall functioning of the family. This is further complicated among families with a parent who has history of obesity or undergone weight loss surgery (WLS). Although WLS can positively impact other family members, it can also exacerbate conflicts regarding feeding and weight. Such conflicts can involve uncertainty regarding the extent to which the entire family should make the dietary changes recommended for the post-WLS parent. Conflict might also center on the appropriate level of concern regarding the children’s risk of developing (or maintaining) obesity. This paper uses two case examples to describe the application of a specialized, time-limited intervention: Parent-Based Prevention following Bariatric Surgery (PBP-B). The program was developed to address the unique challenges and concerns that arise after, or are exacerbated by, WLS. Each detailed case example illustrates a common child-feeding challenge and the employment of key PBP-B strategies throughout the course of treatment. In the first case, the parent who had undergone WLS believed the family’s current eating behaviors were the same as those that had led to her own overeating, obesity, and co-occurring psychiatric symptoms, while her husband disagreed. In the second case, both parents were concerned about their son’s weight, yet due to their prior eating histories, they felt unable to construct boundaries around the feeding experience. Both cases follow families through the entire intervention and illustrate key points and challenges. These cases underscore the need for novel treatment modalities to support families following parental WLS.     

Putting families in the center: family perspectives on decision making and ADHD and implications for ADHD care

Objective: To examine components of family-centered care in families' stories about treatment decision making for their child with ADHD. Method: Twenty-eight families participated in qualitative interviews that addressed families' perspectives on (a) the treatment decision-making process, (b) the cause and impact of their child's symptoms, and (c) treatment goals and preferences. Results: The majority of families preferred to be primary or shared decision makers regarding treatment decisions. Families' perspectives on the cause of the child's symptoms varied and often were not consistent with a biomedical framework. Families described multiple areas of impairment on child, family relationships, and family functioning. Perspectives toward evidence-based treatments were mixed, with families also expressing interest in and pursuing interventions not delineated in current treatment guidelines. Conclusion: These findings reinforce the importance of eliciting families' perspectives and involving these important stakeholders in shared decision making as critical components of family-centered care for children with ADHD.     

歧视知觉、抑郁和农村留守儿童的学业成绩：纵向中介模型

以1147名双亲外出儿童和父亲外出儿童为被试,采用追踪研究设计,探讨了农村留守儿童歧视知觉和学业成绩之间的相互作用关系以及抑郁在其中的中介作用。结果发现:（1）农村留守儿童的学业成绩显著负向预测其随后的歧视知觉,但是歧视知觉不能显著预测其随后的学业成绩;（2）抑郁在留守儿童的学业成绩和歧视知觉之间起着纵向中介作用。这表明,学业成绩是降低留守儿童歧视知觉水平的重要资源,良好的学业成绩不仅可以直接降低农村留守儿童的歧视知觉,而且还能通过降低其抑郁水平来降低农村留守儿童的歧视知觉水平。     

歧视知觉、抑郁和农村留守儿童的学业成绩：纵向中介模型

以1147名双亲外出儿童和父亲外出儿童为被试,采用追踪研究设计,探讨了农村留守儿童歧视知觉和学业成绩之间的相互作用关系以及抑郁在其中的中介作用。结果发现:（1）农村留守儿童的学业成绩显著负向预测其随后的歧视知觉,但是歧视知觉不能显著预测其随后的学业成绩;（2）抑郁在留守儿童的学业成绩和歧视知觉之间起着纵向中介作用。这表明,学业成绩是降低留守儿童歧视知觉水平的重要资源,良好的学业成绩不仅可以直接降低农村留守儿童的歧视知觉,而且还能通过降低其抑郁水平来降低农村留守儿童的歧视知觉水平。     

Those Easily Forgotten: The Impact of Emigration on Those Left Behind

Much has been written about the experiences and stresses of those who emigrate. By contrast, little attention has been paid to the experiences of those who stay behind—family members and friends who for various reasons do not to join their loved ones in the destination country. In this article, I describe the experiences of some South Africans whose families and friends have emigrated. This study forms part of a larger research project focusing on the impact of emigration on South African family life. Twenty‐one participants were interviewed by means of a semistructured interview at least 6 months after one or more family member(s) and/or friend(s) left South Africa, to explore participants’ experiences around their loved ones’ emigration. A thematic analysis of the data reveals that those left behind experience various emotions, ranging from emotional ambivalence to anger and distress. Emigration is mostly experienced as a vast loss, almost akin to a “death,” bringing about significant changes in social networks and relationships. The therapeutic significance of the findings for those working with emigrant families is also explored.     

Preventing School Bullying: Investigation of the Link between Anti‐Bullying Strategies,Prevention Ownership,Prevention Climate,and Prevention Leadership

School bullying has been a major health and safety concern for teachers and students, which calls for effective strategies to address the issue. In this study, we explored individual and organisational factors that improve the effects of teachers’ use of anti‐bullying strategies in reducing or preventing student bullying. Specifically, we examined the moderating role of teachers’ psychological ownership of their school's anti‐bullying system in the relationship between teacher‐reported use of anti‐bullying strategies and student‐reported bullying incidents. We also investigated how principals’ bullying prevention leadership, rated by a group of directors who are the immediate subordinates of these principals, inspires teachers’ psychological ownership of their school's anti‐bullying system through building teachers’ shared perceptions of a bullying prevention climate. Results of multilevel analyses of multisource data from 2,123 teachers, 407 directors, and 15,967 students in 110 junior and senior high schools indicated that the impact of teacher‐reported use of anti‐bullying strategies on student‐reported bullying incidents was strengthened when teachers have a high level of psychological ownership of their school's anti‐bullying system. Further, principals’ bullying prevention leadership was significantly positively related to teachers’ psychological ownership of their school's anti‐bullying system through teachers’ shared perceptions of a bullying prevention climate.     

Leading organizational change in the ‘new’ South Africa

This paper reports on a two‐pronged qualitative research study that used leaders’ life stories and the case research method to understand the leadership of change in 14 South African organizations. We describe how leaders led the changes required to balance the imperatives emanating from South Africa's socio‐political changes and return the country to the international business arena, as well as the challenges created by years of inequality and neglect of the socio‐economic development of the majority of its population. We found that the leaders’ life stories played a significant role in how they perceived and responded to the change situation. Four themes summarizing the actions of the leaders – namely, their efforts to embrace change, to provide hope, to connect change to African values and culture, and to champion diversity – are described. The results of the study suggest that leaders’ life stories can be an important source of information about how they perceive, interpret, and respond to change.     

Community, Culture and Sustainability in Multilevel Dynamic Systems Intervention Science

This paper addresses intertwined issues in the conceptualization, implementation and evaluation of multilevel dynamic systems intervention science (MDSIS). Interventions are systematically planned, conducted and evaluated social science-based cultural products intercepting the lives of people and institutions in the context of multiple additional events and processes (which also may be referred to as interventions) that may speed, slow or reduce change towards a desired outcome. Multilevel interventions address change efforts at multiple social levels in the hope that effects at each level will forge synergistic links, facilitating movement toward desired change. This paper utilizes an ecological framework that identifies macro (policy and regulatory institutions), meso (organizations and agencies with resources, and power) and micro (individuals, families and friends living in communities) interacting directly and indirectly. An MDSIS approach hypothesizes that change toward a goal will occur faster and more effectively when synchronized and supported across levels in a social system. MDSIS approaches by definition involve “whole” communities and cannot be implemented without the establishments of working community partnerships This paper takes a dynamic systems approach to science as conducted in communities, and discusses four concepts that are central to MDSIS—science, community, culture, and sustainability. These concepts are important in community based participatory research and to the targeting, refinement, and adaptation of enduring interventions. Consistency in their meaning and use can promote forward movement in the field of MDSIS, and in community-based prevention science.     

Impact of Ethical Leadership on Organizational Safety Performance: The Mediating Role of Safety Culture and Safety Consciousness

We examined a largely ignored but imperative dimension of safety literature by testing the impact of ethical leadership style on organizational safety performance. We also tested dual mediating paths of safety culture and safety consciousness in the relationship between ethical leadership style and organizational safety consciousness. Data (N = 230) were collected from a large public sector telecom company in Pakistan. Confirmatory factor analysis was used to assess the reliability and validity of the study scales and model fit. Preacher and Hayes’s (2008) macro of mediation was employed to test the direct and indirect paths proposed in the study. The findings suggest that ethical leadership has a positive impact on organizational safety performance. Partial mediating roles of safety culture and safety consciousness were also found between the dependent and independent variables. Theoretical and practical implications are discussed.     

Sustaining and Expanding Systems of Care to Provide Mental Health Services for Children, Youth and Families Across America

The Substance Abuse and Mental Health Services Administration has been instrumental in supporting the development and implementation of systems of care to provide services to children and youth with serious mental health conditions and their families. Since 1993, 173 grants have been awarded to communities in all 50 states, Puerto Rico, Guam, the District of Columbia, and 21 American Indian/Alaska Native communities. The system of care principles of creating comprehensive, individualized services, family-driven and youth-guided care and cultural and linguistic competence, supported by a well-trained and competent workforce, have been successful in transforming the field of children's mental health and facilitating the integration of child-serving systems. This approach has achieved positive outcomes at the child and family, practice and system levels, and numerous articles have been published using data collected from system of care communities, demonstrating the effectiveness of this framework. This article will describe lessons learned from implementing the system of care approach, and will discuss the importance of expanding and sustaining systems of care across the country.     

Comparing Maltreating and Foster Families in Italy

Maltreating and foster families belong to different research areas and have rarely been considered together. This exploratory study compared maltreating and foster families to demonstrate an integrated approach that overcomes the dichotomic view that often separates problematic families from those who have resources. This study had 81 participants: 48 maltreating parents and 33 foster parents and the children who were in foster care. We examined family functioning (FES), adult attachment styles (ASQ) and foster children’s strengths and difficulties (SDQ) in maltreating and foster families to examine the differences and similarities between families. Both types of families had significant differences on the FES and ASQ scales. Maltreating families had a stronger orientation to succeed and a family profile that was more orientated towards independence. Maltreating parents had higher scores on the scale that measured discomfort with closeness than foster families. However, both family types had a high level of confidence. Many foster children had SDQ scores that were in the borderline and problem categories. These components may promote a theoretical view of an integrated model for family and children’s problems that promotes children’s welfare and supports maltreating parents. Practitioners can build on parent’s strengths or protective factors and provide services to address less developed areas.     

Alternative religion kids: spiritual and cultural identity among children and youth involved with new religious movements

ABSTRACT

The term ‘new religious movement’ (NRM) has come to replace the more provocative term ‘cult,’ however this shift of scholarly language has not resulted in a softening of public perception towards those in religious groups perceived as ‘weird’. This perception leaves a distinct mark on the identities of children raised in these communities.Children from alternative and controversial religions comprise a unique subculture.. The experience of growing up in a new religious movement has an important impact on a young person’s cultural and spiritual identity. Drawing on and expanding Useem and Downie’s model of ‘third culture kids’ (TCKs) the model of ‘alternative religion kids’ (ARKs) is developed. It is proposed that ARKs are a subculture in their own right and share a sense of belonging and identity based on their experience of being religious ‘others’. ARKs may be able to connect through a powerful, shared experience not paralleled with other peers.