Multiple family groups for adult cancer survivors and their families: a 1-day workshop model

With marked advances in early detection and aggressive multimodality treatment, many adult cancers are now associated with good prognoses for disease-free survival. A burgeoning literature examining posttreatment quality-of-life issues has highlighted the numerous challenges experienced by patients and families in the aftermath of cancer treatment, further underscoring a need for new family-based psychosocial support interventions for cancer survivors and their families. This paper describes the clinical protocol for one such intervention, a 1-day "workshop" version of a multiple family group (MFG) for head and neck cancer survivors and their families. Data are reported from our experiences in running five 1-day workshops. Families uniformly reported that they were highly satisfied with their MFG participation, leading us to conclude that the abbreviated 1-day MFG model we are advocating is a promising family-focused support intervention for cancer survivors and their families.     

Elucidating the psychosocial context of ‘post‐concussion syndrome’ (PCS): a case study from post‐Milan systemic family therapy

The literature on post‐concussion syndrome (PCS) following mild head injury includes biopsychosocial formulations. However, it is contended that the complexities of the psychosocial remain conceptually underdeveloped. An engagement with this complexity is presented via a case study from post‐Milan systemic family therapy. The work described is with grandparents, a mother and daughter. The latter two both initially experienced PCS following a road traffic accident, yet demonstrated contrasting outcomes in the year post‐injury. Implications for family therapy services and the wider literature are discussed.     

School‐based humanistic counselling for psychological distress in young people: A practice research network to address the attrition problem

Aims: School‐based humanistic counselling (SBHC) is a common psychological intervention for young people, particularly in the UK. However, studies have tended to suffer from high attrition rates, such that effects may have been over‐estimated. This paper describes a low budget ‘star topology’ practice research network (PRN) outcome evaluation of SBHC in a sample where attrition rates were minimised. Design: A practice‐based longitudinal study in a small PRN compared levels of psychological distress at first and last session from session‐by‐session data. Multilevel regression modelling was used to identify predictors of outcomes. Methods: Eight counsellors working across 11 schools agreed to use session‐by‐session self‐rating on the Young Person's CORE (YP‐CORE) yielding data from 256 young people aged 11 to 17. Predictors of outcomes were analysed using multilevel regression analysis. Results: Mean levels of distress on the YP‐CORE reduced from 18.29 (SD = 7.32) at baseline to 9.10 (SD = 6.19) at endpoint, giving a baseline to endpoint effect size of 1.26 (95% CI = 1.06–1.46). Lower levels of psychological distress at endpoint were associated with male clients, younger age groups, greater rates of attendance at counselling, and bereavement as a presenting problem. Conclusions: This ‘star topology’ PRN focused on a single study and demonstrated that such a system can provide relatively low cost, high quality data. The data showed that SBHC is associated with large reductions in psychological distress, and that this cannot be attributed to the high attrition rates of previous datasets.     

A pilot study of a family‐focused intervention for children and families affected by maternal depression

A non‐experimental pilot study examined child, mother and family outcomes of a 10‐session multi‐family group intervention designed to reduce risk and promote resilience for mothers with depression and their families. Positive changes following the Keeping Families Strong intervention included mother‐reported decreases in child behaviour and emotional problems, improvements in the quality of family interactions and routines and improvements in their own well‐being and support from others. Children (9–16 years) reported decreased internalizing symptoms, improved coping, increased maternal warmth and acceptance and decreased stressful family events. Attendance and mother‐reported satisfaction were high, indicating the perceived value of the intervention.     

Balance between volunteer work and family roles: Testing a theoretical model of work‐family conflict in the volunteer emergency services

Trends indicate overall declines in numbers of volunteer emergency service workers and suggest negative organisational factors impacting adversely on volunteers and organisations. Conflict between emergency service work and family is implicated in falling volunteer numbers, and there is thus a need for research on difficulties experienced in balancing volunteer work and family. The current study tested an adaptation of the work‐family conflict (WFC) model originally proposed by Frone, Russell, and Cooper, in a sample of 102 couples in which one partner was an Australian emergency service volunteer. Results supported a model in which volunteer work‐related antecedents, including time invested in on‐call emergency activities and post‐traumatic stress symptoms, had indirect links with outcomes, including volunteer burnout and their partners' support for the volunteer work role, through the effects of WFC. These results add to research using theoretical models of paid work processes to better understand the problems faced by volunteer workers, and identify specific antecedents and outcomes of WFC in the volunteer emergency services. Implications for future research and organisations reliant on volunteer workers are discussed.     

Aggression inhibition in high‐ and low‐risk subjects for child physical abuse: effects of a child's hostile intent and the presence of mitigating information

Exposure of an aggressor to the suffering of his/her victim generally inhibits subsequent attacks [e.g. Baron, 1971a] presumably because of an empathic process. Physically abusive parents and individuals at high risk for child physical abuse are thought to present a deficit in empathy [e.g. Milner, Halsey and Fultz, 1995]. The present research was designed to investigate whether high‐risk, compared to low‐risk, subjects for child physical abuse select more aggressive responses and aggress with more intensity toward a supposed child whose behavior is adequate, inadequate or ambiguous in the presence of the child's pain cues. A second objective was to explore whether high‐risk, compared to low‐risk, subjects for child physical abuse fail to adequately integrate mitigating information and, therefore, do not inhibit their aggressive behavior following the receipt of mitigating information before or during an inadequate child behavior. Participants were engaged in an experimental task that involved attempting to teach a child how to proceed accurately through a computer‐displayed maze and were given the opportunity to send positive (pleasant sounds and happy faces) and negative feedback (mad faces and unpleasant sounds) to the child. Two hundred and fifty undergraduate students participated in the experiment. A 2 × 5 factorial design based on two levels of the participant's risk status (high, low) and five conditions based on the child's behavior and the introduction of mitigating information was employed. As expected, low‐risk, compared to high‐risk, subjects showed less aggression when mitigating information was provided. Aggr. Behav. 32:1–15, 2006. © 2006 Wiley‐Liss, Inc.     

Improving partnerships with families and carers in in‐patient mental health services for older people: a staff training programme and family liaison service

In spite of policies advocating the involvement of families in the care of mental health service users in the UK, there are few examples of initiatives to develop staff confidence and skills in partnership working. This article describes a whole team training initiative and family liaison service to promote family inclusive working on in‐patient wards for older people in Somerset, UK. A three‐day staff‐training programme is described and training outcomes are reported. Staff report a substantial increase in confidence and family meetings held. A pre‐and post‐ training case note audit shows increased consideration of the needs of families. To further increase face to face meetings with families a family liaison service has been established, whereby a staff member with systemic family therapy training joins ward staff to hold family meetings as part of the assessment/admission process. Evaluation of this service has shown it to be effective with positive feedback from families and staff.