The cultural preparedness model of aspiration and engagement: understanding the dynamics of integration

This paper uses the cultural preparedness approach to analyse the interface between the aspirations of immigrants and their engagement with systems of the host country. It draws upon interviews with 84 immigrants from 35 developing countries living in 9 high-income countries. Based upon Edmund Husserl’s hermeneutical phenomenology, two studies are presented to understand the disturbance of equilibrium in cultural preparation status experienced by immigrants as they try to find their way in a host country. Aspiration-Engagement themes and responses to the challenges of integration are discussed. A model of aspiration and engagement based on the cultural preparedness approach is proposed as a framework that guidance and counselling workers could use to help immigrants optimise their engagement with the systems of the host country.     

Adaptation of parent-child interaction therapy for Puerto Rican families: a preliminary study

This study examines how parent-child interaction therapy (PCIT) was adapted for Puerto Rican parents of children aged 4-6 with hyperactivity and other significant behavior problems. Four steps were followed: (1) translation and preliminary adaptation of the treatment manual, (2) application of the treatment to 9 families as part of an exploratory study using repeated measures, (3) treatment revision and refinement, and (4) in-depth interviews with parents (n=15) and clinical psychologists (n=5) from Puerto Rico who provided feedback on treatment process and components. Throughout this process, cultural elements and modifications were recommended to be incorporated into the treatment protocol. Both quantitative and qualitative results suggest that PCIT seems to be an acceptable intervention for this population, with some minor changes. Parents reported a high level of satisfaction, a significant reduction in children's externalizing behavior problems, and reduction of parenting stress and improvement in their parenting practices. Psychologists also evaluated positively the treatment protocol and recommended its use. Results from this study may inform clinicians and researchers who work with Latino families about relevant issues to be considered to promote their participation in behavioral family interventions and to enhance their acceptability and effectiveness.     

Intervention development and cultural adaptation research with diverse families

This article provides an introduction to the special issue on intervention development and cultural adaptation research with diverse families. The need for research on intervention development and on cultural adaptation of interventions is presented, followed by a discussion of frameworks on treatment development. Seven articles included in this special issue serve as examples of the stages of treatment and intervention development, and of the procedures employed in the cultural adaptation with diverse families. An overview of the seven articles is provided to illustrate the treatment development process and the use of pluralistic research methods. We conclude with a call to the field for creative and innovative intervention development research with diverse families to contribute to the body of evidence-based practice with these populations.     

Virtualizing intimacy: information communication technologies and transnational families in therapy

Information communication technologies (ICTs) are a ubiquitous feature of immigrant family life. Affordable, widely accessible, and highly adaptable ICTs have transformed the immigrant experience into a transnational process with family networks redesigned but not lost. Being a transnational family is not a new phenomenon. Transnationalism, however, has historically been reserved for the wealthier professional and political immigrant class who were able to freely travel and use expensive forms of communication before the emergence of accessible technologies. This paper systematically reviews the research literature to investigate the potential impact of ICTs on the lives of transnational families and how these families utilize them. The wide penetration of ICTs also puts into question some of the ways in which scholars have conceptualized the immigrant experience. The appropriate use of technology in family therapy should strengthen culturally competent and equity-based approaches to address the needs of these families. A family therapy with a transnational family illuminates some of the potential that these technologies introduce in the practice of relational clinicians.     

Electrodermal conditioning to stimuli of evolutionary significance: Failure to replicate the preparedness effect

In the present study, an attempt was made to replicate the preparedness effect reported by Öhman, Fredrickson, Hugdahl, & Rimmö (1976). Following Öhman et al. (1976) as closely as possible, a differential conditioning procedure was carried out in which subjects'skin conductance responses (SCRs) were conditioned either to stimuli of evolutionary significance (slides of snakes and spiders) or to evolutionally neutral stimuli (slides of mushrooms and flowers). The experiment consisted of 8 habituation, 12 acquisition, and 20 extinction trials. Electric shock served as an unconditioned stimulus during the acquisition phase. Although SCRs showed significant decreases during habituation and were significantly influenced by the conditioning procedure during acquisition, they were not found to extinguish significantly more slowly in the group that saw slides of snakes and spiders. This result contradicts the earlier results reported by Öman and colleagues. Possible explanations for this failure to replicate their results are discussed.     

Dark Side of the Mothering Role: Abuse of Mothers by Adolescent and Adult Children

Mothering is generally considered women’s major source of identity and satisfaction. But mothering can also bring misery when children develop anti-social behaviors. The rather limited literature on this topic refers to by the term “parent abuse,” with mothers reportedly the usual victims. The present study analyzed the types of abuse by adolescent and adult children reported by women in a community sample. The data come from in-depth life review interviews with 60 women aged between 40 and 65 when initially interviewed, and re-interviewed 5 years later. All women lived in the lower-income western suburbs of Sydney, Australia. Two major categories of abuse were identified: acting-out (including physical attacks and threats) and psychological. Seventy percent of perpetrators were male. Mothers’ explanations for the behavior included family dysfunction, child’s personality, child’s mental illness, social and cultural influences, and gender power imbalance. Strategies used to handle the behaviors were related to these explanations. Compared to older mothers, those aged in their 40s were likely to see the problem as belonging to the child rather than themselves, and were more proficient in accessing community services.     

Disability and disasters: the role of self-efficacy in emergency preparedness

Although individuals with physical disabilities have special needs regarding preparedness for a natural or human-made disaster, little is known about the factors involved in motivating members of this population to engage in behaviors which reduce the probability of negative health outcomes. This study proposes and empirically tests an integrated theory-based model for individuals with physical disabilities in which perceived self-efficacy for emergency preparedness moderates the relationship between perceived threat and emergency preparedness behaviors. A nationwide convenience cross-sectional sample of 294 adults self-identifying as having a physical disability completed an online survey. The general linear model was used to assess the effects on preparedness of perceived threat, perceived self-efficacy, and their interaction. In addition to the hypothesized moderating effect of self-efficacy, it was found that minimal (if any) relationship exists between perceived threat and preparedness among those who reported low levels of self-efficacy. Results suggest that self-efficacy and perceived threat operate jointly to motivate individuals with physical disabilities to take precautionary steps to reduce the consequential adverse health effects of natural and human-made disasters. These findings have important implications for the design of effective interventions for individuals with disabilities.     

Correlates of household smoking bans in low-income families of children with and without asthma

Exposure to secondhand smoke (SHS) harms all children's health, especially children with asthma. Yet, children with asthma are as likely to live with smokers as healthy children. Household smoking bans are being advocated to reduce children's harm from SHS. To measure the effect of household smoking bans on child SHS exposure and to examine correlates of strict smoking bans in a low-income, diverse sample, 91 children with asthma were matched to 91 healthy children. All had at least one smoker living in their homes. Nicotine dosimeters, child cotinine assays, and maternal reports quantified child SHS exposures. Maternal reports of household smoking rules, behaviors, and beliefs, and other family characteristics were also gathered. The presence of a strict household smoking ban vastly reduced children's SHS exposures and was associated with fewer cigarettes smoked by the mother and by other family members, the belief that SHS was a personal health risk, having children with asthma, and living in a single-family home. Many children are exposed to high levels of SHS at home. Strict household smoking bans greatly decrease, but do not eliminate children's SHS exposure. Even in disadvantaged families, mutable factors were associated with strict smoking bans. Increased dissemination and use of established public health strategies are needed to reduce children's SHS exposures.     

The social and communication impact of stuttering on adolescents and their families

Purpose

Stuttering can cause wide ranging psychosocial impact. This is particularly the case for adolescents who may face additional physical, emotional and personality changes as they become adults. This study reports the findings of an investigation into the social and communication impacts of stuttering on Australian adolescents seeking treatment for stuttering and their families.

Method

A cross-sectional design utilising questionnaires assessed the self-perceived communication competence and apprehension, stigma and disclosure, and experiences of teasing and bullying of 36 adolescents who stutter. Additionally, the impact of stuttering on the families of these adolescents was investigated.

Results

Adolescents who stutter have below average self-perceived communication competence, heightened communication apprehension, are teased and bullied more often than fluent peers, and they try to keep their stuttering secret. The families of the adolescents in the study reported high levels of emotional strain, family conflict and difficulty managing their child's frustrations.

Conclusion

The findings from this study emphasise the wide-ranging impact of stuttering beyond the surface level behaviours. Clinicians working with adolescents who stutter should take note of both the outcomes of this study and the suggestions for more effectively coping with the condition in this population.Educational objectives: The reader will be able to: (a) summarise findings with regards to the impact of stuttering on an adolescent's social and communication skills; (b) summarise areas of impact on the families of adolescents who stutter; (c) compare these findings with previous reported data for this population; (d) discuss the clinical implications of the results for working with adolescents who stutter and their families.     

Many stimuli are frightening,but some are more frightening than others: The contributions of preparedness,dangerousness, and unpredictability to making a stimulus fearful

The nonrandom distribution of situational fears has been explained by evolutionary survival relevance of specific fears. Thirty-eight stimuli were taken from the literature on preparedness and were scored on fearfulness, objective dangerousness, and spatiotemporal unpredictability by three separate groups of students. The same items were scored on survival relevance by 15 biologists. Fearfulness of cues significantly correlated not only with survival relevance but also, and even more strongly, with dangerousness and unpredictability. While the fear/survival relevance association virtually disappeared when the unpredictability contribution was partialed out, the fear/unpredictability correlation was only marginally affected when controlling for survival relevance. This suggests that nonrandomness of feared stimuli may result from the spatiotemporal unpredictability that is attributed to these stimuli. The current practice of using snakes and spiders as phobia-relevant, and flowers and mushrooms as neutral, cues was not justified by the ratings of the 15 independent experts.This study was supported in part by a grant from the Dutch Organization for Fundamental Research (ZWO/Psychon, 560-268-001).     

Parent-Child Interaction Therapy for Puerto Rican Preschool Children with ADHD and Behavior Problems: A Pilot Efficacy Study

This study evaluates the initial efficacy of the Parent-Child Interaction Therapy (PCIT) for Puerto Rican preschool children aged 4–6 years with a diagnosis of attention-deficit/hyperactivity disorder (ADHD), combined or predominantly hyperactive type, and significant behavior problems. Thirty-two families were randomly assigned to PCIT ( n =20) or a 3.5-month waiting-list condition (WL; n =12). Participants from both groups completed pretreatment and posttreatment assessments. Outcome measures included child's ADHD symptoms and behavior problems, parent or family functioning, and parents' satisfaction with treatment. ANCOVAs with pretreatment measures entered as covariates were significant for all posttreatment outcomes, except mother's depression, and in the expected direction ( p <.01). Mothers reported a highly significant reduction in pretreatment hyperactivity and inattention and less aggressive and oppositional-defiant behaviors, conduct problems assessed as problematic, parenting stress associated with their child's behavior, and an increase in the use of adequate parenting practices. For the WL group, there were no clinically significant changes in any measure. Treatment gains obtained after treatment were maintained at a 3.5-month follow-up assessment. PCIT seems to be an efficacious intervention for Puerto Rican families who have young children with significant behavior problems.     

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.     

Supporting families of transgender children/youth: Parents speak on their experiences,identity, and views

ABSTRACT

Background: Transgender children/youth demonstrate the best possibility for resilience and positive mental health when they are part of an affirming and supportive family. To optimize families in supporting transgender children/youth, parents/caregivers need to be supported. Transgender children/youth and their families regularly navigate a myriad of challenges through society.

Aims: Within the extant literature on transgender children and youth, relatively little attention is focused on the experiences of parents/caregivers and how their close family relationships are affected. The present qualitative study addresses this gap in knowledge through its exploration of the experiences, identities, and views of parents/caregivers of transgender children/youth.

Method: The study is longitudinal and this article represents the first wave. Fourteen parents of 12 transgender children/youth, aged 6–17, participated in in-depth semistructured interviews. Participants were recruited via social media and at an on-site conference for transgender youth and their families. All children/youth had socially transitioned. Those who were eligible for puberty suppression and/or hormone therapy were receiving those. The interviews were inductively coded for themes by two coders using the constant comparative method.

Results: Participants' reports on their experiences yielded three themes: (1) transgender issues as the family's focus; (2) proactivity, child-focused: preemptive actions to prevent adverse consequences; and (3) self-care. These themes included subthemes on effective coping strategies to mitigate struggles. Three themes related to participants' identity and views emerged: (1) identity reformation, (2) self-evaluation, and (3) views of future. These themes included subthemes that reflected how participants viewed themselves, their child, and the future.

Discussion: A transgender identity in one family member affects all household members. Parents/guardians may experience guilt and self-doubt over decisions. Factors that may improve outcomes with extended family and schools include families' preemptive dissemination of information on transgender identities and explicating expectations of respect and nonintrusion. Ingrained traditions may force life-altering decisions.     

The influence of "preparedness" on autoshaping, schedule performance, and choice.

Two groups of experimentally naive pigeons were exposed to an autoshaping procedure in which the response key was mounted on the wall (the conventional location) or on the floor of the chamber. In two experiments, subjects readily responded to the wall key, but floor-key subjects required shaping. A subsequent experiment compared performance of wall- and floor-key groups on an ascending series of fixed-ratio schedule values, resistance to extinction, differential reinforcement of other behavior, and reversal of key assignment. Each experiment was followed by several sessions of fixed-ratio training; the performance of the wall- and floor-key groups was almost identical throughout. In the final experiment, a fixed-ratio requirement could be completed on either or both keys. Birds initially chose the key on which they had responded during the preceding (reversal of key assignment) experiment. However, within a few sessions both groups showed almost exclusive preference for the floor key. Preference for a key located on the floor may follow from the fact that pigeons are ground feeders and may thus be more "prepared" to peck the floor than to peck a wall. However, autoshaping, under the conditions prevailing here, occurred much more readily to the wall key, suggesting that pecking a vertical surface is more highly prepared. Difficulties in determining relative preparedness seem moot, however, given the lack of between-group differences in the intervening experiments. It is thus unlikely that schedule performances critically depend upon the specific operant response involved.     

Systems of Care: New Partnerships for Community Psychology

For almost two decades, the federal government has supported the development of integrated models of mental health service delivery for children and families, known as systems of care (SOCs), that strive to be child-centered, family-focused, community-based, and culturally competent. These efforts align well with the values and principles (e.g., empowerment, collaboration, strengths emphasis, focus on macro-level social/system change) central to community psychology (CP; Kloos et al. in Community psychology, Cengage Learning, Belmont, 2012). Despite the convergence of many core values, CPs have historically been underrepresented in key roles in SOC initiatives. However, this has changed in recent years, with increasing examples of community psychology skills and principles applied to the development, implementation, and evaluation of SOCs. Because successful and sustainable implementation of SOCs requires community and system-level change, and SOCs are increasingly being urged to adopt a stronger "public health" orientation (Miles et al. in A public health approach to children's mental health: a conceptual framework, Georgetown University Center for Child and Human Development, National Technical Assistance Center for Children's Mental Health, Washington, DC, 2010), there is great potential for CPs to play important roles in SOCs. This paper discusses opportunities and roles for CPs in SOCs in applied research and evaluation, community practice, and training.     

Attentional bias toward fear-related stimuli: an investigation with nonselected children and adults and children with anxiety disorders

Research investigating anxiety-related attentional bias for emotional information in anxious and nonanxious children has been equivocal with regard to whether a bias for fear-related stimuli is unique to anxious children or is common to children in general. Moreover, recent cognitive theories have proposed that an attentional bias for objectively threatening stimuli may be common to all individuals, with this effect enhanced in anxious individuals. The current study investigated whether an attentional bias toward fear-related pictures could be found in nonselected children (n=105) and adults (n=47) and whether a sample of clinically anxious children (n=23) displayed an attentional bias for fear-related pictures over and above that expected for nonselected children. Participants completed a dot-probe task that employed fear-related, neutral, and pleasant pictures. As expected, both adults and children showed a stronger attentional bias toward fear-related pictures than toward pleasant pictures. Consistent with some findings in the childhood domain, the extent of the attentional bias toward fear-related pictures did not differ significantly between anxious children and nonselected children. However, compared with nonselected children, anxious children showed a stronger attentional bias overall toward affective picture stimuli.     

Threat interpretation in anxious children and their mothers: comparison with nonclinical children and the effects of treatment

Interpretation biases towards threat play a prominent role in cognitive theories of anxiety, and have been identified amongst highly anxious adults and children. Little is known, however, about the development of these cognitive biases although family processes have been implicated. The current study investigated the nature of threat interpretation of anxious children and their mothers through (i) comparison of a clinic and non-clinic population, (ii) analysis of individual differences; and (iii) pre- and post-treatment comparisons. Participants were 27 children with a primary anxiety disorder and 33 children from a non-clinic population and their mothers. Children and mothers completed self-report measures of anxiety and indicated their most likely interpretation of ambiguous scenarios. Clinic and non-clinical groups differed significantly on measures of threat interpretation. Furthermore, mothers' and children's threat interpretation correlated significantly. Following treatment for child anxiety, both children and their mothers reported a reduction in threat interpretation.