Mothers continuing bonds and ambivalence to personal mortality after the death of their child--an interpretative phenomenological analysis

The main objective of this study was to identify how bereaved mothers describe their coping strategies in their own words. The literature on parental bereavement is sparse, and the present study aims to add to existing knowledge by eliciting the mothers' experiences covering a wide range of child ages including infants, younger children and adults. Semi-structured interviews were held with 13 bereaved mothers in the UK. Causes of death include accident, illness and suicide. The methodological approach was interpretative phenomenological analysis (IPA). This article reports two inter-related recurrent themes: (1) Continuing the bond with the deceased child and (2) Ambivalence to personal mortality. Participants reported that the relationship with their child was continued in a variety of ways, from tending to the grave and the child's remains, through linking objects or by establishing a symbolic representation of the child within their daily lives. All mothers talked openly about their own mortality, either demonstrating ambivalence about their own death, or expressing clear suicidal ideation. Death was seen as a release from living with the pain of loss. The presence of surviving siblings appeared to moderate suicidal ideation, but mothers expressed concerns about their ability to care adequately for other family members during times of intense grief.     

Lived experiences of school-going early mothers in Swaziland

This study explored the lived family and community experiences of Swazi school-going early mothers (N = 15; age range 13–22 years). Participants responded to family and community relationship experiences focus group discussions. The data were content thematically analysed. The findings suggest that early mothers experience strained relationships with their fathers, and receive emotional and material support from their mothers. The young mothers perceived themselves to be discriminated against by teachers in educational support. Early motherhood appeared to cause feelings of happiness, regret and anxiety in many, and a personal sense of satisfaction and accomplishment in some.     

The value tensions in Korean–American mother–child relationships while facilitating academic success

The current study explored mothers’ perspectives concerning their experiences in facilitating the academic success of their adolescents in American schools, using a naturalistic study design, data from transcribed personal interviews of 17 Korean–American mothers, and a phenomenological analysis approach (Giorgi, 1985, 1997). The purposes of this study were to (a) reveal the layers of context that influenced mothers’ thoughts, actions, and mother–child relationships as they assisted their adolescents in realizing academic success, a core value in Korean culture, and (b) uncover the relationship difficulties mothers perceived in these processes. The results indicated that mothers were influenced by their individualistic and collectivist cultural (meta) contexts as they tried to facilitate the academic success for their adolescents. Second, they were struggling with their competing Korean and American value systems (general context) in the adjustment processes of “becoming an American” and “remaining a Korean.” Third, mothers revealed their value tensions with adolescents (specific context) in school and family settings. In the family setting the tensions involved balancing obedience and respect with freedom and equality, similarity preference with diversity tolerance, and achievement and recognition with happiness and fulfillment.     

Women’s breast-feeding meanings in the context of mother-to-child transmission of HIV

This study explored infant feeding practice meanings of HIV-positive mothers. Informants were eight black South African mothers (age range 18–29 years) enrolled in a mother-to-child transmission (MTCT) prevention programme. In-depth interviews on factors that influence exclusive breast-feeding were conducted with the mothers. Thematic analysis of the data yielded meanings around practices of knowledge contestation with health care providers and family, work demands, and personal preferences. Moreover, successful breast-feeding by mothers with HIV status may depend on addressing contradictory messages by health workers on infant feeding and community and family pressure to mix-feed the infant children.     

Primary care physician attitudes and values toward end-of-life care and physician-assisted death

This study explores how primary care physician attitudes toward physician-assisted death (PAD) are related to their personal values toward end-of-life care and PAD. A group of 810 Michigan family physicians, internists, and general practitioners, divided into 4 typology groups by their intention toward participating in PAD, rated their attitudes toward PAD, along with their values and preferences for their own end-of-life care. Respondents who most objected to PAD were less likely to have executed an advance directive and more likely to have values promoting continued life-sustaining treatment in their own terminal care. Furthermore, a significant number of physicians, who had strong values against their own withdrawal of treatment in terminal care, were opposed to the withdrawing or withholding of life-sustaining treatment in patient care. Considerations of personal physician values are relevant in the discussion of PAD and the withdrawal of treatment in terminal care.     

Examining the role of parental self-regulation in family physical activity: A mixed-methods approach

Physical activity (PA) is essential for good health. However, parents risk becoming less active because of the demands of parenting. This has consequences for children as parents are role models. The present study used a mixed-methods approach to explore parental self-regulation associated with PA. Data were collected from 36 parents with preschool-aged children. They were interviewed about their PA and their family’s PA. Parents also completed PA and self-regulation questionnaires and wore an accelerometer for five days. Qualitative data were examined using an inductive approach to thematic analysis. It showed that parents felt that they had limited time for personal PA. Mothers’ self-regulation was driven by an ethic of care and subjective norms, whereas fathers’ self-regulation was driven by beliefs about the importance of autonomy. Nevertheless, both parents saw caring for their children as the main priority. Quantitative data were examined using multiple regression analyses. Results showed that different self-regulatory behaviours predicted the PA of mothers and fathers. Which predictors were significant depended on the type of activity and how it was measured. The findings warrant longitudinal research that would enable the effect of family dynamics on self-regulation associated with PA to be assessed.     

An Exploration of Mothers' Successful Completion of Family-Centered Residential Substance Use Treatment

Behavioral health and substance use centers have started focusing efforts on creating, adopting, and implementing evidence-based practices and programs that effectively address the needs of women and, particularly, mothers entering treatment with children. However, women with substance use disorders (SUDs) remain an underserved and understudied population; even less studied are the complexities and unique SUD treatment needs of women who have children. Family therapists' systemic training is a valued approach in conceptualizing and implementing treatment for mothers with SUDs and their families. This study explored the construct of mothering children during family-centered substance use treatment using a transcendental phenomenological approach. Analysis revealed themes related to motherhood, parenting, and support for mothers and children. Two themes emerged from the data: (a) grappling with motherhood and addiction leading to the decision for treatment and (b) specific aspects of the treatment program conducive to motherhood. Results indicated the positive impact of mothers' experiences in family-centered substance use treatment, aligning with previous literature that suggests mothers are more engaged in treatment when their children remain in their care. The insights gleaned from the participants in this study provide suggestions for further improving programming that supports mothers and their children during the recovery process. Treatment considerations are offered for family therapists working with mothers with SUDs and their families.     

Family Therapy with Unmarried African American Mothers and Their Adolescents

Almost two-thirds of African American births are to unmarried mothers, and these single parents are among the most economically vulnerable in the United States. The effects of chronic stressors such as poverty can compromise the ability of these mothers to parent effectively, particularly during the developmental period of adolescence, typically a stressful phase of parenting. This article describes a multidimensional family therapy (MDFT) approach to working with African American adolescents who have drug and/or behavior problems. It is maintained that addressing the intrapersonal functioning of African American single mothers is vital if they are to re-establish the attachment bonds necessary for the maintenance of essential parental influence in the lives of their adolescents. Through systematic attention to the parent as an individual, leading to a balance between self-care and care for others, parental supervision is more easily achieved and relational impasses between parent and adolescent more equitably resolved.     

The Importance of Perceived Care and Connectedness with Friends and Parents for Adolescent Social Anxiety

Nonclinical social anxiety in adolescence can be highly problematic, as it likely affects current and especially new social interactions. Relationships with significant others, such as close friends, mothers, and fathers, could aid socially anxious adolescents’ participation in social situations, thereby helping reduce feelings of social anxiety. We examined whether making friends as well as high friendship quality help reduce social anxiety over time, and whether friends’, mothers’, and fathers’ care interact in reducing social anxiety. Using longitudinal data from 2,194 participants in a social network (48% girls; M_age = 13.58) followed for 3 years, we estimated friendship selection and influence processes via a continuous time‐modeling approach using SIENA. We controlled for the effects of depressive symptoms, self‐esteem, gender, age, and family structure. Our findings suggest that perceived care by friends mediated the effect of making friends on social anxiety. Perceptions of mother and father, as well as friend care and connectedness, respectively, did not interact in decreasing social anxiety. Nonetheless, care and connectedness with mothers, fathers, and friends jointly predicted decreases in social anxiety. Caring relationships with friends and parents each play a role in mutually protecting early adolescents against increasing in social anxiety over time.     

A family-based approach to adult mental disorders

Recent research studies have provided strong support for a collaborative approach between families and mental health services in the clinical management of major mental disorders. A comprehensive approach to adult mental health care that employs cognitive-behavioural family therapy as the basis for clinical assessment and treatment is described. This model emphasizes home-based intervention, collaboration with primary care, targeted specific interventions, achievement of the personal goals of index patients and their family members, long-term rehabilitation, and assessment of benefits and costs.     

Stress,coping, and adjustment in mothers and young adolescents in single- and two-parent families

Compared stress, coping, and psychological adjustment in single (divorced or separated) and married mothers and their young adolescent children. Single mothers reported more daily hassles related to economic, family, and personal health problems, and more symptoms of depression, anxiety, and psychoticism. Single mothers also reported using more coping strategies related to accepting responsibility and positive reappraisal. After controlling for level of family income, differences in family hassles and coping strategies remained significant. The two groups did not differ on subtypes of symptoms after controlling for income, but single mothers still reported more total psychological symptoms. No differences were found between children in these two family constellations on maternal reports of emotional/behavioral problems or on children's self-reported emotional/behavioral problems, stressful events, or coping. Implications of these findings for adjustment to life in single-parent families are discussed.     

A COMPARISON OF WHITE AND HISPANIC WOMEN'S STORIES OF ADJUSTMENT TO THE BIRTH OF A CHILD

As part of a larger project designed to inform prevention and treatment of postpartum depression and promote positive mother–child relationships in diverse families, this study describes personal stories of postnatal adjustment from 14 White and 9 Hispanic women recruited from prenatal care clinics. Qualitative interviews conducted in the mothers’ primary language (English or Spanish) were analyzed using a modified grounded theory content‐analysis approach. The coding scheme developed to capture the women's discourse about their experiences included child temperament and health; intergenerational patterns; work demands and job loss; schedule changes; increased responsibilities; difficulties with parenting tasks; emotional distress; social stressors and resources; coping strategies; and changes in work, personal, social, and marital domains. More White mothers than Hispanic mothers reported changes in time structure, work stressors, use of psychotropic medication, informational support, and social support from other mothers and professionals; however, within‐group differences were more evident than were cross‐group ethnic differences. Analyses of qualitative interviews led to the integration of Belsky's Determinants of Parenting Model (1984) and the Double ABCX Model of Family Adjustment and Adaptation (McCubbin & Patterson, 1983) into a hybrid third theoretical framework.     

CLOSE RELATIONSHIPS AS SOURCES OF STRENGTH OR OBSTACLES FOR MOTHERS COPING WITH HIV

The current study explores the impact of HIV disease on the interpersonal relationships and social support experiences of mothers living with HIV. Analysis of interviews with 25 mothers with HIV focused on their perceptions of the impact of HIV on close relationships with significant others, including family of origin, children, friends, intimate partners, and parents. The results revealed the following major relationship challenges that mothers had to cope with after the discovery of their HIV-positive status: weighing reasons for and against disclosure of their HIV status, whether HIV disclosure brings relationship partners closer together, finding future caregivers for young children if one's health declines, and coordinating safer-sex practices with sexual partners, especially with the many males who are reluctant to use condoms. The study suggests the importance of understanding both the positive and negative aspects of social interactions in coping with HIV and the struggles that mothers have with the consequences of the HIV diagnosis for both themselves and their significant others.     

Family involvement and empowerment in mental health service provision for children with emotional and behavioral disorders

Involvement of families is a critical component in effective systems of care for children with disabilities and their families. We investigated the sociodemographic correlates of family involvement in mental health services for children who have emotional and behavioral disorders. Further, we investigated the relationship between family involvement and family empowerment. The Family Involvement Scale-Family Version was used to measure involvement of families in the provision of mental services for their children and the Family Empowerment Scale was used to measure pempowerment in families with children who have emotional and behavioral disorders. In additions, demographic data concerming family composition, race, education, incone, membership in a parent support group, and the mental health status of the children were also collected. The results showed that mothers, as well as respondents with less formal education, reported greater involvement in services for their children than fathers and those who were more educated. Further, the knowledge subscale of empowerment was significantly correlated with all, subscales of family involvement and personal empowerment was significantly correlated with the treatment subscale of family involvement.     

Critical incidents: Life events for experienced family therapists

Summary The results of this investigation suggest that therapists' professional style and clinical use of self patterns are impacted by critical life events occurring in their personal life. Many subjects reflected on how changes in their family constellations (both family of origin and family of procreation) were important to their professional development. They frequently mentioned that marriage, children, divorce, and illness or death of a loved one impacted their personal and, then, their professional lives. The important life events of becoming a parent or losing a significant loved one was specifically mentioned as strongly influencing changes in one's professional direction and therapeutic style.Becoming a parent caused the interviewees to reevaluate their expectations of their own parents, their client families and themselves. Changes in career aspirations, interactional patterns, and the capacity to be consistent and calm were explored and understood differently. Many subjects described how this transition in their own life shifted their primary focus and altered many of their existing relationships. In particular, female therapists with younger children related how their sense of being female changed. They sought out other women for intimate contact more frequently, they understood their own mothers better, and they frequently were less judgmental of mothers in their client families.Along with creating their own families, death of a parent was keynoted as having a strong impact on the subjects' personal and professional lives. They described questioning (and frequently changing) the amount of time they spent working and the type of work they did. Many began to push for more emotionally intense relationships personally and therapeutically. Detailing how their therapeutic goals for a family now included connection-making rather than just problem solving, they described being much more willing to share their vulnerabilities and personal needs with clients.     

Intergenerational possession transfers and identity maintenance

Research suggests that older consumers hope to transfer their cherished possessions, bundled with their carefully edited personal history, to younger family members. Further, researchers have found that older consumers worry that their younger loved ones will not care about these cherished, transferred possessions. Using a random, national US sample, this research investigates these findings, examining the pervasiveness of some of the most common themes emanating from previous naturalistic investigations, thus broadening our understanding of intergenerational possession transfers. Findings indicate that many of the key themes in intergenerational possession transfers conducted in naturalistic investigations can be generalized to a majority of the adult population in the US. That is, in this random, national US sample, a majority of respondents report: that they hope their loved ones will care about their cherished possessions, that they plan to pass their family possessions on to subsequent generations, and that their familial possessions reflect their family identity. Findings also indicate that this was significant among all adult age groups, and that females value cherished possessions more than males. Copyright © 2011 John Wiley & Sons, Ltd.     

Family Gender Role and Guilt in Spanish Dual-Earner Families

In dual-earner families the balance between work and family demands facilitates the development of guilt feelings when parents perceive a non-fulfillment of their responsibilities in childcare. Specifically, women who aspire to personal and professional development on the basis of more egalitarian gender role models must deal with the traditional stereotypes that maintain an intensive maternity mandate that prioritizes the family. On the other hand, for men the role change is primarily in the family setting with the development of a new father role more involved in the care of their children, which is not easily compatible with the more traditional breadwinner role. This study explored the feelings of guilt about parenting in 251 employed Spanish parents with children between 3 and 6 years of age, through the Scale of Guilt Feelings about Parenting, and its relationship with traditional stereotypes of maternal and family role. The scale addresses diverse situations pertaining to child rearing in which work requirements do not allow parents full availability for the care of their children. This availability is present in the model of intensive maternity and in the new father role model. Results indicate the presence of similar and high levels of guilt in fathers and mothers, although in men guilt is related to a non-traditional family role ideology, whereas in women guilt is related to a more traditional maternal role stereotype.     

Self-Reported Parenting of Clinic-Referred and Non-referred Mexican American Mothers of Young Children

Behavioral parent training (BPT) interventions for child behavior problems have been based on decades of research that demonstrate links between particular parent behaviors and child externalizing problems. However, the majority of this research has been conducted with European-American (EA) families, and less is known about whether these findings can be generalized to Mexican Americans (MAs). In the current study, we investigated self-reported parenting practices that have been associated with externalizing behavior problems among EA families (harsh parenting, inconsistency, and low parental warmth), to determine if those practices can also differentiate MA mothers whose young children have clinically significant behavior problems from MA mothers whose children do not have behavior problems. Participants were 115 MA families with young children, 58 with a child with clinically significant behavior problems and 57 with a child in the normal range for such problems. Results indicated that MA mothers whose children have behavior problems self-reported significantly less warmth and consistency and more harsh parenting compared to parents whose children’s behavior was in the normal range. These findings indicate that parenting behaviors that are associated with externalizing behavior problems among EA families are associated with the same problems among MA families with young children, suggesting that parent training interventions designed to target these behaviors are also likely to be relevant to MA families with children in this age range. However, findings also indicate that parenting behaviors differ depending on acculturation level, suggesting that BPT programs must respond to variation in normative parenting practices for MA families.     

When Fairness Clashes with Personal Autonomy and Parental Authority: A Comparison of Daughters' and Mothers' Reasoning in Two Cultural Contexts in Turkey

The author examined religious and secular daughters' and mothers' reasoning about personal autonomy, maternal authority, and moral concepts in family decision-making situations in urban Turkey. Sixty-eight daughters and 34 mothers were individually interviewed about decision-making autonomy in general issues and hypothetical daughter–mother conflicts. Results indicated participants regardless of their family status and religious background assigned more decision-making autonomy to mothers when evaluating general issues. Analysis of controversial issues as hypothetical conflicts indicated that daughters and mothers do not hold unitary social judgments about the social world that were always consistent with the norms of their community and family status. There were some religious background differences in evaluations of some conflict stories as a function of whether they evaluated the choices as moral, conventional, personal, and prudential matters. Although secular and religious participants conceptualized daughters and mothers in relational terms rather than characterizing the relations and social issues by harmony, obedience to authority, and acceptance of norms findings suggested that secular women evaluated the hypothetical adolescent–mother conflicts more consistently when the issue entails violation of a moral principle such as justice, fairness, and well-being of the other.     

Correlates of parenting on a neonatal intensive care unit: maternal characteristics and family resources

The association of maternal characteristics, family resources, and receipt of prenatal care with parenting behaviors observed in a neonatal intensive care unit (NICU; n = 383) was assessed. The parenting behavior of mothers not receiving prenatal care (n = 128) was compared to that of mothers of the preceding and subsequent admissions (n = 256) by retrospective chart review. Parenting variables included frequency of visits to the NICU and evaluative ratings of parents' involvement with their infant. Parenting of the no-prenatal-care group was significantly less favorable than the control on all comparisons. Factor analysis supported a priori grouping of parenting variables. A stepwise multiple regression of maternal and family characteristics to the factor-derived variable, parenting, showed significant contributions for prenatal drug use and father involvement. Pediatric interventions assessing maternal social and behavioral characteristics are proposed.