The transactional model of early home intervention

This article describes a developmental model for early home intervention and treatment of environmentally and biologically at-risk infants and their parents: The Transactional Model of Home Intervention. The model identifies the development of both infants and parents as targets of intervention and considers their ongoing interactions or transactions within the family context as the vehicle of intervention. The child and his physical/social environment are conceptualized as actively influencing one another in their reciprocal transactions. An early intervention program based on this transactional model is described. The intervention is tailored to suit the needs of both child and parents and, more generally, the needs of the family. The intervention process involves a problem-solving model of education by which parents acquire cognitive strategies that will enable them to assess the needs of their child and to design a program to fulfill these needs.     

Addressing Parent–Child Conflict: Attachment‐Based Interventions With Parents

This article describes the use of attachment theory to address parent–child conflict. The authors propose that parent–child conflict is attributable to the unmet attachment needs of both children and parents and that attachment insecurity results in problematic patterns of attachment in parent–child relationships. Three conversational frames are presented as a model for applying attachment theory to assist parents in resolving parent–child conflict.     

Using the Double ABCX Model to Integrate Services for Families of Children with ASD

This conceptual paper reviews the need for a family-focused service delivery model within the autism spectrum disorder (ASD) field and suggests that the Double ABCX Model of Stress and Adaptation is a way to address this need. Within the ASD field, there is an absence of service delivery models that are able to address the needs of the family as a unit, rather than the individual child with ASD. This gap is striking given the reciprocal relationship between parent and child outcomes within the ASD field. To support our argument that the Double ABCX model could be used to integrate parent and child-focused interventions within the ASD field, this paper starts by reviewing the mental health outcomes often associated with having a child with ASD. We next provide a historical overview of the Double ABCX model and review a body of ASD intervention literature within the context of the Double ABCX model framework. Doing so shows that a number of child and parent focused interventions within the ASD field can be fit within the Double ABCX framework. However, a handful of methodological and sampling limitations prevent the Double ABCX model from being fully supported as a model that could be applied in a variety of settings. Taken together, this review highlights that the Double ABCX model is a promising strategy to integrate child and parent-focused interventions within the ASD field, but highlights that specific areas of future research are needed in order to build continued support for this argument.     

The Role of Hierachy in Parental Nurturance

This article discusses the importance of parental hierarchy in regard to meeting the developmental nurturing needs of the child. It builds on Stonefish's (2000) epigenetic model of hierarchical relationship development. Through complementary and supplementary relationships between the parent and child, the child is able to have his or her nurturing needs met.     

Comprehensive Counselling: One Pupil's Integration

A case-study is used to show how an eclectic approach towards counselling can be helpful in the integration of a child with special educational needs into a mainstream secondary school. The value of a problem-solving model which focuses on personal agency and self-help skills is demonstrated. In particular, the effectiveness of goal setting, feedback and modelling to change perceptions, increase self-responsibility and change behaviour is emphasised. Limitations of the school context, particularly the attitudes of some staff, on the effectiveness of the approach are outlined. It is concluded that comprehensive counselling, whilst taking the needs of the majority as a starting point, is equally a means of enabling those with 'special' needs to achieve true integration.     

Predicting the nursing care needs of children in an inpatient psychiatry unit

This study examined factors that could be used in the prediction of nursing care needs of the child or adolescent requesting admission into an inpatient psychiatric unit. Using a time sampling observer methodology, nursing care activities provided to 40 child/adolescent inpatients were recorded and used as estimates of nursing care needs. Results indicated a great deal of variability in the nursing care needs of the inpatients. An encouraging finding of this study was that with relatively little difficulty, information can be obtained that is predictive of the child's or adolescent's nursing care needs. Significant predictive contributions were particularly noted for information pertaining to the sex of the child/adolescent, ratings of intellectual functioning, and history of possible abuse and/or neglect.     

Self‐Interests and Beliefs: Predictors of Mothers’ Views of Child Care1

Mothers (N= 270) completed questions related to child care for their children who were between 2 and 6 years of age. They completed a 9‐page questionnaire that included scales used to assess their attachment to their careers, financial need to work, and gender‐role beliefs as predictors of their ratings of the effects of child care on 4 criterion measures. Findings supported the hypothesized model that a mother's needs and her self‐interests and beliefs would influence her ratings of the benefits and costs of child care, her anxiety in leaving her child in child care, and her views of the effects of child care on her child. It is suggested that future research should avoid biases that might arise from participant or observer self‐interest and seek more objective approaches to the examination of the impact of child care on children.     

Psychologists' role in family-centered approach to practice, training, and research with young children

Family-centered, community-based, coordinated care for children with special needs is presented as the best practice model for providing services to children and families. Psychologists must learn to play an active role in this frame-work that both integrates psychology with other health and education disciplines and uses the broad spectrum of psychological knowledge about families, development, community organization, and intervention strategies. Key principles of family-centered child psychology affect practice research and training. The psychologist becomes part of a team created to support families as the primary care-givers of their children. Training programs must reorganize the types of experiences both in the classroom and the field to train new psychologists within this model. As mandates for family-centered care affect policies at the state and federal levels, research will remain a critical factor in understanding the effects of these policy shifts on child and family functioning and the delivery of services.     

Look to Norway: Serving new families and infants in a multiethnic population

Despite recognition that immigrant women face significant health challenges, addressing the healthcare needs of immigrants is a source of debate in the United States. Lack of adequate healthcare for immigrants is recognized as a social justice issue, and other countries have incorporated immigrants into their healthcare services. Oslo, the fastest growing capital in Europe, is rapidly shifting to a heterogeneous society prompting organizational action and change. The New Families Program serves first-time mothers and their infants in an Oslo district serving 53% minorities from 142 countries. Anchored in salutogenic theory, the program aims to support the parent–child relationship, children's development and social adaptation, and to prevent stress-related outcomes. Formative research has informed the successful program development and implementation within the existing maternal and child healthcare service. Implications for addressing maternal and child health needs of an immigrant population are presented.     

The single parent: Power and the integrity of parenting

I have explored some issues of power and the balance of power in the situation of the single parent and the family. The single parent may need the support of a holding environment to achieve psychological integration as exemplified by my treatment with Ms. B. Without a cooperative mate and with societal prejudice, the psychotherapeutic situation may be the only nurturing environment. The therapist empowers the single parent by providing a supportive, nurturing environment. Parenting is receiving bad press in this decade. More examples of child abuse and the extreme of homicide come to public attention. Children do have power and society needs to support a constructive use of child as well as parental power. At this stage in societal/cultural development the legal system is unfortunately more available to punish than provide lines of protection or guidance to parent or child. The psychoanalytic literature hasn't been kind or supportive to the parent. We must keep in mind that the psychotherapist's lot is simpler, less stressful, and more protected from real life stresses than that of the single parent. I suggest a model of parenting with the establishment of ongoing dialogue between parent and child in which each is receptive to the other. While it is the parental task to set limits and teach about the real world, the goal is to establish an exchange in which parent and child are both teacher and student. This creative relationship produces growth and builds esteem for parent and child alike.     

A confusion of tongues or whose reality is it?

In a 1933 paper Ferenczi implied that conflict between the adult's and the child's construction of reality is traumatic for the child. As all individuals construct their own view of reality, it is inevitable that there will be conflicting constructions between child and adult--and between analyst and analysand. This may be biologically rooted; recent ethological studies suggest that parent-child conflict is ubiquitous because of a divergence of needs. When a child perceives a marked divergence between his or her construction of reality and that of the caretaker, the child may tend to reject the information proffered by the caretaker. This may appear later as a resistance to learning from the analyst. The divergence of needs between child and caretaker may have a profound influence on the child's cognitive development. The capacity to share other constructions of reality is a developmental achievement which may be facilitated by the psychoanalytic process.     

Children with Special Health Care Needs: Impact of Health Care Expenditures on Family Financial Burden

We investigated the relationship between health care expenditures for Special Health Care Needs (SHCN) children and family perception of financial burden. Using 2005/2006 National Survey of Children with Special Health Care Needs data, a multivariate logistic regression model was used to estimate the relationship between the SHCN child’s health care expenditure and perceived financial burden, while controlling for family and child characteristics. Our analysis suggests that health care expenditures for a SHCN child of $250 and more are associated with family perception of financial burden. In addition, families with lower socioeconomic status also perceived financial burden at lower level of expenditures. Members of the health care team who treat children with SHCN have an important role in understanding and assessing family financial burden as part of the care delivery to the child and the family. Our study reinforces the need to treat the whole family as the unit of care, especially when caring for children with special health care needs.     

Characteristics of Children in Foster Care,Family-Style Group Care,and Residential Care: A Scoping Review

When risky child and family circumstances cannot be resolved at home, (temporary) 24-h out-of-home placement of the child may be an alternative strategy. To identify specific placement risks and needs, care professionals must have information about the child and his or her family, care history, and social-cultural characteristics at admission to out-of-home care. However, to date information on case characteristics and particular their similarities and differences across the three main types of out-of-home settings (namely foster care, family-style group care, and residential care) is largely lacking. This review compiles and compares characteristics of school-aged children of average intelligence and their families at the time of each child’s admission to one of the three care modalities. A scoping review technique that provides a broad search strategy and ensures sufficient coverage of the available literature is used. Based on the 36 studies included, there is consensus that the majority of normally intelligent children in care demonstrate severe developmental and behavioral problems. However, the severeness as well as the kinds of defining characteristics present differ among the children in foster care, family-style group care, and residential care. The review also identifies several existing knowledge gaps regarding relevant risk factors. Future research is recommended to fill these gaps and determine the developmental pathway in relation to children’s risks and needs at admission. This will contribute to the development of an evidence-based risks and needs assessment tool that will enable care professionals to make informed referrals to a specific type of out-of-home care when such a placement is required.     

Child Abuse and Adolescent Parenting

Abstract

Adolescent parents are commonly identified as an at-risk group in the child abuse literature. However, theoretical models specific to the area of child abuse and adolescent parenting are not well developed. This essay reviews established theories on child abuse, abusive parenting, and adolescent parenting to synthesize a proposed child abuse and adolescent parenting model. An ecological perspective is used to organize the theoretical model. The components of this model are supported by existing research on child abuse and adolescent parenting. The new synthesized model on child abuse and adolescent parenting should be viewed as an informed way to organize and conduct future research in this area. Further theory development on child abuse and adolescent parenting should be encouraged.     

The Well- and Unwell-Being of a Child

The concept of the ‘well-being of the child’ (like the ‘child’s welfare’ and ‘best interests of the child’) has remained underdetermined in legal and ethical texts on the needs and rights of children. As a hypothetical construct that draws attention to the child’s long-term welfare, the well-being of the child is a broader concept than autonomy and happiness. This paper clarifies some conceptual issues of the well-being of the child from a philosophical point of view. The main question is how well-being could in practice acquire a concrete meaning and content for a particular issue or situation. A phenomenological-hermeneutic research perspective will be outlined that allows the child’s well-being to be elucidated and specified as an anthropological and ethical idea. It is based on a contextual understanding of generative relationships, a combination of the theory and practice of making sense, here described as ‘generative insight’, which could provide ethical guidance for decision making in families, legal practice, medicine or biomedical research.     

Understanding Strengths in Relation to Complex Trauma and Mental Health Symptoms within Child Welfare

Strengths can have a potent effect in mitigating the impact of trauma on mental health needs and functioning. Yet, evidence is limited on the role that strengths may have in ameliorating trauma-related or mental health symptoms over time. Providing a comprehensive assessment that includes strengths, as well as needs, is an important step in making appropriate service recommendations for youth in child welfare. This study assessed 7,483 children and adolescents entering an intensive stabilization program through the Illinois child welfare system. The interaction of individual, child strengths in relation to complex trauma exposure, traumatic stress symptoms, risk behaviors, and other mental health needs were examined. Results indicated strengths are relatively stable over time and inversely associated with several negative outcomes, including risk behaviors (?.32, p?<?.001), emotional/ behavioral needs (?.33, p?<?.001) and overall functioning (?.47, p?<?.001). Traumatic stress symptoms were also related to increases in these negative outcomes. Overall, strengths had a buffering effect on traumatic stress symptoms and outcomes over time. The role of strengths in relation to traumatic stress symptoms, however, was less consistent. Youth with histories of complex trauma exposure had significantly fewer useable strengths than youth without this exposure. However, strengths improved for both youth with and without complex trauma exposure over the course of stabilization services. These findings suggest that early identification and development of child strengths can mitigate risk-taking behaviors, mental health, and functional difficulties among youth in the child welfare system. Implications for more targeted trauma-informed and strengths-based assessment, and treatment/service planning are discussed.     

A Review of the Use of Trauma Systems Therapy to Treat Refugee Children,Adolescents, and Families

ABSTRACT

Children and adolescents within refugee families face adverse childhood experiences emanating from multiple sources. These traumatic events can begin with persecution within their country of origin, during the migration process, and within their re-settled countries. More specifically, these children and their families are more prone to the four core stressors being: traumatic, acculturative, isolative and resettlement stress. Trauma Systems Therapy for Refugees (TST-R) is a promising treatment model to address child and adolescent mental health disparities revolving around direct and vicarious trauma. In TST-R, the treatment team systematically targets the needs of the child, while collaborating with cultural brokers from the refugee community, their school, and family unit. Researchers have used TST-R as an intervention for reducing trauma symptoms in Somali, Somali-Bantu, and Bhutanese children, adolescents, and their families. We review the strengths and limitations of this model. Further research is needed to determine its applicability to other communities within the United States and abroad.     

The drama of the gifted child and the psycho-analyst's narcissistic disturbance.

In order to develop a true self, the child needs, in the first weeks and months of his life, his mother's appropriate emotional response, mirroring and respect. These narcissistic aspects have to be distinguished from the drive wishes. Only the mother's appropriate responses make it possible for the child to experience his feelings as belonging to his own self. If the child does not get the right narcissistic response, he will continue to search for narcissistic supplies for the rest of his life. The most suitable objects for this will be his own children initially, who are completely at his disposal. Specially gifted children who are sensitive, alert and have many 'antennae', will quickly learn to adapt to the narcissistic needs of their parents. Their behaviour will then give the mother all the mirroring, consideration and admiration which she had missed as a child herself. The result will be that, in spite of excellent performance, the child's own true self cannot develop. All this leads to narcissistic vulnerability and to new attempts in the adult to find at last an available 'mother' in his own child, partner, or, if he has become a psycho-analyst, in his patient. In the transference this type of analysand first experiences narcissistic rage before deep mourning is possible. This process of mourning enables him finally to accept his own deprivation as a child, to give up the unconscious idealizations and with them the hope of finding such a 'mother'. This leads regularly to the liberation of the life forces and allows creativity to develop. Only after this has been achieved is the analysis of drive conflicts possible and becomes emotionally effective.     

Meeting the emotional needs of infants and toddlers in foster care: The collaborative mental health care experience

This paper describes a partnership between an infant mental health consultation program and child welfare authorities, with a special focus on the use of a consultation model to support infants and toddlers in foster care. The authors describe a model of practice that incorporates the transactional model with a developmental perspective to help foster parents understand and address the emotional needs of these children. The clinical implications section reviews strategies for addressing attachment and relationship disturbances, promoting self‐regulation, and enhancing social competence in infants and young foster children.