Beyond Support: Group Psychotherapy with Low-Income Mothers

A review of the functioning of a group for low-income mothers during a 3-year period suggests that a positive therapeutic outcome can be achieved in spite of unorthodox group structural configurations and processes. General psychosocial characteristics of the target population are delineated, and techniques are described which are intended to enable members to participate and benefit from a group experience which includes significant exploration of interpsychic material. Case illustrations are offered of psychodynamic formulations and process interventions. Group leadership is examined, and it is suggested that a flexible, active, and autonomous stance on the part of leaders is a significant variable in achieving a positive group outcome.     

Strengths-Based Practice in Child Welfare: A Systematic Literature Review

Journal of Child and Family Studies - This paper examines the academic research discourse on strengths-based practice in child welfare. A gap in the literature exists concerning systematic research...     

The Effectiveness of Parenting Programs for Incarcerated Mothers: A Systematic Review

There is evidence to suggest that maternal incarceration can have negative implications for children. Children in these families can be at greater risk for conduct problems and antisocial behavior, as well as school dropout and academic failure. Institution-based parenting programs represent one means of addressing the potential negative impacts of maternal incarceration on children’s wellbeing. Through parent training programs, mothers may develop skills and strategies to help their children cope with the challenges and stressors associated with incarceration. However, it is currently unclear whether parenting programs for mothers in these facilities have a positive effect on different parenting outcomes. We conducted a systematic search of several electronic databases using key search terms and identified sixteen treatment studies. The results suggest that in the short-term, corrections-based parenting programs are associated with positive effects on parenting behavior, parenting attitudes, and parenting knowledge. However, these programs appear to have no effect on parenting stress immediately post-treatment. Implications for practice and recommendations for future research are discussed.     

Motives and Barriers for Physical Activity among Low-Income Black Single Mothers

Physical activity is associated with positive health outcomes, yet previous evidence suggests that single mothers, Black women, and those with low-income levels have low rates of physical activity. The purpose of the present study was to examine health status, as well as barriers and motives for physical activity, among low-income, Black single mothers from an intersectionality framework. Participants (n = 32) in this cross-sectional, mixed methods study completed questionnaires to assess physical activity, health status, stress, and barriers to physical activity and then participated in one of six focus groups to explore physical activity motives and barriers. Although participants reported many risk factors for disease including obesity, stress, and family disease history, most participants were not engaging in behaviors that would improve health such as regular leisure-time physical activity. Participants cited being a role model, stress relief, and weight loss as motives for physical activity that were connected to their social identities as low-income, Black single mothers. Chronic stress and stressors, responsibilities associated with single motherhood, and lack of social and community supports were described as barriers to physical activity. Future researchers and practitioners should consider these specific motives and barriers when designing interventions to increase physical activity among low-income, Black single mothers. We recommend that these programs focus on: promoting motives for physical activity that are meaningful and specific to this subpopulation of mothers, reducing stress, and enhancing affordable physical activity opportunities in the community for single mothers and their children.     

A Systematic Review of Quality of Life Measures in Pregnant and Postpartum Mothers

Quality of life has emerged as an essential health component that broadens the traditionally narrow concerns focused on only morbidity and life expectancy. Although a growing number of tools to measure quality of life are in circulation, there is a lack of guidelines as well as rigorous assessment for their use with pregnant and postpartum populations. It is also unclear whether these instruments could validly be employed to measure patient-reported outcomes in comparative effectiveness research of maternal care interventions. This paper reviews articles cited in CINAHL, COCHRANE, EMBASE, PSYCINFO, and PUBMED that addressed quality of life in pregnant and postpartum populations. Instruments used to measure quality of life in selected articles were assessed for their adherence to international guidelines for health outcomes instrument development and validation. The authors identified 129 articles that addressed quality of life in pregnant and/or postpartum women. Out of these, only 64 quality (generic and specific) scales were judged relevant to be included in this study. Analysis of measurement scales used in the pregnant and/or postpartum populations revealed important validity, reliability and psychometric inadequacies that negate their use in comparative effectiveness analysis in pregnant and post-partum populations. Valid, reliable, and responsive instruments to measure patient-reported outcomes in pregnant and postpartum populations are lacking. To demonstrate the effectiveness of various treatment and prevention programs, future research to develop and validate a robust and responsive quality of life measurement scale in pregnant and postpartum populations is needed.     

Facilitated Parent-child Groups as Family Support: A Systematic Literature Review of Supported Playgroup Studies

Supported playgroups are community-based services that provide low intensity family support, through regular group sessions for parents and their young children. Led by a playgroup facilitator, the program aims to enrich children’s early learning, enhance positive parenting behaviors, provide social connections for parents, and enable access to other community services. Despite high community acceptance and government investment, little is known about the extent to which such services are effective. This paper reports findings from a systematic review of research on supported playgroups and their effectiveness to improve child, parent, and community outcomes. Thirty-four studies were included, of which 28 were conducted in Australia. Programs targeted a diverse range of families who were considered socially disadvantaged. Seven studies employed experimental or quasi-experimental designs from which reliable evidence for effectiveness could be established. A high proportion of studies were qualitative and included action research, case studies, or ethnographies. A range of qualitative and quantitative measures were used to assess child, parent, and community outcomes. While findings suggested that supported playgroup programs were highly valued by parents and other stakeholders, rigorous evidence of effectiveness for achieving desired improvements in child outcomes or parenting behavior was rare and limited by low quality study designs. More explicit theories of change about how different types of supported playgroup programs can meet diverse family needs are required. Such theories of change would provide directions for specific content and delivery approaches that could address and improve different child and parent outcomes targeted to specific populations of attending families.     

Meaning and Health: A Systematic Review

The research base linking meaning with physical health is significantly underdeveloped in comparison to that linking subjective well-being and physical health. We address this deficit by first providing an overview of the study of meaning, and then examining evidence of its positive relationship to physical health in a systematic review of relevant literature. We searched PsycINFO and PubMed databases for studies of varying design and populations, excluding studies that did not have clear measures of meaning and physical health and/or did not address their relationship. Overall, higher levels of meaning are clearly associated with better physical health, as well as with behavioral factors that decrease the probability of negative health outcomes or increase that of positive health outcomes. Methodological challenges and future directions are discussed.     

Interfaith Spiritual Care: A Systematic Review

Journal of Religion and Health - Although knowledge on spiritual care provision in an interfaith context is essential for addressing the diversity of patients’ religious and spiritual needs,...     

Treatment of Childhood Obesity: A Systematic Review

Childhood obesity trends have increased dramatically over the past three decade’s. The purpose of this quantitative systematic review is to provide an update of the evidence, illustrating the efficacy of childhood obesity treatment, considering whether treatment fidelity has been measured and/or reported and whether this related to the treatment effect size. Searches revealed 61 relevant articles published from January 2000 to 2009, including both randomized and non-randomized controlled trials of childhood and adolescent obesity treatment interventions. The review identified scant measurement and reporting of issues around treatment fidelity, an increase in the number of interventions outside of the US, (particularly across Europe) and an emergence of studies involving older children and adolescents in a range of settings. Interventions comprising a dietary, exercise, and behavioral component, supported by family involvement and delivered by trained interventionists in specialized or supervised settings, appeared to offer a potentially effective treatment for obesity. However, concern remains over study quality (particularly sample size), dropout rates and study design. Variations in outcome measures and intervention designs means generalizable conclusions cannot be easily be made. Of greater concern is the lack of consideration for treatment fidelity, which has implications for the transfer of knowledge and the reliability of interventions. Conclusions from the review include; the need for increased accuracy of reporting and objective measurement of treatment fidelity; the need for further investigation of potential cost-effective treatment options (including maintenance strategies to enhance sustainability of current interventions); and an increase in the number of longitudinal trials beyond 1?year in duration.     

Investigating Elite End-of-Athletic-Career Transition: A Systematic Review

This article presents a systematic review of the literature investigating factors that contribute to a successful end-of-career transition among elite athletes. The systematic review included 10 studies that focused on elite athlete retirement that in part measured positive outcomes, which fall under the flourishing construct. Results indicated that although there has been an abundance of research examining multiple effects of transition out of sport among elite athletes, there appears to be no current literature explicitly examining flourishing within this elite population. The results of the review have practical implications for sport psychology practitioners who are aiming to facilitate a successful transition for elite athletes through their end-of-athletic-career transition. The findings from the systematic review are discussed, and the article provides recommendations for future research and for current applied practice.     

Integrated Treatment Programmes for Mothers with Substance Use Problems: A Systematic Review and Meta-analysis of Interventions to Prevent Out-of-home Child Placements

Approximately half of mothers receiving substance use treatment are involved with childcare proceedings. This review aims to determine whether integrated treatment programmes for mothers with substance use problems are effective in preventing out-of-home placement (temporally/permanent) and influencing other maternal factors such as patterns of substance use, treatment completion and parenting behaviours. Six trials were identified—two randomised controlled trials and four non-randomised controlled studies. The pooled sample of participants was 1717. The results showed that mothers who participated in integrated treatment programmes were significantly less likely to have the children removed from their care (Odds Ratio (OR)?=?0.40, 95% CI?=?0.27, 0.61), more likely to complete substance use treatment (OR?=?3.01, 95% CI?=?1.79, 5.06), and more likely to reduce their alcohol consumption (Standardised Mean Difference (SMD)?=??0.40, 95% Cl?=??0.78, ?0.01) and drug use (SMD?=??0.30, 95% CI?=??0.53, ?0.07). However, non-significant reductions were observed for parent–child conflict (SMD?=??0.35, 95% CI?=??0.72, 0.03) and child abuse risk (SMD?=??0.03, 95% CI?=??0.36, 0.31). While the findings from this review suggest that mothers involved in integrated treatment programmes could potentially be less likely to experience out-of-home child placements and more likely to improve substance use treatment outcomes, little evidence exists for the effectiveness of these interventions. Further research, particularly high-quality RCTs, is required to demonstrate and persuade health and public policy on the far-reaching value of the integrated approaches.

     

Psychological Distress Among Religious Nonbelievers: A Systematic Review

Studies of religious belief and psychological health are on the rise, but most overlook atheists and agnostics. We review 14 articles that examine differences between nonbelievers and believers in levels of psychological distress, and potential sources of distress among nonbelievers. Various forms of psychological distress are experienced by nonbelievers, and greater certainty in one’s belief system is associated with greater psychological health. We found one well-documented source of distress for nonbelievers: negative perceptions by others. We provide recommendations for improving research on nonbelievers and suggest a model analogous to Pargament’s tripartite spiritual struggle to understand the stresses of nonbelief.     

Family Adjustment to Childhood Cancer: A Systematic Review

This systematic review integrates qualitative and quantitative research findings regarding family changes in the context of childhood cancer. Twenty-eight quantitative, 42 qualitative, and one mixed-method studies were reviewed. Included studies focused on family functioning, marital quality, and/or parenting in the context of pediatric cancer, were written in English, and were published between 1996 and 2009. Overall, qualitative findings show that families alter roles, responsibilities, and day-to-day functioning to accommodate the needs of children with cancer. Although some degree of family reorganization is normative, the extent and impact of these changes varies. Quantitative work shows that mean levels of family functioning (e.g., cohesion, flexibility) are similar between families facing cancer and normative or comparison samples. However, families follow different trajectories of improvement, decline, or stability in family closeness and marital quality. Parenting has received limited quantitative research attention, but qualitative work suggests that parents perceive deeper bonds with ill children and may spoil or overprotect them. Conclusions support future work examining the influence of family-level variables on the adjustment of individual family members.     

Psychological Distress in Refugee Children: A Systematic Review

Nearly one-quarter of the refugees worldwide are children. There have been numerous studies reporting their levels of psychological distress. The aim of this paper is to review systematically and synthesize the epidemiological research concerning the mental health of refugee children residing in Western countries. A Cochrane Collaboration style review was conducted searching nine major databases, bibliographies, and grey literature from 2003 to 2008. Included studies had to meet the reporting standards of STROBE and investigate mental health in non-clinical samples of asylum seeking and refugee children residing in OECD countries. A total of twenty-two studies were identified of 4,807 retrieved citations, covering 3,003 children from over 40 countries. Studies varied in definition and measurement of problems, which included levels of post-traumatic stress disorder from 19 to 54%, depression from 3 to 30%, and varying degrees of emotional and behavioral problems. Significant factors influencing levels of distress appear to include demographic variables, cumulative traumatic pre-migration experiences, and post-migration stressors. Importantly, the research base demands greater contextual and methodological refining such that future research would have greater generalizability and clinical implications.     

Raising American Citizens: Socialization Goals of Low-Income Immigrant Latino Mothers and Fathers of Young Children

Based on ecocultural theory, this study utilizes focus group interviews to explore the ways Latino immigrant mothers and fathers transmit the values and beliefs they wish their young children to internalize. Findings suggest that parents purposely “pick and choose” values they deem “Latino,” such as the importance of family and values they deem “American,” such as independence, to pass on to their children. Parents recognized three main barriers that might stand in their way of teaching their children to adapt to two cultural groups: balancing work and family, low self-esteem, and lack of good parental role models. However, they also pointed out two sources of strength that can help them overcome these barriers: optimism and motivation. This study provides a basis for generating hypotheses to be tested with larger datasets and informs the development of theory and culturally sensitive interventions and measures to evaluate Latino parenting.     

Ethical Challenges with Welfare Technology: A Review of the Literature

Demographical changes in high income counties will increase the need of health care services but reduce the number of people to provide them. Welfare technology is launched as an important measure to meet this challenge. As with all types of technologies we must explore its ethical challenges. A literature review reveals that welfare technology is a generic term for a heterogeneous group of technologies and there are few studies documenting their efficacy, effectiveness and efficiency. Many kinds of welfare technology break with the traditional organization of health care. It introduces technology in new areas, such as in private homes, and it provides new functions, e.g. offering social stimuli and entertainment. At the same time welfare technology is developed for groups that traditionally have not been extensive technology users. This raises a series of ethical questions with regard to the development and use of welfare technologies, which are presented in this review. The main challenges identified are: (1) Alienation when advanced technology is used at home, (2) conflicting goals, as welfare technologies have many stakeholders with several ends, (3) respecting confidentiality and privacy when third-party actors are involved, (4) guaranteeing equal access and just distribution, and (5) handling conflicts between instrumental rationality and care in terms of respecting dignity and vulnerability. Addressing these issues is important for developing and implementing welfare technologies in a morally acceptable manner.     

What Low-Income,Depressed Mothers Need From Mental Health Care: Overcoming Treatment Barriers From Their Perspective

Maternal depression is a major public health concern, as children of depressed mothers have a substantially increased risk for psychiatric problems into adulthood. Low-income mothers have high rates of depression, yet few receive mental health care. Barriers have been identified, but solutions have been based on what mental health professionals believe is helpful rather than mothers’ own perspectives, or require participation in an existing treatment. The purpose of our study was to learn what low-income, depressed mothers believe they need from mental health care to overcome barriers to mental health care. Twelve mothers with at least one child between the ages of 2 and 17 participated in individual interviews. Using qualitative grounded theory methodology, data were organized into six theoretical constructs. These included: (1) attitudes, expectations, and emotions impact the intention to enter treatment, (2) identifying as self-sufficient inhibits the intention to enter treatment, (3) providing knowledge, skills and environmental resources facilitate treatment entry, (4) habits and life circumstances that make treatment seem unimportant inhibit treatment entry, (5) balancing acceptance, change, and the therapeutic relationship facilitates treatment retention, and (6) sharing similarities with people involved in treatment often, but does not always facilitate treatment retention. A 3-step theory was developed regarding variables that influence mothers’ (a) intentions to enter treatment, (b) treatment entry, and (c) treatment retention. Offering what low-income, depressed mothers believe they need could better engage and retain them in mental health treatment.     

Emotion Regulatory Strategies in Complicated Grief: A Systematic Review

Prolonged grief disorder, characterized by severe, persistent, and disabling grief, has recently been included in the International Classification of Diseases-11 (ICD-11). Emotional disturbances are central to such complicated grief responses. Accordingly, emotion regulation is assumed critical in the development, persistence, and treatment of complicated grief. Yet, a comprehensive review on this topic is lacking. We conducted a systematic review (PROSPERO: CRD42017076061) searching PsycInfo, Web of Science, and PubMed to identify quantitative research examining relationships between emotion regulation and complicated grief. Sixty-four studies on 7,715 bereaved people were identified, focusing on a variety of emotion regulation strategies (i.e., experiential avoidance, behavioral avoidance, expressive suppression, rumination, worry, problem solving, cognitive reappraisal, positive thought, and mindfulness). Our synthesis showed strong evidence that experiential avoidance and rumination play a role in the persistence of complicated grief. More generally, surveys support positive associations between putative maladaptive emotion regulation strategies and complicated grief, and negative associations between putative adaptive emotion regulation strategies and complicated grief. Laboratory research yielded mixed results. Emotion regulation is critical in complicated grief, and in particular experiential avoidance and rumination form important targets in complicated grief treatments. We advise expanding current knowledge, by employing more advanced, intensive data collection methods and experiments across diverse samples. Increasing knowledge in this domain will improve clinical practice.