Shared caregiving: comparisons between home and child-care settings

The experiences of 84 German toddlers (12-24 months old) who were either enrolled or not enrolled in child care were described with observational checklists from the time they woke up until they went to bed. The total amount of care experienced over the course of a weekday by 35 pairs of toddlers (1 member of each pair in child care, 1 member not) did not differ according to whether the toddlers spent time in child care. Although the child-care toddlers received lower levels of care from care providers in the centers, their mothers engaged them in more social interactions during nonworking hours than did the mothers of home-only toddlers, which suggests that families using child care provided different patterns of care than families not using child care. Child-care toddlers experienced high levels of emotional support at home, although they experienced less prompt responses to their distress signals. Mothers' ages were unrelated to the amounts of time toddlers spent with them, but older mothers initiated more proximity.     

Zones of Proximal Emotional Development — Psychotherapy Within a Neuroaffective Perspective

This article outlines a conceptual framework for assessing personal and emotional functions of a person’s zone of proximal emotional development. The framework is based on the integrative theory Neuroaffective Developmental Psychology (NADP), which brings together attachment theory, neuropsychology, developmental psychology, and trauma theory. Within the NADP framework, this article describes a way of understanding children’s normal emotional mental organization and of examining how this mental organization may be developed or disturbed by relational issues. It also describes how a child’s mental organization can be disturbed and thus, without intervention, disturb the child’s personality development on a lifelong basis. The article presents three case vignettes, describing three children growing into adolescence with three different attachment patterns and suggested individually tailored intervention plans for each of them, relevant and useful for clinicians working with vulnerable children and families. Because the nervous system retains its plasticity throughout life, attachment is not necessarily an unchangeable pattern. That is why we as clinicians should develop psychotherapeutic methods and a research-based way of determining “what works for whom” by assessing the zone of individual proximal emotional development. The text outlines the characteristics of NADP and how it can be used to structure an intervention plan.     

Very Young Child Well-being in Military Families: A Snapshot

Since the September 11th attacks on the U.S., more than 2 million children have experienced parental deployment during their early years, with potentially lasting impact. When a parent is deployed, a number of factors may affect the well-being of the service member and his/her family. One parental factor—posttraumatic stress disorder or distress—might be particularly powerful in its effect on young children and the family system. We analyzed baseline data from an intervention development project which focused on supporting military families with very young children during post-deployment. The purpose of this research is to understand the relationships between parental mental health status, parenting stress, couple functioning, and young child well-being. The effects of mental health status of home-front and service member parents and the role of couple functioning on parent–child interactions and behavioral problems of young children were examined in a sample of military families during the post-deployment period. Findings suggest that service member posttraumatic stress symptoms are associated with higher parental report of child behavior problems. Higher quality of the couple relationship appears to lessen the impact of parental posttraumatic stress but is not related to parent perceptions of child behavior concerns. Implications for future research with military families are discussed.     

Family interaction and communication deviance in disturbed and normal families: a review of research.

Recent family interaction studies are reviewed with an emphasis on looking for dimensions along which disturbed and normal families differ. Several areas of consistency in the literature were found, including: family coalition patterns, patterns of conflict, flexibility versus rigidity, family effectiveness and efficiency, and deviant styles of communication. It was concluded that several measures reliably discriminate disturbed from normal families and that one type of measure in particular is a reliable predictor of thought disorder in offspring. Implications for clinical practice and future research are discussed.     

Using confidence ratings to identify a target among foils

Sauer, Brewer, and Weber (2008) advanced a novel procedure for testing eyewitness recognition memory. Rather than providing a single decision (i.e., identifying a lineup member or rejecting the lineup as a whole), participants rated their confidence that each lineup member was the culprit. Classification algorithms determined when patterns of confidence ratings indicated suspect guilt or innocence. Across varied test stimuli, confidence-based classifications equalled or out-performed single decisions. However, Sauer et al.’s classification criteria were designed to optimize performance for the data to which they were applied. If effective classification using confidence ratings requires such idiosyncratic criteria, the applied utility of the confidence procedure is nil. We re-analysed the data from Sauer et al.’s two identification experiments and demonstrated that confidence-based classification performance exceeding that of a traditional lineup task did not depend on uniquely developed classification criteria. Confidence-rating lineups offer a potentially promising alternative to procedures requiring single decisions from witnesses.     

Aging family caregivers: policies and practices

This review examines later life family support for adults with developmental disabilities from a life course perspective that takes into account social trends and changes in service patterns and in attitudes of families. Key issues addressed include: (1) trends affecting family caregiving, (2) health and social outcomes of life-long caregiving, (3) support needs of families, (4) family support policies and practices, and (5) recommendations for a research and policy agenda. Research examining outcomes of life-long caregiving has shown that most families adapt well to having a family member with disabilities. However, some families are at risk for poorer physical and mental health outcomes. These include cultural minorities and families of adults with behavioral challenges. Caregiving does seem to have a negative impact on maternal employment and family income as mothers often give up or cut back on employment to care for a child with developmental disabilities, who is more likely to continue living in the family home throughout adulthood than other adult children. Federal and state initiatives are addressing issues of family support through both the developmental disabilities and aging service systems.     

Family Imprisonment,Maternal Parenting Stress and Its Impact on Mother-Child Relationship Satisfaction

Parental imprisonment, and more recently other close family imprisonment, has been associated with long-term harms to children. A number of researchers have proposed that parenting stress caused by family imprisonment could impact on caregivers’ ability to offer a secure parent–child relationship after a close family member is imprisoned. Such relationship problems might then mediate further harms to children. The Family Stress-Proximal Process (FSPP) model conceptualises family imprisonment as an ongoing stressor that influences relational processes in families. Using HILDA, a nationally-representative Australian survey, we test key aspects of this theoretical model for women affected by close family imprisonment. We demonstrate that recent close family imprisonment does indeed significantly increase risks of high maternal parenting stress. Women affected by this high parenting stress are also significantly more likely to report feeling less satisfied with their relationship with their child one year later. Nonetheless, only a third of women experiences high parenting stress after close family imprisonment. And, women who experience close family imprisonment without high parenting stress do not have a greater risk of subsequent relationship dissatisfaction. We conclude that the prevention or reduction of parenting stress in families affected by close family imprisonment could have a protective effect on subsequent mother-child relationships.     

Treating emotionally disturbed youth: A comparison of home-based and outpatient interventions

The purpose of this study was to compare home-based and outpatient treatment for families with an emotionally disturbed child. Following treatment, both groups reported improvement in child and family functioning. Guidelines are offered to therapists working with families-at-risk of having a child removed from the home.John J. Zarski, PhD, is coordinator of the Marriage and Family Therapy Training Program and Leslie Barnes Fluharty, MS, is a doctoral student in counseling psychology at the University of Akron, Akron, OH.     

Attrition among families of divorce: Patterns in an outpatient psychiatric population

The accelerated divorce rate has greatly increased the number of children of divorce. In addition, the children and families of divorce are proportionately overrepresented in populations seeking child guidance and psychiatric services. However, the patterns in the use of such services by these families has been unexamined. In our study we find no differences in the use of outpatient psychiatric services between families where both biological parents are present and families of divorce. A closer look at the divorced families reveals that recently divorced mother-headed families more frequently interrupt both the evaluation and treatment phases of clinic contact. Several clinical patterns are described which help explain the finding and it is suggested that the traditional child guidance model may not be the most suitable intervention modality in working with these families.     

The Familial Context of Creativity: Patterns of Nurturance in Families of Creative Children

This article presents the results of a longitudinal research study undertaken to understand the familial context of creative children. The objective was to identify commonalities and specifics in patterns of nurturance present in the home environments of creative children. The participants, identified using intensity sampling, comprised four children in the age group three to 16 years at the time of selection, who had received public recognition for their creative pursuits; their families, and each child’s guru/coach. Qualitative semi-structured interviews and naturalistic observations were used to understand the dynamic nature of the relationships within the family setting that led to the discovery of the child’s creativity and its subsequent nurturance. Detailed case profiles were developed over a three year period. The case profiles reflected commonalities in the basic processes of nurturance. All the families were cohesive, with the members sharing a commonality of purposes. Parents actively fostered their children’s creativity by allocating resources—money, time and effort; introducing the child to the domain and the field; being closely involved in the learning process; and expressing praise. The uniqueness of the cases lay in the specifics – in the quality of cultural capital available to the families, in the parents’ experiences as children which were the motivational source for parenting. The key feature in nurturance was the synchronicity of purpose created by strong parental motivation to nurture their child’s creativity and the strong internal motivation of the child to persevere in the creative domain.     

Concensus Rorschach interaction patterns of families with an asthmatic child

This paper reports a study of interaction in families with a child suffering from bronchial asthma. Eighteen families, subdivided into two groups according to the severity of the child's illness, were given the Consensus Rorschach following Willi's procedure. Quantitative assessments of family members on cognitive-affective functioning and social interaction were obtained. Factor analysis of quantitative scores revealed diversified interactional strategies among family member groups. Families as wholes varied as to patterns of cross-generational alliances and/or domination of different family members and could be clustered into four interactional pattern groups. There was no correlation between this grouping and the severity of the child's illness. Some measures of cognitive-affective functioning differentiated between family members of asthmatics from the two severity subgroups. The correspondence of these findings to prevailing family theories of psychosomatic illness is discussed.     

Examining Influences on Problem Recognition and Help-Seeking for Child Externalizing Behaviors Among African American Mothers

Childhood behavior problems are one of the most common clinical referrals. If left untreated, these behaviors can result in detrimental consequences to the child’s development (Wehmeier et al., 2010; Scholtens et al., 2012). Behavior parent training has been identified as first-line treatment for oppositional behavior; however, many racial minority families fail to enroll in behavior parent training. The current study examines maternal help-seeking for children displaying oppositional behavior in hopes to delineate variables that might influence parent training enrollment among African American families. Participants were 112 African American mothers who were provided child behavior vignettes and completed measures assessing factors related to problem recognition, parental attributions, child rearing values, mental health stigmatization, racial identity, and treatment utilization. Results found that when presented with a child displaying clinically significant externalizing child behaviors, slightly more than half of African American mothers recognized clinically significant child behavior problems. Mothers were more likely to engage in behavioral parent training if problematic behavior was recognized. Additionally, mothers’ attributions of child behavior, cultural values, and mental health stigmatization were influential to help seeking. This study supports the importance of considering cultural variables that impact problem recognition and subsequent treatment utilization among African American families.     

The contributions of child–mother attachment,maternal parenting stress,and military status to the prediction of child behavior problems

Studies show that children with a military parent are at heightened risk of the development of behavior problems. However, there is limited work examining how other factors experienced by military families may also influence behavior problems. In the current study, we recruited three types of Canadian families with a preschooler: families with a deployed military member, families with a nondeployed military member, and nonmilitary families. We examined whether the nonmilitary parent's (in all cases the mother) parenting stress and attachment relationship with the child are associated with behavior problems, and whether deployment status further contributes to the prediction. Child–mother dyads participated in an observed attachment assessment, and mothers reported on their stress levels and their child's behavior. Results showed that both child attachment insecurity and parenting stress were associated with elevated levels of internalizing problems; however, only parenting stress was associated with conduct problems. Military deployment predicted higher levels of internalizing and conduct problems beyond the contributions of attachment and stress. Furthermore, having a father in the military (whether deployed or not) also contributed to internalizing problems. These findings shed light on how the military lifestyle impacts early childhood mental health through the complex interplay between various parts of their environment.     

The relevance of current clinical practice in child psychotherapy to child psychiatry

SUMMARY

The role of child psychiatrists is evolving. Economic and psychosocial factors such as marital breakdown, inner city decline, unemployment, plus increased awareness of conditions such as Substance Abuse and all forms of Child Abuse have led to stress for children and their caretakers. There is also increasing recognition that with help many troubled children and their families can emerge better able to function. Child psychiatrists occupy a pivotal position in the child mental health team and need to be familiar with all the treatment options available to ensure their effective use. This paper presents examples of current work being undertaken by child psychotherapists and discusses the implications of this for the training of child psychiatrists as well as for clinical work.     

Lack of acknowledgment in the family Rorschachs of families with a child at risk for schizophrenia.

Lack of acknowledgment, a characteristic of the direct interactions of families of schizophrenics, was found also to characterize the Family Rorschach interactions of families whose disturbed, non-psychotic adolescents were assessed at high risk for schizophrenia on the basis of parental communication deviance. The same high-risk families had unbalanced interaction patterns as reflected in three measures of family structure.     

Relationships between adult attachment representations and family ritual quality: a prospective, longitudinal study

Meaningful family rituals have been associated with positive outcomes for families and children. No studies, however, have investigated predictors of family ritual quality, the identification of which would be important for understanding why some families create and enact meaningful family rituals while others lack rituals or have problematic rituals. We propose that adult attachment security may be an important predictor of family ritual quality because family rituals may provide a sense of stability and cohesiveness for the family. The purpose of this study was to examine relationships between adult attachment representations and the quality of family rituals, using a prospective, longitudinal design. Prior to the birth of their first child, 125 couples completed the Adult Attachment Interview, and a subsample of 70 mothers and 62 fathers completed the Family Rituals Questionnaire when their first child was 7 years old. Different patterns of relationships between attachment representations and family rituals were found for mothers and fathers. Maternal Insecure Attachment was associated with higher routinization of family rituals. Being in a couple with mixed attachment classifications (e.g., one Secure partner and one Insecure partner) was related to a pattern of low routinization and low meaning for family rituals. The results of this study are interpreted in terms of two patterns of rituals that have been described by clinicians--rigid ritualization and underritualization, and suggestions for working with these ritual patterns in families with Insecure attachment are provided.     

Perception of Cognitive Ability in Families of Adolescents

The families of 20 hospitalized adolescents were compared with a control group of 20 non-pathological families on the accuracy with which family members could predict each others' performance on two tests of intellectual ability. Accuracy of prediction was measured by the discrepancies between actual scores obtained by each family member and the scores other family members predicted he or she would obtain. The control and experimental groups were found to differ significantly on socioeconomic status and intellectual ability, and when these variables were controlled, a covariance analysis revealed no significant difference between the groups on accuracy of predictions. The results suggest that variables other than psychopathology must be taken into account in explaining apparent differences between healthy and disturbed families on measurements of interpersonal judgments. Implications for research and family therapy are discussed.     

Family Stress and Adjustment as Perceived by Parents of Children with Autism or Down Syndrome: Implications for Intervention

ABSTRACT

This study examined stress and adjustment in parents of three groups of families: those with an autistic child, those with a Down syndrome child, and those with only developmentally normal children. A total of 54 families participated, with 18 representing each group. Parents of autistic children generally reported more family stress and adjustment problems than parents of children with Down Syndrome who, in turn, reported more stress and adjustment problems than parents of developmentally normal children. Although parents of disabled children reported more stress associated with caring for their child, they generally showed resilience in adjusting to the presence of a severely disabled family member. Implications for family intervention are discussed.     

Coping in Families with a Retarded Child

The impact of a retarded child on a family has previously been described by individual family members' reports. This study of 40 families, 10 in each of four critical periods during the life of the retarded child, utilized videotaped interviews with whole families, with subsequent clinical observation and analysis based on the Beavers family assessment model. Healthy and problematic adaptations are delineated, with specific attention to systems concepts such as family structure and power, member individuation, feeling expression, and values. The report includes data analysis and a summary of pattern differences in family functioning.     

THE PERSONAL IS PHILOSOPHICAL IS POLITICAL: A PHILOSOPHER AND MOTHER OF A COGNITIVELY DISABLED PERSON SENDS NOTES FROM THE BATTLEFIELD

Abstract: Having encountered landmines in offering a critique of philosophy based on my experience as the mother of a cognitively disabled daughter, I ask, "Should I continue?" I defend the idea that pursuing this project is of a piece with the invisible care labor that is done by people with disabilities and their families. The value of attempting to influence philosophical conceptions of cognitive disability by virtue of this experience is justified by an inextricable relationship between the personal, the political, and the philosophical. If one grants that the "special relationship" between mother and child requires moral recognition, then I need first to make vivid the case that this relationship in the case of a child who lacks some "normal capacities" is indistinguishable from any mother-child relationship. If this is so, then I believe I can make a case that has as its conclusion that the moral personhood of even the severely cognitively disabled must be granted. Moreover, such recognition, I argue, necessitates the recognition of others who bear no special relationships to the child.