Mothers and Children Together

Summary

Treatment groups for both mothers and children together who have experienced mother assault is a unique therapeutic milieu which has been underutilized in the treatment field. This article presents a 10-week feminist-informed family systems group model as part of a treatment approach for children exposed to family violence and can be used with families of children from pre-school to adolescence. This model provides a context in which the experience of family violence can be debriefed, and issues related to trauma, safety, secrecy, and post-abuse family restructuring can be addressed by family members together. In addition, play and art therapy based interventions are presented and are tailored for the beginning, middle, and end of the group process.     

Elective mutism in children: A family systems approach

Abstract

Elective mutism in children is a relatively rare symptom which is more prevalent in the kindergarten population and has a higher incidence among immigrant families. Treatment strategies for this silent symptom include speech therapy, behavior modification, psychoanalytic, psychotherapeutic, family systems and a combination of these approaches. This paper reviews the types of elective mutism and proposes common characteristics of elective mutists' families. The potential for a redefinition of the term “elective mutism” is examined. It is concluded that family dynamics are an integral part of the elective mutism problem and need to be considered in a comprehensive treatment plan.     

Treating Parents and Children Together

SUMMARY

In this paper I look at two traditions of psychotherapy with children: family therapy {here considered in its common paradigm of systems theory and not in its diversity of approaches) and individual psychodynamically oriented child therapy. The author examines how, in these two modalities of treatment, the real world of the parent-child relationship, which remains mostly a world of women and children, tends to be left out in practice. Many family therapists “exclude” children from their sessions and concentrate on the marital relationship while child therapists “exclude” parents from the core of the therapeutic process. The issues for therapists and the consequences for adults and children in families in this com-partmentalization of services are examined within a feminist framework. The development which is advocated is for therapists to expose themselves fully to the world of the parent-child relationship as a fust step in reexamining their stereotypical views of motherhood and fatherhood which trap women in conflicted and potentially exploitative situations and do not consider that children actively construct their own relationships.     

Group Treatment of Sexually Abused Adolescent Girls: A Review of Outcome Studies

Abstract

This paper considers factors that make children “at risk” for postdivorce maladjustment. The risk factors include (a) demographic variables of sex, age and socioeconomic status; (b) predivorce family functioning; (c) postdivorce relationship with the ex-spouse; (d) postdivorce parentchild interaction; and (e) social support systems. Treatment programs incorporating these factors are briefly described. Recommendations are provided for the clinician and researcher.     

COVID-19 pandemic impact on family life and exacerbated emotional and behavioral health among preschool children: A longitudinal study

Background/ObjectiveThis study aimed to examine associations of the impact of COVID-19 pandemic on family life with emotional and behavioral health among preschool children.MethodsA longitudinal study including 1595 preschool children aged 3–6 years and their families was conducted in Anhui Province. The linear regression was applied to examine associations between the impact of COVID-19 pandemic on family life and emotional and behavioral health.ResultsResults of the multivariable linear regression indicated that the severe impact of COVID-19 pandemic on family life was significantly associated with more sleep problems, poor dietary behavior habits, more anxiety symptoms, and more problematic behaviors; and these effects exhibited gender and age differences.ConclusionsThe severe impact of COVID-19 pandemic on family life significantly increased the risk for exacerbated emotional and behavioral health among preschool children. It is considered vital to identify risk factors for vulnerable families and then to implement precise interventions when necessary for emotional and behavioral health of children in these families.     

Identification and Follow-Up by Primary Care Doctors of Children with PTSD After Terrorist Attacks

Abstract

Many children and adolescents were among the victims of the suicide bomb attacks in Israel since March, 2000. While the number with emotional and behavioral symptoms was expected to be high, very few children who developed terrorism-related posttraumatic stress disorder (PTSD) were actually referred to mental health professionals for assessment or treatment. Prolonged exposure to terrorism lowers even further the number of children who remain in treatment. This article discusses reasons and presents a training program for primary care providers (pediatricians, family doctors) in identifying PTSD in child victims, and for mobilizing them to carry out long-term follow-up of these children.     

Consider the Children

Summary

In this article, we consider interventions for children exposed to family violence in light of the research on children's problems associated with witnessing family violence. Next, we review risk and protective factors related to these children's adjustment with the view that all children are not similarly affected by exposure to family violence. Against this background, we then move to consider directions for interventions from a systemic perspective. We take into account not only the exposure to interactions between their mother and father, but also children's relationships with their mother, father, and siblings, as well as within broader systems such as the peer group, the school, and the community. We consider the critical challenges within each of these important systems for children exposed to family violence, and we propose some potential interventions to address the problems. Finally, we summarize an evaluation of an intervention that incorporates some of the elements identified by a systemic perspective. The evaluation revealed a significant improvement in children's self-reports of depression and anxiety over the course of the program. Mothers rated their children as significantly improved in emotional and hyperactive behaviour problems. There was no relation between mothers' involvement in counselling and children's improvement. Overall, the results suggest that the Peer Group Counselling Program effectively provided support to children exposed to family violence. Finally, we discuss the steps necessary to support children and families in moving toward violence-free lives.     

Child and family therapy: A collaborative approach

Abstract

When a child is the identified patient, people often expect individual sessions to be a part of treatment. Yet, family therapists routinely violate this expectation by working with children solely in the context of the family. This article discusses how the therapeutic process can be facilitated by conducting at least a small number of individual sessions with children. Such behavior by the therapist communicates to children, parents, and involved referral sources a respect for their opinions and lays the groundwork for cooperation. The advantages and disadvantages of such an approach are discussed.     

Behavioral-systems marital and family therapy: Integration and clinical application

Abstract

This paper describes our integration of two of the more prevalent approaches to marital and family therapy: the behavioral (social learning) and the family systems (communication theory) approaches. A discussion of the development of family rules from a behavioral point of view is presented as an example of conceptual integration. However, the major intent of the paper is to present a rather detailed explication of the authors' multivaried strategies for intervention, which are designed to integrate and innovate upon the major behavioral and family systems treatment techniques.     

Elevated attention deficit hyperactivity disorder symptoms in children who stutter

PurposeThis study described the proportion of children who stutter who exhibit Attention Deficit Hyperactivity Disorder (ADHD) symptoms, manifesting in inattentive and hyperactive/impulsive behaviours. Children who stutter with these challenging behaviours may not respond as quickly and successfully to stuttering treatment. A preliminary exploration of differences in treatment responsiveness for children with and without ADHD symptoms was undertaken.MethodParticipants were 185 preschool children who stutter who had completed stuttering therapy within 3 months prior to study commencement. Differences between groups of children who stutter with and without elevated ADHD symptoms were investigated, in terms of pre-treatment stuttering features (stuttering severity and typography), demographic variables (age at onset, time between onset and commencement of therapy, family history and sex) and treatment data (post-treatment stuttering severity and number of sessions to achieve discharge criteria).ResultsOne-half (50%) of participants exhibited elevated ADHD symptoms. These children required 25% more clinical intervention time to achieve successful fluency outcomes than children without elevated ADHD symptoms. Findings suggest that more ADHD symptoms, increased pre-treatment stuttering severity, and male sex were associated with poorer responsiveness to stuttering treatment.ConclusionThe large proportion of children exhibiting elevated ADHD symptoms, and the increase in clinical contact time required in this subgroup to achieve successful fluency outcomes, is suggestive of the need for clinicians to tailor stuttering intervention to address these concomitant behaviour challenges. Findings support the use of careful caseload management strategies to account for individual differences between children, and strengthen prognostic information available to parents and clinicians.     

Youth Depression in the Family Context: Familial Risk Factors and Models of Treatment

Research on parent risk factors, family environment, and familial involvement in the treatment of depression in children and adolescents is integrated, providing an update to prior reviews on the topic. First, the psychosocial parent and family factors associated with youth depression are examined. The literature indicates that a broad array of parent and family factors is associated with youth risk for depression, ranging from parental pathology to parental cognitive style to family emotional climate. Next, treatment approaches for youth depression that have been empirically tested are described and then summarized in terms of their level of parent inclusion, including cognitive–behavioral therapy, interpersonal therapy, and family systems approaches. Families have mostly not been incorporated into clinical treatment research with depressed adolescents, with only 32% of treatments including parents in treatment in any capacity. Nonetheless, the overall effectiveness of treatments that involve children and adolescents exclusively is very similar to that of treatments that include parents as agents or facilitators of change. The article concludes with a discussion of the implications of these findings and directions for further research.     

Expanding the family systems approach: Cultural,class, developmental and gender influences in drug abuse

Abstract

The family systems approach to drug abuse has illuminated the dysfunctional family dynamics often associated with adolescent drug abuse. However, for adults with long histories of drug problems, the model is less compelling. Evidence suggests that cultural variations, social class differences, individual and family life cycle development, and gender influence the origins and continuance of long-term drug abuse. Examples are offered of how these factors shape the adult course of drug addiction. The authors suggest that clinicians learn the particular meanings of individuals' family ties, dependencies and living arrangements. In doing so, they will consider the broader context in which drug abuse occurs and will enhance the accuracy and effectiveness of their assessments and treatment strategies.     

Multiple Victimization and the Process and Outcome of Child Psychotherapy

Abstract

Maltreated youngsters present a complex picture of treatment needs. This is nicely illustrated by a review of the treatment outcome research with abused children. Prominent among their treatment issues are relationship problems and poor emotion regulation strategies. The treatment relationship and process variables in psychotheraphy are of particular concern with maltreated children. Concepts and research in these areas are reviewed. Finally, the recommendation is made that multiply victimized children need a comprehensive, multi-component approach to treatment.     

Emotional and behavioural problems in children dealing with maternal breast cancer: a literature review

ABSTRACT

A significant number of breast cancer survivors are living with their minor children. In this review we investigated the impact of maternal breast cancer on children. A literature search conducted through PubMed, Scopus, Cochrane Library and CINAHL yielded 26 relevant studies, which documented a variety of effects. Evidence has been presented that dealing with maternal breast cancer can cause uncertainty, anxiety and depression in children, but may also lead to enhanced social and academic performance. The risk of problems in these children is reported to be associated with both low parental affective responsiveness and excessive parental involvement. Internalising child problems were shown to be linked with maternal depression and family dysfunction, and externalising problems with family dysfunction and communication problems. Some of these problems may be modified by interventions for supporting these families, which should be designed to include both parents and children, and also the healthcare personnel.     

Collaborating on Family Safety

Summary

The problems of child maltreatment and violence against women have traditionally been viewed and treated as two distinct issues. In response to these two forms of family violence, two separate service systems with different approaches to prevention, treatment and intervention have developed. This article outlines sources of conflicts between child protection workers and battered women's advocates, and elaborates on these conflicts using child protection workers' and battered women's advocates' own words elicited in a series of focus groups. Models of cross-system collaboration in the United States are then described, and recommendations are made for practice and policy which support collaboration across systems.     

Multiple Points of Intervention as an Approach in Child Psychotherapy

ABSTRACT

This article develops an integrated model that emphasizes multiple points of intervention in therapeutic work with children. It draws on nonlinear dynamic systems theory, Winnicott's theory of play and transitional space, elements of contemporary relational theory, client-centered therapy, Gestalt therapy, family systems, behavior therapy, selected aspects of cognitive behavior therapy, psychological education, and school consultations.     

Current Treatment Strategies for Sexually Abused Children

SUMMARY

Given the disturbingly high prevalence of child sexual abuse, the expertise of medical and mental health professionals in treating child sexual abuse victims is essential. Relevant issues in treating these children include the mindfulness of developmental considerations, incorporation of a multi-modal therapeutic evaluation approach, clarification of treatment goals, appropriate use of and integration of various treatment modalities, and effective treatment termination. This article provides an introduction aid overview of treatment of sexually abused children of all ages, from preschoolers to adolescents, with special emphasis on the importance of developmentally linked evaluation and treatment strategies. Treatment is discussed in terms of goals, stages from evaluation to termination, and formats and modalities including individual psychotherapy, family psychotherapy, group psychotherapy and hypnotherapy, to provide a comprehensive overview of current treatment strategies for sexually abused children.     

A Systemic Analysis of the Dynamics and Organization of Urban Street Gangs

Street gangs function as ongoing, open social systems in relation to their surrounding sociocultural context. Fundamentally, gangs are comparable to some family systems. In fact, most gangs do consider themselves to be “families.” The same concepts used to describe family systems may also be applied to street gangs. Street gangs usually exhibit a highly complex organization, structure, process, and functionality. All of these aspects intertwine within and around the gang to form a web of interconnectedness and continuity. To better understand street gangs and provide effective intervention plans, they must be viewed from this systematic and holistic perspective.     

Exploring the Use of an Integrative and Ecological Framework When Treating Children with Trauma

ABSTRACT

Children’s clinical symptoms can often only be understood within their individual and family contexts. However, contemporary research has pointed to the importance of also working with children’s social identities and macrosystem environment when attempting to understand and treat clinical problems. The case of a 10-year-old Dominican-American girl who presented with a significant trauma history, oppositional behavior, and difficulties interacting with her peers is examined using a developmental ecological framework. Attachment theory, cognitive behavioral therapy, narrative therapy, and multicultural family systems therapy, with a focus on trauma responses, are integrated when exploring the case. Additionally, the benefits of exploring the influence of social identities (race, ethnicity, immigration status/perceived immigration status, and class) are explored via an approach that focus on transformation and healing from oppressive systems by integrating sociopolitical realities in therapy.     

The interface of family disturbance and individual patienthood

Abstract

This paper addresses the need to approach understanding the individual patient's psychopathology from the vantage point of two etiologic systems: psychoanalytic object relations theory and family systems theory. The complementarity of these approaches is emphasized. It is suggested that the processes of internalization and projection are bridging concepts and that marital relationships provide a unique research context.