Family Involvement in Residential Treatment: Staff, Parent, and Adolescent Perspectives

We conducted interviews with staff members, parents, and adolescents at a residential treatment center to examine the frequency, nature, and satisfaction with contact between parents and adolescents and parents and staff. We also assessed perceived barriers to family involvement and possible solutions for improving this involvement. Results indicated that there is more contact between parents and adolescents than in previous studies. In addition, contact between parents and staff occurred frequently, although there were discrepancies regarding their reasons for the contact. Most parents and adolescents reported that the amount of contact was adequate, but the majority of staff members perceived there to be not enough contact. Adolescents reported that there was not enough contact with secondary sources of support, most often other family members. Barriers to family involvement included transportation, parent responsibilities and personal problems, and legal issues. In addition, parents reported that strained family relationships and problematic adolescent behavior interfered with their involvement. The need for residential treatment centers to broaden services to include parents as well as members of the larger support network is discussed.     

Therapist, Parent, and Youth Perspectives of Treatment Barriers to Family-Focused Community Outpatient Mental Health Services

This exploratory qualitative study describes treatment barriers to receiving family-focused child mental health services for youths with disruptive behavior problems from multiple perspectives. Data were collected during a series of focus groups and interviews, including: 4 therapist focus groups (n = 26), 3 parent focus groups (n = 14), and 10 youth (10–13 years) semi-structured interviews. Data analysis followed inductive, iterative processes typical of qualitative research using an editing style and thematic content analysis approach. Therapist, parent, and youth stakeholder participants discussed perceived barriers to effective treatment, the problems with current child outpatient therapy, and desired changes (i.e., policy, intervention, etc.) to improve mental health services. Results indicate similar themes around treatment barriers and dissatisfaction with services within and across multiple stakeholder groups, including inadequate service system support, lack of family involvement and feeling overwhelmed with the complexities of families’ needs; however, parents and therapists, in particular, identified different contributing factors to these barriers. Therapists highly endorse using family-focused therapy and desire parent participation; however, parents feel unsupported by their child’s therapist. Parents’ report feeling blamed and not heard by service providers which negatively impacts their attitude about service delivery, causing discomfort and resistance to participation in their youth’s treatment. Youth also discussed dissatisfaction with mental health services, specifically related to their direct experiences in therapy, and desired more active, directive family-focused approaches. Overall, stakeholders reported much frustration and dissatisfaction with current community-based outpatient child therapy services. Study findings can inform service provision, intervention development, and future research.     

Resilience Factors in Paediatric Inflammatory Bowel Disease: Health Care Provider,Parent and Youth Perspectives

Journal of Child and Family Studies - Exploring factors related to resilience in youth with inflammatory bowel disease may elucidate modifiable risk factors and inform interventions. Yet, how...     

Adolescent and Parent Perspectives on Ethical Issues in Youth Drug Use and Suicide Survey Research

The contributions of adolescent and parent perspectives to ethical planning of survey research on youth drug use and suicide behaviors are highlighted through an empirical examination of 322 7th-12th graders' and 160 parents' opinions on questions related to 4 ethical dimensions of survey research practice: (a)evaluating research risks and benefits, (b)establishing guardian permission requirements, (c)developing confidentiality and disclosure policies, and (d)using cash incentives for recruitment. Generational and ethnic variation in response to questionnaire items developed from discussions within adolescent and parent focus groups are described. The article concludes with a discussion of the potential contributions and challenges of adolescent and parent perspectives for planning scientifically valid and ethically responsible youth risk survey research.     

Adolescent Group Psychotherapy: Collaborative Opportunity for Patients,Parents, and Therapist

This brief report examines the uses of an Observation Team with a Parent Support Group. In particular, attention is placed on the idea of the Observation Team acting as a Reflecting Team in the final session of the group's life. Using the Observation Team in this manner has evolved from an amalgamation of ideas from family therapy and group therapy theory.     

Therapist Self-as-Context and the Curative Relationship

This article discusses how the way the therapist relates to his or her personal responses to client material during the session contributes to making the relationship with the client an effective tool for treatment. Ideas from third wave behavior therapy are used to describe aspects of therapist involvement in the relationship and modes of therapist awareness of inner responses. In two vignettes, negative client reactions to an intervention bring problematic therapist material to the fore. Both cases highlight how the stories the therapists spun about themselves as professionals and persons could easily have limited their effectiveness in responding to the material. The vignettes also illustrate how clinicians can overcome personal meanings and judgments to access a more productive mode of interacting with the feelings a critical incident in the relationship evokes in them. It is argued that observing their own content from a psychological distance makes it possible for clinicians to use their feelings without getting caught up in them. These same feelings may then help the therapist perceive how the incident relates to the client’s daily life problems. The therapist’s engagement in a sense of self-as-context is described as a therapeutic stance that provides the psychological distance needed to help overcome alliance ruptures and other potential gridlocks and which may transform the therapist’s inner response to client content into a tool for addressing important client issues.     

Therapist Focus on Parent Involvement in Community-Based Youth Psychotherapy

Parent involvement in the treatment of childhood disruptive behavior problems is a critical component of effective care. Yet little is known about the amount of time therapists are involving parents in treatment and factors that predict therapists' efforts to involve parents in routine care. The purpose of this study is to examine therapists' within-session involvement of parents in community-based outpatient mental health treatment. The data are from a larger longitudinal observational study of psychotherapy for children ages 4-13 with disruptive behavior problems and include videotaped psychotherapy sessions coded for the therapeutic strategies delivered as well as measures of child, parent/family, and therapist characteristics at baseline. Parent involvement is defined as the proportion of time in the session that therapists direct treatment strategies towards parents. Results indicated that therapists directed treatment strategies towards parents an average of 44% of the time within a session. Multilevel modeling was used to examine client-level (child, parent, and family functioning) and provider-level (therapist experience and background) predictors of parent involvement. Therapists involved parents more when the child had higher levels of behavior problems, when the parent reported higher levels of internalized caregiver strain, and when the therapist was more experienced. The results highlight potential areas to target in efforts to increase parent involvement, including training less experienced therapists to increase their focus on directing strategies towards parents.     

Therapist Factors Matter: A Systematic Review of Parent Interventions Directed at Children’s Behavior Problems

The present review systematically explored research examining the relationship between therapist‐related factors and the outcomes of parent interventions directed at children’s behavior problems. A systematic search of the literature was conducted with online scientific databases, parenting programs, web sites, and bibliographic references of the selected articles, according to PRISMA guidelines. A total of 24 quantitative studies met the inclusion criteria. Although some methodological limitations were identified with respect to the measurement of therapist factors, the reviewed research strongly suggests that the therapist plays a critical role in parent interventions directed at behavior problems. In particular, many parent outcomes are found to be related to the parent–therapist alliance, the therapist’s fidelity to the intervention, specific therapist’s in‐session actions, and the therapist’s personal variables. The parent–therapist alliance and therapist fidelity to the intervention consistently relate to changes in parenting practices, and alliance additionally relates to fewer perceived barriers to participation in treatment, more treatment acceptability, and greater parenting satisfaction and self‐efficacy. In addition, specific in‐session therapist interpersonal actions relate to parents’ engagement and satisfaction, while both the therapist’s interpersonal actions and more active skills relate to parent change. Therapist’s personal variables have been scarcely or poorly studied to date, but the results found justify the need to develop further research in this area. In conclusion, more attention should be given to the role of the therapist when implementing parenting programs directed at behavior problems, and more and better research is needed that can overcome the methodological limitations identified.     

Parent and Adolescent Depressive Symptoms: The Role of Parental Attributions

This study examined whether negative parental attributions for adolescent behaviour mediate the association between parental and adolescent depressive symptoms, and whether this relationship is moderated by adolescent gender. Mothers and fathers and 124 adolescents (76 girls and 48 boys; ages 14 to 18) participated. Adolescents were primarily Caucasian, and varied in the level of depressive symptoms (with 27% of the sample meeting diagnostic criteria for a current unipolar depressive disorder). Parents and adolescents completed measures of depressive symptoms, and participated in a videotaped problem-solving discussion. After the discussion, each parent watched the videotape and, at 20 s intervals, offered attributions for their adolescent’s behaviour. Adolescent gender moderated the relation between parental attributions and adolescent depressive symptoms, with stronger associations for female adolescents. For both mothers and fathers, both parental depressive symptoms and negative attributions about the adolescent’s behaviour made unique contributions to the prediction of depressive symptoms in adolescent females. There also was evidence that negative attributions partially mediated the link between depressive symptoms in mothers and adolescent daughters. The results are interpreted as consistent with parenting as a partial mediator between parental and adolescent depressive symptoms, and suggest that adolescent girls may be particularly sensitive to parents’ negative interpretations of their behaviour.     

Understanding Adult Participant and Parent Empowerment Prior to Evaluation in the Undiagnosed Diseases Network

The burden of living with an undiagnosed condition is high and includes physical and emotional suffering, frustrations, and uncertainty. For patients and families experiencing these stressors, higher levels of empowerment may be associated with better outcomes. Thus, it is important to understand the experiences of patients with undiagnosed conditions and their families affected by undiagnosed conditions in order to identify strategies for fostering empowerment. In this study, we used the Genetic Counseling Outcome Scale (GCOS-24) to assess levels of empowerment and support group participation in 35 adult participants and 67 parents of child participants in the Undiagnosed Diseases Network (UDN) prior to their UDN in-person evaluation. Our results revealed significantly lower empowerment scores on the GCOS-24 in adult participants compared to parents of child participants [t(100)?=???3.01, p?=?0.003, average difference?=???11.12, 95% CI (??3.78, ??18.46)] and no significant association between support group participation and empowerment scores. The majority of participants (84.3%, 86/102) are not currently participating in any support groups, and participation rates were not significantly different for adult participants and parents of child participants (11.4 vs. 19.7%, respectively, FE p?=?0.40). Open-ended responses provided additional insight into support group participation, the challenges of living with undiagnosed conditions, and positive coping strategies. Future research will evaluate the extent to which empowerment scores change as participation in the UDN unfolds.     

Parent Work Conditions and Adolescent Core Self-Evaluations: Examining the Effects of Work Resource Drain and Parent Gender

Purpose

Using resource drain and social cognitive theory frameworks, this study investigates the process through which parent time and energy resource drain relates to adolescent core self-evaluation. Parent–child interactive and routine activities and parental social support are tested as mediators.

Methodology

Data are reported by mothers, fathers, and adolescent children in 151 middle-class, dual-earner families from the 500 Family Study. Hypotheses are tested using path analysis and moderated mediation.

Findings

Parent work hours negatively relate to adolescent reports of received social support, partially due to decreased time spent engaged in parent–child interactive activities. Fathers’ work hours indirectly relate to adolescent core self-evaluations through parent–child interactive activities and social support from fathers; this indirect relationship was not found for mothers. Exploratory analyses examined differences by parent and child gender. Fathers’ work hours are more likely to detract from parent–child routine activities relative to mothers’ work hours. The relationship between father work hours and parent–child interactive activities is buffered for sons compared to daughters.

Implications

Results help to explain why parent work-related resource drain relates to adolescent core self-evaluations. Parent gender, type of resource drain, and type of activity are identified as potential boundary conditions. Interactive activities and social support are key mediators warranting attention.

Originality/Value

Social cognitive theory is used as a framework for linking parent work-related resource drain and child outcomes. Mechanisms are identified that explain adolescent core self-evaluations development. Use of multisource data helps to mitigate problems with single-source data used in previous studies.

     

Functions Served by Corporal Punishment: Adolescent Perspectives

This exploratory study investigated the functions served by corporal punishment as perceived by high school students in a developing country. A qualitative research design was used. Participants were a convenient sample of five high school students. Data were collected using the focus group interview technique. Results show that adolescents have contesting views on the functions served by corporal punishment in school. Adolescents' perspectives coalesced into three main conceptual spheres namely: hedonistic/sadistic, regulatory and instrumental functions. Teachers and other professionals, whose mandate is the welfare of adolescents, need to recognise the influence and importance of adolescent perspectives on functions served by corporal punishment.     

Adolescent Suicidal Risk: Psychological,Problem Solving,and Environmental Factors

This study examined the life stress and problem-solving interactional model of suicide proposed by Clum, Patsiokas, and Luscomb (1979) . Thirty-three hospitalized suicidal adolescents were compared with 21 adolescents hospitalized for other psychiatric problems and with 89 controls. The assessment battery was composed of psychological measures, problem-solving measures, and environmental and family measures. The discriminant analyses revealed that the suicide group could be discriminated from the psychiatric control group but not from the high school control group. Unexpectedly, life stresses did not contribute to the identification of current suicide risk. The results suggest the importance of assessing suicide risk at the time of admission to minimize any subsequent changes in the risk group.     

青少年恋爱关系：研究取向、方法与影响因素

青少年恋爱关系是在性吸引基础上建立起来的一种相互认可的、至少持续一段时间的强烈的情感联系和互动关系, 其研究取向主要有生物社会取向、认知表征取向和发展背景取向, 研究方法主要包括自我报告法、观察法和录像回顾法。影响青少年恋爱关系的有个体因素、人际关系因素和社会因素, 未来可在理论的整合、关系品质的稳定性及微观背景作用的机制、样本的代表性等方面进一步研究。     

Parent vs. Self-Report: Contributions Toward Diagnosis of Adolescent Psychopathology

Assessment of psychopathology in adolescents can be complicated due to uncertainties about who should be considered the primary informant. While a multimethod, multiinformant approach to assessment allows for a thorough assessment, it can also result in contradictory findings. The purpose of this study was to use a sample of 121 adolescents to investigate issues of parent-adolescent agreement on behavior rating scales and a structured diagnostic interview. Additionally, this study evaluated whether adolescent report offers unique information to the assessment beyond the parent's report. The sample included both normal controls and adolescents who met criteria for diagnosis of an Internalizing or Externalizing disorder based on the DSM-IV criteria. Agreement between parents and adolescents on the Diagnostic Interview for Children and Adolescents—Revised (DICA-R) was low for ADHD (39.4%) and Externalizing Disorders (41.1%) and moderate for Internalizing Disorders (56.6%). A significant difference was found between the number of ADHD symptoms reported, with parents reporting more symptoms (M = 9.42) than adolescents (M = 8.34). Regression analysis indicated that the adolescent completed Youth Self-report (YSR) contributed unique information beyond the parent completed measures in predicting both the adolescent and the parent interviews for Internalizing Disorders. This finding emphasizes the need to continue to collect self-report information, especially when assessing Internalizing disorders, which inherently contain symptoms indicating high-risk behaviors such as suicide ideation.     

Parent and Adolescent Gender Role Attitudes in 1990s Great Britain

Using data from the British Household Panel Survey, this short-term longitudinal study examined relationships between early- and mid-adolescents' gender role attitudes and the attitudes of their parents. Between 1994 and 1997, 602 families answered questions about the roles of husbands and wives, and whether or not having a working mother is harmful to families. Results confirmed that the gender differences that have been found consistently in the literature regarding adults extend back into early adolescence. Adolescent girls' attitudes were markedly more nontraditional than all other family members. However, results only partially supported our hypotheses regarding family influence on attitudes. In particular, we found little evidence that adolescent attitudes would more closely resemble those of the same-gender parent. Analysis of individual questions supports arguments that gender roles are complex and socially determined, and that British men of both adult and adolescent generations have begun in principle to accept nontraditional roles for wives but are less willing to support any erosion of male power in the family.     

Parent Perspectives on Family Involvement in Therapeutic Foster Care

There has been an increasing focus on family involvement in the treatment of children with serious emotional disorders, but it has received only limited attention in relation to out-of-home placements. I present the findings from a qualitative study of family involvement from the perspectives of parents whose children were placed in therapeutic foster care (TFC). Parents' perspectives on their involvement in placement decisions, relationships with professionals and TFC providers, practices related to family involvement, barriers to involvement, and strategies to enhance family involvement are described. Parents of children in TFC wanted to have contact with their children and to participate in decision making. They described relationships and practices that contributed to their involvement.