Training program in psychosocial intervention for high-risk infants and their families

A multidisciplinary training program for psychosocial intervention in the Neonatal Intensive Care Unit (NICU) was developed. The purpose of the program was to train mental health and health care professionals in a psychosocial preventive intervention model for high-risk infants and their families throughout the infants' hospital course in the NICU. The program was divided into modules that include assessment and intervention with the infant, parents, family, and larger caregiving environment. Over a 3-year period 40 trainees from 9 disciplines were trained. A randomized clinical trial was conducted which showed the positive effects of the intervention. A clinical service including inpatient and outpatient follow-up has been established in the NICU based on the psychosocial model developed from the training program.     

Preventive intervention with latency-aged children of divorce: A replication study

This replication study assessed the efficacy of a school-based preventive intervention for latency-aged children of divorce. The Children of Divorce Intervention Program (CODIP) emphasizes support, identifying and expressing divorce-related feelings, training situationally relevant communication, problem solving, and anger control skills, and enhancing self-esteem. Fifty-four children of divorce participated in the 11-session program conducted in small groups. Their adjustment was contrasted at pre and post with that of demographically matched peers (N = 78) from intact families on teacher, parent, self-report, and group leader measures. Children of divorce were less well adjusted than their peers before the intervention. They improved significantly after the intervention, approaching youngsters from intact families in adjustment status. The replication data support CODIP's efficacy as a preventive alternative for children of divorce. Needed future development and research steps are considered.     

Preventive intervention strategies with hard-to-reach mothers: A collaboration between midwives and psychotherapists

Maternal refusal of psychiatric services can pose a problem for both the family and mental health practitioners. With a sample of mothers who had refused psychiatric services in the past, the present study examined the effectiveness of initiating and maintaining mental health services when midwives acted as mediators. After the midwives had developed a relationship with the mothers, suggestions for mental health services were made again. For part of the sample, therapists accompanied the midwife on a home visit and scheduled subsequent therapy sessions in the home. For the remaining subjects, referrals were made to the local community mental health center. Results indicated substantially greater success in both the initiation and maintenance of therapy when midwives acted as mediators and therapy continued in the home.     

An integrated model for intervention with infants,preschool children,and their maltreating parents

Service delivery systems for maltreating parents need to be comprehensive, integrated, and coordinated in order to address the ecological, developmental, and psychotherapeutic needs of maltreating families. This article presents a center-based, intensive model of intervention for multiproblem, maltreating families. The program described addresses the needs of the entire family; incorporates the evaluation and treatment of the child's, as well as the parent's, development; and provides services in a multifamily group milieu. The following interventions are integrated in the treatment approach: (1) family milieu approach, (2) assistance with functioning of the “parental ego,” (3) traditional therapies, and (4) developmental-structuralist approach to parent-child interaction. Challenges encountered and solutions employed in working with maltreating families are discussed. A detailed case study is presented to illustrate the types of interventions used.     

Infants and their families at risk: Assessment and intervention

One of the basic premises of child-rearing and intervention models is that infant behavior is part of a communication system with the caregiving environment. However, infants vary in the messages that they convey to the caregiving environment, and parents vary in their ability to interpret their infants' signals and provide appropriate caregiving. This paper examines some of the tension that may exist between infant communication and appropriate caregiving. We examine research findings from several different populations of at-risk infants and their mothers in which infant signals and parental responses are variously effective in providing clues for appropriate caregiving. Some kinds of fits or matches between infant characteristics and maternal characteristics may be better than others for optimal infant development. The implications for intervention are also discussed.     

Home-based intervention for infants with developmental disorders

A hom-based therapeutic program for infants with developmental disorders is described. The program is used at the Institute for Psychophysiological and Speech Disorders, Belgrade, Yugoslavia. Significant changes in infant developmental competence provide support for the use of parents as direct intervention agents for their infants. Positive changes in marital and family relationships are important side effects of parent involvement in the therapeutic habilitation of their children.     

Crisis intervention with families of servicemen missing in action

This study investigated reactions and processes in a crisis situation as well as experiences of those who engaged in crisis intervention activities. Thirty-two volunteers, who worked with 55 families of servicemen missing in action during the October 1973 Mideast war, described the families' reactions to the given situation as well as their own involvement. Reactions to crisis and expectations from the volunteers are described and discussed. Special scrutiny was directed at the volunteering phenomenon, and at the volunteers' motivations, needs, reactions, and conflicts.     

Toward culturally sensitive intervention with arab families in Israel

Over the past three decades, Arab society in Israel has been undergoing processes of transition. These processes are manifested by changes in the economy, education, the status of women, family structure, and by socio-cultural changes and transformations in patterns of coping with social problems. There is a serious lack of empirical research on the implications of this process for the value systems of Arab society and families in Israel and a dearth of relevant intervention-oriented literature. This article outlines the basic cultural values in the Arab society in Israel in an attempt to illuminate the relevance of these values for family structure and for direct interventions with Arab families in Israel.     

Ladies in waiting: a group intervention for families coping with deployed soldiers

It is widely recognized that military service during wartime can take a toll on a soldier's psychological health. Recent work has revealed effects on the families left behind as well, as reflected, for example, in an increase in child abuse and neglect in these families. My interest in studying the transgenerational transmission of trauma led me to offer the National Guard a pro bono group therapy for women whose husbands had been deployed overseas. A slightly unorthodox approach paved the way not only to group treatment but, ultimately, individual treatment for these women and their children. My hope is that this work can serve as a model for other therapists who share my interest in treating the intergenerational transmission of trauma by implementing group and mother-child psychotherapy.     

Psychoeducation: A promising intervention strategy for families of children and adolescents with mood disorders

Mood disorders and suicide in youth represent major health concerns requiring effective intervention strategies. This paper briefly summarizes the literature on childhood mood disorders and discusses expressed emotion (EE) and the link between lowering EE and improved outcome for mood disordered individuals. Family psychoeducation is discussed as a means of reducing EE and similarities and differences between psychoeducation and other therapeutic interventions explored. The authors' adaptations that made psychoeducation developmentally appropriate for families of children and adolescents are reviewed. Psychoeducation for families of mood disordered youth is suggested as worthy of further clinical and empirical effort.     

Primary psychological intervention with families of earthquake survivors in armenia

Abstract

We studied the impact of the December 1988 earthquake on children and their families in Armenia, USSR. Important cultural characteristics affected symptom presentation and treatment strategies. In this paper we discuss the impact of Armenian culture, particularly the way children reflect the status of their parents, on treatment interventions.     

Counting the stitches that count: Preventive intervention promises and public health

Continued public support for the design, implementation, and dissemination of preventive interventions depends on achievement of four major criteria: (a) Reductions in the incidence or prevalence rates of diagnosable emotional and behavioral disorders, (b) reductions in the need for mental health services through effective primary and secondary interventions, (c) enhancement of the effectiveness of obtained services as screening and early detection efforts are implemented, and (d) reductions in the nation's health care costs associated with emotional and behavioral dysfunctions. Strategies including risk reduction, risk avoidance, health promotion, empowerment, and resource development are preventive insofar as they contribute to achievement of the aforementioned outcomes.     

Preventive group psychotherapy for at-risk infants and their mothers

There is increased evidence that infants who receive poor quality social stimulation from their primary caregiver are at risk for later developmental difficulties. This paper describes a preventive intervention for mother-infant dyads exhibiting impaired patterns of social interaction. An impaired relationship with the primary caregiver has been found to be associated with social and emotional deficits in early childhood as well as with significant psychopathology in adulthood. The intervention consisted of group treatment of mothers and their infants. Each group session has 4 subsections which, together, were directed towards improving the mothers' ability to relate in a stimulating and nurturant manner to their children. Types of intervention included didactic instruction, modeling, and interpretation of the infant's behavior. Qualitative data suggested that the group intervention has positive effects on the mother-infant dyads.     

Read your baby: A follow-up intervention program for parents with NICU infants

An intervention model designed to provide education and support to parents of sick or preterm infants throughout their first year of life is described. The intervention focused on helping parents communicate more skillfully with their infant and encouraging parents to maximize their infant's participation in the family system. Seventeen medium-risk infants received intervention; another seventeen served as controls. Independent evaluations of all families at 12 months adjusted age revealed that intervention babies were significantly advanced on Bayley Scales of Infant Development and Mastery Motivation tasks and that their mothers viewed them as easier to care for and less irritable.     

Division of household labor and child care in dual-earner African-American families with infants

This study examined 63 middle- to lower-middle income dual-earner African-American mothers' and fathers' involvement in child care with their infant and in household work, and the degree of support they received for child care. Although analysis revealed gender-differentiated patterns of involvement in care giving and household work along traditional lines, African-American fathers were far from being distant or uninvolved in these activities. Father involvement in child care and household activities did not vary as a function of whether mothers worked full time or part time. The data are discussed with respect to possible gender role convergence in child care and household work in African-American families.     

Maternal gatekeeping, coparenting quality, and fathering behavior in families with infants

The present study examined the role of maternal gatekeeping behavior in relation to fathers' relative involvement and competence in child care in 97 families with infant children. Parents' beliefs about fathers' roles were assessed prior to their infant's birth. Parents' perceptions of maternal gatekeeping behavior (encouragement and criticism) and coparenting relationship quality were assessed at 3.5 months postpartum. The authors assessed fathers' relative involvement and competence in child care using a combination of parent report and observational measures. Results suggest that even after accounting for parents' beliefs about the paternal role and the overall quality of the coparenting relationship, greater maternal encouragement was associated with higher parent-reported relative father involvement. Moreover, maternal encouragement mediated the association between coparenting quality and reported relative father involvement. With respect to fathers' observed behavior, fathers' beliefs and parents' perceptions of coparenting relationship quality were relevant only when mothers engaged in low levels of criticism and high levels of encouragement, respectively. These findings are consistent with the notion that mothers may shape father involvement through their roles as "gatekeepers."     

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.