Differentiating between child protection and family support in the Canadian child welfare system's response to intimate partner violence,corporal punishment,and child neglect

Rates of reported child maltreatment nearly doubled in Canada over the period 1998–2003, an increase that reflects growing awareness of the harmful effects of an expanding array of parental behaviors, including corporal punishment, lack of supervision, and exposure to intimate partner violence (IPV). Some of these situations may benefit from voluntary family support programs outside of the child welfare system. Analyzing a sample of 11,807 investigations, this paper compares cases where the sole concern is exposure to IPV, or hitting a child, or neglect, or other forms of investigated maltreatment. Situations where exposure to IPV or potentially abusive hitting were the sole reason for investigation presented with fewer risk factors and were less likely to lead to ongoing child welfare interventions compared to other maltreatment investigations. While situations involving alleged neglect presented a higher risk profile and elicited a more intensive child welfare response than did exposure to IPV or hitting, opportunities for alternative services were nevertheless identified. The study also found that visible minority families were overrepresented in cases involving hitting and that Aboriginal families were overrepresented in cases involving neglect. Overall the findings support the development of alternative response programs in Canada.     

Factors that Precipitate and Mitigate Crises in Ministry

Using a modified Delphi technique, this study reports mixed-method data for factors identified as leading to crises in ministry. Data were collected from a random stratified sample of Uniting Church clergy based in southern Australia. Three phases (Phase 1?N?=?85, Phase 2?N?=?95, Phase 3?N?=?75) identified precipitants to crises in ministry and strategies to mitigate these crises. Strategies included a need for ongoing mandatory professional development, professional supervision, peer support, and formal ethics training. Results are discussed in the light of job demands, job control and job support, and the self-determination needs of competence, relatedness, and autonomy.     

Maternal Relationship Insecurity and Depressive Symptoms as Moderators of Home Visiting Impacts on Child Outcomes

The purpose of this study was to determine the extent to which maternal relationship insecurity and severe depressive symptoms moderate home visiting impacts on developmental and behavioral outcomes in 2-year old children. In an experimental trial of the Healthy Families Alaska home visiting program, families (N = 249) were randomly assigned to home visiting (n = 126) or community services as usual (n = 123). Maternal severe depressive symptoms (CES-D ≥ 24) and relationship insecurity were measured using the Center for Epidemiologic Studies Depression Scale and the Attachment Style Questionnaire at baseline. Child cognitive and psychomotor development and behavior problems were measured with the Bayley Scales of Infant Development and the Child Behavior Checklist at follow-up. The results revealed that home visiting significantly impacted three outcomes—child cognitive development, internalizing behavior, and externalizing behavior. Home visiting impacts were limited to subgroups defined by maternal depressive symptoms and relationship insecurity. Home visiting improved cognitive development (B = 6.02, p < .03), and decreased internalizing behavior (B = ?3.83, p = .02) and externalizing behavior problems (B = ?3.74, p = .03) in children of mothers with either severe depressive symptoms or high levels of discomfort with trust at baseline, but not both. Family engagement in home visiting seems to play a role in mediating these moderating effects. These findings reflect the importance of screening for maternal relationship insecurity and depressive symptoms to distinguish family subgroups likely to benefit from home visiting from those for whom an enhanced service model might be needed.     

Ungedeckte psychotherapeutische Bedarfe bei Stimulanzienkonsumenten

Background

Despite changes in the regulations concerning outpatient psychotherapy in Germany, relatively few patients with substance use disorders receive this type of treatment.

Objectives

The results of a recent study among stimulant users are taken as an example to illustrate the psychotherapeutic needs of patients with substance use disorders.

Materials and methods

A total of 392 individuals with active use of amphetamine and/or methamphetamine were included using a broad range of recruitment strategies. In a mixed methods approach, qualitative as well as quantitative data were gathered regarding the history of substance use, the motives for use, and traumatic experiences during childhood.

Results

Psychological distress was a frequent motive even at the initiation of stimulant use. About two thirds of the participants (65.1?%) reported at least one form of childhood trauma (sexual, physical or emotional abuse, emotional or physical neglect).

Conclusion

The findings suggest a high need for psychotherapy among patients with substance use disorders. It seems important to further improve the information as well as the training of psychotherapists to work with these clients.     

School-Based Supports and Interventions to Improve Social and Behavioral Outcomes with Racially and Ethnically Minoritized Youth: A Review of Recent Quantitative Research

School discipline disproportionality has long been documented in educational research, primarily impacting Black/African American and non-White Hispanic/Latinx students. In response, federal policymakers have encouraged educators to change their disciplinary practice, emphasizing that more proactive support is critical to promoting students’ social and behavioral outcomes in school. Results from a literature review conducted nearly a decade ago indicated that there was, at that point, a paucity of empirical research related to considering students’ culture (e.g., race, ethnicity) and supporting school behavior. The purpose of this study is to replicate and expand the previous review to summarize the characteristics of the most recent school-based quantitative research addressing interventions to promote social and behavioral outcomes for racially and ethnically minoritized youth. We screened 1687 articles for inclusion in the review. Upon coding 32 eligible research studies, we found that intervention and implementer characteristics within these studies varied, but noted strong intervention effects in studies that included established evidence-based practices, adapted interventions, as well as new practices piloted with student participants. Results inform recommendations to continue to study interventions that promote positive social and behavioral outcomes for racially and ethnically minoritized students to disrupt a long history of subjection to exclusionary discipline disproportionately.

     

Psychotherapeuten und Internet

Background

Communication is part and parcel of every interaction. This raises the question of the role of modern media in mental health care. The aim of this explorative study was to investigate the use of modern media in the clinical practice.

Material and methodology

In an Internet survey 234 psychotherapists from Nordrhein-Westfalen (NRW) were surveyed about the extent to which they integrate new media in the practice and their opinion about this integration. For this purpose a questionnaire was developed based on the questionnaire of Wangberg et al. (2007).

Results

Most of the psychotherapists already use e-mails as well as mobile communication to contact their patients. The main reason for choosing this modern way of communication is the possibility to simplify the management of formal issues. Psychotherapists were indifferent about the idea of web-based counseling.

Conclusion

Forms of digital media are used as an addition to conventional ways of therapeutic communication but face-to-face interaction cannot be replaced completely which is also indicated by the fact that professionals still highly value personal contact.     

Sexualit?t in Zeiten des Internet

The Internet shows several more or less specific characteristics, in particular accessibility, anonymity, affordability, worldwide connectivity and interactivity. These characteristics hold chances as well as risks for the development of sexuality and sexual relationships. Rarely stressed and investigated are the possible positive effects, such as easier sexual contacts especially for individuals with social deficits, for sexual minorities (e.g. gay, lesbian, transgender, sadomasochists or fetishists), reducing sexual prejudices and stereotypes, better partner matching and easy access to reliable information and counseling platforms about sexual issues. The psychotherapist more often encounters the problematic effects of Internet pornography and cybersex, such as avoiding real life (offline) sexual and non-sexual social contacts, the stress on relationships (e.g. through cyber infidelity), intensifying fantasies and impulses that are harmful to oneself or others up to criminal behavior (e.g. use and circulation of child pornography). Describing a case history this review discusses the role of the Internet in the development of sexual addictive or compulsive symptomatology, including treatment options. Only a differentiated analysis of the chances and risks can counterbalance the increasing tendencies to demonize and pathologize the use of the Internet for sexual purposes.     

Therapiekonzeption für traumatisierte Patienten mit schweren Persönlichkeitsstörungen

Comorbidity between severe personality disorder and posttraumatic stress disorder is a frequent clinical problem. Severe personality disorders are characterized by an impaired regulation of emotions, a low mentalization capacity and deficits in personality integration. For severe personality disorders and posttraumatic stress disorder, a variety of evidence-based treatment approaches of psychodynamic and cognitive-behavioral origin are available. However, a closer inspection of these treatment concepts shows that they do not sufficiently take the respective comorbid condition into account. No single concept is able to cover all problem areas presented by patients with this comorbidity. Therefore, an attempt is made to present an integrative psychodynamically oriented therapy concept for traumatized patients with personality disorders which contains elements from psychodynamic, cognitive-behavioral and other concepts. The phase structure of the concept clarifies the sequence hierarchy of the therapeutic interventions. The content of the five phases are: (1) safety, holding and strengthening of coping capacities, (2) emotion regulation and self-care, (3) mentalization and development of stable representations, (4) gentle trauma processing and (5) conflict-oriented psychotherapy and treatment of maladaptive relationship patterns.     

Parental Attitudes,Beliefs, and Perceptions about Genetic Testing for FAP and Colorectal Cancer Surveillance in Minors

Familial adenomatous polyposis (FAP) is the second most common hereditary colorectal cancer syndrome and confers a nearly 100% lifetime risk of developing colorectal cancer. Understanding factors that facilitate and inhibit genetic testing and cancer surveillance in children who are members of families affected by FAP will better equip clinicians to clarify misunderstandings and facilitate appropriate care. The aims of this study were to examine parental attitudes and beliefs regarding endoscopic surveillance and genetic testing in minors at risk for developing FAP. This cross-sectional study includes analyses of qualitative and quantitative interview data collected from parents of children with or at risk for FAP. This report includes data from 28 parents with a total of 51 biological children between 10–17 years of age. The parents had a clinical and/or genetic diagnosis of FAP. Most commonly reported facilitators included provider recommendation (surveillance) and personalized medical management (genetic testing). Most commonly reported barriers included lack of provider recommendation (surveillance) and cost (genetic testing).     

Patientensuizid im psychiatrischen Fachkrankenhaus

Suicide prevention especially with psychiatric inpatients is traditionally a very important aspect of psychiatric treatment. During the 1970s and 1980s there was a noticeable increase in so-called hospital suicides in Germany, especially suicides of schizophrenic inpatients. The number of psychiatric inpatient suicides has currently decreased again and a shift to more depressive suicides has also been observed. Furthermore questions which are asked in court are presented and discussed.