A Safety and Coping Planning Intervention for Suicidal Adolescents in Acute Psychiatric Care

Transitioning from an acute psychiatric care setting to a less restrictive environment after a suicidal event is arguably the most critical period of suicide risk for adolescents, making comprehensive safety and coping plans for this population ever more critical. In this paper we provide theoretical and empirical rationale for the need for developmental adaptations to current safety planning procedures for suicidal adolescents, as well as the standardization of pediatric safety plans for broader use across settings that provide acute psychiatric care to adolescents. We describe how we developed the Adolescent Safety and Coping Plan (ASCP) using qualitative in-depth interviews with 20 adolescents and their parents, explain the specific components of the ASCP, and give a case example of the ASCP being used with a young adolescent and her parents. Finally, we conclude with a discussion of the barriers and facilitators of the use of the ASCP in settings that provide acute psychiatric care, as well as the need for future research to test the ASCP with diverse adolescent and family populations and settings.     

Student volunteer social support and infant intervention: A case study

The emphases in infant mental health have been in the three areas of supporting the mother-infant dyad through education, psychotherapy to help parents resolve emotional conflicts that interfere with the parent-infant interaction, and support during the acute crisis that follows an abnormal birth. The case described herein involves a child with a genetic defect born to competent parents, a chronic stressful situation that does not fit these categories. It became apparent in the first few months after the birth that both the child and parents were in need of some help in coping with the situation. An intervention was designed to help provide both the necessary stimulation for the baby and the needed emotional support for the family, while it acknowledged their skill and competencies as parents. This was done through the help of college student volunteers, who assisted the mother in the home. Developmental data recorded at birth, 7 months, 12 months, and 39 months indicate that the child is severely multiply handicapped. Interview data with the parents at those times document their personal and family difficulties, the eventual resolution as a family in dealing with this problem, and the importance of the volunteer help during that process.     

When Is Seeking Safety Functional? Taking a Pragmatic Approach to Distinguishing Coping From Safety

Currently, most exposure-based treatments call for clinicians to assess for and remove all safety behaviors during exposure tasks. However, the notion that safety behaviors are detrimental across all scenarios has recently been challenged, and research regarding the effects of safety behaviors on exposure outcomes is limited and inconsistent. In clinical practice, classifying a strategy as a safety behavior can be a complex and challenging endeavor, particularly when distinguishing between harmful safety behaviors and helpful coping behaviors. We outline an approach that emphasizes the pragmatic truth criterion and uses functional outcomes to classify behaviors as serving either safety or coping functions. Our focus on doing what “works” simplifies decision-making for clinicians and maintains the focus of treatment on enhancing functioning. We propose a model for using functional outcomes to distinguish between safety and coping behaviors and illustrate our approach through case examples.     

Including Both Voices: A New Bidirectional Framework for Understanding and Improving Intergroup Relations

Methods: If successful intergroup harmony is to be achieved between two groups, then both groups' voices must be heard. Despite this, 60 years of social psychological “intergroup” prejudice research has tended to adopt a solely majority‐centric perspective, with the majority group portrayed as the active agent of prejudice, and the minority group as passive targets. Objective: This paper critically reviews relevant literature, highlighting this unidirectional imbalance, and proposes a new, two‐stage bidirectional framework, where we encourage researchers and educators to first understand how minority and majority groups' intergroup attitudes and emotions impact intergroup dynamics, before tailoring and implementing contact and recategorisation strategies to improve intergroup relations, nationally and internationally. Conclusion: We argue that the interactive nature of the intergroup dynamic needs to be better understood, and each group's voice heard, before prejudice can be effectively reduced. Lastly, we describe an Australian study, the Dual Identity and Electronic‐contact (DIEC) programme, that has been conducted and has successfully applied this bidirectional framework.     

EFFECTS OF CONTEXTUAL COMPETENCE ON SOCIAL INITIATIONS

The frequency of social initiations and satisfaction with interactions in three dyads, each consisting of 1 student with disabilities and 1 nondisabled peer, were assessed under two alternating conditions: Condition 1 assessed the interactions around a set of four trained computer games, and Condition 2 assessed interactions when students were playing a set of four untrained computer games. Training was conducted with a multiple baseline design across participants and was followed by social interaction probes using an alternating treatments design. The results indicated greater frequencies of social initiations by 5 of 6 participants, higher degrees of game satisfaction by all participants, and equal or higher degrees of peer satisfaction by 5 of 6 participants when playing trained games in comparison to untrained games.     

The role of religion when crisis looms: A church community at a crossroads

The present study examined the relationship between religion and well-being in older adults during a time of financial difficulty within their religious community. Focus-group and one-on-one interviews were carried out with 39 participants sampled from three Anglican parishes in eastern Canada during a financial crisis that was likely to lead to the closing of two churches. Three main themes emerged from the analyses: Crisis, Transition, and Status Quo. The financial situation was discussed as a crisis; other issues were viewed as opportunities for transition, and personal faith was perceived as being stable and constant. The results of the present study suggest that for older adults, the more internal and faith-based aspects of religiosity have a stronger impact on well-being than do changes that revolve around the external or religious aspects of church participation.     

More than the Terrible Twos: The Nature and Severity of Behavior Problems in Clinic-Referred Preschool Children

The primary goals of this study are to describe the nature and severity of disruptive behavior problems in clinic-referred preschoolers from low-income environments and to explore the validity of DSM-IV disruptive disorders for young children. We examine the relation between DSM-IV symptoms, standardized behavior checklists, and observational ratings as a means of exploring measurement validity in this age group. Seventy-nine clinic-referred preschoolers (ages 2 through 5 years) from low-income environments were assessed. To examine whether clinic-referred preschool children have symptoms that are consistent with DSM-IV disruptive behavior disorders, parents were administered a semistructured diagnostic interview, modified for developmentally appropriate usage. In addition, parents completed the Child Behavior Checklist (CBCL) and children's behavior problems were assessed with observational ratings during parent–child interaction. Nearly half of the sample met criteria for conduct disorder, and three quarters met criteria for oppositional defiant disorder. Preliminary evidence for the validity of DSM-IV disruptive disorders in preschool children was demonstrated through association with CBCL scores, behavior ratings, and significant levels of impairment. Future efforts aimed at validating these diagnoses in preschoolers and implications for prevention are discussed.