Caregiver perceptions of Parent Peer Support Services within the Wraparound Service Delivery Model

This qualitative study examined caregivers’ perceptions of Parent Peer Support (PPS) services, embedded in the Wraparound service delivery model for youth with severe emotional and behavioral disturbances (SEBD), to identify potential engagement facilitators and barriers. Wraparound is a holistic process involving multiple formal and informal providers to collectively implement an individualized, family-centered plan of care focused on maintaining youth with SEBD within the community. PPS are frequently referred to caregivers involved in Wraparound to provide additional support. Caregivers (n?=?35) previously involved in an evaluation of one state’s Wraparound model participated in a single 30–60-min interview. Interview questions examined caregivers’ expectations about PPS, reasons for accepting or refusing PPS, and caregivers’ perceived impact of PPS. Transcribed interviews were analyzed using strategies from grounded theory methodology. Perceived need, as well as desire for shared experiences, knowledge, and assistance in accessing resources, facilitated accepting the PPS service. Barriers included inaccurate expectations of PPS, time limitations on Wraparound services, escalating youth behavior requiring more restrictive placements, scheduling difficulties, perceived unresponsiveness, and caregivers feeling overwhelmed by the number of providers. Caregivers indicated that PPS provided several benefits for themselves, youth in the care, and their families. However, potential barriers to ongoing engagement included perceived intrusiveness, as well as misalignment between services offered and caregivers’ needs.     

Perceiving parts and shapes from concave surfaces

“A hole is nothing at all, but it can break your neck.” In a similar fashion to the danger illustrated by this folk paradox, concave regions pose difficulties to theories of visual shape perception. We can readily identify their shapes, but according to principles of how observers determine part boundaries, concavities in a planar surface should have very different figural shapes from the ones that we perceive. In three experiments, we tested the hypothesis that observers perceive local image features differently in simulated 3-D concave and convex regions but use them to arrive at similar shape percepts. Stimuli were shape-from-shading images containing regions that appeared either concave or convex in depth, depending on their orientation in the picture plane. The results show that concavities did not benefit from the same global object-based attention or holistic shape encoding as convexities and that the participants relied on separable spatial dimensions to judge figural shape in concavities. Concavities may exploit a secondary process for shape perception that allows regions composed of perceptually independent features to ultimately be perceived as gestalts.     

The Application of Behavior Change Theory to Family-Based Services: Improving Parent Empowerment in Children’s Mental Health

We describe the development of a parent empowerment program (PEP) using a community-based participatory research approach. In collaboration with a group of dedicated family advocates working with the Mental Health Association of New York City and state policy makers, academic researchers took an iterative approach to crafting and refining PEP to better prepare family advocates to help bridge the gaps in service access among children with emotional and behavioral problems. Despite the growth of family-led, family support programs nationally, research that demonstrates the positive benefits of such programs is scarce in the children’s mental health literature. The PEP model is based on research data about barriers families face in mental health service utilization (e.g., stigma, perceptions of providers, attitudes towards mental illness, service availability, etc.). PEP is premised on (a) the concept of empowerment as a process, (b) the need to engage parents in becoming active agents of change, and (c) the application of an integrated framework to empower parents, called the Parents as Agents of Change model. Our paper focuses on describing the application of a Unified Theory of Behavior Change as a theoretical framework to help activate parents as change agents in meeting their children’s mental health needs. Based on an integrated model of grassroots driven Principles of Parent Support and research-based Unified Theory of Behavior Change, PEP’s Parents as Agents of Change model provides a conceptual framework for testing the effectiveness of family support services in children’s mental health, a much-needed area for future research.     

Discursive Construction of Political Categories and Moral Fields: God Versus Rights and Access in a Reproductive Health Legislative Debate

Using a discursive lens, we argue that politicians rhetorically construct categories, storylines, and moral fields. We further claim that such discursive products are action‐oriented toward gaining popular support in a public sphere that is politically fault lined along similar moral orders. As a case in point, we analyze speeches delivered during congressional voting on a Reproductive Health bill (RH bill). Employing a mixed methods strategy, we first implement a quantitative lexical analysis of frequently used words, followed by a qualitative detection of cohering storylines on both sides of the debate. Results show that oppositionists mark their speeches with a deployment of the word God, while bill supporters use the word access conspicuously. One storyline claims that The RH bill stands against God, while the other purports that The RH bill advocates rights and access. Although both storylines assert moral righteousness, they invoke two different moral orders backed by power blocs and the public at large. The God story appeals to a Catholic discourse and the moral order loudly supported by the politically powerful Catholic Bishops Conference of the Philippines. The rights/access narrative references a liberal morality frame maintained by social liberals and Philippine President Aquino. We end our paper by introducing the idea of an intrastate discursive lens to analyze moral fields constructed by politicians, oriented toward winning support from the public at large.     

Using a Constant Family in Role-Plays for Training MFTs

Marriage and Family Therapy training programs use role-plays and simulations to train their students in interviewing skills and in various therapeutic models. A review of literature shows that these training tools do not allow student-therapists to experience therapy beyond the first session. This article presents a modified version of the role-play, in which a constant family is used in preparing student-therapists for clinical work. This article describes a training scenario using the constant family role play and includes feedback from student-therapists. The authors present the benefits, limitations, and potential training considerations that can enhance use of the constant family role play.     

Assessing the specific psychopathology of binge eating disorder patients: Interview or self-report?

Research addressing the assessment of binge eating and associated eating disorder psychopathology has steadily increased in recent years. Few studies have examined the relationship between the various assessment methods. This study compared an investigator-based interview, the Eating Disorder Examination (EDE), with a self-report version of that interview, the EDE-Q. Fifty-two individuals (six men and 46 women) with binge eating disorder (BED) completed both instruments. Modest-to-good agreement and significant correlations (P < 0.0001) were found between the two methods on all four subscales assessing specific eating disorder psychopathology (i.e., Restraint, Eating Concern, Weight Concern, and Shape Concern subscales). However, higher levels of disturbance were consistently reported on the EDE-Q than the EDE interview. The two methods were not significantly or reliably related to one another when assessing binge eating. This may be due in part to the difficulty inherent in identifying binges in subjects with BED. Examination of individual item scores suggest that it might be possible to improve the performance of the EDE-Q by clarifying the definitions of certain complex features, although this should not be at the expense of compromising the practical utility of its self-report format.