SAFE START: AN EARLY CHILDHOOD MENTAL HEALTH PROGRAM IN A TERTIARY HEALTHCARE SETTING—A CRITICAL REVIEW

Early childhood mental health programs are vital for the current and future mental health and brain development of infants, toddlers, and preschoolers. Founded in 2014, Safe Start is the only early childhood mental health program in Beirut, Lebanon. It aims at being the prototype of such services at the national level. A retrospective analysis of the outcomes of the first year of operations has resulted in important findings about the age of the participants, their diagnoses, previous therapies that the participants have undergone, types of referrals recommended, and the number of participants who were lost to follow‐up. This first analysis pointed at the need for more in‐depth research to encompass the gaps and benefits of such services. It shows the pivotal importance of designing awareness strategies about the importance of early childhood mental health services and care; to move from a diagnostic seeking behavior to commitment to psychotherapy and follow‐up interventions.     

Does knowing translate to doing? Practitioners’ experiences of Circle of Security-Parenting (COS-P) training and implementation

This study sought to understand how practitioners perceive and experience the Circle of Security-Parenting (COS-P) training, and further, how they integrate and implement it into practice, and how these experiences influence their use and understanding of the program and its underlying model. A thematic analysis of semistructured interviews at two time points (shortly after training and 3–6 months after training) was used to explore 12 practitioners’ experiences of COS-P training and subsequent implementation. Three main themes were identified; clinical salience, personal salience, and partial use of the program. The findings reflected participants’ common perception that the model is relevant and generalizable to a wide variety of contexts. It also highlighted potential barriers to implementation, particularly practitioners’ experiences using only components of the COS-P program in isolation. The results suggest practitioners’ assumptions about client complexities, vulnerabilities, and/or incapacities, can prompt practitioners to withhold the use of COS-P (in part or whole), thereby potentially neglecting key components required for client change. The only participants who implemented the COS-P training in full had additional training in Circle of Security.     

Representations of guidance counselors,psychologists, and psychoeducators regarding psychological assessment

IntroductionSocial representations related to collaborative/therapeutic and information-gathering assessment could explain some psychological assessment practices. However, no other study has attempted to examine the actual place of these models in psychological assessment practices.ObjectiveThe goal of this study was to examine the social representations of different groups of professionals with regard to their preferred approach to psychological assessment.MethodA latent profile analysis was conducted on a sample of licensed Canadian guidance counselors (n = 382), psychologists (n = 235), and psychoeducators (n = 97).ResultsResults revealed three psychological assessment profiles, which significantly differ in terms of a few social factors. Results also showed that some psychological assessment practices differ across profiles.ConclusionThis study provides a better understanding of psychometric instruments users’ approaches to assessment and the influence of social factors.     

Treatment of developmental stress disorder: mind,body and brain – analysis and pharmacology coupled

The schism between psychiatry, psychology and analysis, while long present, has widened even more in the past half‐century with the advances in psychopharmacology. With the advances in electronic brain imaging, particularly in developmental and post‐traumatic stress disorders, there has emerged both an understanding of brain changes resulting from severe, chronic stress and an ability to target brain chemistry in ways that can relieve clinical symptomatology. The use of alpha‐1 adrenergic brain receptor antagonists decreases many of the manifestations of PTSD. Additionally, this paper discusses the ways in which dreaming, thinking and the analytic process are facilitated with this concomitant treatment and hypervigilence and hyper‐arousal states are signficiantly decreased.     

MEASUREMENT OF FATHER–CHILD ROUGH‐AND‐TUMBLE PLAY AND ITS RELATIONS TO CHILD BEHAVIOR

Although there is increasing evidence of paternal influence on child outcomes such as language and cognition, researchers are not yet clear on the features of father–child play that are most valuable in terms of child development. Physical play such as rough and tumble play (RTP) is a favored type of father–child play in Western societies that has been linked to children's socioemotional competence. It is important, therefore, to determine the implications of this play for child development. In this review and meta‐analysis, associations between father–child physical play and child behavior were examined. The review also focused on study methods. Sixteen studies are reviewed, N = 1,521 father–child dyads, 35% boys. Study characteristics such as definitions of physical play, play settings, play measures, and coding were examined. The meta‐analysis found weak to moderate population effects for links between father–child physical play and child aggression, social competence, emotional skills, and self‐regulation. Research investigating the effect of father–child physical play on children's development will be improved when definitions clearly identify the nature of play, settings facilitate boisterous play, and measures include frequency and quality of play interactions. This play shows promise as an enhancer of positive father–child relationships and a catalyst for child development.     

Disquiet in the consulting room: everything/nothing that is said here is confidential

Writing from experiences in the consulting room in private practice in Australia, the author refers to the layered complexity of a conflict of ethical duty which has legal and social implications. The paper explores how the ethics that are congruent with creating a safe vas bene claustrum can be diametrically opposed to the social and legal structures and processes on which we all rely. It is suggested that within the vas, analysts and analysands engage in a shared process of emotionally connected, layered, symbolic thinking. Subpoenas directed at analysts are seeking concrete evidence that will stand up in court. The paper argues that this is a category error based on ignorance and misconceptions of what analytic work entails. The intrusion of a subpoena into the vas has the potential to cause havoc in the mental health and the lives of already vulnerable, possibly traumatized and isolated individuals. It can undermine a fundamental human right and undermine the profession of psychotherapy as a whole. The paper proposes that analysts have an ethical obligation to protect the work contained within the vas from these category errors and to educate other professionals as to why we cannot provide the kind of evidence that the courts require.     

Does body dissatisfaction have the same meaning for males and females? A measurement invariance study

ObjectivesThe aim of this study was to assess the psychometric equivalence of body dissatisfaction (BD) between males and females.MethodTwo scales, BD and Drive to Thinness (DT), from the Eating Disorder Inventory-3 were evaluated. The sample was comprised of 1616 adolescent males and 1429 adolescent females. Factorial invariance across gender of two scales was assessed in order to evaluate the equivalence of scores.ResultsThe results showed full invariance for the DT scale items, and partial invariance for BD scale items. The content analysis of the items confirmed that items related to the perception of thighs, stomach and hips showed differential functioning across gender.ConclusionsDifferent representation of the BD construct between males and females was concluded, and caution was recommended in assessing and interpreting BD in male samples with questionnaires designed for women.     

Factorial structure and psychometric properties of the French adaptation of the Dissociative Experiences Scale (DES) in non-clinical participants

IntroductionThe Dissociative Experiences Scale (DES) is a widely used instrument for assessing dissociation. However, there is disagreement regarding the internal structure of the DES and scores tend to be highly skewed.ObjectiveThe present study was designed to test the psychometric properties of a French version of the DES in non-clinical participants, in addition to applying a response scale as recommended by Wright and Loftus (1999) in order to resolve the problem of skewed scores.ResultsExploratory and confirmatory factor analysis (computed in two independent samples) suggested a two-factor solution, which seem to represent two forms of dissociation (“automatic pilot” related dissociation episodes and “defensive” dissociation episodes). Results also revealed high internal consistency, and satisfactory results in terms of skewness and floor effects. Finally, significant associations with other measures (anxiety, depression, traumatic experiences) indicate good concurrent validity.ConclusionsThis study offers evidence that the present version of the French adaptation of the DES reveals good psychometric properties. Analyses of the internal structure of the DES suggest that two types of dissociative experiences are being measured: automatic pilot-related dissociation episodes (e.g., associated with different types of cognitive failures) and defensive dissociation episodes that may act as defensive mechanisms, especially in persons who have been traumatized (e.g., the avoidance of a memory related to a traumatic event).     

Foetal trauma,body memory and early infant communication: a case illustration

This paper presents the complex case of a male patient who started life as an unwanted pregnancy and adoptee in an era of socio‐cultural shame and blame. When able to contact his birth mother later in life, he experienced a number of confronting synchronicities as well as visions which he felt were related to failed abortion attempts and to other pre‐ and post‐natal events. The case material lends weight not only to Freud's, Ehrenwald's and FitzHerbert's assertions that the earliest form of mother‐infant communications is telepathic in nature but that this mode of communication can be retained if emotional trauma inhibits normal developmental processes. Contemporary neuroscience research is presented supporting the hypothesis that emotional memory can become imbedded in the psyche/soma of the foetus. Such memory traces can later emerge into imagery and/or words if the traumatic impingement has been substantial enough and if other defensive strategies are in place. Clinical implications are then suggested regarding analysts’ attention to the emotional conditions underpinning their patients’ conceptions and foetal development; the connection to projective identification components of the countertransference as being aspects of the earliest telepathic mother/infant communication channel and the need for reductive analyses in analyst training programmes.