Promoting child and family wellness: priorities for psychological and social interventions

In order to foster the well‐being of children and families we propose a shift in the priorities of psychological and social interventions. Following a brief discussion of the concept of wellness, we present a framework for interventions to promote child and family wellness. Psychological and social intervention strategies to promote child and family wellness are then reviewed and interpreted in terms of the framework. Recommendations for changing priorities for programmes and policies are based on the framework and a review of the effectiveness of existing interventions. Copyright © 2000 John Wiley & Sons, Ltd.     

Characteristics of patients in routine psycho-oncological care,and changes in outcome variables during and after their treatment

Objective: The primary aim of this study was to determine the characteristics of clients and interventions in routine psycho-oncological care. The secondary aim was to determine the course of symptomatology during and after the psychological interventions.

Design: During a period of nine months, all clients who sought help in one of the seven psycho-oncological care institutes in the Netherlands were approached to participate in the present study (N = 483). Information was gathered with respect to demographic and medical characteristics, and type and duration of the interventions. In addition, depression, anxiety, well-being, quality of life, fatigue and daily function were determined before interventions and three and nine months later.

Results and conclusions: Compared to the Dutch cancer population, patients in psycho-oncological care were more often young and female. Compared to the general Dutch population, they were highly educated and were more likely to have a partner. Clinical levels of depression, anxiety and/or fatigue were found among 83% of the patients. After three months, only 23% had completed their intervention; this figure was 62% after nine months. Symptoms decreased significantly for all outcome variables. An importance difference with randomised controlled trials is the low session frequency and the long intervention time of patients in clinical care.     

Examining the initial usability,acceptability and feasibility of a digital mental health intervention for college students in India

Generalised anxiety disorder (GAD) is prevalent among college students in India; however, barriers like stigma, treatment accessibility and cost prevent engagement in treatment. Web- and mobile-based, or digital, mental health interventions have been proposed as a potential solution to increasing treatment access. With the ultimate goal of developing an engaging digital mental health intervention for university students in India, the current study sought to understand students' reactions to a culturally and digitally adapted evidence-based cognitive behavioural therapy (CBT) for GAD intervention. Specifically, through theatre testing and focus groups with a non-clinical sample of 15 college students in India, the present study examined initial usability, acceptability and feasibility of the “Mana Maali Digital Anxiety Program.” Secondary objectives comprised identifying students' perceived barriers to using the program and eliciting recommendations. Results indicated high usability, with the average usability rating ranking in the top 10% of general usability scores. Participants offered actionable changes to improve usability and perceived acceptability among peers struggling with mental health issues. Findings highlight the benefits of offering digital resources that circumvent barriers associated with accessing traditional services. Results build on existing evidence that digital interventions can be a viable means of delivering mental healthcare to large, defined populations.     

Guided Recovery: An Interpretative Phenomenological Analysis of Service Users’ Experiences of Guided Self-Help for Bulimic and Binge Eating Disorders

The efficacy of Cognitive Behavioral Therapy–based Guided Self-Help for mild to moderate bulimia and binge eating disorders has been well supported. However, limited research has explored in-depth individual experiences of this treatment approach. In-depth semi-structured interviews were conducted with 4 individuals who had completed Cognitive Behavioral Therapy–based Guided Self-Help (CBT-GSH) for bulimic or binge eating disorders. The interviews were transcribed verbatim and subsequently analyzed using Interpretative Phenomenological Analysis (IPA). Three superordinate themes emerged: Autonomy and volition; A dynamic relationship: the guided and the guide; and The unwanted friend. The reciprocal nature of the guide/guided relationship was identified as integral to the success of the therapeutic approach. However, participants expressed initial uncertainty towards the therapeutic process, and experienced an uncomfortable dissonance between a lack of volition in therapy seeking and the need to continually self-prescribe CBT-GSH. The findings affirm the central role of the guide in promoting motivation to engage with therapy and highlight the potential benefits of in-session weighing. However, it may be necessary to provide additional support on commencing CBT-GSH to address concerns about the therapeutic approach in this group.     

Early Eye Movement Desensitisation and Reprocessing (EMDR) intervention in a disaster mental health care context

‘Early psychological intervention’ is defined as commencing treatment within three months of the traumatic event, with the aim to prevent or treat posttraumatic stress disorder, ongoing distress or acute stress disorder. In natural disaster situations, specific issues may limit the amount of time available for treatment and the possibility of interventions. Eye Movement Desensitisation and Reprocessing (EMDR) can be used without regard to these limits. The aim of the study is to evaluate the effects of EMDR, Recent Traumatic Episode Protocol (R-TEP) provided within three months of the traumatic event to a large sample of individuals exposed to the earthquake that hit Emilia Romagna Region (Northern Italy) in 2012. This study is based on a retrospective review of medical records collected during the activities of psychological and psychosocial unit in the immediate aftermath of earthquake. In total, 529 participants completed the Impact of Event Scale Revised (IES-R) (pre e post treatment). In order to provide a comparison similar to a waitlist-like control group, a method of cohort analysis was applied. In addition, possible time dependent effect was tested. ET (early-treated sample, participants treated within one month after the earthquake) and LT (late-treated sample, participants treated after the first month from the earthquake) reported at post-treatment an improvement to a level below the IES-R cutoff (65.8% of the ET sample and 64.02% of the LT sample). Control group analogue and time-outcome correlation suggest that positive changes in symptoms were likely due to the treatment provided and not merely to the time lapse from the traumatic event. The results of this study suggest that EMDR is a viable treatment option in response to a disaster crisis and in reducing psychological distress of acutely traumatized individuals within the context of a natural disaster.     

Prospective writing: Randomized controlled trial of an intervention for facilitating growth after adversity

Little is known about how posttraumatic growth (PTG) can be fostered and controversy surrounds how it is best measured. We designed and tested an intervention, prospective writing, to facilitate PTG by encouraging people to explore new possibilities after adversity. Adults (N = 188) with recent adverse experiences were randomly assigned to do prospective writing, factual writing, or no writing weekly for one month. PTG was assessed with both retrospective and current-standing measures. Hierarchical linear modeling and response profile analysis were used to assess the intervention’s impact, and latent growth curve modeling was used to test mediation. Prospective writing participants showed the greatest gains in PTG as assessed by the current-standing measure, but did not reliably show greater retrospective PTG than controls. Although large effect sizes for the mediation paths suggested that engagement with new possibilities may be a plausible mechanism, this result fell short of statistical significance. Prospection-based interventions merit further investigation.     

Safe and unsafe school spaces: Comparing elementary school student perceptions to common ecological interventions and operationalizations

There is a burgeoning literature on school safety in the United States. Often, researchers determine the problem and intervention. Few studies, however, examine how students understand school safety. In this study, elementary school students in the United States (n = 225) marked safe and unsafe school places; this was correlated with other commonly used school safety measures. Results indicate that children have different perceptions of safety based on school location. Additionally, for older children, unsafe places correlated with injury data, adult absence and low levels of territoriality. For younger children, unsafe places were associated with adult absence and referrals. Safe places were places that were more likely to have an adult. Results bring into question some common safety interventions. Implications include working with children to determine what is meant by ‘safe’ and interventions. Copyright © 2010 John Wiley & Sons, Ltd.     

Gender differences in the person-activity fit for positive psychology interventions

Research on positive psychology interventions (PPIs) has established the value of activities such as acts of kindness, gratitude, and savoring life’s joys, for increasing individuals’ sense of well-being. Critical to the efficacy of PPIs is person-activity fit – the degree activities stem from intrinsic motivation. Although person-activity fit effects are well documented, gaps remain in our understanding of how sociodemographic variables, particularly age and gender, play a role. We investigated how gender may affect self-reported person-activity fit across three PPIs: A gratitude journal; Acts of Kindness; and Savoring life’s joys. Age was explored since the subject sample ranged widely, from 18 to 51?years. Twenty-eight men and 82 women completed person-activity fit questionnaires. A multiple analysis of variance resulted in a main effect for gender, with women showing greater person-activity fit for all three PPIs. Among women only, age correlated significantly with person-activity fit for all three PPIs, suggesting greater maturational variability among men.     

Lunch Buddy Mentoring for Children Victimized by Peers: Two Pilot Studies

The authors describe two pilot studies examining the potential benefits of Lunch Buddy (LB) mentoring, a manualized approach to school-based mentoring. LB mentoring takes place during the school lunch period and is designed to promote positive changes in children's peer relationships. In both studies, changes in peer victimization were assessed after one and three semesters of LB mentoring. In the first study, LB mentors were paired with elementary school children (N = 24) identified by child and teacher reports as victimized by peers. Results revealed significant declines in self- and teacher-rated victimization after one and three semesters of mentoring. In the second study, LB mentors were paired with victimized children who also engaged in bullying behavior (N = 23). Results indicated significant declines in self- and teacher-ratings of peer victimization after three semesters of mentoring. In both studies, ratings of perceived harm were low and ratings of satisfaction were high. Discussed are the implications of these findings for future research and for efforts to develop a nonharmful way to help children who are repeatedly victimized.