Profession Differences in Family Focused Practice in the Adult Mental Health System

There is a large gulf between what psychiatric services should (or could) provide and what they do in practice. This article sought to determine practice differences between the differing professions working in adult mental health services in terms of their family focused work. Three hundred and seven adult mental health professionals completed a cross‐sectional survey of family focused practices in adult mental health services. Findings highlight that social workers engaged in more family focused practice compared to psychiatric nurses, who performed consistently the lowest on direct family care, compared to both social workers and psychologists. Clear skill, knowledge, and confidence differences are indicated between the professions. The article concludes by offering direction for future profession education and training in family focused practices.     

Learning from parents' stories about what works in early intervention

Using a multiple case study approach, this ethnography examined the experiences of parents of children deemed at risk for developmental delays or disabilities who had received early intervention (EI) services (birth to age 3 years) in a large urban location in Western Canada. Participants (11 adult parents and 7 children) were drawn from six families. Methods of data collection included focus groups (FG), face‐to‐face interviews and file reviews. Member check and expert reviews were conducted throughout data collection and data analyses as part of the validation process in this ethnography. Qualitative content analyses followed by thematic analyses highlighted the implementation of family‐centred practices (FCP) as a main theme. Parents identified how EI professionals using FCP embraced collaborative practices. FCP resulted in parents leading the EI process for their children. More specifically, EI professionals shared strategies and information to support parents in gaining a deeper understanding of their children's individual developmental characteristics. Parents expressed how empowering this level of understanding was for them as they learned to articulate what were their children's needs for developmental, health and educational services. Recommendations for future research include inquiring about parents' experiences for families of diverse constellations and/or residing in smaller urban or rural communities.     

Relationships among perceived psychological growth,resilience and burnout in physicians

The purpose of this study was to examine the relationships between perceived growth as a physician (i.e., positive psychological changes experienced as a result of the professional experience) and burnout after controlling for the effects of perceived family support, dispositional resilience, age, and marital status among physicians. Physicians (n = 289) rated perceived support from family and completed the short form of the Posttraumatic Growth Inventory, the Resilience Scale, and Maslach Burnout Inventory. Results of hierarchical regression analyses revealed that the addition of perceived growth significantly improved prediction of resilience and perceived family support for burnout, showing that higher growth, resilience, and family support all were associated with lower levels of burnout. Moreover, the effects of growth on depersonalization, a domain of burnout, were stronger for physicians who perceived a lower level of family support, whereas the effects of growth on personal accomplishment, another domain of burnout, were stronger for physicians who showed a lower level of dispositional resilience. Current results have clinical implications for understanding protective factors for burnout, that is, a sense of personal growth may be a key factor for physicians who may be less resilient or may not perceive strong family support.     

Caregiving for children through conflict and displacement: a pilot study testing the feasibility of delivering and evaluating a light touch parenting intervention for caregivers in the West Bank

A child's adjustment to wartime stress is reliant not only on individual responses and qualities, but very significantly on the availability of support that they may receive from their parent or caregivers and quality of relationships. Strengthening parental support has the potential to be valuable. A pilot two-arm randomised controlled trial investigated the feasibility of delivering and evaluating the “Caring for Children Through Conflict and Displacement” intervention with caregivers in the West Bank. Feasibility to recruit and train non-specialist staff on-the-ground to screen families for eligibility, collect outcome data, deliver the intervention and to recruit and retain families in the study were examined. Research staff and intervention facilitators were successfully appointed in the field, screened participants and delivered the intervention to 120 caregivers, collecting outcome measures pre-and post-delivery. All families completed the outcome measures, with very little missing data. This indicated that the intervention can be delivered feasibly and evaluated with families in this humanitarian context. Preliminary outcome data showed promise that the intervention may have the potential to both improve family functioning and reduce children's problem behaviour. Implications of family-focused initiatives, particularly within a conflict/post-conflict context for the prevention of several negative health and social outcomes directions, are discussed.     

When family and research clash: The role of autobiographical emotion in the production of stories of the Italian civil war, 1943–1945

This paper engages the emotional side of Second World War storytelling practices and research. Specifically, it explores how a politics of trust and togetherness animates communities of remembrance concerning the anti-Fascist Resistance experience in northern Italy. I reflect on my encounter with memories of wartime violence through the lens of autobiographical emotion. In a region torn asunder by conflicting stories of loss and violence during the anti-Nazi resistance and civil war, I possess a dual identity of researcher and Partisan's grandchild. This carries a powerful emotional bond of ethical obligations that cannot be ignored in the research process. Drawing on affect theory, I contextualize my oral history fieldwork experience in relation to that emotional bond.     

Longitudinal Impact of a Family Critical Time Intervention on Children in High-Risk Families Experiencing Homelessness: A Randomized Trial

A randomized trial compared effects of a Family Critical Time Intervention (FCTI) to usual care for children in 200 newly homeless families in which mothers had diagnosable mental illness or substance problems. Adapted from an evidence‐based practice to prevent chronic homelessness for adults with mental illnesses, FCTI combines housing and structured, time‐limited case management to connect families leaving shelter with community services. Families were followed at five time points over 24 months. Data on 311 children—99 ages 1.5–5 years, 113 ages 6–10 years, and 99 ages 11–16 years—included mother‐, teacher‐, and child‐reports of mental health, school experiences, and psychosocial well‐being. Analyses used hierarchical linear modeling to investigate intervention effects and changes in child functioning over time. Referral to FCTI reduced internalizing and externalizing problems in preschool‐aged children and externalizing for adolescents 11–16. The intervention led to declines in self‐reported school troubles for children 6–10 and 11–16. Both experimental and control children in all age groups showed reductions in symptoms over time. Although experimental results were scattered, they suggest that FCTI has the potential to improve mental health and school outcomes for children experiencing homelessness.     

Using a metaperspective to clarify the structural-narrative debate in family therapy

The debate in family therapy between structural and narrative therapists often seems irreconcilable. Drawing from work in theoretical sociology that identifies the basic structure of existing social theory, a metaperspective is introduced to clarify a discussion between leading figures in the debate. Disparate views of family interactions are examined in terms of more fundamental disagreements about the center of attention in therapy. Narrative and structural modes of presentation are examined as separate traditions that could not be further apart conceptually. Efforts to identify common ground are discussed in terms of more significant differences that are minimized by drawing out similarities. This analysis provides a framework for standing outside entrenched arguments to see more clearly the unique contributions of each approach.