Exploring emotions in dialog between health provider,parent and child. An observational study in pediatric primary care

IntroductionThis paper is part of the theoretical thread of health psychology and it presents a study aimed to recognize information useful to implement psychological interventions finalized to personalize medical treatments and engage users in pediatrics.ObjectiveIn this paper is presented an observational study aimed to explore doctor-patient dialog about worries in pediatric primary care; it has been carried out identifying dialogical interaction patterns, or typical dialog between health providers, parent and child.MethodWe documented conversations in 265 visits; we audio-recordered, transcribed and analyzed them with Verona Coding Definitions of Emotional Sequences. Dialogs between participants were analyzed one by one. Frequencies of emotions’ signals (cues/concerns) and responses were analyzed through Redundancy Analysis, aimed to establish a quantitative relationship between these pair of groups of variables considering the asymmetrical relationship between them.ResultsSix “Dialogical Interaction Patterns” were obtained by interpreting these relationships; they show dialogs mainly aimed at obtaining information useful for diagnosis and treatment, with a limited exploration of worries or issues related to the condition of the child. Pediatric conversations seem to be characterized by a very high attention to cognitive aspects of medical questions with a poor consideration of emotions as useful information to medical practice.ConclusionsThese dialogs seem to ensure the rapidity and the efficiency of medical visits. Nevertheless, it could be useful to implement psychological interventions to achieve an enrichment of the dialog between participants, helping them to recognize users’ emotions as useful to define shared medical strategies.     

La méthode d’intervention en psychodynamique du travail face au « tournant gestionnaire » : l’exemple d’une intervention dans une unité mixte de recherche

This text aims to show the continuing interest in using the “canonical” method of investigation in work psychodynamics in the context of what is commonly called the managerial turning point. In order to demonstrate this methodology, the authors will rely on a survey conducted in a U.M.R of science called “hard science” following a recommendation of the Agency for evaluation of research and higher education. We will raise the impact of this intervention, allowing participants to think about their work relationship and the necessary modalities in order to do it continuously well, within the managerial logic context.     

Changing systems by changing individuals: the incubation approach to systems change

This article describes and evaluates the implementation of an innovative approach to systems change, the incubation approach, which was developed on a systems change project designed to increase the capacity of multiple systems (e.g., law enforcement, child protection, domestic violence, mental health, early education) to respond to children’s exposure to violence. The incubation approach encourages change agents to collaborate with project staff to gently nurture, or “incubate,” feasible and warranted change in target systems. Project staff gain concrete commitment from motivated and accessible change agents and collaborate with those agents to implement change actions. This approach works well with committed, executive-level change agents in target systems, with stable systems that have low turnover and well-integrated subsystems, and when seed funds are provided to key organizations.     

Description of a Behavioral Intervention to Reduce Substance Use and Related Risk and Increase Positive Parenting among Urban Mothers with Alcohol and Other Drug Problems

The abuse of alcohol and other substances by mothers raising adolescent children has serious adverse effects on family functioning and youth outcomes, and on mothers’ own health and adaptation. Mothers who are also HIV-infected face additional challenges. In the present report, we describe a multi-session intervention conducted in individual sessions for mothers with alcohol and other substance use problems who are raising adolescent children. We outline the primary components of the intervention and include case studies and examples of exercises and tools. We found that engagement with the intervention and high rates of attendance were facilitated by tapping into mothers’ desires to improve their relationships with their adolescent children, the use of a harm reduction approach toward substance use, and intensive outreach. We also discuss lessons learned in the course of implementing and evaluating the intervention.     

An approach to preventing coparenting conflict and divorce in low-income families: strengthening couple relationships and fostering fathers' involvement

In the context of current concern about levels of marital distress, family violence, and divorce, the SFI study is evaluating the effectiveness of an intervention to facilitate the positive involvement of low-income Mexican American and European American fathers with their children, in part by strengthening the men's relationships with their children's mothers. The study design involves a randomized clinical trial that includes assignment to a 16-week couples group, a 16-week fathers group, or a single-session control group. Couples in both group interventions and the control condition include partners who are married, cohabiting, and living separately but raising a young child together. This article presents the rationale, design, and intervention approach to father involvement for families whose relationships are at risk because of the hardships of their lives, many of whom are manifesting some degree of individual or relationship distress. We present preliminary impressions and qualitative findings based on our experience with 257 families who completed the pretest, and the first 160 who completed one postintervention assessment 9 months after entering the study. Discussion centers on what we have learned and questions that remain to be answered in mounting a multisite preventive intervention to strengthen relationships in low-income families.     

Is There Life After DEBI? Examining Health Behavior Maintenance in the Diffusion of Effective Behavioral Interventions Initiative

The evidence-based interventions that are identified, packaged, and disseminated by the Division of HIV/AIDS Prevention at the Centers for Disease Control and Prevention as part of the Diffusion of Effective Behavioral Interventions (DEBI) initiative—commonly referred to the "DEBIs"—currently represent a primary source of HIV prevention interventions for community-based providers. To date, little attention has focused on whether the intended outcomes of the DEBIs, i.e., reductions in HIV-related risk behaviors, are maintained over time. This review summarized evidence for the sustainability of the effects of the DEBIs on HIV sexual risk behavior and intravenous drug use from studies of original and adapted DEBIs. Evidence of intervention decay or a lack of any intervention effect was identified in several original and adapted versions of the DEBIs included in this review. Recommendations include modifications to current criteria for inclusion in the DEBI portfolio, in addition to the development of remediation strategies to address intervention decay. Further, theoretical models that specify the processes that underlie the maintenance of health behaviors over time should be used in developing HIV prevention interventions.     

With a Sword Pointing to the East,West, South,and North

In his In Defense of War, Nigel Biggar argues for an account of war based in Christian love. In the process, he opposes Christian pacifists, the British Left, liberal accounts of just‐war, and accounts of just‐war based on self‐defense. Although framed in terms of love, his account pivots around punishment, which is further explicated by a thorough review of the recent war in Iraq, the invasion of which he deems justified. This review compares Biggar's monograph to prior iterations of a love‐based approach to just war by Paul Ramsey and Oliver O'Donovan. Biggar's contributions regarding love, punishment, and policy analysis are recognized, as well as his attempt to carry on the tradition of the ‘mournful warrior’. As a model for the kind of scrutiny that Christian ethicists should bring to bear on serious social issues, Biggar's monograph is excellent. However, the political stance and – largely implicit and unstated – political theology operating behind this book are, in the end, disconcerting.     

Expressive writing promotes self‐reported physical,social and psychological health among Chinese undergraduates

The present study examines the efficacy of expressive writing among Chinese undergraduates. The sample comprised of 74 undergraduates enrolled in a 9‐week intervention (35 in experimental class vs. 39 in control class). The writing exercises were well‐embedded in an elective course for the two classes. The 46‐item simplified Chinese Self‐Rated Health Measurement Scale, which assesses psychological, physical and social health, was adopted to measure the outcome of this study. Baseline (second week) and post‐test (ninth week) scores were obtained during the classes. After the intervention on the eighth week, the self‐reported psychological, social and physical health of the experimental class improved. Psychological health obtained the maximum degree of improvement, followed by social and physical health. Furthermore, female participants gained more psychological improvement than males. These results demonstrated that the expressive writing approach could improve the physical, social and psychological health of Chinese undergraduates, and the method can be applied in university psychological consulting settings in Mainland China.     

Pathways of Risk and Resilience: Impact of a Family Resilience Program on Active‐Duty Military Parents

Over the past decade, studies into the impact of wartime deployment and related adversities on service members and their families have offered empirical support for systemic models of family functioning and a more nuanced understanding of the mechanisms by which stress and trauma reverberate across family and partner relationships. They have also advanced our understanding of the ways in which families may contribute to the resilience of children and parents contending with the stressors of serial deployments and parental physical and psychological injuries. This study is the latest in a series designed to further clarify the systemic functioning of military families and to explicate the role of resilient family processes in reducing symptoms of distress and poor adaptation among family members. Drawing upon the implementation of the Families Overcoming Under Stress (FOCUS) Family Resilience Program at 14 active‐duty military installations across the United States, structural equation modeling was conducted with data from 434 marine and navy active‐duty families who participated in the FOCUS program. The goal was to better understand the ways in which parental distress reverberates across military family systems and, through longitudinal path analytic modeling, determine the pathways of program impact on parental distress. The findings indicated significant cross‐influence of distress between the military and civilian parents within families, families with more distressed military parents were more likely to sustain participation in the program, and reductions in distress among both military and civilian parents were significantly mediated by improvements in resilient family processes. These results are consistent with family systemic and resilient models that support preventive interventions designed to enhance family resilient processes as an important part of comprehensive services for distressed military families.     

Improving parent–child interactions through interactive reading workshops

IntroductionMany authors agree on the importance of training parents in early literacy strategies.ObjectiveThis study analyses the effects of an intervention to improve parent–child interactions during reading sessions, using interactive reading techniques.MethodThe design is exploratory and includes a treatment group (n = 22), which benefited from four interactive reading workshops, and a control group (n = 18), which did not benefit from specific training. Both groups read the same books, three times a week, for 10 weeks. The children come from middle socioeconomic backgrounds and attend preschool or kindergarten (grades 1–3).ResultsThe analyses were conducted on the basis of pre- and post-intervention video observations, coded using the Adult–Child Interactive Reading Inventory (ACIRI). Results from an ANCOVA show that parental behavior, and in turn child behavior, improves in post-intervention: parents improve their children's attention to the text and implement literacy strategies, while the children become more involved in the interactions.ConclusionInteractive reading workshops for parents improve the quantity and quality of parent–child interactions when reading books in a natural and playful context.