Community implementation of PMTO™: Impacts on referrals to specialist services and schools

Sigmarsdóttir, M. & Björnsdóttir, A. (2012). Community implementation of PMTO?: Impacts on referrals to specialist services and schools. Scandinavian Journal of Psychology 53, 506–511. In 2000, the city of Hafnarfjörður, Iceland, implemented Parent Management Training – Oregon Model (PMTO^?) to prevent and treat behavioral problems among children. This paper describes the implementation and findings regarding impacts in the community. As hypothesized, findings showed that the number of referrals to specialist services decreased in Hafnarfjörður following PMTO implementation and increased in two comparison communities not implementing the method. Within the Hafnarfjörður community, recorded instances of behavior problems reduced in elementary schools working in line with PMTO. The results presented are the first such findings in Iceland and suggest the kinds of systematic changes communities may experience following the implementation of an evidence‐based program.     

Acceptability and Cultural Fit of Spiritual Self-Schema Therapy for Puerto Rican Women with Addiction Disorders: Qualitative Findings

We present findings on the (1) acceptability of Spiritual Self-Schema (3-S) therapy with Puerto Rican women and (2) fit with women's cultural, gender, literacy, clinical, and religious backgrounds. 3-S is a well-documented efficacious intervention for substance use and HIV risk behaviors. Participants were 13 urban, low-income Puerto Rican women in a residential treatment program in a large Northeastern city.

Findings from therapy session videotapes, focus groups, and clinician memos indicate high acceptability and fit of 3-S therapy for Puerto Rican women. However, lack of fit in several areas indicates the need for modification of specific aspects of 3-S for Latinas.     

Plenary address – A year of living ‘dangerously’: Reflections on risk,trust, trauma and change

This paper examines the role of emotions in the construction and performance of mis/trustful relations; with medical professionals, their technologies, and ultimately, with oneself. Using personal experience of two common conditions as illustrative examples, it questions what it means and feels like to trust, and how, where and by whom such feelings can be enhanced or undermined. It explores some of the ways in which discourses of risk are mobilized and embodied to create a crisis of trust, asking; what kind of selves and emotionalities surface, and what are the health outcomes, when bodies are viewed as ‘at risk’? Visualizing technologies that probe the interior for data play an increasingly prominent role in healthcare, and are typically considered more trustworthy sources of knowledge about the body than anything that might be produced by the tech-free sensing self. However, not all (even ‘physical’) trauma can be seen or quantified, and not all information is equal. The paper reflects on the emotional dissonance that ensues when one's own perceptions and representations are at odds with those of medical experts for whom one is supposed to perform trust. It examines the feeling rules that are broken when we fail to appreciate our treatment at their hands, and asks: What happens when we resist expert author-ity by telling different stories about our embodied selves, ones that make space for emotions in contexts where they are rarely seen to count, and where only what can be measured matters?     

A Trauma-Informed Call to Action: Culturally-Informed,Multidisciplinary Theoretical and Applied Approaches to Prevention and Healing

ABSTRACT

The prevalence of trauma and its negative impact on humankind has created a burgeoning awareness of the need for systems that are trauma-informed across the lifespan. A collaborative project with the National Partnership to End Interpersonal Violence (NPEIV) sought out research as a call-to-action to mitigate the impact of trauma. The following is an introduction to a special double-issue focused on theoretical and applied approaches to using trauma-informed care in multi-disciplinary, mental and physical health, criminal justice, school-based, and community settings. Consideration is given to essential issues such as resilience, self-care, and cultural awareness.     

Prospective association of parental and child internalizing symptoms: Mediation of parenting practices and irritability

Maternal internalizing symptoms have been linked with child internalizing symptoms, but paternal internalizing difficulties have received little attention. Our aims were to prospectively analyse the simultaneous effect of maternal and paternal internalizing symptoms on child internalizing difficulties, examining gender differences, and to verify the mediating effect of parenting practices and child irritability. The sample included 470 families assessed at child ages 3, 6, 8, and 11. Multi-group structural equation modelling was performed with Mplus8.2. Complete equivalence was found between boys and girls for all paths. Maternal internalizing symptoms at age 3 had an indirect effect on child internalizing symptoms at age 11, via irritability at age 8. Paternal internalizing symptoms at age 3 were not associated with any of the variables under study. Maternal internalizing symptoms and child irritability are targets for intervention in order to prevent child internalizing difficulties.     

Long-term school-level effects of the Olweus Bullying Prevention Program (OBPP)

In agreement with two predictions, this somewhat unusual study documented that 70 elementary schools (A-schools) with continued and repeated use of the Olweus Bullying Questionnaire (OBQ) in a four-year follow-up period of 2007–2010, two to eight years after original implementation of the Olweus Bullying Prevention Program (OBPP), had a clearly more favorable long-term development in terms of being-bullied problems, as measured with a completely independent data source, the National Pupil Survey than 102 comparable schools (B-schools) that had not conducted any OBQ-surveys in the same period. The odds of being bullied for students in a Norwegian average elementary school were also almost 40% higher than for students who attended a school with continued use of the OBQ, and very likely, other components of the program. Several alternative explanations of the findings were explored and found wanting. Results suggested that A-schools with continued use had changed their “school culture” for the better with regard to awareness, preparedness and competence in handling and preventing bullying. This form of ‘organizational learning’ has major consequences in that new groups of students will benefit from such a school environment. It was generally concluded – in spite of a highly stable average of the level of bullying problems in Norway – that it is fully possible to substantially reduce such problems not only in one-year evaluations, as has been amply documented before, but also in the long term, up to eight years after original implementation, with a program such as the Olweus Bullying Prevention Program.     

Rethinking Traumatic Brain Injury from Intimate Partner Violence: A Theoretical Model of the Cycle of Transmission

ABSTRACT

Despite growing evidence of the repeated nature of traumatic brain injury (TBI) in women experiencing intimate partner violence (IPV), there is no theoretical model depicting TBIs as a cyclical process throughout a lifetime. Situational analysis methodology was used on interviews with 10 women who self-reported passing out from being hit in the head during an episode of IPV to create a theoretical model depicting the cycle of transmission of TBI. We define the cycle of transmission of TBI as the way that women experience multiple TBIs over the course of their lifetime and how TBI can be perpetuated in a family or community. The cycle begins in childhood or adolescence, when women receive a TBI from abuse, sports, or motor vehicle accident. They enter into abusive relationships with men who are also described as living with a TBI and the women receive other TBIs during this relationship. With repeating head trauma, women described increasing TBI symptoms: problems with memory, cognition, executive functioning, depression, and concentration. If they do seek help, they must choose between healthcare and protective shelter. With either choice, the element of instability could be introduced and the cycle of transmission continues. This theoretical model shows that it is necessary to move beyond individual behaviors to think about how TBIs are transmitted through communities and how untreated symptoms can impact help-seeking behavior and perpetuate other risk factors for receiving a TBI.