Benchmarking key service quality indicators in UK Employee Assistance Programme Counselling: A CORE System data profile

Background: Levels of psychological distress appear to be increasing in the workplace, in parallel with the growth of employee assistance programme (EAP) provision offering a range of talking treatments. However, such growth takes place in the absence of a substantive body of supporting research evidence despite a quarter of a decade of research activity. Aims: To analyse a national sample of EAP data and profile relative service quality on a set of key service indicators. Method: CORE System data profiles of over 28,000 clients were voluntarily donated by six EAP service providers. An established benchmarking methodology was used to assess the relative quality of EAP service provision compared with published CORE System benchmarks for NHS primary care and UK higher education student counselling services. Results: High quality data profiled an EAP service clientele who were quantifiably distressed, accessed treatment quickly, with the majority completing treatment and demonstrating high rates of recovery and/or improvement relative to published benchmarks from the NHS and HE comparative sectors. Limitations of the study and implications for practice and further investigation are considered.     

Associations of Mother–Child Reminiscing about Negative Past Events,Coping, and Self‐Concept in Early Childhood

Parent–child reminiscing conversations in early childhood have received theoretical attention as a forum for children's self‐concept development, but this has been little addressed in empirical work. This study examines associations between emotion reminiscing and children's self‐concepts and, building from the reminiscing and personality development literatures, also explores the role of children's coping. Sixty 4‐ and 5‐year‐old children and their mothers completed reminiscing conversations about events in which the child had experienced negative emotion, children completed an age‐appropriate assessment of their self‐concept, and mothers and teachers reported on children's coping strategies. Children's self‐perceived timidity was associated with their explanations for negative emotions during reminiscing. Children's self‐perceived negative affect was associated with fewer emotion resolutions during reminiscing, and with distinctive patterns of coping. Both reminiscing and coping made unique contributions to children's self‐concepts, and findings also suggest that coping may in some contexts indirectly connect reminiscing with self‐concept. These findings suggest that reminiscing conversations both reflect children's characteristics and provide a context for learning about their characteristics, along with strategies for emotion management. Copyright © 2013 John Wiley & Sons, Ltd.     

Paternal Postnatal and Subsequent Mental Health Symptoms and Child Socio‐Emotional and Behavioural Problems at School Entry

Research on the effect of paternal mental health problems, particularly on young children, is based predominantly on clinical levels of depression. Furthermore, potential mediators such as marital discord have often been overlooked. This longitudinal community study assessed the association between paternal mental health symptoms in a community sample (N = 705) assessed at 3 months postnatally (Edinburgh Postnatal Depression Scale) and 36 months (General Health Questionnaire) and children's socio‐emotional and behavioural problems at 51 months (Strengths and Difficulties Questionnaire) as reported by mother, father and teacher. Controlling for socioeconomic status and maternal mental health symptoms at 3 and 36 months, paternal postnatal depressive symptoms predicted more father‐reported child problems at 51 months but, in contrast to previous findings, not mother‐reported problems. Paternal mental health symptoms at 36 months predicted both maternal and paternal reports of child problems at 51 months controlling for both paternal and maternal postnatal symptoms. Paternal mental health symptoms at 3 and 36 months were not significant predictors of teacher‐reported child problems. Postnatal marital discord and paternal mental health problems at 36 months both mediated the relationship between paternal postnatal symptoms and later child emotional and behavioural problems. Child gender did not moderate the relationship. Implications for interventions are discussed. Copyright © 2013 John Wiley & Sons, Ltd.     

Multiple Attachment Representations in Clinical Practice: Case Study of a Six-Year-Old Maltreated Child

Research on attachment predominantly traces the effect of a single or primary attachment and/or attachment style on working models and behavior. However, most children form multiple attachments. This article reviews research on multiple attachment representations in children and considers how such information can usefully be applied to clinical settings. Through the case study of a six-year-old adopted boy with a history of maltreatment, it explores how those internal working models can be assessed in treatment and the clinical value of recognizing different attachment representations and styles. Implications for treatment interventions are explored.     

Health Literacy,Health Inequality and a Just Healthcare System

Limited health literacy is a pervasive and independent risk factor for poor health outcomes. Despite decades of reports exhibiting that the healthcare system is overly complex, unneeded complexity remains commonplace and endangers the lives of patients, especially those with limited health literacy. In this article, we define health literacy and describe the empirical evidence associating health literacy and poor health outcomes. We recast the issue of poor health literacy from within the ethical perspective of the least well-off and argue that poor health outcomes deriving from limited health literacy ought to be understood as a fundamental injustice of the healthcare system. We offer three proposals that attempt to rectify this injustice, including: universal precautions that presume limited health literacy for all healthcare users; expanded use of technology supported communication; and clinical incentives that account for limited health literacy.     

Soup,Stitches, and Song

Abstract

This article discusses ways that clinical practitioners can utilize creative strategies in working with clients who are experiencing grief following the death of their adolescent child. It presents a brief literature review regarding this specific type of parental grief as well as practical and helpful ways to utilize books, songs, and tangible projects in the grieving process.     

Replication and Extension of a Hierarchical Model of Social Anxiety and Depression: Fear of Positive Evaluation as a Key Unique Factor in Social Anxiety

Wang, Hsu, Chiu, and Liang (2012, Journal of Anxiety Disorders, 26, 215–224) recently proposed a hierarchical model of social interaction anxiety and depression to account for both the commonalities and distinctions between these conditions. In the present paper, this model was extended to more broadly encompass the symptoms of social anxiety disorder, and replicated in a large unselected, undergraduate sample (n = 585). Structural equation modeling (SEM) and hierarchical regression analyses were employed. Negative affect and positive affect were conceptualized as general factors shared by social anxiety and depression; fear of negative evaluation (FNE) and disqualification of positive social outcomes were operationalized as specific factors, and fear of positive evaluation (FPE) was operationalized as a factor unique to social anxiety. This extended hierarchical model explicates structural relationships among these factors, in which the higher-level, general factors (i.e., high negative affect and low positive affect) represent vulnerability markers of both social anxiety and depression, and the lower-level factors (i.e., FNE, disqualification of positive social outcomes, and FPE) are the dimensions of specific cognitive features. Results from SEM and hierarchical regression analyses converged in support of the extended model. FPE is further supported as a key symptom that differentiates social anxiety from depression.     

Innovative Approaches to Child Custody and Domestic Violence in New Zealand

Summary

In 1995, as part of a major review of domestic violence law, the New Zealand Parliament amended the legislation under which disputes about custody of and access to children are determined by the Court. Specifically, the amendment introduced a rebuttable presumption that a parent who had used violence against a child or against the other parent would not have custody of, or unsupervised access to the child unless the Court could be satisfied that the child would be safe during visitation arrangements. Three years after the implementation of this legislation, it is timely to reflect on the impact of this major domestic violence law reform initiative. Our findings indicate that there are indeed advances. Psychological violence is now clearly being considered when Courts are assessing the issue of children's safety. As well, the delineation of mandatory risk assessment factors has led many judges to see a continuum of power and control tactics as relevant in domestic violence related visitation proceedings; the previous emphasis on physical violence has given way to an analysis which more closely reflects accords with women's and children's realities of the abuse they are exposed to. Some of the old problems continue to exist despite the law changes. There are still recent cases where perpetrators of serious violence are awarded unsupervised access and where their violence continues to be construed as “out of character,” arising because of the perpetrator's “despair” about the breakdown of his relationship. These and other issues are discussed.     

Dating Violence Perpetration: The Predictive Roles of Maternally versus Paternally Perpetrated Childhood Abuse and Subsequent Dating Violence Attitudes and Behaviors

This study investigated both young men's and young women's perpetration of physical, sexual, and psychological forms of dating violence, examining predictors of violence including maternally or paternally perpetrated forms of various types of child maltreatment, as well as attitudes toward dating violence and dating violence victimization. Results of hierarchical linear regressions found that childhood experiences of maternal neglect predicted men's physical perpetration, and childhood sexual abuse predicted women's sexual perpetration and men's psychological perpetration. Further, positive attitudes toward dating violence predicted women's physical, psychological, and sexual perpetration, as well as men's sexual perpetration, and experiences of dating violence victimization were the strongest predictors of most forms of dating violence perpetration, particularly among women. Implications for future research and prevention initiatives are discussed.     

Measuring Abuse Sequelae: Validating and Extending the Trauma Symptom Checklist–40

This study used the Trauma Symptom Checklist–40 (TSC–40) to index both childhood sexual abuse (CSA) and childhood physical abuse (CPA) in a college student sample of both men and women (N = 441). Although the TSC–40 was designed as a measure of CSA trauma, this study concludes the measure is appropriately reliable for indexing the traumatic sequelae of CPA as well as CSA in nonclinical samples. This study also explored the effects of gender and abuse severity on resulting symptomatology, finding that women and severely abused individuals report the most negative sequelae. Both CSA and CPA emerged as significant explanatory variables in TSC–40 scale scores beyond gender, supporting its validity for indexing traumatic sequelae in nonclinical samples.