SAFE START: AN EARLY CHILDHOOD MENTAL HEALTH PROGRAM IN A TERTIARY HEALTHCARE SETTING—A CRITICAL REVIEW

Early childhood mental health programs are vital for the current and future mental health and brain development of infants, toddlers, and preschoolers. Founded in 2014, Safe Start is the only early childhood mental health program in Beirut, Lebanon. It aims at being the prototype of such services at the national level. A retrospective analysis of the outcomes of the first year of operations has resulted in important findings about the age of the participants, their diagnoses, previous therapies that the participants have undergone, types of referrals recommended, and the number of participants who were lost to follow‐up. This first analysis pointed at the need for more in‐depth research to encompass the gaps and benefits of such services. It shows the pivotal importance of designing awareness strategies about the importance of early childhood mental health services and care; to move from a diagnostic seeking behavior to commitment to psychotherapy and follow‐up interventions.     

MEASUREMENT OF FATHER–CHILD ROUGH‐AND‐TUMBLE PLAY AND ITS RELATIONS TO CHILD BEHAVIOR

Although there is increasing evidence of paternal influence on child outcomes such as language and cognition, researchers are not yet clear on the features of father–child play that are most valuable in terms of child development. Physical play such as rough and tumble play (RTP) is a favored type of father–child play in Western societies that has been linked to children's socioemotional competence. It is important, therefore, to determine the implications of this play for child development. In this review and meta‐analysis, associations between father–child physical play and child behavior were examined. The review also focused on study methods. Sixteen studies are reviewed, N = 1,521 father–child dyads, 35% boys. Study characteristics such as definitions of physical play, play settings, play measures, and coding were examined. The meta‐analysis found weak to moderate population effects for links between father–child physical play and child aggression, social competence, emotional skills, and self‐regulation. Research investigating the effect of father–child physical play on children's development will be improved when definitions clearly identify the nature of play, settings facilitate boisterous play, and measures include frequency and quality of play interactions. This play shows promise as an enhancer of positive father–child relationships and a catalyst for child development.     

EXPANDING INFANT MENTAL HEALTH TREATMENT SERVICES TO AT‐RISK PRESCHOOLERS AND THEIR FAMILIES THROUGH THE INTEGRATION OF RELATIONAL PLAY THERAPY

The expansion of infant mental health (IMH) to at‐risk preschoolers and their families has contributed to the integration of relational play therapy (RPT) into IMH treatment services for this population. Integrating RPT allows access to specialized play and expressive techniques specific to preschool and family development, which improves the clinical ability to meet the multiple and complex needs of at‐risk parent–child dyads and their families. This article will examine the RPT literature and explore the similarities and differences between IMH and RPT. In addition, two case studies will highlight a five‐phase, integrative clinical‐treatment process and provide insight into how IMH clinicians are integrating RPT models and maintaining adherence to the IMH treatment approach.     

DEVELOPMENT OF THE PARENT‐CHILD PLAY SCALE FOR USE IN CHILDREN WITH FEEDING DISORDERS

The Parent‐Child Play Scale was developed as a scale that complements the Parent‐Child Feeding Scale, created by I. Chatoor et al. (1997), to evaluate mother–infant/toddler interactions in two different caregiving contexts of a young child's everyday life, specifically play and feeding. This Play Scale can be used with infants and toddlers ranging in age from 1 month to 3 years and provides reliable global ratings of mother–child interactions during 10 min of videotaped free‐play in a laboratory setting. The scale consists of 32 mother and infant/toddler interactive behaviors which are rated by trained observers from videotaped observations. Four subscales are derived: Dyadic Reciprocity, Maternal Unresponsiveness to Infant's/Toddler's Cues, Dyadic Conflict, and Maternal Intrusiveness. Construct validity and interrater and test‐retest reliability of the Play Scale have been demonstrated. This Play Scale discriminates between children with and without feeding disorders as well as between children with different subtypes of feeding disorders as defined by the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, Revised (DC:0–3R) (Feeding Disorder of State Regulation, Feeding Disorder of Caregiver‐Infant Reciprocity, and Infantile Anorexia). It can be used for research or clinical practice in the diagnosis and treatment of early feeding problems, to assess the pervasiveness of mother–infant/toddler difficulties and to monitor changes following therapy.     

Associations between prenatal substance exposure,prenatal violence victimization,unintended pregnancy,and trauma exposure in childhood in a clinical setting

Given the importance of early prevention and intervention strategies for children exposed to trauma, detection of early risk factors for exposure to traumatic events in childhood is critical. The present study examined associations between three known prenatal risk factors that characterize environmental instability in utero—prenatal substance exposure, prenatal violence victimization, and unintended pregnancy—and child exposure to interparental violence and other adverse experiences in a sample of 198 mother–child dyads (M child age = 44.48 months) referred to a hospital clinic for treatment following exposure to trauma. Prenatal substance and violence exposure were associated with child trauma exposure, and prenatal violence victimization was also associated with maternal severity ratings of traumatic exposures. Unintended pregnancy was not associated with child trauma exposure or severity. These findings expand our understanding of prenatal risk factors for trauma exposure in childhood and, specifically, highlight prenatal substance exposure and violence victimization as risk factors for subsequent exposure to trauma in early childhood. Results suggest that prenatal prevention and intervention programs should target reducing maternal substance use and in-utero exposure to violence.     

Moving towards Soul – an alchemical journey. Rehabilitation of women suffering from ‘chronic pain’ in a clinical and Jungian context

The aim of this paper is to explore the connection between symptom and symbol in the body of women suffering from chronic pain, diagnosed as fibromyalgia. The working hypothesis has been that the symbol that emerges from the symptom in the body can bridge the gap to a deeper meaning of pain and suffering, thereby becoming the agent of change for healing of the bodymind and the experience of pain in the physical body. To explore this subject I will introduce some recent research from the field of fibromyalgia, and the concepts of agency and affect systems in the body, which are important cornerstones in my work. I will briefly present my clinical concept of ‘Form and Freedom’. From this theoretical base I give some clinical examples of what I see as an alchemical journey towards soul, presented through vignettes, images and the words of three women – Maria, Riba and Ishtar. I conclude with how I see analytical psychology taking its rightful place alongside, informing or in conjunction with, as in my case, other psychotherapeutic modalities, working in creative ways that enhance healing in patients who suffer from chronic pain.