Exploration of Mechanisms behind Changes after Participation in a Parenting Intervention: A Qualitative Study in a Low‐Resource Setting

Parenting interventions are effective for preventing psychological difficulties in children. However, their active ingredients have not been comprehensively explored. How do they work? What are the mechanisms operating behind changes? In 2012, a randomized controlled trial of a parenting intervention was conducted in low‐resource communities of Panama. Effects on child behavioral difficulties, parental stress, and parenting practices were large in the short and long term. This was an ideal opportunity to explore potential mechanisms operating behind effects found in this low‐resource setting. Twenty‐five parents were interviewed. Data were analyzed through an inductive semantic thematic analysis. Three themes emerged from the data: (a) psychological mechanisms behind changes, (b) behavioral changes in parent, and (c) changes in the children. Parents described that the intervention triggered changes in emotion regulation, self‐efficacy, and problem solving. Parents also reported behavioral changes such as praising their children more often, who in turn seemed more responsible and better at following instructions. The study offers participant‐driven insight into potential pathways of change after participation in this parenting intervention, pathways that are often overlooked in quantitative studies. Future studies should further explore these pathways, through mediator and moderator analyses, and determine how much is shared across interventions and across different cultural settings.     

Stronger Than You Think: Older Women and Physical Activity

Many negative stereotypes of older women are related to changes in the body that render it incompetent (e.g., weak, frail, debilitated). Such stereotypes disempower women in the eyes of others and in their own eyes if they come to embody the stereotype. One way to resist the stereotype and remain empowered is to engage in regular physical activity, which increases stamina, energy, muscle strength, joint flexibility, and balance. Here we review the physical and mental health benefits of physical activity for older women and discuss the barriers that keep many older women from regular exercise. We discuss ways that feminist therapists can encourage their older clients to become more physically active, provide information about role models who can inspire clients, and suggest resources suitable for recommendation.     

Characteristics of patients in routine psycho-oncological care,and changes in outcome variables during and after their treatment

Objective: The primary aim of this study was to determine the characteristics of clients and interventions in routine psycho-oncological care. The secondary aim was to determine the course of symptomatology during and after the psychological interventions.

Design: During a period of nine months, all clients who sought help in one of the seven psycho-oncological care institutes in the Netherlands were approached to participate in the present study (N = 483). Information was gathered with respect to demographic and medical characteristics, and type and duration of the interventions. In addition, depression, anxiety, well-being, quality of life, fatigue and daily function were determined before interventions and three and nine months later.

Results and conclusions: Compared to the Dutch cancer population, patients in psycho-oncological care were more often young and female. Compared to the general Dutch population, they were highly educated and were more likely to have a partner. Clinical levels of depression, anxiety and/or fatigue were found among 83% of the patients. After three months, only 23% had completed their intervention; this figure was 62% after nine months. Symptoms decreased significantly for all outcome variables. An importance difference with randomised controlled trials is the low session frequency and the long intervention time of patients in clinical care.     

When east meets west: reflections on the use of Buddhist mindfulness practice in mindfulness-based interventions

The Western mental health profession has included Buddhist practices in its clinical applications, and Buddhisms’ contribution to mindfulness-based interventions (MBIs) could be considered as one of its main inputs. However, MBIs appear to depart in some key ways from their Buddhist origins whereby it may reduce its psychotherapeutic value and affect the accurate dissemination of the Buddhas’ teachings. This paper reflects on some of these departures, by firstly discussing the term mindfulness, which, as used in the MBIs, has a more restrictive meaning than that meant by the Buddha. Secondly, this paper discusses the usefulness of MBI therapists being knowledgeable in a range of meditation techniques, rather than in only a few. And thirdly, this paper discusses the usefulness of MBI therapists having a personal mindfulness practice of ones’ own, and concludes by suggesting that an explicit acknowledgement of the Buddha in the formation of the MBIs be considered.     

A Content Analysis of the Offender Population in Counseling Journals

We discuss the findings of an exploratory content analysis related to the offender population by examining literature from 2008 to 2018 in 23 American Counseling Association (ACA) and ACA‐affiliated counseling journals. The findings and implications of the analysis are discussed.     

Enhancing parental reflective functioning through early dyadic interventions: A systematic review and meta‐analysis

Parental reflective functioning (PRF) is an important predictor of infant attachment, and interventions that target parent–infant/toddler dyads who are experiencing significant problems have the potential to improve PRF. A range of dyadic interventions have been developed over the past two decades, some of which explicitly target PRF as part of their theory of change, and some that do not explicitly target PRF, but that have measured it as an outcome. However, no meta‐analytic review of the impact of these interventions has been carried out to date. The aim of this review was to evaluate the effectiveness of dyadic interventions targeting parents of infant and toddlers, in improving PRF and a number of secondary outcomes. A systematic review and meta‐analysis was conducted in which key electronic databases were searched up to October 2018. Eligible studies were identified and data extracted. Data were synthesised using meta‐analysis and expressed as both effect sizes and risk ratios. Six studies were identified providing a total of 521 participants. The results of six meta‐analyses showed a nonsignificant moderate improvement in PRF in the intervention group (standardised mean difference [SMD]: –0.46; 95% confidence interval [CI] [–0.97, 0.04]) and a significant reduction in disorganised attachment (risk ratio: 0.50; 95% CI [0.27, 0.90]). There was no evidence for intervention effects on attachment security (odds ratio: 0.71; 95% CI [0.19, 2.64]), parent–infant interaction (SMD: –0.10; 95% CI [–0.46, 0.26]), parental depression (SMD: –1.55; 95% CI [–3.74, 0.64]) or parental global distress (SMD: –0.19, 95% CI [–3.04, 22.65]). There were insufficient data to conduct subgroup analysis (i.e. to compare the effectiveness of mentalisation‐based treatment with non‐mentalization‐based treatment interventions). Relational early interventions may have important benefits in improving PRF and reducing the prevalence of attachment disorganisation. The implications for future research are discussed.     

A systematic review of interventions to address workplace bias: What we know,what we don't,and lessons learned

Despite the extensive literature about the pervasiveness and impact of microaggressions in the workplace, little is known about what specific workplace interventions have been adopted to mitigate them and, for those adopted, whether the efforts are effective. Given the nature of this special journal issue, we originally sought to answer this call by focusing solely on workplace interventions targeting microaggressions. However, it became clear that the relative paucity of such interventions (as documented in the literature) necessitated that we cast a broader net. We therefore present the results of a systematic review of studies that evaluate the effectiveness of workplace interventions focused on subtle bias and/or its behavioral manifestations. The review identified only six papers that met the inclusion criteria of: 1) reporting a real-world workplace intervention with a goal of reducing subtle bias and/or behavioral manifestations and 2) including a systematic evaluation of attitude, awareness, and/or behavioral change. Multiple themes across the identified studies are summarized. The discussion addresses the dearth of well-documented interventions and examines lessons learned from existing interventions to inform the development of future training focused on microaggressions in order to contribute to long-lasting change.     

Parent‐implemented brief functional analysis and treatment with coaching via telehealth

We evaluated the use of parent‐implemented brief functional analyses in the home with coaching delivered via telehealth. Parents of 7 children with autism conducted functional analyses of their child's challenging behavior. For 4 participants, the brief functional analysis provided information regarding the function of the child's challenging behavior. A full functional analysis indicated a social function for 1 participant. The brief functional analysis yielded false positive results and subsequent assessment indicated an automatic function for another participant. The final participant did not engage in sufficient rates of challenging behavior to provide information regarding the function of the child's challenging behavior. Treatment evaluations occurred with 4 participants; these evaluations provided support for the results of the functional analysis. Together with previous research, the results indicate that parent‐implemented brief functional analyses, followed by additional assessment as needed, may be an effective method for assessing and treating challenging behavior via telehealth.     

A Model of Intention to Participate in Parenting Interventions: The Role of Parent Cognitions and Behaviors

A wide range of factors, from perceived child behavior problems to sociocultural factors, have been identified as impacting the engagement of parents in parenting interventions. However, parents’ cognitions and behaviors have not been evaluated sufficiently to understand their role in initial parental engagement. The current study aimed to examine why some parents are more likely to want to participate in parenting programs and how their cognitions and behaviors are related to their intention to participate in future parenting interventions. We tested the hypothesised model of parental factors on intention to participate using structural equation modelling (SEM) in AMOS. This study (N = 6,733) analyzed existing data from the International Parenting Survey (IPS), a web-based tool developed to collect information about parents’ views on family and parenting at a population level in several countries. Results showed that parents’ coercive parenting, parental consistency, positive encouragement, relationship with their child, parental self-efficacy, psychological distress, and help-seeking behaviors were significantly related to their intention to participate in future parenting interventions. The structural model of parents’ cognitions and behaviors explained 16% of the variance in intention to participate. Although the current model explained a small but significant percentage of the variance, it expands existing understanding regarding parental cognitions and behaviors and their relationship to intention. Implications for further research and engagement practice are discussed.