A Narrative Approach to Child and Family Therapy in Africa*

Professional family therapy in Africa is heavily influenced by theories and principles of Western family practice. Its practice structure and philosophies are however grounded on African family values and the principles and orientations of traditional African psychology. This paper presents a clinical report that illustrates adaptations we make to incorporate compatible aspects of narrative family practice in African and Western cultures. A summary of African family values and child psychology intended as a background perspective is provided. The paper is significant against the background of the current need for forging multiculturally relevant healing methods that fit well with the globalized nature of the contemporary world. Augustine Nwoye, PhD, is Associate Professor and Chairman, Department of Psychology, Kenyatta University, Nairobi, Kenya (amnwoye@avu.org). Professor. Nwoye has developed an African paradigm for mental health and, in particular, for family and couple therapy. He also has experience in dealing with stress and multiple losses, especially surrounding HIV/AIDS within an African context. *An earlier version of the paper was presented to the members of staff and students of the Faculty of Education, University of Cambridge, England, UK, and the initial version was presented to the members of the Family Therapy Program of the Faculty of Medicine of the University of Calgary, Calgary, Canada. I wish to thank Dr. Colleen McLaughlin (University of Cambridge) and Professor Karl Tomm (University of Calgary) for their invitation, assistance, time, attention, and suggestions.     

Social anxiety disorder in children and youth: A research update on aetiological factors

Social Anxiety Disorder (SAD) is a heterogeneous and distressing problem for many children and youth. This review focuses on the etiology and maintenance of SAD, and examines research findings in several key areas of investigation: genetic or hereditary factors (twin and family studies), temperament characteristics (behavioural inhibition), and parent–child interactions (attachment, parenting styles). It is concluded that genetic influences, behavioural inhibition, and parent–child interactions play significant and interactive roles in the development and maintenance of SAD. Other influences such as peer relationships, social skills deficits, and traumatic experiences are also acknowledged. Ultimately, an understanding of such pathways should facilitate effective early screening and intervention of children at risk for severe social anxiety.     

Boys will be boys: a pre‐line‐up gameplay has beneficial effects on boys' but not girls' identification performance

Fifty children, aged between 4 and 7 years, underwent a sequential photo line‐up procedure in order to identify a man they had met the previous day. Half of the participants engaged in a pre‐procedure gameplay with the female interviewer. It was hypothesised that the game would stimulate rapport building and would ultimately result in an increased performance during the line‐up procedure. The beneficial effect was indeed observed, but only for the male participants. This finding suggests that gameplay may be a fruitful strategy to decrease child witness discomfort and to increase participation. Copyright © 2006 John Wiley & Sons, Ltd.     

The development of the family alliance from pregnancy to toddlerhood and children outcomes at 18 months

This paper presents a longitudinal study of the development of family interactions from pregnancy to toddlerhood. Family interactions are increasingly acknowledged as a predictive factor for children's psychopathological outcomes. We used an observational setting, the Lausanne Trilogue Play, to evaluate the ‘family alliance’, namely, the quality of interactive coordination between family members. Families participated at the 5th month of pregnancy, and at 3‐ and 18‐months after birth. The sample (N=39) consisted of non‐referred primiparous families. Results show that (i) family alliance is stable during the first two years for most families: the quality of prenatal interactions between parents and a baby doll is thus predictive of the subsequent interactions with the actual child; (ii) there are links, but only a few, between family interactions and children outcomes reported by parents. Methodological issues (observation versus self‐reported questionnaires) are discussed. Copyright © 2006 John Wiley & Sons, Ltd.     

A Comparison of Interactions Among Children,Parents, and Therapists in Cognitive Behavior Therapy for Anxiety Disorders in Australia and Japan

Despite growing attention to the efficacy of culturally adapted cognitive-behavioral treatment (CBT) programs for children and adolescents, there is still little empirical and practical information available to therapists who adapt original treatment protocols to suit clients of a specific culture. The current study aimed to compare therapeutic interactions across CBT treatment delivered with two different cultural groups. We developed an observational coding system to examine behaviors exhibited by child, parent, and therapist during CBT sessions conducted in Australia and Japan for children with anxiety disorders. Our results demonstrated significant differences between the two countries with respect to the treatment readiness of children, the proportion of talking during the sessions by parents and children, therapists’ laughter, length of silence during the first session, and parent indices of accommodation. In terms of transitions over time (i.e., first to last CBT session), parents in both countries tended to talk more during the last CBT session, whereas only Australian therapists talked less over time. The proportion of silence decreased over time during the Japanese sessions, and the amount of interruptions by parents increased over time for Australian sessions. Finally, our exploratory analyses demonstrated that a number of behavioral observations were correlated with anxiety treatment outcome at posttreatment. This study suggests that interactions between a child, parent, and therapist during CBT sessions may be affected by the culture in which the CBT session occurs, which could have implications for culturally adapted CBT programs.     

Emotional Abuse Questionnaire (EAQ): A New Scale for Measuring Emotional Abuse and Psychological Maltreatment1

Emotional abuse is the core of all other kinds of child abuses and maltreatments. The significant and serious outcomes of other kinds of abuses are often due to the emotional aspects. Moreover, emotional abuse has several forms, and each form may lead to different adverse outcomes for children and adolescents. Unfortunately, there is not a comprehensive instrument to assess all categories of emotional abuse. A 30-item self-report questionnaire was developed for ages 12 years and older. The sample included 328 students aged 12 to 19 years selected randomly from students referred to different student counseling centers. Exploratory factor analysis categorized the scale into six subscales. Confirmatory factor analysis revealed that all items were fitted with the subscales significantly. Content and concurrent validity demonstrated good validity and reliability for each subscale. Overall reliability was also significantly acceptable.     

儿童癌症疼痛相关问题探讨

几乎所有的癌症患儿在其病程中都会经历疼痛,其中70％以上患儿在某一时刻会有重度疼痛。目前儿童癌痛的有效控制率令人担忧。对于下面几个问题如果能够充分了解,将有助于患儿的疼痛控制。这些问题包括：疼痛控制力度不够的原因;疼痛产生原因;疼痛的评估方法;疼痛的药物治疗和非药物治疗原则。     

Child versus adult psychoanalysis: Two processes or one?

Child analysis continues to be seen as a different technique from adult analysis because children are still involved in a developmental process and because the primary objects continue to play active roles in their lives. This paper argues that this is a false dichotomy. An extended vignette of the analysis of a latency‐aged girl is used to demonstrate that the psychoanalytic process that develops in child analysis is structurally the same as that in adult analysis. Both revolve around the analysis of resistance and transference and use both to promote knowledge of the patient’s mind at work. And both techniques formulate interventions based on the analyst’s appraisal of the patient’s mental organization. It is hoped that stressing the essential commonality of both techniques will promote the development of an overarching theory of psychoanalytic technique.     

Adult Attachment in Children Raised by Parents with Schizophrenia

Maternal schizophrenia is known to have an adverse effect on the quality of mother–infant interaction; and children of parents with severe mental illness run a higher risk of poor mental health and social outcomes. Hence, children raised by a parent with schizophrenia may be less likely to attain secure attachment, although there is less evidence so far to support this. Moreover, there is a lack of research in this field that focusses on the needs and experiences, the strengths and vulnerabilities, of the children themselves. Qualitative methods are thus needed to generate new insights and hypotheses. The present study uses semi-structured interviews with 23 adults who, as children, were raised with a parent who experienced schizophrenia. This reveals a range of attachment problems, resulting in difficulties in forming secure adult relationships. Problems with trust and intimacy were found to be common.     

The rise of the child's voice; the silencing of the spiritual voice

In recent years the notion of the child's voice has gained prominence, particularly influenced by the United Nations Convention on the Rights of the Child (UNCRC) in 1989 which outlined rights for children on an international scale. Many countries, including the UK, subsequently legislated for the child's voice to be heard in a variety of arenas including the education system. Despite the concept of the child's voice now being firmly established within schools in England, this paper argues that one aspect of their voice is not being heard: their spiritual voice. Drawing on evidence from research, this paper proposes that a variety of factors have culminated in a tendency towards a silencing of the child's spiritual voice. It argues that this silencing is an important one which should be acknowledged and rectified if educators in all schools are to treat the concept of the whole child seriously, and fully value their well‐being.