Impact of Caregiver Factors on Youth Service Utilization of Trauma-Focused Cognitive Behavioral Therapy in a Community Setting

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an increasingly available evidence-based therapy that targets the mental health symptoms of youth who have experienced trauma. Limited research has examined how to engage and retain families in TF-CBT services in community settings. Using a mixed-methods approach, the goal of this exploratory study was to identify caregiver factors that impact youth enrollment and completion of community-delivered TF-CBT. The study included 41 caretakers of youth referred to therapy at a local child advocacy center following a forensic assessment substantiating youth trauma exposure. Caregiver factors examined include caregiver demographics, trauma exposure, and mental health symptomology. Results from multivariate logistic regressions indicate that caregivers reporting more children residing in the household were significantly more likely to enroll youth in therapy (OR 2.27; 95 % CI 1.02, 5.03). Qualitative analyses further explicate that parents with personal trauma or therapy experiences expressed positive opinions regarding therapy services for youth, and were more likely to enroll in or complete services. Findings suggest that caregivers with personal traumatic experience and related symptomatology view therapy as important and are more committed to their child receiving therapy. Future research on service utilization is warranted and should explore offering parental psychoeducation or engagement strategies discussing therapy benefits to parents who have not experienced trauma and related mental health symptomatology.     

The referential communication skills of children with imaginary companions

The present study investigated the referential communication skills of children with imaginary companions (ICs). Twenty-two children with ICs aged between 4 and 6 years were compared to 22 children without ICs (NICs). The children were matched for age, gender, birth order, number of siblings, and parental education. All children completed the Test of Referential Communication (Camaioni, Ercolani & Lloyd, 1995). The results showed that the children with ICs performed better than the children without ICs on the speaker component of the task. In particular, the IC children were better able to identify a specific referent to their interlocutor than were the NIC children. Furthermore, the IC children described less redundant features of the target picture than did the NIC children. The children did not differ in the listening comprehension component of the task. Overall, the results suggest that the IC children had a better understanding of their interlocutor's information requirements in conversation. The role of pretend play in the development of communicative competence is discussed in light of these results.     

Developmental and sex-related differences in preschoolers' affective decision making

This study investigated developmental and sex-related differences in affective decision making, using a two-deck version of Children's Gambling Task administered to 3- and 4-year-old children. The main findings were that 4-year-old children displayed better decision-making performance than 3-year-olds. This effect was independent of developmental changes in inductive reasoning, language, and working memory. There were also sex differences in decision-making performance, which were apparent only in 3-year-old children and favored girls. Moreover, age predicted awareness of task and the correlation between the latter and decision-making performance was significant, but only in 4-year-old children. This study thus indicates that there is a remarkable developmental leap in affective decision making, whose effects are apparent around the age of 4, which according to our results, also marks the age when the correlation of declarative knowledge and decision-making performance becomes significant.     

Post-Discharge Experiences of People with Psychosis Following Partial Hospital Program Completion

Partial hospital programs are day programs which act as a bridge between inpatient and outpatient care for people with severe and persistent mental illness. This study explored the gap that exists in understanding the post-discharge experiences of people who have experienced psychosis. Qualitative interviews were conducted with 8 participants with psychosis, at least 4 weeks after completing partial hospital program. Identified themes included improved sense of wellness, changes in structure/routine, accessing community resources, social support and engagement, engagement in leisure, and impact of medication. Occupational therapists can use these findings to enhance programming at partial hospital programs and other similar programs.