Integrated Treatment Programmes for Mothers with Substance Use Problems: A Systematic Review and Meta-analysis of Interventions to Prevent Out-of-home Child Placements

Approximately half of mothers receiving substance use treatment are involved with childcare proceedings. This review aims to determine whether integrated treatment programmes for mothers with substance use problems are effective in preventing out-of-home placement (temporally/permanent) and influencing other maternal factors such as patterns of substance use, treatment completion and parenting behaviours. Six trials were identified—two randomised controlled trials and four non-randomised controlled studies. The pooled sample of participants was 1717. The results showed that mothers who participated in integrated treatment programmes were significantly less likely to have the children removed from their care (Odds Ratio (OR)?=?0.40, 95% CI?=?0.27, 0.61), more likely to complete substance use treatment (OR?=?3.01, 95% CI?=?1.79, 5.06), and more likely to reduce their alcohol consumption (Standardised Mean Difference (SMD)?=??0.40, 95% Cl?=??0.78, ?0.01) and drug use (SMD?=??0.30, 95% CI?=??0.53, ?0.07). However, non-significant reductions were observed for parent–child conflict (SMD?=??0.35, 95% CI?=??0.72, 0.03) and child abuse risk (SMD?=??0.03, 95% CI?=??0.36, 0.31). While the findings from this review suggest that mothers involved in integrated treatment programmes could potentially be less likely to experience out-of-home child placements and more likely to improve substance use treatment outcomes, little evidence exists for the effectiveness of these interventions. Further research, particularly high-quality RCTs, is required to demonstrate and persuade health and public policy on the far-reaching value of the integrated approaches.

     

Clinical Implications for Multi-Racial Individuals

Abstract

Multi- racial individuals experience distinctive struggles and challenges that can impact their mental health. However, despite the growing population and unique presenting issues there remains a scarcity of literature to effectively support them. In addition, there is a lack of research exploring the unique experience of the multiple heritage population. The article offers implications for effectively working with individuals of multi-racial decent as well as a call to action for MFTs to develop multicultural competencies for the profession.     

Sketching while narrating as a tool to detect deceit

In none of the deception studies that used drawings to date, was the effect of sketching on both speech content and drawing content examined, making it unclear what the full potential is of the use of drawings as a lie detection tool. A total of 122 truth tellers and liars took part in the study who did or did not sketch while narrating their allegedly experienced event. We formulated hypotheses about the total amount of information and number of complications reported and about various features of the drawings. Participants in the Sketch-present condition provided more information than participants in the Sketch-absent condition, and truth tellers reported more details than liars, but only in the Sketch-present condition. In contrast to previous research, no Veracity differences occurred regarding the content of the drawings, perhaps because sketching was introduced as a tool that facilitated verbal recall and not as a stand-alone tool.     

Face detection in 2‐ to 6‐month‐old infants is influenced by gaze direction and species

Humans detect faces efficiently from a young age. Face detection is critical for infants to identify and learn from relevant social stimuli in their environments. Faces with eye contact are an especially salient stimulus, and attention to the eyes in infancy is linked to the emergence of later sociality. Despite the importance of both of these early social skills—attending to faces and attending to the eyes—surprisingly little is known about how they interact. We used eye tracking to explore whether eye contact influences infants' face detection. Longitudinally, we examined 2‐, 4‐, and 6‐month‐olds' (N = 65) visual scanning of complex image arrays with human and animal faces varying in eye contact and head orientation. Across all ages, infants displayed superior detection of faces with eye contact; however, this effect varied as a function of species and head orientation. Infants were more attentive to human than animal faces and were more sensitive to eye and head orientation for human faces compared to animal faces. Unexpectedly, human faces with both averted heads and eyes received the most attention. This pattern may reflect the early emergence of gaze following—the ability to look where another individual looks—which begins to develop around this age. Infants may be especially interested in averted gaze faces, providing early scaffolding for joint attention. This study represents the first investigation to document infants' attention patterns to faces systematically varying in their attentional states. Together, these findings suggest that infants develop early, specialized functional conspecific face detection.     

Two-year-olds' search strategies and visual tracking in a hidden displacement task

Children younger than 3 years have difficulty with search tasks that involve hidden displacement. Partial visual information was provided about a ball's path as it moved toward a hiding place. Children (2.0 and 2.5 years old) saw a ball rolling down a ramp placed behind a transparent screen with 4 opaque doors. A wall, placed on the ramp and directly behind 1 of the doors, protruded above the screen and stopped the ball. Children were asked to find the ball. The transparency of the screen permitted visual tracking of the ball between the doors, but its final resting place was obscured. Both age groups were equally proficient at tracking the ball as it rolled behind the screen, but the 2.5-year-olds were more likely to reach to the correct door. Looking behavior was related to errors in the younger group in that tracking that stopped short or continued past the correct door was associated with incorrect choices.     

Maladaptive conflict monitoring as evidence for executive dysfunction in children with chromosome 22q11.2 deletion syndrome

Using an adaptation of the Attentional Networks Test, we investigated aspects of executive control in children with chromosome 22q11.2 deletion syndrome (DS22q11.2), a common but not well understood disorder that produces non-verbal cognitive deficits and a marked incidence of psychopathology. The data revealed that children with DS22q11.2 demonstrated greater difficulty than controls in locating and processing target items in the presence of distracters. Importantly, children with DS22q11.2 showed a deficit in the ability to monitor and adapt to stimulus conflict. These data provide evidence of inadequate conflict adaptation in children with DS22q11.2, a problem that is also present in schizophrenia. The findings of specific executive dysfunction in this group may provide a linkage between particular genetic abnormalities and the development of psychopathology.     

On the Tedium of the Good

It seems to be a phenomenon of contemporary life that we consider goodness embarrassing and rather dull. In contrast, the activities and inner lives of villains are deemed more complex and fascinating than those of good people. This paper attempts to understand the conception of goodness that underlies this phenomenon, and I suggest that informing it is the combination of two ideas, in tension with each other: firstly, a distorted understanding of the ancient conception of full virtue as the absence of all inner conflict; and secondly, the intuition that real goodness is only apparent and generated in inner conflict. In response, I offer an alternative picture of goodness as an ongoing, active and progressive relation to value, and conclude that in order to render goodness attractive again we need more adequate portraits of goodness from both philosophy and art.