Striving to do well what comes naturally: social support, developmental psychopathology, and social policy

Social support can have significant stress-preventive and stress-buffering benefits for troubled individuals in everyday circumstances. Consequently, it is not surprising that many therapeutic and preventive programs enlist social support to address problems of child and family psychopathology, especially in the context of "two-generation interventions" that seek to improve child well-being by strengthening parental functioning and parent-child relationships. Home visitation programs are the best known of these two-generation strategies and have become the focus of state-level and national efforts to support families and prevent harm to children. The conclusions of basic research studies on social support converge significantly with the findings of evaluation studies of the impact of home visitation programs to yield important new insights into the conditions in which formal social support is likely to be beneficial. or ineffective, in improving child and family well-being. Both basic and applied research literatures emphasize the importance of linking formal social support to informal social networks in extended families, neighborhoods, and communities, and attending to the complex reactions of the recipients of support and the needs of support providers. These studies are reviewed and evaluated to highlight the connections between social support, developmental psychopathology. and social policy.     

Development of a multisystemic parent management training intervention for incarcerated parents,their children and families

The majority of men and women prison inmates are parents. Many lived with children prior to incarceration, and most have at least some contact with their children and families while serving their sentences. Because prison populations have increased in the United States, there has been a renewed interest in finding ways not only to reduce recidivism, but also to prevent incarceration in the first place, particularly among the children of incarcerated parents. Positive family interaction is related to both issues. The ongoing development of a multisystemic intervention designed to increase positive family interaction for parents and families involved in the criminal justice system is described. The intervention package currently includes a prison‐based parent management training program called Parenting Inside Out (PIO); a prison‐based therapeutic visitation program; and complementary versions of PIO designed for jail and probation and parole settings. Work on other components designed for justice‐involved parents, children and for caregivers during reunification from prison is ongoing. Program development has occurred within the context of strong support from the State department of corrections and other key governmental and non‐profit sector groups, and support systems have been established to help maintain the interventions as well as to develop complementary interventions, policies and procedures.     

The short‐term impact of a problem‐solving skills programme for Iranian parents

Background: The ability of children to solve problems is an important influence on the social‐cognitive development of children. Parents and children who use problem‐solving strategies display more positive parent‐child relationships. It follows that parents will be more effective in promoting the children's development and healthy parent‐child relationships if they are skilled in problem‐solving strategies and encourage their children to use these strategies. Aim: The aim of the present study was to evaluate the short‐term efficacy of a problem‐solving skills program for Iranian parents (the ‘Raising a Thinking Child’ program) on the parent‐child relationship. Materials and method: Sixty‐four mothers of 4–8 year‐old children participated voluntarily in 12 2‐hour weekly workshops over a three month period. Parents were taught a procedure for problem‐solving and provided with the opportunity to consider how the procedure could be applied in response to challenging behaviors of their children. The problem‐solving strategies were taught as an alternative to ineffective approaches such as punishing and reprimanding. Results: Results indicated that teaching problem‐solving skills to parents had a positive influence on a number of dimensions of parenting as measured by the Parent Child Relationship Inventory. Conclusion: Parents who attended the program felt more supported, more involved with their children and better able to balance limit setting and child autonomy.     

Family well‐being and disabled children: A psychosocial model of disability‐related child behaviour problems

Background: When parents receive a diagnosis that their child is disabled, many families adjust to this healthily and cope well, but others do not. Feelings of hopelessness, social isolation of the family within the community and child behaviour problems have all been reported. While utilization of social support systems is well documented in the literature as being a significant factor in family coping and adjustment to the child's disability, less attention has been focused on the role of psychological factors. Objective: This theoretical study aims to address this inbalance by integrating perspectives from a social model of disability with psychological research on the role of cognitive change in families' coping and adjustment to having a disabled child, and thus to produce a new psychosocial model of disability‐related child behaviour problems. Method: Negative societal attitudes to disability identified by a social model of disability are interpreted with respect to how they might translate to parent views of their disabled child within the family. Resultant parenting beliefs and their possible implications for family interaction, child behaviour and family health and well‐being are explored within this new framework. Conclusions: The psychosocial model of disability‐related child behaviour problems provides a useful conceptual framework that has both clinical and research implications for professionals working with families with disabled children.     

Family‐Based Therapy for Parent–Child Reunification

Children in highly conflicted, divorced families can become triangulated and polarized in their relationships with their parents. In time, this can lead to a child refusing to have a relationship with a parent, refusing for example, to see or talk to him or her. This access refusal can sometimes become extended, lasting months to years. When this occurs, the courts may request professional involvement to help facilitate parent–child reunification. This article outlines a family‐based treatment model for parent–child reunification cases. This family‐based treatment incorporates treatment goals for each family member and each family member is asked to be a part of the solution in resolving the family's problems. I provide a case illustration as well as helpful tips for treating these families.     

Genomic tools for health: Secondary findings as findings to be shared

PurposeWhether and how to disclose secondary finding (SF) information to children is ethically debated. Some argue that genetic testing of minors should be limited to preserve the child’s future autonomy. Others suggest that disclosure of SFs can occur if it is in the best interests of the child. However, the ways that parents conceptualize and weigh their child’s future autonomy against the interests of their child and other family members are unknown.MethodsTo explore how parents understand SF disclosure in the context of their child and other family members’ lives, we conducted semistructured interviews with 30 families (40 parents in total). All parents had children who were enrolled in a genetic sequencing protocol that returned results by default.ResultsWe found that parents did not routinely conceptualize SFs as distinctive health information. Rather parents saw this information as part of their child’s overall health. To make decisions about disclosure, parents weighed their child’s ability to understand the SF information and their other family member’s need to know.ConclusionBecause most families desired SF information, we argue that disclosure of SF be reconceptualized to reflect the lived experiences of those who may receive this information.     

Adopting a population-level approach to parenting and family support interventions

Evidence-based treatments and preventive interventions in the child and family area have not met with widespread adoption by practitioners. Despite the high prevalence of child behavioral and emotional problems, many parents and families in need are not receiving or participating in services, and when they do, the most efficacious interventions are not what is usually provided. Simultaneously addressing the issues of low penetration and insufficient dissemination of evidence-based programming requires a population approach to parenting and family support and intervention. Process issues are important, particularly in relation to engagement of stakeholders, recruitment of practitioners, consideration of organizational factors, and use of media and communication strategies. This article discusses why there is a need for a population-based approach, provides a framework of how to conceptualize such an approach, and describes an example from our own work of a recently initiated prevention trial that illustrates a population-based approach in action. The rationale, structure, and goals of the Triple P System Population Trial are described in the context of the aforementioned population framework.     

Anxiety in children: Perceived family environments and observed family interaction

Assessed differences between families with a child diagnosed with anxiety disorder and control families on self-report measures of parenting and independent observers' ratings of family interaction. Children rated their parents, and parents rated themselves on the parental variables of warmth/acceptance and psychological autonomy/control. Similar constructs were rated by independent observers of family interaction generated via a revealed differences discussion task. Parents of children with anxiety disorders were rated by observers as less granting of psychological autonomy than controls. In addition, children with anxiety disorders rated both their mothers and fathers as less accepting than control children rated their parents. Results are discussed in terms of socialization, family systems, and attachment theories regarding the tolerance and acceptance of different and/or negative emotions within families. The possible relation of family interaction styles to the internalizing disorders in childhood is explored.     

Non-genetic and non-gestational parenthood: consequences for parent-child relationships and the psychological well-being of mothers, fathers and children at age 3

BACKGROUND: Findings are presented of the third phase of a longitudinal study of children conceived by assisted reproduction procedures involving surrogacy and/or donor conception. METHODS: At the time of the child's third birthday, 34 surrogacy families, 41 donor insemination families and 41 oocyte donation families were compared with 67 natural conception families on standardized interview and questionnaire measures of the psychological well-being of the parents, mother-child relationships and the psychological well-being of the child. RESULTS: The differences found between family types reflected higher levels of warmth and interaction between mothers and their 3-year-old children in assisted reproduction families than in families with a naturally conceived child. A higher proportion of surrogacy parents than donor conception parents had told their children about the nature of their birth. CONCLUSIONS: It appears that the absence of a genetic and/or gestational link between parents and their child does not have a negative impact on parent-child relationships or the psychological well-being of mothers, fathers or children at age 3.     

IMPLEMENTATION OF A COMMUNITY‐BASED FAMILY‐CENTERED PROGRAM IN PORTUGAL: A MULTIPLE CASE STUDY EVALUATION

Family‐centered, community‐based programs are particularly suited to support families with at‐risk children or maltreated children and achieve family preservation or reunification. In these child protection and child welfare cases, assessment is of great importance to inform decision making. But the implementation of services to support the families change and its evaluation in real settings is not without challenges. The Integrated Family Assessment and Intervention Model (IFAIM) was designed to conduct assessment and intervention with multichallenged families with at‐risk or maltreated children and support the activities of the child protection system. In this article, we describe a pragmatic, focused on improvement, action research multicase study of the process and outcome of IFAIM's first implementation. Multiple factors affected implementation, namely, factors related with the teams, the organizations, and the communities. An improved model of implementation based on the evaluation results is proposed.     

Planned lesbian families: their desire and motivation to have children

BACKGROUND: There is no information about the desire and motivation for children among planned lesbian families. The overall aim of this research was to examine whether planned lesbian families differ from heterosexual families in desire and motivation to have a child. The reason for studying this is that desire and motivation to have children are characteristics that are supposed to effect parenting and the parent-child relationship. METHODS: A total of 100 lesbian two-mother families were compared with 100 heterosexual families. All data were collected by means of questionnaires. RESULTS: Lesbian parents and heterosexual parents rank their parenthood quite similarly; however, happiness is significantly more important for lesbian mothers than it is for heterosexual parents and identity development is less important for lesbian mothers than it is for heterosexual parents. Furthermore, compared with heterosexual parents, lesbian parents had spent more time thinking about their motives for having children, and their desire to have a child was stronger. CONCLUSIONS: Lesbian parents especially differ from heterosexual parents in that their desire to have a child is much stronger. The study's findings may be helpful for counsellors in their work to inform and assist lesbian couples in their decision to have a child.     

Observation of family functioning at mealtime: a comparison between families of children with and without overweight

OBJECTIVE: To examine differences between families of children with and without overweight on parental control and support. METHODS: Twenty-eight families with an overweight child and a control group of 28 families with a normal weight child (age range 7-13 years) participated in the study. Observations and self-reports of mealtime family functioning were administered and analyzed. RESULTS: Parents of children with overweight reported to exert more control on their children's feeding behavior and an equal amount of parental support in comparison with parents of children without overweight. However, observations at mealtime indicated that in families with an overweight child, maladaptive control strategies were twice as prevalent, and less parental support was displayed. CONCLUSIONS: Self-reports and observations provide complementary information on how parents interact with their overweight children. Family-based treatment programs should include discussions on the adequate amount of parental control and support.     

The Role of the Family in Children's Responses to Stressful Medical Procedures

The role of the family in removing various psychological risk factors for the hospitalized child is explored. The importance of the physical presence of the parents and siblings is documented and programs to increase their presence on the pediatric ward are described. The potential for the parent to act as either a positive or negative model, bearer of relevant information, and source of control over medical procedures is discussed. Finally, programs that train parents in risk reduction strategies are presented and the need for future research in this area is stressed.     

Adoption as a natural experiment

Adoption provides a unique opportunity for the study of child development. Because adopted children are raised in families in which they have no genetic relationship with their parents, and possibly none with their siblings, they provide a rare opportunity to study the relative importance of genetic, shared environmental, and nonshared environmental influences on the development of child characteristics and behaviors. Because children are adopted from a variety of circumstances and at a wide range of ages, studies of adopted children and their families provide researchers the opportunity to examine the short- and long-term influences of a wide range of environments on children's development. Because children are adopted into homes with a range of characteristics (e.g., multiracial homes), adoption provides the opportunity to study the range of influences of these homes on child development. Adoption research that focuses on each of these areas is reviewed in this article. We present conclusions about the value of adoption in psychological research and some reasons why many psychologists ignore the opportunities presented by studying adoptive families, as well as potential useful directions for future research with adopted children and their families.     

Solo mothers and their donor insemination infants: follow-up at age 2 years

BACKGROUND: Findings are presented of the second phase of a longitudinal study of solo-mother families created through donor insemination (DI). METHODS: At the time of the child's second birthday, 21 solo DI mother families were compared with 46 married DI families on standardized interview and questionnaire measures of the psychological well being of the mothers, mother-child relationships and the psychological development of the child. RESULTS: The solo DI mothers showed greater pleasure in their child and lower levels of anger accompanied by a perception of their child as less 'clingy'. Fewer emotional and behavioural difficulties were shown by children of solo than married DI mothers. CONCLUSIONS: The findings from this first cohort of solo DI families to be studied lend further weight to the view that these women represent a distinct subgroup of single parents, who, out of a strong desire for a child, have made the active choice to go it alone. Moreover, this route to parenthood does not necessarily seem to have an adverse effect on mothers' parenting ability or the psychological adjustment of the child.     

Sib understanding of genetics and attitudes toward carrier testing for X‐linked severe combined immunodeficiency

X‐linked severe combined immunodeficiency (XSCID) is the most common genetic form of SCID, a rare disease with profoundly impaired immunity. SCID was previously fatal but now can be treated by bone marrow transplantation. Mapping of XSCID in 1985 and identification of the disease gene, IL2RG, in 1993 made possible patient and carrier diagnosis. We assessed understanding of the genetics of XSCID in adult sibs recruited from families in which a proband had enrolled in our protocols and had attended an XSCID family workshop. Thirty‐seven female and three male sibs completed a questionnaire and semistructured interview. Overall knowledge of genetics of XSCID was excellent. An overwhelming majority of participants (93%) believed that daughters should be tested for XSCID carrier status; 89% would prefer to have their own daughter tested prior to age 18 years (M = 9, median = 12), and 34% would test at birth. Moreover, 89% felt they would disclose carrier results to their daughter before adulthood (M = 12 years, median = 12); 51% would tell prior to adolescence. XSCID sibs were optimistic about medical science and assertive in their search for the latest information. Genetic information should be made available to families over time and should include discussion of reproductive risks for sons surviving with XSCID and daughters as they grow up. We recommend that genetic counseling for XSCID include children in age‐appropriate discussions and that counselors help parents weigh benefits of early testing and disclosure versus the potential harm of loss of child autonomy. Published 2001 Wiley‐Liss, Inc.     

Using action research to facilitate change in child protection services

We have been involved over several years in the planning and development of services for child abuse investigation and therapy, including the development of multiagency (“child advocacy”) centers and education for Court programs. Our roles have been in research, program evaluation, group facilitation, advocacy, and planning. The approach taken was that of “action research.” This approach allows for the collaboration of researchers, service providers, and clients in the analysis of a social problem and/or related social services. It also allows for the multiple roles demanded of the researcher in facilitation of change. In contrast to action research, the more common approaches of scientific inquiry and program evaluation assume a one‐way influence of science on practice, which may partially account for the low rates of utilization of research knowledge and low participation in research by practitioners. Action research is described, and contrasted with other approaches. Advantages and problems in action research are illustrated by reference to the child protection projects we are currently involved in. © 2002 Wiley Periodicals, Inc.     

脑性瘫痪幼儿父母养育态度的中日比较研究

目的 :探讨不同的养育环境对脑性瘫痪幼儿父母的养育态度的影响。方法 :以中日两国 5～ 6岁脑性瘫痪幼儿和他们的父母 (中国 40组、日本 1 8组 )为研究对象 ,应用田研式亲子关系检查量表测定了父母的养育态度。结果 :中日两国脑性瘫痪幼儿的养育环境有显著差异 ,表现为中方多为独生子女、散居在家者多 (P <0 0 0 1 ) ;而日方则全体均入托。中日两国父母均见到“保护”和“服从”的过保护养育态度 ,但中国父母更加显著 (P <0 0 5～P <0 0 0 1 )。而且中国独生组和散居组过保护养育态度显著高于非独生组和入托组 (P <0 0 1～P <0 0 0 1 )。结论 :过保护养育态度是中日两国脑性瘫痪幼儿父母共同的特征性的态度 ,是父母对孩子身体残障状况的反应。独生残障儿童又使中国父母过分保护养育态度的出现率增高     

Effecting Change in Maltreating Fathers: Critical Principles for Intervention Planning

Although fathers perpetrate a significant proportion of child maltreatment, the intervention needs of abusive and neglectful fathers have not been adequately addressed or researched. This paper argues that well-designed treatment has the potential to benefit men, their children, and their families. However, the treatment needs of maltreating and at-risk fathers are unique, and programs must be designed accordingly. Based on the integration of parenting, child abuse, change promotion, and batterer treatment literatures, five principles to guide intervention with maltreating fathers are advanced: (a) overly controlling behavior, a sense of entitlement, and self-centered attitudes are primary problems of abusive fathers; thus, the development of child-management skills should not be an initial focus of intervention; (b) abusive fathers are seldom initially ready to make changes in their parenting; (c) fathers' adherence to gender-role stereotypes also contributes to their maltreatment of children; (d) the relationship between abusive fathers and the mothers of their children requires special attention; and (e) because abusive fathers have eroded children's emotional security, the need to rebuild trust will affect the pace of change and potential impact of relapse on the child. These principles are contrasted with the supportive and child-management goals of conventional group parenting programs, and the implications for providing service to fathers are considered.     

Collaboration for child adjustment: issues for school- and clinic-based child psychologists.

Therapeutic gains for children may be maximized if the important systems serving their mental health needs develop sophisticated collaborative relationships. School- and clinic-based psychologists may overlook important ways in which they can cooperate. School-based psychologists may not be aware of how to extend or support the therapeutic interventions suggested by other psychologists. Clinic-based child therapists may lack a full understanding of both the promise of school-based programs and the constraints under which schools operate. Collaborative efforts between clinic- and school-based practitioners may increase ecologically valid treatment options. This article explores both the gains and the potential pitfalls that may arise when school- and clinic-based practitioners work together.