A CHILD PSYCHOTHERAPIST IN PRIMARY MENTAL HEALTH

This paper outlines the author's application of psychodynamic thinking and approaches to brief therapeutic work with children, adolescents and their families in community mental health settings. It is the author's belief that systemic and narrative therapy insights and techniques combine well with psychoanalysis in the assessment and treatment of many concerns felt and expressed by parents and young people. The therapist's tasks are to listen empathically to clients who are in distress and to explore the clients' beliefs about the origins of their problems, as well as their previously attempted solutions. In proceeding at the family's pace, opportunities arise for facilitating more effective ways of resolving conflict. Clients are often more free than they realise to change their interpretation of their experience, and this has important consequences for the maintenance and solution of problems. Brief therapy seeks to remind clients of their strengths and resources and to share ways to encourage clients to resume effective ways of learning about themselves.     

Evaluation of a multi-site program designed to strengthen relational bonds for siblings separated by foster care

Sibling relationships in foster care settings have received increased attention in recent years. Despite growing evidence regarding the protective potential of sibling relationships for youth in care, some sibling groups continue to experience foster care related separation, and few programs exist to address the needs of these youth.This study describes and evaluates Camp To Belong, a multi-site program designed to provide short-term reunification to separated sibling groups through a week-long summer camp experience. Using a pre-test post-test survey design, this paper examines changes in youth ratings of sibling conflict and sibling support across camps located in six geographically distinct regions of the United States. The effects of youth age, number of prior camp exposures, and camp location were tested using multilevel modeling procedures.Findings suggest that participation in Camp To Belong may reduce sibling conflict, and improvements in sibling support are noted for youth who have had prior exposure to the camp’s programming. Camp-level variance in the sibling support outcome highlight the complex nature of relationships for siblings separated by foster care, and suggest the need for additional research. Lessons learned from this multi-site evaluation and future directions are discussed.     

Impact of job characteristics on turnover intention and the mediating effects of job satisfaction: experiences of home visiting geriatric care workers in Korea

This study investigated the effects of job characteristics on turnover intention and the mediating effects of job satisfaction. A survey of 317 Korean care workers currently providing in-home elderly care service in the city of Seoul and its suburbs was conducted. The results of multiple regressions and an analysis of mediating effects indicated that role ambiguity and workload had significant effects on turnover intention. In addition, job satisfaction had a mediating effect on the influence of role ambiguity and workload on turnover intention. Finally, theoretical and practical implications are discussed.     

‘There’s a lot of places I’d like to go and things I’d like to do’: the daily living experiences of adults with mild to moderate intellectual disabilities during a time of personalised social care reform in the United Kingdom

Adult social care services in the United Kingdom have undergone a period of transformation over recent years, characterised by a drive towards personalised care. Concurrently, social care budgets have been significantly reduced. This study aimed to explore the daily living experiences of adults with mild/moderate intellectual disabilities, who are at risk of no longer meeting eligibility criteria for statutory support. Focus group discussions, which included both people with intellectual disabilities and support workers, were analysed thematically. Two broad themes are presented: independence and agency; and social capital and well-being. While some participants echoed ideas central to the personalisation narrative, a number of contextual barriers to achieving greater independence and agency were discussed. Moreover, greater independence was not a desired goal for all participants. The findings highlight the potential mismatch between personalised social care, as delivered within significant budget constraints, and the needs of adults with intellectual disabilities.     

Responding to child deaths: the work of Australia's Victorian Child Death Review Committee

The Victorian Child Death Review Committee (VCDRC) in Australia is a multidisciplinary Ministerial Advisory Committee established to review the deaths of children either currently child protection clients or known to the statutory child protection system. The Committee provides advice about each child death as well as insights into what are the surrounding patterns and issues. Key to this role is examining the contribution of the service sectors to the protection of children and the routine practices that are in place to respond to children and vulnerability. This paper provides a snapshot of the cases referred to the VCDRC and the key messages for practice drawn from them. What emerges is that often the threshold for when statutory child protection services must be involved in child and family matters can be ambiguous and that agreement about intervention, the level and nature of need or risk, and when cumulative harm and neglect require statutory responses are not always shared between agencies. It is clear that the lack of common frameworks about what constitutes child protection intervention challenges services. It is recommended that there be and used agreed definitions and frameworks to ensure shared understandings and collaborative responses across the service and legal systems.     

Specialization and the Survival of Self‐Help Organizations

This article examines the survival rates of 589 self‐help organizations in order to understand how self‐help niches, organizations specializing in biomedical, human services, and behavioral health, differentially impact longevity. Drawing on a study of the self‐help movement, we examine how the various mechanisms by which specialization impacts self‐help movement organizations' chances of survival. Extending the concepts of embeddedness, countervailing powers, and organizational specialization to self‐help organizations, we investigate how formal structures and professional alliances differentially promote longevity. Results show how formalization enhances self‐help organizations' longevity, and serves as a mechanism by which specialization impacts organizational viability. While formalization has a robust and beneficial impact on longevity, some professional linkages are negatively associated with survival and others are positively associated with it.     

Everything for the Children: Orphans Growing Up in Informal Adoptive Families in China

Most orphaned children in China are cared for by their extended families or become state wards under the guardianship of child welfare institutions. Some exceptions are children who are found and cared for by families in the community, without a formalized adoption or foster relationship. In some locations, institutions now accept guardianship for these children and support the informal adoptive family to continue to care for them. This article examines the outcomes for these children as they became young adults by comparing these 12 children raised within the system as they approach or have approached young adulthood (now aged 16–40 years-old). Some of the participants were either informally adopted or lived in institutional care. The results of this study found that the family environment was more conducive to the young people’s wellbeing as they approached or entered adulthood. The participants raised in informal care appeared to be treated similar to the biological children in these families. When the institution formalized the state guardianship responsibility, it also meant the families had state resources for support to protect the children’s rights to economic security, education, health care, and social participation. This practice by the institution supported the addition of informal adoption, as one step closer to permanency than foster care. Future implications include considering this option to help promote the family system assisting these children, families, and the state.     

Fear,Defensive Strategies and Caring for Cognitively Impaired Family Members

One topic rarely addressed in the literature on older adults and interpersonal violence is the violence that can be experienced by family carers in relationship with a person living with cognitive impairment. This violence tends to remain hidden and is rarely framed as intimate partner violence. We examine how situations of intimidation and violence invoked fear in family carers and how they interpreted and reacted to these circum- stances. Interview and diary data were collected from family members who had previously or were currently experiencing some form of aggression in caring for someone with cognitive impairment or dementia. Drawing on discussions of fear and applying the analytic lens of defensive strategies, we explore how these carers responded to situations of intimidation and violence.     

Receipt of Formal and Informal Help with Specific Care Tasks among Older People Living in their Own Home. National Trends over Two Decades

Sweden is seen as a typical example of a social democratic welfare regime, with universal and generous welfare policies. However, in the last decades, there have been substantial reductions in the Swedish provision of care for older people. This study aimed to examine trends in sources of care‐receipt in older people (77+) living in their own home and with a perceived need for help with two specific tasks: house cleaning and/or food shopping. Trends in care‐receipt were examined in relation to gender, living alone, having children and socio‐economic position. Data from the 1992, 2002 and 2011 data collection waves of the national study, Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD), were used. Response rates varied between 86 and 95 per cent, and the sample represents the population well. Trends and differences between groups were explored in bivariate and logistic regression analyses. There was a reduction in formal care‐receipt regarding house cleaning and food shopping over the study period. It was more common for women than men to receive formal care, and more common for men than women to receive informal care. Reductions in formal care have affected older women more than older men. Still, living alone was the most influential factor in care‐receipt, associated with a greater likelihood of formal care‐receipt and a lower likelihood of informal care‐receipt. It can be concluded that public responsibility for care is becoming more narrowly defined in Sweden, and that more responsibility for care is placed on persons in need of care and their families.