A bereavement model for working with families of handicapped children

SUMMARY. This paper presents a model for counselling families of young handicapped children. It is argued that the process that parents go through following the birth of a handicapped child is akin to bereavement following loss. Therefore, professionals on a wide range of disciplines should be sensitive to the grief that parents are experiencing. The authors have used Le Poidevin s theory of adjustment to loss to structure their own theories and to devise a checklist to aid other professionals. Their experience indicates that the birth of the handicapped child may act as a catalyst for psychological growth in parents—mast particularly mothers.     

A comparison of two programmes for victims of child sexual abuse: a treatment outcome study

This study aimed to evaluate the comparative effectiveness of individual therapy and combined individual and group therapy in the treatment of the psychological sequelae of child sexual abuse. The Child Behaviour Checklist (CBCL), the Youth Self Report form (YSR), the Children's Depression Inventory (CDI) and the Trauma Symptom Checklist for Children (TSCC) were administered before treatment and 6 months later to a group of 20 young people who participated in individual therapy (IT) programmes and to a group of 18 young people who participated in programmes that involved combined individual and group therapy (IGT). For both types of programmes, statistically significant improvement occurred on the following scales: the total problems, internalizing problems, externalizing problems, withdrawn, somatic complaints, anxious/depressed, social problems, attention problems and aggressive behaviour problems CBCL scales; the total depression, interpersonal problems and anhedonia CDI scales; and the depression and anger TSCC scales. The only scale for which one therapy programme led to greater improvement than another was the CDI ineffectiveness scale. The IGT programme led to a reduction in the mean CDI ineffectiveness score, whereas a slight increase in the mean ineffectiveness score occurred in the IT group. There were no significant differences in the rates of clinically significant improvement associated with the two treatments and no major differences between cases who improved and those that did not improve over the course of therapy. From this study, it may be concluded that after 6 months, individual therapy and combined individual and group therapy were equally effective in the treatment of the psychological sequelae of child sexual abuse. Copyright © 2002 John Wiley & Sons, Ltd.     

Multi-family psychoeducation groups in the treatment of children with mood disorders

This study examined the impact of adjunctive multi-family psychoeducation groups (MFPG) on mood-disordered children aged 8 to 11 and their families. Participants were 35 children and 47 parents from families randomly assigned to either immediate MFPG plus treatment as usual (n = 18) or a 6-month wait-list condition plus treatment as usual (n = 17). At the 6 month follow up, immediate treatment families reported: Increased parental knowledge about childhood mood symptoms; increased positive family interactions as reported by the parent; increased perceptions of parental support as reported by children; and increased utilization of appropriate services by families. Expected impact on decreasing negative family interactions was not found. Results are largely consistent with hypothesized findings and support the need to further investigate the adjunctive role of psychoeducation in the treatment of childhood mood disorders.     

Support and education groups for children of battered women

The children of battered women have been called the forgotten victims of domestic violence. Indeed, few clinicians have published accounts of their work with these children. This article describes in detail a support and education group program for children of battered women. Five hundred and seventy-five children have participated in the program, with promising results on several measures of success.     

A treatment program for children with sexual behavior problems

This paper discusses the problems and treatment of children with sexual behavior problems. These children coerce, intimidate or force other children by threats of physical harm to comply with their sexual requests, frequently a reenactment of their own experiences. This paper describes a comprehensive therapeutic foster care approach to these children.     

Parenting groups for parents whose children are in care

Excluding very severe child abuse cases, biological parents are usually encouraged to maintain contact with their children in care. Parent‐child contact is often considered important because it can maintain the child's psychological identity and well‐being. It can also maintain parent‐child attachment and in some cases facilitate reunification. Improving parenting skills is viewed as an important method by which contact between children and their biological parents can be enhanced. However, mainstream parenting groups are often unsuitable for parents whose children are in care for a number of reasons. There is stigma involved with having children in care, such parents have very complex lives and there are reduced opportunities to practise skills learnt with their children. Groups designed specifically for parents whose children are in care appear to be a promising approach to improving the quality of contact between these parents and their children. This paper will review group‐based approaches to working with biological parents whose pre‐school‐aged children have been placed in care. The paper will also report the findings of a research project designed to identify key facilitators and barriers to parental involvement in a group‐based programme which includes contact between parents and their children who have been placed in care. Copyright © 2009 John Wiley & Sons, Ltd.     

A critique of outcome evaluation in child abuse treatment

Controlled studies that examine the effectiveness of intervention with child abusing families are a rarity in the literature. Yet child welfare workers sorely need empirically based methods to treat these parents. The author analyzes 16 studies of child abuse treatment in terms of methods and findings, and suggests how future studies may be made more useful for practitioners.     

Tandem treatment: A model for work with parents of troubled children

The complexity of individual work with parents whose children are in treatment because of their difficulties is explicated. An exploratory study of 15 mothers' experiences with such treatment is reported. The focus of the study was on parents' expectations, their relationships with their own and their child's clinician, the process of treatment and termination. The findings are integrated with relevant literature and clinical experience to provide a tandem treatment model in which emphasis is placed on clarifying parents' expectations, working with parents' individual issues as well as their role as parents, and focusing first on their children's problems, then gradually moving to the parents' concerns about their own problems.Ms. Staver is a retired Chief Psychiatric Social Worker, Judge Baker Guidance Center     

A pilot study of support and education groups for college students with insulin-dependent diabetes mellitus

College students with insulin-dependent diabetes mellitus often ignore the care of their illness. Faced with managing this illness independently for the first time, they lack the knowledge and experience to do so effectively. Their need to establish autonomy often prevents them from seeking the advice of health professionals. In view of this, the author undertook a pilot study to investigate the role of a peer support group on a college campus as a means of improving the diabetic students' management of their illness. Three closed-membership groups met for 10 weekly sessions. Hemoglobin A1c (the measure of average blood sugar over the preceding 3-month interval) determinations prior to participation in the group ranged from 4.0 to 11.7, with a mean of 8.16; after participation in the group, the mean hemoglobin A1c levels of group members dropped to 6.10 (p less than .001). (Hemoglobin A1c measures lower than 6.2 reflect physiologic blood sugar measures of someone without diabetes.) These results suggest that the peer-group approach may be a viable way to improve the metabolic control of young adults with diabetes at the time in their lives when they are learning to manage their illness independently.     

A study to determine if and how bereavement support programs provided by Irish and Canadian hospices are evaluated

A study of the bereavement programs provided by hospices in Ireland and the Canadian province of Alberta was done to determine if and how these are evaluated for efficacy. All but one hospice offered multiple different bereavement programs, with routine in-house evaluations of all programs performed. In all cases, staff and client unsolicited and solicited comments made during and at the end of each program provided data for continuing program refinement. Most hospices also routinely employed a self-devised questionnaire to gain specific sought information to retain or change programs. Other information, including news about program developments elsewhere, was also actively sought for program adoption or for the improvement of existing programs. With most bereavement programs having been in place for many years, participants were confident their programs are needed, safe, and effective. Their continuing quest for high-quality programming, however, meant they were active in monitoring these programs and in seeking developments in this field.     

Family reunification efforts that work: A three year follow-up study of children in residential treatment

A three year follow-up study of children discharged from a residential treatment program was conducted to determine long-term family reunification rates. The primary interest was a comparison of families which had received different types of parent involvement programs during their child's placement. Results indicated that families which had received a combination of experiential and didactic involvement programs reunified at a significantly higher rate than did those receiving either program separately. Results are discussed with regard to the difficulties of achieving successful reunification for families with children in placement.     

A follow-up study of adopted children from Romania

Romania became notorious in recent history for the problems in its child welfare system. A black cloud continues to hang over the country since media reports, such as 20/20's Shame of a Nation, and other writings and broadcasts have focused worldwide attention on the child welfare problems in Romania. During this same time period from 1990 to 1993, several thousand children were adopted from Romania by North American families. This study describes the positive and negative aspects of children adopted from Romania. It gives particular attention to the experiences of families who adopted children from institutional settings compared to other placements.A version of this paper was presented at the 21st Annual North American Council on Adoptable Children Conference, Norfolk, Virginia, August 3–6, 1995.     

Psychoeducational groups with foster parents of sexually abused children

Psychoeducational groups for foster parents of sexually abused children were successfully delivered. Groups with nonrelative foster parents required less basic behavior management training than groups for foster parents related to the children in their care. Relative groups also required considerable attention to issues of visitation with birth parents. The groups helped foster parents improve their ability to care for sexually abused children. Participants were highly satisfied with the groups. Additional program development and research is clearly warranted.Ms. Winterfelt is in private practiceThe Project was supported by the Children's Bureau, ACF. DHHS.Copies of the training curriculum and videotape are available from Ms. Yeaton, Dept. of Psychiatry, Children's Hospital, 747 52nd Street.