Psychosocial interventions used to treat children with ADHD: safety and efficacy

Although stimulant therapy is the most common treatment for attention-deficit/hyperactivity disorder (ADHD) in children, it is not always effective in reducing behavioral symptoms. As a result, research on psychosocial interventions has progressed in recent years. This article provides a synopsis of psychosocial interventions for childhood ADHD, with an emphasis on basic behavior management principles, evidence-based interventions, and safety issues. Developmental issues that distinguish psychosocial interventions for children and adolescents are highlighted, and practical recommendations for collaborating with mental health professionals are provided.     

EBV. Managing the physiological and psychosocial implications of the Epstein-Barr virus

EBV has both physiological and psychological implications. Few medical/nursing interventions are available to alleviate the physical stressors and fatigue. The primary nursing intervention, therefore, becomes one of providing emotional support and psychosocial interventions. Providing measures to ensure adequate sleep will assist the patient in more positive feelings about self. Although causation and diagnosis of this syndrome may be debated in the medical literature, the nursing role is to provide support and guidance for these patients. Longitudinal studies could be done to facilitate the understanding of the long-term effects of EBV and the outcome measures of mental health interventions.     

Improving the well-being of couples facing cancer: a review of couples-based psychosocial interventions

The purpose of this review article is to assess the available scientific evidence on the effects of couples-based psychosocial interventions for couples when one spouse faces cancer. For the present study, we conducted an extensive search of three electronic databases using a comprehensive search strategy. The literature search identified 14 studies evaluating couples intervention where one partner is facing cancer. Among them, eight studies concluded there was overall improvement for patients and eight studies reported overall improvement for partners, whereas an additional five studies showed partial improvement for patients and three demonstrated partial improvements for partners. Taken in the aggregate, these studies illustrated partial effectiveness--most had some positive results--but with clear limitations in terms of how many aspects of psychosocial well-being changed, lack of equal effectiveness for both patients and their partners, or limited maintenance of improvements over time, a common concern with brief psychosocial interventions. Although couples-based interventions may facilitate emotional support and dyadic coping, how these psychosocial interventions should be delivered, at what point in the illness and treatment they should be delivered, and how long they should continue remain as future challenges.     

Psychosocial Treatment of Oppositional Defiant Disorder

Abstract

Objective:To review and describe empirical outcome studies on the psychosocial treatment of children and adolescents meeting the criteria for Oppositional Defiant Disorder (ODD).Method:To locate these treatment outcome studies, an extensive review of the literature using the PsycINFO database was conducted. Results:Psychosocial treatments designed solely for youth meeting the criteria for ODD are rare. Rather, it seems that most of the intervention studies have involved youth with Conduct Disorder as well as ODD, even though these two disorders have distinct differences. Selected psychosocial interventions, including anger control and stress inoculation training, assertiveness training, multisystemic therapy, and rational emotive therapy, have produced favorable outcomes in the studies conducted and published to date. Conclusions:Social workers serving ODD youth should seek training in these provisionally supported evidence-based practices. Given the scarcity of treatments designed solely for ODD with adolescents, there is a need for more outcome studies on this specific population, and for more studies of social work practice involving such youth.     

Multi dimensional system for evaluating preventive program for upper extremity disorders among computer operators

Typing is associated with musculoskeletal complaints (MSCs), caused by multiple risk factors. Although a wide variety of ergonomic intervention programs were conducted to reduce risk factors and MSC's, only few of them were found evidence based. This study aimed to test the efficacy of a workplace intervention in reducing MSC's among computer workers. 66 computer workers were assigned randomly to one of three intervention programs: ergonomic intervention including biofeedback, intervention without biofeedback and control group without intervention. The efficacy was tested by advanced assessment including; pain location and severity, posture at work, upper extremity 3D kinematics, muscle activity and psychosocial status. Working hypothesis; significant score differences will be found between the study groups which underwent ergonomic intervention and the control group on the following measures: pain complaints, upper extremity kinematics, muscle activity and psychosocial status. Significant differences were found between pre and post intervention and between research groups and the control group in pain, posture and motion. The ergonomic intervention with biofeedback had no unique contribution in comparison to other interventions. In conclusion; the proposed intervention program was found efficient for reducing pain among computer workers.     

Correlates of AUDIT Risk Status for Male and Female College Students

Abstract

Objective: The current study identified gender-specific correlates of hazardous drinker status as defined by the AUDIT. Participants: A total of 462 college student volunteers completed the study in 2006. The sample was predominantly Caucasian (75%) and female (55%). Methods: Participants completed a survey assessing demographics, alcohol use patterns, and health indices. Scores of 8 or more on the AUDIT defined the at-risk subsample. Logistic regression models determined which variables predicted AUDIT risk status for men and women. Results: The at-risk participants reported higher alcohol use and related problems, elevated sleep problems and lower health ratings. High typical blood alcohol concentration (BAC), lifetime drug use, and psychosocial problems predicted risk status for males. Binge frequency and psychosocial problems predicted risk status for females. Conclusions: Different behavioral profiles emerged for men and women identified as hazardous drinkers on the AUDIT. The efficacy of brief alcohol interventions could be enhanced by addressing these behavioral correlates.     

A Summary of Selective Experimental Research on Psychosocial Interventions for Sexually Abused Children

This study was conducted to explore current trends in psychosocial interventions for sexually abused children through a review of recent research. Our comprehensive review is limited to published (quasi) experimental studies in the English language over a period of 2000–2013. It provides a detailed analysis of the final 18 articles that met our inclusion criteria, from the 670 potentially relevant articles that were identified. Reviewers analyzed candidate articles to determine whether they met inclusion or exclusion criteria. The retrieved studies reported positive results with respect to improvements in the negative psychosocial sequelae of child sexual abuse following the use of a diverse set of treatment strategies. Of the various interventions, cognitive behavioral therapy was shown to be the most promising type of intervention for sexually abused children. In this review, we discuss some of the implications of psychosocial interventions for victims of child sexual abuse, citing both the methodological and ethical issues that should be considered.     

Relationships Between Psychosocial Risks and Stress in Homeless Children

Homeless children are typically exposed to the worst environmental conditions associated with poverty. Despite recent attention to psychosocial risks associated with homelessness, limited attention has been paid to stress-related symptoms in homeless children. Better understanding of homeless children’s experience of stress could point the way toward improvement of services for them. The purpose of the present exploratory study was to assess associations between child psychosocial riskfactors and emotional and behavioral symptoms of stress in homeless children, Twenty-two homeless nlothers of 29 children between the ages of 2 and 10 were surveyed about known psychosocial risks for homeless children and completed the Pediatric Emotional Distress Scale (PEDS), a 17-item measure of stress-related symptoms in children. Findings suggest that the stress-related symptoms of these children are related to the cumulative effects of environmental risk factors. The PEDS appears to be a sensitive measure of stress in children, and its brevity provides an advantage in assessments in high-stress situations. More developmental work with low-SES samples, however, is recommended.     

Relationships Between Psychosocial Risks and Stress in Homeless Children

Homeless children are typically exposed to the worst environmental conditions associated with poverty. Despite recent attention to psychosocial risks associated with homelessness, limited attention has been paid to stress-related symptoms in homeless children. Better understanding of homeless children's experience of stress could point the way toward improvement of services for them. The purpose of the present exploratory study was to assess associations between child psychosocial risk factors and emotional and behavioral symptoms of stress in homeless children. Twenty-two homeless mothers of 29 children between the ages of 2 and 10 were surveyed about known psychosocial risks for homeless children and completed the Pediatric Emotional Distress Scale (PEDS), a 17-item measure of stress-related symptoms in children. Findings suggest that the stress-related symptoms of these children are related to the cumulative effects of environmental risk factors. The PEDS appears to be a sensitive measure of stress in children, and its brevity provides an advantage in assessments in high-stress situations. More developmental work with low-SES samples, however, is recommended.     

Latino caregiver psychosocial factors and health care services for children involved in the child welfare system

Children in the child welfare system have a high prevalence of health problems, making pediatric health service use critical. Latino children represent a growing proportion of the child welfare system, and are at increased risk for health problems. Many have argued that Latino caregivers can provide Latino children with the least disruptive out-of-home placement, but little is known about how caregiver factors might relate to health services utilization or child health status within this population. This study assessed relationships between caregiver psychosocial factors, health care service utilization, and health status for children in the child welfare system. This sample featured 48 Latino caregivers involved in child welfare. Logistic regression models were used to test for relationships between caregiver psychosocial factors and appointment adherence and child health status. Problem-focused coping was positively related to well-child status. No psychosocial factors were related to medical appointment adherence. Case workers may help improve child health outcomes by promoting problem-focused coping skills among Latino caregivers.     

The Experience of Forced Relocation as Expressed in Children’s Drawings

Forced relocation of people from their homes due to changes in borders, war, or natural disasters has been recognized in the literature as a stressor which has affected communities throughout the world. However, the responses of latency-aged children to these stressors have not been sufficiently addressed. In an attempt to fill that gap, this article presents a phenomenological and diagnostic analysis of drawings made by Israeli children aged 7–9 who were evacuated from localities in the Gaza Strip area. The drawings indicate that the experience of forced relocation remained a significant one for the children, even 2 years after the event. The children’s drawings reveal the difficulties they experienced, as well as the coping strategies that they used to work through the experience and adjust to the situation. The drawings indicate that with the passage of time their perceptions of the evacuation were not traumatic. The main coping strategies reflected in the children’s drawings are defense and distancing mechanisms, as well as family and community support. In addition, the children included numerous ideological statements in their drawings, which evidently reflect an attempt to understand the meaning of the relocation, and emphasize their group affiliation. As a result, it is important to include the components of ideology, community, and family in evaluations and psychosocial interventions in order to promote the children’s constructive coping.     

Interventions for Internationally Adopted Children and Families: A Review of the Literature

Internationally adopted (IA) children are at increased risk for health-related, developmental, and behavioral difficulties. This article reviews the literature on various interventions currently used with IA populations; including health-related interventions provided by medical specialists, preparation programs provided by adoption agencies and other social service organizations, treatments for attachment and behavioral disorders, psychoeducational services, programs designed to improve children’s care prior to adoption, and parent-based initiatives. Surprisingly, very little systematic information exists regarding the effectiveness of interventions designed to prevent and remediate these difficulties in IA children. Recommendations for future research activity and for best practice approaches to intervention are discussed.     

Evaluation of the orphans reunification project in Eritrea

As a result of the 30-years war of liberation with Ethiopia, Eritrea has been faced with a ruined infrastructure, devastated economy and damaged social fabric. A large number of children were orphaned (up to 90,000) due to the war. Since 1994 The Orphan Reunification Project has assisted some 13,768 orphans and their extended families (6947) with economic assets to shore up their vulnerability. This article reports on some key findings of a major evaluation of the project, conducted jointly by the Government of the State of Eritrea, UNICEF and two international NGOs. The evaluation focuses on: (a) the impact of the main strategic intervention alternative of direct economic support to target families; (b) the psychosocial status or outcome of the reintegrated orphans; (c) the outcome of the projects capacity building component; and (d) the cost-effectiveness of the project.Findings from the evaluation suggest that direct economic support, particularly provision of livestock to farm households, has led to a further increase in assets. The evidence clearly shows that the status of assisted orphans compares favorably with that of non-orphans, thus indicating that the psychosocial integration between the host families and the orphans has been successful. Although orphan boys were indicated to be slightly better off, the gender differences were not dramatic. Substantial evidence also suggests that the project has built capacities of the relevant government ministry on a number of key areas—research skills and appreciation of the importance of solid operational research before social interventions, participatory planning, monitoring and management tools, community mobilization and advocacy for child protection. Finally, the reunification project is found to be significantly more cost-effective, psychosocially acceptable and sustainable than the alternative strategy of keeping the children in orphanages.     

Outcomes of family centered meetings for families referred to Child Protective Services

In order to address the number of children entering the foster care system each year and to promote the family's participation in the decision-making process, family-centered meetings have been widely adopted throughout the United States as well as in other countries. Since 1989, Family Group Conferencing, Family Group Decision Making, and Family Team Meetings have all been introduced into public child welfare systems. This paper will refer to all three approaches as family-centered meetings. However, little empirical research has been done to test the impact of these meetings on families referred to Child Protective Services (CPS). This paper examines literature on the impact of family-centered meetings with families referred to CPS on child and family functioning outcomes. The results suggest that more research is needed to examine fidelity models and specific types of interventions being implemented. However, all of these three appear to increase kinship care placements. More research is needed, specifically regarding the contexts where family-centered interventions could be appropriate. Implications for practice are also discussed, with special consideration of integrating family-centered interventions with other interventions to promote both family participation and child safety.     

Social gradients and participant characteristics in child behavior problem interventions

A social gradient has been found in both children's behavior problems and among the users of services that treat such problems. If low-resource families are simultaneously at higher risk of having a child with behavior problems and less inclined to use services to address such problems, healthcare inequality and social inequity could be exacerbated. I focus on social gradients in participant characteristics in two evidence-based parent training interventions that target children who display behavior problems: Parent Management Training—Oregon Model (PMTO) and Brief Parent Training. This study extends the literature on social gradients in participant characteristics by focusing on family social and economic resources independently and in an additive cumulative risk index. I investigated potential social gradients overall in a pooled sample and in separate analyses relating social gradients to more intensive treatment. The results revealed inverse social gradients among the intervention participants compared with the Norwegian general population of families with children; intervention participants had fewer social and economic resources. The inverse social gradient was partially replicated through analyses that focused on treatment intensity. Families with fewer resources were more likely to receive high-intensity treatment; however, these associations disappeared for families with > 3 cumulative risks. These results indicate that these PMTO interventions do not exacerbate social inequality by serving a high-resource population.     

Better together? Cooperation between youth welfare office and child and adolescent psychiatry: A methodological approach

Previous international literature describes a lack of systematic research about cross-institutional cooperation in social and health services although the need is indicated. More and more children and adolescents have complex psychosocial needs. Thus, they require help from different institutions and professions to receive optimal care. However, there is a great need of improvement of the cooperation between institutions in social (e.g. Youth Welfare Office) and health services (e.g. Child and Adolescent Psychiatry (CAP), even in Germany. Therefore, an official Agreement of Cooperation (AoC) between these institutions was implemented as a first attempt to enhance and structure cross-institutional work in Dresden, Germany. This methodological paper describes the corresponding evaluation project that includes cross-sectional and longitudinal assessments. It thereby focuses on the employees' and families' satisfaction as well as the psychosocial development and mental health of children at the intersection of the aforementioned institutions before and after the implementation of the AoC. In addition, it gives a review of literature about cross-institutional work.     

Exploring patterns of employee psychosocial outcomes among child welfare workers

Child welfare workers continue to suffer from increased levels of job stress and burnout, often resulting in an intention to leave. Although the literature on these psychosocial employee outcomes is extensive, much of it is limited in that it has failed to determine if variability exists across these constructs in a way that can be systematically categorized. This cross sectional exploratory study utilized a statewide purposive sample of respondents (N = 209) from a public child welfare organization in a Northeastern state. Two complementary cluster methods and discriminant function analysis were used to determine if subtypes of job stress, burnout, well-being, job satisfaction and intent to leave exist among public child welfare workers. Since the results yielded three different clusters of workers, an Analysis of Variance was used to identify significant group differences, while Scheffé post hoc tests were examined to determine which groups differed. Findings show that the all three clusters significantly vary from one another in terms of the adverse employee psychosocial outcomes. Our findings suggest that child welfare workers represent a heterogeneous group with dissimilar psychosocial needs. To meet those employee needs and maximize their work output, child welfare administrators should make a concerted effort to better understand the unique needs of this strained workforce.     

Australian Social Work Reviewers 2010

Abstract

Children placed in out-of-home care are a particularly disadvantaged group in society, who have often been exposed to trauma and socioeconomic disadvantage. As a result, they experience poorer health outcomes than children in the general population, especially mental health outcomes. One health outcome that has yet to be researched thoroughly is overweight and obesity of children placed in out-of-home care. Hence, the overall goal of this paper was to review the extant literature over the last decade on weight-related issues for children in out-of-home care, with particular emphasis on overweight and obesity. The findings of the review revealed that there is a lack of rigorous Australian research in relation to prevalence rates of overweight and obesity in children in out-of-home care; there is a lack of strategies or interventions designed specifically to combat overweight and obesity in children in out-of-home care; and one of the major limitations of Australian research to date is the use of self-report measures to assess the weight status of children in out-of-home care. It was concluded that prevention and intervention strategies are needed that target children as they enter out-of-home care.     

A Systematic Review of Psychosocial Interventions in Treatment of Opioid Addiction

Opioid addiction has become a U.S. epidemic. It is important to determine whether psychosocial interventions help prevent relapse. A total of 14 studies were included in this systematic review. Most studies compared psychosocial interventions in conjunction with pharmacological maintenance. Only 2 studies found that psychosocial interventions led to statistically significant benefits for outcomes related to opioid abuse when compared to maintenance and less or no psychosocial intervention. Psychosocial interventions were not found to be additive to pharmacological treatments during induction or maintenance stages. Further research is needed to determine effectiveness of psychosocial interventions during dose reduction and long-term relapse prevention.