Caregivers' Endorsement of Barriers to Mental Health Services for Children and Youth in Child Welfare

The purpose of this study was to examine the three most common types of caregivers in the child welfare system (birth parents, relative caregivers, and foster parents), an active child welfare case, caregivers' endorsement of barriers to mental health services and mental health service use by caregivers for the children under their care. The sample consisted of 430 dyads (caregivers and their children). Results indicate that an active child welfare case, provider characteristics, and accessibility of services predicted mental health service use for children. Implications for the child welfare and mental health systems are discussed.     

Support and Profiles of Nonoffending Mothers of Sexually Abused Children

Maternal support offered to sexually abused children following disclosure may be a crucial factor in children's recovery. A person-centered approach was used to examine how profiles of nonoffending mothers could better describe their ability to support their children after disclosure. Cluster analyses based on a total of 226 nonoffending mothers recruited from child protective services yielded four distinctive groups of mothers: resilient, avoidant-coping, traumatized, and anger-oriented reaction. These profiles differed on measures of support, parenting, and variables related to attitude following disclosure. The discussion underscores the relevance of adopting a tailored approach to intervention with mothers of sexually abused children.     

Assessing the Effect of an Electronic Decision Support System on Children's Mental Health Service Outcomes

This study examined the effect of clinician adoption on an agency built Electronic Discussion Support System on the reduction of youth risk factors. This exploratory study is the first of its kind to assess an agency-built Electronic Decision Support Systems (EDSS) within a children's mental health program to see how it is utilized in a treatment as usual climate. The results showed a significant difference between the reduction-in-risk rating for two of the domains of the North Carolina Family Assessment Scale (Parental Capability and Environment). Yet findings showed that only a few staff utilized the EDSS regularly. Based on the findings, it appears there was a break down in the implementation process. Although the agency had the best of intentions by building the Dashboard, without proper emphasis on implementation their goal was never fully actualized.     

Psychosocial Well‐Being and the Relationship Between Divorce and Children's Academic Achievement

As an unprecedented number of children live in families experiencing divorce, researchers have developed increasingly complex explanations for the consequences associated with marital dissolution. Current accounts focus on changes to family finances, destabilized parenting practices, elevated parental conflict, and deterioration of the parent–child relationship, to explain the impact of divorce. A less studied explanation draws attention to children's diminished psychosocial well‐being following divorce. Using data from the Early Childhood Longitudinal Study—Kindergarten cohort (ECLS‐K) (N = 10,061), I examined the role of psychosocial well‐being in the relationship between divorce and children's outcomes. The results suggest that divorce is associated with diminished psychosocial well‐being in children, and that this decrease helps explain the connection between divorce and lower academic achievement.     

Exploring the Context of Child Sexual Abuse in Jamaica: Addressing the Deficits

Jamaican media sources have recently noted the prevalence of child sexual abuse within the country. While research has continually noted the mental health impact of child sexual abuse, there is a dearth of literature on the relationship between the two in Jamaica. The purpose of this article is to provide the context of child sexual abuse in Jamaica, including the cultural considerations, current legislation, government created agencies, and modes of treatment. Moreover, recommendations are given for public health educators, school personnel, and mental health service providers in order to improve the psychological well-being of sexually abuse children.     

“They Look at You like You're Nothing”: Stigma and Shame in the Child Support System

More than 22 million or 1 in 4 children in the United States are currently served by the child support program. This program, the third largest used to address childhood poverty, regulates non‐custodial parents' financial support of their children through federal, state, and municipal legislation and policies. The collateral consequences, particularly those related to economic stability and criminal justice involvement, associated with child support system participation have been widely studied. However, many of the interpersonal interactions between those who have cases in the system and those who work in the system have been largely ignored. In this article, I use courtroom observations, in‐depth interviews, and cultural artifacts to explore the practices of stigmatization and shaming in this important legal and bureaucratic process. I explore stigma and shame in three thematic areas: (1) shame in social interactions, (2) shame as a tool of social control, and (3) the social consequences of shame. I ultimately suggest that stigma and shame in the child support system, resembling that in the welfare and criminal justice systems, reinforces cognitive boundaries between parents perceived as “responsible” and those perceived as “deadbeats.”     

Mental Health Knowledge Gaps in the Child Protection Work with Parents: A Narrative Review of the Social Work Literature

This is a narrative review of the latest peer-reviewed social work literature on the child protection work with parents. Aiming to identify knowledge gaps, the study researches the mental health aspects of the implicit or explicit theoretical perspectives underpinning the assessment and intervention with parents. An electronic database search extracted 38 peer-reviewed journal articles. It was found that the theoretical perspectives the publications adopted were the managerial, the critical, the humanistic, the psychodynamic and the behavioural. The study identified mental health knowledge gaps in the assessment and intervention work with parents across all theoretical perspectives and stressed the need for process and effectiveness studies on the work with parents, under explicit theoretical perspectives. The study finally highlights the need for the social work profession to increase its mental health literacy through mental health education for students and practitioners alike.     

Child Welfare and Juvenile Justice: Examining the Unique Mental Health Needs of Girls

This study investigated the prevalence of mental health problems among girls who are involved in child welfare or juvenile justice systems. The sample consisted of 1,193 girls ranging in age from 4 to 18, the majority (82.3%, n = 982) of which were older than age 12. Differences based on race/ethnicity and developmental age groups were examined. Consistent with other research, this study found that the mental health needs of girls involved in the child welfare or juvenile justice systems are several times higher than in the general population. Intervention approaches must be developed that take into consideration differences in gender, age, and racial and ethnic group.     

A Child and Adolescent Mental Health Day Program Working at the Edge of Chaos: What Complexity Science May Tell Us About Team,Family and Group Systems

The purpose of this article was to explore the potential application of the science of complexity to aspects of team, family and group systems. A child and adolescent mental health Day Program as a tightly knit multidisciplinary team closely interacting with family systems, provides an opportunity to illustrate concepts of this general scientific framework and offer potentially unique insights. In particular, the relevance of diversity and interconnectivity between parts of a system are highlighted. Ideas explored include team functioning, how change occurs in families and new ways of looking at groups. Furthermore, complexity provides support for intensive multisystemic interventions such as the Day Program to assist families with severe and chronic child mental health issues.     

Exploring Mental Health Adjustment of Children Post Sexual Assault in South Africa

Large numbers of children are affected by child sexual abuse in South Africa. This study aimed to assess psychological adjustment of children post sexual assault. In-depth, semistructured interviews were conducted with caretakers, and structured interviews using mental health assessment screening tools were given to children at three intervals over a five-month period after presentation at a sexual assault center. Almost half of the children met clinical criteria for anxiety, and two-thirds met criteria for full symptom post-traumatic stress disorder two to four weeks post disclosure. With standard care, we observed some recovery; 43.3% of children still met full symptom post-traumatic stress disorder nearly six months postdisclosure. Our findings indicate that current practice in South Africa does not promote adequate recovery for children.     

Intimate Partner Violence and Social Relational Theory: Examining the Influence of Children and Important Others on Mothers' Transition Out of Violent Relationships

Interviews with survivors of intimate partner violence were conducted to gain information on the transition from violent relationships to new non‐violent relationships. A subset of this data was re‐analysed using Social Relational Theory to gain further insight into the roles of children and important others who were identified as impacting this transition for mothers who had exited violent relationships. This paper reviews two major themes discovered during the SRT analysis that were inherent in the women's experiences: (i) agency of children, family, peers and community and (ii) power. In addition, this paper suggests implications for research, intervention and psychotherapeutic practice.     

Effectiveness of the Coral Tree Family Service family inpatient unit: a longitudinal study exploring change in family functioning

Child mental health disorders represent a major burden to public health in Australia due to high prevalence rates, the widespread impact across domains, and the potential for difficulties to persist into adolescence and adulthood. Extensive evidence exists for the use of parent management training and cognitive behavioural therapy to treat difficulties experienced by children; however, a proportion of children do not benefit as expected from these treatments. The use of complementary therapeutic approaches and variations to the mode and intensity of existing intervention is warranted; family inpatient units represent a unique example of this. The aim of this study is to evaluate the effectiveness of a well-established Australian inpatient unit that admits the whole family, for children aged 12 years and younger referred with mental health, behavioural, or emotional difficulties. This study's longitudinal within-subject study design utilised routinely collected outcome data from the systemic clinical outcome and routine evaluation, 15 item (SCORE-15)—a valid and reliable measure of family functioning—from a sample of 980 participants attending the Family Residential Program. This study reported significant improvement in family functioning across all outcome variables between baseline and post-intervention, with no variables returning to pre-intervention levels at follow-up. Clinically significant changes in overall family functioning showed that 37% of participant scores moved from the clinical range at baseline to the nonclinical range post-intervention. This study represents the first empirical evaluation of the Family Residential Program, and the reported results provide compelling evidence for the program to effect improvement in family functioning for families with long-standing and severe difficulties. Poor rates of questionnaire completion following intervention frequent the literature base of family inpatient units, with low post-intervention (56%) and follow-up (12%) rates evident in this study. This study uniquely contributes to the growing evidence base of family inpatient units using rigorous evaluation methods.     

Over 1000 Aluminium Cans for Forty Dollars: The Provisioning Contributions of Older Children from the Perspectives of Welfare‐Reliant Lone Mothers

In this article, as a child and family mental health therapist, I connect the feminist concept of ‘provisioning’ and the experiences of ‘young carers’ to critically examine the family care contributions made by older children living in poverty. I present the findings of a qualitative study consisting of two focus groups in which ten (n = 10) welfare‐reliant lone mothers living in Toronto, Canada described the nature and significance of the contributions made by their older children (11–17 years old) to help their families ‘make ends meet’. Using grounded theory, two main categories emerged: (1) the nature of the provisioning by older children, and (2) the significance of the contributions. The implications of the findings suggest that mental health approaches with older children living in poverty inappropriately misrepresent and pathologise their emotional distress and family contributions.     

A Social Constructivist Perspective on the Potential Relevance of Selected DSM‐5 Disorders for South African Children and Youth

In South Africa, careless implementation of child psychiatry's biomedical model of ‘mental disorder’ could stigmatise children and youth who have been made vulnerable by the lingering effects of apartheid — poverty and malnutrition, violence and abuse, and the HIV/AIDS pandemic. A focus on DSM‐5 category changes — regarding post‐traumatic stress disorder and ADHD — demonstrates that these psychiatric labels are impracticable and irrelevant in a post‐colonial developing country, where mental health care is delivered in the context of scarce services and unequal access. A social constructivist perspective enables us to broaden policy decisions and suggest directions for research.     

Divorce and Adult Psychological Well‐Being: Clarifying the Role of Gender and Child Age

Substantial evidence indicates that marital dissolution has negative consequences for adult well‐being. Because most research focuses on the average consequences of divorce, we know very little about factors that moderate this association. The present study tests the hypothesis that the effects of marital dissolution on adult well‐being are greatest for those with young children in the home at the time of marital dissolution. Analysis of data from the National Survey of Families and Households (N= 4,811 men and women married at the baseline interview) supports this hypothesis, especially among women. For women without young children, marital dissolution appears to have few negative consequences for psychological well‐being. Differential exposure to secondary stressors that accompany marital dissolution partly explains these patterns.