Enabling and disabling emotional diversity: Negotiating autism spectrum disorder in therapeutic encounters

Autistic youth are often understood as emotionally suspect in schools, workplaces and households, and autistic behaviour is strongly regulated. In contrast, neurodiversity advocates suggest that all sociality exists on a spectrum, and that autistic people represent the diversity of that spectrum. Situated within this debate, this paper examines the narratives of specialists who navigate pedagogies of emotional suspicion in their work with autistic youth. I draw on interviews with autism professionals in Massachusetts, USA to elucidate how they negotiate the tensions between regulating emotional behaviour and recognising emotional diversity as they mediate the construction of autistic youth as emotional suspects.     

Reading case studies of people with autistic spectrum disorders: a cultural studies approach to issues of disability representation

Autistic spectrum disorders have been described, defined and differentiated from other neurological conditions primarily on the basis of case studies. A small group of highly influential case studies forms a core narrative of autism, which is challenged by other narratives. In this research, analytical techniques from cultural studies are used to uncover the social construction of autism through the production and interpretation of these narratives. The location of power within these narratives is explored through uncovering voice, the use of fictive techniques, intertextuality and other aspects of the texts studied.     

Storying transition-to-work for/and youth on the autism spectrum in the United States: a critical construct synthesis of academic literature

We explored how academic literature constructs the ‘worker with autism.’ Drawing on a systematic review of transition to work for youth with disabilities, we analyzed how 17 articles constructed ‘autism,’ ‘work,’ and the ‘worker with autism.’ We identified two argumentative approaches: the intervention story and the complex story. Intervention stories centered autism as a problem in need of treatment and work as a simple, positive endeavor. Complex stories offered various and more positive accounts of autism alongside broader notions of work. We recommend that academics experiment with writing which expands work (and career) possibilities for youth situated on the autism spectrum.     

Addressing the impact of trauma before diagnosing mental illness in child welfare

Congress set requirements for child welfare agencies to respond to emotional trauma associated with child maltreatment and removal. In meeting these requirements, agencies should develop policies that address child trauma. To assist in policy development, this study analyzes more than 14,000 clinical assessments from child welfare in Illinois. Based on the analysis, the study recommends child welfare agencies adopt policies requiring that (1) mental health screenings and assessments of all youth in child welfare include measures of traumatic events and trauma-related symptoms; (2) evidence-based, trauma-focused treatment begin when a youth in child welfare demonstrates a trauma-related symptom; and (3) a clinician not diagnose a youth in child welfare with a mental illness without first addressing the impact of trauma. The study also raises the issue of treatment reimbursement based on diagnosis.     

Social support and psychoeducational interventions with middle class dropout youth

There are substantial numbers of high school dropouts among middle class, high achieving and majority youth. Yet, little research has been undertaken to identify the psychosocial and family characteristics, educational needs, and program requirements of middle class dropout youth. This paper reports the educational history, individual psychosocial characteristics and family backgrounds of 102 middle class dropout youth who participated in an educational treatment program within a university. Data from a questionnaire and a family assessment instrument indicate that middle class dropout youth have a variety of family, social, emotional and learning disorders. Implications for clinical interventions are presented along with a case history and treatment plan of one of the youth in the study.     

Social and emotional learning in middle school curricula: A service learning model based on positive youth development

Service learning is an instructional methodology that may benefit students' social and emotional learning (Zins, Bloodworth, Weissberg, & Walberg, 2007). Though service learning is not a new pedagogy, there are few examples of how to successfully deliver service learning in school curriculum for middle school students (Gestsdottir, Bowers, von Eye, Napolitano, & Lerner, 2010; Mueller et al., 2011). This article discusses the theoretical basis for and practical implementation of a school-based positive youth development model that utilizes service learning to build the social and emotional skills of middle school students. First, this article presents the importance of social and emotional learning during adolescence. Next, utilizing a positive youth development framework, the possible social and emotional outcomes of service learning are outlined. Lastly, a case study of the Wyman Center's Teen Outreach Program® is presented as an example that integrates service learning, built on a positive youth development framework, into middle school curricula. Challenges of this model, future research questions and implications on practice and policy are suggested.     

With the silence of a thousand cries: extremes of autistic advocacy

In the past year, I have observed a growing trend toward extremes of autistic civil rights advocacy, at least partially characterized by disdain for scientific research and knowledge alongside a preference for lived experiences. This concerns me, an individual on the autism spectrum and someone who desires to help autistic individuals through the psychological study of autism. Hence my intent here: to discuss and bring attention to this situation. In so doing, I hope to create civil and respectful dialogue on the subject. I will conclude by discussing implications and potential actions which might bring about positive outcomes.     

Managing Risk: Self-Regulation Among Homeless Youth

While homeless youth are characterized by their risky behaviours we know little about how they conceptualize and manage risk in their everyday lives. This article will flesh out one aspect of a doctoral study that explored homeless youth’s conceptualizations of risk, by unearthing their self-regulation practices. Deploying an ethnographic lens, 18 youth were followed over a 1–4 year period to capture their risk perception and practices as they unfolded. The findings question the relevancy of the prominence of expert discourses in theories of risk. The study’s empirical findings run counter to the thesis that expert systems predominate in practices of self-regulation. In contrast, practices of self-regulation were not so much in response to expert discourses or social norms but were balanced by personal experience, intuition, and situated knowledges. Results provide valuable insights into the interplay of lay and expert knowledges in the construction of risk among an identified risky and at-risk group. Lessons can also be drawn for clinical practice and the relevancy of the expert role that social workers play in the lives of homeless youth.     

Therapeutic Engagement of Adolescents with Emotional and Behavioral Disorders

Youth engagement is increasingly recognized as a preferred approach and often necessary step in the treatment of emotional and behavioral disorders. The purpose of this study was to explore the degree and quality of youth engagement in the therapeutic process, compare engagement scores between youth accessing residential and day treatment, and explore the association between engagement and interpersonal difficulties in a sample of youth with an emotional and/or behavior disorder in residential and day treatment programs based in Southern Ontario. Cross-sectional surveys of standardized measures were administered to youth and a separate survey to their Prime Workers. Relevant constructs included client engagement (as rated by youth and Prime Workers), and youth-rated behavioral screen, interpersonal problems and family functioning. Both Prime Workers and youth rated youth as moderately high in their level of engagement in therapy. Furthermore, Prime Worker and youth ratings did not significantly differ statistically, suggesting that youth may have actually engaged at a moderate level. Interpersonal problems were shown to be negatively associated with youth engagement, and family functioning approached significance for only youth in residential treatment. Assessing youth engagement during the treatment process as an intervention technique may highlight areas where greater clinical efforts are needed. Future considerations include testing methods of sharing and discussing results of an engagement measure within the context of a one-on-one clinical encounter with youth.     

A study of new referrals to a menopause clinic and their initial outcomes: how can we improve the service we provide?

This retrospective case-note study was performed to examine the ways in which an already established menopause clinic could improve service to its patients. The management of 151 patients was examined. Most were referred by their general practitioner and the most common reason for referral was to seek an alternative to hormone replacement therapy (HRT). The consultant saw 17% of the patients, and with the trainee was most likely to discharge the patient. Better information on alternatives to HRT, more consultant input and better use of telephone consultation for follow-up would enhance the service provided by the menopause clinic.     

A place for mobility in metaphors of youth transitions

ABSTRACT

Metaphors are central in the study of youth; in fact, it has been argued that ‘youth’ itself could be considered a metaphor. In a recent assessment of transition-related metaphors, Cuervo and Wyn [2014. “Reflections on the Use of Spatial and Relational Metaphors in Youth Studies.” Journal of Youth Studies 17 (7): 901–915.] have noted that such metaphors as ‘niches’, ‘pathways’, ‘trajectories’ and ‘navigations’, often contain an element of movement. However, it is still under-debated how we can systemically incorporate mobility into the study of young people to capture the precarity characterising their lives (a), but also heuristically link to metaphors used to describe the changing shape of careers of young people (b). Indeed, scholarship on ‘boundaryless careers’ and ‘peripatetic careers’ appear to have developed separately from the youth-related literature, albeit dealing in part with similar issues. Departing from Furlong’s work on metaphors in youth studies, this article interrogates potential for intertwining research lines within the growing debate on mobility in youth transitions. The article develops at a conceptual level; however it takes on Furlong’s legacy in the sense of contributing to a youth research agenda which is attentive to both the creation of new imaginative categories for the study of current conditions of youth, and the challenges that emerge in discursively positioning youth in society.     

Walk-in Together: A pilot study of a walk-in online family therapy intervention

Many Australians are requiring mental health care, including families, leading to long wait times in order to access support. Walk-in therapy reduces barriers to mental health support services by providing support at the time that families seek help. This paper presents a proof-of-concept study investigating the acceptability and short-term effectiveness of an online walk-in family therapy service, Walk-in Together (WIT). Part 1 of the paper describes the experiences of 44 family members from 22 families who presented to a public family therapy clinic for a virtual walk-in family therapy session. The session was conducted by a team of three experienced family therapists. Family members' experiences were sought pre-session, post-session, and at 6 weeks follow-up via survey and interview. Part 2 of the paper explores therapist perceptions (n = 7) of the WIT approach, through thematic analysis of semi-structured interview data. Post-session feedback showed 85% of family members found WIT to be helpful and 50% were optimistic about their future as a family after their WIT session. Six weeks post-session it was revealed that WIT supported planning for families in equipping them to move forward with 88% of family members reporting that they knew what to do after the session. All therapists uniformly experienced the model as offering a timely and beneficial service, suitable for diverse presentations and constellations of families. These preliminary results suggest the significant utility of this WIT intervention as a well-received and helpful service for families, who valued the easy access and rapid therapeutic response afforded by the online, walk-in delivery model. This proof-of-concept paper suggests the potential for further development and growth of WIT, as well as other mental health support services using a walk-in, telehealth model to meet the rising demand for therapeutic support for families in distress.     

Self-regulation and the etiology of sexual deviance: evaluating causal theory

Recently introduced theories of sex offending, including the self-regulation model and the multimodal self-regulation theory, have implicated self-regulatory deficits as a key variable in the development of sexually inappropriate interests and behaviors. While dysregulation has been considered an important component of a variety of behavioral, emotional, and interpersonal disorders, sexual behaviors have rarely been conceptualized within this context. In this study, we have examined a number of variables linked to self-regulation and dysfunctional outcomes in a sample of 95 sex-offending men. Results of a path analysis demonstrated that self-regulatory deficits were significantly predictive of paraphilic and antisocial behaviors in this group. Implications for our understanding of the etiology of sexual deviance and future research in this area are discussed.     

How Do Social Workers Respond to Potential Child Neglect?

Although neglect is a common form of child maltreatment, it can be difficult to detect within a clinical interview between a social work clinician and client for the purpose of assessment and intervention, leading to a failure to act and secure a child's safety. This Canadian study utilized the objective structured clinical exam (OSCE) to assess social work clinicians' ability to recognize and respond to a case of suspected child neglect. Twenty-three participants (social work students, recent graduates of a Masters in Social Work programme, and experienced social workers) conducted a 15-minute interview with a standardized client followed by a structured reflective dialogue focusing on case conceptualization and emotional awareness. Qualitative analysis of the reflective dialogues revealed participants' difficulty in detecting child neglect as opposed to focusing on a client's negative self-beliefs or mental health issues. Implications for social work education and practice are suggested.     

Are clinician's ever biased in their judgments of the capacity of older adult's to make medical decisions?

Capacity assessment is a growing area of practice in geriatrics. In this pilot study we illustrate the potential relationship between clinician variables and capacity ratings. Twelve older adults with mild dementia or schizophrenia were rated by six clinicians from diverse disciplinary backgrounds. Capacity ratings were associated with clinician values regarding patient involvement in medical decisions, clinician-patient mismatches on such values, and emotional reactions to patients. Expanding our understanding of the impact of clinician variables on capacity ratings may enhance the reliability and validity of capacity assessments and help to promote autonomy when appropriate.     

Barriers and facilitators of the transition to adulthood for foster youth with autism spectrum disorder: Perspectives of service providers in Illinois

The lack of established and well-evaluated models of coordination between child welfare agencies and other public institutions presents lingering challenges to preparing foster youth to make the transition to adulthood. This may be particularly true for foster youth with developmental disabilities who must exit child welfare systems and enter into adult service systems, if eligible. The qualitative study we present explores the barriers and facilitators of the transition to adult service systems from the perspectives of service providers. Due to the rising prevalence of autism spectrum disorder (ASD) in the general population, focus groups were specifically conducted to better understand the transition of foster youth with ASD. Barriers included perceptions of two separate systems and abrupt transitions; a lack of training, identification, and tracking of autism; and confusion about services and funding. Facilitators included persistence and professional relationship building, and consistent communication and information sharing. Implications for improving the transition to adult service systems are discussed.     

Self-reported and case file maltreatment: Relations to psychosocial outcomes for youth in foster care

The aim of the current study was to explore the relation between maltreatment and psychosocial outcomes for youth in foster care, and how this relation differs according to reporter type (self-report or case file). Participants included 285 children and adolescents and their caregivers who completed self-report questionnaires about lifetime maltreatment and psychosocial adjustment. Youths' case files containing lifetime maltreatment reports were obtained from Division of Social Services (DSS), and were coded for physical and sexual abuse, emotional maltreatment, and neglect using the Modified Maltreatment Classification System (MMCS; English & LONGSCAN Investigators, 1997). Crosstabs analysis was used to summarize proportions of youth whose caregivers reported clinically significant internalizing and externalizing and average to high adaptive functioning within groups of youth who had a) neither self-reported nor case file maltreatment, b) only case file maltreatment, c) only self-reported maltreatment, and d) both case file and self-reported maltreatment for each maltreatment type (physical and sexual abuse, emotional maltreatment, and neglect). Results showed that externalizing symptoms differ according to reporter type for physical and sexual abuse, and that internalizing symptoms differ according to reporter type for sexual abuse. Implications for methodology in maltreatment research are discussed.     

Self-Reported Personal Well-Being of Youth Accessing Intensive Mental Health Treatment

Normative samples have been shown to rate their personal wellbeing (PWB) as positively high and high PWB is associated with many enduring benefits. Cummins (J Happiness Stud 10(6):1–17, 2009) has suggested that PWB has an equilibrium that is set at a rather high positive state and maintained through psychological mechanisms he termed homeostatic protected mood (HPM). Investigators who have explored PWB and mental health disorders have often focused on schizophrenia in adult populations, with varied results, and scant attention has been paid to clinical samples of youth with emotional and/or behavioral disorders. The purpose for this report was to explore the level of PWB reported by a subsample of youth who accessed residential treatment (n = 30) and intensive home based treatment (n = 33) at 12–18 months post-discharge, and explore whether clinical variables could predict PWB. Many youth reported high PWB despite experiencing continued challenges in symptoms and psychosocial functioning. Demographic and clinical characteristics did not predict participants’ PWB scores, lending support for the HPM theory with this sample of youth with emotional and behavioral disorder.     

‘It’s like exercise for your soul’: how participation in youth arts activities contributes to young people’s wellbeing

Active participation in organised youth arts activities is generally considered ‘good’ for young peoples’ social and emotional wellbeing. There is, however, less known about how youth arts participation helps to create wellbeing benefits. This paper details a retrospective narrative study that sought to understand not only what wellbeing benefits 17 participants attributed to youth arts activity, but more specifically, how these outcomes occurred. The concept of liminality, within a spaces of wellbeing approach, is used as a framework to explore and understand participant’s stories of their time at Corrugated Iron Youth Arts, in Darwin, Australia. A pattern of transformation involving three phases emerged through an analysis of participant stories. This involved (1) joining in, (2) developing skills and gaining experience, and (3) becoming a ‘real’ performer. These stages have strong resonance with contemporary conceptualisations of liminal experiences, and provide further evidence for the value of youth arts activity as a space for the development of social and emotional wellbeing.