Raising the Stakes in Child-at-Risk Cases Eliciting and Maintaining Parents' Motivation

This paper, the third in a series concerned with family therapy in cases involving children at risk of abuse, describes an approach to maximising parents' interest and commitment to therapy. After overviewing the difficulties faced by therapists in working with parents who are notorious for their ‘resistance’, we provide guidelines for minimising the negative consequences of notification and for constructing therapeutic leverage in order to elicit and maintain parents' motivation throughout the course of therapy.     

The Sandwich Generation: Dependency, Proximity, and Task Assistance Needs of Parents

This study was designed to determine the extent of sandwiched families and the impact of dependency and proximity to task assistance provided to parent(s). Data were collected in Idaho, Oregon, Utah, and Michigan from a random sample of 40–65-year-old respondents. Fifteen percent are sandwiched between needs of aging parents and financially dependent children. Respondents are much more likely to be providing assistance to mothers than fathers. Parents are most likely to live near, but not necessarily with, the respondent. Spouses and partners' parents, however, are likely to live farther away. Task assistance provided most often to aging parent(s) includes help with transportation and shopping; financial assistance was reported least often. Income of respondent and dependency and proximity of parents are significantly related to providing assistance to parents. This study offers a unique glimpse at the relationships between personal characteristics, dependency, proximity, and task assistance issues as they pertain to the sandwich generation.     

A model for short-term group therapy on a children's inpatient unit

The paper describes the group therapy model which has evolved over the past two years on the Child Psychiatry Inpatient Unit of North Carolina Memorial Hospital. It begins with a brief review of the literature concerning group therapy with latency-aged children. The setting and patient population are described. Vignettes from group sessions are used to illustrate techniques which have evolved to deal with this particular setting and population. These include a leadership style characterized by much clarification, modeling, and limit setting; extensive focus on beginning and terminating; clearly defined behavioral limits; the use of time out; and use of play materials requiring little skill or attention as anxiety binders as well as projective media; and observation and supervisory discussions open to all members of the treatment team. The paper concludes with a discussion of the potentials and limitations of group therapy in such a setting. The thesis is that this model is effective in diagnosing developmental levels, in developing interpersonal skills, in substituting verbalization for action, and in mastering separation anxieties, though the setting limits the extent to which controlled regression, transference, and group pressures can develop and be used to produce change.     

Maternal union instability and childhood mortality risk in the Global South, 2010–14

Efforts to improve child survival in lower-income countries typically focus on fundamental factors such as economic resources and infrastructure provision, even though research from post-industrial countries confirms that family instability has important health consequences. We tested the association between maternal union instability and children’s mortality risk in Africa, Latin America and the Caribbean, and Asia using children’s actual experience of mortality (discrete-time probit hazard models) as well as their experience of untreated morbidity (probit regression). Children of divorced/separated mothers experience compromised survival chances, but children of mothers who have never been in a union generally do not. Among children of partnered women, those whose mothers have experienced prior union transitions have a higher mortality risk. Targeting children of mothers who have experienced union instability—regardless of current union status—may augment ongoing efforts to reduce childhood mortality, especially in Africa and Latin America where union transitions are common.     

Deactivating the Buttons: Integrating Radical Exposure Tapping with a Family Therapy Framework

The purpose of this paper is to describe and illustrate with case examples a brief intervention termed Radical Exposure Tapping (RET). RET can be integrated with family therapy to address stuck points where the therapy is hindered by a family member's affective block, an intense and unchangeable emotional reactivity to a specific trigger. RET draws from the methodology of Eye Movement Desensitization and Reprocessing (EMDR) and combines it with the tapping sequence of the Emotional Freedom Technique (EFT) to produce an intervention that is more flexible than EMDR, provides greater rigor than using the EFT technique alone and can be effective in a single session within the context of family therapy. The paper puts this work into context by first over viewing definitions of trauma and Post‐Traumatic Stress Disorder, arguing that family members' emotional reactivity may be a symptom of PTSD even when they would not qualify for the diagnosis because they had not experienced a life threatening event.     

Caught in the Cross Fire: Children’s Right to Education During Conflict — The Case of Nepal 1996–2006

The article focuses on the impact on children, schools and education during the 10 year conflict in Nepal and raises questions for further research on schooling in the post‐conflict era. The article is based on research undertaken as part of a British Council funded Higher Education Link. Focus group discussions and interviews were conducted with school children, parents, teachers and community leaders between 2004 and 2006 and draws on informal discussions and observations with NGOs and teachers in the post‐conflict period, including NGOs visual methods to enable children’s voices to be heard in the peace process.