The Conversational Model and Child and Family Counselling: Treating Chronic Complex Trauma in a Systemic Framework

Child and Family Counselling Teams in NSW Community Health Services are expected to provide therapeutic services to children who have experienced complex trauma. However, parental trauma is often overlooked or referred elsewhere. A systemic perspective informed by attachment theory and trauma theory provides the basis for addressing parental trauma in Child and Family Counselling Teams, thereby improving parenting. The Conversational Model is an evidence‐based intervention for chronic complex trauma. The foundations of the Conversational Model and its brief component, Short Term Intensive Psychodynamic Psychotherapy, are outlined and a case study is given to illustrate the usefulness of the intervention in Child and Family Counselling. Highlighted is the importance of addressing systemic trauma through parenting to improve attachment quality, family relationships, and children's function.     

Experiences of adolescent mothers in Costa Rica and the role of parental support

ABSTRACT

Adolescent pregnancy is often thought of as a social problem, one that can cause the adolescent mother hardship, including poverty, low-educational attainment, and housing instability. Although much research has been conducted about adolescent pregnancy in the developed world, less has considered adolescent pregnancy in the developing world. This qualitative study focuses on women who were impoverished in Costa Rica who had been pregnant in adolescence. The goal of the study was to gain a better understanding of the lived experiences of the mothers, as well as the kinds of support they received during and after the pregnancy. The research sample consisted of 22 female participants who were impoverished and had experienced an unintended pregnancy in adolescence. The key finding from this study was that parental support was the most important factor in mitigating adolescent experiences of stress and negative feelings about their choices related to the pregnancy. The study has implications for the understanding of the experiences of women who are vulnerable with respect to adolescent pregnancies in Latin America and for Latina migrants to the United States.     

Place attachment among children in a street situation in Pelotas,Brazil

This article explores the processes which affect street children and youths’ relationships with the place called the ‘streets’. The street as a place to live is violent and hostile. However, street dwellers aspire to see the street environment positively. In fact, being able to establish a positive relationship with the street, to become attached to it, is crucial for coping within it. In this research, longitudinal qualitative data concentrating on processes were produced time-geographically with 19 street children and youths in the Brazilian town of Pelotas. The analyses of this research reveal that attachment changes over time instead of remaining static. Examples from the streets demonstrate how the human–environment relationship is shaped by constantly changing encounters of physical, social and mental (f)actors. This article stresses the importance of individual life experiences and goals for the attachment processes and for what positively affects the attachment.     

High Educational Aspirations Among Pregnant Adolescents Are Related to Pregnancy Unwantedness and Subsequent Parenting Stress and Inadequacy

On the basis of theories of maternal identity development, role conflict, and childbearing motivation, the authors tested whether high educational aspirations among pregnant adolescents are related to the unwantedness of the pregnancy and whether pregnancy unwantedness leads to subsequent parenting stress and inadequacy. Longitudinal data from 100 first‐time‐pregnant, unmarried Latina adolescents (M age = 17.3 years) were analyzed. Results from structural equation path modeling confirmed these associations, with strong educational ambitions related to greater unwantedness of the pregnancy, which led to feeling trapped by parenting at 6 months postpartum, which in turn was related to unaffectionate parenting and feeling inadequate in mothering at 1 year postpartum. The potential long‐term negative consequences of high educational aspirations for pregnant adolescents' adjustment to parenting are discussed.     

Traditional versus Western perceptions of mental illness: women of Moroccan origin treated in an Israeli mental health center

This paper focuses on the problems encountered in providing Westernized psychiatric treatment to a population with traditional healing beliefs. The sample comprised women of Moroccan origin living in Israel undergoing treatment for psychiatric disorders (N=38), and their treating psychiatrists (N=9). Ethnographic interviews were conducted among both groups. The results revealed that the symptoms, perceptions of the illness, and problems encountered in the therapeutic relationship differed across three age groups, young women (20–30 years), more mature women (31–42 years), and older women (43–60 years). While cultural conflict appeared to affect the development of mental illness in each group, this was most pronounced among women in the middle age range. Moreover, problems in the therapeutic alliance were greatest in this age group. The data from the therapists indicated that they maintained a Western perspective in both their understanding and diagnoses of these patients' illnesses. The different perspectives of the therapists and each of the three groups of women are discussed. It is concluded that professionals treating traditional populations must avoid imposing Western standards, and consider the treatment in the context of cultural beliefs. The developmental stages of the individual, and the stage of acculturation must also be taken into account if treatment is to be effective.     

Nurture,bureaucracy and re-balancing the mind and heart

With increasing managerialism and bureaucratisation in the caring professions, where the focus of attention is directed primarily to the techno-rational, the instrumental and the impersonal, care becomes labour in the service of economy, efficiency and effectiveness. Relying on the work of psychodynamic theorists, the first part of this paper offers a critical analysis of selected 'snapshots of practice' demonstrating the costs of abdicating emotion and nurture in the care process. The second part of the paper describes an 18-month co-operative inquiry involving women practitioner/students in health, social care and education. The study highlights the quest for meaning and significance in learning and work and the process of re-balancing the mind and heart in the context of the bureaucratic organisation as one of heroic dimensions. Establishing a sustained community of care yielded a renewed sense of direction and creative action among participants.     

Evaluation of a Training to Reduce Provider Bias Toward Pregnant Patients With Substance Abuse

The objective of this article is not to present a scientific or systematic study, but to provide an initial framework for designing a training workshop to enhance health practitioners’ (nurses, social workers, physicians, etc.) knowledge regarding substance abuse treatment and to decrease their bias toward substance-abusing women, particularly pregnant women in rural communities. We incorporated the 4 Transdisciplinary Foundations from the Substance Abuse and Mental Health Services Administration Competencies Model, with specific competencies targeted that related to provider bias. After the conference, 52 of the 70 participants completed a questionnaire to self-assess knowledge level and confidence in skill related to substance abuse management. Participant mean scores were statistically significantly higher following the conference than 1 week prior (p < .001) in the area of “gender difference with substance abuse,” moving from an average of 2.6 to 4.5 on a 5-point Likert scale. Our conference was successful in increasing attendees’ knowledge about gender difference and substance abuse among pregnant patients.     

Workplace racial composition, perceived discrimination, and organizational attachment

Prior research has devoted considerable attention to the relationship between the racial and ethnic composition of jobs and various indicators of organizational attachment. Fewer studies, however, examine how workplace racial composition affects individuals’ experiences of racial discrimination or how these experiences impact workers’ organizational attachment. To address this lacuna, we first examine the effects of workplace racial composition on perceived racial and ethnic discrimination. Next, we examine whether perceived racial discrimination mediates the association between racial composition and organizational attachment observed in prior studies. Finally, we explore whether these relationships are similar (symmetric) or different (non-symmetric) for non-Whites and Whites. The analyses indicate: (1) working with predominately same-race coworkers tends to diminish perceptions of racial discrimination, (2) perceived racial discrimination mediates some of the effects of racial/ethnic composition on organizational attachment, and (3) some non-symmetric effects between non-Whites and Whites are found. We conclude with implications for future research.