The purpose of this audit was to explore the experiences of 42 professionals trained over a three‐year period as trainers in behavioural family therapy. Trainers completed…
The purpose of this audit was to explore the experiences of 42 professionals trained over a three‐year period as trainers in behavioural family therapy. Trainers completed a questionnaire designed to explore their motivations, frustrations, sources of support and benefits they experienced through involvement with the Meriden Family Programme. Quasi‐qualitative, thematic analyses were performed on the data. The audit found numerous intrinsic motivations for being a trainer, as well as a wide range of benefits, including belief in the approach, wanting to help families, enjoyment of teaching and professional development. Frustrations encountered were disinterest of staff, lack of support and restrictions on the trainers' role. Trainers were resourceful and used various solutions to overcome these. Recommendations are made on how to manage and maintain enthusiasm and support of trainers, or other family work champions.
The aim of this article is to summarise the available evidence from systematic reviews about the effectiveness of interventions to prevent or treat child physical abuse…
The aim of this article is to summarise the available evidence from systematic reviews about the effectiveness of interventions to prevent or treat child physical abuse and neglect. A computerised search was undertaken of major electronic databases up to December 2005 using key search terms. Only systematic reviews were included in which the primary studies evaluated the effectiveness of targeted or indicated interventions for child physical abuse or neglect. A total of 31 systematic reviews were identified and 15 met all the inclusion criteria. They covered a range of interventions/services, including home visiting, parenting programmes, multi‐component interventions, intensive family preservation services, family‐focused casework and multi‐systemic family therapy. There was limited evidence of the effectiveness of services in improving objective measures of abuse and neglect, due in part to methodological issues involved in their measurement, but good evidence of modest benefits in improving a range of outcomes that are associated with physical abuse and neglect, including parental and family functioning and child development. The results also showed some interventions (eg. media‐based and perinatal coaching) to be ineffective with high‐risk families. The evidence provided by these reviews has clear implications for children's services in the UK and other western developed countries.
This chapter explores the impact of delivering culturally community family therapy with strength-based strategies, to transgenerational Black Haitian families living in…
This chapter explores the impact of delivering culturally community family therapy with strength-based strategies, to transgenerational Black Haitian families living in Haiti and the Dominican Republic following the 2010 earthquake. A series of workshop intervention over several years, which were co-facilitated by community pastors and leaders provided a cultural-based intervention drawing on Black British and Caribbean culture, Haitian culture, Christian spiritual belief systems, in conjunction with some bi-cultural attachment and systemic methods and techniques. Community feedback through testimonies contributed to evaluation and outcomes in developing new strategies to manage stress, and family conflict and distress, together with developing new strategies in sharing a vision for the future across the community.
The purpose of this paper is to describe the University of Exeter Family Interventions (FIs) training programme for the South West region which was commissioned as part of…
The purpose of this paper is to describe the University of Exeter Family Interventions (FIs) training programme for the South West region which was commissioned as part of the NHS England Access and Waiting Times standards (A&WTS) initiative for early psychosis. This programme (10 taught days and 6 months of supervised practice) is designed to maximise implementation in practice.
The programme introduces students to a flexible, widely applicable FI approach which integrates cognitive behavioural/psycho-educational and systemic approaches. It refreshes and develops CBT-based psycho-social intervention skills, so that clinicians feel confident to use them in family sessions and integrate these with foundation level family therapy skills. The approach facilitates engagement, and it is designed so that every session is a “mini intervention”. This enables clinicians to offer standard NICE-concordant FI or a briefer intervention if this is sufficient to meet the particular needs of a family.
This paper provides details of the regional training programme and evaluates the first four training courses delivered to nine early intervention in psychosis teams. It considers how a combination of training a critical mass of staff in each service, ongoing supervision, regional events to maintain skills and motivation to deliver FI, and the national and regional auditing of FI as part of the A&WTS all contribute to clinical implementation.
The unique design of this programme maximises implementation in practice by virtue of its widely applicable integrated FI approach, the focus on ongoing skills development and by embedding it within regional and local service support structures.
In recent years, a wide range of psychosocial health interventions have been implemented among military service members and their families. However, there are questions…
In recent years, a wide range of psychosocial health interventions have been implemented among military service members and their families. However, there are questions over the evaluative rigor of these interventions. We conducted a systematic review of this literature, rating each relevant study (k = 111) on five evaluative rigor scales (type of control group, approach to participant assignment, outcome quality, number of measurement time points, and follow-up distality). The most frequently coded values on three of the five scales (control group type, participant assignment, and follow-up distality) were those indicating the lowest level of operationally defined rigor. Logistic regression results indicate that the evaluative rigor of intervention studies has largely remained consistent over time, with exceptions indicating that rigor has decreased. Analyses among seven military sub-populations indicate that interventions conducted among soldiers completing basic training, soldiers returning from combat deployment, and combat veterans have had, on average, the greatest evaluative rigor. However, variability in mean scores across evaluative rigor scales within sub-populations highlights the unique methodological hurdles common to different military settings. Recommendations for better standardizing the intervention evaluation process are discussed.
Effective treatments for juvenile sexual offenders are needed to reduce the societal impact of sexual crimes. The purpose of this paper is to review the empirical…
Effective treatments for juvenile sexual offenders are needed to reduce the societal impact of sexual crimes. The purpose of this paper is to review the empirical literature on treatments for this clinical population.
The authors searched PsycInfo and MEDLINE (via PubMed) for studies that evaluated outcomes of treatments with juvenile sexual offenders.
There are a small but growing number of treatment studies (n=10) with juvenile sexual offenders, and all of these studies evaluated cognitive-behavioral therapy or multisystemic therapy for problem sexual behaviors. The results of these studies are promising, although conclusions about treatment effectiveness have been frequently limited by methodological problems.
The authors provide recommendations for treatment providers and policymakers to consider in their decisions about interventions for juvenile sexual offenders. Furthermore, the authors offer suggestions for researchers who seek to develop effective interventions targeting this clinical population.
Multisystemic therapy (MST) is described and contrasted with practice in traditional services for young people who have committed crime, behaved anti‐socially, abused…
Multisystemic therapy (MST) is described and contrasted with practice in traditional services for young people who have committed crime, behaved anti‐socially, abused substances or suffered family conflict. The challenges to traditional services posed by MST are examined, including consideration of the process of engagement in therapy, the intensive individualised therapy delivered in the young person's own home or local community, and the quality assurance systems.
Behavior problems are common in toddlers and preschoolers. Richman, Stevenson, and Graham (1975) identified difficulties with eating, sleeping, toileting, temper, fears…
Behavior problems are common in toddlers and preschoolers. Richman, Stevenson, and Graham (1975) identified difficulties with eating, sleeping, toileting, temper, fears, peer relations, and activity as typical in this young population. While all young children should be expected to experience behavior problems as part of their normal development, an ongoing challenge in the field has been to determine when these “normal” developmental problems rise to the level of being considered “clinical” behavior problems (Keenan & Wakschlag, 2000). For example, when does a two-year-old child's tantrum behavior, a three-year-old's urinary accidents, and a four-year-old's defiance become clinically significant? To answer these questions, clinicians must examine the frequency, intensity, and durability of these difficulties, their potential to cause injury to the child or others, the extent to which they interfere with the child development, and the degree to which they disrupt the lives of their siblings, caregivers, peers, teachers, and others.
The widespread provision of evidence‐based psychosocial interventions (PSI) for people who experience psychosis and their families requires that the mental health…
The widespread provision of evidence‐based psychosocial interventions (PSI) for people who experience psychosis and their families requires that the mental health workforce has access to educational and training programmes in these treatment approaches. Such training has been available in England since 1992 when the first PSI programmes were established at The Institute of Psychiatry, London and The University of Manchester. While training is now more widely available (Brooker, 2002), little is known about the extent and distribution of training across England, or of the detail of individual programmes. To remedy this, the NIMHE National PSI Implementation Workgroup conducted a survey of university accredited PSI education/training in January 2006.Twenty‐six courses were represented in the returns from the eight regions served by CSIP regional development centres. This paper presents the findings of this survey and discusses the current provision of PSI training in England in 2006.
Several decades of mental health research in the UK repeatedly report that people of African-Caribbean origin are more likely than other ethnic minorities, including the…
Several decades of mental health research in the UK repeatedly report that people of African-Caribbean origin are more likely than other ethnic minorities, including the White majority, to be diagnosed with schizophrenia and related psychoses. Race-based inequalities in mental healthcare persist despite numerous initiatives such as the UK’s ‘Delivering Race Equality’ policy, which sought to reduce the fear of mainstream services and promote more timely access to care. Community-level engagement with members of African-Caribbean communities highlighted the need to develop culturally relevant psychosocial treatments. Family Intervention (FI) is a ‘talking treatment’ with a strong evidence-base for clinical-effectiveness in the management of psychoses. Benefits of FI include improved self-care, problem-solving and coping for both service users and carers, reducing the risk of relapse and re-hospitalisation. Working collaboratively with African-Caribbeans as ‘experts-by-experience’ enabled co-production, implementation and evaluation of Culturally adapted Family Intervention (CaFI). Our findings suggests that a community frequently labelled ‘hard-to-reach’ can be highly motivated to engage in solutions-focussed research to improve engagement, experiences and outcomes in mental health. This underscores the UK’s Mental Health Task Force’s message that ‘new ways of working’ are required to reduce the inequalities faced by African-Caribbeans and other marginalised groups in accessing mental healthcare. Although conducted in the UK (a high-income multi-cultural country), co-production of more culturally appropriate psychosocial interventions may have wider implications in the global health context. Interventions like CaFI could, for example, contribute to reducing the 75% ‘mental health gap’ between High and Low-and-Middle-Income counties reported by the World Health Organization.