Family Counseling Research Articles

Lesson Fragments Modelling in the System of Practical Training of Speech Therapy Students

The study investigates the effective techniques to train primary skills of organizing and conducting speech therapy classes with speech therapy students. The article demonstrates that lesson modelling is a necessary and important technique that functions as an intermediate link between lesson plan preparation and its implementation. The purpose of the study is to determine the tasks and the most effective ways to use lesson modelling in the system of practical training of speech therapy students. Methodology and research methods: experimental analysis of typical mistakes made at the primary stage of lesson plan implementation by speech therapy students; comparative analysis of the tasks set before speech therapy students in the course of their professional training at the stages of note taking, modelling and implementation of lesson fragments; systematization of the main aspects of lesson modelling taught in various modules of specialized speech therapy disciplines. Research results. The research has revealed that lesson modelling of speech therapy classes increases the effectiveness of students’ training in their work with children and adults with speech disorders, as well as in family counseling and other areas of their professional activity. It is shown that there are certain skills that are best practiced at the first stages of lesson modelling; they include the skills of competent selection of speech material, tasks distribution in the overall structure of a lesson and the development of various models of a speech therapist’ speech behavior when working with different categories of persons with speech disorders. The article concludes by summarizing the data on the role, tasks, content and characteristic features of lesson modelling in the system of practical training of speech therapy students, and the prospects for the development of this method.

Hereditary conditions associated with elevated cancer risk in childhood

The widespread use of next-generation sequencing (NGS) technologies revealed that a significant percentage of tumors in children develop as a part of monogenic hereditary diseases. Predisposition to the development of pediatric neoplasms is characteristic of a wide range of conditions including hereditary tumor syndromes, primary immunodeficiencies, rasopathies, and phakomatosis. The mechanisms of tumor molecular pathogenesis are diverse and include disturbances in signaling cascades, defects in DNA repair, chromatin remodeling, and microRNA processing. Timely diagnosis of tumor-associated syndromes is important for the proper choice of cancer treatment, genetic counseling of families, and the development of surveillance programs. The review describes the spectrum of neoplasms characteristic of the most common syndromes and the molecular pathogenesis of these diseases.

Fetal and Neonatal Autopsy in the Molecular Age: Exploring Tissue Selection for Testing Success.

While conventional autopsy is the gold-standard for determining cause of demise in the fetal and neonatal population, molecular analysis is increasingly used as an ancillary tool. Testing methods and tissue selection should be optimized to provide informative genetic results. This institutional review compares testing modalities and postmortem tissue type in 53 demises occurring between 20 weeks of gestation and 28 days of life. Testing success, defined as completion of analysis, varies by technique and may require viable cells for culture or extractable nucleic acid. Success was achieved by microarray in 29/30 tests (96.7%), karyotype in 40/54 tests (74.1%), fluorescent in situ hybridization in 5/9 tests (55.6%), and focused gene panels in 2/2 tests (100%). With respect to tissue type, postmortem prepartum amniotic fluid was analyzed to completion in 100% of tests performed; compared to 84.0%, 54.5%, and 80.8% of tests using placenta, fetal only, and mixed fetal-placental tissue collection, respectively. Sampling skin (83.3%, in cases with minimal maceration) and kidney (75.0%) were often successful, compared to lower efficacy of umbilical cord (57.1%) and liver (25.0%). Addition of genetic testing into cases with anomalous clinical and gross findings can increase the utility of the final report for family counseling and future pregnancy planning.

Prognosis of Patients Having Post Traumatic Extra Dural Hematoma with and without Lucid Interval

Background: There is limited research in our country on the prognosis of patients with post-traumatic extradural hematoma, particularly in relation to the presence or absence of a lucid interval. Understanding this relationship is vital for effective surgical planning and family counselling. Objective: The study aimed to assess the prognosis of patients with post-traumatic extradural hematoma, focusing on the impact of a lucid interval on patient outcomes. Methods: This retrospective study, approved by the hospital's ethical committee, included 46 patients with post-traumatic extradural hematoma, both with and without a lucid interval. The study variables were age, gender, mechanism of injury, pupillary abnormalities, Glasgow Coma Scale (GCS) score upon admission, and presence of a lucid interval. Patient outcomes at discharge, including mortality, residual disabilities, and functional recovery, were documented. Data analysis was performed using SPSS 23, employing descriptive statistical methods. Results: The average age of patients was 27.04±7.74 years, with the majority (52.2%) aged between 21 and 30 years. Males constituted 84.8% of the study group. Regarding the GCS score, 23.9% of patients scored below 8. The study found that 37.0% of the patients experienced mortality, 23.9% had residual disabilities, and 58.7% achieved functional recovery. Notably, functional recovery was 50.0% in patients who experienced a lucid interval, compared to 90.0% in those who did not. Conclusion: The study concluded that patients with post-traumatic extradural hematoma who present without a lucid interval have a better prognosis than those with a lucid interval. The delay in timely management associated with a lucid interval leads to increased morbidity and mortality.

Evolution of family relationship in Kyrgyzstan

The relevance of the study is determined by the observed changes in the structure, role models, and functions of the family in Kyrgyzstan over the last decade. Consequently, there is a need to form beliefs and values that may qualitatively differ from previous ones and influence the socialisation of the younger generation in the process of creating new family institutions. The purpose of the study is to clarify the role and conduct a deep analysis of various aspects, such as psychological, biological, religious studies, and others, to identify patterns and problems that people face in marriage, and to provide recommendations for improving individual well-being. Among the methods used, statistical, analytical, comparative, and others are noteworthy. The study on the evolution of family relations, covering various aspects, provides important conclusions about changes in this context. It presents an increase in the diversity of family structures, with some remaining more traditional and others being more adaptive to modern changes. It was found that education and migration play a key role in shaping family relations, influencing partner choices and family decisions. Religious and philosophical beliefs remain important factors shaping family values. The study highlights the impact of biological factors, such as health and genetics, on family decisions, especially in the context of childbirth and child-rearing. All aspects collectively provide a deep understanding of how family relationships evolve in contemporary Kyrgyzstan. The practical value of the study lies in the development of adaptive family policies, educational programs, support for family counselling, and psychological assistance to strengthen families

Changes in dietary habits and BMI z-score after a 6-month non-randomized cluster-controlled trial among 6-12 years old overweight and obese Norwegian children.

Effective prevention programs to address the high prevalence of childhood overweight and obesity and the concomitant health consequences have been warranted. To improve dietary habits and weight status among Norwegian children with overweight/obesity in the primary care setting. A 6-month non-randomized cluster-controlled intervention among 137 children, aged 6-12 years, with overweight/obesity and their parents. Intervention and control groups were recruited by public health nurses and followed-up by 12 Healthy Life Centers across Norway. The intervention group received individual family counseling and participated in nutrition courses and physical activity groups. A frequency questionnaire assessing sociodemographic characteristics and dietary habits was completed by the parents. Trained public health nurses measured height and weight using standardized methods to calculate body mass index (BMI) and BMI z-scores. The intervention resulted in an increased odds of consuming evening meals (OR: 3.42), a decreased availability of salty snacks (β = -0.17), a decreased intake of salty snacks (-0.18), an increased consumption of water (β = 0.20), and a decreased estimated total intake of energy (β = -0.17), carbohydrates (β = -0.17), mono- and disaccharides (β = -0.21), sucrose (β = -0.24), and saturated fatty acids (β = -0.17). The intervention directly predicted lower BMI z-score (β = -0.17), and post-treatment levels of energy (β = -0.65), saturated fat (β = 0.43), and total carbohydrates (β = 0.41) were directly linked to BMI z-score after intervention. Age and sex were indirectly associated with BMI after intervention through energy and saturated fat intake. The intervention had a beneficial impact on nutrient intake and weight status among children with overweight/obesity. These findings provide support for implementing complex intervention programs tailored to local primary care settings. Clinicaltrials.gov, NCT02290171. Registered 13. November 2014, https://clinicaltrials.gov/ct2/show/NCT02290171.

Complications After Open Skull Base Surgery for Brain Tumors: A 26-Year Experience.

Open skull base surgery carries the risk of significant complications. It is important to inform patients and family members clearly of the details of these complications. This study aimed to present the numerous complications encountered with open skull base surgery for brain tumors. This report analyzed the complications experienced by patients treated with open skull base surgery by a single skull base surgeon at a single tertiary center over 26 years. A retrospective study was performed using the University of Puerto Rico Neurosurgery database to identify patients who were managed using open skull base procedures from 1995 to 2020. The neurosurgical database for each patient had been prospectively recorded. Patients with skull basetumors under the author's care during the study period were includedin the investigation. Exclusions include patients with non-tumoral conditions and non-skull base tumors and those operated using a microscopic transsphenoidal route. Patients who experienced an intraoperative or postoperative complication within 30 days of the surgery were further analyzed. In the cohort, 141 patients with brain tumors underwent open skull base surgery. The cohort had a median age of 48 (range 3-79). It consisted of 101 (71.6%) females and 40 (28.4%) males, with a female-to-male ratio of 2.5:1. The approach most frequently used was an orbitofrontal craniotomy (with or without zygomatic osteotomy) in 79 patients (56%). A petrosal approach was utilized in 26 patients (18%). Forty-six patients (33%) developed an intraoperative or postoperative complication. Twenty-four percent of the complications occurred in the 30-day postoperative period. Five patients had more than one complication. The median age of the patients who experienced a complication was 44.5 (range 22-79), with a female-to-male ratio similar to the entire cohort. Cranial nerve injury was the most frequent complication. Worsening or loss of vision in the affected eye occurred in 5.7% of the patients. A cerebrospinal fluid leak occurred in 2% of the patients. Six patients died, two of them after a massive myocardial infarction. The results of this study showed that approximately one-third of the patients undergoing open skull base surgery can develop a complication. The most frequent complication was injury to a cranial nerve. A large number of complications occurred intraoperatively. The majority of the complications in patients with tumors in the posterior fossa were associated with injury to a cranial nerve. At the middle fossa, damage to the optic nerves is a noteworthy complication. Complications at the anterior fossainvolved worsening of vision ormyocardial infarction. Less aggressive surgery near the cavernous sinus and the petroclival region may reduce complications. Understanding the complications can help counsel patients and family members.

Genotype–phenotype correlations in paediatric and adolescent phaeochromocytoma and paraganglioma: a cross-sectional study

Phaeochromocytoma (PC) and paraganglioma (PGL) syndromes associated with germline pathogenic variants are associated with high morbidity and mortality. Establishing genotype–phenotype correlations within a young population is challenging due to their...

Prospective evaluation of NGS-based sequencing in epilepsy patients: results of seven NASGE-associated diagnostic laboratories.

Epilepsy is one of the most common and disabling neurological disorders. It is highly prevalent in children with neurodevelopmental delay and syndromic diseases. However, epilepsy can also be the only disease-determining symptom. The exact molecular diagnosis is essential to determine prognosis, comorbidity, and probability of recurrence, and to inform therapeutic decisions. Here, we describe a prospective cohort study of patients with epilepsy evaluated in seven diagnostic outpatient centers in Germany. Over a period of 2 months, 07/2022 through 08/2022, 304 patients (317 returned result) with seizure-related human phenotype ontology (HPO) were analyzed. Evaluated data included molecular results, phenotype (syndromic and non-syndromic), and sequencing methods. Single exome sequencing (SE) was applied in half of all patients, followed by panel (P) testing (36%) and trio exome sequencing (TE) (14%). Overall, a pathogenic variant (PV) (ACMG cl. 4/5) was identified in 22%; furthermore, a significant number of patients (12%) carried a reported clinically meaningful variant of unknown significance (VUS). The average diagnostic yield in patients ≤ 12 y was higher compared to patients >12 y cf. Figure 2B vs. Figure 3B. This effect was more pronounced in cases, where TE was applied in patients ≤ 12 vs. >12 y [PV (PV + VUS): patients ≤ 12 y: 35% (47%), patients > 12 y: 20% (40%)]. The highest diagnostic yield was achieved by TE in syndromic patients within the age group ≤ 12 y (ACMG classes 4/5 40%). In addition, TE vs. SE had a tendency to result in less VUS in patients ≤ 12 y [SE: 19% (22/117) VUS; TE: 17% (6/36) VUS] but not in patients >12 y [SE: 19% (8/42) VUS; TE: 20% (2/10) VUS]. Finally, diagnostic findings in patients with syndromic vs. non-syndromic symptoms revealed a significant overlap of frequent causes of monogenic epilepsies, including SCN1A, CACNA1A, and SETD1B, confirming the heterogeneity of the associated conditions. In patients with seizures-regardless of the detailed phenotype-a monogenic cause can be frequently identified, often implying a possible change in therapeutic action (36.7% (37/109) of PV/VUS variants); this justifies early and broad application of genetic testing. Our data suggest that the diagnostic yield is highest in exome or trio-exome-based testing, resulting in a molecular diagnosis within 3 weeks, with profound implications for therapeutic strategies and for counseling families and patients regarding prognosis and recurrence risk.

Characterization of D4Z4 alleles and assessment of de novo cases in Facioscapulohumeral dystrophy (FSHD) in a cohort of Italian families.

Facioscapulohumeral dystrophy (FSHD) is an autosomal dominant disease, although 10%-30% of cases are sporadic. However, this percentage may include truly de novo patients (carrying a reduced D4Z4 allele that is not present in either of the parents) and patients with apparently sporadic disease resulting from mosaicism, non-penetrance, or complex genetic situations in either patients or parents. In this study, we characterized the D4Z4 Reduced Alleles (DRA) and evaluated the frequency of truly de novo cases in FSHD1 in a cohort of DNA samples received consecutively for FSHD-diagnostic from 100 Italian families. The D4Z4 testing revealed that 60 families reported a DRA compatible with FSHD1 (1-10 RU). The DRA co-segregated with the disease in most cases. Five families with truly de novo cases were identified, suggesting that this condition may be slightly lower (8%) than previously reported. In addition, D4Z4 characterization in the investigated families showed 4% of mosaic cases and 2% with translocations. This study further highlighted the importance of performing family studies for clarifying apparently sporadic FSHD cases, with significant implications for genetic counseling, diagnosis, clinical management, and procreative choices for patients and families.

Predicting traumatic brain injury outcomes using a posterior dominant rhythm.

Predicting severe traumatic brain injury (sTBI) outcomes is challenging, and existing models have limited applicability to individual patients. This study aimed to identify metrics that could predict recovery following sTBI. The researchers strived to demonstrate that a posterior dominant rhythm on electroencephalography is strongly associated with positive outcomes and to develop a novel machine learning-based model that accurately forecasts the return of consciousness. In this retrospective study, the authors assessed all intubated adults admitted with sTBI (Glasgow Coma Scale [GCS] score ≤ 8) from 2010 to 2021, who underwent EEG recording < 30 days from sTBI (n = 195). Seventy-three clinical, radiographic, and EEG variables were collected. Based on the presence of a PDR within 30 days of injury, two cohorts were created-those with a PDR (PDR[+] cohort, n = 51) and those without (PDR[-] cohort, n = 144)-to assess differences in presentation and four outcomes: in-hospital survival, recovery of command following, Glasgow Outcome Scale-Extended (GOS-E) score at discharge, and GOS-E score at 6 months post discharge. AutoScore, a machine learning-based clinical score generator that selects and assigns weights to important predictive variables, was used to create a prognostic model that predicts in-hospital survival and recovery of command following. Lastly, the MRC-CRASH and IMPACT traumatic brain injury predictive models were used to compare expected patient outcomes with true outcomes. At presentation, the PDR(-) cohort had a lower mean GCS motor subscore (1.97 vs 2.45, p = 0.048). Despite no difference in predicted outcomes (via MRC-CRASH and IMPACT), the PDR(+) cohort had superior rates of in-hospital survival (84.3% vs 63.9%, p = 0.007), recovery of command following (76.5% vs 53.5%, p = 0.004), and mean discharge GOS-E score (3.00 vs 2.39, p = 0.006). There was no difference in the 6-month GOS-E score. AutoScore was then used to identify the 7 following variables that were highly predictive of in-hospital survival and recovery of command: age, body mass index, systolic blood pressure, pupil reactivity, blood glucose, and hemoglobin (all at presentation), and a PDR on EEG. This model had excellent discrimination for predicting in-hospital survival (area under the curve [AUC] 0.815) and recovery of command following (AUC 0.700). A PDR on EEG in sTBI patients predicts favorable outcomes. The authors' prognostic model has strong accuracy in predicting these outcomes, and performed better than previously reported models. The authors' model can be valuable in clinical decision-making as well as counseling families following these types of injuries.

Supplementary Motor Area Syndrome After Resection of a Dominant Hemisphere Parasagittal Meningioma: A Case Report

BACKGROUND AND IMPORTANCE: Supplementary motor area (SMA) syndrome is a common, transient postoperative complication of intra-axial tumor resections involving the SMA and posterior cingulate gyrus. It is also reported as a rare complication of resecting extra-axial lesions. Meningiomas represent the most common, nonmalignant primary central nervous system tumor in adults, which present most commonly in parasagittal locations. Resection of dominant hemisphere parasagittal meningiomas overlying or infiltrating into the SMA region carry a recognizable risk for developing SMA syndrome postoperatively. CLINICAL PRESENTATION: We present a 58-year-old woman with intermittent headaches and concern for new-onset seizures. MRI demonstrated an extra-axial mass involving the left frontal convexity and SMA region with homogenous postcontrast enhancement. There was radiographic involvement of the superior sagittal sinus and inner table of the skull. Fluid-attenuated recovery signal and perilesional vasogenic edema were also noted. The imaging findings favored a parasagittal meningioma, and surgical resection was performed. Arachnoid invasion and pial infiltration of the tumor over the SMA were evident during the operation. CONCLUSION: A detailed understanding of the functional neuroanatomy and clinical pathophysiology of eloquent cortical regions is important for preoperative planning and patient counseling. Surgical resection of lesions in such areas can result in rare complications uniquely implicated in specific patient subsets. Recognizing these patients in the preoperative setting is imperative for proper counseling of patients and families.

Contemporary Adlerian Family Counseling

The following theoretical article presents a contemporary Adlerian Family Counseling model, which describes the salient elements of Adlerian Family Counseling as well as its implications for marriage, family, and couple counselors. The authors of the article cover areas of Adlerian Family Counseling and its integration into family systems. Specifically, the article represents contemporary Adlerian Counseling and its application to family systems as well as working with diverse family and couples’ contemporary issues. Lastly, the article pays special attention to working with cultural and LGBTQIA + areas of marriage, family, and relational counseling.

1140. Impact of an Implementation Science Initiative to Improve Vaccine Confidence for Invasive Meningococcal Disease (IMD) Prevention within American Indian (AI) Communities

Abstract Background Meningococcal vaccine uptake among adolescents remains suboptimal. This project aimed to identify barriers and motivators for vaccination in AI communities. Methods Between 12/2022 and 2/2023, 3 live family education sessions were held within AI communities in WI and ND. Healthcare provider (HCP) participants also attended a workshop to review current vaccine recommendations. Surveys were administered before/after the workshop and family education sessions. Results Surveys were completed by 56 family members. Baseline confidence in vaccine safety, efficacy and benefit was low, which increased after the sessions (Fig. 1). Parent understanding that the vaccine cannot cause disease improved from 51% to 82% (p =.001). Top reported barriers to vaccination were concern for immediate side effects and long-term side effects, and low perceived risk for IMD (34%, 26%, 25%, respectively). Parents identified learning more about IMD (40%), friends/family getting vaccinated (19%), and a local outbreak (12%) as top motivators to seek vaccination. When asked what they thought would motivate families to seek vaccination, HCPs leading the sessions (n=11) identified learning more about IMD (82%) and friends/family getting vaccinated (27%) only. HCP confidence in counseling families was low and improved after the sessions (Fig. 2). HCPs attending the workshop (n=28) reported discomfort contradicting patients/families as the top challenge in addressing vaccine hesitancy, and more HCPs felt confident having conversations to reduce vaccine hesitancy after the workshop (80%) than before (28%). HCP knowledge improved after the workshop, and more HCPs understood that MenACWY booster doses are not needed when initial vaccination occurs at age ≥16 (50%), and correctly identified “provider recommendation” as the top literature-reported factor influencing parental vaccine decisions (50%) compared to baseline (32% and 14%, respectively). HCP action plans for after the sessions prioritized routinely discussing vaccines at well visits (80%), providing written materials (50%) and staying current on new vaccines (50%). Conclusion Parent and provider knowledge and confidence improved after the program and offered insights into community-level motivators and barriers to vaccination. Disclosures All Authors: No reported disclosures

Construction and Psychometric Properties of Family-Oriented &amp; Developmental-Based Sexuality Education Questionnaire for Iranian Families: Online National Research

Background: Sexual education is one of the required and challenging areas for empowering families. It seems necessary to use appropriate tools in identifying and promoting the sexual education of parents. Objectives: This study aimed to investigate the construction and psychometric characterization of the Family-oriented and Developmental-based Sexuality Education Questionnaire for Iranian families. Methods: In this descriptive and survey research, the statistical population included all Iranian families in 2021. A number of 1,024 people throughout Iran were selected as the research sample using online sampling. The data were gathered through the Parental Sexual Education Style Questionnaire (PSESQ), Parental Self-efficacy Scale (PSES), and Family-oriented and Developmental-based Sexuality Education Questionnaire (F&amp;DSEQ). The data were analyzed using Cronbach's alpha coefficient, correlation coefficient, and exploratory factor analysis in SPSS 26 and AMOS 24 software. Results: Three factors were extracted from the exploratory and factor analysis, including eleven factors in three general factors (sexuality education knowledge, attitude, and skills). These eleven factors could explain 58.319% of the variance in 58 items of the questionnaire. Cronbach's alpha coefficient was 0.92 for the whole questionnaire. Also, Cronbach's alpha of the components was in the range of 0.65 to 0.92. Conclusions: The Family-oriented and Developmental-based Sexuality Education Questionnaire has good reliability and validity and can be used to measure sexuality education knowledge, attitude, and skills. Therefore, F&amp;DSEQ can be used in research, care, and educational interventions by specialists in the fields of nursing, midwifery, psychology, and family counseling.

Development and Validation of the EFFAM Scale (Family Functioning Scale-Madrid)

Most models that analyse risk and protective factors during adolescence include the family system and family functionality as key elements. For this reason, Family Counselling Services play an important role in addressing adolescent problems. These services require quick and easy-to-apply assessment tools that integrate different dimensions of family functioning. To develop and validate a brief scale for use in Family Counselling Services, exploring and confirming its factorial structure and testing its psychometric properties. Confirmatory Factor Analysis using structural equation modeling. 441 family members in seven units. Results: A 5-factor structure was confirmed, with a good fit. All the Average Variance Extracted values were higher than the Maximum Shared Squared Variance values. The results confirm the structure of the Family Functioning Scale-Madrid. In addition, the scale demonstrates adequate psychometric properties and stable structure during two evaluation periods with different samples. The instrument is considered reliable and consistent for of assessing family intervention carried out in Family Counselling Services.

Korelasi Pendidikan dan Konseling KB Saat Hamil dengan Penggunaan KB Pasca Salin Pada Ibu Nifas di Puskesmas Paringin Selatan

The return of fertility in the mother after delivery is unpredictable. Therefore a woman should start contraception as early as possible after delivery. The low coverage of postpartum family planning at the South Paringin Health Center in 2021 (57.91%) may be due to the low education and not optimal quality of counselling. This study aims to examine the correlation between family planning education and counselling with the use of postpartum family planning. This study used a quantitative method with a cross-sectional approach. With the population of all postpartum mothers in a working area of South Paringin Health Center, from January to October 2022 using a simple random sampling technique of 136 people using the Chi-Square statistical test. The result of this study found that out of 136 people, 87 respondents (63%) used postnatal family planning. The secondary education level was 60 people (44.12%), and 117 people (86.03%) were given family planning counselling. The results of research on the relationship between education and the use of postpartum family planning obtained ρ = 0.430 (ρ &gt; 0.05) and family planning counselling, ρ = 0.032 (ρ &lt;0.05). Concluded that there is no relationship between education and postpartum family planning and there is a relationship between family planning counselling and postpartum family planning.

선택적 함묵증 청소년의 자기표현 및 관계 향상을 위한 미술치료 단일사례연구

Objectives The purpose of this study is to investigate the effect of art therapy in the improvement of self-ex-pression and interpersonal relationships in adolescents with selective mutism. Methods The research subject is a third-year middle school male student with selective mutism who meets all five criteria of DSM-5 diagnosis. The art therapy of this study was conducted from November 2019 to February 2020, totaling 19 sessions. The research subject received one session per week, each lasting 45 minutes. However, sessions that were conducted in parallel with test and counseling, and the interview counseling of father were ex-tended to 90 minutes each. The parents, who were going through divorce, received individual counseling, family counseling session was conducted once, the father, mother, and a homeroom teacher were provided counseling as needed after the sessions with the subject. The study used HTP for examining changes in self-expression of the research subject with selective mutism, and KSD for exploring changes in relationships. HTP and KSD were evaluated by comparative analysis of pre- and post-test results. The process of change was qualitatively analyzed based on the artwork created during art activities, session transcripts, and counseling journals for each session. Results Firstly, in the post-test of the HTP, the size of the drawings increased by approximately three times, the positioning and composition became more stable, the shading in the human figures disappeared and the depiction of a smiling expression indicated an improvement in self-expression. Secondly, in the post-test of the KSD, the size of the drawings increased by approximately four times, and the positioning, pen pressure, use of an eraser being more stable and the inner aspect of the face being apparent indicated an improvement in interpersonal relationships. Thirdly, throughout the progression across sessions, the subject exhibited emotional stability and genuine self-expression, leading to positive changes in both self-expression and interpersonal relationships. Conclusions considering the combined results, art therapy had demonstrated significant effects on self-ex-pression and interpersonal relationships in adolescents with selective mutism.

Self-compassion and its Relation to Psychological Happiness among Widowed Men in Karak Governorate

The study aimed to identify the level of self-compassion and its relationship to psychological happiness among widowed men in Jordan. The sample consisted of (100) widowed men who were selected by using the convenience sampling method. The measures of self-compassion and psychological happiness were applied. The study used the descriptive correlational method. The results showed that the level of self-compassion was medium, as well as the level of psychological happiness. The results also showed that there is a positive correlation between psychological happiness and each of the dimensions of self-compassion. There was no difference in the level of self-compassion and psychological happiness of widowed spouses according to the variables (age, number of years of widowhood). The study came out with some recommendations among of which are: including some concepts such as self-compassion and psychological happiness in family counseling (for married couples), and addressing other variables to link them with empathy, such as decreasing stress and low self-esteem.

TIMELY INITIATION OF POSTPARTUM MODERN CONTRACEPTIVE UTILIZATION AND ASSOCIATED FACTORS AMONG WOMEN OF CHILD BEARING AGE IN ARBA MINCH TOWN PUBLIC HEALTH FACILITIES, GAMO ZONE, ETHIOPIA

ABSTRACT Background: Most the women average time to first postpartum ovulation is 45 days and can occur as early as 25 postpartum days (1). But, many women do not recognize that they are at risk of pregnancy during this period. Most postnatal women are exposed to pregnancy, by seven to nine months after delivery up till now have not obtained contraceptives (2). Objectives: - To assess the timely initiation of postpartum modern contraceptive utilization and associated factors among women of childbearing age in Arba Minch Town health facilities. The method:-An institutional-based cross-sectional study was employed using pretested interviewer-administered questions among 574 interviewees. The systematic random sampling method was done from April 15 to May 15, 2020. Bivariate and multivariate logistic regression analysis was done. P-value &lt; 0.05 was used to consider as statically significant variables. Results: The magnitude of timely initiation of postpartum contraceptive utilization was found to be 260 (45.3%) 95% [CI: 40.1-49.0]. The educational level of respondents, (AOR=0.46; 95% [CI: 0.31-0.71], No of ANC visit [AOR=2.913,95% [CI:1.39-6.07], counseling of postpartum family planning after the last delivery (AOR=2.29,95% [CI:1.46-3.58], couple discussed (AOR=4.94,95%[CI:3.01-8.09], resumption of sexual intercourse (AOR=1.74, 95% [CI: 1.36-2.77] and return of menses (AOR=(6.6, 95% [CI:1.91-22.78) were significantly associated variables with timely initiation of postpartum contraceptive utilization. Conclusion: less than half of the study participants have timely initiated modern contraceptives in Arba Minch Town. Family planning programs should be established incorporated at antenatal and postnatal follow-up actively. Keywords: Timely initiation, modern contraceptive,