Family-oriented Interventions Research Articles

Different perspectives in psychiatry: how family-oriented are professionals in Germany?

ΒackgroundChildren of parents with a mental illness have up to 50% chance of developing a mental illness themselves. Numerous studies have shown that preventive family-oriented interventions can decrease the risk by 40% and that professionals are a decisive factor influencing family-oriented practice. There are also substantial differences between professions in terms of their family-oriented practices. This study examines the level of family-oriented practice for different professional groups in Germany.MethodsData were used from the baseline assessment of the two-group randomized controlled multicenter trial ci-chimps as a subproject of CHIMPS-NET, which took place from January 2020 to May 2021 in 18 clinical centers in Germany. Child and adolescent mental health systems as well as adult mental health systems took part and every professional involved in the treatment was invited to participate. Data was used from 475 mental health professionals including physicians, psychologists, psychotherapists for adults and for children and adolescents, occupational/ music/ physio/ art therapists/ (social) education workers and nursing/ education service. Family-oriented mental health practice was examined using the translated version of the Family-Focused Mental Health Practice Questionnaire (FFMHPQ) with means and standard deviations calculated for each of the 18 FFMHPQ-GV subscales. ANOVAs were computed to compare professions and significant differences were examined via post hoc analyses (Scheffé). Additionally, effect sizes were calculated (Omega squared).ResultsDifferences were seen between the professions in all aspects of family-oriented practice: Both regarding organizational policy and support aspects, issues concerning working with parent-clients, as well as professional skills and knowledge aspects. Psychotherapists for children and adolescents scored the highest family-oriented practices compared to all other professional groups on almost all subscales.ConclusionThis study examines the level of family-oriented practice for different professional groups in Germany. Apart from skills and knowledge about the impact of mental illness and parenting, psychotherapists for children and adolescents had the highest scores and engaged most in family-oriented practice. Psychotherapists for adults got the least workplace support for family-oriented practice but were competent providing resources and referral information to the concerned families and feel confidence working with them. Due to these results, a training need exists to improve skills and knowledge about the impact of mental illness and parenting. Additionally, there is still potential for institutional support in promoting family-oriented work.Trial registrationThe CHIMPS-NET-study was registered with the German Clinical Trials Register on 2019–12-19 (DRKS00020380) and with Clinical Trials on 2020–4-30 (NCT04369625), the ci-chimps-study was registered with the German Clinical Trials Register (DRKS00026217) on 2021–08-27 and with Clinical Trials on 2021–11-04 (NCT05106673).

Use and attitudes towards digital technologies in addiction rehabilitation in the SARS-CoV-2 pandemic

Abstract Background Before the start of the pandemic, digital technologies were hardly used in addiction rehabilitation in Germany - also due to the lack of a legal framework. During the SARS-CoV-2 pandemic, the funding agencies enabled their use. The aim of the study is to describe the use of and attitudes towards digital technologies in addiction rehabilitation from the perspective of both clinic management and rehabilitation patients. Methods Clinic management of all 1044 outpatient and inpatient addiction rehabilitation clinics in Germany were asked in summer 2022 to complete an online questionnaire on the use of and attitudes towards digital technologies in addiction treatment. 415 clinics provided answers (response rate 40%). In addition, 460 rehabilitation patients from 34 different clinics were questioned in written form (mean age 46.0 years (SD: 13.3), 73% male; 81% alcohol addiction). Results According to the clinic management, digitally conducted therapies were carried out in individual therapy (inpatient: 22% vs. outpatient 62%), group therapy (4% vs. 37%), family-oriented interventions (55% vs. 51%), and pre-admission interviews (45% vs. 45%). Among the rehabilitation patients, 10% in inpatient and 37% in outpatient rehabilitation stated that they had used digitally conducted therapies. 87% of the clinic management felt that digital therapy offers were useful during the pandemic, and 84% were in favour of using them beyond the pandemic. Among rehabilitation patients, the approval rate was 85% and 59% respectively. Conclusions Digital technologies were used for different therapy services in addiction rehabilitation. The majority of both clinic management and rehabilitation patients were in favour of this, even beyond the pandemic. For further use after the pandemic, the establishment of a legal, financial and organisational framework is required. Non-inferiority studies (comparing digital to face-to-face) could add to the evidence. Key messages • Digital technologies were used for therapeutic purposes (e.g. individual therapy, group therapy, family-oriented interventions) by a large proportion of addiction clinics during the pandemic. • The majority of clinic management and rehabilitation patients are in favour of the use of digital technologies in addiction rehabilitation even beyond the pandemic.

Exploring the connection between parental bonding and smartphone addiction in Chinese medical students

BackgroundSmartphone addiction bodes adverse consequences, affecting different populations, including medical students. Parental bonding in childhood had been associated with addiction and recovery in later life. Therefore, this study aimed to examine the associations between parental bonding and smartphone addiction among Chinese medical students.MethodBinary logistic regressions were used to investigate the associations between parental bonding with mothers and fathers, respectively, and smartphone addiction. Interaction terms of care and protection were included in the models.ResultsA total of 517 medical students were included in the study. The prevalence of smartphone addiction was 48.16% (n = 249). The estimated effects of maternal and paternal parenting on smartphone addiction differed. Maternal protection was positively associated with smartphone addiction (OR, 1.046;95% CI, 1.005-1.087), and maternal care enhanced the estimated effect of protection on smartphone addiction. Paternal care was negatively associated with smartphone addiction (OR, 0.954;95% CI, 0.919-0.989).ConclusionsChinese medical students with overprotective mothers or with indifferent fathers tended to exhibit traits of smartphone addiction. Further studies on factors influencing the associations between parental bonding and smartphone addiction may pave the way for potential family-oriented interventions for smartphone addiction.

Family-oriented interventions in long-term care residential facilities for older people: A scoping review of the characteristics and outcomes.

Family-oriented interventions in long-term care (LTC) residential facilities are heterogenous in design, characteristics, and outcomes. To synthesize characteristics (e.g., type, provider, and duration) and outcomes of family-oriented interventions in LTC residential facilities. We followed the JBI methodology and searched seven databases for quantitative, qualitative, and mixed method studies that reported family-oriented interventions in LTC residential settings for older people; defined in this review as ≥60 years. Interventions that included residents, resident families, health professionals, or any combinations of these three were included if the study reported post-intervention assessment of at least one family-related outcome. Thirteen studies met the inclusion criteria. Interventions were found to be multifaceted, and education was the most common element. Nurses were the most common intervenors, and most interventions had more than one target (residents, resident families, or staff). Most outcomes were related to family involvement, satisfaction with care, quality of life, communication, symptom management, and shared decision making, and none of the studies reported a negative impact. Family-oriented interventions were associated with high care quality and better resident-staff-family partnership. Staff education and staff-family conversation are relatively cheap interventions to help family involvement, facilitate shared decision-making, and improve family satisfaction.

Transgenerational concordance in parent-to-child transmission of suicidal behaviour: a retrospective, nationwide, register-based cohort study of 4 419 642 individuals in Denmark

Suicidal behaviour runs in families, but the nature of transgenerational concordance needs elucidation. The aim of this study was to examine parent-to-child transmission by investigating whether presence and nature of parental suicidal behaviour was associated with suicidal behaviour in children. We did a retrospective, nationwide, register-based cohort study in Demark using register data. We included all individuals born after 1953 who were 10 years or older and who were recorded as living in Denmark at some point between Jan 1, 1980, and Dec 31, 2016. Adults listed as living with their child at first registration in the Civil Registration System were considered as parents; later records of different legal parents allowed identification of potential step-parents. Self-reported ethnicity data were not available. Exposure to parental suicide attempt and suicide was identified using information from hospital contacts and causes of death from national registers. The examined outcomes were suicide attempt and death by suicide. We calculated incidence rate ratios (IRRs) and cumulative hazards for children's suicide attempt and suicide, taking into account type of parental suicidal behaviour, child's age of exposure, and sex. In total, 4 419 642 individuals aged 10-63 years were observed during 1980-2016. Of these individuals, 150 222 (3·4%) were exposed to one or more parents with a suicide attempt, 31 564 (0·7%) to at least one parent who died by suicide, and 12 834 (0·3%) to both events. Individuals exposed to parental suicide attempt had higher rates of suicide attempt (IRR 2·72 [95% CI 2·33-3·17]) than individuals exposed to parental suicide (1·77 [1·50-2·09]) when compared with unexposed individuals. Higher rates of suicide were found for individuals exposed to parental suicide (IRR 3·18 [95% CI 2·84-3·58]) than for those exposed to parental suicide attempt (2·37 [2·19-2·57]). The cumulative hazard of suicide attempt was 0·07 for individuals exposed to parental suicide attempt, and the cumulative hazard of suicide was 0·009 for individuals exposed to parental suicide. Individuals exposed to parental suicide had higher odds of violent suicidal methods than those exposed to suicide attempt alone (odds ratio 2·0 [95% CI 1·7-2·3]). A concordant pattern of higher rates of the same type of suicidal behaviour as the one of the parents was observed, including type of suicide method. Preventive, family-oriented interventions are warranted to mitigate familial transmission of risk, as are clinical considerations of familial exposure in risk assessment of patients. Mental Health Services, Capital Region of Denmark.

Clinical Implementation and Evaluation of Three Implementation Interventions for a Family-Oriented Care for Children of Mentally Ill Parents (ci-chimps): Study Protocol for a Randomized Controlled Multicenter Trial.

BackgroundIn Germany, approximately three million children under the age of eighteen have a mentally ill parent. These children are at an increased risk of developing a mental illness themselves (1) as well as a physical illness (2). While research has identified numerous evidence-based family-oriented interventions, little is known about how to implement such interventions effectively and efficiently in clinical practice in Germany. This implementation study (ci-chimps) evaluates three clinical implementation projects with three different implementation interventions for the optimal implementation of the tailored family-oriented preventive and therapeutic interventions in the CHIMPS-NET (children of mentally ill parents—research network) with an implementation model for children of mentally ill parents.MethodsA two-group randomized controlled multicenter trial will examine changes in family-oriented practice and aspects of implementation at baseline as well as at 12- and 24-months follow-up. The CHIMPS-Network consists of 20 clinical centers. The centers in the intervention group receive the support of all of the three implementation interventions: (1) optimal pathways to care, (2) education and a training program for professionals, and (3) systematic screening for children. The centers in the control group do not receive this specific implementation support.DiscussionWhile we know that children of mentally ill parents are an important target group to be addressed by preventive and therapeutic interventions, there is often a lack of structured implementation of family-oriented interventions in clinical practice in Germany. Using a randomized controlled multicenter trial design with a large and wide-ranging sample (clinics for adult psychiatry and clinics for child and adolescent psychiatry, university clinics and clinics at the real health care) will provide a robust understanding of implementing family-oriented changes in German clinical practice.Trial RegistrationThe CHIMPS-NET-study was registered with the German Clinical Trials Register on 2019-12-19 (DRKS00020380) and with Clinical Trials on 2020-4-30 (NCT04369625), the ci-chimps-study was registered with the German Clinical Trials Register (DRKS00026217) on 2021-08-27, the Clinical Trials registration is in review process.

Factors Associated with Family Belongingness in Children Under Legally Required Health Care

It is known that family dysfunctions increase the risk of abuse, neglect and delinquency in children. On the other hand, family belonging was shown as one of the protective factors against these types of risks. In this study, it was aimed to investigate the relationship between family belonging and various risk factors for children and their families who are being treated in a mental health clinic with the decision of health measure. The study group consisted of 57 adolescents who were treated with a health measure decision, and the control group consisted of 42 adolescents who were treated in the same clinic without any health measure, both groups were over the age of 14. The Parenting Style Scale and The Family Belonging Scale were applied to the participants who took part in the study on a voluntary basis. Data in the sociodemographic information form were updated with the help of parents. Children with health measure decisions had higher rates of grade repetition, exposure to a negative life event, domestic physical and verbal violence, living in a fragmented family system, presence of mental illness in the mother, and a history of delinquency in family members compared to children in the control group. It was found that children's participation in social activities, and the education and income levels of the parents were lower. Additionally, authoritarian and negligent parenting styles were more pronounced and family belonging was lower in the same group. In the regression analysis, it was revealed that the family belonging of children who had been followed up with a health measure desicion, increases with the participation in social activities and decreases with physical violence. Our study supported that in studies targeting children at risk or in need of protection, family-oriented interventions are protective, preventive and curative.

Treatment-engagement fears in family-oriented interventions: validation of the caregiver traps scale for eating disorders

ABSTRACT As more caregivers of children (of any age) struggling with an eating disorder are recruited as partners in care, it is important to identify potential barriers to such involvement. The Caregiver Traps Scale for Eating Disorders (CTS-ED) was developed as a measure of caregiver fears with respect to treatment-engagement. The purpose of this study was to evaluate its psychometric properties. One hundred and twenty four parents of children with ED participated in the validation of this instrument. Data were analyzed through exploratory factor analysis. The exploratory factor analysis revealed one factor, accounting for 39% of the variance, with a mean of 3.99 (scale from 1 to 7), indicating that caregivers endorsed clinically significant fears relating to their involvement in their child’s treatment. The scale yielded high internal consistency (α = .89). As expected, the CTS-ED was significantly positively correlated with a measure of accommodating and enabling of ED symptoms, and negatively correlated with a measure of parental self-efficacy. This scale shows promise as a measure for clinicians and researchers to identify parental fears that could potentially fuel accommodating, enabling or treatment-interfering behaviors. Suggestions for its utility as a clinical and supervision tool are also provided. Clinical Significance Development of an assessment tool to identify caregiver fears with respect to therapy engagement in the context of family-oriented interventions for eating disorders Tool has the potential to increase the positive involvement of caregivers to support their child (of any age) with an eating disorder Tool can be used clinically and to support self-reflective practices to improve compassionate clinician engagement of caregivers struggling to support their child

Relationship between decreased visual acuity and physical activity time in school age children

Abstract Objective This study aimed to investigate the physical activity of children with decreased visual acuity, thereby providing basic data for developing strategies to enhance the physical activity of school-age children. Methods The participants were 1,194 children and 1,194 parents who participated in the 10th Korean Children Panel Survey. Logistic regression analysis was conducted to examine the status of the physical activity of children with decreased visual acuity according to the accessibility of community facilities. Results The mother perceived the accessibility of community facilities as low, children with decreased visual acuity reported 1.20 times shorter over-the-weekend leisure activity time compared with vision-typical children, and they spent 1.41 and 1.33 times shorter on caring for pets and religious activity, respectively. Conclusions To increase the physical activity of children with decreased visual acuity, family-oriented interventions should be provided. It is also important to establish a community environment with enhanced accessibility of community facilities by examining the level of accessibility perceived by parents.

Family-oriented interventions in long-term care residential settings: a scoping review protocol.

The objective of this review will be to identify the characteristics (eg, type, duration, and provider) of family-oriented interventions in long-term care residential settings. The authors will also identify which outcomes are reported in the literature when implementing family-oriented interventions. An array of family-oriented interventions in long-term care residential settings exist. Given the heterogeneity of current literature, mapping characteristics and intended outcomes of family-oriented interventions is an essential step to inform how best to support families of patients in long-term care residential settings. This review will consider studies describing family-oriented interventions for families of elderly patients in long-term care residential settings, with no exclusion based on country, gender, or comorbidities. Interventions that address any family-related issue, such as quality of life, psychological burden, and family involvement in patient care, are eligible for inclusion. Studies will be excluded if the patients are cared for at their own homes or institutionalized care is provided on a temporary basis. Quantitative, qualitative, and mixed method study designs will be considered for inclusion. A scoping review will be conducted using the JBI methodological approach. Seven databases will be systematically searched: MEDLINE, CINAHL, Scopus, Evidence-Based Medicine Reviews including Cochrane Library, PsycINFO, OpenGrey, and the Grey Literature Report. Citations will be screened against the inclusion criteria by two reviewers independently. Relevant data will be extracted from the included studies, and will be synthesized, summarized, and reported following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Findings will be published in a peer-reviewed journal.

Couple- or family-oriented interventions and outcomes for preventing mental health problems and promoting mental health: a scoping review protocol.

The objective of this scoping review is to map the literature describing couple- and family-oriented interventions and outcomes to prevent mental health problems and promote mental health. Literature involving couple- and family-focused mental health interventions has gained increased attention over the past two decades, yet little is known about the efficacy of these interventions for promoting mental health and preventing mental disorders. Despite recognition that the most sustainable method for reducing the increasing burden of mental disorders is primary prevention, there has been no systematic investigation of relevant couple- and family-focused interventions. This scoping review will consider studies that include couples or multiple family members who have participated in couple- and family-focused interventions aimed at primary prevention of mental disorders and promotion of mental health. This study will include experimental, quasi-experimental, and observational study designs, as well as qualitative studies. Conference abstracts, posters, editorials, commentaries, and opinion papers will be excluded. Multiple databases will be searched, including PubMed (MEDLINE), CINAHL, ERIC, PsycINFO (via EBSCO), Web of Science, Scopus, and Research Information Sharing Service (RISS). Trial registers and gray literature will also be searched. Two independent reviewers will screen the abstract/title of retrieved citations using inclusion and exclusion criteria. After screening titles and abstracts of identified citations, relevant studies will be retrieved in full. Using a data extraction instrument developed specifically for this review, eligible studies will be extracted and presented in diagrammatic or tabular form, accompanied by a narrative summary.

The impact of a cancer diagnosis on sibling relationships from childhood through young adulthood: a systematic review

ABSTRACT Cancer is a serious, life-threatening illness that impacts the entire family system, with implications for patients themselves, their siblings, parents, and extended family. Given increasing identification of siblings as uniquely important and enduring fixtures in each other’s lives, investigation into the influence of cancer on sibling relationships is warranted. The current systematic review pursued the question: What interpersonal factors in sibling relationships are affected by coping with a cancer diagnosis from childhood through young adulthood? In September 2019, a systematic search of extant literature was conducted, from inception to present, resulting in nine studies meeting inclusion criteria. Results were sorted into psychosocial factors and family factors. Psychosocial factors included the quality of sibling relationships, social support, and psychological distress. Family factors included family functioning and family conflict. Findings suggest practice recommendations for peer support of siblings of cancer patients, as well as systemic and family-oriented interventions that harness strengths and prevent long-term negative effects on the entire family. Future research should expand knowledge on sibling relationships in the cancer context by examining their influence on practical issues such as financial burden, including a greater diversity of socio-demographic variables, and evaluating promising evidence-based models of care for oncology social work.

Study of the effectiveness of comprehensive, timely, and family-oriented interventions in reducing the symptoms of autism in children.

Background and Objectives:The onset of rehabilitation interventions in children with autism spectrum disorder below 5 years old has been associated with the reduction of autism symptoms in all developmental domains. The present study aimed to illustrate the importance of early family-oriented interventions in the reduction of the problems and symptoms of children with autism spectrum disorder.Methodology:This study was a pretest-posttest clinical trial without a control group. Fifty patients were selected using a convenience sampling method, of which forty patients were male and 10 females with a mean age of 3.2 ± 1.4. The efficacy assessment was evaluated using the Autism Behavior Checklist (ABC) and the Autism Treatment Evaluation Checklist (ATEC) as pretest and posttest. Data were analyzed by independent T-test using SPSS software.Results:The difference between pretest and posttest was significant in all aspects of the ATEC test (communication, health, sensory and cognitive awareness, socialization) at the level of P < 0.001. Moreover, the difference between pretest and posttest was significant at P < 0.001 for the aspects of speech, social and communication, and general performance, and at P < 0.002 for the sensory processing.Conclusion:Timely interventions under 6 years old with an emphasis on family-oriented and growth aspects over one year can help autistic children in the aspects of speech, social and communication, sensory processing, and sensory and cognitive awareness.

Leveraging Delivery of Blood Pressure Control Interventions among Low-income African American Adults: Opportunities to Increase Social Support and Produce Family-level Behavior Change.

Few family-oriented cardiovascular risk reduction interventions exist that leverage the home environment to produce health behavior change among multiple family members. We identified opportunities to adapt disease self-management interventions included in a blood pressure control comparative effectiveness trial for hypertensive African American adults to address family-level factors. We conducted and analyzed semi-structured interviews with five intervention study staff (all study interventionists and the study coordinator) between December 2016 and January 2017 and with 11 study participants between September and November 2015.1 All study staff involved with intervention delivery and coordination were interviewed. We sampled adult participants from the parent study, and we analyzed interviews that were originally obtained as part of a previous study based on their status as a caregiver of an adolescent family member. Thematic analysis identified family influences on disease management and the importance of relationships between index patients and family members, between index patients and study peers, and between index patients and study staff through study participation to understand social effects on healthy behaviors. We identified four themes: 1) the role of family in health behavior change; 2) the impact of family dynamics on health behaviors; 3) building peer relationships through intervention participation; and 4) study staff role conflict. These findings inform development of family-oriented interventions to improve health behaviors among African American index patients at high risk for cardiovascular disease and their family members.

Tobacco Use among Adult Muslims in the United States

Background: Compared with the general United States (US) population, Muslims in the US exhibit elevated rates of tobacco use. As a result, they might be at a higher risk for preventive disease and premature death as compared with the general US population. Objective: This study investigated the Social Cognitive Theory (SCT) factors that are associated with tobacco use among a sample of adult Muslims in the US. Methods: Data were collected (November 2016–March 2017) using a cross-sectional, on-line survey from a convenience sample of adult (≥ 18 years) US Muslims. Participants with a lung cancer history were excluded. Associations between SCT factors and tobacco use were investigated with bivariate analyses and multinomial logistic regression models. Results: Eligible participants (n = 271) from 30 states completed the survey; 52.8% reported current tobacco use. A higher rate of current tobacco use was reported by men (62.8%) as compared to women (41.3%), x2(1, N = 271) = 12.49, p < .001. In terms of cognitive factors, individuals who (1) expected more personal consequences for tobacco use on health, and (2) had more confidence regarding ability to abstain from tobacco use, were less likely to report current tobacco use. In terms of environmental factors, individuals whose family members did not use tobacco were less likely to report current tobacco use. Conclusion: The study findings suggest that family-oriented interventions emphasizing self-efficacy and personal consequences to prevent tobacco use can potentially be effective in reducing tobacco use rates in the adult US Muslim population.

Family-oriented interventions for adults with acquired brain injury and their families: a scoping review.

This scoping review sought to describe the literature on the different types of interventions to support families of patients with acquired brain injuries (ABIs) and their outcomes. Acquired brain injuries are among the leading causes of disability in adults worldwide and have physical, cognitive or/and behavioral consequences not only for the patient, but also for the family. Several support interventions have been proposed in different contexts at different phases of recovery with various levels of evidence, yet no synthesis is available to date. We included studies that focused on family members of patients suffering from ABI. The concept under review included any type of intervention or action oriented to support families of patients with ABI, in any care setting. We included all published qualitative and quantitative designs, including those in the gray literature. A three-step search strategy was performed. Searches were conducted in eight major databases, MEDLINE, PubMed, Embase, CINAHL, PsycINFO, Cochrane, JBI Database of Systematic Reviews and Implementation Reports, Web of Science in April 2017, and seven databases for unpublished studies in November 2017. This review was limited to studies published in English and French since January 2007. Additional studies were searched amongst reference lists of all included articles. We included 89 studies, 19 secondary studies (systematic reviews n = 13, other type of reviews n = 6) and 70 primary studies (experimental studies n = 20, quasi-experimental studies n = 33, other designs n = 17). Even if heterogeneity was found in the characteristics of the 64 selected interventions, emotional support and education were highlighted as the main core components for family-oriented interventions. Mental health and burden were the two most prevalent outcomes found in this scoping review. Interventions targeted families and patients together in 56% of the cases or families alone. This scoping review provides an actual state of the current evidence available for families of patients with ABI. Extended and heterogeneous literature was found, showing the growing interest for considering ABI as a family issue in recent years. However, the overall level of evidence found indicates that more research is still needed to determine key components to intervene within this specific population.

Generativity Among Elderly in a Rural Area of Maharashtra, India: Correlates and Relationship With Quality of Life Approved.

Generativity, "a concern for others and a need to contribute something to the next generation," is a dimension of successful aging in and of itself, but also predicts other positive health outcomes. We examine its manifestations and correlates among elderly in rural India and assess the association between generativity and quality of life (QoL). Three hundred and forty-eight rural Indian elderly completed an interviewer-assisted questionnaire assessing generativity, QoL, and other personal and familial factors. Regression models were used to examine potential correlates of generativity and the relationship between generativity and QoL. Higher education, inheritance income, more living children, and a son/daughter living in the home predicted higher levels of generativity. Higher levels of generativity were associated with higher QoL. There are both personal and familial correlates of generativity, and family relationships are important for generative development. Family-oriented interventions to increase generativity among elderly Indians could improve QoL.

Family-oriented interventions for adults with acquired brain injury and their families: a scoping review protocol.

The aim of this scoping review is to examine the range and nature of family-oriented interventions that have been developed and/or tested for people with acquired brain injuries (ABI) and their families in all settings. Specifically the review questions are.

Psychotherapeutic interventions for suicidal adolescents – a systematic review of the current literature

Although suicidal thoughts and behaviors are common in adolescents, the German guidelines for suicidality in children and adolescents state a lack of evidence for the effectiveness of specific psychotherapies for those patients. The aim of this systematic review was to summarize and critically discuss newest advances in the evaluation of specific therapeutic approaches for suicidality in youths. Building on other recent systematic reviews, 11 manuscripts published between 2013 and 2017 were included in this review. Included are studies on interventions in emergency departments, psychotherapeutic approaches specifically targeting suicidality despite other psychopathology, interventions for youth with specific disorders or risk-factors, and one study evaluating an online-intervention. First positive effects can be claimed for family interventions in emergency departments (regarding lower hospitalization rates) as well as cognitive-behavioral, dialectical-behavioral, and family-oriented interventions (regarding reducing suicidality). Promising results were also found in a pilot study on an online-intervention. However, further research is necessary, as replication of outcomes has not been attempted or published in most cases and studies including large sample sizes with long-term follow-up evaluation are very rare.

Addressing Pediatric Obesity in Clinic.

There is an epidemic of pediatric obesity in the United States. In most cases, there is an excess in the amount of calories consumed, compared with the amount of calories expended. Numerous body systems are affected by pediatric obesity, with complications varying between boys and girls. Behavioral, genetic, and environmental factors affect the ability of children to avoid becoming obese. Primary care physicians should screen for obesity in children as much as possible. Associated risk factors for obesity should be uncovered. Methods of preventing obesity should be discussed routinely with children and their families. Healthy dietary habits are key, and so are family-oriented interventions, such as eating together at dinnertime. One hour of moderate to vigorous activity daily is recommended for children and adolescents. While pediatric bariatric surgery is an option, there are also numerous nonpharmacological and pharmacological measures available as management for pediatric obesity. Family-based approaches, such as reducing screen time, have been very successful. Non–weight-bearing exercises also help children and adolescents expend calories without causing injury to themselves. Family availability, activity preference, and developmental levels should all be considerations when managing pediatric obesity. Motivational interviewing may also be helpful, especially when customized for each specific patient and family. Clinicians will play an increasing role in terms of identifying, treating, and preventing pediatric obesity; measures that can be done in the clinic should be considered more and more.