Parent-child Treatment Research Articles

Experience of Pediatric Nurses in Parent-Child Isolation Units of COVID-19 Designated Hospitals: A Qualitative Study.

The omicron pandemic in Shanghai has created unprecedented challenges for pediatric medical institutions, and the work of pediatric nurses has changed rapidly due to the introduction of parent-child treatment. This study aimed to explore the experiences of pediatric nurses in the parent-child isolation unit of COVID-19-designated hospitals and provide a basis for developing feasible interventions as the next step. Using phenomenological research methods, 12 nurses working in the parent-child isolation unit of Shanghai Children's Medical Center affiliated with Shanghai Jiao Tong University School of Medicine from April 1, 2022, to June 15, 2022, were selected by purposive sampling. Semi-structured interviews and data analysis were conducted using Colaizzi's 7-step analysis. Data analysis revealed three major themes and 11 subthemes. The main themes were "risk factors", "protection factors", and "resilience strategies". The sub-themes were "challenge of caring for both adults and children simultaneously", "lack of adult expertise leads to inadequate coping skills", "change in the care population increased communication difficulties", "physical and psychological distress", "social support", "social recognition", "awareness of responsibilities and roles", "team coming together", "hunger for knowledge", "health promotion", and "psychological adjustment strategies". Hospital managers should optimize hospital management strategies, pay attention to multi-departmental and multidisciplinary team cooperation, reduce the burden on pediatric nurses, improve the work and rest environment, mobilize the hospital support system, and maintain nurse's physical and mental health, establish a warm parent-child isolation unit encourages nurses to listen to the patients' voices and adopt diversified communication methods, and strengthen the publicity of the nursing profession, improve social support and recognition, and enhance the sense of self-worth and mission.

Characteristics of the population of aparent-child unit: early interaction-based treatment as achance in child and adolescent psychiatry

In inpatient child psychiatric parent-child treatment, the child is admitted as apatient and the parents as accompanying persons. Due to the importance of parent-child interaction in the development and maintenance of mental disorders in children, parents are integrated more centrally in the treatment of children with emotional or behavioral disorders. In order to further expand this form of treatment in the future and to make it more effective, the characteristics of the previous utilization population of achild psychiatric parent-child unit in Tyrol were examined with regard to child symptomatology and the burden on parents. The Child Behavior Checklist 1½-5, Child Behavior Checklist 6-18R, and Tröster's (2011) Parent Stress Inventory scores of 96parent-child pairs were used to examine child symptom expression and parent stress. The 6-10year old patients had higher T‑scores (M = 76.9, SD = 7.1) than the 0-5year old patients (M = 63.1, SD = 12.4) on the CBCL total scale, t (50) = -3.52, p < 0.001. On the EBI total scale, the 0-5year old patients and the 6-10year old patients did not differ in terms of T‑scores, t (54) = -0.75, p = 0.459, as well as in the EBI child domain t (54) = -1.75, p = 0.087 and in the EBI parent domain, t (54) = 0.19, p = 0.846. Also, the four diagnostic groups did not differ in the EBI total scale, F (4,58) = 1.34, p = 0.266, nor in the parent domain of the EBI, F (4,58) = 1.44, p = 0.232, nor in the child domain of the EBI, F (4,58) = 2.81, p = 0.033. Early identification and treatment of behavioral or mental disorders in very young children seems crucial to prevent long-term negative consequences as well as chronicity. Parent-child therapies should generally focus on identifying and changing current dysfunctional patterns of interaction between parent and child.

Parent-Child Treatment in Child and Adolescent Psychiatry: Models and Clinical Implementation Using the Example of a Modular Parent-Child Ward

The joint treatment of mentally ill children and their parents represents a special treatment concept in child and adolescent psychiatry. A study conducted by the Working Group (BAG) "Early Childhood" shows the current situation of care and possible models of child and adolescent psychiatric parent-child treatment in Germany. Using the parent-child ward of the Child and Adolescent Psychiatry Department in Magdeburg as an example, the combined treatment of mentally ill children and their parents is presented. The treatment approach consists of a three-week diagnostic phase, after which families are discharged again to their home environment followed by a five-week therapy block, for which the families have to be readmitted to the ward. With a focus on the parent-child relationship, the treatment concept - in contrast to regular child psychiatric treatments - is dynamically adapted to the quality of the parent-child interaction and not primarily related to the disorder of the children. First studies indicate the effectiveness of the special treatment setting and illustrate the efficiency of a joint treatment of parents and child, which, however, is associated with increased economic costs. Based on these results, the chances and limitations of parent-child wards are discussed and conclusions for parent-child treatment are drawn.

9/11 Twenty Years On: Fractured Identities; Fear of the Other; Forging a New Path for Our Children Introduction to the Section

ABSTRACT This is an introduction to a collection of papers that commemorates the twentieth anniversary of 9/11. The nature of the content of the papers which follow is spurred by reflections on this anniversary from a number of domains: child and adult psychoanalysis; the healing arts of theater; the parent-child treatment of Afghani and Iraqi asylum-seeking families; the Law of the Mother and siblingships; the changes occurring in psychoanalytic views of secularism; and the confrontation of racial prejudice and othering in the workplace and its repercussions upon the self. Concepts of splitting, the bearing of ambivalence, and the capacity to reflect and resist fragmentation are illuminated.

A Pilot Study of Universal Teacher–Child Interaction Training at a Therapeutic Preschool for Young Maltreated Children

Young children are disproportionately exposed to maltreatment but are underrepresented in research on effective treatments. Universal Teacher-Child Interaction Training (TCIT-U), developed from Parent-Child Interaction Therapy, may be especially appropriate for maltreated children as they often experience caregiver disruptions which pose challenges to traditional parent-child treatment. Furthermore, research suggests that teachers can play an important role for children who lack positive caregiving experiences. The current study examined the effectiveness of TCIT-U versus treatment-as-usual (TAU) at a therapeutic preschool for youth exposed to maltreatment. Thirty-eight children (2–5 years old) and eight teachers from four classrooms participated in the study. Teacher behaviors were observed and coded at baseline, mid-treatment, post-treatment, and 3-month follow-up. Teachers reported on children’s behavior and social-emotional skills at baseline, post-treatment, and 3-month follow-up. TCIT-U teachers demonstrated substantial increases in positive attending skills (PRIDE [Praise, Reflection, Imitation, Description, and Enjoyment] skills) and decreases in negative talk and questions during intervention phases, and these skills were maintained at follow-up. In addition, children in the TCIT-U classrooms demonstrated a significantly greater increase in overall social-emotional skills by post-treatment than children in the TAU classrooms, and effect sizes were moderate for all child outcomes. Findings provide preliminary support for TCIT-U’s effectiveness in a therapeutic setting for children exposed to maltreatment.

Systematic review of meditation-based interventions for children with ADHD.

Meditation-based interventions such as mindfulness and yoga are commonly practiced in the general community to improve mental and physical health. Parents, teachers and healthcare providers are also increasingly using such interventions with children. This review examines the use of meditation-based interventions in the treatment of children with Attention-Deficit Hyperactivity Disorder (ADHD). Electronic databases searched included PsycINFO, Medline, CINAHL, and AMED. Inclusion criteria involved children (aged to 18years) diagnosed with ADHD, delivery of a meditation-based intervention to children and/or parents, and publication in a peer-reviewed journal. Studies were identified and coded using standard criteria, risk of bias was assessed using Risk of Bias in Non-randomised Studies- of interventions (ROBINS-I), and effect sizes were calculated. A total of 16 studies were identified (8 that included children in treatment, and 8 that included combined parent-child treatment). Results indicated that risk of bias was high across studies. At this stage, no definitive conclusions can be offered regarding the utility of meditation-based interventions for children with ADHD and/or their parents, since the methodological quality of the studies reviewed is low. Future well designed research is needed to establish the efficacy of meditation-based interventions, including commonly used practices such as mindfulness, before recommendations can be made for children with ADHD and their families.

Comparing the Multicomponent Coping Power Program to Individualized Parent-Child Treatment for Improving the Parenting Efficacy and Satisfaction of Parents of Children with Conduct Problems.

This study compared the multicomponent Coping Power (group) program to individualized parent-child treatment with respect to changing the parenting efficacy and satisfaction of parents of children with conduct problems. One hundred fourteen parents of 9-12-year-old children with conduct problems were randomized to Coping Power or individualized treatment at an urban children's mental health clinic. Parents reported their pre- and post-treatment parenting efficacy and parenting satisfaction (Parent Sense of Competence Scale). Mixed effect models revealed that parenting efficacy and satisfaction significantly increased from pre- to post-treatment, and there was no evidence that this effect is different between Coping Power and individualized treatment, even after controlling for initial severity of child symptomatology. Findings support the effectiveness of Coping Power as an intervention for parenting efficacy and satisfaction among parents of children aged 9-12 years with conduct problems.

Trauma-Focused Cognitive-Behavioral Therapy for Children and Adolescents: Assessing the Evidence

Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is a conjoint parent-child treatment developed by Cohen, Mannarino, and Deblinger that uses cognitive-behavioral principles and exposure techniques to prevent and treat posttraumatic stress, depression, and behavioral problems. This review defined TF-CBT, differentiated it from other models, and assessed the evidence base. Authors reviewed meta-analyses, reviews, and individual studies (1995 to 2013). Databases surveyed were PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, PILOTS, the ERIC, and the CINAHL. They chose from three levels of research evidence (high, moderate, and low) on the basis of benchmarks for number of studies and quality of their methodology. They also described the evidence of effectiveness. The level of evidence for TF-CBT was rated as high on the basis of ten RCTs, three of which were conducted independently (not by TF-CBT developers). TF-CBT has demonstrated positive outcomes in reducing symptoms of posttraumatic stress disorder, although it is less clear whether TF-CBT is effective in reducing behavior problems or symptoms of depression. Limitations of the studies include concerns about investigator bias and exclusion of vulnerable populations. TF-CBT is a viable treatment for reducing trauma-related symptoms among some children who have experienced trauma and their nonoffending caregivers. Based on this evidence, TF-CBT should be available as a covered service in health plans. Ongoing research is needed to further identify best practices for TF-CBT in various settings and with individuals from various racial and ethnic backgrounds and with varied trauma histories, symptoms, and stages of intellectual, social, and emotional development.

Predictors, Moderators, and Treatment Parameters of Community and Clinic-Based Treatment for Child Disruptive Behavior Disorders.

This study examines predictors, moderators, and treatment parameters associated with two key child outcomes in a recent clinical trial comparing the effects of a modular treatment that was applied by study clinicians in the community (COMM) or a clinic (CLINIC) for children with oppositional defiant disorder (ODD) or conduct disorder (CD). Based on a literature review, moderator and predictor variables across child, parent, and family domains were examined in relation to changes in parental ratings of the severity of externalizing behavior problems or the number of ODD and CD symptoms endorsed on psychiatric interview at pretreatment, posttreatment, and 36-month posttreatment follow-up. In addition, associations between parameters of treatment (e.g., hours of child, parent, and parent-child treatment received, treatment completion, referral for additional services at discharge) and child outcomes were explored. Path models identified few moderators (e.g., level of child impairment, attention deficit hyperactivity disorder diagnosis, level of family conflict) and several predictors (child trauma history, family income, parental employment, parental depression) of treatment response. Treatment response was also related to a few treatment parameters (e.g., hours of child and parent treatment received, treatment completion, referral for additional services at discharge). We discuss the implications of these findings for maximizing the benefits of modular treatment by optimizing or personalizing intervention approaches for children with behavior disorders.

Parent‐Only Treatment for Childhood Obesity: A Randomized Controlled Trial

Parent-only (PO) treatments for childhood obesity are feasible, more cost-effective and potentially easier to disseminate. The objective of this study was to determine whether a PO treatment is not inferior to a parent + child (PC) treatment for childhood obesity. Eighty parent-child dyads with an 8-12 year old overweight or obese child (>85th BMI-P) were recruited and randomized into PO or PC treatment for childhood obesity. Parents or parent-child dyads attended 5-month treatment groups. Child and parent body size, child caloric intake, and child physical activity were assessed at baseline, post-treatment, and 6-months follow-up. Noninferiority testing using mixed linear models was used to compare PO treatment with PC treatment. Results showed that the PO group was not inferior to the PC group in terms of child weight loss. Results also showed that the PO group was not inferior to the PC group in terms of parent weight loss and child physical activity, but not child caloric intake. This study suggests that a PO treatment could provide similar results to PC in child weight loss and other relevant outcomes, and potentially could be more cost-effective and easier to disseminate. Although further research is needed, this study suggests that PO groups are a viable method for providing childhood obesity treatment.

Parent-child treatment in general psychiatry

German psychiatry has been using parent-child treatment for only a few years-in contrast to Anglo American countries. Now, however, similar modalities are now on the rise in Germany, and it is time to list experiences and considerations of possible quality standards for such treatment units. To account for the necessary broadening of perspectives including the whole family system, the term "parent-child treatment" is used instead of the frequently used "mother-child treatment."