Psychosocial Services Research Articles

Ensuring our exstrophy-epispadias complex patients and families thrive.

Individuals with bladder exstrophy-epispadias complex (EEC) need long-term integrated medical/surgical and psychosocial care. These individuals are at risk for medical and surgical complications and experience social and psychological obstacles related to their genitourinary anomaly. This care needs to be accessible, comprehensive, and coordinated. Multiple surgical interventions, reoccurring hospitalizations, urinary and fecal incontinence, extensive treatment regimens for continent diversions, genital differences, and sexual health implications affect the quality of life for the EEC patient. Interventions must include psychosocial support, medical literacy initiatives, behavioral health services, school and educational consultation, peer-to-peer opportunities, referrals to disease-specific camps, mitigation of adverse childhood events (ACEs), formal transition of care to adult providers, family and teen advisory opportunities, and clinical care coordination. The priority of long-term kidney health will necessitate strong collaboration among urology and nephrology teams. Given the rarity of these conditions, multi-center and global efforts are paramount in the trajectory of improving care for the EEC population. To achieve the highest standards of care and ensure that individuals with EEC can thrive in their environment, multidisciplinary and integrated medical/surgical and psychosocial services are imperative.

An Integrated Perspective for Understanding the Psychosocial Impact of Acute Cardiovascular Events

The psychosocial impact of acute cardiovascular disease (CVD) events, including cardiac and stroke events, is gaining increasing recognition, with recommendations regarding an integrated cardiovascular approach coming from organizations such as the European Society of Cardiology Council on Stroke. This study aims to document the similarities and differences between heart disease and stroke in the prevalence, predictors and consequences of, and treatments for, anxiety and depression. This scoping review provides an overview of the evidence of similarity and difference in the mental health impacts of cardiac events and strokes. It found that research into postevent anxiety and depression is generally more advanced in the cardiac area than in the stroke area, with research related to poststroke anxiety prevalence, predictors, and treatment being particularly sparse. Despite these limitations, the review reveals enough similarities in the psychosocial impacts of cardiac and stroke events to warrant investigation of the potential for integrated psychosocial services for CVD patients, paying particular attention to collaborative care models of intervention.

Важливі навички в період стресу. досвід проведення навчання груповому курсу управління стресом для дорослих самодопомога+ (self-help+)

Relevance. The full-scale war on the territory of Ukraine resulted in severe and long-lasting distress among its population. The distress caused by the hostilities may cause a psychological trauma among Ukrainians. [1] According to experts of the World Health Organization, one of the consequences of the military actions taking place in Ukraine is the emergence of mental health problems. [2] This may affect a quarter of the country's population, namely, according to Yarno Gabiht, a representative of the above mentioned organization, the number will approach 10 million. Moreover, mental disorders can be displayed in different ways: starting from manifestations of anxiety and ending with more severe conditions. [2] Talking about "more severe conditions", the concept of post-traumatic stress disorder is meant. The above-mentioned representative of the WHO also pointed to the fact that the number of those applying for the help concerning the described problem after the end of the 10-month period from the beginning of the invasion of Russian troops has increased. [2] WHO experts have developed a number of short-term scalable psychological interventions, one of which is a group stress management course for adults, Self-Help Plus (SH+). SH+ consists of pre-recorded audios and an illustrated “Essential Stress Skills” manual that could be used by participants for individual skill development. [3; 4] This group stress management course for adults offers a range of psychological exercises aimed at mastering stress management skills. The exercises, presented in the form of illustrations and short comments, show equal effectiveness both in conditions of active hostilities and in peaceful communities, among persons who have been diagnosed with or not diagnosed with a mental disorder. Working according to the instructions of the manual, the facilitator (assistant) together with the co-facilitator teach stress management skills to people who have been affected by adverse circumstances. [3; 4] It should be noted that Self-Help Plus is not psychotherapy or psychological counseling, or a substitute for more specialized services. This guideline is evidence-based, requires fewer resources to implement, is short-term and reduces time to provide help, and provides skills that can be useful when access to psychosocial service providers is absent or limited, and those are the essential advantages of this course. Also, one of the key tasks of short-term interventions is the redistribution of the burden between informal organizations, medical workers and experts in the field of mental health. [5] The goal of the work was to help people learn how to cope with stress in adverse life circumstances. Methods. 20 people agreed to participate in the Self-Help Plus course: 16 women and 4 men, aged 24-67. For the experimental study, the questionnaire "Coping strategies of R. Lazarus", the reactive and personal anxiety scale of C. D. Spielberger - Y. L. Khanin (STAI), the Hospital Anxiety and Depression Scale (HADS) and the method of mathematical processing of the criterion by T.Student were used for the experimental study. The results. With the help of R. Lazarus's "Coping strategies" questionnaire, it was found that a significant part of the participants, which is 60%-80%, shows maladaptive behavior, which is expressed through coping strategies: confrontation, distancing and escape. According to the results of the Ch.D. Spielberger-Y.L. Khanin scale of reactive and personal anxiety (STAI), the level of reactive anxiety decreased in the studied group. A repeat survey on the Hospital Anxiety and Depression Scale (HADS) showed signs of reduction in mood disorder to moderate/mild state or no disorder at all. In the course of the study, it was found out that most participants of the Self-Help Plus (SH+) course developed stress management skills. According to the Student's formula, the Student's t-criterion of 2.09 was obtained, which makes the probability of an error-free forecast about 95%.

Family Fellowship Society for Psychosocial Rehabilitation Services (1993-2019): A Self-help Movement.

Family Fellowship Society for Psychosocial Rehabilitation Services is an initiative of families of persons with mental illness and with psychiatric disabilities. It has been advocating self-help movement on the part of the families who have been on the lookout for alternative care services. This venture has been technically supported by the mental health professionals at National Institute of Mental Health and Neurosciences, Bangalore. It is a collaborative effort of families and professionals to address the needs that have been felt by the consumers and the professionals. It is the first of its kind in India. Over a period of 26 years, 150 + families have availed the alternative care for psychosocial rehabilitation services for their wards. In this context, an attempt was made to enlighten the psychosocial rehabilitation services at family fellowship society.

Beliefs, attitudes and experiences of virtual overdose monitoring services from the perspectives of people who use substances in Canada: a qualitative study

BackgroundSolitary use of substances is a risk factor for substance use-related mortality. Novel e-health harm reduction interventions such as virtual overdose monitoring services (VOMS) have emerged in North America to improve access to emergency overdose support for people who use substances (PWUS). To date, little research has been published, and the perspectives of PWUS are needed to inform evaluation and policy efforts.ObjectiveTo explore the beliefs, values and perceptions of PWUS around using and accessing VOMS in Canada.MethodsA qualitative study following grounded theory methodology was conducted. Using existing peer networks, purposive and snowball sampling was conducted to recruit PWUS (≥ 18 years) with previous experience with VOMS. Thematic analysis was used to analyze twenty-three interviews. Several methods were employed to enhance rigor, such as independent data coding and triangulation.ResultsTwenty-three one-on-one telephone interviews of PWUS with previous experience with VOMS were completed and analyzed. The following themes emerged: (1) feelings of optimism around VOMS to save lives; (2) privacy/confidentiality was highly valued due to stigma and fear of arrest; (3) concerns with reliable cell phones negatively impacting VOMS uptake; (4) concerns around emergency response times, specifically in rural/remote communities; (5) desire for trusting relationships with VOMS operators; (6) importance of mental health supports and referrals to psychosocial services; and (7) possible limited uptake due to low public awareness of VOMS.ConclusionThis qualitative study provided novel insights about the VOMS from the perspectives of PWUS. PWUS generally felt optimistic about the potential of VOMS as a suitable harm reduction intervention, but several potential barriers around accessing VOMS were identified that may limit uptake. Future research is warranted.

Social and Psychological Challenges Facing Orphaned Children Living in the Orphanage Centres in Tanzania

The study aimed to assess social and psychological challenges facing orphaned children living in the orphanages in Tanzania. The motivational theory of Abraham Maslow guided this study with the use of the qualitative approach. In-depth interviews were employed to collect data from the research participants. The study was carried out in four orphanage centres within three wards in Dar es Salaam Region. A purposive sampling technique was employed to get 29 participants for this study. Specifically, the study intends to answer the following unexplored questions: i) What are the social challenges facing orphaned children living in the orphanages? ii) What are the psychological challenges facing orphaned children living in the orphanages? The findings revealed that in the orphanages orphaned children experienced various social challenges including shortage of basic needs, shortage of educational materials, and lack of sport gears as well as poor health services. They also faced psychological challenges like physical punishment, bullying behaviours from fellows, segregation, isolation and poor attachment from their caregivers. Such challenges are indicators for defining ineffectiveness of caregivers in providing psychosocial services to orphaned children. The study concluded that in the present context, orphanages are not a good residence for orphans’ psychosocial wellbeing due to shortage of funds and presence of untrained personnel. The study recommended that, the government should formulate interventional policies and enact laws which would look after the welfare of orphaned children rather than depending on the institutional Care.

Climate change and mental health: a call to action to include mental health and psychosocial support services (MHPSS) in the Pakistan flood crisis.

The recent flood crisis in Pakistan has had significant impacts on the physical, mental and socioeconomic fabric of almost 33 million people. Floods in Pakistan are leading to a range of negative impacts on health and major disruptions to healthcare services. The lack of mental health and psychosocial support services (MHPSS) is a significant concern in rural areas of Pakistan in providing support to communities affected by floods. It is important for the government and mental health policymakers to work with academic coalitions and non-governmental organisations to replicate low-resource MHPSS models that will develop and advocate for effective, gender-sensitive mental healthcare throughout the country.

The Impact of the COVID-19 Pandemic on Patients With CKD: Systematic Review of Qualitative Studies

COVID-19 disproportionately affects people with comorbidities, including chronic kidney disease (CKD). We describe the impact of COVID-19 on people with CKD and their caregivers. A systematic review of qualitative studies. Primary studies that reported the experiences and perspectives of adults with CKD and/or caregivers were eligible. MEDLINE, Embase, PsycINFO, CINAHL searched from database inception to October2022. Two authors independently screened the search results. Full texts of potentially relevant studies were assessed for eligibility. Any discrepancies were resolved by discussion with another author. A thematic synthesis was used to analyze the data. Thirty-four studies involving 1,962 participants were included. Four themes were identified: exacerbating vulnerability and distress (looming threat of COVID-19 infection, intensifying isolation, aggravating pressure on families); uncertainty in accessing health care (overwhelmed by disruption of care, confused by lack of reliable information, challenged by adapting to telehealth, skeptical about vaccine efficacy and safety); coping with self-management (waning fitness due to decreasing physical activity, diminishing ability to manage diet, difficulty managing fluid restrictions, minimized burden with telehealth, motivating confidence and autonomy); and strengthening sense of safety and support (protection from lockdown restrictions, increasing trust in care, strengthened family connection). Non-English studies were excluded, and inability to delineate themes based on stage of kidney and treatment modality. Uncertainty in accessing health care during the COVID-19 pandemic exacerbated vulnerability, emotional distress, and burden, and led to reduced capacity to self-manage among patients with CKD and their caregivers. Optimizing telehealth and access to educational and psychosocial support may improve self-management and the quality and effectiveness of care during a pandemic, mitigating potentially catastrophic consequences for people with CKD. During the COVID-19 pandemic, patients with chronic kidney disease (CKD) faced barriers and challenges to accessing care and were at an increased risk of worsened health outcomes. To understand the perspectives about the impact of COVID-19 among patients with CKD and their caregivers, we conducted a systematic review of 34 studies involving 1,962 participants. Our findings demonstrated that uncertainty in accessing care during the COVID-19 pandemic exacerbated the vulnerability, distress, and burden of patients and impaired their abilities for self-management. Optimizing the use of telehealth and providing education and psychosocial services may mitigate the potential consequences for people with CKD during a pandemic.

Predictors of Post-Traumatic Stress Symptoms in Nurses during COVID-19 Pandemic: The Role of Occupational Stressors, Personality Traits, and Availability of Protective Equipment

Purpose: During the coronavirus disease 2019 (COVID-19) pandemic, healthcare professionals were more frequently affected by post-traumatic stress disorder than the general population. The purpose of this historical, prospective study was to determine the influence of occupational stressors and personality traits on the magnitude of post-traumatic stress symptoms in nurses. The secondary objective was to examine the mediating role of protective equipment use on the relationship between exposure to pandemic-related stressors and levels of post-traumatic stress symptoms in nurses. Methods: The study was conducted after the first wave of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic among nurses working at the University Hospital of Split, Croatia. A total of 380 nurses completed the web-based survey. Among them, 217 (57.1%) worked with COVID-19 patients and 163 (42.9%) worked in non-COVID departments. A quantitative, cross-sectional, descriptive, and comparative design was used. Results: Personality traits (introversion, neuroticism, and openness), along with exposure to work stressors (public criticism, workplace hazards and harms, and work conflicts) and direct exposure to work with patients suffering from SARS-CoV-2 infection, may serve as significant risk factors for the development of post-traumatic stress symptoms (p < 0.05). The use of protective equipment did not alter the effect of exposure to pandemic-related stressors on the amount of trauma experienced during the COVID-19 pandemic. Conclusion: Personality characteristics and levels of work stress are the most important predictors of the development of post-traumatic stress symptoms in nurses who worked during the first wave of the COVID-19 pandemic. Healthcare facilities and their leaders need to make more efforts to provide better psychosocial support services for nurses.

Social work interventions to provide adequate psychosocial services in South African schools

Through its constitution, South Africa has declared provision of high-quality education to all citizens is a human right. However, violence, bullying and poverty threaten to impede, if not preclude attainment of this goal. This voice from practice highlights social work interventions that provide psychosocial support to learners to tackle the challenges.

Emotional and behavioral problems of pediatric cancer survivors and their siblings: Concordance of child self-report and parent proxy-report.

Childhood cancer confronts families with major challenges. The study aimed at developing an empirical and multi-perspective understanding of emotional and behavioral problems of cancer survivors diagnosed with leukemia and brain tumors and their siblings. Further, the concordance between child self-report and parent proxy-report was examined. 140 children (72 survivors, 68 siblings) and 309 parents were included in the analysis (respond rate: 34%). Patients, diagnosed with leukemia or brain tumors, and their families were surveyed on average 7.2months after the end of intensive therapy. Outcomes were assessed using the German SDQ. Results were compared with normative samples. Data were analyzed descriptively, and group differences between survivors, siblings, and a norm sample were determined using one-factor ANOVA followed by pairwise comparisons. The concordance between the parents and children was determined by calculating Cohen's kappa coefficient. No differences in the self-report of survivors and their siblings were identified. Both groups reported significantly more emotional problems and more prosocial behavior than the normative sample. Although the interrater reliability between parents and children was mostly significant, low concordances were found for emotional problems, prosocial behavior (survivor/parents), and peer relationship problems (siblings/parents). The findings point out the importance of psychosocial services in regular aftercare. These should not only focus on survivors, but additionally address the siblings' needs. The low concordance between the parents' and the children's perspectives on emotional problems, prosocial behavior, and peer relationship problems suggests the inclusion of both perspectives to allow needs-based support.

Throwback, trials, and triumphs: stories of unmarried retired Filipina Public School teachers

Background: Globally, there is an apparent demographic movement toward an aging population. This poses difficulties, especially for retired public school teachers who are single. Additionally, the researcher, who has spent years offering psychosocial services to clients, is aware of this group's susceptibility to aging-related difficulties that may jeopardize their well-being.
 Methods: A qualitative-phenomenological approach was adopted. In-depth semi-structured interviews were conducted with 6 participants aged 60 to 80, unmarried retired public school teachers. Employing thematic analysis, interview transcripts were analyzed for themes to organize the data.
 Results: Four major themes emerged: (1) Embracing a Positive Emotional State, with Sub-themes (a) Awakening of reality being single for life, (b) Maintaining a smooth interpersonal relationship, (c)Achieving a sense of meaning, (2) Confronting the challenges with Sub-themes (a) Dependency of family members (b)Managing financial needs (c) Coming to terms with death (3) Coping With Life Eventualities with Sub-themes (a) Staying productive (b) Participating in Civic and Religious Organizations (c) Connecting with God (4) Breaking stereotypes about being a spinster teacher and ageism.
 Conclusion: Aging vulnerabilities can particularly challenge those who live without a spouse. However, having a hopeful, positive attitude about the future helps the unmarried remain motivated to cope with life. Ultimately, this will bring the elderly to resiliency and acceptance. Their experiences can add to a growing study in developmental psychology and personality that looks at how life accounts reveal the inherent aspects of lived human experience. The outcome of the past, the wisdom behind the trials, and the success stories of the life of participants were essential for understanding the strategies they use to manage age and aging-related challenges and age successfully.
 Limitations of the findings: The scope was limited to Northern Negros area while the number of participants in this study was within the acceptable range of six (6). The participants were all female and all were teachers from the public school system. Thus, the findings are not conclusive, and this limitation made it difficult to explore their experiences within the broader context of their lives.
 Direction for Future Research: Future research can be built upon the results that were acquired in this study. Further research could also be done on effective preventative and therapeutic strategies for elderly single people. It is advised to conduct additional research using more extensive samples of this demographic that is to include single male retired public and private school teachers. A longitudinal study might provide a more comprehensive and in-depth view of aging and spinsterhood. Examining the extended family's perspectives, other professions, and the larger population is an aspect that could help broaden and deepen the understanding of the experiences of single and retired teachers.
 Practical Value of the Paper: The findings will serve as baseline data for improving interventions and programs of DepEd and OSCA, which must concentrate on offering practical assistance, like psychosocial services and a solution for social acceptance, to eradicate stigma. Mental health professionals must have knowledge and guidance on how to facilitate the well-being of the elderly and enhance their quality of life as they age.

“I literally had no support”: barriers and facilitators to supporting the psychosocial wellbeing of young people with mental illness in Tasmania, Australia

BackgroundThere has been limited focus on understanding the barriers and facilitators to meeting the broader psychosocial needs of young people with mental illness from the perspectives of young people. This is required to advance the local evidence base and inform service design and development. The aim of this qualitative study was to explore young people’s (10–25 years) and carers’ experiences of mental health services, focusing on barriers and facilitators to services supporting young people’s psychosocial functioning.MethodsThis study was conducted throughout 2022 in Tasmania, Australia. Young people with lived experience of mental illness were involved in all stages of this research. Semi-structured interviews were conducted with 32 young people aged 10–25 years with experience of mental illness, and 29 carers (n = 12 parent–child dyads). Qualitative analysis was guided by the Social-Ecological Framework to identify barriers and facilitators at the individual (young person/carer level), interpersonal, and service/systemic level.ResultsYoung people and carers identified eight barriers and six facilitators across the various levels of the Social-Ecological Framework. Barriers included, at the individual level: (1) the complexity of young people’s psychosocial needs and (2) lack of awareness/knowledge of services available; at the interpersonal level: (3) negative experiences with adults and (4) fragmented communication between services and family; and at the systemic level: (5) lack of services; (6) long waiting periods; (7) limited service accessibility; and (8) the missing middle. Facilitators included, at the individual level: (1) education for carers; at the interpersonal level: (2) positive therapeutic relationships and (3) carer advocacy/support; and at the systemic level: (4) flexible or responsive services, (5) services that address the psychosocial factors; and (6) safe service environments.ConclusionsThis study identified key barriers and facilitators to accessing and utilising mental health services that may inform service design, development, policy and practice. To enhance their psychosocial functioning, young people and carers want lived-experience workers to provide practical wrap-around support, and mental health services that integrate health and social care, and are flexible, responsive and safe. These findings will inform the co-design of a community-based psychosocial service to support young people experiencing severe mental illness.

Implementing a psychosocial care approach in pediatric inpatient care: process evaluation of the pilot Child Life Specialist program at the University Hospital of Munich, Germany.

Child Life Specialists (CLSs) are psychosocial care professionals of child development and health who focus on the individual needs and rights of young patients. CLSs accompany sick children and focus on the children's perspective and their reality of life. CLS programs are already established in clinical settings in the United States and other Anglophone countries but have not yet been piloted in the German health care setting, neither has their implementation been evaluated in this context. This study aimed to explore the factors influencing the implementation of a pilot CLS program in pediatric inpatient care at the Dr. von Hauner Children's Hospital at the University Hospital of Munich, Germany. Building on methods commonly employed in the evaluation of complex interventions, we developed a logic model to guide the process evaluation of our program. Semi-structured interviews with four groups of stakeholders were conducted in person or via videoconferencing between June 2021 and January 2022. Data was analyzed collectively using the method of qualitative content analysis by Mayring. Fifteen individual interviews were conducted with patients (children aged 5-17 years, n = 4), parents (n = 4), CLSs (n = 4) and other health professionals (n = 3). Factors influencing the implementation were identified on three levels: system, staff and intervention. On the system level, a clearer definition of CLSs' tasks and responsibilities was perceived as important and would likely lead to a delineation from other (psychosocial) professions and a reduction of potential resistances. On the staff level, lacking training opportunities and feelings of being insufficiently skilled were limiting the CLSs professional self-confidence. On the intervention level, the emergence of a unique characteristic of the CLSs' work (i.e., preparation for medical procedures) supported the acceptance of the new program. The implementation of a CLS program into an established hospital system with existing psychosocial care services is challenging. Our results contribute to a better understanding of implementation processes of such an additional psychosocial care approach and provide recommendations for addressing upcoming challenges.

Analysis of data items and gaps in Australia's national mental health services activity and capacity data collections for integrated regional service planning.

Background: Services data are an important source of information for policymakers and planners. In Australia, significant work has been undertaken to develop and implement collections of mental health services data. Given this level of investment, it is important that collected data are fit for purpose. Objective: This study aimed to: (1) identify existing national mandated and best endeavours collections of mental health services activity (e.g. occasions of service) and capacity (e.g. full-time equivalent staff) data in Australia; and (2) review the content of identified data collections to determine opportunities for data development. Method: A grey literature search was conducted to identify data collections. Where available, metadata and/or data were analysed. Results: Twenty data collections were identified. For services that received funding via multiple funding streams, data were often captured across several collections corresponding with each funder. There was significant variability in the content and format of collections. Unlike other service sectors, there is no national, mandated collection for psychosocial support services. Some collections have limited utility as they do not include key activity data; others do not include descriptive variables like service type. Workforce data are often not collected, and where data are collected, they are often not comprehensive. Conclusion: Findings are an important source of information for policymakers and planners who use services data to inform priorities. Implications: This study provides recommendations for data development, including mandating standardised reporting for psychosocial supports, filling workforce data gaps, streamlining data collections and including key missing data items in some collections.

Predicting which cancer patients will see a psychiatrist or counsellor from their initial oncology consultation document using natural language processing.

e13544 Background: Patients with cancer often have unmet psychosocial needs. Early detection of who might require referral to a counsellor or psychiatrist may help improve their care. In this work, we investigated whether natural language processing (NLP) can predict which patients will see a counsellor or psychiatrist from a patient’s initial oncologist consultation document. NLP is the branch of artificial intelligence that uses language models to accomplish tasks using written text. A different application of NLP has recently been popularized through the ChatGPT online question-answering system. In this work, we used traditional and neural language models to predict whether patients will see a psychiatrist or counsellor based on their initial oncologist consultation document. Methods: This retrospective prognostic study used data from 47,625 of 59,800 patients who received initial cancer care at any of the 6 BC Cancer sites located in the province of British Columbia between April 1, 2011 and December 31, 2016. We excluded patients with multiple cancer diagnoses, or those that did not see a medical or radiation oncologist within 180 days of their cancer diagnosis. We trained neural language models to predict which patients would see a psychiatrist or counsellor in the twelve months following their initial oncologist consultation. We used the non-neural language model bag-of-words, as well as three neural models: convolutional neural networks (CNN), long-short term memory, and bidirectional encoder representations from transformers. Results: The models performed similar to or better than previous applications of artificial intelligence in predicting psychosocial needs. Our best-performing models, utilizing CNNs, achieved a balanced accuracy above 75% and a receiver-operator area-under-curve (AUC) above 0.80 when predicting which patients would see a psychiatrist. Performance was lower for predicting which patients would see a counsellor, with balanced accuracy and AUC exceeding 70% and 0.75, respectively. We examined what words or phrases our models used to make the predictions, finding symptom burden, certain cancers, and family history of cancer were positive predictors of future referral to psychosocial services. Conclusions: Our results suggest NLP can be used to predict which cancer patients require referral to a psychiatrist or counsellor from their initial oncologist consultation. Future research may be able to extend our work to predict other needs of cancer patients such as palliative care, or other cancer outcomes more generally.

Adaptation under strain: an ethnographic process evaluation of community-based psychosocial support services for refugee claimants during the height of the COVID-19 pandemic in Montreal, Canada.

During the first 2 years of the COVID-19 pandemic in Canada, tens of thousands of refugee claimants faced worsened resettlement stress with limited access to services. Community-based programs that address social determinants of health faced significant disruptions and barriers to providing care as a result of public health restrictions. Little is known about how and if these programs managed to function under these circumstances. This qualitative study aims to understand how community-based organizations based in Montreal, Canada, responded to public health directives and the challenges and opportunities that arose as they attempted to deliver services to asylum seekers during the COVID-19 pandemic. We used an ethnographic ecosocial framework generating data through in-depth semi-structured interviews with nine service providers from seven different community organizations and 13 refugee claimants who were purposively sampled, as well as participant observation during program activities. Results show that organizations struggled to serve families due to public health regulations that limited in-person services and elicited anxiety about putting families at risk. First, we found a central trend in service delivery that was the transition from in-person services to online, which presented specific challenges including (a) technological and material barriers, (b) threats to claimants' sense of privacy and security, (c) meeting linguistic diversity needs, and (d) disengagement from online activities. At the same time, opportunities of online service delivery were identified. Second, we learned that organizations adapted to public health regulations by pivoting and expanding their services as well as fostering and navigating new partnerships and collaborations. These innovations not only demonstrated the resilience of community-organizations, but also revealed tensions and areas of vulnerability. This study contributes to a better understanding of the limits of online service delivery for this population and also captures the agility and limits of community-based programs in the COVID-19 context. Its results can inform decision-makers, community groups and care providers to develop improved policies and program models that preserve what are clearly essential services for refugee claimants.

Family-centered pediatric psychosocial care in Qatar

Pediatric psychosocial care approaches are used to advocate for family and child strength and durability in health scenarios and to improve the overall well-being of children impacted by severe medical situations. This article focuses on family-focused care in pediatric psychosocial services in Qatar. Using secondary sources, this desk review advocates for a family-centered care approach to support hospitalized children, their families, and the healthcare provision team in pediatric psychosocial care. It argues that if improvements are made to four main areas including education and training, healthcare environment, financial support and advocacy, and future research and audits, Qatar’s pediatric psychosocial care program would more effectively cater to evidence-based child and family-friendly approaches. This article concludes by providing policy recommendations for Qatar’s pediatric psychosocial care provision.

Separate units for incarcerated people who committed sexual offenses: luxury or necessity?

The policy on treatment of people who commit sexual offenses (PSOs) varies greatly across countries, creating different treatment environments. This study was conducted in Flanders (i.e., the Dutch-speaking part of Belgium) where PSOs receive their treatment in the community. Before this transfer takes place, many PSOs spend time inside prison together with other offenders. This raises the question to what extent PSOs are safe in prison and whether this period would benefit from an integrated therapeutic program. This qualitative research study focuses on the possibility of separate housing for PSOs by examining the current experiences of incarcerated PSOs and contextualizing those with the professional experience of national and international experts in the field. Between 1 April 2021 and 31 March 2022, 22 semi-structured interviews and six focus groups took place. Participants were comprised of 9 imprisoned PSOs, 7 international experts on prison-based PSO treatment, 6 prison officer supervisors, 2 prison management delegates, 21 healthcare workers (both inside and outside prison), 6 prison policy coordinators, and 10 psychosocial service staff members. Nearly all interviewed PSOs reported suffering at the hands of fellow inmates or prison staff because of the nature of their offenses, varying from exclusion and bullying to physical violence. These experiences were corroborated by the Flemish professionals. Consistent with scientific research, the international experts all reported working with incarcerated PSOs who reside in living units separate from other offenders and the therapeutic benefits to this approach. Despite this growing evidence, the Flemish professionals remained reluctant to implement separate living units for PSOs in prisons because of the perceived risk of increased cognitive distortions and further isolation of this already stigmatized group. The Belgian prison system is not currently organized to create separate living units for PSOs, which has important ramifications for the safety and therapeutic opportunities of these vulnerable prisoners. International experts emphasize a clear benefit for introducing separate living units where a therapeutic environment can be created. Although this would have significant organizational and policy-oriented implications, it would be useful to explore whether these practices could be implemented in Belgian prisons as well.

Validation of the Psychosocial Assessment Tool Sibling Module Follow-Up Version.

Psychosocial screening is recommended to connect siblings of youth with cancer to psychosocial services, but the lack of validated sibling-specific screening tools is a barrier to routine screening. The current study aimed to validate and establish a clinical cutoff for the recently developed Psychosocial Assessment Tool (PAT) Sibling Module follow-up version to address this barrier. Parents (N = 246) completed the PAT Sibling Module follow-up version for all siblings within their families ages 0-17years (N = 458) at three time points between 6- and 24-month post-cancer diagnosis. For one target sibling within each family aged 8-17 years, parents also completed the Strengths and Difficulties Questionnaire, and the target sibling completed the Child PTSD Symptom Scale. Cross-sectional and longitudinal analyses examined internal consistency and convergent and predictive validity. Receiver operator characteristic analyses were used to establish a maximally sensitive and specific clinical cutoff. Internal consistency was acceptable for all age versions (Kuder-Richardson 20s ≥ 0.79), except for the ages 0-2 version, which had low internal consistency at 18 months post-diagnosis (Kuder-Richardson 20 = 0.57). Convergent (r values >0.7, p values <.001) and predictive (r values >0.6, p values <.001) validity were strong at each time point. An optimal clinical cutoff of 0.32 was identified (range: 0.00-1.00). The PAT Sibling Module follow-up version is a reliable and valid screener for sibling psychosocial risk following cancer diagnosis. Validation of a sibling-specific screener and establishment of a clinical cutoff are necessary first steps to addressing siblings' unmet psychosocial needs and improving trajectories of sibling functioning.