Psychosocial Support For Children Research Articles

Psychological Effects of Armed Conflicts on Children

Armed conflicts have caused extreme social crises worldwide, where children represent the most vulnerable group, often experiencing severe trauma and violence in war zones. Globally, one in four children lives in a country affected by armed conflicts, natural disasters, or epidemics. This study aims to provide an overview of research on the psychological impact of armed conflicts on children, including the types of mental disorders that result after war trauma and interventions to minimize psychological damage after exposure to war and conflict. The research was based on a systematic review of the literature, using the Elsevier, Google Scholar, and PubMed databases. Key terms used in the research include: war and mental health or armed conflict, children or refugees and trauma or exposure to war trauma; and post-traumatic stress disorder. Children’s continued exposure to war trauma is associated with mental health problems including post-traumatic stress disorder (PTSD), depression, suicidal thoughts or behaviors, dissociative disorders, depersonalization, derealization, numbing, catatonia, and behavior disorders, especially aggression and violent criminal behavior. Based on the studies used, the results show that the crises caused in children by wars has significant effects on mental health, such as anxiety, depression, post-traumatic stress, sleep disorders, and suicidal thoughts. The cited studies recommend increasing human resources for the identification, diagnosis, rehabilitation, and psychosocial support of children who are evacuated from war zones to other countries.

Pashe Achhi: A Low-Tech Model of Learning and Psychosocial Support for Children and Caregivers

ABSTRACT Pashe Achhi is a telecommunication model that emerged out of the COVID-19 pandemic in Bangladesh to provide support to 0- to 5-year-old children and their caregivers through mobile-to-mobile phone calls. It is a caregiver-child facing and/or only caregiver focused, low-resource, low-tech model that constitutes a 20-minute phone call. The phone calls include a 10-minute psychosocial support segment to caregivers and a 10-minute stimulation segment to their children through play. After the initial intervention period during the pandemic, this model has been tested further and evaluated based on two modalities: 5-month and 9-month interventions. An experimental study design using randomized assignment of the treatment and comparison group was used for this evaluation. The improvement in cognitive development scores among children has been found to be higher after 5 months than after 9 months of intervention. The model has implications for further research as an early childhood development (ECD) solution during crisis situations and ECD access to children of ultra-poor households.

Mental health and psychosocial support for children with upper limb musculoskeletal conditions.

This study describes mental health and psychosocial screening processes, access to care and interventions provided to children with upper limb musculoskeletal conditions. A cross-sectional e-survey study was conducted of 107 healthcare professionals who work with children with congenital hand and upper limb differences and brachial plexus birth injuries. Of them, 41 (38%) reported that they routinely screen for mental health and psychosocial concerns. Few (12%) reported the use of standardized outcome measures. In total, 51 (48%) healthcare professionals reported that there was a waiting list for mental health services at their institution. Collectively, healthcare professionals were unsatisfied with the staffing, access to care and types of interventions available. Reported barriers to care included the growing need for mental health support, lack of resources and poor continuity of care after referrals. Future research should focus on identifying and validating a mental health screening tool and investigating the processes affecting access to mental health care.Level of evidence: IV.

Legal guarantees for ensuring and protecting the right of a child to mental health in times of war

The article is devoted to the study of the problems of ensuring the child's right to health, namely the right to mental health in the conditions of war. Children are one of the least protected groups of the population and the most vulnerable in times of war. Customary international humanitarian law guarantees that children affected by armed conflict are entitled to special respect and protection among the various categories of persons under special protection.
 Mental health is an integral determinant of a child's overall health. The challenges to mental health and psychological well-being and development of children caused by the full-scale war have also affected the realisation of the right to health. Based on the analysis of special legal and psychological studies, the author reveals general approaches to the analysis of the essence and content of mental health as an integral part of the child's overall health. The basic scientific and theoretical concepts of using the concepts of "health", "mental health", "mental well-being" are considered. The terminology "mental health" / "psychological health", "mental well-being" / "psychological well-being" is studied and differentiated. The author argues that the use of the term "psychological health" is erroneous when interpreting the content of the concept of "health", identifying it with the related concept of "mental health". The multidisciplinary, complex nature of the phenomena under study is emphasised. The multidisciplinary, complex nature of the phenomena under study is emphasised. The author's definitions of the categories "mental health" and "child's mental health" as an object of law are proposed.
 The article provides a general theoretical overview of a child's personal non-property right to health and examines the main concepts of rationality of using the concepts of "right to health" and "right to healthcare". Particular attention is paid to the study of international legal and national acts that guarantee the rights related to such intangible good as child health, including mental health. The author analyses the norms of international humanitarian law containing guarantees for the realisation of the child's right to health in time of war, according to which children in the zone of hostilities and armed conflicts, as well as those children who have suffered as a result of hostilities, should be protected.
 The author comments on the normative definition of the concept of "child affected by hostilities and armed conflicts" in terms of its compliance with modern realities and formulates proposals for improving the legislation in the field of research, which will contribute to the improvement of child mental health protection and the development of the Ukrainian system of psychological assistance and psychosocial support for children. The elements of the legal mechanism for the implementation, protection and defence of the child's right to mental health should include prevention; timely identification of children in need of psychological assistance; and provision of a wide range of psychological services. Educational institutions should play a primary role in ensuring the child's right to mental health.

Brief Report: Family Accommodation is Associated with the Impact of Childhood Anxiety in Autism.

Anxiety is commonly experienced by children on the autism spectrum, and can negatively impact their lives. Family accommodation has been linked to the impact of anxiety on the child's life in non-autistic children. This study tested whether the same relationship holds for children on the autism spectrum. A community sample (n = 118) of parents of children on the spectrum completed questionnaires on their child's autism characteristics and severity and impact of their child's anxiety, their own anxiety and family accommodation behaviours. Family accommodation was associated with the impact of child anxiety, over and above anxiety severity of the child and parent. Findings support the involvement of parents in psychosocial support for children on the autism spectrum experiencing anxiety.

Delivering Hospital-Based Pediatric Palliative Care: The Symptoms, Interventions, and Outcomes for Children With Cancer in Bangladesh.

PURPOSEThe majority of pediatric cancer deaths occur in low- and middle-income countries (LMICs). Pediatric palliative care (PPC) focuses on relieving physical, psychosocial, and spiritual suffering throughout the continuum of cancer care and is considered integral to cancer care for children in all settings. There is limited evidence from LMICs about the characteristics, symptoms, and outcomes of children with cancer who receive PPC, which is needed to define the global need and guide the development of these services.METHODSThis retrospective review of clinical records of children who received PPC was conducted during a pilot project (January 2014-August 2015) that implemented a PPC team at a tertiary hospital in Dhaka, Bangladesh. Clinical data on diagnosis, symptoms, treatment status, deaths, and key palliative care interventions were collected and analyzed using descriptive statistics.RESULTSThere were 200 children who received PPC during the pilot project. The most common diagnoses were acute lymphoblastic leukemia (62%) and acute myeloid leukemia (11%). Psychosocial support for children (n = 305; 53%) and management of physical symptoms (n = 181; 31%) were the most common types of interventions provided. The most frequently recorded symptoms were pain (n = 60; 30%), skin wounds (n = 16; 8%), and weakness (n = 9; 5%). The most common medications prescribed were morphine (n = 32) and paracetamol (n = 21).CONCLUSIONA hospital-based PPC service addresses pain and symptom concerns as well as psychosocial needs for children with cancer and their families in a setting where resources are limited. Health care facilities should incorporate palliative care into the care of children with cancer to address the needs of children and their families.

The Development of Child Life Services and the Child Life Services Model in Taiwan

Child life services is a professional service that supports children and adolescents seeking medical treatment. These services provide age-appropriate medical understandings and psychological preparation, coping skills, and psychosocial support for children with the goal of reducing fear, anxiety, and psychological trauma during healthcare provision. In addition to supporting young patients, child life services also support family members and caregivers, facilitating their effective response to related disease and medical situations. Child life specialists are experts in providing child life services. This article reviews the historical development of child life services, including its development and theory, related professional training and education, and the application and intervention goals of child life services in medical care. Finally, the establishment and developmental model of promoting child life services in Taiwan are reviewed with the goal of providing information for the promotion and utilization of child life services by healthcare professionals in practice settings.

Improving the diagnostics of the impact of domestic violence in children with the use of semi-structured interview

The authors propose a semi-structured interview to identify the effects of domestic violence in children. The interview includes a list of questions aimed at identifying possible cases of domestic violence, signs of emotional problems, impaired behavior and attention, preneurotic, autonomic and somatic disorders, typical situations of their occurrence in children, as well as family and interpersonal contexts. Observing behaviors and non-verbal manifestations during the interview that accompanies the respondent's answers allow us to identify not only the clear signs of the problem, but also to recognize the hidden, non-verbal manifestations to better understand the nature of the problem in children. Quantitative and qualitative analysis confirmed the diagnostic value of the proposed interview. The group of children affected by domestic violence found a much higher prevalence of emotional problems (depression, anxiety, emotional lability, heightened emotional sensitivity), behavioral disorders (aggressiveness, passivity, excessive obedience), sleep disorders and fears, vegetodistonic and somatic problems. Children were significantly more likely to show signs of psycho-physiological arousal (tears, tremors, agitation, paleness of palms, sudden paleness of redness, etc.) during the interview, indicating high emotional tension and sensitivity to topics related to the situation in the family in general and domestic violence in particular. Revealing the effects of psychological trauma through interviewing is an important task and competence of psychiatrists, psychologists and social workers during medical and psychological examination, as well as the psychosocial support of children affected by domestic violence.

Emerging Challenges in Psychosocial Support for Children and their Families in Ethiopia: Implications for Social Work

Ethiopia is in an early phase of development of formal psychosocial support for children and families. Examining the historical, political and economic factors affecting the current landscape of social work services in Ethiopia show that there are a number of factors influencing risks and vulnerabilities of children and families. Each of these vulnerabilities will be discussed briefly as they relate to the methods of service being provided currently. In addition, this paper reviews the current status of service providers, the gaps in the provision of services, and considers recommendations for the profession of social work seeking to meet these needs to ensure the protection of human rights for women and their children.

Psychosocial Support for Children Orphaned by HIV/AIDS in Zimbabwe

Healthy psychosocial development during childhood is a key determinant to the future well-being of all individuals. In many areas of Africa, demand for psychosocial support continues to grow in response to the increasing number of children left orphaned as a result of the HIV/AIDS pandemic. These orphans face various challenges and yet, in most cases, they lack access to basic psychological provisions necessary for their continued survival and mental well-being. This article examines the psychosocial support provisions needed by orphans to ensure positive outcomes.

Integrative approach to the construction of psychosocial rehabilitation of mental and behaviour disorders in children moved out of “Anti-Terrorist Operation” zone

IntroductionThe problem of children's mental health in Ukraine – it is one of the most pressing problems in the country's health. This is due to the increasing number of extreme situations (military operations in the territory of Ukraine) for the last time that calls for the training of specialists capable of carrying out psychosocial rehabilitation to victims of “anti-terrorist operation”(ATO).ObjectivesThe mental and behaviour disorders in children affected of ATO. We studied 261 families: 107 adults and 154 children. The aim of the project was to optimize the provision of psycho-social support for children and adolescents with problems of the psychic sphere by developing a system of psychological adjustment and social education at the Centre for psychosocial rehabilitation of children, as well as the creation of the necessary conditions that expand the comfort and a safe space for the child to enhance positive impacts and mitigate negative impacts of the social environment.MethodsThe leading role was played by a combination of two areas of work, namely the psychocorrection (trainings, art-, individual-, family-, hyppo-therapy) and social work.ResultsIn 85.4% of the children showed stabilization of mental and emotional state, reducing aggression, increasing motivation to social activity. In 56.3% of families – reducing conflict relations.ConclusionsThe non-standard way of psycho-correction allowed organizing a fruitful and creative leisure, which resulted in the reduction of aggression and anxiety, increased motivation for the successful development of new activities and problem-solving skills and conflict situations with peers and family members.Disclosure of interestThe authors have not supplied their declaration of competing interest.

HỖ TRỢ TÂM LÍ XÃ HỘI CHO TRẺ SAU THIÊN TAI THẢM HỌA: THIẾT KẾ NỘI DUNG VÀ ĐÁNH GIÁ HIỆU QUẢ CHƯƠNG TRÌNH TẬP HUẤN NÂNG CAO NĂNG LỰC CHO CÁC NHÀ TÂM LÍ, GIÁO DỤC VÀ NHÂN VIÊN CÔNG TÁC XÃ HỘI

HỖ TRỢ TÂM LÍ XÃ HỘI CHO TRẺ SAU THIÊN TAI THẢM HỌA: THIẾT KẾ NỘI DUNG VÀ ĐÁNH GIÁ HIỆU QUẢ CHƯƠNG TRÌNH TẬP HUẤN NÂNG CAO NĂNG LỰC CHO CÁC NHÀ TÂM LÍ, GIÁO DỤC VÀ NHÂN VIÊN CÔNG TÁC XÃ HỘI

Mental health and psychosocial support for children in areas of armed conflict: call for a systems approach.

This paper focuses on the question of whether separate attention to children who have faced specific conflict-related events is justified, or whether the scarce resources for mental health should be spent on the development of services for children more broadly in low- and middle-income countries (where most contemporary armed conflicts are taking place). It is argued that a systems approach to mental health and psychosocial support for children is warranted.

Psychosocial Rehabilitation of Adolescents with Deviant Behavior

Currently the problem of aid and compensation for children and adolescents with deviant behavior (DB) is one-sided. All obligations under this psychocorrection contingent assigned to the law enforcement agencies. As a pilot project was established program of psychosocial rehabilitation of adolescents with DB on the basis of «Ecopark». The project involved 118 adolescents from 12 to 14 years with a variety of behavioral problems. The aim of the project was to optimize the provision of psycho-social support for children and adolescents with behavioral problems by developing a system of psychological adjustment and social education at the Centre for psychosocial rehabilitation of children and adolescents as well as the creation of the necessary conditions that expand the comfort and a safe space for the child to enhance positive impacts and mitigate negative impacts of the social environment. The leading role was played by a combination of two areas of work, namely the psychocorrection (correctional educational training, individual therapy, family therapy, animal-assisted therapy) and social work (pet care, occupational therapy, ecotherapy). The high efficacy of 85,6% DB adolescents was shown the stabilization of mental and emotional state, reducing aggression, increasing motivation to work, reducing conflict relations, the 5,7% – with middle rouge, the 5,9% – with low rouge. The non-standard way of psycho-correction allowed organizing a fruitful and creative leisure, which resulted in the reduction of aggression and anxiety, increased motivation for the successful development of new activities and problem-solving skills and conflict situations with peers and family members.

Commentary: A social environment approach to promotive and protective practice in childhood resilience--reflections on Ungar (2014).

The field of mental health and psychosocial support for children in humanitarian emergencies has been evolving rapidly. A decade ago, researchers and practitioners frequently took a deficits approach that emphasized problems such as trauma, particularly post-traumatic stress disorder (PTSD), in zones of armed conflict. Assessments focused on PTSD and typically led to the provision of curative responses such as Western psychotherapies as the first response for the affected population. Practitioners expressed diverse concerns about this approach, including its narrow, medicalized definition of the problem (mental disorder), the unsustainability of the programs it generated, the relative inattention to the context, the privileging of individual over systemic approaches, and the lack of cultural sensitivity. For these and other reasons, humanitarian practitioners have increasingly favored a resilience approach that features the agency of children, families, and communities and seeks to build upon existing assets or strengths. Already there is evidence of the effectiveness of numerous interventions that embody a resilience approach. Yet resilience approaches have been limited by a lack of conceptual clarity and ongoing questions about how to assess and measure it. In this context, Michael Ungar's Practitioner Review is an important contribution to practice.

Psychosocial support for children in the Republic of South Sudan

This paper describes an exploratory outcome evaluation ofWar Child Holland’s psychosocial support intervention I DEAL, a life skills intervention aimed at improving the ability of children and young people aiected by armed con£ict in the Republic of South Sudan to ‘deal’ with their daily lives. The speci¢c objectives were to assess whether I DEAL is consistent with local perceptions of wellbeing, and to explore the outcomes, as well as the factors that in£uence outcomes of this intervention. The research was conducted using mixed methods, with a focus on qualitative and participatory methods: group exercises, individual goal setting (N1⁄4110)and interviews(N1⁄4 62).Totriangulate ¢ndings from children, interviews were held with teachers (N1⁄4 7), facilitators (N1⁄4 5), and parents (N1⁄411). It was found that the content of the intervention was consistent with children’s perceptions of wellbeing. Speci¢c outcomes that were reported by children and con¢rmed by facilitators, teachers and parents included decreased ¢ghting and improved relationshipswithpeers andparents. Findings suggest that I DEAL positively aiect children’s social coping skills and has the potential to improve children’s emotional coping skills and classroom performance.

Health-related quality of life in children with disorders of sex development (DSD)

Disorders of sex development (DSD) are rare genetic conditions resulting in atypical development of the sex organs. While some evidence is available on psychosexual outcomes, much less is known about the quality of life in this population, especially in children. Health-related quality of life (HRQOL) is a widely accepted endpoint for assessment and evaluation of interventions and medical care. Within the German DSD Network study, 86 children aged 8-12 years with several subtypes of DSD were recruited from Germany, Austria and Switzerland. Demographic, medical and psychosocial variables were collected through interviews of the attending physicians, the children and the parents. HRQOL was the primary outcome. It was assessed by the KINDL-R Questionnaire [2001]. Psychosexual determinants included gender identity/gender dysphoria, gender role behaviour, the child's knowledge about the condition and number/timing of genital surgery. A significant reduction of HRQOL was reported in children's self-report (p < 0.001), in particular in the area of self-esteem (p < 0.001), physical well-being (p < 0.01) and school functioning (p < 0.05). Girls with congenital adrenal hyperplasia who experienced gender dysphoria reported lower HRQOL scores compared to the study group at large. Atypical gender role behaviour was not associated with HRQOL. Psychosocial support of children with DSD and their families appears to be necessary in at least some cases and must be accessible for all patients.

Psychosocial support for children and families requiring renal replacement therapy

Chronic kidney disease (CKD) and the need for renal replacement therapy (RRT) can place a great strain on the child and family. As well as the medical and nutritional prescription, each child and family requires an individual psychosocial prescription that requires input from multiprofessional team members. The information needs of each child and family need to be constantly evaluated as well as the choice of therapy in relation to social, psychological and economic factors. Many tertiary units lack adequate "time" to deliver such assessments and coordinate the support and respite care for those on long-term dialysis, especially when significant numbers of children are now accepted onto RRT programmes with co-morbidities. National and international standards are needed for the staffing of comprehensive tertiary paediatric renal units as well as studies evaluating supportive care to families.

Community adherence support improves programme retention in children on antiretroviral treatment: a multicentre cohort study in South Africa

BackgroundHIV-positive children in low-income settings face many challenges to adherence to antiretroviral treatment (ART) and have increased mortality on treatment compared to children in developed countries. Adult ART programmes have demonstrated benefit from community support to improve treatment outcomes; however, there are no empirical data on the effectiveness of this intervention in children. This study compared clinical, virological and immunological outcomes between children who received and who did not receive community-based adherence support from patient advocates (PAs) in four South African provinces.MethodsA multicentre cohort study of ART-naïve children was conducted at 47 public ART facilities. Outcome measures were mortality, patient retention, virological suppression and CD4 percentage changes on ART. PAs are lay community health workers who provide adherence and psychosocial support for children's caregivers, and they undertake home visits to ascertain household challenges potentially impacting on adherence in the child. Corrected mortality estimates were calculated, correcting for deaths amongst those lost to follow-up (LTFU) using probability-weighted Kaplan-Meier and Cox functions.ResultsThree thousand five hundred and sixty three children were included with a median baseline age of 6.3 years and a median baseline CD4 cell percentage of 12.0%. PA-supported children numbered 323 (9.1%). Baseline clinical status variables were equivalent between the two groups. Amongst children LTFU, 38.7% were known to have died. Patient retention after 3 years of ART was 91.5% (95% CI: 86.8% to 94.7%) vs. 85.6% (95% CI: 83.3% to 87.6%) amongst children with and without PAs, respectively (p =0.027). Amongst children aged below 2 years at baseline, retention after 3 years was 92.2% (95% CI: 76.7% to 97.6%) vs. 74.2% (95% CI: 65.4% to 81.0%) in children with and without PAs, respectively (p=0.053). Corrected mortality after 3 years of ART was 3.7% (95% CI: 1.9% to 7.4%) vs. 8.0% (95% CI: 6.5% to 9.8%) amongst children with and without PAs, respectively (p=0.060). In multivariable analyses, children with PAs had reduced probabilities of both attrition and mortality, adjusted hazard ratio (AHR) 0.57 (95% CI: 0.35 to 0.94) and 0.39 (95% CI: 0.15 to 1.04), respectively.ConclusionCommunity-based adherence support is an effective way to improve patient retention amongst children on ART. Expanded implementation of this intervention should be considered in order to reach ART programmatic goals in low-income settings as more children access treatment.

Barriers to and facilitators of adherence to pediatric antiretroviral therapy in a sub-Saharan setting: insights from a qualitative study.

Despite the need for HIV-positive children to adhere effectively to antiretroviral treatment (ART), a guiding theory for pediatric ART in resource-limited settings is still missing. Understanding factors that influence pediatric ART adherence is critical to developing adequate strategies. In-depth qualitative interviews were undertaken in Kinshasa, Democratic Republic of the Congo, with 20 sets of HIV disclosed and nondisclosed children along with respective caregivers to better characterize barriers, facilitators, and adherence experiences in children taking ART. Commonly cited barriers included lack of food or nutritional support, lack of assistance or supervision for children, lack of assistance for caregivers, and being unable to remember to take medicines on a consistent basis. Facilitators included having a strong caregiver-child relationship and support system along with strategies for maintaining adherence. Similar themes arose within the child-caregiver sets, but were often characterized differently between the two. Children who were aware of their HIV status displayed fewer instances of frustration and conflict concerning taking medicines and within the child-caregiver relationship. Continued study on pediatric ART adherence should account for differing perspectives of children and caregivers, as well as between status disclosed and nondisclosed children. Areas of future intervention should focus on child-caregiver relationships, disclosure of HIV status, and available nutritional and psychosocial support for children and their caregivers.