abstract: There are significant and wide-ranging health benefits of physical activity, yet the majority of adolescents in the United States do not engage in the recommended amount. This poses a significant public health challenge. Parents have a substantial influence on adolescents' levels of activity, indicating that parenting may be an especially salient target of interventions designed to promote physical activity. The current study tested the hypothesis that a family intervention to promote effective parenting would have a positive collateral effect on adolescent physical activity. This study also tested whether the increase in activity was mediated by changes in parental monitoring and family relationship quality. Furthermore, the current study assessed whether adolescent gender moderated the relationship between parental monitoring and physical activity, such that increased parental monitoring predicted increases in physical activity for girls, but not for boys. Participants were 232 adolescents at risk for behavior problems drawn from a larger randomized controlled trial of the Family Check-Up. Adolescents completed questionnaires and participated in a family assessment with their caregivers in the 6th through 9th grades. Youth randomized to the intervention reported significantly more physical activity at follow-up relative to controls. Results failed to confirm the role of family factors as mediators of the effect of the intervention on physical activity. When gender was considered as a moderator, it appeared that parental monitoring was strongly and positively correlated with physical activity for girls, but not for boys. While the mechanism by which the Family Check-Up leads to increased physical activity remains unclear, its robust effects suggest that family intervention can be used to promote physical activity and might therefore have further-reaching health benefits. / Dissertation/Thesis / Masters Thesis Psychology 2015

Schizophrenia is a severe and chronic disorder in many cases. The illness can impact on the whole family. Family interventions are a psychosocial treatment for schizophrenia. A robust evidence base has developed supporting the use of family interventions, as reduced relapse and other clinical benefits can be produced. The majority of service users in forensic services suffer from schizophrenia. Yet little is known about the need, acceptability or feasibility of family intervention in forensic services. The over-arching goal of this programme of research was to review the literature for family intervention and conduct a comprehensive needs assessment, with a final aim to resolve the barriers of implementation of family intervention within forensic services. Meta-analysis indicated that the efficacy of family interventions resulted in positive outcomes in reduced relapse and psychotic symptoms, and improved knowledge and relationships. Family interventions were found to be applicable to the psychological needs of forensic service users. Problems were identified with staff training and supervision on forensic wards, with few wards providing family intervention as part of treatment for schizophrenia. Relatives of forensic service users expressed a need for family intervention. Staff highlighted that the barriers to family intervention were associated with insufficient time, poor support, lack of training, deficient information sharing, and geographic limitations between family homes and the forensic units. Staff offered solutions to implementing family intervention that related to revised policy and improved supervision. Relatives and staff held positive attitudes toward family intervention with open-minded attitudes towards the use of a web camera to facilitate family intervention in forensic services (e-FFI). The fourteen week web based family intervention (e-FFI) feasibility study generated reduced levels of stress, stigma and expressed emotion with improvements in the family’s knowledge of schizophrenia, personal health and an acceptance of forensic services. E-FFI was administered with ease achieving positive feedback from the family and the forensic service.

In this four-week, family-focused pilot intervention study, researchers studied the impact of culturally relevant nutrition and activity sessions on eleven children from eight Native Hawaiian and Pacific Islander (NHPI) families. Mixed methods were used in analysis. In their favorite meal drawings, children included more fruits and vegetables at week four than week one, which was consistent with their self-reported intake of healthy foods that were new to them. From week one to four, mean total scores increased on the nutrition and exercise knowledge exercise questionnaire and the physical activity self-efficacy tool; however, the mean total score decreased on healthy diet self-efficacy tool, and two children moved to less healthy BMI categories. This is the first study on the impact of a family intervention on nutrition and healthy activity for NHPI children. Further studies are needed with larger samples and longer duration to determine the most helpful intervention for NHPI families.

Yes / Purpose – The purpose of this article is to argue that a common understanding of the terms social value, social cost benefit, social return on investment etc. would be useful for those seeking to engage with the topic in the fields of health, wellbeing and early family intervention Design/method/approach – The article considers a commissioned study delivered by the authors which reviews the literature pertinent to this field. Findings- The authors suggest that there is considerable confusion with regard to the meaning of terms which are used almost interchangeably in the fields of health, wellbeing and early family intervention. Originality/value – The authors put forward a model to provide consistency of meaning across three levels of interventions.

A família além de vivida cotidianamente, é pensada, refletida e pesquisada com diferentes enfoques e objetivos, por diferentes perspectivas teóricas, práticas e metodológicas. Para se estudar a família é preciso antes de tudo desnaturalizá-la e recuperar sua própria história, pois os modelos que hoje temos são resultados de processos de transformação da forma de se ver e educar a criança, como também do contexto social, histórico e cultural em que vivemos. Isso inclui o fenômeno da Violência Doméstica, e mais especificamente o uso de violência física de pais contra filhos, que apesar das modificações ocorridas na visão da criança e das práticas educativas na família ao longo do tempo, sempre existiu e persiste de forma endêmica em nossos dias, constituindo um problema de saúde pública, e requerendo estratégias de intervenção por parte dos serviços de saúde e desenvolvimento social. O presente projeto tem o objetivo de investigar, junto a pais e mães com histórico de violência física contra seus filhos, a visão sobre o que é educar uma criança, sobre seu papel de pai/mãe e sobre as conseqüências de seus comportamentos sobre o filho. Busca, dessa forma, trazer contribuições para uma melhor compreensão do problema da agressão física de pais contra filhos, necessária a programas de intervenção que ultrapassem ações punitivas e de cunho imediatista, visando transformações nas relações familiares a partir da consideração da ótica do agente agressor. Os entrevistados são pais e mães denunciados por agressão física contra os filhos ao Conselho Tutelar da cidade de Barretos ? SP. O modelo de entrevista utilizado é denominado ?história de vida temática?, que prevê inicialmente o relato da história de vida do entrevistado, complementada por um conjunto de tópicos previamente definidos pelo pesquisador. Optou-se pela não delimitação prévia do número de sujeitos, utilizando-se o ponto de saturação. Dessa maneira, foram realizadas seis entrevistas, tendo sido gravadas, transcritas e analisadas qualitativamente. A análise dos dados aponta inconsistências entre as concepções parentais a respeito do que é educar e de seu papel como educadores e as práticas educativas que utilizam com os filhos no cotidiano. Evidencia dificuldades dos pais em utilizar recursos educativos alternativos à punição física e uma naturalização cultural do bater como forma de colocar limites e disciplinar a criança; aponta também a falta de suporte social e econômico dos pais como fatores de risco e de estresse, e a necessidade de implementar programas de intervenção que promovam a integração entre suas concepções e práticas como educadores. / Nowadays, family is investigated, studied and the object of research of many theoretical perspectives, with different goals and methodologies. However, in order to study the family it is necessary to rescue its history, because the present models we have are the final result of a complex process of social, historical and cultural transformation, and also changes in the ways we see the childhood, what do parents expect from their children and the childrearing practices used to get to the educational goals. Domestic violence is included in all this process, especially the physical violence that parents use against their children, and that constitutes a public health problem in our context. The main objective of this research is to investigate points of view of parents that use physical violence against their children, their conceptions about the educational process, their role as parents and the consequences of their actions in the child?s development. In this direction, it searches contributions to understand the problem of physical violence of parents against their children, to improve intervention programs that overcome punitive actions, seeking effective transformation in family relationships, considering the parent?s point of view. The study was performed in a city of State of São Paulo through interviews with three mothers and three fathers from different families, that had been disclosed for physical violence against their children. Methodology was constructed in a qualitative perspective, using a model of semi-structured interview called ? Thematic Life History?, where participants expose their personal history since their childhood, followed by a previously defined list of topics. Interviews were recorded, transcribed and qualitatively analyzed. Data analysis revealed that parent?s conceptions are not corresponding to their every day actions with their children; the difficulty of parents at knowing or using alternative and non-violent chidrearing practices and a cultural and historical naturalization of the use of physical punishment to establish limits and discipline the child. It also points out the parents` low social and economical support as a risk factor and as the cause of stress for the studied families as well as the necessity of changes in intervention programs to offer the possibility of joining parents conceptions and practices, aiming the improvement of child`s positive global development.

<p>Barn till psykisk sjuka kan ha ökad risk för psykisk ohälsa men detta kan uppvägas av tillgängliga skyddsfaktorer. Barn har blivit mer uppmärksammade inom vuxenpsykiatrin på senare år. Beardslees familjeintervention implementeras sedan 2008 i Sverige. Studien undersökte hur vuxenpsykiatrin stödjer barn till psykisk sjuka, speciellt angående interventionen. Tio anställda, utbildade i interventionen, från sju psykiatriska kliniker i Stockholm intervjuades. Materialet analyserades abduktivt. Barns reaktioner och behov visade sig påverkas av föräldrafunktionen och risk- och skyddsfaktorer hos barnet, i omgivningen och situationen. Interventionen upplevdes bli ett sätt att uppmärksamma barn och skapa dialog inom familjen. Samtidigt upplevde deltagarna bristande kunskap om hur man kommunicerar med barn. För att stödja barn som mår dåligt skulle ett samarbete med BUP behövas. Ingen barnpolicy på avdelningsnivå finns och barns delaktighet ansågs låg. Preventivt arbete kan minska riskfaktorerna, men fokus måste också vara att öka barns möjlighet att hantera vardagssituationen, vilken kan förändras av omständigheterna och över tid.</p> / <p>Children of mentally ill parents have a higher risk to develop psychiatric problems but this risk can be reduced by protective factors. In recent years children of mentally ill have received more attention within adult psychiatry. The Beardslee family intervention has been implemented in Sweden since 2008. This study examines how adult psychiatry supports children of mentally ill, with focusing specifically on this intervention.  Ten professionals, educated in the intervention, from seven psychiatric hospitals in Stockholm, were interviewed and data analyzed abductive. Children's reactions and needs was shown to be influenced by the parenting skills and factors of risk and protection within the child, the environment and the situation. The intervention was perceived as a way of paying attention to the child and to create a dialogue within the family. At the same time the participants experienced a lack of knowledge about how to communicate with children. In order to support children cooperation with child psychiatry is required. No policy of how to handle children was available at the hospital units and the participation of children is considered to be low. Prevention may decrease the risk factors but there must also be a focus on increasing the possibility for the child to cope with the everyday situation. This situation may also change depending on circumstances and over time.</p>

Objective. Family Therapy (FT) and Family Management (FM) approaches to psychosis have been divided by their understanding of causality. FM holds a biological understanding which has been identified as having negative consequences for the person with psychosis. FT, by exploring family interactions has been criticised for blaming families for causing their relations psychosis. These two approaches have now been integrated, but how causality is discussed in an integrated approach has only now been explored. Design and methods. This qualitative research asked clinicians working in the most established integrated service how they discuss causality. Four focus groups were conducted and a framework approach using thematic analysis was used. Results. Five themes were explored; uncomfortable discussion; constructing a shared understanding; therapeutic style; limiting exploration; and blame. Conclusion. Discussing causality with families was identified as uncomfortable. However, through the development of a therapeutic-relationship three identified tools can be used to construct a shared understanding of causality. The therapeutic style of explorative conversation--based in FT, integrated with the stress-vulnerability model--based in FM, was identified as an important aspect of an integrated model that resolved criticisms levied at each individual approach. Factors that limited exploration were identified as major challenges to causality discussions, but techniques to remedy these problems were also identified. The risk of families feeling blamed/blaming themselves and attempts to avoid/reduce blame made up a dominant theme of the research. The research concludes by challenging the need to avoid/reduce blame, arguing that blame should be openly explored within family interventions.

Barn till psykisk sjuka kan ha ökad risk för psykisk ohälsa men detta kan uppvägas av tillgängliga skyddsfaktorer. Barn har blivit mer uppmärksammade inom vuxenpsykiatrin på senare år. Beardslees familjeintervention implementeras sedan 2008 i Sverige. Studien undersökte hur vuxenpsykiatrin stödjer barn till psykisk sjuka, speciellt angående interventionen. Tio anställda, utbildade i interventionen, från sju psykiatriska kliniker i Stockholm intervjuades. Materialet analyserades abduktivt. Barns reaktioner och behov visade sig påverkas av föräldrafunktionen och risk- och skyddsfaktorer hos barnet, i omgivningen och situationen. Interventionen upplevdes bli ett sätt att uppmärksamma barn och skapa dialog inom familjen. Samtidigt upplevde deltagarna bristande kunskap om hur man kommunicerar med barn. För att stödja barn som mår dåligt skulle ett samarbete med BUP behövas. Ingen barnpolicy på avdelningsnivå finns och barns delaktighet ansågs låg. Preventivt arbete kan minska riskfaktorerna, men fokus måste också vara att öka barns möjlighet att hantera vardagssituationen, vilken kan förändras av omständigheterna och över tid. / Children of mentally ill parents have a higher risk to develop psychiatric problems but this risk can be reduced by protective factors. In recent years children of mentally ill have received more attention within adult psychiatry. The Beardslee family intervention has been implemented in Sweden since 2008. This study examines how adult psychiatry supports children of mentally ill, with focusing specifically on this intervention.  Ten professionals, educated in the intervention, from seven psychiatric hospitals in Stockholm, were interviewed and data analyzed abductive. Children's reactions and needs was shown to be influenced by the parenting skills and factors of risk and protection within the child, the environment and the situation. The intervention was perceived as a way of paying attention to the child and to create a dialogue within the family. At the same time the participants experienced a lack of knowledge about how to communicate with children. In order to support children cooperation with child psychiatry is required. No policy of how to handle children was available at the hospital units and the participation of children is considered to be low. Prevention may decrease the risk factors but there must also be a focus on increasing the possibility for the child to cope with the everyday situation. This situation may also change depending on circumstances and over time.

Teen Triple P is a behavioural family intervention for parents of adolescents. It is a multi-level intervention package that allows the strength and format of the intervention to be tailored to the needs of the family. Teen Triple P is available in three modalities: individual; group; and self-directed programs. This research investigated whether a self-directed program, Self-directed Teen Triple P, which consists of a parent workbook and video is sufficient to reduce risk factors known to be associated with the development of serious emotional and behavioural problems in adolescents and enhance protective factors. The present research sought to: a) determine the impact of a self-directed behavioural family intervention program on parents’ perceptions of their adolescent’s behaviour; b) assess the efficacy and consumer acceptance of a self-directed parenting intervention; c) identify clinical implications arising from this research to assist practitioners in the appropriate use of self-directed behavioural family intervention programs; and d) examine the psychometric properties of treatment outcome measures for use with adolescents and their parents. A central tenet of this research is the principal of sufficiency that is, examining the ability of a behavioural family intervention to produce desirable outcomes for adolescents and their parents under lowest intervention and cost conditions. Fifty-one Queensland families with children in Year 7 or 8, aged 11-14 years, were recruited from the community by means of flyers distributed to schools, newspaper and radio advertisements. Participants were randomly assigned to 1 of 3 conditions: (1) Standard self-directed Teen Triple P, a 10 module workbook program supplemented by a video; (2) Enhanced Self-directed Teen Triple P, the same program as Standard self-directed Teen Triple P, but included 10, 15-minute weekly telephone consultations with a Triple P therapist to assist in tailoring the program to meet the individual family’s needs; or (3) Waitlist control, a comparison group who initially only completed the measures, but later went on to do a replication of the standard intervention. The program was implemented with average recruitment (61%), and moderate attrition rate (23.5%). At post-intervention, using parent report measures of adolescent behaviour and parenting practices, parents in the enhanced condition reported significantly fewer adolescent behaviour problems and less use of dysfunctional parenting strategies than parents in the waitlist condition. Parents in the standard condition reported improvements in some areas but not as large or wide-spread as the enhanced group. Improvements were maintained at 3-month follow-up. There was no significant difference among conditions at post-intervention or follow-up on parents’ self-report measures of depression, anxiety, stress or relationship quality. The psychometric properties of measures of adolescent functioning, parenting style, relationship satisfaction and parental adjustment previously reported on different samples were confirmed. An underlying factor structure for the Parent Problem Checklist was identified and implications for its use discussed. Modifications to the scoring of the Consumer Satisfaction Questionnaire are discussed in the light of its factor structure. This research provides important information regarding the efficacy of a self-directed behavioural family intervention as an early intervention for families of early adolescents experiencing some problematic behaviour. It also provides some clinical implications of using self-directed interventions with families.

A família além de vivida cotidianamente, é pensada, refletida e pesquisada com diferentes enfoques e objetivos, por diferentes perspectivas teóricas, práticas e metodológicas. Para se estudar a família é preciso antes de tudo desnaturalizá-la e recuperar sua própria história, pois os modelos que hoje temos são resultados de processos de transformação da forma de se ver e educar a criança, como também do contexto social, histórico e cultural em que vivemos. Isso inclui o fenômeno da Violência Doméstica, e mais especificamente o uso de violência física de pais contra filhos, que apesar das modificações ocorridas na visão da criança e das práticas educativas na família ao longo do tempo, sempre existiu e persiste de forma endêmica em nossos dias, constituindo um problema de saúde pública, e requerendo estratégias de intervenção por parte dos serviços de saúde e desenvolvimento social. O presente projeto tem o objetivo de investigar, junto a pais e mães com histórico de violência física contra seus filhos, a visão sobre o que é educar uma criança, sobre seu papel de pai/mãe e sobre as conseqüências de seus comportamentos sobre o filho. Busca, dessa forma, trazer contribuições para uma melhor compreensão do problema da agressão física de pais contra filhos, necessária a programas de intervenção que ultrapassem ações punitivas e de cunho imediatista, visando transformações nas relações familiares a partir da consideração da ótica do agente agressor. Os entrevistados são pais e mães denunciados por agressão física contra os filhos ao Conselho Tutelar da cidade de Barretos ? SP. O modelo de entrevista utilizado é denominado ?história de vida temática?, que prevê inicialmente o relato da história de vida do entrevistado, complementada por um conjunto de tópicos previamente definidos pelo pesquisador. Optou-se pela não delimitação prévia do número de sujeitos, utilizando-se o ponto de saturação. Dessa maneira, foram realizadas seis entrevistas, tendo sido gravadas, transcritas e analisadas qualitativamente. A análise dos dados aponta inconsistências entre as concepções parentais a respeito do que é educar e de seu papel como educadores e as práticas educativas que utilizam com os filhos no cotidiano. Evidencia dificuldades dos pais em utilizar recursos educativos alternativos à punição física e uma naturalização cultural do bater como forma de colocar limites e disciplinar a criança; aponta também a falta de suporte social e econômico dos pais como fatores de risco e de estresse, e a necessidade de implementar programas de intervenção que promovam a integração entre suas concepções e práticas como educadores. / Nowadays, family is investigated, studied and the object of research of many theoretical perspectives, with different goals and methodologies. However, in order to study the family it is necessary to rescue its history, because the present models we have are the final result of a complex process of social, historical and cultural transformation, and also changes in the ways we see the childhood, what do parents expect from their children and the childrearing practices used to get to the educational goals. Domestic violence is included in all this process, especially the physical violence that parents use against their children, and that constitutes a public health problem in our context. The main objective of this research is to investigate points of view of parents that use physical violence against their children, their conceptions about the educational process, their role as parents and the consequences of their actions in the child?s development. In this direction, it searches contributions to understand the problem of physical violence of parents against their children, to improve intervention programs that overcome punitive actions, seeking effective transformation in family relationships, considering the parent?s point of view. The study was performed in a city of State of São Paulo through interviews with three mothers and three fathers from different families, that had been disclosed for physical violence against their children. Methodology was constructed in a qualitative perspective, using a model of semi-structured interview called ? Thematic Life History?, where participants expose their personal history since their childhood, followed by a previously defined list of topics. Interviews were recorded, transcribed and qualitatively analyzed. Data analysis revealed that parent?s conceptions are not corresponding to their every day actions with their children; the difficulty of parents at knowing or using alternative and non-violent chidrearing practices and a cultural and historical naturalization of the use of physical punishment to establish limits and discipline the child. It also points out the parents` low social and economical support as a risk factor and as the cause of stress for the studied families as well as the necessity of changes in intervention programs to offer the possibility of joining parents conceptions and practices, aiming the improvement of child`s positive global development.