Thesis advisor: Mary E. Walsh / The out-of-school factors that low-income children face can impact their wellbeing and ability to learn (Rothstein, 2010), leading to low academic performance, and, in turn, high levels of stress among their teachers. One of the numerous potential strategies that exist to address this problem is the implementation of systemic student support interventions, which are hypothesized to support teachers in addition to students (Ball & Anderson-Butcher, 2014). Using the City Connects intervention as an example of a comprehensive, systemic student support intervention that has demonstrated positive effects for students, this dissertation study examines the impact of this same intervention on teachers. The study used data obtained from annual surveys administered to all teachers in public schools (across several districts) where the City Connects intervention was implemented. The sample consisted of 656 responses from teachers in Boston Public Schools that were participating in the City Connects intervention during three designated school years (2012-13, 2013-14, and 2015-16). The study implemented a mixed-methods approach that allowed for an in-depth analysis of teachers’ perceptions of support from the City Connects intervention through both quantitative and qualitative data sources. Following exploratory and confirmatory factor analyses of the survey instrument itself, survey data was analyzed using the Validating Quantitative Data Model (Creswell & Plano Clark, 2007), in which quantitative findings were confirmed and expanded upon through analysis of data from a small number of open-ended survey questions. The results of this dissertation study support the continued use of systemic student support interventions in schools, as data confirm that teachers in schools with City Connects report being supported by the intervention. These results hold for veteran teachers who have been teaching for over sixteen years and have participated in the City Connects intervention for over ten years. Ultimately, the findings of this dissertation study suggest that, in addition to leading to positive changes in students’ developmental trajectories, student support interventions can improve the experiences of other members of the school community. / Thesis (PhD) — Boston College, 2018. / Submitted to: Boston College. Lynch School of Education. / Discipline: Counseling, Developmental and Educational Psychology.

Background and Aims: Mental health difficulties during the perinatal period (pregnancy to 1 year postnatal) are commonplace and are associated with significant impacts for mothers and infants. There is an acknowledgement that more needs to be understood about perinatal mental health, particularly during pregnancy, and that service and treatment options need to be improved. Women's lived experience of difficulties during pregnancy, particularly when experiencing moderate to severe mental health difficulties, is a little researched area. A need for wider treatment options than medication alone has been highlighted and Peer Support Interventions (PSIs) are often considered within this area. Despite this, there is yet to be a review of their effectiveness to date that also considers women's views of such interventions. Therefore, this thesis aimed to systematically review literature focused on women's views of PSIs and their effectiveness. In addition, it also aimed to explore the lived experience of women with moderate to severe difficulties with their mental health during pregnancy, with a focus on trying to establish any psychological needs/needs they may have. Methods: A mixed methods systematic review was conducted to meet the aims on PSI interventions. This involved searching electronic databases, quality assessment of included papers and summarising results, including a meta-synthesis for qualitative findings. The empirical project, on women's lived experiences, utilised an Interpretative Phenomenological Analysis approach to explore the lived experience of women experiencing moderate to severe mental health difficulties during pregnancy. Semi-structured interviews were conducted with 11 women recruited via a specialist perinatal mental health service. Results Thirteen studies were included in the review. Results highlighted the heterogeneity of types of PSIs and methodologies employed to evaluate these. Most studies focused on PSIs for the postnatal period and were often aimed at depression. There was a lack of research on PSIs targeted antenatally, or for other types of mental health difficulties. There was tentative evidence for the use of telephone based PSIs in reducing depressive symptomatology postnatally, but less evidence for the use of other types of PSI, or for interventions during pregnancy. The qualitative evidence highlighted the acceptability of PSIs to women and a meta-synthesis of qualitative research identified a number of themes representing women's views of PSIs. From the empirical project, several Superordinate themes were identified: Need for acceptance, Need for awareness, Search for explanations, What helped, Emotional intensity, Societal influences and Service provision. Within these a range of emergent themes were also found. These themes highlighted possible psychological needs and other needs during this time, as well as providing a greater understanding of women's lived experience. Conclusions: There is a need for more research to establish effectiveness of PSIs during pregnancy and of other modes of delivery and to build on existing findings on the effectiveness of telephone based PSIs. Women viewing PSIs as highly acceptable for perinatal mental health difficulties, should cause services to consider their use, or other opportunities for sharing of peer advice/information. Themes identified from the empirical project highlight the need for greater awareness and acceptance of mental health difficulties during pregnancy, as well as the impact of societal influences on women during this time, and the role clinicians and services could play in achieving greater awareness. Small changes within services could help raise awareness levels and help women feel less isolated.

Bakgrund: Depression är ett globalt hälsoproblem med allvarliga konsekvenser. Stora livsförändringar som till exempel barnafödande innebär ofta stora påfrestningar, vilket kan leda till psykisk ohälsa. Postpartumdepression (PPD) är ett sjukdomstillstånd som drabbar modern men även fadern och inte minst hela familjen.Syfte: Syftet med studien var att beskriva männens upplevelser när de drabbas av förlossningsdepression. Metod: En allmän litteraturstudie med induktiv ansats, niovetenskapliga artiklar användes för resultaten och kodades ner till teman och kategorier. Resultat: Resultatet i litteraturstudien delades in i tre teman och sexkategorier. Det första temat var fädernas upplevelser av stress. Fäderna upplevde stress genom att känna ansvar att bära upp hemmet ekonomiskt och av att inte få tillräckligt med sömn. Andra temat var fädernas upplevelser av otillräckligt stöd.Stödet från sjukvården visade stora brister, i form av otillräcklig information och avsaknad av stöd riktad till fäderna. Sista temat var påverkan i relationen. Fäderna upplevde i hög grad en bristfällig delaktighet vilket skapade utanförskap till både modern och barnet. Konklusion: PPD hos fäder är ett vanligt tillstånd med risker för allvarliga konsekvenser. Det saknas i stor utsträckning tillräckliga möjligheter att både upptäcka och behandla tillståndet. Om stödet är bristfälligt ökar risken för allvarliga konsekvenser som att barnens utveckling och relationen till partner försämras. / Background: Depression is a global health problem with serious consequences. Major life changes such as childbirth often involve great stress, which can lead to mental illness. Postpartum depression (PPD) is a disease that affects the mother but also the father and not least the whole family. Aim: The aim of this study was to describe men’s experiences when suffering of postpartum depression. Method: A general literature study with inductive approach including nine scientific articles were used for the results and coded down to themes and categories. Results: The results of the literature study were divided into three themes and six categories. The first theme was fathers' experiences of stress. The fathers experienced stress due to feelings of responsibility for the economy and due to lack of sleep. The second theme was fathers' experiences of insufficient support. The support given by the health caresystem was insufficient due to lack of information and support directed to the fathers.The last theme was impact in relationship. The fathers’ experiences include to a large extent a lack of participation which led to a sense of exclusion towards the mother and the child. Conclusion: Paternal PPD is a frequent condition with potential serious consequences. To a large extent there are lack of sufficient possibilities to detect and treat the condition. If the support is inadequate, the risk of serious consequences such as the children’s development and the relationship with the partner deteriorates.

The prevalence of anxiety amongst children with Autism Spectrum Conditions (ASC) is reportedly considerably higher than the general population (Ozsivadjian & Knott, 2011). Research considering intervention for children with ASC and anxiety has predominantly been from a clinical perspective, with limited evidence based literature being found that explored the needs of these students in relation to anxiety within the mainstream secondary school educational context. Anxiety can increase during adolescence for children with ASC (White, Ollendick, Scahill, Oswald, & Albano, 2009) and many of the anxiety related worries of children with ASC have been found to be related to school (Ozsivadjian & Knott, 2011). However, there is a dearth of research regarding practical support within an educational setting that can be implemented by schools on a needs basis to support students with ASC and signs of anxiety. Four students with a diagnosis of an ASC who had presented with signs of anxiety were identified from mainstream secondary schools across one English local authority. A parent and an educational practitioner who worked with each student also participated. A qualitative multiple embedded case study design was utilised. Suitably differentiated methods for gaining this cohort of students’ views and engaging them in the research were employed. Data from semi-structured interviews and educational documentation were analysed for main themes using thematic analysis based upon Braun and Clarke's (2006) six phase model. The perceived needs and difficulties of anxious students with ASC and what is considered to be effective practice in supporting them within a mainstream secondary school setting are outlined. The study provides some understanding of the needs of students with ASC and how schools support management of their anxiety. The research intends to extend knowledge of the needs of these students and what works in effectively supporting these students within a mainstream secondary school setting.

No description available.

The purpose of this study was to, through qualitative interviews, create anunderstanding of social workers' experiences of interventions aimed at children whohave witnessed violence between relatives. Understanding should therefore becreated about the implementation of interventions from the perspective of socialworkers'. Therefore, we wanted to create an understanding about what opportunitiesand difficulties social workers experience with the interventions to meet thechildren's needs, as well as which approaches social workers think are important inthe interventions. To find answers to these questions, we interviewed nine socialworkers who currently works or have worked with interventions for children whohave witnessed violence between relatives. In analyses of the interviews, we appliedtheories about discretion and evidence-based practice, along with previous research.From the results, we could see that there are both difficulties and opportunities inthe interventions. Discretion can be used in the interventions to be more flexible andfollow the individual child, while manuals help professionals so that they don´tforget important parts of the intervention. The social workers also expressed thechallenges with knowing how to act in certain situations, and therefore stated theneed for guidance. The result further showed that the interventions createopportunities for children to express their experiences and put to words what theyhave been trough. The social workers though experienced difficulties when thechildren don´t talk in the interventions. The result therefore showed how the socialworkers can use their discretion and professional expertise to handle thesechallenges and facilitate the children’s narrative. This could be done throughworking alongside the manuals and follow the needs of the individual child.Important approaches in the interventions that were expressed by the social workers,were for example the use of tools, relationship building and to relief the children’sfeelings of guilt and shame.

Many parents experience preterm birth as traumatic and develop high levels of emotional stress, anxiety, and depressive symptoms. This can have a negative impact on the bonding process and the development of their parental identity. The emotional support provided by the staff varies between Swedish neonatal intensive care units (NICUs), and little is known about parents´ needs and preferences for emotional support. Further, there are knowledge gaps regarding parental stress in fathers and their needs for emotional support, differences in stress between mothers and fathers, change of parental stress over time and potential predictors for parental stress. The aim of this thesis was to explore the needs and preferences for emotional support in parents of preterm infants during their infant’s hospitalisation in a NICU, and to describe parental stress in mothers and fathers up until the infant’s age of 12 months and predictors for parental stress.  Study I was a qualitative study using semi-structured interviews with 51 parents of preterm infants, which were analysed using qualitative content analysis. The results showed that parents need a sense of coherence during their infant’s stay in a neonatal intensive care unit, and they want to be offered emotional support according to their preferences. Many parents preferred to attend professionally led parental groups as other NICU parents could really understand their situation and feelings. Parents also emphasised the value of combining parental groups with other means of support. Study II was a longitudinal cohort study in which data on self-reported parental stress during the first year were obtained from 493 mothers and 329 fathers of preterm infants and analysed using descriptive statistics, Student’s independent t-tests, linear regression, and linear mixed-effects modelling. The results showed that mothers perceived more role restriction than fathers, and that fathers experienced more social isolation than mothers. Further, parental stress decreased during the first year for mothers but increased for fathers, especially between 6 months and 12 months postpartum. For both mothers and fathers, having twins and a lower perceived general health were associated to higher levels of parental stress. In addition, mothers with infants of lower gestational age experienced significantly higher levels of parental stress.  In conclusion, individualised emotional support is important for parents of preterm infants for them to manage their situation both during their infant’s hospitalisation and during the first year postpartum. Apart from professional support, peer-support in the form of professionally led parental groups are perceived to be potentially valuable emotional support by parents. This peer-support could, preferably, be combined with other means of support during hospitalisation as ‘one size does not fit all’. In a next step, support interventions need to be designed, tested, and evaluated. Antonovsky’s theory of Sense of Coherence can be used to identify emotional needs in NICU parents and how to provide emotional support consistent with the parents’ preferences. After discharge from the NICU, vulnerable groups of parents, including parents of very preterm infants and twins need additional support. Moreover, there is a need in fathers for additional emotional support programmes offered during the first year of infants’ lives.

Intensifying interventions to improve the quality of care that children receive from parents/ primary caregivers is mandated by several strategic objectives, such as the National Plan of Action for Children 2012-2017 (South Africa 2012), the White Paper on Families in South Africa (2013), and the Children’s Amendment Act 41 of 2007 (South Africa 2007). Parenting programmes remain popular parenting interventions (Daly, Bray, Bruckauf, Byrne, Margaria, Pecnik & Samms-Vaughan 2015:18; Richter & Naicker 2013:9) reporting outcomes of enhanced parent-child relationships, improved behaviour of children, and reduced parental stress. There is a concern that parenting programmes offered in South Africa lack evidence of their efficacy (Wessels 2012:9) and cultural and contextual relevance for the recipients (Begle, Lopez, Cappa, Dumas & de Arellano 2012:56; Richter & Naicker 2013:1). The study developed a locally specific parenting support intervention for parents/ primary caregivers living in the low-cost housing development of Welbedacht East using the Intervention Development Design model. Parents/ primary caregivers were involved throughout the study, contributing to the intervention’s applicability, as well as its contextual and cultural relevance. Bioecological and social inclusion theories framed the study. A qualitative research approach supported by an exploratory, descriptive and contextual design was used. Two purposive samples (parents/ primary caregivers and community champions) were recruited. Semi-structured interviews were conducted to collect the data. Thematic analysis (Braun & Clarke 2006) produced the findings that were presented at a consultation workshop attended by research participants and relevant stakeholders where the parameters of the intervention were determined. These were subsequently developed into the elements and intervention protocols by four indigenous community experts following the Delphi process. Lincoln and Guba’s (1985) approach to trustworthiness as presented by Porter (2007:85) and Thomas and Magilvy (2011:152) was used. Cultural competence was maintained throughout and ethical considerations were observed to circumvent harm to participants and uphold the integrity of the research process. The perceptions of the parents/ primary caregivers were consistent with scholarly indicators of ‘good enough’ parenting, but the contextual stressors they experienced challenges their ability to fulfil some of these indicators. An intervention was needed to increase parental capacity to improve parent-child relationships, cultivate life skills for improved psychological health, and advance the financial independence of parents. It was concluded that a parenting programme on its own would fail to address the most pressing needs of parents/ primary caregivers living in disadvantaged circumstances and custom-made parenting support interventions were needed to increase parental capacity to manage the structural challenges that compromised parenting, such as socioeconomic interventions of a social developmental nature. / Social Work / D. Phil. (Social Work)