Thesis (Ph. D.)--University of Texas at Austin, 2003. / Vita. Includes bibliographical references. Available also from UMI Company.

This study investigates success in parental mental health and child welfare work. Research has established the potential direct and indirect impacts of mental illness on parenting, the parent–child relationship, and the child, and the extent to which this poses a public health challenge. Problems with how adult and children’s services understand and deliver support to parents with mental health problems and their children have also been identified. In contrast, there has been little research about how parents with mental health difficulties and their children can be supported successfully. ‘What works’, or what constitutes success in parental mental health and child welfare work is missing from the literature. This study aims to begin to address this gap by providing an original contribution to conceptualising and evaluating success in parental mental health and child welfare work. This is an exploratory study, and as such covers a diverse population, i.e. different family members, different cultural and ethnic backgrounds, parents with different diagnoses, and statutory and voluntary sector agencies. The main issue here is to cover diversity; in terms of exploring different opinions of success – both in outcomes and processes – rather than to ensure applicability of the findings to all families in which there are parents experiencing mental illness. An interpretative approach was chosen for the study (within that data) to explore these issues. This was obtained by undertaking a multiple embedded case study methodology (Yin, 2003) with 12 families and their key workers from community mental health, children’s social care and the voluntary sector. Data collection was undertaken in three stages: individual interviews with parents, children and the professionals who support them; a review of the agency case files kept about the same families; and three focus groups. Participants were asked to identify successful situations that had occurred in each case study family during the 18 months prior to interview and give details about why these situations worked out well. The focus groups were convened to discuss the emerging findings from the first two phases of data collection. An examination of emerging themes, and the interplay between themes, gives insight into the shared ideas about what works and the shared methods and practices that are associated with successful outcomes. On the basis of these similarities, the findings offer a contribution to knowledge and practice about a mode of working which seems to make it possible to succeed in helping families previously considered beyond help. What is more, the practitioners also benefit from the helping relationship in this context.

A thesis submitted in partial fulfillment of a PhD in Community Psychology at the University of Zululand, South Africa, 2012. / Ongoing global crises impact negatively on human health. International comparison studies may improve health promotion. A community psychology, appreciative inquiry was conducted into local staff perceptions of selected child and adolescent mental health interventions in the Kent and Zululand regions of the United Kingdom and South Africa respectively. The Kent findings, supported by a quasi-experimental investigation, indicated that intervention was beneficial, the mental health practitioner role had value and additional mental health practitioners should be employed. The Zululand findings, complemented by a single client case study, suggested that intervention provided a valuable people focused programme, and that additional emphasis should be placed on promoting the intervention, its structure and staffing. Evaluative comparisons thus illustrated the differential effectiveness of the respective interventions. The Kent service could learn from the way in which the Zululand intervention was people orientated and the Zululand programme could learn from the way in which the Kent intervention was structured and organized. Findings highlighted the ongoing need to evaluate existing models of community psychology, create new models, and the temporal and contextual nature of any such models.

D.Cur. / Working with children within a therapeutic relationship requires expert knowledge, expert skills, intuition, feeling and empathy for the child (Weitzman, 2003: 5). Internationally there is a need for the development of creative and effective service delivery models to be implemented by trained play therapists (Weitzman, 2003: 6). The purpose of the study was to develop a model for the advanced psychiatric nurse practitioner to facilitate the mental health of young children diagnosed with HIV by meeting the following objectives: to explore and describe the life-world of young children diagnosed with HIV; to describe and evaluate a model to facilitate the mental health of young children diagnosed with HIV; and to describe guidelines for the implementation of the model.

Background: Orphanhood is a major consequence of the HIV/AIDS epidemic in sub-Saharan Africa. There is little evidence concerning psychological problems for AIDS-orphaned children. This thesis explores the relationship between orphanhood status and mental health. It also examines mediating influences of environmental risk and protective factors, and interactions between factors, on children’s psychological problems. Methods: 1200 isiXhosa-speaking children were interviewed, using standardised questionnaires, in deprived urban settlements of Cape Town. A qualitative stage with 60 AIDS-orphaned children, 42 caregivers and 20 professionals explored participant perceptions of risk and protective factors. A quantitative stage compared 1025 AIDS-orphaned children to control groups of other-orphans and non-orphans. Data were analysed with t-tests, chi-sq, anovas, regression and log-linear analyses. The study took place in collaboration with Cape Town Child Welfare. Results: AIDS-orphaned children reported more depression (p<.001), peer relationship problems (p<.001), post-traumatic stress (p<.001), suicidal ideation (p<.05), delinquency (p<.001) and conduct problems (p<.001) than other-orphans and non-orphans. Anxiety showed no differences. Compared to Western norms, AIDS-orphaned children showed higher levels of internalising problems and delinquency, but lower levels of conduct problems. These differences remained when controlling for socio-demographic factors. A number of factors strongly mediated the relationship between AIDS-orphanhood and mental health. These include poverty-related factors (food, education and social security, p<.001). caregiving-related factors (caregiver illness, p<.001, excessive housework p<.001, being a streetchild, p<.001) and AIDS-related stigma (p<.001). Cumulative effects were also found. Food insecurity and AIDS-related stigma interacted to raise likelihood of disorder from 19% to 83%, and orphanhood status and bullying interacted to raise likelihood from 12% to 76%. Conclusions: This thesis shows clear evidence of heightened psychological problems amongst AIDS-orphaned children. It also indicates mediating factors and points to areas of possible intervention. The South African Ministry of Social Development plans to scale up the study to a national survey of AIDS-orphanhood.

Children go to school for approximately 32 hours each week of an academic year. Many children who are in need of mental health treatment do not get the services they need because of barriers such as lack of access and stigma. Teachers are one of the primary sources of referrals for children's mental health services, and they often make referrals based on their perceptions of their students' mental health needs. Although teachers are typically the primary source of referrals for mental health services, they usually do not have any specialized mental health training. The purpose of this study was to gain insight into the perceived needs of teachers' in Title I schools on what is needed to help their students with emotional and behavioral problems. This research study was framed by Bronfenbrenner's bioecological model, which provides one framework for research and practice of school-based mental health. Bronfenbrenner's theory explains the impact of a child's interrelations with classmates, peers, parents, community, and society upon his or her development, particularly his or her mental health. Data was collected from audiotaped face-to-face interviews with 12 Title I elementary teachers. The interviews were then transcribed, coded, and several themes were identified. Relevant themes included the school's role in mental health, the school's current plan to help children, quality of mental health services, barriers to services, supports at school for mental health; reasons for referrals, administration training and classes on mental health, behavioral management systems, and changes to classrooms that will benefit children with mental health problems. Teachers are on frontlines everyday with students and should have all the training that's needed to help their students be successful.

Made available in DSpace on 2016-04-29T13:31:00Z (GMT). No. of bitstreams: 1 Flavia Blikstein.pdf: 1941762 bytes, checksum: 9f036f75bb2d7801ee39313339efd3f4 (MD5) Previous issue date: 2012-11-07 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This dissertation s main objective is to contribute to the advancement of the field of mental health for children and adolescents. This study aims to investigate the causes of the continuation of the practice of hospitalization of children and adolescents in psychiatric hospitals in the state of São Paulo despite the advances of Brazilian Psychiatric Reform. CAISM Philippe Pinel was chosen as the main research site, due to its status as a reference institution for the hospitalization of children and adolescents in the state of São Paulo. Through medical records, we investigated the profile of admissions between January 2005 and December 2009. The methodological strategies were developed in order to grasp the nuances of children and adolescents hospitalized during this period, and highlight their paths to institutional admission. Based on the data analyzed, we could make some key inferences about the functioning of the mental health field for children and adolescents. In our study, we observed that children and teenagers are sent to institutions in two ways: either through health services, or by court order. After a comparative analysis between these two forms of routing, we found that the institutionalization via court order, in many cases, occur in circumstances that contradict the norms of Psychiatric Reform and the Statute of Children and Adolescents. We conclude that new practices and policies in the field of mental health must prioritize transversal actions between different sectors of governmental institutions. / A presente dissertação tem como principal objetivo colaborar com o desenvolvimento do campo da saúde mental infantojuvenil. Para tanto, este estudo propõe-se a investigar como e por que, apesar dos avanços da Reforma Psiquiátrica brasileira, se mantém a internação de crianças e adolescentes em hospitais psiquiátricos no Estado de São Paulo. Escolhemos como campo de pesquisa o CAISM Philippe Pinel por ser a instituição de referência para a internação de crianças e adolescentes no Estado de São Paulo. Por meio dos prontuários, investigamos o perfil das internações entre janeiro de 2005 e dezembro de 2009. As estratégias metodológicas foram desenvolvidas a fim de apreender as particularidades das crianças e adolescentes internados neste período e evidenciar suas trajetórias institucionais até a internação. A partir da análise dos dados produzidos, pudemos fazer algumas observações sobre o funcionamento do campo da saúde mental infantojuvenil. Em nosso estudo observamos que as crianças e adolescentes são encaminhados à internação de duas formas distintas: por serviços de saúde ou por ordem judicial. Após uma análise comparativa entre estas duas formas de encaminhamento, pudemos observar que as internações via ordem judicial, em diversos casos, ocorrem em circunstâncias que contradizem as normas da Reforma Psiquiátrica e do Estatuto da Criança e do Adolescente (ECA). Concluímos assim que novas práticas e políticas públicas do campo da saúde mental infantojuvenil devem priorizar ações transversais e intersetoriais do poder público

Background: Over the past decades the public health relevance of mental health conditions in children and adolescents has been of growing concern. However, so far no detailed epidemiological data has been available for a representative national sample in Germany. Objectives: The present paper reports prevalence rates of general and specific mental health problems among children and adolescents in Germany and describes the link between symptoms and impairment as well as the treatment situation. Methods: The mental health module (BELLA study) examines mental health problems in a representative sub-sample of 2,863 families with children aged 7–17 from the National Health Interview and Examination Survey among Children and Adolescents (KiGGS). Mental health problems were determined using the extended version of the strengths and difficulties questionnaire (SDQ). Further standardised screening measures were employed to screen for anxiety disorders (SCARED), conduct disorder (CBCL), attention deficit-/ hyperactivity disorder (FBBHKS, Conners’ Scale) and depressive disorders (CES-DC). Furthermore, substance abuse and suicidal tendencies were assessed. Health-related quality of life (HRQoL) and health care use were determined. Results Overall, 14.5% of the children and adolescents aged 7–17 fulfilled the criteria for at least one specific mental health problem associated with impairment, or had an overall mental health problem indicated by an abnormal SDQ score and present impairment. However, high comorbidity was found in the children concerned. Symptoms of overall mental health problems were present in 8.6% of the children and 6.6% of the adolescents. This number was reduced to prevalence rates of 6.3 and 4.9% when additional impairment was taken as a criterion. Irrespective of the type of disorder, fewer than half of the children affected were reported as receiving treatment. However, for those suffering from mental health problems, large impairments in HRQoL were observed. Conclusions: The observed prevalence of mental health problems as well as their large impact on well-being and functioning calls for early prevention. This is especially important with regard to the large decrease in HRQoL in the children and adolescents affected.

Promoting Alternative Thinking Strategies (PATHS) is an intervention program for children with behavioral and emotional deficits, designed for use, and shown to be effective when used in the classroom a minimum of 3 times per week. However, in some settings, as in the current study, PATHS is being used just once per week. The purpose of this quantitative study was to determine whether PATHS was beneficial in helping elementary school aged children improve their behavioral and emotional health when implemented once per week in a group therapy setting. PATHS was developed based on cognitive behavioral theory, which focuses on improving internalizing symptoms of mental health disorders (thoughts) as well as the externalizing symptoms (behaviors). A one-way, repeated measures ANOVA was utilized to analyze archival data of 193 scores, collected over a single school year. Results indicated that elementary school aged children who received PATHS once per week in a group setting showed a decrease in aggression and disruptive behaviors, and an increase in concentration and attention as well as social and emotional competence. Social change implications could involve the results of the study informing how we might promote overall emotional and behavioral well-being in children. At the organizational level, the expansion of the use of PATHS at reduced costs and time within other settings will extend these benefits to more children with behavioral and emotional deficits. Future studies are suggested to examine further the effectiveness of PATHS when implemented in other programs and alternative ways.

This project addressess the importance of early childhood intervention for California's infants and toddlers and how the managed care trends are affecting families' ability to obtain help for their children.