Evaluation of a University-Community Partnership to Provide Home-Based, Mental Health Services for Children from Families Living in Poverty

A university-community partnership is described that resulted in the development of community-based mental health services for young children from families living in poverty. The purpose of this pilot project was to implement an evidence-based treatment program in the homes of an at-risk population of children with significant emotional and behavior problems that were further complicated by developmental delays. Outcomes for 237 children who participated in the clinic’s treatment program over a 2 year period are presented. Comparisons are included between treatment completers and non-completers and the issues of subject attrition, potential subject selection bias, and the generalizability of the results are addressed. The need for more professionals who are trained to address mental health issues in very young children who live in very challenging conditions are discussed

Home-Based Parent-Child Therapy in Low-Income African American, Caucasian, and Latino Families: A Comparative Examination of Treatment Outcomes

This study examined parent and child treatment outcomes for a home-based Parent-Child Therapy (PCT) program for 66 children from families living in poverty. African American, Caucasian, and Latino families were examined to determine if an evidence-based program would produce similar results across different ethnic groups. The results showed that caregivers across the three ethnic groups reported improved child challenging behavior, increased positive parent-child interactions, improved parental expectations, higher levels of nurturing, and less reliance on verbal and corporal punishment as a form of discipline. Practical implications for these results are discussed

Treatment Outcomes for At-Risk Young Children With Behavior Problems: Toward a New Definition of Success

This study examined the outcomes of Early Pathways (EP), an in-home parent–child therapy program with 447 at-risk children younger than 5 years of age who were referred for severe behavior and emotional problems, such as aggression, oppositional behavior, and separation anxiety. EP emphasized parent-directed training of child behavior strategies including psychoeducation regarding child development, child-led play, and cognitive-behavioral techniques. Outcomes were assessed using a unique 2-dimensional definition of treatment completion, which consisted of treatment duration and an assessment of reliable change for the primary outcome measure of child behavior problems. Results showed that the majority of children (63.4%) met or exceeded treatment completion. In addition, repeated-measures multivariate analyses of variance at pretest, posttest, and follow-up revealed increased child prosocial behaviors, reduced child behavior problems, improved caregiver nurturing, an increase in parents’ developmentally appropriate expectations of children, improved parent–child relationships, and a decrease in clinical diagnoses following treatment. This study offers guidance for developing effective early-intervention services for families in poverty to enhance outcomes for their young children. Along with its existing large-scale, community-based effectiveness studies, future research should establish additional statistical support including a randomized, waitlist control design of EP

Early Pathways Therapy for Young Children in Poverty: A Randomized Controlled Trial

Early Pathways is a home-based, parent and child therapy program for the treatment of disruptive behaviors among young children living in poverty. In this study, 199 clinically referred children were randomly assigned to an immediate treatment (IT) or wait-list control (WL) conditions. Results indicated that parents in the IT condition reported significant improvements in their child’s disruptive and prosocial behaviors and increased nurturing and decreased use of corporal and verbal punishment by their parents compared to the WL families. Gains were maintained for children in both the IT and WL conditions at 3-month follow-up

Home-Based Parent Child Therapy for Young Traumatized Children Living In Poverty: A Randomized Controlled Trial

A randomized control trial was used to evaluate the effectiveness of a home-based, parent-and-child therapy program specifically developed for toddlers and preschoolers living in poverty with trauma symptoms. Sixty-four children 5-years of age and younger were referred to a community-based clinic for behavior problems and emotional difficulties. All children had experienced one or more potentially traumatic events and met the DSM-5’s criteria for Post-Traumatic Stress Disorder in Children Six Years of Age and Younger. All families received government assistance indicating that their income met the federal definition for poverty. Participants were randomly assigned to either immediate treatment or wait list control groups. Significant between-group differences on all post-treatment measures were found. After the waitlist group completed treatment, significant improvements for both groups were found on all measures at six-weeks follow-up. Outcomes included reductions in challenging behaviors and emotional symptoms of trauma, improved caregiver-child relationships, and increased caregiver adherence to treatment strategies. This study offers support for early intervention of children with trauma symptoms and identifies the clinical challenges and advantages of providing therapy services in a home setting for very young children in poverty

Development of a Barriers Scale to Predict Early Treatment Success for Young Children in Poverty with Behavior Problems

Research has demonstrated that participation in parent and child therapy (PCT) programs significantly reduces problematic behaviors while increasing positive behaviors in the child. However, PCT programs report rates of early termination as high as 60% among families in poverty. Research to reduce these early termination rates has historically focused on barriers to treatment including logistical conflicts, socioeconomic status, child age, and symptom severity. Despite attempts to address these variables and reduce early termination rates, progress has been slow in advancing the research in this area. In addition, few measures have been designed to accurately assess how barriers to treatment impact treatment attendance and participation, particularly for families of young children living in poverty. The purpose of this study was to develop and pilot a clinician-report screening tool, the Treatment Barriers Scale (TBS), to assess barriers to treatment participation in primarily low-income, urban minority families receiving home-based therapy for their young child’s challenging behaviors. Data from 330 families consecutively referred to a mental health clinic for behavior problems were analyzed to identify the initial psychometric and predictive properties of this new tool in screening treatment barriers in this population. The resulting 17-item scale consisted of two factors, labeled Treatment Process Barriers and Operational Barriers. Each factor demonstrated acceptable levels of internal consistency (.82 and .80, respectively). Children with more-severe challenging behavior at pretest were more likely to be successful by the third session in treatment. Families with higher TBS scores were more likely to be less successful early in treatment. Limitations of the study and implications for future research and practice were discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved

Predicting Treatment Success in Child and Parent Therapy Among Families in Poverty

Behavior problems are prevalent in young children and those living in poverty are at increased risk for stable, high-intensity behavioral problems. Research has demonstrated that participation in child and parent therapy (CPT) programs significantly reduces problematic child behaviors while increasing positive behaviors. However, CPT programs, particularly those implemented with low-income populations, frequently report high rates of attrition (over 50%). Parental attributional style has shown some promise as a contributing factor to treatment attendance and termination in previous research. The authors examined if parental attributional style could predict treatment success in a CPT program, specifically targeting low-income urban children with behavior problems. A hierarchical logistic regression was used with a sample of 425 families to assess if parent- and child-referent attributions variables predicted treatment success over and above demographic variables and symptom severity. Parent-referent attributions, child-referent attributions, and child symptom severity were found to be significant predictors of treatment success. Results indicated that caregivers who viewed themselves as a contributing factor for their child\u27s behavior problems were significantly more likely to demonstrate treatment success. Alternatively, caregivers who viewed their child as more responsible for their own behavior problems were less likely to demonstrate treatment success. Additionally, more severe behavior problems were also predictive of treatment success. Clinical and research implications of these results are discussed

The Culturally-adapted Early Pathways Program for Young Latino Children in Poverty: A Randomized Controlled Trial

This study used a randomized controlled design with treatment and wait-list conditions to evaluate the efficacy of a culturally adapted version of the Early Pathways program (EP; Fox & Gresl, 2014), an in-home, parent–child therapy program with 137 at-risk Latino children under the age of 6 referred for severe behavior and emotional problems, such as aggression, oppositional behavior, self-injury, and property destruction. EP directly engaged the parent–child dyad, emphasizing parent-directed training, child-led play, psychoeducation, and cognitive–behavioral strategies. Cultural modifications included establishing community partnerships to identify Latino family needs, translation of materials, offering bilingual services, acculturation assessment, and cultural competence training. Multivariate analyses of covariance (MANCOVA) revealed significant differences between the immediate and delayed treatment groups on all posttest measures with the pretest scores as covariates. After the delayed group completed treatment, repeated measures, multivariate analyses of variance (MANOVA) showed significant improvement for both groups on all measures with maintenance at 4- to 6-week follow-up. Outcomes included reduced child behavior problems, increased child prosocial behaviors, improved caregiver limit setting, enhanced caregiver nurturing, improved parent–child relationships, and a decrease in clinical diagnoses following treatment. This study highlights the efficacy of using culturally adapted early intervention services for young Latino children in poverty referred for significant behavior and emotional problems

Spartan Daily, April 18, 1980

Volume 74, Issue 50https://scholarworks.sjsu.edu/spartandaily/6617/thumbnail.jp

The Global Economic Crisis: Impact on India and Policy Responses

India's financial sector is not deeply integrated with the global financial system, which spared it the first round adverse effects of the global financial crisis and left Indian banks mostly unaffected. However, as the financial crisis morphed in to a full-blown global economic downturn, India could not escape the second round effects. The global crisis has affected India through three distinct channels: financial markets, trade flows, and exchange rates. The reversal in capital inflows, which created a credit crunch in domestic markets along with a severe deterioration in export demand, contributed to the decline of gross domestic product by more than 2 percentage points in the fiscal year 2008–2009. In line with efforts taken by governments and central banks all over the world, the Government and the Reserve Bank of India took aggressive countercyclical measures, sharply relaxing monetary policy and introducing a fiscal stimulus to boost domestic demand. However, this paper argues that with very limited fiscal maneuverability and the limited traction of monetary policy, policy measures to restore the Indian gross domestic product growth back to its potential rate of 8–9% must focus on addressing the structural constraints that are holding down private investment demand.india global financial crisis; gdp growth