A systemic approach to school-based consultation: Combining interventions that belong to different theoretical traditions. Chapter 9

This chapter is licensed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made. The images or other third party material in this chapter are included in the chapter's Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the chapter's Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.This chapter illustrates the idea that a systems perspective can encompass any idea that helps increase our understanding and effectiveness. An underlaying assumption is that the adoption of a systems perspective encourages—even requires—the possession of a plurality of theories and instruments because of the extremely complex nature of dynamic systems. The authors describe a real-life, school-based intervention that combines a normative approach (Marte Meo), with a non-normative perspective (Coordination Meetings), and how the interventions, derived from different philosophical and theoretical traditions, have been included within a single systems-oriented framework.publishedVersio

Systemic perspectives and psychiatric diagnosis: Mutually exclusive or mutually inclusive? Chapter 7

This chapter is licensed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made. The images or other third party material in this chapter are included in the chapter's Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the chapter's Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.In common with most others who work in the field of mental health, the authors have been obliged to develop a professional relationship with the two dominant diagnostic guides, The International Classification of Disease 10 (ICD-10) and the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5). While they concur with the widely held view that there are many problematic issues connected to both diagnostic systems, many of the conflicts generated within the mental health field that we are aware of seem to emerge from the different meanings that are attributed to them and/or the ways in which they are applied. We argue for the position that a system of diagnostic categories is necessary for all psychotherapists, in a parallel but different manner to the way in which it is important for medical practitioners. We systemic therapists also have a fundamental need of organizing the domain of human suffering so that we can bring order to our clinical practice, our research and our professional communication. The most important question is “how?”.publishedVersio

Children subjected to family violence: A retrospective study of experiences of trauma-focused treatment

Exposure to adverse childhood experiences is a risk factor for the development of serious psy chiatric and somatic illness. Although trauma-focused therapy is effective in reducing symptoms, not all children benefit from it. To improve treatment efficacy, the children’s perspective on what they perceive as helpful versus hindering is necessary. This study aimed, retrospectively, to explore how children exposed to family violence experienced treatment at the Child and Adolescent Mental Health Service. Seventeen children and youths were interviewed 4–5 years after treatment. The thematic analysis resulted in five themes: confusion, the need to feel heard, fear of consequences, feelings of pain, and identifying oneself as an agent. The results emphasize the importance of the therapeutic relationship, and that trust, genuine interest, and reciprocity are necessary for the child to engage in treatment. However, neither the child’s own agency nor external obstacles such as continuous exposure to abuse should be underestimated in terms of the child’s engagement.publishedVersio

Bottom-up and top-down approaches to understanding oppositional defiant disorder symptoms during early childhood: a mixed method study

Background: Children with clinical levels of conduct problems are at high risk of developing mental health prob lems such as persistent antisocial behavior or emotional problems in adolescence. Serious conduct problems in child hood also predict poor functioning across other areas of life in early adulthood such as overweight, heavy drinking, social isolation and not in employment or education. It is important to capture those children who are most at risk, early in their development. The Diagnostic and Statistical Manual of Mental Disorders (DSM–5) is commonly used in clinical settings, to identify children with conduct problems such as oppositional defant disorder (ODD).This paper presents a cross-sectional study in a clinical setting, and describes behaviors in 3- to 8-year-olds with ODD. Our aim was to investigate whether there were problematic behaviors that were not captured by the diagnosis of ODD, using two diferent methods: a clinical approach (bottom-up) and the nosology for the diagnosis of ODD (top-down). Method: Fifty-seven children with clinical levels of ODD participated in the study. The mothers were interviewed with both open questions and with a semi-structured diagnostic interview K-SADS. The data was analyzed using a mixed method, convergent, parallel qualitative/quantitative (QUAL+QUAN) design. For QUAL analysis qualitative content analysis was used, and for QUAN analysis associations between the two data sets, and ages-groups and gen der were compared using Chi-square test. Results: In the top-down approach, the ODD criteria helped to identify and separate commonly occurring opposi tional behavior from conduct problems, but in the bottom-up approach, the accepted diagnostic criteria did not cap ture the entire range of problematic behaviors-especially those behaviors that constitute a risk for antisocial behavior. Conclusions: The present study shows a gap between the diagnoses of ODD and conduct disorder (CD) in younger children. Antisocial behaviors manifest in preschool and early school years are not always sufciently alarming to meet the diagnosis of CD, nor are they caught in their entirety by the ODD diagnostic tool. One way to verify suspicion of early antisocial behavior in preschool children would be to specify in the ODD diagnosis if there also is subclinical CD.publishedVersio

Strengthening identity : a study of landscape architects interpretations and concretisation of visions at Tenstaterrassen

Järvalyftet i Stockholm är en utvecklingssatsning för att förbättra levnadsvillkoren i stadsdelarna kring Järvafältet. I Vision Järva 2030 uttrycks bland annat att stadsmiljön i området ska förbätt-ras, samt att områdenas identitet ska stärkas. Ten-staterrassen är ett projekt inom satsningen som innebär byggandet av bostäder ovanpå en över-däckning av motorvägen norr om Tensta. Syftet med det här arbetet är att, med Tenstater-rassen som exempel, undersöka hur landskapsar-kitekter arbetar med platsidentitet. Frågan som arbetet sökt svar på är hur de landskapsarkitekter som arbetat med Tenstaterrassens offentliga ytor ser på identitet kopplat till plats, och hur deras synsätt visar sig i gestaltningen. Metoden som används i studien är kvalitativa in-tervjuer med landskapsarkitekter och planerare som arbetar med projektet. Dessutom studeras själva förslagshandlingen för Tenstaterrassen. Främst används forskning om plats och identitet inom urbansociologi och kulturgeografi i stu-dien. Utifrån teorin utvecklas ett antal identitets-skapande aspekter som används för analysen av materialet. Studien visar att landskapsarkitekternas tolkning av identitet handlat om att se den sociala poten-tialen i sitt arbete. De har genom en platspecifik gestaltning av Tenstaterrassen velat stärka männ-iskors känslor av tillhörighet på platsen. Studien visar också att tolkningen skiljt sig från hur deras beställare sett på platsidentitet.Järvalyftet is a development initiative designed to improve living conditions within the neigh-borhoods surrounding Järvafältet in Stockholm. Vision Järva 2030 expresses the desire not just to improve the urban environment of the area but also to strengthen the identities of the areas themselves. Tensta terrace is a project that in-volves the construction of housing on top of the over-decking of the highway north of Tensta. The purpose of this thesis is, with Tensta terrace as an example, to examine how landscape archi-tects work with place identity. The question that this work seeks to answer is how the landscape architects who worked with the Tensta terrace project interpret the word identity and how their approach to it is reflected in the design of the site. The method used in this study is qualitative; utili-zing interviews with the landscape architects and planners involved in the project. Also the propo-sal document for Tensta terrace is studied. Re-search on place and identity in urban sociology and human geography is used in the study. Using these theories, this thesis identifies and develops a number of aspects of identity; which are used in the analysis of the material. The study shows that landscape architects’ in-terpretation of identity relates to seeing the so-cial potential of their work. They have, through a site specific design of Tensta terrace, tried to strengthen people’s feelings of belonging to the place. The study also shows that the client had different idea of the concept of place identity

Välfärd hos nötkreatur på boskapsmarknader i Addis Ababa och Ambo, Etiopien

In Ethiopia, cattle have an important role in the farming system and are the main source for meat and milk. The cattle production also provides employment opportunities and cash income, which is important, especially for the poor and landless households in Ethiopia. However, there are several constraints limiting the production and ultimately affecting the animal welfare negatively. The goal of this study was to investigate the welfare of cattle at different markets in Ethiopia and the study was based on animal-, resource- and management measures. The assessment was carried out through health recordings of the animals, observations of the management practices at the markets, and interviews with the stakeholders. The study was carried out at three cattle markets, Kera market and Kara market which are located in Addis Ababa and Gudar market which is located in Ambo. The health recordings involved the following parameters; lameness, body condition scoring, lesions/swelling, cleanliness, hoof health, diarrhea, ocular and nasal discharge. In order to comply with the cattle markets in Ethiopia, the assessments were based on a modified animal welfare protocol. All parameters were scored using a 4-level scale and a total of 94 animals were scored during the recordings. Also, at every observation the surroundings at the markets were observed and several factors were taken in-to account; weather, number of people and animals present at the market, feed and water sources and if animals were tied or walked loose. Five interviews were conducted and an interview form was outlined in advanced. The questions focused on how far the animals had been transported (by walking or by vehicle), food and water availability (during transport and after arriving at the market) and if there were any sick or injured animals. Questions were also asked regarding the management practices at the markets. The results indicated that body conditions, lesions/ swelling, and cleanliness were the most common welfare problems for the animals. For all animals, 60 % were scored thin or very thin, and 55 % of the animals had minor or moderate signs of lesions/swelling. Approximately 60 % of the animals were minor or moderately dirty to their body, indicating that the cleanliness of the animal was low. Furthermore, lack of feed and water, ineffective management practices, lack of proper handling of animals and lack of education were common problems at the markets in Ethiopia. The results also showed that the animals were often beaten or hit with sticks. Also, the transport of cattle to the markets, either by truck or by walking with the animals, is ineffective and subjects the animals to stressful environments that also increases the risk or injuries. In order to improve the welfare of cattle at the markets there is a need to give the animals proper feed and water which meets their requirements, educate stakeholders, apply more effective management routines. Furthermore, enforce laws and regulations regarding animal welfare, which the authorities control and that non-compliance are followed by sanctions.Nötkreatur spelar en viktig roll för jordbrukssektorn i Etiopien och djuren är den främsta källan för mjölk och kött. Dessutom ger nötkreatursproduktionen en ökad sysselsättning och är en viktig inkomstkälla, speciellt för de fattiga och ägandelösa i Etiopen. Dock är produktionen väldigt begränsad av en rad faktorer som har en negativ effekt på nötkreaturens välfärd. Målet med denna studie var att undersöka välfärden för nötkreatur på djurmarknader i Etiopien och grundade sig på djur-, resurs- och skötselbaserade mätningar. Detta utfördes genom att studera djurens fysiska hälsa, beskriva rutinerna på marknaderna och genom intervjuer med de som hade ansvar för djuren. Studien genomfördes på tre olika boskapsmarknader, Kera marknad och Kara marknad som ligger i Addis Ababa och Gudar Marknad som ligger i Ambo. Hälsobedömningen inkluderade följande parametrar; hälta, hull, sår/svullnader, renlighet, klövhälsa, diarré samt okulär och nasal utsöndring. Protokollet för hälsobedömningen var modifierad och anpassad för att kunna studera nötkreatur på boskapsmarknader i Etiopien. Bedömningen genomfördes med hjälp av en 4-gradig skala och totalt 94 djur graderades under hälsobedömningarna. Under varje observation antecknades miljön på marknaderna och flera faktorer noterades såsom väder, antal människor och djur, mat- och vattentillgången och om djuren var bundna eller gick lösa. Fem intervjuer genomfördes och ett frågeformulär användes under varje intervju. Frågorna fokuserade på hur djuren hade transporterats till marknaden (på lastbil eller genom vandring), mat- och vattentillgången (under transport och på marknaden) samt om det fanns sjuka eller skadade djur. Frågor ställdes också angående rutiner och skötsel på marknaden. Resultaten från insamlade data indikerade att hull, sår/svullnader samt smutsiga djur var de vanligaste hälsoproblemen. Av alla djur bedömdes 60 % vara magra eller mycket magra och 55 % av djuren hade mindre eller måttliga sår/svullnader på kroppen. Cirka 60 % av djuren var mindre eller måttligt smutsiga. Dessutom var avsaknad av foder och vatten, ineffektiva rutiner på marknaden och brist på kunskap vanliga välfärdsproblem på marknaderna i Etiopen. Resultaten visade också att djuren behandlades och hanterades ovarsamt och slogs ofta med pinnar. Transporten av djuren till marknaderna var ineffektiv och utsatte djuren för en ny miljö som kan vara stressande och dessutom öka risken för skador. För att förbättra välfärden krävs det att djuren får tillräckligt med foder och vatten som möter deras näringsbehov, utbilda de personer som har hand om djuren och tillämpa mer effektiva skötselrutiner på marknaderna. Även införa lagar och regler om djurskydd, som kontrolleras av myndigheter och är försedda med sanktioner om de inte efterlevs

Impact of EU-regulation on pigs’ welfare during transport

Each year 225 million pigs are transported within the European Union (EU) for slaughter, fattening and breeding. This results in poor animal welfare due to the fact that animals are exposed to several numbers of stress factors in the vehicle during loading, transit and unloading. Animal welfare can be defined as how well the animal attempts to cope with its environment and during transport there is often severe difficulty for the pigs to cope properly. There is a growing societal concern for animal welfare. This resulted in that the European Union enacted a law called the EU-regulation with certain directives of how to improve the welfare of the animals during transport. The literature review focuses on EU-regulation and pigs’ welfare during transport. Dead on arrival, unfit for transport, dehydration, lameness, severe injury and exhaustion were used to evaluate welfare of pigs during transport. The incidences of these welfare indicators were higher in 2005/2006 and lower in 2009. Therefore, the impact of EU-regulation 1/2005 shows that the welfare of pigs has been improved, at least in some aspects. The biggest challenge in the future is for all the member states in the EU to comply to the Regulation as this is not a reality today. More progress can be done in the future and there is a need for the Regulation to improve in order to be totally satisfactory regarding the welfare of the pigs.Varje år transporteras 225 miljoner grisar inom Europeiska Unionen (EU) för slakt, gödning och avel. Detta resulterar i sämre välfärd då djuren utsätts för en rad olika stressfaktorer i fordonet under lastning, färd och avlastning. Djurvälfärd kan definieras som hur bra ett djur kan anpassa sig till sin omgivning och under transport har grisar ofta väldigt svårt att anpassa sig till den förändliga miljön. En ökad oro för djurens välfärd resulterade i att den Europeiska Unionen skapade en förordning som har speciella direktiv för att förbättra djurvälfärden under transport. Litteraturstudien fokuserar på EU-förordningen och grisars välfärd under transport. ”Dead on arrival”, olämpliga för transport, uttorkning, hälta, allvarlig skador och utmattning användes för evaluera grisarnas välfärd under transport. Förekomsten av dessa välfärdsfaktorer var högre åren 2005/2006 och lägre år 2009. Därför visar EU-förordningen 1/2005 att grisarnas välfärd har ökat inom vissa områden. Den största utmaningen för framtiden är att alla medlemsländerna i EU ska följa förordningen då detta inte är en verklighet idag. Men mer framsteg kan göras och det finns ett behov av förbättra EU-förordningen för att grisarnas välfärd ska bli optimal

Erosionsskydd i strandzoner

Erosion in coastal areas is a common problem all around the world. The range of the problem depends on several factors, i.e. type of bed-rock and soil, wind and wave climate. Another factor is whether the area is of high interest, i.e. if the area is important for tourism and recreation, if there are houses and other buildings close to the shoreline or if it is a site of special scientific interest. The higher the value, the more money is spent to keep the problem in check. There are several ways to solve the problem, in this thesis, I have studied the most common solutions. Even though coastal protection is effective for a specific site, it may cause erosion further down stream. There are lots of things you have to take in consideration before you start to build. The economy plays a big part. The reason I chose this subject, is because I'm very interested in the forces of nature and the fact that the climate seams to be changing, with more extreme weather as a result. As more and more coastal areas get exploited the importance of coastal protection gets bigger. The first part of this thesis is a literature study about erosion and different types of coastal protection. In the second part I've taken a look at already built constructions and tried to compare how they were built and how they work, with the general guidelines of the manuals I've studied. There are no perfect solutions, you have to adopt the design from one place to another, because of the different conditions.Erosion är ett vanligt problem längs alla världens kuster. Hur omfattande problemet är beror på vilken bergrund och jordart man har på platsen samt våg- och vindklimat. En annan aspekt är hur viktig platsen är, om den har höga naturvärden eller är bebyggd. Ju högre värdena är desto större resurser läggs ned på att försöka få bukt med problemet. Sätten att lösa problemen är flera och i detta arbete har jag tittat på de vanligaste lösningarna. Bara för att man har byggt ett erosionsskydd behöver det dock inte betyda att problemet är löst. Även om erosionsskyddet fungerar bra för platsen kan det leda till att erosion uppstår någon annan stans. Vad man väljer att göra beror lite på vad man har för krav och vad man vill ha för resultat, men som i alla projekt så är det ändå ekonomin som avgör i slutänden. Bakgrunden till arbetet är en fascination för naturens krafter samt det faktum att klimatet verkar förändras allt snabbare med mer extrema väder som följd. En utökad exploatering av kuster har också gjort att det blivit allt viktigare att bygga erosionsskydd. Den största delen av arbetet består av en litteraturstudie. Manualer har lästs igenom för att få en bra bild av de olika erosionsskydden och hur de använts. Sedan har jag gjort en fallstudie där jag har tittat på hur man använt dessa i praktiken. Detta var svårare än jag trodde då det inte finns några exakta mallar för hur olika erosionsskydd skall byggas utan bara riktlinjer. Detta beror på att de måste anpassas efter den plats där det byggs. Sen har det varit svårt att få fram ritningar för de fallstudier som jag har gjort och en ordentlig jämförelse har därför inte kunnat göras. De exempel jag tittade på verkade fungera väldigt bra och det är ju huvudsaken. Det som man kan diskutera är hur bra vissa av dem flöt in i den omgivande naturen. På vissa platser kanske det heller inte spelar någon större roll

I want to be a mom who is clean, who loves herself, and feels ok with herself-pregnant women’s thoughts about motherhood and their unborn child when in treatment for substance use problems

There exists a vast amount of research and literature on pregnant women struggling with substance use problems and the challenges they can face in providing adequate and sensitive parenting. The aim of the present study was to explore the thoughts about motherhood and their unborn child of pregnant women in voluntary or involuntary substance use treatment, and to gain insight into their childhood attachment experiences. A total of 16 women in involuntary or voluntary treatment were interviewed about their thoughts about motherhood, their unborn child, and the treatment they were receiving. A phenomenological/hermeneutic analytical approach was used. Four categories emerged from the analysis: Influences of childhood experience, on becoming a mother, relating to the unborn child, and the meaning of treatment. The findings and their implications for treatment planning and support are discussed as a contribution to discussions of issues around compulsory treatment for pregnant woman with an SUD.publishedVersio

Journalstudie av ordinære akuttvedtak og akutt familieråd i barnevernet. En kartlegging av 329 akuttsaker i barnevernet. Delrapport III fra prosjektet ‘Familieråd når det haster med å finne en løsning’

In this report we present the main findings from a study comparing emergency cases in which ordinary emergency decision-making was used, with cases in which an emergency family group conferences (FGCE) were held. The empirical data is based on client records, altogether 329 records of emergency cases in child protection. 270 of these were ordinary emergency cases and 59 were FGCEs. The findings are to be viewed in the context of the summary of findings from the qualitative study presented at the beginning of this report. It must be stressed that this does not provide a basis for generalisation. Nevertheless, we believe that the survey identifies some important trends. The lack of studies on the use of FGCs makes it difficult to compare the findings with other research. Overall, findings from the study of client records support the findings from the qualitative interviews and demonstrate that the use of FGC in acute situations leads to greater mobilisation of relatives and networks, which better facilitates less-intrusive solutions for children in emergency situations. The findings from our study show that the use of FGC in acute situations creates impetus to find solutions among relatives and networks, leading to a decrease in the use of government measures in both the short and long term. The use of FGCE also appears to contribute to making the acute situation less dramatic and traumatic, and thereby reduces levels of insecurity in children and parents. This is related to the fact that children can be with someone they know, while providing them and their parents with more information and greater understanding of what is about to happen. This creates a greater sense of control and predictability for both children and parents, which reduces the levels of stress in the acute situation while preparing them for a possible relocation. Finally, we would like to mention that the qualitative study also identified challenges in the use of FGCEs, particularly when suspected violence and/or abuse is involved. In such cases, ordinary FGC should be considered, as well as 'shuttle councils' adapted to CWS cases involving violence and high levels of conflict. We are also critical of the use of FGC when children lack trust in the adults in the family and thus do not want to partake in a FGC.Prosjektet er finansiert av Barne- ungdoms- og familiedirektoratet (Bufdir).publishedVersio