Behavioural Training For Parents Of Mentally Retarded Children

Seven families participated in a behavioural training program for parents of mentally retarded children. The goals of this research were to: conduct a more extensive and systematic assessment of behavioural generality following basic behavioural training; determine how certain task characteristics affect such generalization; determine if certain forms of additional training (i.e., self-management training) enhance such generalization; assess the longterm maintenance and setting generality of parent skills following training; assess the role of individual characteristics in the initial and generalized effects of training; and provide an analysis of both therapist and client costs associated with such training.;The research design was a multiple-baseline across families with multiple generalization probes across child tasks. Parent training was administered in two successive phases: basic training followed by self-management training. Direct observations of parent/child teaching interactions provided measures of parents\u27 ability to implement behavioural teaching skills and measures of the generality of these skills across a variety of child tasks.;Although all parents showed marked increases in their ability to effectively implement behavioural teaching skills in an easy target task during basic training, different parents showed different patterns of generalized teaching to non-target child tasks. During self-management training, parents who had not yet generalized accurate teaching to all non-target tasks did so, while parents who had already demonstrated generalized teaching with certain tasks often showed additional increases. Changes in children\u27s correct responding to parental teaching generally parallelled changes in parent behaviour. Changes in parent and child behaviour were maintained over a 4-month follow-up period. Parents also demonstrated high rates of accurate teaching with new child tasks in the home setting, up to 5 months following the termination of training. Pretraining measures of parent stress were significantly correlated with parent and child behaviour change. Overall, parent satisfaction with the training program was very high.;It was postulated that the self-management procedures were successful because they promoted the transfer of stimulus control from the parent trainer to the parent. Overall, this research helped to identify a socially valid training approach that is effective in promoting generalized and maintained behaviour change at a cost that is not prohibitive. The clinical implications of this training approach were discussed

Examining Integrated Youth Services Using the Bioecological Model: Alignments and Opportunities

Integrated youth service (IYS) is a collaborative approach that brings practitioners together from across disciplines to provide comprehensive services including mental health care for youth and their families. IYS models serve as an advancement in practice as they go beyond the capacity of individual programs and services to reduce the fragmentation of care. Yet, there continue to be opportunities to expand on this perspective and promote health beyond the scope of formalized services. The bioecological model is a theoretical model that examines individual development within multiple systems of influence as well as through interactional processes between the individual and their environment. This paper provides an overview of the bioecological model and the major components of the IYS model, describing alignment and complementarity. The bioecological model provides some explanations for why IYS models may be effective and helps to provide direction to expand applied practice toward a more holistic perspective

Prevalence and Correlates of Youth Suicidal Ideation and Attempts: Evidence from the 2014 Ontario Child Health Study

© The Author(s) 2019. Objectives: To present the 12-month prevalence and correlates of suicidal ideation and attempts in a sample of youth in Ontario. Methods: Data come from the 2014 Ontario Child Health Study, a provincially representative survey of families with children in Ontario. Youth aged 14 to 17 y (n = 2,396) completed a computer-assisted, self-administered questionnaire in their home to assess the occurrence of suicidal ideation, suicidal attempts, and associated correlates, including non-suicidal self-injury, mental disorders, substance use, peer victimization and exposure to child maltreatment. Socio-demographic information was collected from the parent. Logistic regression models were used to identify correlates that distinguished between youth reporting: 1) no suicidal ideation or attempts, 2) suicidal ideation but no attempts, and 3) suicidal ideation and attempts. Results: The 12-month prevalence of suicidal ideation and attempts was 8.1% and 4.3%, respectively. All clinical and behavioural correlates were significantly higher among youth reporting suicidal ideation or attempts, as compared with non-suicidal youth. In adjusted models, depression and non-suicidal self-injury were each independently associated with elevated odds of suicidal ideation (OR = 4.84 and 4.19, respectively) and suicidal attempt (OR = 7.84 and 22.72, respectively). Among youth who reported suicidal ideation, the only variable that differentiated youth who attempted suicide v. those who did not, in adjusted models, was non-suicidal self-injury (OR = 3.89). Conclusions: Suicidal ideation and attempts are common among youth in Ontario, often co-occurring with mental disorders and high-risk behaviours. These findings underscore the need for effective prevention and intervention strategies, particularly for youth depression and non-suicidal self-injury

Prevalence and Correlates of Youth Suicidal Ideation and Attempts: Evidence from the 2014 Ontario Child Health Study

Objectives: To present the 12-month prevalence and correlates of suicidal ideation and attempts in a sample of youth in Ontario. Methods: Data come from the 2014 Ontario Child Health Study, a provincially representative survey of families with children in Ontario. Youth aged 14 to 17 y (n = 2,396) completed a computer-assisted, self-administered questionnaire in their home to assess the occurrence of suicidal ideation, suicidal attempts, and associated correlates, including non-suicidal self-injury, mental disorders, substance use, peer victimization and exposure to child maltreatment. Socio-demographic information was collected from the parent. Logistic regression models were used to identify correlates that distinguished between youth reporting: 1) no suicidal ideation or attempts, 2) suicidal ideation but no attempts, and 3) suicidal ideation and attempts. Results: The 12-month prevalence of suicidal ideation and attempts was 8.1% and 4.3%, respectively. All clinical and behavioural correlates were significantly higher among youth reporting suicidal ideation or attempts, as compared with non-suicidal youth. In adjusted models, depression and non-suicidal self-injury were each independently associated with elevated odds of suicidal ideation (OR = 4.84 and 4.19, respectively) and suicidal attempt (OR = 7.84 and 22.72, respectively). Among youth who reported suicidal ideation, the only variable that differentiated youth who attempted suicide v. those who did not, in adjusted models, was non-suicidal self-injury (OR = 3.89). Conclusions: Suicidal ideation and attempts are common among youth in Ontario, often co-occurring with mental disorders and high-risk behaviours. These findings underscore the need for effective prevention and intervention strategies, particularly for youth depression and non-suicidal self-injury

A mixed methods pilot study with a cluster randomized control trial to evaluate the impact of a leadership intervention on guideline implementation in home care nursing

Abstract Background Foot ulcers are a significant problem for people with diabetes. Comprehensive assessments of risk factors associated with diabetic foot ulcer are recommended in clinical guidelines to decrease complications such as prolonged healing, gangrene and amputations, and to promote effective management. However, the translation of clinical guidelines into nursing practice remains fragmented and inconsistent, and a recent homecare chart audit showed less than half the recommended risk factors for diabetic foot ulcers were assessed, and peripheral neuropathy (the most significant predictor of complications) was not assessed at all. Strong leadership is consistently described as significant to successfully transfer guidelines into practice. Limited research exists however regarding which leadership behaviours facilitate and support implementation in nursing. The purpose of this pilot study is to evaluate the impact of a leadership intervention in community nursing on implementing recommendations from a clinical guideline on the nursing assessment and management of diabetic foot ulcers. Methods Two phase mixed methods design is proposed (ISRCTN 12345678). Phase I: Descriptive qualitative to understand barriers to implementing the guideline recommendations, and to inform the intervention. Phase II: Matched pair cluster randomized controlled trial (n = 4 centers) will evaluate differences in outcomes between two implementation strategies. Primary outcome: Nursing assessments of client risk factors, a composite score of 8 items based on Diabetes/Foot Ulcer guideline recommendations. Intervention: In addition to the organization's 'usual' implementation strategy, a 12 week leadership strategy will be offered to managerial and clinical leaders consisting of: a) printed materials, b) one day interactive workshop to develop a leadership action plan tailored to barriers to support implementation; c) three post-workshop teleconferences. Discussion This study will provide vital information on which leadership strategies are well received to facilitate and support guideline implementation. The anticipated outcomes will provide information to assist with effective management of foot ulcers for people with diabetes. By tracking clinical outcomes associated with guideline implementation, health care administrators will be better informed to influence organizational and policy decision-making to support evidence-based quality care. Findings will be useful to inform the design of future multi-centered trials on various clinical topics to enhance knowledge translation for positive outcomes. Trial Registration Current Control Trials ISRCTN0691089

‘Youth-friendly’ characteristics of professionals in mental health settings

Adolescents have a unique developmental vulnerability to suicide, with youth presenting as the second most vulnerable group to suicide across the lifespan. Youth have been recognized as underserved mental health service recipients, with only one in six of those in need receiving care. Calls for innovative mental health services to better serve youth have been articulated for over a decade and the adolescent health and mental health communities have responded. However, to date there has been little empirical discussion of the caregiver characteristics that would increase the likelihood of youth feeling comfortable discussing their mental health concerns. Objectives of this study were twofold: (1) to ask a large sample of Canadian youth [n = 11 171: 5146 males, 6001 females (n = 24 participants did not indicate their sex )] to identify characteristics of mental health professionals they would define as ‘youth-friendly’, and (2) to test which youth-friendly characteristics are deemed important to youth based on their circumstances, including those experiencing recent suicidality. Gender differences are also tested and explored. The absence of youth-friendly mental health service provision is proposed to be a modifiable barrier to help seeking in at-risk youth