Parents of Children With Mental Illness: Exploring the Caregiver Experience and Caregiver-Focused Interventions

© 2011 Alliance for Children and FamiliesSerious mental illness in children can significantly impact the parents who care for these children in both positive and negative ways. Caregiver strain and enrichment manifests in all areas of parents’ lives, including work, mental and physical health, and social and family relationships. Research has identified numerous predictors of caregiver strain such as severity of child’s illness and impairment, race, and social support. These parents need strengths-based, parent-focused interventions to help them care for themselves and their family in a healthy, effective manner. A brief summary describes 4 types of interventions for parents of children with mental illness and the supporting research. Education, support, and skill building are all important components in parent interventions. A parent focus for interventions and research will decrease caregiver strain and create a healthier environment for the entire family

Preface

This is the Preface from the book, "Rooted in Strengths: Celebrating the Strengths Perspective in Social Work," available at http://hdl.handle.net/1808/30023

Strengths Model for Youth: Moving toward a Client-Centered, Strengths-based Model of Case Management in Community Mental Health

Approximately 13 to 20% of U.S. children and adolescents experience a mental disorder in a given year (Perou et al., 2013), with only half of these youth receiving mental health care (Kataoka, Zhang, & Wells, 2002; Merikangas, Nakamura, & Kessler, 2009). Even when children do access mental health services, approximate- ly 40% to 60% discontinue before completing their treatment (Baruch, Vrouva, & Fearon, 2009; Hoste, Zaitsoff, Hewell & le Grange, 2007; Miller, Southam-Gerow & Allin, 2008; Oruche, Downs, Holloway, Draucker & Aalsma, 2014). These statistics highlight the critical need for identification and implementation of effective child and family interventions for the mental health service system. Case management is a widely offered service within the children’s mental health system, but there is a scarcity of literature and research on models of case management and their effec- tiveness. This chapter introduces one model of case management, Strengths Model for Youth, and summarizes the current evidence on its effectiveness

Practitioner’s Guidebook: Best Practices in Assessment for the Kansas Serious Emotional Disturbance Waiver

The Kansas Serious Emotional Disturbance (SED) Waiver Best Practices Guide for Assessment was developed to share best practices in assessment for Kansas children and families. Additionally, this guide was developed to support community mental health centers (CMHCs) in conducting accurate and equitable SED Waiver eligibility processes. CMHCs can supplement their initial staff CAFAS training and CAFAS booster training with this guide, as it accounts for specific challenges or concerns that are unique to Kansas and Kansas’ SED Waiver eligibility process. The Guide is organized as follows: • Brief introduction to the CAFAS and PECFAS; • Developer identified CAFAS/PECFAS administration guidelines; • Summary of the common challenges observed regarding the CAFAS administration in Kansas and accompanying best practice recommendations; and • General best practices for conducting child and family assessments in mental health contexts. This guide closes with an example case vignette and decision flow charts for some of the CAFAS domains

Quick Reference: Print-Friendly Best Practices and User Flowcharts for Kansas Serious Emotional Disturbance Waiver

Purpose: This Quick Reference Guide was developed to provide clinicians with easy-to-access recommendations and decision guides for common challenges in CAFAS/PECFAS assessment. The first section of the guide summarizes common challenges in overall CAFAS administration, and the second section reviews common challenges within each domain. Both sections include recommended assessment practices for addressing each challenge. The Guide concludes with quick reference decision flow charts for two CAFAS domains, which clinicians often find most challenging or confusing to complete, the Self-harmful Behavior domain and the Thinking domain

Predictors and Moderators in the Randomized Trial of Multi-Family Psychoeducational Psychotherapy for Childhood Mood Disorders

OBJECTIVE: This study investigated predictors and moderators of mood symptoms in the randomized controlled trial (RCT) of Multi-Family Psychoeducational Psychotherapy (MF-PEP) for childhood mood disorders. METHOD: Based on predictors and moderators in RCTs of psychosocial interventions for adolescent mood disorders, we hypothesized that children’s greater functional impairment would predict worse outcome, while children’s stress/trauma history and parental expressed emotion and psychopathology would moderate outcome. Exploratory analyses examined other demographic, functioning, and diagnostic variables. Logistic regression and linear mixed effects modeling were used in this secondary analysis of the MF-PEP RCT of 165 children, ages 8–12, with mood disorders, a majority of whom were male (73%) and White, non-Hispanic (90%). RESULTS: Treatment nonresponse was significantly associated with higher baseline levels of global functioning (i.e., less impairment; Cohen’s d = 0.51) and lower levels of stress/trauma history (d = 0.56) in children and Cluster B personality disorder symptoms in parents (d = 0.49). Regarding moderators, children with moderately impaired functioning who received MF-PEP had significantly decreased mood symptoms (t = 2.10, d = 0.33) compared with waitlist control. MF-PEP had the strongest effect on severely impaired children (t = 3.03, d = 0.47). CONCLUSIONS: Comprehensive assessment of demographic, youth, parent, and familial variables should precede intervention. Treatment of mood disorders in high functioning youth without stress/trauma histories and with parents with elevated Cluster B symptoms may require extra therapeutic effort, while severely impaired children may benefit most from MF-PEP

Delivering the Strengthening Families Program to Native American Families During COVID-19: Lessons & Next Steps

The COVID-19 pandemic (COVID) of 2020 has forced adaptation for all Americans. Programs that serve Native American children and families are particularly critical during this time due to the disproportionate risks and disparities faced by this population. The objective of this qualitative evaluation is to gather adult participant feedback on strengths and needed changes with a telehealth adaptation of the Strengthening Families Program. This evaluation builds on previous knowledge of SFP group leadership which suggests that supportive helping relationships paired with dynamic flexibility are facilitators of effective family engagement. Participant feedback suggests that caregiver’s felt comfort, care, and genuine concern. In addition all participants noticed a difference in their families’ communication and relationships. Although tragic and challenging, the COVID-19 pandemic, forced a spotlight on barriers (limited internet access, social services, and food resources) that were needed to sustain participation and increase resilience among Native American residents in this mid-western state.  The individualized planning and checking in on every level which started out as a “how do we replicated this service” became about building resilience strategies for Native American families in this critical time in history

Factors Influencing Mental Health Service Utilization by Children with Serious Emotional and Behavioral Disturbance: Results from the LAMS Study

The official published article is available online at http://doi.org/10.1176/appi.ps.62.6.650.OBJECTIVE: To describe service utilization of a cohort of children with emotional and behavioral disorders who visited outpatient mental health clinics in four Midwest cities. METHOD: Data come from the Longitudinal Assessment of Manic Symptoms (LAMS) Study. 707 youth (ages 6–12 years) and their parents completed diagnostic assessments, demographic information and an assessment of mental health service utilization. Analyses examined the relationship of demographics, diagnoses, impairment, and comorbidity to the type and level of services utilized. RESULTS: Service utilization is multimodal with half of the youth receiving both outpatient and school services during their lifetime. Non-need factors including age, sex, race, and insurance, were related to types of services used. Youth diagnosed with a bipolar spectrum disorder had higher utilization of inpatient services and two or more services at one time compared to youth diagnosed with depressive or disruptive disorders. More than half of youth diagnosed with bipolar or depressive disorders had received both medication and therapy during their lifetime whereas for youth diagnosed with a disruptive disorder therapy only was more common. Impairment and comorbidity were not related to service utilization. CONCLUSIONS: Use of mental health services for children begins at a very young age and occurs in multiple service sectors. Type of service use is related to insurance and race/ethnicity, underscoring the need for research on treatment disparities. Contrary to findings from results based on administrative data, medication alone was infrequent. However, the reasonably low use of combination therapy suggests that clinicians and families need to be educated on the effectiveness of multimodal treatment

Mental Health Service Use by Children With Serious Emotional and Behavioral Disturbance: Results From the LAMS Study

To describe service utilization of a cohort of children with emotional and behavioral disorders who visited outpatient mental health clinics in four Midwest cities