PTSS in fathers of VLBW infants two to four years postpartum:A pilot study

Aim: The aim of the study was to conduct a pilot study to compare fathers of very low birth weight (VLBW; <1,500 g) infants and term infants at 2- 4 years postpartum for self-reported posttraumatic stress symptoms (PTSS) related to the previous birth of their baby and for depression and anxiety. The prevalence of paternal PTSS was compared with that of a historical cohort of mothers of VLBW infants followed up at a similar postnatal age. Method: Twenty-six fathers of VLBW infants and 22 fathers of term infants completed 4 validated psychological questionnaires at 2- 4 years postpartum. Results: PTSS levels were significantly higher in fathers of VLBW infants than in fathers of term infants, and PTSS levels did not differ significantly between fathers and the mothers of VLBW infants of a historical cohort. There was a significant association between perceived levels of social support and PTSS severity in fathers of VLBW infants but not for their anxiety or depression severity. Conclusion: PTSS directly related to the birth of their VLBW infants are present in fathers at 2- 4 years postpartum and occur at similar levels to those found in mothers of VLBW infants. Routine screening for PTSS in fathers of VLBW infants is important, and targeted psychological support should be offered. Larger-scale studies in the area are needed to elucidate further information about PTSS in fathers postpartum

Personal storytelling in mental health recovery

Purpose: Creating more positive individual narratives around illness and identity is at the heart of the mental health care recovery movement. Some recovery services explicitly use personal storytelling as an intervention. This paper looks at individual experiences of a personal storytelling intervention, a recovery college Telling My Story course. Design/methodology/approach: Eight participants who had attended the Telling My Story course offered at a UK recovery college were interviewed. Data were analysed using Interpretative Phenomenological Analysis. Findings: Five key themes emerged: a highly emotional experience, feeling safe to disclose, renewed sense of self, two-way process and a novel opportunity. Originality/value: The findings suggest that storytelling can be a highly meaningful experience and an important part of the individual’s recovery journey. They also begin to identify elements of the storytelling process which might aid recovery, and point to pragmatic setting conditions for storytelling interventions to be helpful. More time could be dedicated to individuals telling their story within UK mental health services, and we can use this insight into the experience of personal storytelling to guide any future developments

'Being human’: A grounded theory approach to exploring how trainers on clinical psychology doctorate programmes decide whether or not to disclose personal experiences of psychological distress to clinical psychology doctorate trainees

Objective: Recent research and guidelines recommend that trainers on clinical psychology doctorate training programmes consider disclosing personal experiences of psychological distress to trainees. Disclosure is thought to promote cultures of openness, to validate and normalise trainee distress, encourage trainee disclosure and help-seeking and challenge stigmatising narratives. However, little is known about how trainers decide whether, what or how to disclose. This study aims to address that gap by exploring the processes and factors involved in trainers deciding whether or not to disclose personal experiences of distress to trainees, generating findings of relevance across counselling, psychotherapy and psychology training courses. Methods: In-depth interviews were conducted with nine trainers on UK clinical psychology doctorate programmes from around the country and analysed in accordance with constructivist grounded theory methods. Results: Findings indicated that participants valued disclosure personally and professionally, but were wary of the dangers of disclosure. Disclosure decisions were made by judging the context against internally held criteria. If criteria were not met, then disclosures were not made. Outcomes, whether positive or negative, served to reinforce the value of disclosure and the importance of managing risks, creating a positive feedback loop. Conclusions: The findings of this study suggest factors that are important for trainers to consider when deciding whether or not to disclose. The six-factor framework developed may be useful for trainers to consider within reflective practice, supervision or during guided self-reflection in order to make safe, helpful and ethical decisions

Parents’ and teachers’ knowledge of trauma and Post-Traumatic Stress Disorder in children and adolescents and their agreement towards screening

Background: Trauma exposure is common in children and adolescents. Parents and other key adults, such as teachers, are necessary to facilitate help-seeking behavior, which involves recognizing trauma and adverse reactions and awareness of accessing treatments. Where screening measures in schools are used to detect post-traumatic stress disorder (PTSD), the attitudes of parents and teachers towards screening need to be considered. Objective: To examine whether parents and teachers can accurately detect trauma events, symptoms and effective treatments. In addition, to assess how supportive parents and teachers are towards PTSD screening in schools. Method: A total of 439 parents and 279 teachers completed online questionnaires assessing PTSD knowledge across three domains: traumatic events, PTSD symptoms and evidence-based treatments. Responses of acceptability of using PTSD screening tools in schools were elicited. Results: Teachers and parents were accurate in recognizing trauma events and PTSD symptoms. However, understanding was inclusive, with events not considered traumatic and non-PTSD diagnostic criteria being endorsed. Trauma-Focussed Cognitive-Behavioral Therapy was recognized as an effective treatment for PTSD, but Eye-Movement Desensitization and Reprocessing was not. Treatments not recommended by health guidelines were frequently endorsed. The majority of participants were supportive of PTSD screening in schools, but a minority were not. Conclusions: Parents and teachers are able to recognize trauma events and symptoms of PTSD, although this tends to be overly inclusive. Schools could be targeted to promote understanding trauma among parents and teachers. Agreement with screening is encouraging and further research is warranted to understand barriers and facilitators

The prevalence of burnout and secondary traumatic stress in professionals and volunteers working with forcibly displaced people: A systematic review and two meta-analyses

Research suggests that professionals and volunteers who work with forcibly displaced people (FDP) experience burnout and secondary traumatic stress (STS) as a result of working with such a highly traumatized population. In the present systematic review and meta-analyses, we report the pooled prevalence rates of burnout and STS in individuals working both professionally and voluntarily with FDP. The CINAHL Complete, E-Journals, ERIC, MEDLINE Complete, OpenDissertations, PsycARTICLES, and PsycINFO databases were searched for articles published historically to September 2019. Studies (N = 15) were included and assessed for quality if (a) their sample comprised individuals working in a professional or voluntary capacity with refugees, asylum seekers, forced migrants, or displaced persons and (b) reported on an outcome of STS or burnout. Two meta-analyses were conducted using random-effects models to assess the prevalence of (a) burnout and (b) STS. The pooled prevalence of high-level burnout was 29.7%, 95% CI [13.8%, 45.6%], with considerable heterogeneity between studies, Q(5) = 112.42, p <.001, I 2 = 95.6%. The pooled prevalence of moderate, high, and severe STS was 45.7%, 95% CI [26.1%, 65.2%] with considerable heterogeneity between studies, Q(12) = 1,079.37, p <.001, I 2 = 98.9%. Significant differences were observed in reported prevalence depending on the measure administered. This review highlights the high prevalence of high-level burnout and moderate-to-severe STS reported by individuals working with FDP. The results have implications for future research, employment support for individuals working with FDP, and measure selection for assessing STS

The Experiences of Mental Health Professionals Supporting Forced Migrants: A Qualitative Systematic Review

Many forced migrants experience trauma in pre-migration, journeying, and post-migration phases of flight. Therefore appropriate mental health provision is required. Whilst previous reviews have explored the experiences of health-care staff in supporting forced migrants, no review was found that focused solely on the experiences of mental health professionals. This qualitative thematic synthesis integrates the findings from ten qualitative studies and identifies analytical constructs that encompass the challenges and facilitators for mental health professionals. Findings will inform how services can be developed to best support staff and enable the provision of high-quality mental health care for this potentially vulnerable population.Plusieurs migrants forcés vivent un trauma lors de la pré-migration, du voyage et de la post-migration. Une offre adéquate en santé mentale est donc nécessaire. Alors que des études précédentes ont exploré les expériences du personnel des services de santé dans le soutien aux migrants forcés, aucune études axée seulement sur les expériences des professionnels en santé mentale n’a été trouvée. Cette synthèse thématique qualitative intègre les résultats de dix études qualitatives et identifie les constructions analytiques englobant les obstacles et les facilitateurs pour les professionnels en santé mentale. Les résultats sont susceptibles d’orienter le développement de services visant à mieux soutenir le personnel et permettre la prestation de soins en santé mentale de qualité pour cette population potentiellement vulnérable

Parents experience of using “cold” facilities at a children’s hospice after the death of their baby:A qualitative study

There is a growing movement in children’s hospice care to offer families time with their baby after death through use of a “cold cot”; however, there is very limited research in this area. We interviewed seven parents (four mothers and three fathers). Our thematic analysis identified six themes: being able to care for my baby in a way that I never had, space and time to adjust to the loss, time as a family, having my baby close, creating memories, and awareness of societal perceptions. The authors conclude that these facilities provided memories, strengthened legacy, and were a valuable experience

Meta-analysis found high rates of post-traumatic stress disorder and associated risk factors in parents following paediatric medical events

Aim: This meta-analysis identified how prevalent parental post-traumatic stress disorder (PTSD) was after their children's medical events and evaluated the risk factors that increased the likelihood of PTSD.  Methods: The MEDLINE, PsycINFO and PTSDpubs databases were searched for papers published in English from 1980 to June 2018. The prevalence of parental PTSD was pooled across the studies and risk factors were extracted whether PTSD symptoms were correlated with other research variables or when the authors had conducted between group analyses of PTSD. We also explored the effects of the assessment method, parental gender and medical events and the risk of bias.  Results: The 54 studies that were identified had a pooled PTSD prevalence rate of 30.3% (95% confidence interval 25.3%–35.5%). Childhood cancer cases yielded the highest rates of parental PTSD. A total of 33 potential risk factors were identified. The risk factors with medium to large effects were: comorbid parental psychological responses and functioning, acute stress responses, child behavioural functioning, uncertainty about the child's illness and negative coping strategies. The findings are discussed within the context of high heterogeneity.  Conclusion: The prevalence of parental PTSD after paediatric medical events was relatively high, and 33 risk factors were identified