Improvements in the quality of the parent-child relationship following treatment with an integrated family approach

ObjectiveThis study investigated changes in the emotional availability of the parent and the child in the dyadic relationship, parental reflective functioning, and parental perception of the relationship with their child following treatment with an integrated family approach in adult and child mental health care services. The aim of the study was to investigate if an integrated family approach in treatment contributes to good practice in mental health care.BackgroundChildren of parents with a mental disorder are at increased risk for developing mental health problems themselves during lifetime. Infants are extremely vulnerable for environmental influences. Parents with mental disorders are at risk for mis-attuned behavior and non-optimal emotional availability. This increases the risk of adverse cascading effects on the parent-child relationship and child development. A secure parent-child relationship is an important protective factor against the intergenerational transmission of mental disorders. Although treatment of the parental mental disorder is important, it does not automatically change undesirable patterns in the parent-child relationship. Therefore, an integrated family approach to mental health treatment is recommended.MethodsThis study involved a mixed methods design using questionnaires, an observation instrument and semi-structured interviews. The variables examined were the quality of the parent-child interaction, the parental perspective on their relationship with the child, their problems with child upbringing, and on their parental reflective functioning. The clinical sample consisted of 50 patients with a variety of mental disorders and their young children.ResultsAfter finishing the integrated treatment the quality of the parent-child interaction had improved significantly. Likewise, we found a significant improvement in parental perception regarding the relationship with the child and the parental role. The majority of the parents interviewed showed that they were better able to mentalize about themselves, their child and their relationship with the child, but the data from the questionnaire showed mixed results regarding parents’ reflective functioning.ConclusionTreatment with an integrated family approach to mental health care in which the parental role of the patient, the young child, and the parent-child relationship are integrated in treatment, can be a valuable addition to the current practice of mental health care in which patients are commonly perceived as individuals

Parents' perspectives on the results of mandatory child protection support:A qualitative study

In situations where parents do not accept support while their family situation is assessed as unsafe (for instance in cases of child abuse and neglect), it is sometimes necessary to offer mandatory support to families. The aim of the current study is to investigate how parents perceive the results of mandatory support from Child Protection Services (CPS) and which elements of the mandatory support parents mark as crucial for the results of the support. In-depth semi-structured interviews were conducted with 18 parents. Parents report mixed feelings about the results of the mandatory support. According to parents, reaching alignment with professionals about the problem definition, as well as the aims of CPS at the start of mandatory CPS, is a crucial element contributing to results of CPS. Additionally, the perceived quality of the support (both on the organizational and professional level) is simultaneous important conditions for a positive view on the support of parents. Implications for practice include the importance of multi-directed partiality of professionals to reach an agreement about the problems definition and the aims of the mandatory CPS involvement.</p

Parents' perspectives on the results of mandatory child protection support:A qualitative study

In situations where parents do not accept support while their family situation is assessed as unsafe (for instance in cases of child abuse and neglect), it is sometimes necessary to offer mandatory support to families. The aim of the current study is to investigate how parents perceive the results of mandatory support from Child Protection Services (CPS) and which elements of the mandatory support parents mark as crucial for the results of the support. In-depth semi-structured interviews were conducted with 18 parents. Parents report mixed feelings about the results of the mandatory support. According to parents, reaching alignment with professionals about the problem definition, as well as the aims of CPS at the start of mandatory CPS, is a crucial element contributing to results of CPS. Additionally, the perceived quality of the support (both on the organizational and professional level) is simultaneous important conditions for a positive view on the support of parents. Implications for practice include the importance of multi-directed partiality of professionals to reach an agreement about the problems definition and the aims of the mandatory CPS involvement.</p

Child Maltreatment in Families Receiving Mandatory Versus Voluntary Child Protection Support:A Matched Cohort Study

Child safety is an important outcome of child protection services (CPSs); however, this is often assessed in terms of official registries (e.g., rereports). Little empirical evidence is available about how the frequency of child maltreatment changes during CPS intervention by using self-report measures. The present study evaluates the frequency of child maltreatment experienced by children receiving mandatory child protection support compared to carefully matched children receiving voluntary child protection support. The current study is part of an ongoing Dutch longitudinal study on family violence consisting of several cohorts with similar designs. Both parents and children reported on the frequency of child maltreatment using validated questionnaires at two timepoints, 12 months apart. To facilitate careful comparison, both groups were matched using propensity scores based on background variables, resulting in two groups of N = 178 children. GLMM analyses showed a significant decrease in the mean number of child maltreatment incidents over time in the total group. However, this decrease did not differ for children receiving mandatory and voluntary child protection support. The findings indicate that, despite possible motivational challenges in the mandatory group, mandatory child protection support elicits comparable results as voluntary support. Implications for further research and practice are discussed.</p

Child Maltreatment in Families Receiving Mandatory Versus Voluntary Child Protection Support:A Matched Cohort Study

Child safety is an important outcome of child protection services (CPSs); however, this is often assessed in terms of official registries (e.g., rereports). Little empirical evidence is available about how the frequency of child maltreatment changes during CPS intervention by using self-report measures. The present study evaluates the frequency of child maltreatment experienced by children receiving mandatory child protection support compared to carefully matched children receiving voluntary child protection support. The current study is part of an ongoing Dutch longitudinal study on family violence consisting of several cohorts with similar designs. Both parents and children reported on the frequency of child maltreatment using validated questionnaires at two timepoints, 12 months apart. To facilitate careful comparison, both groups were matched using propensity scores based on background variables, resulting in two groups of N = 178 children. GLMM analyses showed a significant decrease in the mean number of child maltreatment incidents over time in the total group. However, this decrease did not differ for children receiving mandatory and voluntary child protection support. The findings indicate that, despite possible motivational challenges in the mandatory group, mandatory child protection support elicits comparable results as voluntary support. Implications for further research and practice are discussed.</p