Home-Based Parent Child Therapy for Young Traumatized Children Living In Poverty: A Randomized Controlled Trial

A randomized control trial was used to evaluate the effectiveness of a home-based, parent-and-child therapy program specifically developed for toddlers and preschoolers living in poverty with trauma symptoms. Sixty-four children 5-years of age and younger were referred to a community-based clinic for behavior problems and emotional difficulties. All children had experienced one or more potentially traumatic events and met the DSM-5’s criteria for Post-Traumatic Stress Disorder in Children Six Years of Age and Younger. All families received government assistance indicating that their income met the federal definition for poverty. Participants were randomly assigned to either immediate treatment or wait list control groups. Significant between-group differences on all post-treatment measures were found. After the waitlist group completed treatment, significant improvements for both groups were found on all measures at six-weeks follow-up. Outcomes included reductions in challenging behaviors and emotional symptoms of trauma, improved caregiver-child relationships, and increased caregiver adherence to treatment strategies. This study offers support for early intervention of children with trauma symptoms and identifies the clinical challenges and advantages of providing therapy services in a home setting for very young children in poverty

Early Pathways Therapy for Young Children in Poverty: A Randomized Controlled Trial

Early Pathways is a home-based, parent and child therapy program for the treatment of disruptive behaviors among young children living in poverty. In this study, 199 clinically referred children were randomly assigned to an immediate treatment (IT) or wait-list control (WL) conditions. Results indicated that parents in the IT condition reported significant improvements in their child’s disruptive and prosocial behaviors and increased nurturing and decreased use of corporal and verbal punishment by their parents compared to the WL families. Gains were maintained for children in both the IT and WL conditions at 3-month follow-up

Building a Grad Nation: Progress and Challenge in Ending the High School Dropout Epidemic

This fourth annual update on America's high school dropout crisis shows that for the first time the nation is on track to meet the goal of a 90 percent high school graduation rate by the Class of 2020 -- if the pace of improvement from 2006 to 2010 is sustained over the next 10 years. The greatest gains have occurred for the students of color and low-income students most affected by the dropout crisis. Many schools, districts and states are making significant gains in boosting high school graduation rates and putting more students on a path to college and a successful career. This progress is often the result of having better data, an understanding of why and where students drop out, a heightened awareness of the consequences to individuals and the economy, a greater understanding of effective reforms and interventions, and real-world examples of progress and collaboration. These factors have contributed to a wider understanding that the dropout crisis is solvable.While progress is encouraging, a deeper look at the data reveals that gains in graduation rates and declines in dropout factory high schools occurred unevenly across states and subgroups of students (e.g. economically disadvantaged, African American, Hispanic, students with disabilities, and students with limited English proficiency). As a result, large "graduation gaps" remain in many states among students of different races, ethnicities, family incomes, disabilities and limited English proficiencies. To repeat the growth in graduation rates in the next ten years experienced in the second half of the last decade, and to ensure progress for all students, the nation must turn its attention to closing the graduation gap by accelerating progress for student subgroups most affected by the dropout crisis.This report outlines the progress made and the challenges that remain. Part 1: The Data analyzes the latest graduation rates and "dropout factory" trends at the state and national levels. Part 2: Progress and Challenge provides an update on the nation's shared efforts to implement the Civic Marshall Plan to reach the goal of at least a 90 percent high school graduation rate for the Class of 2020 and all classes that follow. Part 3: Paths Forward offers recommendations on how to accelerate our work and achieve our goals, with all students prepared for college and career. The report also offers "snapshots" within schools, communities, and organizations from Orlando to Oakland that are making substantial gains in boosting high school graduation rates

In-Home Counseling for Young Children Living in Poverty: An Exploration of Counseling Competencies

Home-based counseling is increasingly an alternative mode of providing counseling services for children and families, reduces barriers to accessing traditional counseling services, and has also been shown to be effective. As such, the purpose of this qualitative study was to explore and describe the competencies needed to provide such counseling services. This study yielded five categories of competencies—necessary knowledge sets, case conceptualization, counseling behaviors, flexibility in session, and professional dispositions and behaviors. We also outline implications for counseling practice, counselor education, and public policy

Sent Home and Put Off-Track: The Antecedents, Disproportionalities, and Consequences of Being Suspended in the Ninth Grade

This study is based upon a longitudinal analysis of data for a cohort of 181,897 Florida state students who were first time 9th graders in the 2000-01 school year and follows them trough to high school and post-secondary outcomes. Analysis of 9th grade suspension data finds that black students, students who are economically disadvantaged, and special education students are three demographics subgroups that are disproportionately suspended, both in the frequency of suspensions and the duration in number of school days lost. While poverty and ethnicity are themselves highly correlated, poverty alone does not explain the disproportionate suspension rates amongst black students. Further analyses show that out-of-school suspensions in the 9th grade year are also significantly and negatively correlated to later high school graduation as well as post-secondary enrolment and persistence. Thus demographic disparities in disciplinary incidents serve to further widen any academic achievement gaps. Closer analysis though shows though that disciplinary incidents are interrelated with other of indicators of student disengagement from school, such as course failures and absenteeism. Therefore, policies seeking to address these issues cannot focus on reducing suspensions alone, but must also address student attendance and course passing in a comprehensive and systematic manner

Shared Decision-Making: an autoethnography about service user perspectives in making choices about mental health care and treatment

Shared decision-making (SDM) between mental health medication prescribers and service users is a central pillar in the recovery approach, because it supports people experiencing mental ill-health to explore their care and treatment options to promote their well-being and to enable clinicians to gain knowledge of the choices the service user prefers. SDM is receiving increasing recognition both in the delivery of physical and mental health services; and as such, is of significance to current practice. As an expert-by-experience with over 30 years of receiving mental health treatment, I have made many choices about taking medication and accessing other forms of support. The experiences of SDM have been variable over my career as a service user: both encounters when I have felt utterly disempowered and interactions when I have led decision-making process based on my expertise-by-experience. In this article, I recount two experiences of exploring care and treatment options: firstly, a discharge planning meeting; and secondly, the choice to take medication over the long-term, despite the side effects. The article will explore both opportunities and barriers to effective shared decision-making, as well as skills and processes to facilitate this approach. The need to balance power between service users and professionals in this interaction is highlighted, including the need to respect expertise built on lived experience, alongside that of clinical expertise. This narrative is framed within an autoethnographic approach which allows me to contextualize my personal experiences in the wider environment of mental health care and support

Exorcising memories of internalised stigma: The demons of lived experience

Public stigma and self-stigma impact negatively on the lives of people with mental health issues. Many people in society stereotype and discriminate against people with mental ill-health, and often this negative process of marginalisation is internalised by people with lived experiences. Thus, this negative internalisation leads to the development of self-stigma. In this article, I reflect on my own experiences of shame and self-stigma as a person with mental ill-health socially bullied by peers from my community and social groups. I present a personal narrative of both public and self-stigmatisation which I hope will enable me to exorcise memories of internalised stigma, which are encountered as my demons of lived experience. Using reflexivity, a process used widely in health and social care fields, I consider how social bullying shattered my fragile confidence, self-esteem, and self-efficacy in the early days of my recovery; the impact of associative stigma on family members is also explored. Following this, the potential to empower people who experience shame and stigma is explored alongside effective anti-stigma processes which challenge discrimination. I connect the concept of recovery with the notion of empowerment, both of which emphasise the importance of agency and self-efficacy for people with mental ill-health. Finally, I consider how the concepts of empowerment and recovery can challenge both the public stigma held by peers in the community and the self-stigma of those with lived experiences

Models Underpinning Mental Health: A Proposal for A User-Based Framework

Purpose: This article seeks to explore the models of mental health used in the delivery of care and the impact theoretical frameworks have on the implementation of practice. It discusses the development of a user-led model of care which is based on forms of practice which enhance the place of experiential knowledge in developing care and treatment, and service users’ responsibility for involvement in their own care. Approach: A conceptual discussion of the literature is presented which leads to the suggested development of a new model of care to underpin the implementation of mental health practice. Findings: The biomedical model of mental health predominates explanations of the aetiology of disease, the development of treatments and the delivery of care. Other models such as the bio-psycho-social model and the spiritual model have also been developed. Moreover, in their practice, professionals often adhere to the traditional model that underpins their professional training. Originality: A user-led model of care to frame the delivery and implementation of mental health support is posited and it is suggested that professionals need to receive training which reinforces developmental rather than routinised learning. Such training would enable them to respond to ways of innovative working which reinforce the autonomy and power of service users in their experience of mental health care and support. This suggests the potential of both a new way for professionals to work alongside service users, recognising the primacy of their expertise, and puts forward a novel emphasis on the kind of training practitioners receive