Trauma-informed care with women diagnosed with postpartum depression: a conceptual framework
Postpartum depression (PPD) is a mental health disorder that affects approximately 20% of all new mothers. PPD frequently co-occurs with and is exacerbated by trauma, particularly for women from vulnerable populations. Trauma-informed care (TIC) is a best practice that recognizes the importance of, and takes steps to promote recovery from, trauma while preventing retraumatization. Despite its potential utility, there is limited research published on TIC, including how TIC is operationalized across practice settings. Further, despite the prevalence and negative effects of untreated PPD, to date there have been limited articles published on TIC and PPD. The purpose of this article is to provide a TIC framework for service delivery for women diagnosed with PPD including explicit strategies for how TIC should be structured across roles, settings, and systems. Implications for health practice, policy, and future research are provided.
The Systemic Therapy Inventory of Change (STIC) Initial Scales: Are they sensitive to change?
The Systemic Therapy Inventory of Change (STIC) is a multisystemic and multidimensional feedback system that provides therapists feedback about systemic domains of client change in individual, couple, and family therapy over time. The goal of the present study is to investigate the sensitivity to change of the scores of the STIC Initial Scales. In total, 583 clients who voluntarily sought individual, couple, or family therapy services and participated in a randomized controlled trial study were included in the study. Their pre- and posttherapy responses to the STIC Initial measures and corresponding validation measures for individual functioning, couple relationship, child adjustment, and family functioning were compared. The results support the sensitivity to change of the scores of the four STIC Initial Scales investigated: Individual Problems and Strengths (IPS), Relationship with Partner (RWP), Family/Household (FH), and Child Problems and Strengths (CPS). Of particular note, the IPS demonstrated even greater change over time than the BDI-II, BAI, and OQ-45. The discriminant validity of measuring change with the CPS was not supported. Thus, the STIC Initial IPS, RWP, and FH can be usefully employed to measure multisystemic changes in both research and clinical work.
Abuse disclosures of youth with problem sexualized behaviors and trauma symptomology
Background: The majority of youth with problem sexualized behaviors (PSB) have substantiated experiences of abuse or exposures to violence (Silovsky & Niec, 2002). Little is known about specific abuse experiences that may differentiate youth with PSB from those without. Few studies have examined the types of abuse associated with post-traumatic stress symptomology. Objective: The current study explored two research questions: (1) Do children with PSB differ from children without PSB in terms of their abuse disclosures?; and (2) Are the types of abuse disclosed associated with the child’s scores on a post-traumatic stress measure?. Participants & setting: Data were analyzed for youth (N = 950) ages 3-18 years who completed a clinical assessment at a child advocacy center in the Midwest during the 2015 calendar year. Methods: Youth completed assessments that included a forensic interview and either the Trauma Symptom Checklist for Young Children (TSCYC) for children ages 3-10 years, or the Trauma Symptom Checklist for Children (TSCC) for children ages 11-16 years. Bivariate logistic regression was used to answer the research questions. Results: Findings indicated that youths who disclosed offender to victim fondling were less likely to disclose PSB (OR = 0.460, p = .026), and children exposed to pornography were more likely to disclose PSB (OR = 3.252, p = .001). Additionally, youth who disclosed physical abuse (OR = 1.678, p = .001) or victim to offender sexual contact (OR = 2.242, p = .003) had higher odds of clinically significant trauma scores. Conclusions: Implications for practitioners and future research directions are discussed.
Responding to Crisis of Aging People in Prison: Global Promising Practices and Initiatives
The “aging prisoner” crisis continues to gain international attention. The high human, social, and economic costs of warehousing older adults with complex physical, mental health, social, and spiritual care needs in prison continue to rapidly increase at a disproportionate rate compared to the general prison population. Over the past two decades, there has been some national and international movement in corrections and the community for programs, initiatives, and policies that foster the physical, mental, social, spiritual, and economic well-being of older adults. These promising practices often included comprehensive case management services for medical, mental health, substance abuse, family, social services, housing, education, or vocational programs. Program-specific aspects include one or more of the following: “age” and “cognitive capacity” sensitive environmental modifications, interdisciplinary staff and volunteers trained in geriatric-specific correctional care, complimentary medicine, specialized case coordination, the use of family and inmate peer supports and volunteers, mentoring, and self-help advocacy group efforts.
Relations between Reactive and Proactive Aggression and Daily Emotions in Adolescents
The current study examined whether individual differences in reactive and proactive aggression: 1) relate to level of daily emotion, including happiness, sadness, anger, and fear, 2) predict across-day variability in these emotions, and 3) moderate reactivity of these emotions to positive and negative events. Participants were a racially/ethnically diverse sample of 144 adolescents (80 girls, 64 boys; M age = 13.55 years; SD = 1.34). Adolescents self-reported on reactive and proactive aggression in a home visit prior to the collection of daily data. Using daily dairy procedures, adolescents then reported on their daily emotions and positive/negative events over 12 consecutive days. Higher reactive aggression was associated with greater levels of daily anger, more variability in anger across days, and heightened angry reactivity to negative events. Additionally, higher reactive aggression predicted lower levels of daily happiness but greater happy reactivity to positive events. Finally, higher reactive aggression was linked to increased variability in daily fear. In contrast, proactive aggression was largely unrelated to adolescents’ daily emotions, with the exception that higher proactive aggression predicted less variability in happiness across days. Results indicate that reactive aggression is characterized by significant emotionality at the daily level, and proactive aggression is characterized by lack of emotionality.
Repeated Disasters and Chronic Environmental Changes Impede, Generational Transmission of Indigenous Knowledge
The purpose of this study was to elucidate meaning from shared cultural perceptions of experiencing hurricanes and other environmental changes among an Indigenous community on the Gulf Coast. This study contributes to the scarce research exploring environmental determinants of Indigenous health disparities, and epidemic and widespread problem.
The Collateral Consequences of State Central Registries: Child Protection and Barriers to Employment for Low-Income Women and Women of Color
Virtually every social worker knows about the core role of state central registries in the child welfare system. Less well known is how the very registries that protect children can also threaten the economic security of their families and, in so doing, undermine child safety.
Eating Breakfast and Family Meals in Adolescence: The Role of Body Image
Regularly eating breakfast and meals with family has important health implications for youth. However, the association between eating breakfast and family meals regularly with body image has not been explored. Utilizing the 2009-2010 World Health Organization’s Health Behavior in School-Aged Children U.S. survey (N = 12,642), we sought to begin this conversation. Our findings suggest that eating breakfast and meals with parents more regularly may be related to more positive body image. This cross-sectional glance suggests that policies and programs that encourage youth and families to regularly eat breakfast and family meals may also encourage better body image among youth.
Understanding School Sabotage Among Survivors of Intimate Partner Violence From Diverse Populations
Higher education is an important pathway to safety for survivors of intimate partner violence (IPV). Recent work documents tactics of school sabotage (behaviors aimed at sabotaging educational efforts) identified by school staff and IPV advocates. However, the perspectives of current students who are IPV survivors are unexplored. As part of a multiphasic study, 20 semi-structured qualitative interviews with community college students who reported current or recent IPV were conducted. Identified tactics included disrupting child care, emotional abuse tied to school, and using manipulation to limit access to campus or resources. Identified impacts include preventing focus, diminished academic achievement, emotional or mental health challenges, and instilling a desire to overcome.
Medu-14. Genomic analysis of ETMR guides efficacious DFMO drug combinations
Embryonal tumor with multilayered rosettes (ETMR), formerly termed ETANTR, is a rare pediatric tumor carrying a poor prognosis and occurring primarily in patients less than 4 years of age. The median overall survival of <1 year for patients diagnosed with these primitive neuroectodermal (PNET)-like tumors demands the development of novel treatment regimens. Recent clinical and experimental data shows treatment with the highly tolerated drug DFMO (α-difluoromethylornithine) improves overall survival in neuroblastoma patients; and ETMR patients currently receiving DFMO on our expanded use trial have displayed clinical benefit. In neuroblastoma, DFMO reduces tumor burden through G1 cell cycle arrest, induction of senescence, and targeted cytotoxicity towards cancer stem cells. The effect of DFMO on tumors is mediated through polyamine depletion leading to disruption of the Lin28/Let-7 axis. We hypothesize that; ETMR, characterized by particularly high Lin28 expression, will be responsive to DFMO treatment. We have shown that DFMO treatment of the BT-183 and BIO-296-08 ETMR cell lines leads to a reduced number of viable cells, reducing viable cell number by 50% at 144 hours of exposure (CellTiter Glo). This reduction in viable cells is coupled with a simultaneous reduction in the overall expression of Lin28 as well as a reduction in the proportion and viability of the cancer stem cell subpopulation (flow cytometry). High throughput drug testing of BT-183 and RNA sequencing of six individual ETMR tumors identified temozolomide and the HDAC inhibitor panobinostat as ideal combination agents in treating ETMR cells. Treatment with temozolomide (IC50 2–6µM) and panobinostat (IC50 2-6nM), even in the presence of DFMO, resulted in a potent reduction in ETMR cell viability (CellTiter Glo). These data warrant further work elucidating the mechanism of this therapy and provides rationale for the development of clinical trials incorporating the use of DFMO in this lethal disease.
A Research Protocol for Studying Participatory Processes in the Use of Evidence in Child Welfare Systems
This paper presents a protocol for a funded study of technical assistance strategies used to support the use of evidence, and, in particular, how participatory processes contribute to the use of evidence to improve outcomes for populations. Findings from the study will increase understanding of the relationships between technical assistance, stakeholder participation and evidence use in child and family services. The authors argue that publishing such a protocol can increase transparency between researchers and practitioners and raise awareness of the need for research on how stakeholder participation can strengthen evidence use in child welfare service settings. The authors also reflect on the potential value and limitations of published protocols. This study will systematically gather input from stakeholders with expertise in technical assistance to develop a compilation of strategies that can be used to support the use of evidence. The study will identify strategies that include stakeholder involvement and assess which strategies under what conditions facilitated the use of research evidence. The study will address four research questions: What technical assistance strategies are used to support the use of research evidence? What are the consensus-driven terms and definitions of identified strategies? To what extent do technical assistance strategies involve stakeholders and for what purpose?
Public Health Social Work as a Unifying Framework for Social Work’s Grand Challenges
Introduced in 2013 by the American Academy of Social Work and Social Welfare, the Grand Challenges for Social Work (GCSW) implicitly embrace a public health perspective. However, the lack of a specific overarching conceptual framework creates a challenge for moving the GCSW from concept to practice. In this article, authors propose that public health social work (PHSW) provides a unifying framework for moving the GCSW from concept to practice. Authors undertook a review of the literature, including a review of published literature and all Web sites and other Web materials focused on the GCSW. Three GCSW were selected to illustrate the utility of PHSW and the social work health impact model (SWHIM): (1) stopping family violence, (2) eradicating social isolation, and (3) achieving opportunity and justice. Using a wide-lens PHSW approach, the illustrations focus on actions that can influence populations through strengthened environments and multilevel interventions. The public health field reflects the rigorous science behind the theoretical models, community-based approaches, and attention to effects of social determinants of health at the population level. Because health and inequalities are the focus of many of the GCSW, incorporating both public and population health, together with the SWHIM, can help provide structure to achieve collective goals.
Integrative Systemic Therapy: Lessons on Collaboration and Training for the 21st Century
The field of couple, marital, and family therapy (CMFT) is at an important juncture of identity development and synthesis. Integrative Systemic Therapy (IST) is a problem‐centered metaframeworks approach that meets the growing needs of family therapists working with diverse and complex family systems and restores the field to its original focus on collaboration. This paper describes the process by which IST developed featuring anecdotes from live interviews with the founders. We briefly outline IST’s theoretical pillars and the essential way IST practitioners deliver treatment including a blueprint for therapy. Finally, we propose that IST is a comprehensive, systemic guide uniquely beneficial to CMFT training and discuss our approach to integrating IST into our training of students in a COAMFTE accredited program.
Process and Product Innovations from a Statewide Capacity-Building Initiative for Substance Use Treatment and Recovery
Statewide behavioral health collaborative capacity-building initiatives are designed to support substance use agencies in strengthening their behavioral health services delivery and implementing evidence-supported practices. This study explored the types of innovations resulting from one such statewide behavioral health initiative, as well as the facilitators and barriers to implementing these innovations, from the perspective of the substance use agencies involved in the initiative. Data were collected through semistructured interviews with 67 agency stakeholders and 93 agency progress reports. Results indicated that 161 innovations emerged through this project for the substance use agencies, including staffing; policy, procedure, and technology; partnerships; training and media products; and service innovations. Agency facilitators included collaboration/partnership, project buy-in, and quality of agency staff. Barriers to implementation included lack of collaboration or partnerships, agency infrastructure or climate, lack of project buy-in, and funding and billing issues. The article concludes with a discussion on implications for social work practice in behavioral health.
Modes of Belonging: Debating School Demographics in Gentrifying New York
This article examines the frameworks that stakeholders bring to debates about diversifying schools in gentrifying areas of New York City. Using critical ethnographic methods, I explore stakeholders’ hopes and fears about the effects of shifting school demographics and the relationships between student demographics and school quality. I find that stakeholders use racialized discourses of belonging to discuss whether, why, and how student demographics matter. These discourses of belonging overlap with perceptions of demographic change as opportunities for integration, fears of gentrification, and threats to individual property. Complicating celebrations of “diversity,” I explore the ways in which race is implicated in considerations of who belongs in a school and to whom a school belongs.
Preventive Benefits of U.S. Childcare Subsidies in Supervisory Child Neglect
Using data from age 3 of the Fragile Families and Child Wellbeing Study, the current study explores the complex relationships between U.S. child care subsidies and neglect. Specifically, the study examines two research questions: (1) Are U.S. child care subsidies associated with self-reported neglect among low-income mothers? (2) What individual types of self-reported neglect are significantly reduced by receipt of child care subsidy? Using negative binomial regression examining the relationships among mothers who were income-eligible for child care subsidy, we found that child care subsidy was associated with lower levels of supervisory neglect, indicating an important role of subsidy in the lives of low-income families.
Growth-promoting supervision: Reflections from women of color psychology trainees
This paper discusses growth-promoting supervisory practices from the perspectives of women of color psychology trainees. Based on three personal narratives, we discuss the unique ways that supervisors invite the multiple salient identities of trainees into the supervisory relationship and engage in a mentorship approach tailored to each trainee. We discuss key themes that emerged across the three narratives: the importance of a supervisor pivoting between the role of the expert and the role of a learner, the value of embracing an attitude of shared responsibility toward promoting trainee growth, and the role of cultural humility in the supervisory relationship. We draw from various theories in framing our work, including Paulo Freire’s theory of conscientização and Atkinson, Morten, and Sue’s (1998) Five-Stage Model of Cultural/Racial Identity Development. We close with situating these impactful supervisory practices within the context of the American Psychological Association’s (2015) “Guidelines for Clinical Supervision in Health Service Psychology.”
Development of a Dementia-Focused End-of-Life Planning Tool: The LEAD Guide (Life-Planning in Early Alzheimer’s and Dementia)
Background and Objectives: To address the unique characteristics of Alzheimer’s disease and related dementias (ADRD) that complicate end-of-life (EOL), we created, refined, and validated a dementia-focused EOL planning instrument for use by healthy adults, those with early-stage dementia, family caregivers, and clinicians to document EOL care preferences and values within the current or future context of cognitive impairment. Research Design and Methods: A mixed-method design with four phases guided the development and refinement of the instrument: (1) focus groups with early-stage ADRD and family caregivers developed and confirmed the tool content and comprehensiveness; (2) evaluation by content experts verified its utility in clinical practice; (3) a sample of healthy older adults (n = 153) and adults with early-stage ADRD (n = 38) completed the tool, whose quantitative data were used to describe the psychometrics of the instrument; and (4) focus groups with healthy older adults, family caregivers, and adults with early-stage ADRD informed how the guide should be used by families and in clinical practice. Results: Qualitative data supported the utility and feasibility of a dementia-focused EOL planning tool; the six scales have high internal consistency (α = 0.66–0.89) and high test–rest reliability (r = .60–.90). On average, both participant groups reported relatively high concern for being a burden to their families, a greater preference for quality over length of life, a desire for collaborative decision-making process, limited interest in pursuing life-prolonging measures, and were mixed in their preference to control the timing of their death. Across disease progression, preferences for location of care changed, whereas preferences for prolonging life remained stable. Discussion and Implications: The LEAD Guide (Life-Planning in Early Alzheimer’s and Dementia) has the potential to facilitate discussion and documentation of EOL values and care preferences prior to loss of decisional capacity, and has utility for healthy adults, patients, families, providers, and researchers.
The Family Resilience Inventory: A Culturally Grounded Measure of Current and Family‐of‐Origin Protective Processes in Native American Families
The purpose of this article is to introduce the Family Resilience Inventory (FRI) and present findings on initial efforts to validate this measure. The FRI is designed to assess family resilience in one’s current family and in one’s family of origin, enabling the assessment of family protective factors across these generations. The development of the FRI was the result of many years of ethnographic research with Southeastern Native American tribes; yet, we believe that this scale is applicable to families of various backgrounds. Items for the FRI were derived directly from thematic analysis of qualitative data with 436 participants, resulting in two 20‐item scales. Due to missing data, eight cases were removed from the 127 participants across two tribes, resulting in an analytic sample size of 119. Conceptually, the FRI is comprised of two factors or scales measuring distinct dimensions of family resilience (i.e., resilience in one’s current family and resilience in one’s family of origin). The results of the confirmatory factor analysis supported the hypothesized two‐factor structure (X2(644) = 814.14, p = .03, X2/df = 1.10, RMSEA = .03, CFI = .97, TLI = .96). Both the subscales and the total FRI scale (α = .92) demonstrated excellent reliability. The results also provided preliminary evidence of convergent and discriminant validity. This measure fills a gap in the absence of community‐based, culturally grounded, and empirical measures of family resilience. The examination of family resilience, which may occur across generations, is an exciting new contribution of the FRI.
Using Qualitative Data-Mining to Identify Skillful Practice in Child Welfare Case Records
Using qualitative data-mining methods, this study analyzed 39 child welfare case records in order to identify examples of skillful practice. Conducted in partnership with a public child welfare agency in northern California, the study found that child welfare workers are implementing many of the practices promoted by statewide and national child welfare practice frameworks. Broad categories of skillful practice identified included: (1) effective communication by social workers, (2) support for client self-determination, and (3) active intervention strategies. Study findings provide support for incorporating case record review processes in training and supervision in order to integrate practice-based expertise with research-based evidence.