Objective. To explore general practitioners’ (GPs’) experiences in helping children as next of kin of drug-addicted, mentally ill, or severely somatic ill adults. These children are at risk of long-term mental and somatic health problems. Design. Qualitative focus-group study. Setting. Focus-group interviews were conducted in western Norway with a total of 27 GPs. Participants were encouraged to share stories from clinical encounters with parents who had one of the above-mentioned problems and to discuss the GP's role in relation to helping the patients’ children. Results. The GPs brought up many examples of how they could aid children as next of kin, including identifying children at risk, counselling the parents, and taking part in collaboration with other healthcare professionals and social workers. They also experienced some barriers in fulfilling their potential. There were time constraints, the GPs had their main focus on the patient present in a consultation, and the child was often outside the attention of the doctors, or the GPs could be afraid of hurting or losing their vulnerable patients, thus avoiding bringing up the patients’ children as a subject for discussion. Conclusions. Norwegian GPs are in a good position to help children as next of kin and doctors make a great effort to support many of them. Still, support of these children by GPs often seems to depend not on careful consideration of what is best for the patient and the child in the long run, but more on short-term convenience reasons.
Fifteen mothers displaying depressive symptoms six weeks after giving birth were recruited from a health centre and participated in a study using the Marte Meo intervention method. Subsequent findings were promising; the mothers' viewing their interaction with their babies seemed to be the key to facilitating selfreflection, a renewed sense of vitality and increased capacity for mentalisation. This viewing thus had an overall positive influence on increasing sensitive mother-child interaction and decreasing maternal depressive symptoms. A conceptual model is outlined.
Siblings of children with neurodevelopmental disorders (ND) are at increased risk of mental health problems. The burden on families of children with ND is exacerbated in low-income countries with limited health services and dependency on informal care systems. Yet, there is little research on family impacts of ND in non-Western settings, and no evidence-based interventions for siblings. We examined initial outcomes and feasibility of a manual-based intervention for siblings and parents of children with ND, called SIBS, delivered in Cambodia. SIBS has promising evidence from an open trial in Norway. We delivered eight groups for 52 siblings (M age = 12.7 years, SD = 2.7; 44.0% female) and 56 caregivers (M age = 43.5 years, SD = 8.5; 61.1% mothers) of 54 children with ND at the only public child mental health clinic in Cambodia. We aimed to improve sibling and parent mental health and family communication. The SIBS intervention comprises three separate sibling/parent group sessions and two joint sibling-parent dialogue sessions. Parent-reported mental health scores for siblings were higher than sibling self-report. Parent mental health problems at baseline were high, with no difference between mothers and fathers. There was significant improvement in parent mental health and parent-rated mental health for siblings from baseline to 4-month post-intervention (effect sizes d = 0.44 to 0.52). There was no change in sibling-reported mental health or family communication. Sibling- and parent-rated user satisfaction was high. We conclude that the SIBS intervention showed promise in Cambodia. However, revision of the communication component is needed.
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