Families attending child and adolescent mental health (CAMH) services are often assumed to have problems in key areas such as communication, belonging/acceptance and problem‐solving. Family therapy is often directed towards addressing these difficulties. With increasing emphasis in family therapy and human services fields over the last decade on identifying and building from strengths, a different starting point has been advocated. This paper describes a large survey of the self‐reported pre‐therapy functioning of children and families using a public CAMH service (n=416). Before commencing family therapy parents identified family strengths across a range of key areas, despite the burden of caring for children with moderate to severe mental health problems. This evidence supports theoretical and clinical work that advocates a strengths perspective, and highlights how resilience framed in family (and social) rather than individual terms enables a greater appreciation of how strengths may be harnessed in therapeutic work.
The present study sought to evaluate the influence of interactive journaling on criminal recidivism and identify significant predictors of recidivism among a sample of 183 male inmates incarcerated in a local jail facility randomly assigned to either an interactive journaling condition or a control group. All participants met DSM-IV-TR criteria for substance dependence, had their current offense indicate substance involvement, and had a minimum of one previous arrest in the prior 12 months. The recidivism rate (51%), in terms of subsequent bookings within a 12-month period, for the journaling group was significantly lower than the recidivism rate (66%) for the control group, χ(2)(1, 183) = 4.13, p < .05. The three most significant independent predictors of subsequent bookings were severity of posttraumatic stress disorder, group assignment (journaling vs. placebo), and employment status. Interactive journaling appears to show promise as a brief treatment intervention strategy for substance dependence in local jail settings and may have the potential for reducing recidivism.
Parent and Child Therapy (PACT) is an attachment‐based intervention for children aged between 4 and 12 years old experiencing emotional and behavioural problems. It is appropriate for distressed parent—child relationships which have not responded to systemic family therapy. PACT seeks to reframe parent—child relationship distress using narrative techniques and experiential tasks based on the concept of supported looking. Therapy occurs in parallel for parent and child using a one‐way screen. PACT improves parents' reflective capacity and sensitivity, and for the child's sense of security in her primary attachment relationship. An outline of the four stages of PACT is presented along with a case study to illustrate the course of PACT. Finally, we discuss the dissemination of PACT within a busy child and adolescent mental health service and outline our plans for future outcome evaluation.
In the consumer satisfaction literature, there is little exploration of the relationship between change and satisfaction and the two are often conflated. This qualitative study interviewed parents a year after using child and adolescent mental health services. Eliciting an account of their experiences enabled the development of ‘grounded theories’ about what constitutes satisfaction for parents. The outcomes suggest that in addition to the expectable stories of ‘high change and satisfaction’ or ‘no change and low satisfaction’, considerable numbers of people are satisfied with a service despite experiencing little or no change, while others who experience positive change are not satisfied. Understanding these alternative stories helps address critical issues that affect the way therapists respond to people's needs and provide services — these matters are often within the capacity of therapists and services to address, even when working with limited resources.
Brief family therapy, including single session therapy, is widely used to provide a timely and responsive service for children with emotional and behavioural problems. However, there is surprisingly little information about how these children and families fare in the longer term. The brief family therapy program described here was directed toward children with problems of moderate severity. Child Behaviour Checklists (CBCL) were completed by parents before, three months after, and twelve months after therapy; 110 parents also participated in semi‐structured telephone interviews twelve months after therapy. Parents' CBCL ratings showed a significant decrease in children's problems after therapy, which were maintained over the subsequent year, although some children continued to experience difficulties. Parents generally found brief therapy a helpful experience. Ways to strengthen the preventive possibilities of brief therapy work will be identified at both a practical and conceptual level.
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