Integrated CARE: Adaptation of Child-Adult Relationship Enhancement (CARE) Model for Use in Integrated Behavioral Pediatric Care

2020 ◽  
pp. 000992282095993
Author(s):  
Becky Scott ◽  
Robin H. Gurwitch ◽  
Erica Pearl Messer ◽  
Lance P. Kelley ◽  
Dennis R. Myers ◽  
...  
Keyword(s):  
Primary Care ◽  
Behavioral Health ◽  
Parental Stress ◽  
Short Form ◽  
Interaction Model ◽  
Pediatric Care ◽  
Stress Index ◽  
Relationship Enhancement ◽  
Attrition Rates ◽  
Attitude Inventory

The authors adapted the established Child-Adult Relationship Enhancement (CARE) interaction model for use in integrated behavioral health clinics. CARE was modified for delivery in the examination room, during routine primary care visits. Adopting a real-world implementation approach, clinical social workers were trained in the new model—IntegratedCARE—and provided the brief, 3-session treatment to 30 different parent-child dyads. Measurements included the Parental Stress Index–4 Short Form (PSI 4-SF), the Eyberg Childhood Behavior Inventory (ECBI), and the Therapy Attitude Inventory (TAI). There was a statistically significant mean score decrease on the both subscales of the ECBI at pre- and posttreatment. Scores on the TAI indicated that participants were satisfied with the treatment. Attrition rates were somewhat lower than similar studies. Findings indicate the IntegratedCARE model is feasible for sustainable delivery by trained behavioral health professionals in primary care.

Commercial Exergaming in Home-Based Pediatric Constraint-Induced Therapy: A Randomized Trial

2021 ◽  
pp. 153944922098411
Author(s):  
Tien-Ni Wang ◽  
Yu-Lun Chen ◽  
Jeng-Yi Shieh ◽  
Hao-Ling Chen
Keyword(s):  
Parental Stress ◽  
Short Form ◽  
Self Care ◽  
Stress Index ◽  
Dose Equivalent ◽  
Nintendo Wii ◽  
Home Based ◽  
Significant Difference ◽  
Motor Outcomes ◽  
Psychosocial Benefits

Constraint-induced therapy (CIT) is highly effective yet not accessible to many families. Integrating commercial exergaming in home-based CIT may support the availability and attainability of the intervention. The study compared the effects of supplementary use of Nintendo Wii in home-based CIT with dose-equivalent conventional CIT. Eighteen children with cerebral palsy were randomly assigned to 8 weeks of CIT (CIT) or 4 weeks of CIT, followed by 4 weeks of Wii-augmented CIT (CIT-Wii). Outcome measures included the Bruininks–Oseretsky Test of Motor Proficiency (Manual Dexterity), the ABILHAND-Kids, the WeeFIM (Self-Care), the Test of Playfulness, the Engagement Questionnaire, and the Parenting Stress Index–Short Form. Both groups significantly improved motor outcomes and playfulness. The CIT group demonstrated greater improvement in self-care skills, whereas parental stress decreased only in the CIT-Wii group. CIT-Wii yields no significant difference in treatment effects from conventional CIT and may provide psychosocial benefits.

Mindfulness-based wellbeing for socio-economically disadvantaged parents: a pre-post pilot study

2015 ◽  
Vol 10 (1) ◽  
pp. 17-28 ◽  
Author(s):  
Catrin Eames ◽  
Rebecca Crane ◽  
Eluned Gold ◽  
Sophie Pratt
Keyword(s):  
Risk Factors ◽  
Parental Stress ◽  
Economically Disadvantaged ◽  
Short Form ◽  
Small Sample ◽  
Stress Index ◽  
Post Intervention ◽  
Content Type ◽  
Mindfulness Skills ◽  
The Impact

Purpose – Behavioural parent training (PT) interventions partially mediate risk factors for the development of child behavioural problems. Mindfulness skills could have benefit in alleviating the impact of these risk factors for parents who are socio-economically disadvantaged. The paper aims to discuss these issues. Design/methodology/approach – A pre-post single group comparison of disadvantaged mothers attending the Mindfulness-Based Wellbeing for Parents (MBW-P) programme. Findings – Changes were observed in facets of parental stress (Parenting Stress Index-Short Form; Abidin, 1995), depression (Beck Depression Inventory-II; Beck et al., 1996) and brooding (Ruminative Responses Scale; Nolen-Hoeksema and Morrow, 1991), with moderate to large effect sizes and incidences of clinical change. Research limitations/implications – The research design, although pragmatic, includes a small sample and no control or long-term comparison group. Social implications – Mothers considered as the “hardest to reach” group in terms of vulnerability, risk factors and being likely to gain from intervention demonstrated positive shifts post-intervention. A targeted mindfulness-based intervention, delivered pragmatically within a health service context, may have benefit in reducing the impact of risk factors on parental wellbeing. Originality/value – To the authors’ knowledge, this is the first evaluation of a targeted mindfulness group delivered within routine health care settings, in identified “high risk” areas, by routine staff.

scholarly journals Parental Stress and Disability in Offspring: A Snapshot during the COVID-19 Pandemic

2021 ◽  
Vol 11 (8) ◽  
pp. 1040
Author(s):  
Martina Siracusano ◽  
Assia Riccioni ◽  
Leonardo Emberti Gialloreti ◽  
Eugenia Segatori ◽  
Lucrezia Arturi ◽  
...  
Keyword(s):  
Parental Stress ◽  
Neurodevelopmental Disorders ◽  
Short Form ◽  
Autism Spectrum ◽  
Self Report ◽  
Stress Index ◽  
Sotos Syndrome ◽  
Typical Development ◽  
Genetic Syndromes ◽  
Neurodevelopmental Disabilities

Parenting a child with a disability, such as neurodevelopmental disorders and genetic syndromes, implies a high level of stress. During the COVID-19 outbreak—as a period implying additional challenges—few studies have specifically investigated caregivers’ distress among neurodevelopmental disabilities. The objective of the study is to investigate whether during the COVID-19 pandemic, the level of parental stress differs between four disability groups including neurodevelopmental disorders (autism spectrum disorder (ASD), attention deficit and hyperactivity disorder (ADHD)) and genetic syndromes (Rett syndrome (RTT), Sotos syndrome (SS)) in comparison to families with typical development offspring (TD). In total, 220 Italian parents of children affected by neurodevelopmental disabilities (74 ASD, 51 ADHD, 34 SS, 21 RTT, 40 TD; age M 9.4 ± SD 4.2) underwent a standardized evaluation for stress related to parenting through the self-report questionnaire, Parental Stress Index-Short Form (PSI-SF). The main findings show greater levels of parental stress—mainly linked to child behavioral characteristics rather than parental sense of competence—in parents of children affected by a disability in comparison to children with typical development. This study highlights the need to support not only individuals with special needs but also their own caregivers: core figures in the management and outcome of children disorders.

scholarly journals 1. Neuropsychiatric disorders and parental stress during the covid-19 pandemic: an Italian retrospective longitudinal study

2021 ◽  
Vol 11 (4) ◽  
pp. 5-9
Author(s):  
Grazia Maria Giovanna Pastorino ◽  
Francesca Operto ◽  
Valeria De Simone ◽  
Valentina Vivenzio ◽  
Chiara Scuoppo ◽  
...  
Keyword(s):  
Behavioral Problems ◽  
Parental Stress ◽  
Telephone Interview ◽  
Short Form ◽  
Neuropsychiatric Disorders ◽  
Autism Spectrum ◽  
University Hospital ◽  
Stress Index ◽  
Daily Routine ◽  
The Impact

Aim: The objective of our study is to evaluate the impact that the COVID-19 emergency and the related measures adopted have had on the family management of minors with neuropsychiatric disorders. Another objective of this study is to carry out a first longitudinal evaluation of this impact on parental stress, comparing the data collected before the pandemic with those collected during the lockdown. Methods: This is an observational study that involved 271 families of patients already treated at the Child Neuropsychiatry Unit of the Salerno University Hospital between 2 and 23 years (112 with Autism Spectrum Disorder, 86 with epilepsy and 73 with other disorders of neurodevelopment). All participants were given an ad hoc telephone interview and a standardized questionnaire (PSI - Parenting Stress Index-Short Form). The telephone interview showed that a significant percentage of parents reported an increase in their child's daily management difficulties during the lock-down and emotional / behavioral problems, in particular the externalizing disorder. Comparison of the mean scores of the PSI-SF questionnaires completed before and during the lockdown showed a statistically significant increase in scores in the Total Stress scale and in the Parental Distress subscales. Results & Conclusion: The results of our study suggest that the confinement measures and changes in daily routine imposed by quarantine negatively affected the behavioral and emotional dimensions of both children and parents causing a significant increase in parental stress, which is mainly related to feelings of inadequacy in relation to their role in such a delicate situation, and concern for the future.

scholarly journals Pediatric Chronic Migraine Severity and Maternal Stress

2021 ◽  
Vol 13 (4) ◽  
pp. 576-582
Author(s):  
Daniela Smirni ◽  
Marco Carotenuto
Keyword(s):  
Parental Stress ◽  
Maternal Stress ◽  
Short Form ◽  
Primary Headache ◽  
Well Being ◽  
Stress Index ◽  
School Aged Children ◽  
Pediatric Migraine ◽  
Being There ◽  
The Impact

Primary headache is an increasing phenomenon in pediatric age, and very often, it causes disabling limitations in children’s daily activities, negatively affecting family well-being. There are conflicting data in the literature on the impact of children’s migraines on parental experienced stress. This study aimed to evaluate maternal stress in a sample of school-aged children with a migraine without aura (MwoA) and its correlation with migraine intensity and frequency. A total of 474 mothers aged between 31 and 55 participated in the study: 237 were mothers of children with MwoA, and 237 were mothers of typical developing children. All participants were administered the Parent Stress Index-Short Form (PSI-SF) for the assessment of parental stress; the Pediatric Migraine Disability Assessment (PedMIDAS) was administered to children with MwoA to assess the presence of a related disability migraine. The results showed a significantly higher rate of stress in mothers of MwoA children (p < 0.001) in all the domains explored by the PSI-SF and a statistically significant correlation between the maternal stress total score and the intensity and frequency of migraine attacks (p < 0.0001). This study highlights the need for the holistic contribution of the family to be considered in the clinical management of pediatric migraines.

scholarly journals Universal prevention of depression in women postnatally: cluster randomized trial evidence in primary care

2010 ◽  
Vol 41 (4) ◽  
pp. 739-748 ◽  
Author(s):  
T. S. Brugha ◽  
C. J. Morrell ◽  
P. Slade ◽  
S. J. Walters
Keyword(s):  
Primary Care ◽  
Postnatal Depression ◽  
Outcome Measure ◽  
Psychological Intervention ◽  
Short Form ◽  
Intervention Group ◽  
Depression Scale ◽  
Cluster Randomized Trial ◽  
Stress Index ◽  
Control Group

BackgroundTo test whether receiving care from a health visitor (HV) trained in identification and psychological intervention methods prevents depression 6–18 months postnatally in women who are not depressed 6 weeks postnatally.MethodThe study was a prospective cluster trial, randomized by GP practice, with follow-up for 18 months in 101 primary care teams in the Trent area of England. The participants were women scoring <12 on the postal Edinburgh Postnatal Depression Scale (EPDS) at 6 weeks postnatally (1474 intervention and 767 control women). Intervention HVs (n=89, 63 clusters) were trained in identifying depressive symptoms using the EPDS and face-to-face clinical assessment and in providing psychologically orientated sessions based on cognitive behavioral or person-centered principles. The control group comprised HVs (n=49, 37 clusters) providing care as usual (CAU). The primary outcome measure was the proportion of women scoring ⩾12 on the EPDS at 6 months postnatally. Secondary outcomes were mean EPDS score, Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE-OM) score, State–Trait Anxiety Inventory (STAI), 12-item Short Form Health Survey (SF-12) and Parenting Stress Index Short Form (PSI-SF) scores at 6, 12 and 18 months.ResultsAfter adjusting for individual-level covariates, living alone, previous postnatal depression (PND), the presence of one or more adverse life events and the 6-week EPDS score, the odds ratio (OR) for EPDS ⩾12 at 6 months was 0.71 [95% confidence interval (CI) 0.53–0.97, p=0.031] for the intervention group (IG) women compared with the control (CAU) group women. Two subgroups were formed by baseline severity: a ‘subthreshold’ subgroup with a 6-week EPDS score of 6–11 (n=999) and a ‘lowest severity’ subgroup with a 6-week EPDS score of 0–5 (n=1242). There was no difference in psychological effectiveness by subgroup (interaction term: z=−0.28, p=0.782).ConclusionsThis study provides new evidence of a universal, enduring preventive effect for depression in women who screen negative for depression postnatally.

The Predictive Role of Maternal Parenting and Stress on Pupils’ Bullying involvement

2016 ◽  
Vol 34 (17) ◽  
pp. 3691-3710 ◽  
Author(s):  
Fatemeh Alizadeh Maralani ◽  
Mirmahmoud Mirnasab ◽  
Touraj Hashemi
Keyword(s):  
Parenting Style ◽  
Parenting Styles ◽  
Parental Stress ◽  
Maternal Stress ◽  
Function Analysis ◽  
Short Form ◽  
Screening Method ◽  
Stress Index ◽  
Cluster Sampling

The link between inappropriate parenting style and both bullying and victimization is well documented. However, it is not clear as to which kind of parenting style is associated with victimization. Furthermore, no studies have yet been conducted regarding the role of parental stress in bullying and victimization. This study aimed to examine the role of parenting styles and maternal stress in pupils’ bullying and victimization. A total of 300 primary school pupils, enrolled in fourth and fifth grades, participated in the study. Initially, 100 noninvolved pupils were randomly selected using a multistage cluster sampling method. Then using a screening method, 100 bully pupils and 100 victimized peers were selected. Olweus Bullying Scale and teacher nomination were administered for screening these pupils. Baumrind Parenting Style Questionnaire and revised version of Abidin Parental Stress Index (short form) were also applied to all pupils in the study. Data were analyzed using discriminant function analysis. The findings showed that (a) with regard to parenting styles, significant differences were found among groups. Authoritarian parenting style could significantly predict pupils’ bullying behavior, whereas victimization was predictable in families with permissive parenting style. In addition, noninvolved pupils were predicted to have authoritative parenting style. (b) Considering maternal stress, significant differences were observed across groups. Parents of bullies and victims were predicted to have higher maternal stress than noninvolved pupils. The implications of the study in relation to the role of mothers in bullying and victimization are discussed.

Improving Child Behaviors and Parental Stress: A Randomized Trial of Child Adult Relationship Enhancement in Primary Care

2020 ◽  
Author(s):  
Joanne N. Wood ◽  
Devon Kratchman ◽  
Philip V. Scribano ◽  
Steven Berkowitz ◽  
Samantha Schilling
Keyword(s):  
Primary Care ◽  
Randomized Trial ◽  
Parental Stress ◽  
Relationship Enhancement ◽  
Child Behaviors

scholarly journals Parenting styles and child’s well-being: The mediating role of the perceived parental stress

2020 ◽  
Vol 16 (3) ◽  
pp. 514-531
Author(s):  
Elisa Delvecchio ◽  
Alessandro Germani ◽  
Veronica Raspa ◽  
Adriana Lis ◽  
Claudia Mazzeschi
Keyword(s):  
Parenting Style ◽  
Parenting Styles ◽  
Parental Stress ◽  
Short Form ◽  
Economic Status ◽  
Well Being ◽  
Stress Index ◽  
Short Version ◽  
Mediational Role

In the last decades, consensus from laymen, scholars, and policy-makers has emphasized the role of child-parent relationships to promote child’s development and positive well-being. Parenting style was claimed as one of the crucial factors for the child’s positive adjustment. The main aim of the present study was to investigate the relationships between authoritative and authoritarian parenting styles and child’s difficulties. The mediational role of parent’s perception of a difficult child on the above mentioned relation was taken into account. The study was carried out on a sample of 459 couples including mothers (n = 459) and fathers (n = 459) of children aged 2 to 10 years old who filled in the Parenting Styles & Dimensions Questionnaire short version, the Strengths and Difficulties Questionnaire, and the Parenting Stress Index-short form. Main findings indicated that authoritative style was associated with less child’s maladjustment, while the authoritarian one showed the opposite association. These relationships were partially mediated by the perception of a difficult child, which partially explained the link between parenting style and child’s problems. Above and beyond the role of parent’s perception as a difficult child, parenting styles had an important effect on child’s difficulties. Future studies should replicate these results with other samples, use the spouse version of the parenting styles, control the effect of socio-economic status and other variables related to family functioning, as well as to consider the child’s perception regarding parents’ parenting style.

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