Search

Aim To investigate the effectiveness of preventive interventions for 8-17-year-old children of patients diagnosed with depression, anxiety, or bipolar disorder. Methods Sixty-two families including 89 children received either the more extensive Family Talk Intervention (FTI; n = 35), the brief Let's Talk about Children (LTC; n = 16), or Interventions as Usual (IAU; n = 38) in routine care in adult psychiatry. Parent-rated questionnaire data were collected at baseline, after 6 and 12 months. We used growth curve models to investigate the effect of intervention on child mental health problems (SDQ-P Total Difficulties) and perceived parental control of child behaviour (PLOC-PPC). Results Parents in the FTI and LTC groups, versus the IAU group, reported more favourable development in terms of preventing increase in child mental health problems with standardised intervention effects of d = -0.86 and -0.88 respectively, by study end, and reported improved perceived parental control, d = 1.08 and 0.71, respectively, by study end. No significant differences in effect were found when FTI and LTC were compared. Conclusions The results support continued use of FTI and LTC in adult psychiatry, and since LTC is a brief intervention, it might be useful as a minimum-level preventive intervention.

BACKGROUND: One in ten children have a parent diagnosed with a mental illness by specialised psychiatric services. Severe parental mental illness is a well-established risk factor for children's mental health problems, making the identification and support of these children a public health concern. This study investigated the mental health and family context of children of parents diagnosed with depression, anxiety, or bipolar disorder in this clinical setting. METHODS: Parental reports on 87 children aged 8-17 years were analysed. The children's mental health was compared with that of a Swedish population-based sample. Multiple linear regression was used to investigate associations between child mental health and child gender, child age, parent symptoms and social status, family functioning, and perceived parental control. Furthermore, a cumulative risk index explored the effect of multiple risk factors on child mental health. RESULTS: The children reportedly had significantly more mental health problems than did the population-based sample and about one-third had scores above the clinical cut-off. A significant multiple linear regression explained 49% of the variance in child mental health, with lower perceived parental control and younger child age being associated with more child mental health problems. With more reported risk factors, children reportedly had more mental health problems. CONCLUSIONS: The results underline the importance of identifying a patient’s children and assessing multiple relevant risk factors in the child’s life. Furthermore, the results indicate that the needs of younger children and of patients in their parenting role are important to address.

I Sverige finns det tusentals barn som far illa på grund av missförhållanden i familjen. Barnmorskor är en av de yrkeskategorier som omfattas av anmälningsplikten till socialtjänsten vid misstanke om att ett barn riskerar att fara illa. I jämförelse med andra yrkeskategorier som omfattas av anmälningsplikten står vårdpersonal för en underrapportering. Genom sin yrkesroll har barnmorskor ofta en unik inblick i- och ett förtroende hos familjer de möter. Syftet med denna studie är att undersöka BB-barnmorskors erfarenheter av orosanmälan då ett barn misstänks fara illa eller riskerar att fara illa. Studien har utförts genom intervjuer med åtta barnmorskor från tre olika BB-avdelningar. Den insamlade datan bearbetades och tolkades med hjälp av kvalitativ innehållsanalys. Kategorier framkom genom att den först kondenserade texten abstraherades genom kodning till olika kategorier. Resultatet visar på flera olika erfarenheter som presenteras under tre huvudkategorier: Att möta och vårda familjen, Förutsättningar på arbetsplatsen och Behov av kommunikation och återkoppling. Studien visar att en komplex vårdsituation försvårar en bedömning av den egna oron, ett professionellt omdöme tenderar att underlätta denna bedömning. Rädslan för ett brustet förtroende från familjen kan påverka barnmorskors benägenhet att orosanmäla. Barnmorskors agerande vid oro för ett barn påverkas av kollegialt stöd och arbetsklimat. Att ha kunskap om barn som far illa och anmälningsförfarandet är avgörande för handläggning och identifiering av den egna oron. Även en kort vårdtid och hög arbetsbelastning påverkar barnmorskors förutsättningar att uppfylla sin anmälningsplikt. En fungerande kommunikation i vårdkedjan är av stor vikt då det finns en oro för ett barn. För att kunna uppfylla den anmälningsplikt som barnmorskor omfattas av bör förutsättningar för kunskap, kompetens och självförtroende vara en självklar del av BB-barnmorskors arbetsförhållanden.

There are calls for evidence-based methods for helping children to deal with experiences of Intimate Partner Violence (IPV) in many countries. Therefore, it has been commonplace to implement such methods from outside of their home country. The aim of this study is to examine Swedish social workers’ experiences of testing the American Kids’ Club method for child and mother victims of IPV. After having tested leading Kids’ Club groups, seventeen social workers at four different locations were interviewed using a semi-structured interview guide. The results indicate that the social workers generally accepted the method. This was related both to some general features of the method and to their perceiving it as somewhat flexible. According to the social workers, the method needs some cultural adaptation to better suit the Swedish social services setting, otherwise it cannot be fully accepted. Finally, they thought that successful implementation depended on an organizational structure that enabled enough children to be referred to the programme as well as either high personal commitment or an organization that prioritized the method. Based on these results, we conclude that importing an American evidence-based group method to help children exposed to IPV to Sweden demands attention to issues of cultural adaption., I många länder har röster höjts för att hjälpa barn att hantera erfarenheter av våld i nära relation med evidensbaserade metoder. Därför har det blivit vanligt att sådana metoder sprids utanför det land de utvecklades i. Syftet med denna studie är att undersöka svenska socialarbetares erfarenheter av att testa den amerikanska Kids’ Club-metoden för barn och mammor som utsatts för våld i nära relation. Efter att ha lett Kids’ Club-grupper intervjuades sjutton socialarbetare på fyra olika platser med hjälp av en halvstrukturerad intervjuguide. Resultaten indikerar att socialarbetarna i allmänhet accepterade metoden. Detta var relaterat både till några allmänna egenskaper hos metoden och till att de uppfattade den som något flexibel. Enligt socialarbetarna behöver metoden lite kulturell anpassning för att bättre passa svensk socialtjänst innan den kan bli fullt accepterad. Slutligen trodde de att framgångsrik implementering är beroende av en organisatorisk struktur som gör det möjligt att tillräckligt många barn att hänvisas till programmet såväl som högt personligt engagemang eller att organisationen prioriterar metoden. Baserat på dessa resultat drar vi slutsatsen att importera en amerikansk evidensbaserad gruppmetod för att hjälpa barn utsatt för våld i närarelation till Sverige kräver uppmärksamhet på frågor om kulturell anpassning.

Avancerat malignt melanom är en allvarlig sjukdom med historiskt sett dålig prognos. Med de senaste årens nya behandlingar har allt fler patienter uppnått långvarig komplett remission. Syftet med studien var att belysa hur vardagslivet påverkats för människor som initialt fått en dyster prognos men efter behandling befinner sig i komplett remission. Semistrukturerade intervjuer genomfördes med åtta personer från Götaland. Materialet analyserades enligt Graneheim och Lundmans kvalitativa innehållsanalys. Resultatet visar att deltagarnas vardagsliv påverkades av den osäkerhet som ovissheten kring sjukdomen innebar. De pendlade mellan oro och en känsla av trygghet och för att bemästra osäkerheten användes olika strategier. Med tiden kom hoppet om en framtid att väga tyngre än känslan av osäkerhet. De psykiska och fysiska men deltagarna levde med ansågs hanterbara och i ljuset av sjukdomen umbärliga. Deltagarna beskrev även positiva insikter som gav nya perspektiv på tillvaron

Using a repeated measures design posttraumatic stress (PTS), psychological and behavioral problems significantly decreased following intervention in children exposed to intimate partner violence (IPV), with use of traditional group analyses. Analyses using the reliable change index (RCI), however, revealed that few children were improved or recovered, implying that interventions in common use should be evaluated for their significant impact on the individual level in addition to group level statistics. Positive changes in children's behavioral problems were related to the mother's improvement of their own mental health. Direct victimization by the perpetrator was not associated with treatment changes but with higher symptom levels at study entry. Amount of contact with the perpetrator was neither related to symptom load nor to changes following treatment.

Background: This study examined the perceived effectiveness of a 15-week community-based program for 46 children exposed to intimate partner violence (IPV) and their mothers. Aims: The primary aims were to describe the children who entered one of the existing community-based programs in terms of behavioral problems and to evaluate the impact of the program on children's general behavioral functioning as assessed by their mothers. Results: Children's rated behavioral problems (SDQ) dropped following treatment; the effect size was in the medium range. The social impairment caused by the problems decreased as well. The effect regarding behavioral problems was not related to the degree of exposure to IPV or the mothers own changes in trauma symptoms following treatment. Results were analyzed as well at the individual level with the Reliable Change Index (RCI), which showed that the majority of children were unchanged following treatment. Conclusions: One implication from the study is the need for baseline screening and assessment. About half of the current sample had a clinical symptom picture indicating the need for specialized psychiatric/psychotherapeutic treatment. Furthermore, the reduction in behavioral problems was significant but many children still had high levels of behavioral problems after treatment, indicating a need of a more intense or a different type of intervention.

Witnessing violence against a primary caregiver as a child entails a heightened risk of the child developing problems such as post-traumatic stress, depression, behavioural problems, or difficulties with social relationships. Knowledge about the effectiveness of methods developed to support children who have witnessed violence against their mothers is needed. This presentation reports the results from a national evaluation with the aim to study changes in the health and wellbeing of children after participating in support interventions. Eight group-based or individual support interventions directed at children who had witnessed violence against their mother from her partner were compared to: child and adolescent psychiatry, women’s shelters, and the social services, including the individual and family services, and family law. This report is based on mothers’ ratings of 295 children between 3 and 13 years of age, and self-ratings from 64 of these children, aged 9 to 13 years. The study is based on measurements at three times; before or in connection with the start of the intervention (pre-test), when the child had finished the intervention 4 to 6 months later (post-test), and one year after the child started the intervention (one-year follow-up). The mothers, and any 9 to 13-year-old children who agreed to participate, were interviewed and filled out questionnaires about psychological health and wellbeing. Measures included the Strengths and Difficulties Questionnaire, the Trauma Symptom Checklist for Children (TSCC), and measures of emotion regulation and general psychological well-being. The agencies offering support aimed directly at children tended to have better effect than agencies not providing support aimed at children. Generally, children with a high degree of psychological illness at pre-test improved more than children with fewer difficulties. However, the effect sizes were small, and at the one-year follow-up the mothers still rated their children’s psyc