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Despite the growing success of school-based health care during the past two decades, the issue of providing reproductive health care at school-based health centers remains controversial. In this article, focus group data from three school-based centers in Louisiana, each in different stages of development, demonstrates how the controversies about reproductive health may frame more general concerns about school-based care. In addition, community readiness to address directly problematic sexual behavior relates not only to the specific needs and priorities of the community but to recognition of the negative effect of the consequences of sexual behavior such as pregnancy, high drop out, and absenteeism rates on a community's educational, rather than social, goals and values. [ABSTRACT FROM AUTHOR]

Infant mental health is explicitly relational and strengths based as a field. Ethical dilemmas in infant mental health have received insufficient attention at the level of infant mental health professionals (IMHP) and other professionals caring for infants who must grapple with questions of when caregivers and infants have conflicting interests. We present composite cases drawn from North American and Australian contexts, using three systems in which such conflicts may commonly manifest: child protection, home visiting, and medical settings. The field of infant and early childhood mental health (IECMH) should begin to discuss such dilemmas and how best to balance the needs of caregivers and infants when they are not well aligned., (© 2023 The Authors. Infant Mental Health Journal published by Wiley Periodicals LLC on behalf of Michigan Association for Infant Mental Health.)

In this paper, we consider whether the field of infant and early childhood mental health (IECMH) needs its own code of ethics. We begin by describing unique features of infant and early childhood mental health (IECMH) and the diverse strategies that the field has developed to address complex clinical dilemmas, among them workforce development, clinical supports, policy statements, and statements of ethical values. Because of the field's interdisciplinary nature, we also consider how various contributing professions and organizations address ethical issues. While these are important resources that can inform ethical decision-making, we identify some of the limitations of the current approaches. We argue that it is time for the field of IECMH to take an intentional, systematic approach to directly address the complex and unique ethical dilemmas faced by infant and early childhood mental health practitioners, and we grapple with some of the challenges developing such a code might entail. We suggest several avenues for better understanding the scope of ethical issues and ethical decision-making processes in IECMH that could be used to support developing an ethics code that is responsive to the unique and challenging world of infant and early childhood mental health., (© 2023 The Authors. Infant Mental Health Journal published by Wiley Periodicals LLC on behalf of Michigan Association for Infant Mental Health.)

Ethics is concerned with the basis for moral judgments of "right" and "wrong" and is central to the clinical endeavor. Many clinicians integrate ethical estimations into their work without much conscious awareness. However, explicit use of ethical principles and frameworks can help navigate clinical decision-making when there is a sense of moral conflict or ambiguity about the "right" course of action. This article aims to highlight the key concepts and principles in clinical ethics as they apply to IECMH practice and stimulate a bigger conversation in the profession around how to support each other to maintain high ethical standards in working with young children and their families. Specifically, the authors consider the relevance of Beauchamp and Childress' four principles framework (respect for autonomy, beneficence, non-maleficence, and justice), and address some of the special ethical challenges in the field, namely, the vulnerability of the infant, the need for a competent workforce, caring for caregivers, and the problem of multiple patients. Finally, the role of infant rights is briefly explored, noting the significant interest and debate that has been generated by the publication of the World Association of Infant Mental Health's Position Paper on the Rights of Infants., (© 2023 The Authors. Infant Mental Health Journal published by Wiley Periodicals LLC on behalf of Michigan Association for Infant Mental Health.)

Given increased sexual risk-taking among youth with mental health problems, this study sought to understand the developmental trajectory of sexual self-esteem (SSE) among this vulnerable population and how it is impacted by sexual experiences. Participants were 185 adolescents who attended therapeutic/alternative schools in southern New England. Changes in five domains of SSE identified by Zeanah and Schwarz (1996) were examined across adolescents who either: 1) were sexually active at baseline, 2) transitioned to activity during the study, and 3) remained inexperienced at follow-up. In support of the hypothesis that changes in SSE precede onset of experience, youth who transitioned reported higher baseline scores in the Skills domain than those who remained inexperienced. SSE was subsequently impacted by sexual activity, with differences in several domains found at baseline and follow-up across level of experience. Changes in SSE following sexual experience depended, in part, on the percentage of casual partners teens reported., (Copyright © 2011 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.)

A growing literature highlights established and developing approaches to infant mental health assessment and treatment. Like other evidence-based and theory-based interventions, real world application of these approaches requires an understanding of the theoretical and empirical foundations of infant mental health as well as consideration of cultural, systemic, and logistical factors. In this article, the authors present models of universal and targeted interventions in infant mental health, with attention to the adaptations used to apply evidence-based practice in real world settings.

The Nurse-Family Partnership (NFP) model is a well-studied and effective preventive intervention program targeting first-time, impoverished mothers and their families. Data documenting the negative impact of maternal depression and partner violence on the developing young child can be used to make a strong case for augmenting NFP programs to focus on mental health problems impacting the mother-child relationship. This article reviews the rationale for and process of augmenting an NFP program in Louisiana. Data on the prevalence of depression and partner violence in our sample are presented alongside a training protocol for nurses and mental health consultants designed to increase the focus on infant mental health. The use of a weekly case conference and telephone supervision of mental health consultants as well as reflections on the roles of the mental health consultant and the nurse supervisor are presented., (Copyright © 2006 Michigan Association for Infant Mental Health.)

Nurses working in the Nurse Family Partnership (NFP) program provide intensive home-visitation services for first-time, low-income mothers. The goals are to improve maternal health outcomes, child health and development outcomes, and to enhance maternal life-course development; however, many of the families face significant psychosocial and mental health issues that can impede progress achieving their goals. Because of the importance of the nurse-client relationship in achieving positive outcomes, these non-mental-health nurses must shift their approaches and techniques from a medical to a psychosocial model. In this article, we examine the role of the nurse in the NFP and present results of focus groups with experienced NFP nurses regarding their perspectives, challenges, and rewards in conducting this work., (Copyright © 2006 Michigan Association for Infant Mental Health.)

Clinical staff at two hospitals serving children and adolescents were surveyed regarding their observations and experiences regarding the sexuality-related behaviors and issues of patients. Results of this descriptive study indicate that staff frequently encounter a wide range of such problems, including the effects sexual abuse, sexually aggressive or inappropriate behavior, lack of knowledge about basic hygiene and sexual development, pregnancy and contraception, high-risk behaviors, and sexually-transmitted diseases, including AIDS. Similarities and differences of the perceptions by staff of these problems are compared across unit types (children's, adolescents, dually-diagnosed, developmentally-disabled). Implications for staff training, clinical policies, and further research are discussed.

Epidemiological and sociobehavioral data regarding HIV-related risk and injection drug use among adolescents and young adults are examined to provide insight and assistance to nurses delivering preventive intervention and community and clinical care. The increase in HIV/AIDS cases among injection drug users (IDUs), adolescents, and African Americans strongly suggests that clinical care providers acquire a better understanding of the sociocultural and behavioral context within which health care is provided. Transition into injection drug use, high-risk injecting and sexual behaviors, sociodemographic differences, and the importance of social networks are discussed. Nurses are encouraged to provide health promotion, disease prevention messages, and health care to IDUs in small nontraditional clinical settings and to seek out the assistance of the IDUs' social network to increase adherence and compliance to complex prevention and therapeutic efforts.

Although school-based health care programs (SBHCPs) provide affordable and accessible health care to children and adolescents and are known to improve school attendance, a variety of barriers affect their development. Focus groups were conducted in three schools in Louisiana to demonstrate how barriers can affect the initiation and development of SBHCPs. Each school-based program was in a different stage of development. Identifying potential barriers and developing strategies to overcome them can enhance already existing SBHCPs and make it easier for new programs to begin. The social worker serves as an important ally in the development of SBHCPs and is a necessary part of the school-based health care team.

Thirty five middle class parents, pregnant for the first time, were recruited from childbirth classes for participation in a shortterm longitudinal study of parents' constructions of their infants' personalities during pregnancy and in early infancy. Here, we report qualitative findings about parents' descriptions of their infants' personalities before and after birth, as well as descriptions of their relationships with their infants and their first feelings of love for their infants. Descriptions of infant personalities were remarkably vivid before and after birth, but there were changes in the prominence of several attributes over time.

Over 30,000 children die each year from catastrophic illness. Groups for the bereaved have arisen to address the needs of family members following the profound loss of a child. The authors review the commonly held notions of "normal" and "pathological" mourning and their special application to bereaved parents. The case of two women who participated in their fifth group for bereaved parents are presented with the meanings of their repeated attendance examined in the context of incomplete mourning. Implications for professionals working with bereaved parents are discussed.

The maltreated-maltreating cycle is the most striking example of the psychodynamic notion that early relationship experiences are carried forward and reenacted in subsequent relationships. Bowlby's attachment theory proposes that transmission of patterns of relating across generations, including maltreatment, is mediated by an individual's internal working models. Recent research that operationalizes working models in infants and in adults provides preliminary support for the congruence of working models across generations. Results from these investigations suggest that the maltreated-maltreating cycle should be redefined. Instead of specific types of maltreatment, an organizing theme of the parent-child relationship and an associated internal working model that provides a way of experiencing that theme are transmitted and later reenacted. In this paper, preliminary data implicating rejection, role-reversal and fear as themes organizing maltreating relationships are reviewed and directions for further research are discussed.