Integrating Mindfulness into Family Therapy with Adolescents

Individual and group-based psychotherapeutic interventions increasingly incorporate mindfulness-based principles and practices | Family Process

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These practices include a versatile set of skills such as labeling and attending to present-moment experiences, acting with awareness, and avoiding automatic reactivity. A primary motivation for integrating mindfulness into these therapies is compelling evidence that it enhances emotion regulation. Research also demonstrates that family relationships have a profound influence on emotion regulation capacities, which are central to family functioning and prosocial behavior more broadly. Despite this evidence, no framework exists to describe how mindfulness might integrate into family therapy.

This paper describes the benefits of mindfulness-based interventions, highlighting how and why informal mindfulness practices might enhance emotion regulation when integrated with family therapy. We provide a clinical framework for integrating mindfulness into family therapy, particularly as it applies to families with adolescents. A brief case example details sample methods showing how incorporating mindfulness practices into family therapy may enhance treatment outcomes. A range of assessment modalities from biological to behavioral demonstrates the breadth with which the benefits of a family-based mindfulness intervention might be evaluated.

Full reference: Brody, J.L. et al. (2017) A Conceptual Model and Clinical Framework for Integrating Mindfulness into Family Therapy with Adolescents.  Family Process. Published online: 7 June 2017

How parents of young people who self-harm experience support and treatment

Stewart, A. et al. Child and Adolescent Mental Health. Published online: 19 December 2016

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Background: Self-harm in young people is a common reason for contact with clinical services. However, there is little research focusing on parents’ perspectives of care following self-harm. The aim of this study was to explore parents’ experiences of treatment and support for the young person and for themselves.

 

Conclusions: Parents’ views highlight the need for clinicians to consider carefully the perspective of parents, involving them wherever possible and providing practical help and support, including written information. The need for training of clinicians in communicating with young people and parents following self-harm is also highlighted.

Read the full abstract here

Severe Childhood Autism: The Family Lived Experience

Gorlin, J.B. et al. Journal of Pediatric Nursing. Published online: October 6 2016

Highlights

  • Several themes were identified in families caring for a child with severe autism including: the families experienced autism as a mysterious and complex condition, they lived with severe autism-related behavior, and dealt with profound communication challenges, stress, and isolation.
  • Families reported developing compassion for others related to their experience of living with a child with severe autism.
  • Families formed ‘hybrid families’ to assist with raising the child with autism including nuclear and extended family members, and friends.

Abstract

This research examined the experiences of families living with a child with severe autism. There is limited literature on the experiences of families when a child has severe autism as distinct from milder autism and includes the voices of multiple family members.

Van Manen’s phenomenological approach was used for data collection and analysis. This approach allowed for the use of innovative data sources, including unstructured individual and family interviews, observations, and family lifelines (a pictorial, temporal picture with comments of the families lives).This study included 29 interviews with 22 participants from 11 families. All data were creatively triangulated and interpreted.

Six essential themes were identified. First, families experienced autism as mysterious and complex because it is an invisible and unpredictable condition with diagnostic challenges. Second, families described severe autism behaviors that often caused self-injury, harm to others and damaged homes. Third, profound communication deficits resulted in isolation between the family and child. Fourth, families discussed the unrelenting stress from lack of sleep, managing the child’s developmental delays, coordinating and financing services, and concern for the child’s future. Fifth, families described consequences of isolation from friends, school, the public, and health providers. Sixth, families portrayed their need for compassionate support and formed ‘hybrid families’ (nuclear, extended families and friends) to gain support.

Study results can be utilized to educate nurses/other providers about the unique needs of families with children with severe autism and could influence health care policies to improve the care for families caring for children with severe autism.

Read the abstract here

Interventions for Adolescent Mental Health: An Overview of Systematic Reviews

Das, J.K. et al. (2016) The Journal of Adolescent Health. 59(4) pp. S49–S60

mental-health-1420801_960_720Many mental health disorders emerge in late childhood and early adolescence and contribute to the burden of these disorders among young people and later in life. We systematically reviewed literature published up to December 2015 to identify systematic reviews on mental health interventions in adolescent population.

A total of 38 systematic reviews were included. We classified the included reviews into the following categories for reporting the findings: school-based interventions (n = 12); community-based interventions (n = 6); digital platforms (n = 8); and individual-/family-based interventions (n = 12).

Evidence from school-based interventions suggests that targeted group-based interventions and cognitive behavioral therapy are effective in reducing depressive symptoms (standard mean difference [SMD]: −.16; 95% confidence interval [CI]: −.26 to −.05) and anxiety (SMD: −.33; 95% CI: −.59 to −.06). School-based suicide prevention programs suggest that classroom-based didactic and experiential programs increase short-term knowledge of suicide (SMD: 1.51; 95% CI: .57–2.45) and knowledge of suicide prevention (SMD: .72; 95% CI: .36–1.07) with no evidence of an effect on suicide-related attitudes or behaviors. Community-based creative activities have some positive effect on behavioral changes, self-confidence, self-esteem, levels of knowledge, and physical activity. Evidence from digital platforms supports Internet-based prevention and treatment programs for anxiety and depression; however, more extensive and rigorous research is warranted to further establish the conditions. Among individual- and family-based interventions, interventions focusing on eating attitudes and behaviors show no impact on body mass index (SMD: −.10; 95% CI: −.45 to .25); Eating Attitude Test (SMD: .01; 95% CI: −.13 to .15); and bulimia (SMD: −.03; 95% CI: −.16 to .10). Exercise is found to be effective in improving self-esteem (SMD: .49; 95% CI: .16–.81) and reducing depression score (SMD: −.66; 95% CI: −1.25 to −.08) with no impact on anxiety scores. Cognitive behavioral therapy compared to waitlist is effective in reducing remission (odds ratio: 7.85; 95% CI: 5.31–11.6). Psychological therapy when compared to antidepressants have comparable effect on remission, dropouts, and depression symptoms.

The studies evaluating mental health interventions among adolescents were reported to be very heterogeneous, statistically, in their populations, interventions, and outcomes; hence, meta-analysis could not be conducted in most of the included reviews. Future trials should also focus on standardized interventions and outcomes for synthesizing the exiting body of knowledge. There is a need to report differential effects for gender, age groups, socioeconomic status, and geographic settings since the impact of mental health interventions might vary according to various contextual factors.

Read the abstract here

Factors that help children thrive in the face of adversity

American Academy of Pediatrics. ScienceDaily. Published online: 30 April 2016.

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Image source: Ivan // CC BY-SA 2.0

Research suggests certain family, social and community supports help protect kids from long-term physical and mental health problems that can result from childhood hardship and trauma

Research shows that people who experience four or more adverse childhood experiences (ACEs), such as economic hardship, exposure to violence or the death of a loved one, are more likely to have lasting physical and mental health problems. But a new research abstract to be presented at the Pediatric Academic Societies 2016 Meeting suggests that certain family, social and community assets may boost a child’s chances of flourishing in the face of adversity.

For the study, “The Relative Contributions of Adverse Childhood Experiences and Healthy Environments to Child Flourishing,” researchers analyzed data from the 2011-2012 National Survey of Children’s Health, conducted by the National Center for Health Statistics, to gauge children’s health and well-being, physical, emotional and behavioral health indicators, family context and neighborhood environment.

Read the full commentary here 

NEW MENTAL HEALTH ONLINE RESOURCE FOR FAMILIES LAUNCHES

YoungMinds. Published online 21 April 2016.

Families affected by poor mental health collaborate with an expert Consortium including YoungMinds to launch new online portal.

Developed with families, and aimed at families, MindEd for Families is a new site hoping to transform mental health support for relatives in difficulty and crisis.

MindEd for Families offers a large range of e-learning resources, developed to give anyone in regular contact with children and young people the skills to identify and support those they suspect to be affected by mental health issues

MindEd for Families:

  • provides information, advice and guidance about children’s mental health and wellbeing to parents and carers in England
  • improves parents and carers’ knowledge and awareness of children and young people’s emotional health and wellbeing
  • improves parents and carers’ ability to intervene early in mental health issues, working closely with teachers and other professionals to support their child
  • helps reduce stigma around mental health and demystify mental health and psychology
  • supports and enhance national mental health awareness and resilience

Read the full blog post here