Family Focused Practice in Mental Health Care: An Integrative Review

While mental health services are increasingly encouraged to engage in family-focused practice, it is a nebulous and poorly understood term. The aim of this paper was to examine and synthesize evidence on the concept and scope of family-focused practice in adult and child and youth mental health care settings. An integrative literature review method was used. Medline, Embase, CINAHL, PsycInfo and Proquest electronic databases were systematically searched forabstracts published in English between 1994-2014. Data were extracted and constant comparative analysis conducted with 40 included articles. Family-focused practice was conceptualised variously depending on who was included in the „family‟, whether the focus was family of origin or family of procreation, and the context of practice. As a finding of the review, six core and inter-related family-focused practices were identified: family care planning andgoal-setting; liaison between families and services; instrumental, emotional and social support; assessment; psychoeducation; and a coordinated system of care between families and services. While family is a troubled concept, „family‟ as defined by its members forms a basis for practice that is oriented to providing a „whole of family‟ approach to care. In order to strengthen familymembers‟ wellbeing and improve their individual and collective outcomes, key principles and practices of family-focused practice are recommended for clinicians and policy makers across mental health settings.

Transforming Post-Catholic Ireland: Religious Practice in Late Modernity

Transforming Post-Catholic Ireland is the first major book to explore the dynamic religious landscape of contemporary Ireland, north and south, and to analyse the island’s religious transition. It confirms that the Catholic Church’s long-standing ‘monopoly’ has well and truly disintegrated, replaced by a mixed, post-Catholic religious ‘market’ featuring new and growing expressions of Protestantism, as well as other religions. It describes how people of faith are developing ‘extra-institutional’ expressions of religion, keeping their faith alive outside or in addition to the institutional Catholic Church.

Drawing on island-wide surveys of clergy and laypeople, as well as more than 100 interviews, this book describes how people of faith are engaging with key issues such as increased diversity, reconciliation to overcome the island’s sectarian past, and ecumenism. It argues that extra-institutional religion is especially well-suited to address these and other issues due to its freedom and flexibility when compared to traditional religious institutions. It describes how those who practice extra-institutional religion have experienced personal transformation, and analyses the extent that they have contributed to wider religious, social, and political change. On an island where religion has caused much pain, from clerical sexual abuse scandals, to sectarian violence, to a frosty reception for some immigrants, those who practice their faith outside traditional religious institutions may hold the key to transforming post-Catholic Ireland into a more reconciled society.

Autism and ABA: Best Practice in America and the Way Forward for Europe.

According to recent estimates, 1 in each 68 new-borns will be diagnosed with an Autism Spectrum Disorder (ASD) in the USA (Centers for Disease Control and Prevention, 2014), while 1 in every 29 children will be diagnosed with ASD in the UK (Dillenburger, Jordan, McKerr, & Keenan, 2015). Individuals diagnosed with ASD share a set of characteristics at varying levels of severity: impairments in social communication skills and presence of restricted interests and repetitive behaviours (American Psychiatric Association, 2013).Notwithstanding these figures, little effort has been placed in European countries’ policies for reaching an early diagnosis. This has a detrimental effect on future prognosis for children with ASD, since research has clearly shown that when evidence-based interventions are accessed early in life, they can lead to great improvements on the overall functioning of children with ASD, including significant gains in social communication and reduction of inappropriate behaviours (Dawson, Rogers, Munson, Smith, Winter, Greenson, Donaldson, & Varley, 2009).Additionally, when looking at the services available for children with ASD and their families in Europe, it seems that not much improvement has been made in the last decades. Traditional eclectic approaches and a wealth of non-scientific methods seem to be available and often recommended by public bodies, while state-funded evidence-based interventions are not offered as part of the education or health system. Given that there is a wealth of evidence on the effectiveness of interventions based on the science of ABA, it seems that specific action is required to correct the situation, respecting children’s right to effective treatment and inclusion.In the present paper, these issues are fully discussed and recommendations for best practice are offered.

Differences Between Irish and Australian Psychiatric Nurses' Family Focused Practice in Adult Mental Health Services

Psychiatric nurses’ practice with parents who have mental illness, their children and families is an important issue internationally. This study provides a comparison of Irish and Australian psychiatric nurses’ family focused practices in adult mental health services. Three hundred and forty three nurses across Ireland and 155 from Australia completed the Family Focused Mental Health Practice Questionnaire. Cross-country comparisons revealed significant differences, in terms of family focused skill, knowledge, confidence and practice. Australian psychiatric nurses engaged in higher family focused practice compared to Irish nurses. The comparative differences between countries may be attributable to differences in training, workplace support and policy.

Inappropriate prescribing of combination inhalers in Northern Ireland: retrospective cross-sectional cohort study of prescribing practice in primary care

BACKGROUND: Asthma management guidelines advocate a stepwise approach to asthma therapy, including the addition of a long-acting bronchodilator to inhaled steroid therapy at step 3. This is almost exclusively prescribed as inhaled combination therapy.

AIMS: To examine whether asthma prescribing practice for inhaled combination therapy (inhaled corticosteroid/long-acting β2-agonist (ICS/LABA)) in primary care in Northern Ireland is in line with national asthma management guidelines.

METHODS: Using data from the Northern Ireland Enhanced Prescribing Database, we examined initiation of ICS/LABA in subjects aged 5-35 years in 2010.

RESULTS: A total of 2,640 subjects (67%) had no inhaled corticosteroid monotherapy (ICS) in the study year or six months of the preceding year (lead-in period) and, extending this to a 12-month lead-in period, 52% had no prior ICS. 41% of first prescriptions for ICS/LABA were dispensed in January to March. Prior to ICS/LABA prescription, in the previous six months only 17% had a short-acting β2-agonist (SABA) dispensed, 5% received oral steroids, and 17% received an antibiotic.

CONCLUSIONS: ICS/LABA therapy was initiated in the majority of young subjects with asthma without prior inhaled steroid therapy. Most prescriptions were initiated in the January to March period. However, the prescribing of ICS/LABA did not appear to be driven by asthma symptoms (17% received SABA in the previous 6 months) or severe asthma exacerbation (only 5% received oral steroids). Significant reductions in ICS/LABA, with associated cost savings, would occur if the asthma prescribing guidelines were followed in primary care.

On the Limits of Exceptionalism: Principles and Practice in the Pursuit of Alternatives to Full EU Membership

Few states have been less uncomfortable with the relationship they have with the EU than the United Kingdom as a member and Turkey as an associate and would-be member. Both states currently find themselves questioning the substance and future of these relationships with domestic actors and, notably in the Turkish case, external EU voices actively advocating alternatives. While much discussion, particularly in the UK case, has focused on the advantages and disadvantages of particular existing arrangements (e.g. European Economic Area, Swiss bilateralism), this paper considers the broader principles and practices that the EU has to date either explicitly developed or implicitly established to govern the nature and substance of alternatives to [full] EU membership. It assesses the principled, practical and political limitations that exist in establishing alternatives to full membership for states seeking – or having sought for them – the accommodation of their exceptionalism. In doing so the paper considers the potential limits to a renegotiated EU membership for the UK and to an alternative short of full membership for Turkey. It also reflects on the precedent-setting consequences of any new arrangements that the EU might reach with either state for what forms membership and a relationship short of membership might take in the future.

“Paths for Action”: Leadership Theory and Practice in Complex Public Sector Systems

The nature and challenges of public sector leadership and management are examined in four case studies of project management in complex metropolitan environments. The cases selected by the authors as representative of contextual factors affecting decision-making processes and project outcomes. Drawing on recent theoretical work on complex leadership approaches (Uhl-Bein et al 2007, Hazy 2008, Lichtenstein & Plowman 2009), the authors assess leadership practices enacted and the circumstances that influence these practices. Leadership types theorized by Uhl-Bein et al (2007) are identified operating at different levels and across networks, with contextual factors outlined. The article concludes with a framework for leadership practice and management identifying network facilitation and complexity friendly tools as a practice within complex public sector systems.

Good Practice in Achieving Best Evidence Interview with Child Witnesses in Northern Ireland – Criminal Justice Perspectives

This report outlines the findings from a research project examining what works well in investigative interviews (ABE interviews) with child witnesses in Northern Ireland. The project was developed in collaboration with key stakeholders and was joint funded by the Department of Justice NI, NSPCC, SBNI and PSNI. While there is substantial a research literature examining the practice of forensic interview both internationally and within the UK there has been little in the way of exploration of this issue in Northern Ireland. Equally, the existing literature has tended to focus on a ‘deficit’ approach, identifying areas of poor practice with limited recognition of the practical difficulties interview practitioners face or what works well for them in practice. This study aimed to address these gaps by adopting an ‘appreciative inquiry’ approach to explore stakeholder perspectives on what is working well within ABE current practice and identify what can be built on to deliver optimal practice.

An analysis of Child Care Policy and Practice in Barnardo’s Macedon and Sharonmore residential homes in Northern Ireland during the period 1952 – 1990, the period under investigation by the Inquiry.

Report to examine the nature and extent of any abuse in Barnardo’s Macedon and Sharonmore residential homes in Northern Ireland and to determine whether that abuse was caused or facilitated by failings on the part of Barnardo’s, and whether they were systemic in nature. Abuse and systemic failings as defined in the document published by the Inquiry in June 2013 “Definition of Abuse and Systemic Failings”.