353 resultados para Adult child abuse victims - Mental health

em Deakin Research Online - Australia


Relevância:

100.00% 100.00%

Publicador:

Resumo:

The thesis examined variables that could potentially mediate the relationship between child abuse and eating pathology. The relationship was found to be intricate and multi-faceted with important gender differences. The most novel finding was that drive for muscularity was significantly associated with child abuse in males and in females. The portfolio presents four adult case studies, each with different experiences of child abuse. It aims to examine if the core tenets of neurobiological theory of trauma can be useful to understand the lasting effects of child abuse on adult functioning.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

The thesis compared domestically violent men and non-offenders on a number of psychological constructs. The results indicated that, with the exception of attitudes towards women, there were no significant differences between the groups. The thesis examined practical implications of the results for the assessment and treatment of domestically violent offenders. The professional portfolio examines, in four case studies, the purported link between childhood abuse and subsequent maladjustment in the adult.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

The field and experimental studies for this thesis revealed that: the quality of documentation of 'disclosure' (initial) interviews with child abuse witnesses was poor; under optimal note-taking conditions, verbatim records of interview were still not provided, and considerable variability was observed in the quality of notes and strategies employed to document content and structure. The portfolio presents four case studies to illustrate similarities and/or differences between offence behaviour in child sex offenders with impairment, and the offence behaviours that characterise Canter et al.'s intimate, criminal-opportunistic and aggressive type offenders.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Background: Depression amongst adolescents is a costly societal problem. Little research documents the effectiveness of public mental health services in mapping this problem. Further, it is not clear whether usual care in such services can be improved via clinician training in a relevant evidence based intervention. One such intervention, found to be effective and easily learned amongst novice clinicians, is Interpersonal Psychotherapy (IPT). The study described in the current paper has two main objectives. First, it aims to investigate the impact on clinical care of implementing Interpersonal Psychotherapy for Adolescents for the treatment of adolescent depression within a rural mental health service compared with Treatment as Usual (TAU). The second objective is to record the process and challenges (i.e. feasibility, acceptability, sustainability) associated with implementing and evaluating an evidence-based intervention within a community service. This paper outlines the study rationale and design for this community based research trial.

Methods/design: The study involves a cluster randomisation trial to be conducted within a Child and Adolescent Mental Health Service in rural Australia. All clinicians in the service will be invited to participate.  Participating clinicians will be randomised via block design at each of four sites to (a) training and delivery of IPT, or (b) TAU. The primary measure of impact on care will be a clinically significant change in depressive  symptomatology, with secondary outcomes involving treatment satisfaction and changes in other symptomatology. Participating adolescents with significant depressive symptomatology, aged 12 to 18 years, will complete assessment measures at Weeks 0, 12 and 24 of treatment. They will also complete a depression inventory once a month during that period. This study aims to recruit 60 adolescent participants and their parent/guardian/s. A power analysis is not indicated as an intra-class correlation coefficient will be calculated and used to inform sample size calculations for subsequent large-scale trials. Qualitative data regarding process implementation will be collected quarterly from focus groups with participating clinicians over 18 months, plus phone interviews with participating adolescents and parent/guardians at 12 weeks and 24 weeks of treatment. The focus group qualitative data will be analysed using a Fourth Generation Evaluation methodology that includes a constant comparative cyclic analysis method.

Discussion
: This study protocol will be informative for researchers and clinicians interested in considering, designing and/or conducting cluster randomised trials within community practice such as mental health services.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

This article focuses on the evaluation of outcome in child and adolescent mental health services. We examined the outcomes of 46 children with persistent conduct problems by gathering at baseline and six months information from multiple informants on multiple domains including the functioning of the child, risk factors, and parents’ and children’s perceptions of the treatment process. A statistically significant reduction in oppositional/conduct symptoms was reported six months after the initial clinical contact. However, the majority of the group still scored within the clinical range. The various outcome measures are correlated to only a mild to moderate degree. Teachers did not notice the same degree of change at school, despite the changes noticed by parents. Symptom improvement and satisfaction with a service are two separate issues. Parents’ satisfaction was related to their perception of the therapist and the therapy offered. Their satisfaction was high if they perceived that the therapist was able to communicate well, show care and concern, and if the therapy was perceived as organized. Much can be learned from a comprehensive outcome measurement system within a mental health service.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

From 1995 onwards, a child and adolescent mental health service (CAMHS) applied Senge's learning organisation model. This review compared service performance with that of peer services 5 years later and explored whether any differences were associated with the application of this model. The comparison methodology used quantitative analysis of external data from the Department of Human Services, together with qualitative analysis of material including interviews with CAMHS directors and service managers. Results showed high evaluation activity and high quality, efficiency and efficacy of care compared with other services. Several restraints to the optimal application of the model were identified, including inadequate training of new managers, service overload, major external organisational change and limited investment in information systems. Other outcomes are discussed.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Dropout from treatment is a significant problem in child and adolescent mental health services, and findings regarding the role of possible contributing factors are inconsistent. It is argued that this inconsistency may be the result of the confounding effects of different definitions of dropout, and different dropout rates for different diagnoses. A file review of 520 new cases over a 12-month period in a large Child and Adolescent Mental Health Service in Melbourne, Australia was performed. Information was collected about the intake, parents, family, child, diagnoses and treatment. A significant relationship was found between diagnosis and dropout rate, with clients experiencing family problems or conduct disorder and ADHD being more likely to dropout, and those experiencing negative life events, anxiety disorders or those not having a diagnosis being less likely to dropout. These findings offer potential directions for services to consider specific strategies for retaining their clients. Possible reasons for these findings, methodological issues and future research directions are discussed.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Objective: Dropout from child and adolescent mental health services has ramifications for children, families and the services themselves. Understanding the factors that are associated with dropout for different diagnoses has the potential to assist with tailoring of services to reduce dropout. The aim of the current study was to identify such factors.

Method: A file audit was conducted for all referrals to a child and adolescent mental health service over a 12 month period, yielding 520 subjects for analysis (264 male, 256 female, mean age = 12.6 years). Parent, child and service variables of interest were recorded as were diagnoses, which were categorized into 25 superordinate categories.

Results: Almost 50% of subjects dropped out of treatment. Factors associated with dropout varied across diagnosis, and no factor was associated with dropout for all diagnoses.

Conclusion: There are differences in the factors that were associated with dropout for different disorders. This is a useful finding in terms of understanding and preventing dropout in child and adolescent mental health settings, but more research is needed.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

This study provided a critical examination of handwritten records (notes) of interviews contained in a sample of 89 police case files about alleged child abuse. Some of the notes examined related to initial disclosure (complaint) interviews which were not electronically recorded and were meant to be recorded verbatim. Notes of electronically recorded interviews, which merely constituted a convenient summary of the case details, were also examined. Collectively, the analyses focused on the accessibility, completeness and accuracy of the notes, and the degree to which the interviewers' questions and witnesses' answers were differentiated. In relation to the disclosure interviews, a substantial proportion of these were not accessible. Of those where the notes were obtained, the detail recorded was not a complete record of conversation, and there was often poor delineation of questions and responses. Analysis of the electronically recorded interviews showed that these were not an entirely accurate summary of event details even though the note takers' sole task was to document the interview. The implications of these findings are discussed.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

This professional portfolio uses four case studies to demonstrate the utility of personality assessment in the practice of clinical psychology within a Child and Adolescent Mental (CAMHS) service, most notably in aiding clinical practice regarding diagnosis, case formulation and treatment.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Adolescent day programs (ADPs) are an increasingly used approach to treating adolescents with mental health issues. However, there is a dearth of studies empirically examining the outcomes of adolescent day programs. This study retrospectively examined the mental health functioning of 84 adolescents, pre- and post-treatment, who in addition to their ongoing outpatient treatment had participated in an ADP during a five-year period. Their functioning was compared to matched adolescents who participated only in outpatient treatment during the same time period. Statistical and clinical examinations revealed the reported outcomes following ADP treatment were at least comparable, and sometimes significantly better, when compared to the reported outcomes following outpatient treatment excluding ADP involvement. This study, while having some methodological shortcomings, provides some evidence for the efficacy of ADPs.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Purpose - This study aimed to identify the nature and prevalence of workplace stressors faced by interviewers of child sexual assault victims.

Design/methodology/approach - Sixty-eight professionals (police and child protection workers) were invited to anonymously post their perceptions of workplace stressors on an internet forum as part of an investigative interviewing online training course. Specifically, participants were asked to reflect on salient sources of stress encountered in their role of interviewing sexually abused children.

Findings - Three key stressors were identified across the study’s professional groups: (1) inadequate recognition of specialised skills; (2) high workload demands; and (3) interagency tensions. Consistent with previous research, exposure to child abuse reports was not raised as a stressor.

Research limitations/implications - Our study generated suggestions for modifying management practices; however, future research should identify and trial strategies for improving workplace climate in child abuse investigation.

Practical implications - As the stressors isolated by participants related to workplace climate rather than exposure to victims’ accounts of child abuse, minimising negative consequences of work stressors requires changes to workplace culture and practice. Workplace climates need to be modified so that the demands are offset by resources.

Originality/value - Because of its online, anonymous nature, this was the first study to offer participants the opportunity to honestly disclose primary sources of stress in child abuse investigation. The research also makes a much-needed contribution to an area of police practice that is vital yet often overlooked.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

There is a discrepancy between the demand for mental health treatment amongst children, young people and their carers, and the capacity of the current service system to provide evidence based interventions. Innovative models of care are required to redress this discrepancy. One such model is the single session model, which provides a single or small number of solution focused sessions targeting one or two identified problems. Single session interventions have been trialled across a range of presenting concerns including child and youth mental health services. This paper provides a rationale for offering a brief focused intervention as part of a broader Child and Youth Mental Health Service, and introduces a model of how brief intervention fits within a broader system of care.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Study 1 found that poor attachment relationships, dysfunctional family environments, re-victimisation experiences and poor coping skills contibute towards mental health problems as well as the child abuse experiences. Study 2 implemented a therapy program that demonstrated an improvement in the sexual response of women who experienced childhood sexual assault.