Carrie W. Rishel

Impact of Maternal Mental Health Status on Child Mental Health Treatment Outcome

This study examined the effect of maternal depression and anxiety on child treatment outcome. Psychiatric assessments were conducted on 180 mother–child pairs when the child entered treatment in a community mental health center and six months later. Children whose mothers were depressed or anxious were significantly more impaired than children of mentally healthy mothers at both time points. Both groups of children improved at approximately the same rate. The findings suggest that early mental health screening of children and their mothers may be important preventive practices. Addressing the mental health needs of mothers and children simultaneously may be an effective method of reducing their mental health problems.

Evidence-Based Prevention Practice in Mental Health: What Is It and How Do We Get There?

A substantial number of children in the United States suffer from mental health problems. These children enter into adulthood at a disadvantage and often continue to experience mental health problems as adults. Historically, much less attention has been paid to prevention of mental health problems than to treatment and rehabilitative services. In recent years, however, great strides have been made in developing and evaluating prevention interventions in the area of mental health. Nevertheless, the study of prevention still lags behind clinical treatment research in identifying and disseminating effective programs and interventions. The following article draws on the work of numerous prevention scholars to develop a conceptual framework of evidence-based prevention practice in the area of mental health. Suggestions for how researchers, policy makers, and service providers can contribute to the development of evidence-based prevention practice in mental health are considered.

Use of the Child Behavior Checklist as a Diagnostic Screening Tool in Community Mental Health.

Objective: This study examines whether the Child Behavior Checklist (CBCL) can be used as an accurate psychiatric screening tool for children in community mental health settings. Method: Associations, logistic regression models, and receiver operating characteristic (ROC) analysis were used to test the predictive relationship between the CBCL and structured interview-derived diagnoses. Results: Associations between CBCL subscales and specific diagnoses were found, replicating results of previous research. Multivariate models and ROC scoring led to correct diagnostic predictions in a large majority of participants. Corresponding sensitivities, however, were deemed inadequate as they indicated that the screen would miss an unacceptably high number of cases. Conclusions: Using the CBCL as a diagnostic screening tool would result in a large number of cases being missed by the screen. Although the CBCL is unlikely to accurately identify children with specific diagnoses, it could be used as a triage tool to inform practitioners if an in-depth structured diagnostic interview is necessary.

Development and Validation of a Parental Monitoring Instrument: Measuring How Parents Monitor Adolescents' Activities and Risk Behaviors.

The aim of this article is to describe the development and validation of the Parental Monitoring Instrument (PMI). The PMI was administered to a sample of 518 parent—adolescent (aged 12 to 17 years) dyads. Initial findings provide evidence of instrument reliability and validity. The exploratory factor analysis results suggested a seven-factor solution that explained approximately 48% of the variance. An analysis of the questions reveals reasonable interpretations of the seven factors: direct, indirect, restrictive, school, health, computer, and phone monitoring. Administration of the PMI may further our understanding of how parental monitoring is associated with adolescent activities and risk behaviors, setting the stage for informed strategies to improve parent—adolescent relationships.

Evaluating the Efficacy of Traditional and Web-Assisted Instruction in an Undergraduate Social Work Practice Class

SUMMARY This article addresses the dearth of research utilizing a quasi-experimental design and student performance measures in assessing web-assisted instruction in social work undergraduate practice courses. Social work students were randomly placed into two sections of a practice course. The experimental section (n = 18) students received 50% of course lectures with web-assisted instruction while the comparison class (n = 18) received identical lectures delivered in traditional face-to-face format. There were no statistically significant differences on assignments, the midterm exam and a final videotaped exam project between the two sections. These results suggest students in an undergraduate social work practice course learn similarly regardless of course format.

Pathways to prevention for children of depressed mothers: a review of the literature and recommendations for practice.

Maternal depression is one of the most well-documented risk factors for child and adolescent depression, but little work has focused on how to reduce this risk. Although a few interventions have been developed and tested, implementing targeted prevention efforts with depressed mothers and their children is not common practice. The increased risk of depression for children of depressed mothers is so clear, however, professionals can no longer “sit on the sidelines” without initiating specific prevention efforts with this population. To do so requires a paradigm shift—moving from a focus on individual treatment to a prevention approach that engages the entire family as the unit of care. The purpose of this paper is to draw on existing literature to highlight potential “pathways to prevention” for children of depressed mothers. Recommendations for initiating these pathways based on family lifecycle stage, point of contact, and service setting are presented and discussed.

Teaching Note—Integrating Prevention Content Into Clinical Social Work Practice Courses

Rapid changes in health care services and delivery suggest an upcoming paradigm shift in the field of mental health. Recent national reports, health care policy changes, and growing evidence support a shift toward prevention-focused mental health care. The social work profession is uniquely positioned to act as leaders in this shift as the profession’s values, goals, and hallmark practice approach are consistent with preventive care. Most social work students, however, do not receive training in prevention practice. The author’s development, implementation, and evaluation of a prevention-focused master of social work elective in the area of mental health is presented as an example of integrating prevention content into clinical social work practice courses. Implications for social work education are discussed.

Preventing Adolescent Risk Behavior in the Rural Context: An Integrative Analysis of Adolescent, Parent, and Provider Perspectives.

Adolescent risk behavior remains prevalent and contributes to numerous social problems and growing health care costs. Contrary to popular perception, adolescents in rural areas engage in risky behaviors at least as much as youth from urban or suburban settings. Little research, however, focuses on risk behavior prevention in the rural context. This study integrates adolescent, parent, and provider perspectives related to adolescent risk behavior engagement and prevention to suggest promising prevention strategies for rural families and communities.

COMPARING ADOLESCENT AND PARENT PERCEPTIONS OF CURRENT AND FUTURE DISAPPROVED INTERNET USE

The increasing availability and marketing of computerand Internet-based activities have led parents and professionals to question their health impact and to seek best practices for monitoring adolescent and child involvement (Gross, Juvonen, & Gable, 2002). Studies examining different facets of child and adolescent computer and Internet involvement have provided contradictory information about the potential impact. A vast national and international research has focused on the total amount of time spent engaging in computer and Internet activities (Gross et al., 2002; Kaltiala-Heino, Lintonen, & Rimpela, 2004; Livingstone, Bober, & Helsper, 2005; Turow, 1999; Wolak, Mitchell, & Finkelhor, 2002). Findings have associated increased exposure to these resources to improved understanding of school-related concepts (Flynn, 1994; Li & Atkins, 2004), language (Edwards, 1992; Rocheleau, 1995), improved spatial skills (Subrahmanyam, Kraut, Greenfield, & Gross, 2000), a broadened social and support system (Dodge & Kitchin, 2001), increased memory (Li & Atkins, 2004), and increased online self-efficacy (Livingstone et al., 2005) among young children. However, researchers have also found that increased time on the computer or Internet is associated with increased antisocial behaviors (Mesch, 2001) and obesity (Holcomb, 2004; Stanger, & Gridina, 1999; Strauss, Rodzilsky, Burack, & Colin, 2001). Among adolescents, increased exposure has also been affiliated with increased sexual risk behavior (Wolak, Finkelhor, & Mitchell, 2004; Ybarra & Mitchell, 2004), social anxiety (Gross et al., 2002), depression (Seepersad, 2004; Ybarra, Leaf, & Diener-West, 2004), and increased trust for online materials viewed (Livingstone et al., 2005). Given that 55 percent of child and adolescent computer and Internet users report spending time in chat rooms, sending instant messages, and using email (with 39 percent of these activities spent talking to strangers), monitoring children’s and adolescent’s activities on the computer and Internet has become an important issue (Beebe, Asche, Harrison, & Quinlan, 2004; Wolak et al., 2004; Ybarra & Mitchell, 2004). Reports from 749 parent–adolescent dyads have demonstrated that parents of younger adolescents, fathers, and Internet-experienced parents tend to monitor their children’s online activities more than other parents (Wang, Bianchi, & Raley, 2005). However, little is known about the best ways by which parents can monitor their children’s Internet use. There is evidence that child and adolescent perceptions of the extent to which their parents monitor or know their activities, whereabouts, and peer group significantly predict their involvement in a variety of risk behaviors such as drinking (Chilcoat & Anthony, 1996; Peterson, Hawkins, Abbott, & Catalano, 1994), tobacco use (Jackson, 1997), marijuana use (Kandel & Davies, 1992), and risky sexual practices (Huebner & Howell, 2003; Li, Fang, Stanton, Su, & Wu 2003; Stanton et al., 2000). Furthermore, specific approaches used by

Establishing a Prevention-Focused Integrative Approach to Social Work Practice

Establishing a prevention-focused integrative approach to practice is of critical importance for social work. The Affordable Care Act promotes a shift from fragmented health care delivery toward integrated models of service delivery that emphasize prevention. This shift prompts the need for practitioners who understand the interrelationship among mental health, substance use, and physical health care, and who are prepared to address these needs through a collaborative prevention-focused approach. This article describes such an approach to practice in which social workers integrate micro, mezzo, and macro practice efforts across service systems and, along with allied health and social service professionals, effectively and efficiently address major problems of living within the environmental context. Suggestions regarding curriculum implementation and policy advocacy are discussed.