Charlotte Reedtz

Eyberg Child Behavior Inventory (ECBI): Norwegian norms to identify conduct problems in children

This article presents the first Norwegian standardization of an assessment tool specifically designed to measure childhood conduct problems. Norwegian norms for the Eyberg Child Behavior Inventory (ECBI) based on data obtained from a random population sample (N= 4063) of children in the age range of 4 to 12 years are presented. The sample was drawn from rural and urban areas within three Norwegian town districts. Clinical and research advantages of having a properly standardized assessment tool for this specific subclass of childhood psychiatric problems in Norway are discussed.

Implementing new routines in adult mental health care to identify and support children of mentally ill parents

BackgroundMental health problems are often transmitted from one generation to the next. This knowledge has led to changes in Norwegian legislation, making it mandatory to assess whether or not patients have children, and to provide necessary support for the children of mentally ill patients. The main purpose of this study was to evaluate the process of implementing new routines in adult mental health services to identify and support children of mentally ill parents.MethodsThe design was a pre-test post-test study. The sample (N = 219 at pre-test and N = 185 at post-test) included mental health professionals in the largest hospital in the region, who responded to a web-based survey on the routines of the services, attitudes within the workforce capacity, worker’s knowledge on the impact of parental mental illness on children, knowledge on legislation concerning children of patients, and demographic variables.ResultsThe results of this study indicated that some changes are taking place in clinical practice in terms of increased identification of children. Adult mental health services providing support for the children was however not fully implemented as a new practice.ConclusionThe main finding in this study is that the identification frequency had increased significantly according to self-reported data since the Family Assessment Form was implemented. The increase in self-reported identification behavior is however taking place very slowly. Three years after the legislation was changed to making it mandatory to assess whether or not patients have children, it was still not fully incorporated in the routines of the entire workforce. In terms of support for the families affected by parental mental illness, the changes are not yet significant.

Evaluating workforce developments to support children of mentally ill parents: implementing new interventions in the adult mental healthcare in Northern Norway

Background According to new Norwegian laws, mental healthcare for adults are obligated to assess all patients who are parents and to act on their childrens needs. This article describes the study protocol of implementing the interventions Family Assessment and Child Talks for children of patients in the adult psychiatry of the University Hospital of Northern Norway. The project is designed to evaluate the process of changes in clinical practice due to the implementation of two interventions. The interventions to be implemented are a standardised Family Assessment Form and the intervention called Child Talks. The family assessment form is an intervention to identify children of mentally ill parents and their needs. The intervention Child Talks is a health-promoting and preventive intervention where the mental health workers talk with the family about the situation of the children and their needs. Methods/design There are two groups of participants in this study: (1) mental health workers in the clinic (N=220) and (2) patients who are parents (N=200) receiving treatment in the clinic. (1) In the evaluation of clinical practice, the authors use a pre-test, post-test and 1-year follow-up design. At pre-test, the authors evaluate status quo among mental health workers in the clinic regarding knowledge, attitudes, collaborative routines and clinical practice related to families with parental mental illness. After the pre-test is finished, the project move on to implement the interventions Family Assessment Form and Child Talks in the clinic. At post-test and 1-year follow-up, the authors evaluate the impact of implementing the Family Assessment Form in terms of how many children were identified and offered Child Talks in the clinic or referred to other services for additional support. (2) In the evaluation of parents/patients experience with the interventions, the authors use a pre-test post-test design. To identify children of mentally ill patients, the authors collect data on demographical variables for the patient and the child at pre-measures, as well as data on parental competence (PSOC) and parental concerns (PEDS) about their children. At post-measures, the authors evaluate the impact of the intervention in terms of user satisfaction, as well as changes between pre- and post-measures on parental competence (PSOC) and parental concerns (PEDS) about their children. Discussion The implication of implementing new interventions to safeguard children of mentally ill patients and the limitation of not measuring child development directly are discussed.

Translating Knowledge about Parental Mental Illness to the Field of Practice

Parental mental illness is a powerful risk factor, with a potential of serious impact for the children. Mental health problems are often transmitted from one generation to the next. Parental mental illness is however considered to be a malleable risk-factor, which means there are measures that can be taken to counteract the risk. Nevertheless, transferring this knowledge to the field of parental mental illness has been very difficult. The aim of the current study was to explore the relationship between knowledge and attitudes towards a child perspective in adult mental health services and actual clinical practice. The aim was furthermore to investigate which factors are hindering or promoting the translation of new knowledge to the field of practice. In the present study results will be interpreted in light of the theory of reasoned action.

Parents seeking help in child rearing: who are they and how do their children behave?

Purpose – The main aim of this study is to explore characteristics of parents who signed up for parenting classes offered to the universal population and their reasons for participation.Design/methodology/approach – Data were obtained from parents in a study on parent training for children aged two to eight years (n=189), and a follow up survey on these parents (n=118).Findings – Parents had high education, were married, and employed in full time jobs. The mean age of the children was under four years, and their Intensity and Problem scores on ECBI were higher than the Norwegian mean scores for their age group. Parent stress, parental concern, and parenting practices predicted the ECBI Intensity scores to a rather large extent.Practical implications – Parents with high SES risk factors may not come forward to participate in face‐to‐face mental health promotion interventions even if the parenting intervention is offered in a non‐stigmatising way.Originality/value – By offering a universal health promoting ...

Construct Validity of the Eyberg Child Behavior Inventory (ECBI)

Despite the wide use of the Eyberg Child Behavior Inventory (ECBI), its construct validity is still an issue of debate. Whereas previous studies primarily have relied on confirmatory factor analyses (CFAs), the present study aimed to evaluate the Norwegian 22-item version of the ECBI intensity scale using exploratory structural equation modeling (ESEM), which offers more flexibility compared to traditional CFA. The study used data from three samples of parents with children with emerging or existing problem behaviors. Results showed that the ESEM model showed good fit and identified the three factors Oppositional defiant behavior, Conduct problem behavior, and Inattentive behavior. In addition, the ESEM approach revealed several small and significant (&lgr; ⩽ .21) cross-loadings. The results illustrated the strengths of ESEM over CFA and suggest that ESEM provide a useful statistical framework to evaluate the structure of ECBI items.

Knowledge transfer in the field of parental mental illness: objectives, effective strategies, indicators of success, and sustainability

BackgroundMental health problems are often transmitted from one generation to the next. However, transferring knowledge about interventions that reduce intergenerational transmission of disease to the field of parental mental illness has been very difficult. One of the most critical issues in mental health services research is the gap between what is generally known about effective treatment and what is provided to consumers in routine care.DiscussionIn this article we discuss several aspects of knowledge transfer in the field of parental mental illness. Effective strategies and implementation prerequisites are explored, and we also discuss indicators of success and sustainability.SummaryAltogether, this article presents a rationale for the importance of preventive strategies for children of mentally ill parents. Furthermore, the discussion shows how complex it is to change clinical practice.

Evaluation of the Incredible Years Teacher Classroom Management Program in a Regular Norwegian School Setting

ABSTRACT This study examined whether the Incredible Years (IY) Teacher Classroom Management (TCM) program implemented as a school-wide preventive intervention at 1st to 3rd grade in a regular school setting reduces the development of problem behavior and improves social competence. Using a quasi-experimental pre-post design, the IYTCM was implemented in 21 schools and compared with 22 matched schools that did not receive the program. A total of 241 1st to 3rd grade teachers and 1518 students aged 6 to 8 years took part in the trial. Mixed-model analyses found small positive effects on changes in students’ social competence (dw = 0.19), while effects on change in students problem behavior were less than small (dw < 0.20). When the program is implemented as school-wide universal preventive intervention, results suggest a small preventive impact of the IYTCM program in regular school settings for some of the outcomes measured in the study.

Identifying and supporting children of mentally ill parents within adult mental health services

Background Studies have shown that implementing a change of practice in adult mental health care to identify and support children of mentally ill parents is challenging, even though the risk of transgenerational transmission of socioemotional problems and psychopathology has been thoroughly demonstrated the last decade. Aims The current presentation describes the existing practice of identifying and supporting children of mentally ill parents within adult mental health services. The study was conducted after Norwegian health legislation had been changed to make these tasks mandatory. The effort included implementation of two interventions; Family Assessment, an intervention for practitioners to increase identification of patients who are also parents and their children, and child talks, an intervention designed to provide support for parents and children within the participating hospital. Method The sample included mental health professionals in a large university hospital in Northern Norway, who responded to a web-based survey on the routines of the services, attitudes within the workforce capacity, workers knowledge on the impact of parental mental illness on children, knowledge on legislation concerning children of patients, and demographic variables. Register data from the Electronic Patient Journals (EPJ) was analyzed to assess whether or not the self-reported routines match the reality in the clinic. Discussion The prospects of clinical change will be discussed in general, as well as to which extent the two implemented interventions have contributed to changes in the clinical practice, workforce knowledge and attitudes in the participating hospital.

Establishing evidence-based practices within services for children: knowledge transfer challenges

Background Although more knowledge about effective interventions is frequently developed, most services in Norway are not evidence based. Part of the reason might be that practitioners and decision-makers do not know which interventions have scientific evidence for effectiveness and that they don’t search for information in traditional research literature. Although the evidence base of available interventions is growing, little research has been conducted on implementation strategies to bridge the gap between research and practice.