Cheryl-Anne Cait

The Effects of Negative Legacies on the Adjustment of Parentally Bereaved Children and Adolescents

This is a report of a qualitative analysis of a sample of bereaved families in which one parent died and in which children scored in the clinical range on the Child Behavior Check List. The purpose of this analysis was to learn more about the lives of these children. They were considered to be at risk of developing emotional and behavioral problems associated with the death. We discovered that many of these “high risk” children had a continuing bond with the deceased that was primarily negative and troubling for them in contrast to a comparison group of children not at risk from the same study. Five types of legacies, not mutually exclusive, were identified: health related, role related, personal qualities, legacy of blame, and an emotional legacy. Coping behavior on the part of the surviving parent seemed to make a difference in whether or not a legacy was experienced as negative.

SPIRITUAL AND RELIGIOUS TRANSFORMATION IN WOMEN WHO WERE PARENTALLY BEREAVED AS ADOLESCENTS

This article is based on a larger research study that focused on how an adolescent girls identity development is influenced by the death of a parent. A sample of 18 women was recruited for the study. This article highlights the transformation of these womens spiritual and religious beliefs as part of their identity development following the death of their parents. The different pathways the women took with respect to their views on religion and spirituality are exemplified in what follows, highlighting themes of struggle and connection.

Parental Death, Shifting Family Dynamics and Female Identity Development

This article is a report of research that explored how the death of a parent influences a womans identity development. Qualitative methodology and data analysis procedures based on grounded theory were used for the research. Eighteen women who experienced parental death between age 11 and 17, were recruited by convenience sampling. Shifts in family relationships and roles, in part, influenced who these young women became. Many young women were expected to take on a caregiving role to support the surviving parent and replace the deceased. The transition in the relationship between the adolescent girl and surviving parent was an important theme for identity development.

A comparison of walk-in counselling and the wait list model for delivering counselling services

Abstract Background: Walk-in counselling has been used to reduce wait times but there are few controlled studies to compare outcomes between walk-in and the traditional model of service delivery. Aims: To compare change in psychological distress by clients receiving services from two models of service delivery, a walk-in counselling model and a traditional counselling model involving a wait list. Method: Mixed-methods sequential explanatory design including quantitative comparison of groups with one pre-test and two follow-ups, and qualitative analysis of interviews with a sub-sample. Five-hundred and twenty-four participants ≥16 years were recruited from two Family Counselling Agencies; the General Health Questionnaire-12 assessed change in psychological distress. Results: Hierarchical linear modelling revealed clients of the walk-in model improved faster and were less distressed at the four-week follow-up compared to the traditional service delivery model. Ten weeks later, both groups had improved and were similar. Participants receiving instrumental services prior to baseline improved more slowly. The qualitative data confirmed participants highly valued the accessibility of the walk-in model, and were frustrated by the lengthy waits associated with the traditional model. Conclusions: This study improves methodologically on previous studies of walk-in counselling, an approach to service delivery not conducive to randomized controlled trials.

A Relational Psychoanalytic Model for Case Management: A Literature Review

Abstract Relationship building is critical in case management with the seriously mentally ill. A theoretical framework, such as relational psychoanalytic theory, with a strong integrative emphasis provides a structure for the complex interplay of internal and external factors/forces in case management. The purpose of this paper is to provide a literature review in the area of case management: relational psychoanalytic theory, relationship building and psychodynamic theory. The review concludes outlining the appropriateness of this theoretical framework for case management.

Practice-based Qualitative Research: Participant Experiences of Walk-in Counselling and Traditional Counselling

Walk-in single session counselling is becoming a more widely used model for delivering mental health services across Ontario. This paper reports findings from the qualitative phase of a mixed method study, exploring the experiences of those attending walk-in counselling model compared to the traditional service delivery model employing a wait list. We used a comparative case study design for the qualitative phase. Findings reveal that participant outcomes of the walk-in counselling model are influenced by accessibility, how a participant makes sense of the service and the degree to which a participant is motivated and able to engage in counselling. Walk-in counselling supports the mental health system by reducing wait lists associated with traditional service delivery models and meeting the needs many people identify for immediate consultation. Other participants still perceive themselves as requiring ongoing counselling over time and involving in-depth exploration. This research supports health systems providing access to both models.

Cost-effectiveness Analysis of Single Session Walk-In Counselling

Abstract Background: An increasing number of family service agencies and community-based mental health service providers are implementing a single-session walk-in counselling (SSWIC) as an alternative to traditional counselling. However, few economic evaluations have been undertaken. Aims: To conduct a cost-effectiveness analysis of two models of service delivery, SSWIC compared to being waitlisted for traditional counselling. Methods: A quasi-experimental design was employed. Data were collected from two community-based Family Service Agencies, one using SSWIC and one using traditional counselling. Participants were assessed at baseline and four weeks after the baseline. Cost-effectiveness was estimated from the societal and payer’s perspective. Results: The societal and payer’s costs for SSWIC were higher than for those waiting for traditional counselling, and health outcomes were better. SSWIC is not cost-effective compared to being on the waitlist for traditional counselling (or, for a few patients, having received counselling, but after a wait of several weeks). Conclusions: SSWIC has the potential to reduce the pressure on the mental health care system by reducing emergency visits and wait lists for ongoing mental health services and eliminating costly-no shows at counselling appointments. Long-term studies involving multiple walk-in counselling services and comparison services are needed to support the findings of this study.

The Social Construction of Death. Interdisciplinary Perspectives by Van Brussel, L., & Carpentier, N.

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The Invisible Presence in Therapy: Organizational Context and Its Influence on Therapeutic Process

While two people, the social worker and client, might physically sit in therapy there can be invisible presences that influence the therapeutic process. Psychoanalytic relational theory and the concept of the “analytic third” will be used in case discussion to examine the presence of the organization, the social workers and clients relationship to the organization, and conflicts that exist. Understanding agency context, the role social workers play and pressures they feel can support therapists to be mindful practitioners. Implications for social work practice and education will be discussed.