Dianne C. Shanley

How Parents Seek Help for Children with Mental Health Problems

Parents seeking help for their child’s mental health problem face a complicated system of services. We examined how parents navigate the various services available. Sixty parents contacting a children’s mental health center were interviewed regarding their efforts and rationale in seeking help for their child. On average, in the year prior to the interview parents sought help for two different child problems, contacted five different agencies or professionals for help, and parents and/or children received two different treatments. One fifth of the time parents said they accepted treatments that they did not want. Almost all parents (87%) were simultaneously in contact with more than one agency at some point within the previous year. Future help-seeking models need to capture the iterative referral process that many parents experience.

What is a Mental Health Clinic? How to ask Parents about Help-seeking Contacts Within the Mental Health System

We compared parents’ endorsement of having contacted a “mental health clinic or agency” when seeking help for their child, with parents’ recognition of having contacted specific, named mental health agencies in their geographic region. Data were from two studies involving parents of children and adolescents seeking mental health services. Across the two studies, only 28 and 41% of parents reported having contacted a “mental health agency,” but 100% reported contact when asked about specific agencies by name. Incorporating this simple modification in future studies could provide more accurate documentation of help-seeking for, and utilization of, children’s mental health services.

Empowering and protecting children by enhancing knowledge, skills and well-being: A randomized trial of Learn to BE SAFE with Emmy.

Australia needs effective programs to protect children and prevent abuse, but there is little information available for policymakers or families. Using a randomized controlled trial, Learn to BE SAFE with Emmy, a school-based protection program for young children designed by Act for Kids, was evaluated to determine its effectiveness for promoting young childrens knowledge and skills. Grade one children (n=245) from 15 classrooms across 5 primary schools completed assessment measures. A subset of these children received the program (n=131) or acted as a comparison group (n=114). Parents (n=72) completed questionnaires about their childs participation in the program. When compared with children who had not received the program, children who completed Learn to BE SAFE with Emmy demonstrated increased knowledge of interpersonal safety and were more likely to choose a safe response option to hypothetical unsafe scenarios 6 months after participation than at both pre- and post-intervention. Parents reported their children who participated used more safety strategies immediately and 6 months after participation compared to pre-intervention. Outcomes can assist in guiding future policies around the prevention of child abuse and protect the well-being of Australian children.

Child Sexual Abuse Prevention Opportunities: Parenting, Programs, and the Reduction of Risk:

To date, child sexual abuse (CSA) prevention has relied largely on child-focused education, teaching children how to identify, avoid, and disclose sexual abuse. The purpose of this article is to explore how prevention opportunities can include parents in new and innovative ways. We propose that parents can play a significant role as protectors of their children via two pathways: (i) directly, through the strong external barriers afforded by parent supervision, monitoring, and involvement; and (ii) indirectly, by promoting their children’s self-efficacy, competence, well-being, and self-esteem, which the balance of evidence suggests will help them become less likely targets for abuse and more able to respond appropriately and disclose abuse if it occurs. In this article, we first describe why teaching young children about CSA protective behaviors might not be sufficient for prevention. We then narratively review the existing research on parents and prevention and the parenting and family circumstances that may increase a child’s risk of experiencing sexual abuse. Finally, we make a number of recommendations for future approaches to prevention that may better inform and involve parents and other adult protectors in preventing CSA.

Ambivalent attitudes about teaching children with attention deficit/hyperactivity disorder (ADHD)

ABSTRACT Drawing on attitude theories from social psychology, we conducted a survey of Australian pre-service (n = 327) and in-service (n = 127) teachers’ attitudes about teaching children with attention-deficit/hyperactivity disorder (ADHD). This paper reports a content analysis of beliefs, affect and behaviours towards teaching children with ADHD and quantitative analyses pertaining to attitudinal ambivalence – that is, where a teacher may simultaneously report negative and positive evaluations of teaching children with ADHD. While on average, overall or global attitudes were mildly positive for both cohorts, considerable ambivalence about teaching children with ADHD was commonly experienced. Participants reported ambivalent beliefs, affect and behaviours, as well as ambivalence between these attitude components. Paradoxically, participants who knew more about ADHD and held stronger positive global attitudes about teaching children with ADHD reported less ambivalent behaviours towards these children, but reported more ambivalent beliefs. The implications for teachers’ professional development and training are discussed.

The Impact of Parents’ Illness Representations on Treatment Acceptability for Child Mental Health Problems:

To measure parents’ representations of their child’s mental health problems, the validity of the Parents’ Illness Perception Questionnaire–Children’s Mental Health (PIPQ-CMH), a modified version of The Illness Perception Questionnaire–Revised, was established to explore the link between parents’ representations and (a) child problem severity, (b) parental adjustment, and (c) treatment acceptability. Parents (N = 487) of 4- to 15-year-old children (68% boys) from five children’s mental health centers across Southwestern Ontario, Canada completed the PIPQ-CMH along with additional measures to assess validity. The Brief Child and Family Phone Interview was used to assess problem severity, the Depression and Anxiety Stress Scale was used to assess parental adjustment, and an adapted version of the Treatment Acceptability Questionnaire was used to assess the acceptability of five types of psychological treatment. Confirmatory factor analysis demonstrated that the PIPQ-CMH was a reasonable fit to the data. Cronbach’s alpha and test–retest reliabilities were above .70. Significant relationships were found between parents’ perceptions (e.g., timeline, controllability, consequences, illness coherence, emotional representations) and child problem severity, parental adjustment, and treatment acceptability. Preliminary construct validity exists for the PIPQ-CMH as a measure of parents’ representations of child mental health problems. This measure should help to inform the impact of parent representations on the treatment process.

Promoting young children’s interpersonal safety knowledge, intentions, confidence, and protective behavior skills: Outcomes of a randomized controlled trial

Promoting young childrens interpersonal safety knowledge, intentions confidence and skills is the goal of many child maltreatment prevention programs; however, evaluation of their effectiveness has been limited. In this study, a randomized controlled trial was conducted examining the effectiveness of the Australian protective behaviors program, Learn to be safe with Emmy and friends™ compared to a waitlist condition. In total, 611 Australian children in Grade 1 (5-7 years; 50% male) participated, with assessments at Pre-intervention, Post-intervention and a 6-month follow-up. This study also included a novel assessment of interpersonal safety skills through the Observed Protective Behaviors Test (OPBT). Analyses showed participating in Learn to be safe with Emmy and friends™ was effective post-program in improving interpersonal safety knowledge (child and parent-rated) and parent-rated interpersonal safety skills. These benefits were retained at the 6-month follow-up, with participating children also reporting increased disclosure confidence. However, Learn to be safe with Emmy and friends™ participation did not significantly impact childrens disclosure intentions, safety identification skills, or interpersonal safety skills as measured by the OPBT. Future research may seek to evaluate the effect of further parent and teacher integration into training methods and increased use of behavioral rehearsal and modelling to more effectively target specific disclosure intentions and skills.

Recognising an at Risk Mental State for Psychosis: Australian Lay People and Clinicians’ Ability to Identify a Problem and Recommend Help Across Vignette Types

Objective This study assessed lay people and clinicians’ recognition of an at risk mental state (ARMS) for psychosis, their intentions to recommend help, and the equivalence of written and videotaped vignettes when detecting the problem. Methods In an Australian online survey, 52 lay people and 32 psychologists with provisional or full registration were randomly assigned to either a videotaped or written vignette of someone with an ARMS. Measures assessed detection and labelling of the mental health problem, and lay peoples intentions to recommend help. Results Data were analysed with Chi‐Square statistics, Fishers Exact tests, and Multinomial Logistic Regression. Lay people frequently detected that a mental health problem existed but labelled it incorrectly. All clinicians detected that a mental health problem existed and most labelled it correctly. Lay peoples detection that a mental health problem existed was not associated with vignette type but videotaped vignettes produced significantly more correct labelling. Clinicians had poorer labelling when the vignette was videotaped. Correct labelling was associated with intentions to recommend help to a doctor, psychiatrist, and psychologist/counsellor but not with other help sources or with “no help.” Conclusions Results indicated that if lay people received further education about ARMS, they may be more likely to recommend help to certain mental health professionals. They further highlight the need to use multiple vignette methods in mental health literacy research and the importance of simulated learning about ARMS in professional training environments. Replication of these results in larger samples is required.

“Tell, tell, tell again”: the prevalence and correlates of young children's response to and disclosure of an in-vivo lure from a stranger

Despite being a key target outcome to prevent child maltreatment, little research has been conducted to examine the prevalence and predictors of interpersonal safety skills in a standardised manner. In this study, interpersonal safety skills were measured in a Year 1-2 student sample through use of a standardised simulated risk scenario, with three primary skills examined: withdrawal from an unknown confederate (motor safety response), verbal refusal of an abduction lure (verbal safety response) and disclosure of confederate presence. Children who participated in this study had not completed any prior behavioural skills training or child protective education programs. Overall, the prevalence of interpersonal safety skills varied, with 27% children withdrawing from the confederate, 48% refusing the lure and 83% disclosing the confederates presence. For correlates, motor and verbal safety responses were positively associated with each other. However, the only other correlate of interpersonal safety skills was anxiety, with children who had greater anxiety disclosing earlier but also being more likely to agree to leave with the confederate. Future research may seek to examine whether these correlates remain present with different types of interpersonal safety risk (e.g., bullying) and to identify other potential predictors of interpersonal safety skill use.