Khiela J. Holmes

The Use of Collaborative Problem Solving to Address Challenging Behavior Among Hospitalized Children With Complex Trauma: A Case Series

Professionals working in a psychiatric hospital for children are often faced with challenging patients with histories of complex trauma, which manifests as impairments in multiple domains. These children are serviced by numerous systems beyond mental health, and it is important for these systems to interact with them in a nurturing manner. Collaborative Problem Solving (CPS) is a cognitive-behavioral psychosocial intervention with increasing empirical support that emphasizes cognitive lags associated with aggression and behavioral outbursts. This article utilizes case studies to illustrate how CPS was used on a child psychiatric inpatient unit to understand and treat children with complex trauma.

An Innovative, Interdisciplinary Model of Care for Inpatient Child Psychiatry: an Overview

There are profound effects of childhood psychiatric disorders on families and communities. Given that each year over half a million youth receive mental health services through inpatient psychiatric hospitals, focus on assessment and treatment strategies for this group is paramount The purpose of this paper is to present an overview of an innovative, evidenced-based model of inpatient child psychiatric care that challenges commonly used traditional practices of inpatient child psychiatry. The highlighted model utilizes an interdisciplinary approach to clarify psychiatric diagnoses; create a comprehensive biopsychosocial formulation of the child and family; establish a rational medication regimen; provide individually tailored recommendations; and address the “revolving door” of repeated psychiatric hospitalizations. Descriptive analyses are presented that provide demographic, developmental, and psychiatric characteristics of the children admitted to the unit. The potential benefits of using this innovative model with developmentally and psychiatrically complex children are discussed.

The Role of Religiosity in African American Preadolescent Aggression

This study examined the role of parent and preadolescent religiosity in aggression among African American preadolescents with moderate to high aggression. Hierarchical regression analyses were used to determine (a) which aspects of parent and preadolescent religiosity (i.e., church attendance, private religious activities, and intrinsic religiosity) accounted for the most variance in preadolescent aggression and (b) the potential moderating role of socioeconomic status. Participants were 157 African American preadolescents (110 males, 47 females) with elevated levels of aggression and their primary caregivers. Results indicated that higher levels of parent church attendance and preadolescent intrinsic religiosity predicted lower preadolescent aggression. The relation between preadolescent private religious activities and aggression was moderated by socioeconomic status. Implications for prevention and intervention among African American preadolescents with elevated levels of aggression are discussed.