Rachel A. Haine

The family bereavement program: efficacy evaluation of a theory-based prevention program for parentally bereaved children and adolescents.

This article presents an experimental evaluation of the Family Bereavement Program (FBP), a 2-component group intervention for parentally bereaved children ages 8-16. The program involved separate groups for caregivers, adolescents, and children, which were designed to change potentially modifiable risk and protective factors for bereaved children. The evaluation involved random assignment of 156 families (244 children and adolescents) to the FBP or a self-study condition. Families participated in assessments at pretest, posttest, and 11-month follow-up. Results indicated that the FBP led to improved parenting, coping, and caregiver mental health and to reductions in stressful events at posttest. At follow-up, the FBP led to reduced internalizing and externalizing problems, but only for girls and those who had higher problem scores at baseline.

Evidence-Based Practices for Parentally Bereaved Children and Their Families.

Parental death is one of the most traumatic events that can occur in childhood, and several reviews of the literature have found that the death of a parent places children at risk for a number of negative outcomes. This article describes the knowledge base regarding both empirically-supported, malleable factors that have been shown to contribute to or protect children from mental health problems following the death of a parent and evidence-based practices to change these factors. In addition, nonmealleable factors clinicians should consider when providing services for children who have experienced the death of a parent are reviewed.

Locus of control and self-esteem as stress-moderators or stress-mediators in parentally bereaved children

Parentally bereaved childrens locus of control and self-esteem were examined as stress-moderators or stress-mediators of their internalizing and externalizing mental health problems. Seventy-six children ages 8 to 16 and their surviving parent were assessed 4 to 34 months after the death. Stress, locus of control, and self-esteem were measured by child report questionnaires. Internalizing and externalizing mental health problems were measured by child report on both questionnaires and a structured interview and by parent report questionnaires. The results revealed that self-esteem was a significant mediator of the relations between stress and both child and parent reports of internalizing problems but not externalizing problems. No significant mediation effects were found for locus of control. Neither locus of control nor self-esteem was a significant moderator of the relations between stress and childrens internalizing and externalizing problems. Implications for understanding parentally bereaved childrens mental health problems and for developing preventive interventions are discussed.

Positive Parenting as a Protective Resource for Parentally Bereaved Children

ABSTRACT Positive parenting was examined as a protective resource against the adverse effects of negative life events on parentally bereaved childrens mental health problems. The sample consisted of 313 recently bereaved children ages 8 to 16 and their current caregiver. Both the compensatory (direct effect independent of negative life events) and the stress-buffer (interactive effect with negative life events) protective resource models were examined and child gender was explored as a moderator of both models. Results revealed evidence for the compensatory protective resource model for both child and caregiver reports of mental health problems. No evidence of the stress-buffer model or child gender as a moderator was found. Implications for the understanding of childrens responses to the death of a parent and the development and implementation of preventive interventions are discussed.

Factors Associated with Use of Evidence-Based Practice Strategies in Usual Care Youth Psychotherapy

The purpose of this study was to gain an understanding of how therapists providing usual care (UC) psychotherapy are using elements of treatment common to evidence-based practices (EBPs) for children with disruptive behavior disorders (DBPs) and to identify client and therapist characteristics that may be associated with EBP strategies directed toward children and those directed to their caregivers. Results indicate that certain child, family, and therapist characteristics are associated with use of EBP strategies; however, much of the variability in practice was not explained by the variables examined. These findings highlight the complexity of UC psychotherapy and provide directions for future research on implementation of EBPs in UC.

Implications of Parental Suicide and Violent Death for Promotion of Resilience of Parentally-Bereaved Children

This article considers the implications of suicide and violent deaths (including suicide, homicide, and accidents) for the development of interventions for parentally bereaved children. Analyses of data from the Family Bereavement Program find minimal differences in childrens mental health problems, grief or risk and protective factors based on cause of parental death. In addition, cause of death did not substantially affect the relations between risk and protective factors and bereaved childrens outcomes. It is concluded that cause of death from violence or suicide is not a very useful indicator of bereaved childrens need for or likelihood of benefiting from an intervention.

Involvement of Youths with Autism Spectrum Disorders or Intellectual Disabilities in Multiple Public Service Systems

The objectives of this study were to estimate the prevalence of autism spectrum disorders (ASD) and intellectual disability (ID) among youths active in at least one of five public service systems: mental health (MH), educational services for youth with serious emotional disturbance (SED), child welfare (CW), juvenile justice (JJ), and alcohol and drug services (AD). This study also reports the characteristics and patterns of system involvement among these youths. Results indicate that approximately 12% of a random sample of youths involved in these public service systems had ID or ASD. These disabilities were particularly prevalent in youths in the SED (25%), MH (13%), and CW (13%) systems and were less prevalent in the JJ and AD systems (4% each). Youths with ID or ASD were more likely than other youths to be White, have a higher socioeconomic status, and be more likely to have externalizing psychiatric and other problems. Of those with ASD or ID, approximately one-third were served in more than one service system, with the MH and SED systems most likely to be serving youths with externalizing psychiatric disorders. These findings have important implications for service provision, treatment planning, and workforce development.

Caregiver Depression and Medication Use by Youths With ADHD Who Receive Services in the Public Sector

OBJECTIVE This study examined caregiver depression and medication use by youths with attention-deficit hyperactivity disorder (ADHD) in the public sector. METHODS Multivariate logistic regression models were created for 390 youths six to 17 years of age who met ADHD criteria on the Diagnostic Interview Schedule for Children (DISC) and were enrolled in a prospective study of youths served in public-sector service systems. The dependent variable was caregiver report of youth medication use for ADHD in the 12 months before the 24-month interview. RESULTS Only 38% of youths with DISC diagnoses of ADHD were using medication. Youths whose caregivers had depression (41% of the sample) were half as likely as other youths to use medication. Younger age, public insurance, caregiver report of diagnosis, and receipt of medical, mental health, or school services also predicted use. CONCLUSIONS Caregiver depression and its association with medication use warrant further exploration.

School-Based Service Use by Youth With ADHD in Public-Sector Settings

This study investigates rates and predictors of school-based services (SBSs) for 390 youth meeting criteria for Attention Deficit Hyperactivity Disorder and served in the San Diego public sectors. Only 60% of youth had received an Attention Deficit Hyperactivity Disorder diagnosis; these youth were younger, male, Caucasian (versus Latino), and active to public mental health and special education (Emotional Disturbance category) at enumeration of study participants. Higher rates of SBSs (64%) were revealed than in community samples. Only 26% accessed multimodal treatment including SBSs, medication, and mental health. In multivariate modeling, SBSs displayed a curvilinear relationship with age, which may explain previously conflicting results regarding that relationship. Youth with private insurance or receiving mental health or medication were more likely to receive SBSs. Gender, race/ethnicity, and caregiver education, health, and mental health were not related to SBSs use. These findings may reflect sample characteristics. Further exploration of factors influencing SBSs use in different populations is warranted.