Hospitalization for illness or injury can be experienced by children and their families as traumatic, which can impede recovery and lead to ongoing problems. The provision of quality trauma-informed or psychosocial care by hospital staff may mitigate trauma-related problems; however, there is great variability in the use of psychosocial care practices. Most previous research is based on self-report data and focuses primarily on nurses and physicians. The current study aimed to investigate the use of psychosocial care practices among a range of staff in a large urban pediatric hospital, using observations and interviews. A coding matrix of practices and a set of interview questions were developed based on previous research. Participants included 18 direct care hospital staff and 10 patients. Trained observers observed 13 staff and 10 patients, and coded instances of psychosocial care; 17 staff participated in interviews. A large number of instances of psychosocial care were observed but there was substantial variability in overall use and the use of individual practices. Interviewed staff reported many benefits of psychosocial care for patients and staff, although there were some costs, including emotional fatigue. Contrary to current evidence, most staff reported they rely on visible triggers of distress or need before providing psychosocial care. Future research could investigate the optimal ratio of psychosocial to physical care practices, taking into account patient feedback and psychosocial and medical outcomes. To improve the consistency of psychosocial care, training could incorporate the practice examples documented here, include staff self-care, and encourage informal avenues of learning.

This is a repository copy of Parenting practices, children's peer relationships and being bullied at school.

No abstract

This study investigated how supportive relationships with peers and parents protect children against ongoing victimization, internalizing problems and depression. The longitudinal data set tracked progress of 111 children recruited for the trial of Resilience Triple P, and previously bullied by peers. Informants included children, parents and teachers. Higher levels of facilitative parenting (warm parenting that supports peer relationships) and peer acceptance predicted lower later levels of both depression and victimization over time. Higher levels of child friendedness predicted lower levels of child reports of internalizing problems. Children's friendships, acceptance by same sex peers and facilitative parenting all played moderating roles in protecting against ongoing victimization and internalizing problems. Peer acceptance mediated the relationships between facilitative parenting and victimization. Facilitative parenting mediated the relationship between peer acceptance and depression. It was concluded that supportive relationships with parents and peers play important and complementary roles in protecting children against ongoing victimization and depression.

This study examined the effects of a family intervention on victimization and emotional distress of children bullied by peers. The intervention, Resilience Triple P, combined facilitative parenting and teaching children social and emotional skills relevant to developing strong peer relationships and addressing problems with peers. Facilitative parenting is parenting which supports the development of children's peer relationship skills. A randomized controlled trial was conducted with 111 families who reported chronic bullying of children aged six to 12 years. Families were randomly allocated to either an immediate start to Resilience Triple P (RTP) or an assessment control (AC) condition. Assessments involving children, parents, teachers and observational measures were conducted at 0 (pre), 3(post) and 9 months follow-up. RTP families had significantly greater improvements than AC families on measures of victimization, child distress, child peer and family relationships, Key words: school bullying, facilitative parenting, family intervention, controlled trial, victim A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT3 Randomized Controlled Trial of a Family Intervention for Children Bullied by PeersBullying is hurtful behavior which is typically repeated (Olweus, 1993). It can take physical, verbal and relational forms (e.g. deliberate exclusion) and can be carried out in person or through technology. Children who bully do not distribute their aggressive behavior evenly across all available peers; they selectively target a minority of 10% of children (Perry, Kusel & Perry, 1988). For this targeted minority, victimization tends to be quite stable throughout primary school (Boulton & Smith, 1994), and across the transition into middle or high school (Paul & Cillessen, 2003), resulting in the same children being victimized over many years. Bullying in primary school has serious mental health consequences for victims including higher rates of internalizing problems two years later (Arseneault et al., 2008), higher rates of self-harm and psychotic problems by 12 years of age (Fisher et al., 2012;Schreier et al., 2009) and increased incidence of depression and psychiatric problems in early adulthood and up to 32 years later (Sourander et al. 2007;Farrington, Loeber, Stallings, & Ttofi, 2011), after controlling for early adjustment and family factors.There is evidence that children who are bullied demonstrate social behavior which can attract more bullying over time. Poor social competence is one of the strongest predictors for being bullied (Cook, Williams, Guerra, Kim & Sadek, 2010). Children who are bullied have fewer friends than other students, which places them at greater risk of ongoing victimization (Fox & Boulton, 2006). Being emotionally reactive is also a risk factor for victimization. The majority of bullied children act as "passive victims", who demonstrate "internalizing" behaviors of submissiveness, depression and anxiety which act as both risk factors and consequences of bullying, resultin...

Commensurate with the serious risks bullying poses to students’ mental health, substantial attention has been devoted to evaluating school bullying prevention programs. Research on the effectiveness of these interventions shows mixed outcomes. Recent evidence suggests that even programs that reduce overall bullying may have negative outcomes for victims. Most bullying prevention programs incorporate a range of strategies, but we know little about which strategies actively reduce bullying and whether some may have iatrogenic effects. Questions have been raised about programs that involve working with peer bystanders and whether some strategies stigmatize victims. In this article, I propose three theoretically derived hypotheses that describe mechanisms through which encouraging peers to actively defend victims may produce adverse outcomes for victims. More research is needed to test these hypotheses. A deeper understanding of the differential impact of bullying prevention strategies will lead to improvements in programs and more targeted use of effective strategies.

No abstract

No abstract