The effectiveness of a behavioral parent training (BPT) intervention for improving maternal self-efficacy, maternal stress, and the quality of mother-toddler interactions has been demonstrated (Gross, Fogg, & Tucker, 1995). The 1-year follow-up of the 46 parents of toddlers (assigned to an intervention or comparison group) who participated in that study is reported. It was hypothesized that (a) BPT would lead to enduring positive changes in parenting self-efficacy, parenting stress, and parent-toddler interactions; and (b) the amount of parent participation in the intervention would be correlated with greater gains in parent-child outcomes at 1 year. All the families were retained and significant gains in maternal self-efficacy, maternal stress, and mother-child interactions were maintained. Minimal BPT effects were found for fathers. BPT dosage was related to reductions in mother critical statements and negative physical behaviors at 1-year postintervention. The findings are consistent with self-efficacy theory and support parenting self-efficacy as a target for BPT in families of young children.
KK, MW, and SC oversaw the study design. KK and SC led data acquisition through the literature reviews, Delphi surveys, and Open Review surveys, as well as data analysis and interpretation. KK takes responsibility for the integrity of the data and the accuracy of data analysis. All authors attended teleconferences, and all but the core project team (KK, MW, SC) completed anonymous votes and feedback surveys as part of the Delphi process and formed consensus on the final recommendation. KK drafted the manuscript with support from SC, and all co-authors critically reviewed the working draft and agreed to the revisions and final submission. Administrative, technical, and organisational support was provided by SC.
Declaration of interests
AMA receives royalties fromOxford University Press for the Anxiety Disorders Interview Schedule (ADIS), Child and Parent Versions. PB is involved with the development across Australia of routine outcome measurement in public mental health. He chairs the National Mental Health Child and Adolescent Information Development Expert AdvisoryGroup. There is an interest in supporting routine outcome measurement and benchmarking between organisations.
BACKGROUND: The de-escalation skills of inpatient psychiatric nurses are considered key to violence prevention. Yet their efficacy and translation into practice remains in question. OBJECTIVE: The aim of this study is to describe the de-escalation skills of psychiatric nurses. In the process, the investigators uncover ways nurses interact with patients to create and maintain a safe environment. STUDY DESIGN: Grounded theory methods are used to collect and analyze data derived from staff interviews and direct observation of milieu interactions. RESULTS: Staff behaviors are seen to create a safe milieu and promote a positive unit culture. Skills critical to maintaining a safe environment center on nurses’ awareness, attending, caring, and connecting. CONCLUSIONS: The behaviors identified in this study are at the heart of managing the clinical context of acute psychiatric units. Attention to these behaviors is especially critical in light of the staff expertise needed to keep the unit safe.
Youths who were at greatest risk of being restrained during brief inpatient treatment shared particular characteristics related to greater use of inpatient services, guardianship arrangements, special education placement, and history of suicide attempts. Inpatient staff members should remain particularly alert to the processing and regulation problems of these groups of patients.
Life for military spouses of veterans with PTSD is ever-changing and unpredictable. Practitioners need to be aware of the stress that spouses experience and develop programs and interventions that bolster the resilience of military families.
BACKGROUND: Escalation has been depicted as a linear trajectory of behavioral eruption beginning with agitation and proceeding until the patient is out of control. This notion has influenced current descriptions of de-escalation strategies. OBJECTIVES: The study objective was to understand the context and conditions that influence how nursing staffs manage patients who are escalating out of control. DESIGN: Methods consistent with grounded theory were used to collect and analyze the data. Patient-staff interactions were observed for more than 400 hours on inpatient units. Sixteen staff members and 12 patients were interviewed. FINDINGS: Data analysis revealed a nonlinear process of escalation and de-escalation. Two conditions that influenced strategies used by staff members were the type and the trajectory of escalation. This report focuses on patterns of patient escalation. CONCLUSION: The data revealed a complex escalation and de-escalation process that necessitates ongoing assessments of patient status and the milieu and individualizing staff responses.
The PMH graduate faculty believes that they have developed strategies to meet this challenge and to help build a PMH workforce that will maintain the centrality of the relationship in PMH practice.
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