A suitably qualified and experienced mental health professional, assisting the mother to tell her story about the diagnosis and her infant's cardiac surgery, may provide a valuable, brief, and very cost-effective therapeutic intervention for these mothers and infants. It has the potential to alleviate maternal distress, with associated gains for the developing mother-infant relationship, reducing infant morbidity, and enhancing the quality of life for both infant and mother.

This study evaluated the effectiveness of the HOPE program. Participants included 120 Chinese new immigrant parents with preschool children in Hong Kong from 13 preschools which were randomized into intervention group (HOPE) and comparison group (6-session parent education program). Parent participants completed measures on child behavior, parenting stress, social support and self-efficacy before and after intervention. The children were assessed on the WPPSI-R and receptive vocabulary before and after parent intervention. Results indicated significant decrease in post-intervention child behavior problems and parenting stress and increase in social support in the intervention group, compared with the comparison group. Implications for service delivery for parents of preschool children were discussed.

Background: Mothers and infants are exposed to multiple stresses when cardiac surgery is required for the infant. This study reviewed infant responsiveness using a standardized objective observational measure of social withdrawal and explored its association with measures of maternal distress. Methods: Mother-infant pairs involving infants surviving early cardiac surgery were assessed when the infant was aged two months. Infant social withdrawal was measured using the Alarm Distress Baby Scale. Maternal distress was assessed using self-report measures for maternal depression (Edinburgh Postnatal Depression Scale), anxiety (Spielberger State-Trait Anxiety Scale), and parenting stress (Parenting Stress Index-Short Form). Potential associations between infant social withdrawal and maternal distress were evaluated. Results: High levels of maternal distress and infant social withdrawal were identified relative to community norms with a positive association. Such an association was not found between infant social withdrawal and the cardiac abnormality and surgery performed. Conclusion: The vulnerability of infants requiring cardiac surgery may be better understood when factors beyond their medical condition are considered. The findings suggested an association between maternal distress and infant social withdrawal, which may be consistent with mothers' distress placing infants subjected to cardiac surgery at substantially increased risk of social withdrawal. However, it is unclear to what extent infant withdrawal may trigger maternal distress and what the interactive effects are. Further research is warranted. Trialing a mother-infant support program may be helpful in alleviating distress and improving the well-being and outcomes for these families.

This study reported a pilot trial of the Hands-On Parent Empowerment (HOPE) program, a 30-session program designed to instruct parents from disadvantaged backgrounds how to teach learning skills to their preschool children. The participants included 13 parents who newly migrated into Hong Kong from mainland China. The parents were required to complete questionnaires on child behavior problems, parental stress, social support, and self-efficacy before, during, and after intervention. The children were assessed on the Wechsler Preschool and Primary Scale of Intelligence-Revised and the Peabody Picture Vocabulary Test before and after intervention. The results indicated a significant decrease in parent-reported child behavior problems and parental stress, an increase in Performance IQ and vocabulary knowledge among the children. These improvements were also observed by preschool principals. The pilot experience provides insights for social work practice in terms of inter-sectoral collaboration, program content, duration, and intensity in early support for challenged families.

Patient-initiated premature treatment discontinuation, which occurs when patients decide to end psychotherapy before agreed-upon treatment goals have been reached (Kazdin, 1996;Ogrodniczuk, Joyce, & Piper, 2005), is considered a major challenge for psychotherapy practitioners of all orientations (Roseborough, McLeod, & Wright, 2016;Swift & Greenberg, 2012). Despite considerable research into the phenomenon over five decades, patient discontinuation is still poorly understood and difficult to prevent (Barrett, Chua, Crits-Christoff, Gibbons, & Thompson, 2008;Kegel & Fluckiger, 2015). Furthermore, there appear to be no significant differences in discontinuation rates when comparing psychotherapy treatment modalities, settings, patient types and therapist characteristics (Wiersbicki & Pekarik, 1993).The term "discontinuation" is often used interchangeably with "termination", "attrition", "dropout" and "disengagement"