Implementing a Child Mental Health Intervention in Child Welfare Services: Stakeholder Perspectives on Feasibility.

This pilot study integrated quantitative and qualitative data to examine the feasibility of implementing a modified version of a multiple family group behavioral parent training intervention (The 4Rs and 2Ss for Strengthening Families Program [4Rs and 2Ss]) in child welfare (CW) placement prevention services, from the perspectives of participating caregivers (n = 12) and CW staff (n = 12; i.e., 6 caseworkers, 4 supervisors, and 2 administrators). Quantitative surveys were administered to caregivers and CW staff followed by semi-structured interviews to examine the feasibility of implementing the modified 4Rs and 2Ss program, as well as factors impacting feasibility. Results indicated that quantitative benchmarks for high feasibility were met in all assessed areas (e.g., family recruitment, caseworker fidelity ratings, CW staff feasibility ratings) except for family attendance, which was markedly lower than desired. Factors facilitating feasibility included agency and research support, intervention ease-of-use, perceived benefits to existing CW practice, as well as logistical support (e.g., food, transportation, childcare) promoting attendance. Factors hindering feasibility included conflicts between research-based eligibility criteria and existing client population demographics, research-related processes resulting in delays, CW staff role conflicts, added workload burden, complex family issues, and power differentials inherent to CW services which complicated families' voluntary participation.

Underexamined points of vulnerability for black mothers in the child welfare system: The role of number of births, age of first use of substances and criminal justice involvement.

Black mothers and their children continue to interface with the child welfare (CW) system at unacceptably high rates. With research into traditionally understood contributing factors such as poverty, substance use, mental health and intimate partner violence abounding, this study sought to identify underexamined factors that potentially sustain very high rates of CW involvement for Black mothers. A sample of 415 Black mothers who accessed financial assistance through the Temporary Assistance for Needy Families program was analyzed for the factors associated with active CW involvement. Analytic procedures included, first, independent t-test and chi-square tests to determine significant group differences. Second, logistic regression was used to test a range of psychosocial risk factors for active CW involvement. Results from our final model indicated three factors beyond those typically associated with CW involvement, number of births, age at first use of cocaine and legal involvement. The standout impact of having a history of CW involvement is also discussed. Implications for policy and practice are explored.

Perceptions Among Child Welfare Staff when Modifying A Child Mental Health Intervention to be Implemented in Child Welfare Services.

In order to increase access to child mental health evidence-based interventions (EBIs) for vulnerable and hard-to-engage families involved in the child welfare (CW) system, innovative approaches coupled with input from service providers are needed. One potential solution involves utilizing task-shifting strategies and implementation science theoretical frameworks to implement such EBIs in CW settings. This study examined perceptions among CW staff who were members of a collaborative advisory board involved in the implementation of the 4Rs and 2Ss Strengthening Families Program (4R2S) in CW placement prevention settings, utilizing task-shifting strategies and the Practical, Robust, Implementation, and Sustainability Model. Advisory board members reported difficulties in engaging families, heavy workloads, and conflicting implementation initiatives. While 4R2S was perceived as generally aligned with their organization's mission, modifications to the intervention and to agency procedures were recommended to promote implementation success. Suggested modifications to the existing 4R2S training and supervision are discussed. Findings underscore the importance of understanding the experiences of CW service providers, which can inform future efforts to implement child mental health EBIs in CW services.

"Two Hours on a Sunday": Fatherhood Following an Intimate Partner Violence Incident-A Theory of Excision.

Fathers who are arrested after an intimate partner violence (IPV) incident must navigate multiple systems, including child welfare, criminal justice and family court, that regulate their interactions with their family members post-arrest. Contact between fathers and their children is highly regulated in the name of safety, often creating lengthy separations and putting strain on already frayed parent-child relationships. While concerns for the safety of victims and survivors of IPV are warranted, there is increased acknowledgement of the important role that fathers, including those with a history of IPV, play in their children's lives. This exploratory study used grounded theory methodology to interrogate how fathers seeking treatment at an abusive partners' program maintained a relationship with their child(ren) and their identities as fathers. Fourteen fathers with experience in the phenomenon of interest completed in-depth qualitative interviews, focus groups, and demographic questionnaires. These data were analyzed along with observational memos to develop a four-stage theory of excision which captured the four stages of routine and effective separation of fathers from their children's lives observed: (a) extraction; (b) re-assignment of identity; (c) exclusion; and (d) what remains. The presence of a single negative case in this study allowed for a discussion of this excision appearing to operate differently along racial lines. The urgent need to redress the institutional racism within these systems that has resulted in extraordinary burden and injustice to families of color is detailed. Implications for policies and practice with families living with IPV are discussed.

Conceptualizing healing through the African American experience of historical trauma.

For the African American healing journey, it is essential for cultural strengths that preceded and followed the original injury of enslavement, and consequent racially based trauma, to be recognized and elevated. Historical trauma has offered an important framework for understanding how the structural determinants of health are related to mass group-level subjugation for Indigenous people across generations, with a growing focus on protective factors. Here, we expand the application of the historical trauma framework to African Americans, with a focus on intergenerational healing. This exploratory study examined historical evidence of healing among enslaved people of African ancestry on Southern plantations. Two themes associated with how healing practices and strategies were used by healers and seekers of healing-figuring out what to do and fighting back/resisting-were developed using a thematic analysis of a historical text. A conceptual model is introduced illustrating the intergenerational transmission of healing and well-being across generations of African Americans. Implications for policy, practice, and research are explored. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A novel group of type I polyketide synthases (PKS) in animals and the complex phylogenomics of PKSs.

Type I polyketide synthases (PKSs), and related fatty acid synthases (FASs), represent a large group of proteins encoded by a diverse gene family that occurs in eubacteria and eukaryotes (mainly in fungi). Collectively, enzymes encoded by this gene family produce a wide array of polyketide compounds that encompass a broad spectrum of biological activity including antibiotic, antitumor, antifungal, immunosuppressive, and predator defense functional roles. We employed a phylogenomics approach to estimate relationships among members of this gene family from eubacterial and eukaryotic genomes. Our results suggest that some animal genomes (sea urchins, birds, and fish) possess a previously unidentified group of pks genes, in addition to possessing fas genes used in fatty acid metabolism. These pks genes in the chicken, fish, and sea urchin genomes do not appear to be closely related to any other animal or fungal genes, and instead are closely related to pks genes from the slime mold Dictyostelium and eubacteria. Continued accumulation of genome sequence data from diverse animal lineages is required to clarify whether the presence of these (non-fas) pks genes in animal genomes owes their origins to horizontal gene transfer (from eubacterial or Dictostelium genomes) or to more conventional patterns of vertical inheritance coupled with massive gene loss in several animal lineages. Additionally, results of our broad-scale phylogenetic analyses bolster the support for previous hypotheses of horizontal gene transfer of pks genes from bacterial to fungal and protozoan lineages.

A mental health program for ground zero rescue and recovery workers: cases and observations.

Clinical vignettes from the World Trade Center Worker and Volunteer Mental Health Monitoring and Treatment Program at the Mount Sinai Medical Center in New York City are presented. The hospital-based program pairs mental health screenings with federally funded occupational medical screenings to identify persons with mental health problems related to their rescue and recovery roles. The program also provides on-site mental health treatment. The cases illustrate the diverse mental health needs of the rescue and recovery workers, some of whom initially sought treatment years after September 11, 2001. The cases show that in addition to symptoms of posttraumatic stress disorder, workers experienced survivor guilt, distressing memories of childhood trauma, shame associated with intense feelings, substance abuse relapse, psychosis, and problems with family relationships.

A learning collaborative supporting the implementation of an evidence-informed program, the "4Rs and 2Ss for children with conduct difficulties and their families".

In this qualitative study the authors examine factors associated with the successful implementation and plans for continued use of an evidence-informed intervention, the 4Rs and 2Ss Program for Strengthening Families, in a sample of 29 New York State, Office of Mental Health licensed child mental health clinics. A learning collaborative (LC) approach was used as a vehicle for supporting training and implementation of the program. The PRISM theoretical framework ( Feldstein & Glasgow, 2008 ) was used to guide the data analysis. Data were analyzed using a multi-phase iterative process, identifying influences on implementation at multiple levels: the program (intervention), the external environment, implementation and sustainability infrastructure, and recipient characteristics. Clinics that were more proactive evidenced staff with advanced organizational skills were able to take advantage of the trainings and supports offered by the LC and fared better in their ability to adopt the intervention. The ability to adapt the intervention to the specific constraints of the clinics was a strong influence on continued use following the end of the LC. These preliminary results suggest that the supports provided by the LC are useful in consolidating information about the process of implementing evidence-informed interventions in community mental health settings. The impact of these supports is also based on their interactions with specific clinic contextual factors.