ABSTRACT
Belcebú es la historia de un niño con las marcas de la violencia que se perpetúa transgeneracionalmente. Su nombre remite a marcas identitarias confusas y ambivalentes. Ser demonio o exorcista. Ser exceso o restricción. Ser de la abuela o de mamá. Ser un niño o (no ser) un robot. Ser un peso o un sostén. Es también la historia del juego elaborativo en pandemia y con modalidad virtual. Y,por último,es la historia del alcance del analista frente a un contexto de mucha vulnerabilidad AU
Belcebu is the story of a boy with the singsof violence that are perpetuated transgenerationally. His name refers to confusing and ambivalent identity marks. To be a demon or an exorcist. To be excess or restraint. To be from grandma or from mom. To be a child or (not to be) a robot. To be a burden or a support.It is also the story of elaborative play during a pandemic and with virtual modality.And finally, it is the story of the analyst's reach in the face of a context of great vulnerability AU
Belzébuth est l'histoire d'un enfant marqué par la violence qui se perpétue de manière transgénération nelle. Son nom fait référence à des marques d'identitéconfuses et ambivalentes. Être un démon ou un exorciste. Être un excès ou une restriction. Être de grand-mère ou de maman. Être un enfant ou (ne pas être) un robot. Être un poids ou un support.C'est aussi l'histoire du jeu élaboratif dans une pandémie et avec une modalité virtuelle.Et enfin, c'est l'histoire de la portée de l'analyste dans un contexte de grande vulnérabilité AU
Belzebu é ahistória de uma criança com as marcas da violência que se perpetua transgeracionalmente. Seu nome remete a marcas identitárias confusas e ambivalentes. Ser um demônio ou exorcista. Ser excesso ou restrição. Seja da avó ou da mãe. Ser criança ou (não ser) robô. Sendo um peso ou um suporte.É também a história do jogo elaborativo em plena pandemia e com modalidade virtual.E, finalmente, é a história do alcance do analista em um contexto de grande vulnerabilidade AU
Subject(s)
Humans , Male , Child , Family Conflict/psychology , COVID-19/epidemiology , Handling, Psychological , Play Therapy , Remote Consultation , Child Nutrition , Family Relations/psychology , DeceptionABSTRACT
Este artigo pretende conhecer como a rede de cuidados em saúde tem se operacionalizado a partir da percepção de familiares de crianças com demanda de cuidado em saúde mental (SM). Foram realizados dois grupos focais, um com familiares da Atenção Básica (AB) e outro com familiares do Centro de Atenção Psicossocial Infantojuvenil (CAPSij), totalizando 15 participantes. Seguiu-se com a análise lexical do tipo classificação hierárquica descendente, com o auxílio do software R Interface, a fim de análises multidimensionais de textos e questionários (IRaMuTeQ), resultando em cinco classes: A Pílula Mágica; Forças e Fraquezas dos serviços; Procurando por ajuda; Aceitando o diagnóstico da criança e Onde procurei ajuda. Os resultados apontam para dificuldades presentes na AB em identificar e manejar situações de Saúde Mental Infantojuvenil (SMIJ), por meio de uma lógica ainda medicalizante. Ressalta-se que a escola é apresentada como lugar de destaque na produção da demanda por cuidado e a família ainda é pouco convocada à construção das ações. Conclui-se, então, que avanços ainda são necessários para operacionalização de um cuidado pautado nas diretrizes da política de SMIJ.(AU)
This article aims to know how the healthcare network has been operationalized from the perception of family members of children with demand for mental health care (MH). Two focus groups were held, one with family members from Primary Care (PC) and the other with family members from the Child Psychosocial Care Center (CAPSij), totaling 15 participants. A lexical analysis of the descending hierarchical classification type was performed with the help of the software R Interface for multidimensional analyzes of texts and questionnaires (IRAMUTEQ), resulting in five classes: The Magic Pill; Strengths and Weaknesses of services; Looking for help; Accepting the child's diagnosis; and Where did I look for help. The results point to difficulties present in PC in identifying and managing situations of mental health in children and adolescents (MHCA), with a medicalization logic. Note that the school is presented as a prominent place in producing the demand for care, and the family is still not very much involved in the actions. It is, thus, concluded that advances are still needed for operationalization of care guided by MHCA policy guidelines.(AU)
Este artículo tuvo por objetivo conocer cómo opera una red asistencial a partir de la percepción de familiares de niños con demanda de atención en salud mental (SM). Se realizaron dos grupos focales, uno con familiares de Atención Primaria (AP) y otro con familiares del Centro de Atención Psicosocial Infantojuvenil (CAPSij), totalizando 15 participantes. Se realizó análisis léxico del tipo clasificación jerárquica descendente con la ayuda del software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ), lo que resultó en cinco clases: "La píldora mágica"; "Fortalezas y debilidades de los servicios"; "En busca de ayuda"; "Aceptar el diagnóstico del niño" y "¿Dónde busqué ayuda?". Los resultados apuntan las dificultades presentes en AP para identificar y manejar situaciones de salud mental infantojuvenil (SMIJ) mediante una lógica aún medicalizante. La escuela tiene un lugar destacado en la producción de la demanda de cuidados y la familia aún no está muy involucrada en la construcción de acciones. Se concluye que se necesitan avances para ofertar una atención guiada por lineamientos de la política del SMIJ.(AU)
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adult , Middle Aged , Young Adult , Child , Adolescent , Intersectoral Collaboration , Mental Health Assistance , Health Policy , Anxiety Disorders , Parents , Patient Escort Service , Pediatrics , Play and Playthings , Play Therapy , Prejudice , Professional-Family Relations , Professional-Patient Relations , Proprioception , Psychoanalysis , Psychology , Psychomotor Disorders , Psychotherapy , Psychotic Disorders , Referral and Consultation , Attention Deficit Disorder with Hyperactivity , Self Care , Autistic Disorder , Social Alienation , Social Environment , Social Isolation , Social Support , Socialization , Pathological Conditions, Signs and Symptoms , Therapeutics , Violence , Mainstreaming, Education , Shyness , Neurosciences , Adaptation, Psychological , Patient Acceptance of Health Care , Health Centers , Cognitive Behavioral Therapy , Comorbidity , Child Advocacy , Child Behavior Disorders , Child Care , Child Development , Developmental Disabilities , Child Language , Occupational Therapy , Cognition , Communication Disorders , Neurobehavioral Manifestations , Stereotypic Movement Disorder , Behavioral Disciplines and Activities , Disabled Children , Affect , Crying , Aggression , Dermatitis, Contact , Diagnosis , Dissociative Disorders , Dyslexia , Echolalia , Education , Education of Intellectually Disabled , Education, Special , Emotions , Family Conflict , Speech, Language and Hearing Sciences , Medication Adherence , Apathy , Acceptance and Commitment Therapy , Emotional Adjustment , Literacy , Neurodevelopmental Disorders , Autism Spectrum Disorder , Orientation, Spatial , Applied Behavior Analysis , Cognitive Remediation , Emotion-Focused Therapy , Pediatricians , Data Analysis , Sadness , Psychological Distress , Social Interaction , Health Services Accessibility , Human Rights , Hyperkinesis , Intelligence , Interpersonal Relations , Anger , Language Disorders , Learning , Learning Disabilities , Loneliness , Malpractice , Mental Disorders , Intellectual Disability , Nervous System Diseases , Obsessive-Compulsive DisorderABSTRACT
Este estudo qualitativo teve como objetivo compreender, a partir da teoria de bioecológica de desenvolvimento, as implicações da prática profissional no processo de acolhimento de crianças em uma casa-abrigo, na perspectiva de cuidadoras. As participantes foram 10 profissionais de uma casa-abrigo localizada na região sul do Brasil. Utilizou-se a entrevista semiestruturada e a organização e análise dos dados sustentou-se na Grounded Theory, com auxílio do software Atlas.ti 8.4.14. Os resultados evidenciaram uma centralização das ações de acolhimento e atenção em torno dos cuidados físicos das crianças. As ações para promover suporte e cuidados emocionais dentro da casa-abrigo eram delegadas às profissionais da equipe técnica da instituição. Observou-se que as dificuldades encontradas pelas cuidadoras diziam respeito à falta de segurança e preparação para responder e acolher as demandas emocionais das crianças, as quais estão presentes em diversos momentos do processo de acolhimento. Percebeu-se que as práticas institucionais afetaram decisivamente tanto as ações de acolhimento das participantes e o suporte emocional oferecido às crianças na passagem pela casa-abrigo quanto as cuidadoras, no sentido de vivenciarem no trabalho sentimentos de insegurança. Os resultados tensionam ecologicamente a interação nos processos proximais presentes no desenvolvimento humano. Advoga-se pela reflexão sobre as implicações das práticas institucionais de uma casa-abrigo e o desenvolvimento infantil, visando o cuidado integral dos acolhidos.(AU)
Based on the developmental bioecological theory, this study analyzes the implications of professional practice in children's user embracement at a shelter from the caregivers' perspective. Semi-structured interviews were conducted with 10 professionals from a shelter located in southern Brazil. Data organization and analysis was performed based on Grounded Theory using the Atlas.ti 8.4.14 software. Results showed that embracement and attention focus on the physical care of children. Support and emotional care activities were delegated to the institution's technical team. Caregivers faced difficulties regarding the lack of security and preparation to respond to and accept the children's emotional demands, which arise at different moments in the embracement process. The institutional practices decisively affected both user embracement actions and the emotional support offered to the children, as well as the caregivers, in the sense of experiencing feelings of insecurity. These findings ecologically tension the interaction in the proximal processes present in human development. Further reflections on the implications of institutional shelter-based practices for child development are needed to provide comprehensive care.(AU)
Este estudio cualitativo tuvo como objetivo comprender, desde la perspectiva de la teoría bioecológica del desarrollo, las implicaciones de la práctica profesional en el proceso de acogida de niños en una institución infantil desde la perspectiva de las cuidadoras. Las participantes fueron 10 profesionales de una institución de acogida infantil ubicada en la región Sur de Brasil. Se utilizó la entrevista semiestructurada, y para la organización y análisis de datos se aplicó Grounded Theory, con el uso del software Atlas.ti 8.4.14. Los resultados mostraron que las acciones de recepción y atención se centran en el cuidado físico de los niños. Las acciones de promoción de apoyo y cuidado emocional dentro del alojamiento se asignaron a los profesionales del equipo técnico de la institución. Se observó que las dificultades encontradas por las cuidadoras estaban relacionadas con la falta de seguridad y preparación para responder y aceptar las demandas emocionales de los niños, las cuales se encuentran presentes en diferentes momentos del proceso de acogida. Se notó que las prácticas institucionales afectaron decisivamente tanto las acciones de acogida de las participantes como el apoyo emocional que la institución brinda a los niños durante su paso, así como a las cuidadoras en el sentido de experimentar sentimientos de inseguridad en el trabajo. Estos resultados tensan ecológicamente la interacción en los procesos proximales presentes en el desarrollo humano. Se aboga por reflexionar sobre las implicaciones de las prácticas institucionales en los alojamientos institucionales y el desarrollo infantil, apuntando a la atención integral de los acogidos.(AU)
Subject(s)
Humans , Female , Adult , Middle Aged , Professional Practice , Child , Caregivers , Ecology , User Embracement , Human Development , Pain , Parent-Child Relations , Paternal Behavior , Paternal Deprivation , Play and Playthings , Poverty , Psychology , Psychology, Social , Safety , Attention , Sibling Relations , Sleep , Social Adjustment , Social Change , Social Conditions , Social Environment , Social Justice , Social Problems , Social Support , Sociology , Sports , Violence , Battered Child Syndrome , Women , Child Labor , Adoption , Divorce , Family , Child, Abandoned , Child Abuse , Child Advocacy , Child Development , Child, Institutionalized , Child Rearing , Child, Unwanted , Child Welfare , Residence Characteristics , Family Characteristics , Health , Hygiene , Child of Impaired Parents , Liability, Legal , Hunger , Civil Disorders , Parenting , Interview , Domestic Violence , Cultural Diversity , Life , Crime Victims , Alcohol-Related Disorders , Affect , Culture , Personal Autonomy , Official Instructions , Defense Mechanisms , Adult Children , Stress Disorders, Traumatic , Qualitative Research , Friends , Minors , Adolescent Development , Human Rights Abuses , Diet , Alcoholism , Empathy , Health of Institutionalized Children , Family Conflict , Family Relations , Drug Users , Chemically-Induced Disorders , Enslaved Persons , Grounded Theory , Grandparents , Psychological Trauma , Child, Adopted , Child, Foster , Freedom , Adverse Childhood Experiences , Family Separation , Psychological Distress , Right to Health , Emotional Abuse , Freedom of Religion , Social Interaction , Sociodemographic Factors , Social Vulnerability , Citizenship , Family Support , Household Work , Human Rights , Individuality , Institutionalization , Jealousy , Leisure Activities , Loneliness , Love , Malpractice , Maternal Deprivation , Mental Disorders , Motivation , Object AttachmentABSTRACT
Com os avanços tecnológicos e o aprimoramento da prática médica via ultrassonografia, já é possível detectar possíveis problemas no feto desde a gestação. O objetivo deste estudo foi analisar a prática do psicólogo no contexto de gestações que envolvem riscos fetais. Trata-se de um estudo qualitativo sob formato de relato de experiência como psicólogo residente no Serviço de Medicina Fetal da Maternidade Escola da Universidade Federal do Rio de Janeiro (UFRJ). Os registros, feitos por observação participante e diário de campo, foram analisados em dois eixos temáticos: 1) intervenções psicológicas no trabalho em equipe em consulta de pré-natal, exame de ultrassonografia e procedimento de amniocentese; e 2) intervenções psicológicas em casos de bebês incompatíveis com a vida. Os resultados indicaram que o psicólogo nesse serviço é essencial para atuar de forma multiprofissional na assistência pré-natal para gravidezes de alto risco fetal. Ademais, a preceptoria do residente é relevante para sua formação e treinamento para atuação profissional no campo da psicologia perinatal.(AU)
Face to the technological advances and the improvement of medical practice via ultrasound, it is already possible to detect possible problems in the fetus since pregnancy. The objective of this study was to analyze the psychologist's practice in the context of pregnancies which involve fetal risks. It is a qualitative study based on an experience report as a psychologist trainee at the Fetal Medicine Service of the Maternity School of UFRJ. The records, based on the participant observation and field diary, were analyzed in two thematic axes: 1) psychological interventions in the teamwork in the prenatal attendance, ultrasound examination and amniocentesis procedure; and 2) psychological interventions in cases of babies incompatible to the life. The results indicated that the psychologist in this service is essential to work in a multidisciplinary way at the prenatal care for high fetal risk pregnancies. Furthermore, the resident's preceptorship is relevant to their education and training for professional performance in the field of Perinatal Psychology.(AU)
Con los avances tecnológicos y la mejora de la práctica médica a través de la ecografía, ya se puede detectar posibles problemas en el feto desde el embarazo. El objetivo de este estudio fue analizar la práctica del psicólogo en el contexto de embarazos de riesgos fetal. Es un estudio cualitativo basado en un relato de experiencia como residente de psicología en el Servicio de Medicina Fetal de la Escuela de Maternidad de la Universidade Federal do Rio de Janeiro (UFRJ). Los registros, realizados en la observación participante y el diario de campo, se analizaron en dos ejes temáticos: 1) intervenciones psicológicas en el trabajo en equipo, en la consulta prenatal, ecografía y los procedimientos de amniocentesis; y 2) intervenciones psicológicas en casos de bebés incompatibles con la vida. Los resultados señalaron como fundamental la presencia del psicólogo en este servicio trabajando de forma multidisciplinar en la atención prenatal en el contexto de embarazos de alto riesgo fetal. Además, la tutela del residente es relevante para su educación y formación para el desempeño profesional en el campo de la Psicología Perinatal.(AU)
Subject(s)
Humans , Female , Pregnancy , Prenatal Care , Pregnancy, High-Risk , Psychosocial Intervention , Heart Defects, Congenital , Anxiety , Orientation , Pain , Parent-Child Relations , Parents , Paternity , Patient Care Team , Patients , Pediatrics , Placenta , Placentation , Pregnancy Complications , Pregnancy Maintenance , Prognosis , Psychoanalytic Theory , Psychology , Puerperal Disorders , Quality of Life , Radiation , Religion , Reproduction , Reproductive and Urinary Physiological Phenomena , General Surgery , Syndrome , Congenital Abnormalities , Temperance , Therapeutics , Urogenital System , Bioethics , Physicians' Offices , Infant, Premature , Labor, Obstetric , Pregnancy , Pregnancy, Animal , Pregnancy Outcome , Adaptation, Psychological , Pharmaceutical Preparations , Echocardiography , Magnetic Resonance Spectroscopy , Family , Abortion, Spontaneous , Child Rearing , Child Welfare , Mental Health , Family Health , Survival Rate , Life Expectancy , Cause of Death , Ultrasonography, Prenatal , Chromosome Mapping , Parental Leave , Mental Competency , Polycystic Kidney, Autosomal Recessive , Down Syndrome , Perinatal Care , Comprehensive Health Care , Chemical Compounds , Depression, Postpartum , Neurobehavioral Manifestations , Disabled Children , Diagnostic Techniques and Procedures , Gravidity , Crisis Intervention , Affect , Cytogenetic Analysis , Spirituality , Complicity , Value of Life , Humanizing Delivery , Death , Decision Making , Defense Mechanisms , Abortion, Threatened , Delivery of Health Care , Dementia , Uncertainty , Organogenesis , Qualitative Research , Pregnant Women , Early Diagnosis , Premature Birth , Nuchal Translucency Measurement , Child Mortality , Depression , Depressive Disorder , Postpartum Period , Diagnosis , Diagnostic Techniques, Obstetrical and Gynecological , Ethanol , Ego , Emotions , Empathy , Environment , Humanization of Assistance , User Embracement , Ethics, Professional , Cell Nucleus Shape , Prenatal Nutrition , Cervical Length Measurement , Family Conflict , Family Therapy , Resilience, Psychological , Reproductive Physiological Phenomena , Female Urogenital Diseases and Pregnancy Complications , Gestational Sac , Brief, Resolved, Unexplained Event , Fetal Death , Embryonic and Fetal Development , Multimodal Imaging , Mortality, Premature , Clinical Decision-Making , Pediatric Emergency Medicine , Child, Foster , Freedom , Burnout, Psychological , Birth Setting , Frustration , Sadness , Respect , Psychological Distress , Genetics , Psychological Well-Being , Obstetricians , Guilt , Happiness , Health Occupations , Hospitalization , Hospitals, Maternity , Hospitals, University , Human Development , Human Rights , Imagination , Infections , Infertility , Anencephaly , Jurisprudence , Obstetric Labor Complications , Licensure , Life Change Events , Life Support Care , Loneliness , Love , Medical Staff, Hospital , Intellectual Disability , Morals , Mothers , Narcissism , Congenital, Hereditary, and Neonatal Diseases and Abnormalities , Neonatology , Nervous System Malformations , Object AttachmentABSTRACT
O distanciamento social ocasionado pela pandemia de Covid-19 levou a profundas mudanças na rotina das famílias com crianças pequenas, aumentando o estresse no ambiente doméstico. Este estudo analisou a experiência de planejamento e implementação de um projeto de extensão universitária que ofereceu orientação a pais com filhos de 0 a 11 anos por meio de chamadas de áudio durante a pandemia. O protocolo de atendimento foi desenvolvido para atender às necessidades de famílias de baixa renda e listava problemas específicos relacionados ao confinamento em casa e ao fechamento das escolas seguidos por uma variedade de estratégias de enfrentamento. A análise de 223 queixas relatadas pelos usuários em 130 ligações revelou que 94% dos problemas referidos pelos pais foram contemplados pelo protocolo de atendimento e estavam relacionados aos problemas externalizantes (39%) ou internalizantes (26%) das crianças ou ao declínio do bem-estar subjetivo dos pais (29%). Serviços de apoio devem orientar os pais quanto ao uso de práticas responsivas e assertivas que promovam o bem-estar emocional da criança e estabeleçam expectativas comportamentais em contextos estressantes. A diminuição dos conflitos entre pais e filhos resultante do uso dessas estratégias tende a reduzir o sofrimento dos pais, aumentando sua sensação de bem-estar subjetivo. Recomenda-se ampla divulgação dessas iniciativas e seguimento dos casos.(AU)
The social distancing the COVID-19 pandemic entailed has led to profound changes in the routine of families with young children, increasing stress in the home environment. This study analyzed the experience of planning and implementing a university extension program that offered support to parents with children from 0 to 11 years old via audio calls during the COVID-19 pandemic. The service protocol was developed to meet the needs of low-income families and listed specific problems related to home confinement and school closure followed by a variety of coping strategies. The analysis of 223 complaints reported by users in 130 calls revealed that 94% of the problems reported by parents were addressed by the protocol and were related to children's externalizing (39%) or internalizing (26%) problems or to the decline in parents' subjective well-being (29%). Support services should guide parents on the use of responsive and assertive practices that promote the child's emotional well-being and set behavioral expectations in stressful contexts. The reduction in conflicts between parents and children resulting from the use of these strategies tends to reduce parents' suffering, increasing their sense of subjective well-being. Wide dissemination of these initiatives and case follow-up are recommended.(AU)
La distancia social causada por la pandemia de COVID-19 condujo a cambios profundos en la rutina de las familias con niños pequeños, aumentando el estrés en el entorno del hogar. Este estudio analizó la experiencia de planificar e implementar un proyecto de extensión universitaria que ofreció orientación a los padres con niños de cero a 11 años a través de llamadas de audio durante la pandemia COVID-19. El protocolo de atención se desarrolló para satisfacer las necesidades de las familias de bajos ingresos y enumeró problemas específicos relacionados con el confinamiento en el hogar y el cierre de la escuela, seguido de una variedad de estrategias de afrontamiento. El análisis de 223 quejas informadas por los usuarios en 130 llamadas reveló que el 94% de los problemas informados por los padres fueron abordados por el protocolo de atención y estaban relacionados con los problemas de externalización (39%) o internalización (26%) de los niños o la disminución del bienestar subjetivo de los padres (29%). Los servicios de apoyo deberían aconsejar a los padres sobre el uso de prácticas receptivas y asertivas que promuevan el bienestar emocional del niño y establezcan expectativas de comportamiento en contextos estresantes. La reducción de los conflictos entre padres e hijos como resultado del uso de estas estrategias tiende a reducir el sufrimiento de los padres, aumentando su sensación de bienestar subjetivo. Se recomienda una amplia difusión de estas iniciativas y seguimiento de casos.(AU)
Subject(s)
Humans , Female , Infant, Newborn , Infant , Child, Preschool , Child , Orientation , Parents , Personal Satisfaction , Child , Problem Behavior , COVID-19 , Anxiety , Parent-Child Relations , Appetite , Play and Playthings , Problem Solving , Psychology , Psychomotor Agitation , Quality of Life , Reading , Recreation , Remedial Teaching , Respiratory Tract Infections , Safety , Salaries and Fringe Benefits , School Health Services , Self Concept , Autistic Disorder , Sleep , Social Adjustment , Social Conditions , Social Conformity , Social Environment , Social Isolation , Social Problems , Socialization , Socioeconomic Factors , Task Performance and Analysis , Telephone , Temperament , Therapeutics , Time , Unemployment , Violence , Behavior Therapy , Work Hours , Health Policy, Planning and Management , Child Abuse, Sexual , Boredom , Neurosciences , Virus Diseases , Activities of Daily Living , Bereavement , Exercise , Divorce , Child Abuse , Child Development , Mental Health , Mass Vaccination , Relaxation Therapy , Immunization , Self-Injurious Behavior , Civil Rights , Parenting , Panic Disorder , Interview , Cognition , Domestic Violence , Disease Transmission, Infectious , Lecture , Disabled Children , Wit and Humor , Internet , Creativity , Crisis Intervention , Crying , Disaster Vulnerability , Psychosocial Impact , Personal Autonomy , Death , Friends , Aggression , Depression , Drive , Economics , Education, Special , Educational Status , Emotions , Empathy , Faculty , Family Conflict , Family Relations , Fear , Binge Drinking , Meals , Return to Work , Hope , Optimism , Pessimism , Self-Control , Phobia, Social , Psychosocial Support Systems , Work-Life Balance , Adverse Childhood Experiences , Screen Time , Disgust , Sadness , Solidarity , Psychological Distress , Psychosocial Intervention , Teleworking , Financial Stress , Food Insecurity , Sentiment Analysis , Sociodemographic Factors , Social Vulnerability , Family Support , Government , Guilt , Holistic Health , Homeostasis , Hospitalization , Household Work , Sleep Initiation and Maintenance Disorders , Anger , Learning , Learning Disabilities , Leisure Activities , Loneliness , Mental DisordersABSTRACT
O presente estudo qualitativo objetivou compreender as expectativas de mães e cuidadoras sobre a sua participação no Programa ACT para Educar Crianças em Ambientes Seguros na versão remota, no período da pandemia de covid-19. Também visou identificar a percepção das participantes sobre educar uma criança em um ambiente seguro. Foram realizadas entrevistas semiestruturadas on-line com doze mães e cuidadoras, antes da participação no Programa ACT. Os resultados indicaram diferentes expectativas sobre a participação no Programa ACT, entre elas: adquirir novos conhecimentos, aprimorar as habilidades parentais, trocar experiências, receber auxílio no momento da pandemia de covid-19 e possibilitar para a criança um desenvolvimento saudável. Na percepção das mães e cuidadoras, a versão remota do Programa ACT apresenta aspectos positivos; entre eles, a participação de pais e cuidadores que não residem na cidade em que é oferecida a intervenção. No entanto, apontaram como fatores negativos a ausência do contato físico e as interrupções que podem acontecer a partir das falhas de internet. Para as mães e cuidadoras, educar a criança em um ambiente seguro estava relacionado a promover os direitos estabelecidos no Estatuto da Criança e do Adolescente (ECA), como educação, saúde, lazer, cuidado, afeto, assim como protegê-la de situações de violência. Considera-se que as expectativas das participantes estavam alinhadas aos objetivos do Programa ACT. Torna-se prioritário oferecer programas de prevenção à violência aos pais e cuidadores, em especial em momentos adversos como o da pandemia de covid-19, a fim de promover o desenvolvimento e a saúde das crianças, assim como prevenir situações de violação de direitos.(AU)
This qualitative study aims to understand the expectations of mothers and caregivers about participating in the ACT Raising Safe Kids Program in its remote version, during the COVID-19 pandemic period. It also aims to identify the participants' perception of raising a child in a safe environment. Semi-structured on-line interviews were conducted with 12 mothers/caregivers, prior to participation in the ACT Program. The results indicated different expectations regarding the participation in the ACT Program, for example: acquiring new knowledge, improving parenting skills, exchanging experiences, receiving support during the COVID-19 pandemic, and enabling the child to have a healthy development. In the perception of mothers and caregivers, the remote version of the ACT Program has positive aspects, such as the participation of parents and caregivers who do not live in the city where the intervention is offered. However, they pointed out as negative factors absence of physical contact and interruptions due to internet failures. For the mothers/caregivers, educating children in a safe environment was related to promoting the rights established by the Brazilian Child and Adolescent Statute, namely education, health, leisure, care, affection, as well as protecting them from situations of violence. The expectations of the participants were aligned with the objectives of the ACT Program. Offering violence prevention programs to parents and caregivers is a priority, especially in adverse moments such as the COVID-19 pandemic, in order to promote the development and health of children, as well as prevent situations of violation of rights.(AU)
Este estudio cualitativo pretendió comprender las expectativas de madres y cuidadoras sobre la participación en el Programa de ACT para Educar a Niños en Ambientes Seguros en la versión remota, en el periodo de la pandemia de la COVID-19. También se propuso identificar la percepción de las participantes sobre educar a un niño en un ambiente seguro. Se llevaron a cabo entrevistas semiestructuradas en línea con 12 madres/cuidadoras, antes de la participación en el Programa ACT. Los resultados señalaron diferentes expectativas con la participación del Programa de ACT, entre ellas: adquirir nuevos conocimientos, perfeccionar las habilidades parentales, intercambiar experiencias, recibir auxilio en el momento de la pandemia de la COVID-19 y posibilitar al niño un desarrollo saludable. En la percepción de las madres y cuidadoras, la versión remota del Programa de ACT presenta aspectos positivos, como la participación de padres y cuidadores que no residen en la ciudad donde es ofrecida la intervención. Sin embargo, señalaron como factores negativos la ausencia del contacto físico y las interrupciones, que pueden ocurrir por fallas en Internet. Para las madres/cuidadoras, educar al niño en un ambiente seguro estaba relacionado a promover los derechos establecidos en el Estatuto del Niño y del Adolescente de Brasil, como educación, salud, ocio, cuidado, afecto, así como protegerlo de situaciones de violencia. Se considera que las expectativas de las participantes estaban alineadas con los objetivos del Programa de ACT. Es prioritario ofrecer programas de prevención a la violencia a los padres y cuidadores, en especial en momentos adversos como el de la pandemia de la COVID-19, con el fin de promover el desarrollo y la salud de los niños, así como prevenir situaciones de vulneración de derechos.(AU)
Subject(s)
Humans , Female , Adult , Middle Aged , Young Adult , Child Abuse , Disease Prevention , Psychosocial Intervention , Appetite , Personality Development , Play Therapy , Problem Solving , Psychology , Psychomotor Performance , Public Policy , Safety , Schools , Sex Offenses , Authoritarianism , Social Adjustment , Social Class , Social Isolation , Social Responsibility , Social Support , Stress, Psychological , Battered Child Syndrome , Behavior and Behavior Mechanisms , Behavioral Symptoms , Child Abuse, Sexual , Brazil , Online Systems , Character , Child , Child, Abandoned , Child Care , Child Welfare , Mental Health , Negotiating , Interview , Domestic Violence , Coronavirus , Combat Disorders , Communications Media , Comprehensive Health Care , Crime , Hazards , Affective Symptoms , Culture , Surveillance in Disasters , Death , Whistleblowing , Vulnerable Populations , Aggression , Dreams , Family Conflict , Family Relations , Family Therapy , Pandemics , Social Networking , Personal Narrative , Trauma and Stressor Related Disorders , Psychological Trauma , Social Workers , Child, Foster , Frustration , Posttraumatic Growth, Psychological , Respect , Psychological Distress , Sexual Trauma , Social Inclusion , Return to School , Food Supply , COVID-19 , Home Environment , Social Vulnerability , Citizenship , Hematoma , Homicide , House Calls , Human Rights , Infanticide , Life Change Events , Love , Malpractice , Maternal Welfare , Mental Disorders , Narcissism , Object AttachmentABSTRACT
RATIONALE: Workaholism logically corresponds to the experience of work-family conflict (WFC) which is associated with a wide variety of negative employee outcomes. Finding ways to mitigate the occurrence of workaholism and/or lessen its deleterious effects on the work-family interface is practically important. Mindfulness research may hold some promise in this regard. OBJECTIVE: We explore the potential that mindfulness - through its association with accuracy and salience of present moment experience and disengagement from automatic thoughts and debilitating behavior - may buffer the effects of workaholic tendencies on the experience of WFC. METHODS: We use a two-study design (total n = 1022) to examine the role of dispositional mindfulness and mindfulness practice on the workaholism-WFC relationship. RESULTS: Results suggest that (1) trait mindfulness buffers the workaholism-WFC relationship (Study 1; n = 307), and that (2) mindfulness practice and mindfulness training similarly buffer this relationship (Study 2; n = 715). CONCLUSION: Mindfulness effectively serves as a buffer in the relationship between workaholism and WFC.
Subject(s)
Behavior, Addictive , Mindfulness , Family Conflict , Family Relations , Humans , Surveys and QuestionnairesABSTRACT
The aim of the present study is to investigate the effectiveness of Cognitive Developmental Hypnotherapy (CDH) on Differentiation of Self, Meaning in Life and Marital Conflicts in married women. The method is quasi-experimental pretest and posttest with a control group. The statistical population of this study includes married women who came to FUM Counseling and Psychological Services Center to receive psychological services. The sample of this study included 40 married women who were selected by targeted sampling method and randomly assigned to two experimental and control groups. Participants in the pretest and posttest study answered the Differentiation of Self Inventory, the Marital Conflicts questionnaire by Sanaei, and the Meaning in Life questionnaire. The research data were analyzed using ANCOVA and MANCOVA with SPSS-21. The findings showed CDH led to an increase in Differentiation of Self and Meaning in life, and a reduction in Marital Conflicts in women. Accordingly, CDH through using techniques such as induction and empowerment of the Ego is effective in marital conflicts of married women. Therefore, using it as a means to improve the quality of married women's lives is recommended.
Subject(s)
Family Conflict , Hypnosis , Cognition , Female , Humans , Marriage , Surveys and QuestionnairesABSTRACT
Dyadic discussions that directly tap into spouses' views on spirituality and religiousness (S/R) represent an understudied but important facet of marital functioning that may be tied, for better or worse, to marital conflict and resolution processes. This study used longitudinal data gathered from 164 married couples across the transition to parenthood (TtP) to address this possibility. Specifically, during late pregnancy and when their infant was 3, 6, and 12 months old, husbands and wives completed measures about both spouses' spiritual intimacy (i.e., self-disclosure and support of partner's disclosures about spirituality) and spiritual one-upmanship (i.e., relying on spiritual and religious [dis]beliefs and opinions to assert superiority in conflicts). Criterion variables were the frequency of marital conflict and both partners' use of collaborative, hostile, and stalemating communication strategies during marital conflicts. Using fixed-effects regression models with both predictors entered, we found that greater spiritual intimacy by wives and husbands predicted less frequent conflict (p < .01), more collaborative communication by husbands (p < .01) and less stalemating (p < .01) by both spouses. Wives' spiritual intimacy also predicted more collaboration and less verbal hostility by wives (p < .01). By contrast, greater spiritual one-upmanship by both spouses predicted greater stalemating by both spouses (p < .05) and verbal hostility by husbands (p < .05). The findings indicate that 2 contrasting types of S/R dialogues are differentially linked to disagreements and conflict-resolution skills after accounting for stable aspects of the couples across the TtP (e.g., personality traits). (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Subject(s)
Communication , Family Conflict , Spirituality , Adult , Female , Hostility , Humans , Infant , Male , Marriage , Middle Aged , Parents , Pregnancy , SpousesABSTRACT
Sibling relationships wherein at least one sibling suffers from a mental disorder have seldom been studied. The few existing studies found that children with mental disorders reported high levels of disputes within sibling relationships as well as less parental support and admiration. The aim of the present study was to examine the quality of sibling relationships in children and adolescents with a psychiatric diagnosis (clinical sample [CS]) as compared to an age and gender matched healthy control group (HC). One hundred fifty-six children and adolescents (nCS = 78/nHC = 78) between 8 and 18 years of age were recruited. The CS consisted of patients recruited from the daycare facility and inpatient unit of the Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy Charité-Universitätsmedizin Berlin. HC was matched by gender, sibling position, and age. Quality of sibling relationships was examined using the German version of the Sibling Relationship Questionnaire (SRQ-deu, self-report). Additionally, the Child Behavior Checklist (CBCL 4-18) was implemented in the CS to enable a classification into externalizing, internalizing, and combined disorders. The CS sample reported a warmer sibling relationship compared to the HC sample. Conflict within the sibling relationship differed significantly between participants with internalizing, externalizing, and combined disorders. Relevance of sibling relationships as a possible resource for children and adolescents with a mental illness is discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Subject(s)
Family Conflict/psychology , Mental Disorders/psychology , Sibling Relations , Adolescent , Child , Female , Humans , Male , Risk FactorsABSTRACT
BACKGROUND: To improve nursing quality and safety, it is essential to better understand relationships between sleep quality, mindfulness, and work-family conflict among nurses. PURPOSE: To examine the relationships among sleep quality, mindfulness and work-family conflict, and the mediating effect of mindfulness. METHODS: A cross-sectional study was conducted using survey data from five comprehensive tertiary first-class hospitals in Xiamen. Two thousand three hundred seventy-two nurses' data were used as the final sample. Spearman correlations were calculated, bootstrapping analysis, path analysis was conducted. FINDINGS: The sleep quality of nurses was not optimal. Work-family conflict was positively correlated with the Pittsburgh Sleep Quality Index (PSQI) score, while mindfulness level was negatively associated with it. Mindfulness played a mediating role in the prediction of sleep quality based on work-family conflict. CONCLUSIONS: To improve nursing quality, interventions are needed to enhance nurses' sleep quality through mindfulness and work-family conflict improvement.
Subject(s)
Mindfulness , Nurses , China , Cross-Sectional Studies , Family Conflict , Humans , Sleep , Surveys and QuestionnairesSubject(s)
Employment/psychology , Family Conflict/psychology , Mental Healing , Occupational Health , Work/psychology , Adult , Female , Humans , Japan , Life Style , Logistic Models , Male , Meals , Middle Aged , Personnel Staffing and Scheduling , Stress, Psychological , Surveys and QuestionnairesABSTRACT
BACKGROUND: Taking into account the differences in job requirements and conditions, it is expected that workers in some occupations are more susceptible to pain than others. OBJECTIVE: To examine the prevalence of chronic pain among workers of several petrochemical and petroleum refinery plants. We also examined the predictive role of psycho-familial variables (depression, work-family conflict and job stress) in causing chronic pain when controlling for demographic and occupational factors. METHODS: This cross-sectional study was carried out among 674 workers. Those with chronic pain were identified by affirmative answers to screening questions based on the ICD-11 criteria. RESULTS: There were 162 (24.0%; 95% CI 20.8% to 27.3%) workers meeting the ICD- 11 criteria for chronic pain. Headache was the most frequently reported pain (29.9%). We found a significantly (p=0.03) higher prevalence of pain among the middle age than in other age groups. Chronic pain more frequently affected divorced/widowed workers (p<0.001), and those with more work experience (p=0.04). Workers with chronic pain reported significantly higher levels of depression (p<0.001), job stress (p=0.007), and work-family conflict (p<0.001). After controlling for demographic and occupational factors, depression (p<0.001) and work-family conflict (p=0.003) were found to be independent predictors of chronic pain among studied workers. CONCLUSION: Workers who experience higher levels of depression, work-family conflict and job stress might be more prone to chronic pain. The majority of these factors are modifiable, and the problem may thus be solved by establishing appropriate screening programs, and availability of proper services and education.
Subject(s)
Chronic Pain/epidemiology , Occupational Stress/epidemiology , Oil and Gas Industry/statistics & numerical data , Stress, Psychological/epidemiology , Adult , Cross-Sectional Studies , Depression/epidemiology , Depression/psychology , Family Conflict , Female , Humans , Job Satisfaction , Male , Middle Aged , Occupational Stress/psychology , Occupations , Petroleum , Prevalence , Stress, Psychological/psychology , Young AdultABSTRACT
The current study examined the relationships of typically developing (TD) children with siblings with and without intellectual disabilities (ID), as expressed in TD children's drawings and questionnaires answered by TD children and their mothers. It also examined group differences in the sibling relationships, as well as the associations between having a sibling with or without ID and sibling relationships, and TD children's social-emotional adjustment. Participants were mothers and their TD children (8-13 years). Some had ID siblings ID (N=28); others had TD siblings (N=31). Sibling relationships were examined via mothers' and target children's completion of questionnaires, and objective visual indicators (location, size, distance) and observed content-based indicators (support, investment, presence of parents) of children's drawings were assessed following the art-based phenomenological analytic approach. Mothers reported on children's social-emotional adjustment. Findings indicated differences in sibling relationships, including higher levels of positive relationships for children with ID siblings. Children's drawings also showed positive relationship aspects for these children. Sibling relationship qualities were significantly associated with children's adjustment. Children's drawings may be a useful data gathering tool to deepen our understanding of unique aspects of sibling relationships.
Subject(s)
Art Therapy , Intellectual Disability , Sibling Relations , Siblings , Adolescent , Avoidance Learning , Case-Control Studies , Child , Competitive Behavior , Emotional Adjustment , Empathy , Family Conflict , Female , Humans , Male , Pictorial Works as Topic , Social Adjustment , TeachingABSTRACT
The current study examined unfolding relations among mothers' mindful parenting, parent-adolescent recurrent conflict, and adolescents' externalizing and internalizing problems. In a community sample of 117 families (31% black, Asian, American Indian, or Latino), parents and adolescents (52% female; average age = 12.13 years) were followed over 15 months. Parents answered questions about mindful parenting and recurrent conflict, and adolescents reported on their own externalizing and internalizing problems. Path analyses indicated that higher levels of mindful parenting were significantly related to lower levels of recurrent conflict 2-3 months later, controlling for previous levels of recurrent conflict. Moreover, lower levels of recurrent conflict were significantly related to lower levels of externalizing problems and internalizing problems 1 year later, controlling for previous levels of those problems. Subgroup analyses indicated that relations were comparable across subgroups defined by adolescent gender, race, parent marital status, and family financial strain. The effects of mindful parenting were robust even after accounting for other indicators of positive and supportive parenting, namely inductive reasoning and warmth in the parent-adolescent relationship. These findings highlight the potential of mindful parenting to improve family interactions and adolescent adjustment.
Subject(s)
Adolescent Behavior/psychology , Family Conflict/psychology , Mindfulness , Mothers/psychology , Parenting/psychology , Adolescent , Child , Defense Mechanisms , Female , Humans , Internal-External Control , Male , Parent-Child RelationsABSTRACT
INTRODUCTION: Interparental conflict exposure places adolescents at risk for problems with stress and anxiety; existing prevention/intervention strategies focus on reducing interparental conflict. Mindfulness-based programmes may be a promising treatment strategy for this population, but studies have not yet tested whether they are effective in this high-conflict context. In addition, evidence suggests that extensions to traditional treatments, such as delivering components in daily life that are tailored to moments of need, can increase treatment efficacy, particularly when combined with in-person treatments and particularly for adolescents. However, there are no such extensions to mindfulness interventions available. The Moving 2 Mindful study aims to (1) develop an ecological momentary intervention (EMI) supplement to Learning to BREATHE (L2B), an evidence-based mindfulness intervention for adolescents; (2) refine the EMI programme and determine the best delivery plan; (3) examine the feasibility and acceptability of L2B Plus (L2B plus the developed supplement) and (4) examine the potential for L2B Plus to reduce stress and anxiety for adolescents from high-conflict homes. METHODS AND ANALYSIS: The Moving 2 Mindful study proposes a mixed-methods approach to developing and refining a multimethod adaptive supplement to L2B. Feasibility, acceptability and potential effectiveness will be tested in a sample of 38 families, who will be randomly assigned to receive L2B Plus or an active health and wellness control condition and followed until 3 months postintervention. A range of psychosocial and physiological factors will be assessed at multiple time points. This study is registered with clinicaltrials.gov (ID NCT03869749; pre-results). ETHICS AND DISSEMINATION: The Institutional Review Board at Colorado State University has approved this study. Findings will be disseminated in scientific journals and conferences, whether they are positive, negative or inconclusive.
Subject(s)
Anxiety/therapy , Family Conflict/psychology , Mindfulness/methods , Stress, Psychological/therapy , Adolescent , Female , Humans , Longitudinal Studies , Male , Parents/psychology , Randomized Controlled Trials as Topic , Reminder Systems , Text MessagingABSTRACT
At present, scholarship on matricide across many regions of the non-Western world is lacking. For instance, in Ghana, despite the intermittent, yet recurrent, availability of media reports describing matricidal acts over the past quarter century, no existing study has systematically analyzed matricidal killings in the West African nation. To contribute to the literature and extend knowledge about matricide and other forms of lethal violence in Ghana, this article presents the results of an analysis of 21 matricidal acts that occurred in Ghana from 1990 to 2016. Issues studied include demographic characteristics of assailants and victims, modus operandi, temporal and spatial aspects, as well as the motives and circumstances surrounding the crime. The results show that sons were substantially more likely than daughters to kill their mothers, matricide offenders were more likely to suffer from serious psychiatric disorders, matricide offenses generally occurred in the victim's home, and all cases of matricide were characterized by massive physical force and extreme violence. Matricide offenses in Ghana differed from matricides in Western nations in four important respects: (a) none of the 21 matricides was perpetrated with a firearm, (b) in none of the cases did the offender act with a co-offender (accomplice or accessory),
Subject(s)
Crime Victims/statistics & numerical data , Criminals/statistics & numerical data , Homicide/statistics & numerical data , Mothers , Adult , Age Distribution , Aged , Aged, 80 and over , Family Conflict , Female , Ghana/epidemiology , Homicide/ethnology , Humans , Male , Mental Disorders/epidemiology , Middle Aged , Motivation , Social Class , Weapons , Witchcraft , Young AdultABSTRACT
Sibling relations are by nature ambivalent with high levels of both altruistic helping and competition. Higher relatedness is often assumed to reduce the occurrence of conflicts between siblings, but evidence of this has been scarce and mixed. Siblings typically compete over resources and parental attention, and parental constellations vary with sibship types. Since full-siblings compete over the same two biological parents, while half-siblings have only one shared biological parent and often a higher number of parents overall, it is hypothesized that conflicts are more common between full- than half-siblings. This study tested this assumption using the British Millennium Cohort Study (n=7527 children at age 11). Conflicts were measured as children's reports of how much siblings picked on and hurt each other. Households with full-siblings only, maternal half-siblings only, and both full- and maternal half-siblings were compared. The results show that children who were living with only their full-siblings were more likely to experience sibling conflicts compared with children living with their maternal half-siblings only. This was the case also after controlling for several potentially confounding variables. The results suggest that differential access to parental resources of available biological and step-parents may explain the higher amount of sibling conflict between full- compared with maternal half-siblings.
Subject(s)
Family Conflict , Parents , Siblings/psychology , Child , Child, Preschool , Cohort Studies , Family , Family Characteristics , Female , Humans , Male , Mothers , United KingdomABSTRACT
OBJECTIVE: Prior research has identified multiple factors that influence suicidal ideation (SI) among bullied youth. The effects of school bullying on SI cannot be considered in isolation. In this study, we examined the influence of school bullying on SI, through a constellation of risks, which include depressive and anxiety symptoms, family conflict, and alcohol, tobacco, and other drug (ATOD) use. We also provide recommendations for therapists working with bullied youth. METHOD: Our sample consisted of 488 adolescents (ages 10-18 years) from a northern New Jersey, United States suburban community. Students were recruited through the district's physical education and health classes. Students responded to multiple measures, which included family cohesion/conflict, ATOD use, mental health indicators, SI, and school bullying experiences. Following preliminary analyses, several logistic regression models were used to assess the direct influence of bullying on SI, as well as the unique effects of family conflict, depressive and anxiety symptoms, and substance use. In addition, a parallel multiple mediating model with the PROCESS macro in SPSS was used to further assess mediating effects. RESULTS: Logistic regression results indicated that school bullying increased the odds of SI among males and females and that when mediating variables were added to the model, bullying no longer had a significant influence on SI. Overall, these results display that for both males and females, school bullying was a significant contributor to SI. Results from the parallel multiple mediating model further illustrated the mediating effects that family conflict, depression, and ATOD use had between bullying and SI. Some variation was noted based on gender. CONCLUSION: This study draws attention to the multiple experiences associated with school bullying on SI, and how these results may differ by gender. The results of this study are particularly important for those working directly and indirectly with bullied youth. Therapists that engage bullied youth need to consider the multiple spheres of influence that may increase SI among male and female clients. To holistically and adequately assess SI among bullied youth, therapists must also consider how these mechanisms vary between gender groups.
Subject(s)
Anxiety/epidemiology , Bullying/statistics & numerical data , Depression/epidemiology , Students/statistics & numerical data , Substance-Related Disorders/epidemiology , Suburban Population/statistics & numerical data , Suicidal Ideation , Adolescent , Anxiety/psychology , Child , Depression/psychology , Family Conflict/psychology , Female , Humans , Logistic Models , Male , New Jersey/epidemiology , Odds Ratio , Risk Factors , Schools , Sex Factors , Students/psychology , Substance-Related Disorders/psychology , Surveys and QuestionnairesABSTRACT
To explore the effectiveness of a mentalization-based therapeutic intervention specifically developed for parents in entrenched conflict over their children. To the best of our knowledge, this is the first randomized controlled intervention study in the United Kingdom to work with both parents postseparation, and the first to focus on mentalization in this situation. Using a mixed-methods study design, 30 parents were randomly allocated to either mentalization-based therapy for parental conflict-Parenting Together, or the Parents' Group, a psycho-educational intervention for separated parents based on elements of the Separated Parents Information Program-part of the U.K. Family Justice System and approximating to treatment as usual. Given the challenges of recruiting parents in these difficult circumstances, the sample size was small and permitted only the detection of large differences between conditions. The data, involving repeated measures of related individuals, was explored statistically, using hierarchical linear modeling, and qualitatively. Significant findings were reported on the main predicted outcomes, with clinically important trends on other measures. Qualitative findings further contributed to the understanding of parents' subjective experience, pre- and posttreatment. Findings indicate that a larger scale randomized controlled trial would be worthwhile. These encouraging findings shed light on the dynamics maintaining these high-conflict situations known to be damaging to children. We established that both forms of intervention were acceptable to most parents, and we were able to operate a random allocation design with extensive quantitative and qualitative assessments of the kind that would make a larger-scale trial feasible and productive. (PsycINFO Database Record