Plano EVA-TO: plano de enfrentamento à violência autoprovocada do Estado do Tocantins com ênfase na atenção integral à saúde / EVA-TO Plan: plan to face self-inflicted violence in the State of Tocantins with an emphasis on comprehensive health care

O Plano de Enfrentamento à Violência Autoprovocada do Estado do Tocantins com Ênfase na Atenção Integral à Saúde foi desenvolvido para fortalecer a rede de atenção psicossocial, em colaboração com o Sistema Único de Saúde (SUS) e o Sistema Único de Assistência Social (SUAS). Elaborado pelo Grupo de Trabalho "Flor de Pequi", o plano tem como objetivo qualificar a Rede de Atenção à Saúde, orientando gestores e profissionais de saúde na prevenção da violência autoprovocada, automutilação e suicídio, além de promover o acolhimento e compartilhamento do cuidado na rede de atenção à saúde. O documento foi elaborado em resposta a demandas relacionadas aos dados de violência autoprovocada, solicitações do Conselho Estadual de Defesa de Direitos da Criança e do Adolescente e do Conselho Regional de Psicologia. A metodologia, discussão, metas, ações e monitoramento também são abordados no plano.

The Plan for Confronting Self-Inflicted Violence in the State of Tocantins with an Emphasis on Comprehensive Health Care was developed to strengthen the psychosocial care network in collaboration with the Unified Health System (SUS) and the Unified Social Assistance System (SUAS). Elaborated by the "Flor de Pequi" Working Group, the plan aims to enhance the Health Care Network by providing guidance to managers and health professionals in the prevention of self-inflicted violence, self-harm, and suicide, while promoting care and support within the health care system. The document was created in response to demands related to self-inflicted violence data, requests from the State Council for the Defense of the Rights of Children and Adolescents, and the Regional Psychology Council. The plan also addresses methodology, discussion, goals, actions, and monitoring.

El Plan de Enfrentamiento a la Violencia Autoinfligida en el Estado de Tocantins con Énfasis en la Atención Integral de Salud fue desarrollado para fortalecer la red de atención psicosocial en colaboración con el Sistema Único de Salud (SUS) y el Sistema Único de Asistencia Social (SUAS). Elaborado por el Grupo de Trabajo "Flor de Pequi", el plan tiene como objetivo calificar la Red de Atención a la Salud, brindando orientación a los gestores y profesionales de la salud en la prevención de la violencia autoinfligida, la automutilación y el suicidio, además de promover el cuidado y apoyo dentro de la red de atención sanitaria. El documento fue elaborado en respuesta a demandas relacionadas con datos de violencia autoinfligida, solicitudes del Consejo Estatal para la Defensa de los Derechos de la Niñez y la Adolescencia y del Consejo Regional de Psicología. El plan también aborda la metodología, la discusión, las metas, las acciones y el monitoreo

Percepciones y sentimientos de niños argentinos frente a la cuarentena COVID-19 / Perceptions and feelings of Argentine children regarding the COVID-19 quarantine

La Subcomisión de Derechos del Niño y el Comité de Pediatría Social, de la Sociedad Argentina de Pediatría, realizaron un trabajo de campo que permitiera dar voz a nuestros niños, niñas y adolescentes (NNA) durante la cuarentena y el aislamiento social obligatorio impuestos en nuestro país por la pandemia mundial por la enfermedad por el nuevo coronavirus (COVID-19). Los objetivos fueron relevar el impacto sobre sus sentimientos, emociones y deseos; evaluar y comparar las repercusiones personales, familiares y sociales antes, durante y después de la cuarentena; e identificar las necesidades de apoyo y contención.Los resultados de la investigación permiten afirmar que los niños han sido los más afectados y los menos escuchados. La cuarentena ha tenido un enorme impacto individual, social y familiar en los NNA, y reclama un abordaje holístico, comprometido y mancomunado de la sociedad civil, las familias, los profesionales de la salud, los docentes y las autoridades políticas.

The Subcommittee on the Rights of the Child and the Social Pediatrics Committee of the Sociedad Argentina de Pediatría carried out a fieldwork that allowed us to give a voice to our children and adolescents (NNA), during quarantine and social isolation mandatory imposed in our country by the global pandemic COVID-19. The objectives were to analyze the impact on their feelings, emotions and desires; evaluate and compare personal, family and social repercussions pre, intra and post quarantine; and identify support and containment needs.The results of the research allow us to affirm that children have been the most vulnerable and the least listened to. The quarantine has had an enormous individual, social and family impact on children and adolescents and calls for a holistic, committed and joint approach from civil society, families, health professionals, teachers and political authorities

[Perceptions and feelings of Argentine children regarding the COVID-19 quarantine]. / Percepciones y sentimientos de niños argentinos frente a la cuarentena COVID-19.

The Subcommittee on the Rights of the Child and the Social Pediatrics Committee of the Sociedad Argentina de Pediatría carried out a fieldwork that allowed us to give a voice to our children and adolescents (NNA), during quarantine and social isolation mandatory imposed in our country by the global pandemic COVID-19. The objectives were to analyze the impact on their feelings, emotions and desires; evaluate and compare personal, family and social repercussions pre, intra and post quarantine; and identify support and containment needs. The results of the research allow us to affirm that children have been the most vulnerable and the least listened to. The quarantine has had an enormous individual, social and family impact on children and adolescents and calls for a holistic, committed and joint approach from civil society, families, health professionals, teachers and political authorities.

La Subcomisión de Derechos del Niño y el Comité de Pediatría Social, de la Sociedad Argentina de Pediatría, realizaron un trabajo de campo que permitiera dar voz a nuestros niños, niñas y adolescentes (NNA) durante la cuarentena y el aislamiento social obligatorio impuestos en nuestro país por la pandemia mundial por la enfermedad por el nuevo coronavirus (COVID-19). Los objetivos fueron relevar el impacto sobre sus sentimientos, emociones y deseos; evaluar y comparar las repercusiones personales, familiares y sociales antes, durante y después de la cuarentena; e identificar las necesidades de apoyo y contención. Los resultados de la investigación permiten afirmar que los niños han sido los más afectados y los menos escuchados. La cuarentena ha tenido un enorme impacto individual, social y familiar en los NNA, y reclama un abordaje holístico, comprometido y mancomunado de la sociedad civil, las familias, los profesionales de la salud, los docentes y las autoridades políticas.

COVID-19: No Distinction for Children's Spiritual Growth.

COVID-19 cannot rob us of our ability to perform our ministry for children. As adults and ministers, we can show our support for the spiritual growth of children. COVID-19 has not deprived us of our creativity in praise, telling of God's love, prayers, and support for all the children and parents. COVID-19 has not defeated our spiritual life.

Cultivating emotional intelligence in child welfare professionals: A systematic scoping review.

Emotional intelligence (EI) refers to the ability to recognize and appropriately respond to emotions in oneself and others; these competencies include, but are not limited to, empathy, emotion regulation, reflective ability, self-awareness, and psychological flexibility. Such abilities are crucial to meaningful and effective child welfare work. Further, they are part of resilience and healthy coping mechanisms, which are important for those working in child welfare if compassion fatigue and burnout are to be combated. However, little is known about how to cultivate these competencies in child welfare professionals. The present study had two goals: 1) To conduct a systematic scoping review of the literature on interventions purporting to develop and/or enhance EI-related competencies in this population, whether those interventions be at the caseworker, supervisor, or organizational level; 2) To consider future directions for the teaching and enhancement of EI competencies for child welfare professionals. A total of 18 studies met inclusion criteria, with the majority focused on developing mindfulness and/or empathy skills. However, no studies focused on child welfare professionals, and instead focused on social work students or professionals, with a few including other helping professionals. Additionally, none were focused on a supervisory or organizational level. Future directions for research are discussed, including the use of experiential or simulation-based training in order to elicit emotions within a safe and supportive learning context, the use of reflective supervision to help develop self-reflection and emotion regulation skills, and system-wide interventions that enhance the development of emotional intelligence competencies in public child welfare organizations.

A holistic understanding of the effect of stress on adolescent well-being: A conditional process analysis.

Although traditional assumptions tend to conceptualize stress as inherently dysfunctional, psychological theory suggests that it is not intrinsically maladaptive. Contemporary models emphasize that the stress response can be differentiated into both negative and positive aspects, known as distress and eustress. Research examining the differential effect of positive and negative stress on adolescent well-being is limited and has been hindered by a lack of appropriate measurement tools. The aim of the present study was to utilize the recently developed Adolescent Distress-Eustress Scale to provide a balanced understanding of the impact of stress on positive mental health, holistically considering the effect of both distress and eustress on adolescent well-being. One thousand eighty-one Australian adolescents (Mage = 15.14, 54.03% female) completed an online survey composed of the Adolescent Distress-Eustress Scale alongside measures of well-being, self-efficacy, psychological ill-being, physical activity, and daytime sleepiness. Conditional process analysis suggested that distress exerted no direct influence on well-being, with the observed negative relationship fully mediated by psychological and behavioural variables. Contrastingly, eustress was both directly related to increased well-being and exerted an indirect effect through relationships with mediating variables. These results demonstrate that stress can have profoundly positive consequences. Theoretical contributions, implications for practice, and perspectives for future research are discussed.

Children with ADHD draw-and-tell about what makes their life really good.

PURPOSE: The purpose of this study was to engage children with attention deficit hyperactivity disorder (ADHD) in a developmentally sensitive way to explore the children's subjective well-being. Explicitly, their life satisfaction, or what makes their life "really good." To date, little is known about the subjective life experience of children with ADHD or how incorporating children's views separate from the purview of adults and pathology might enhance our understanding or change our approach to evaluation and/or intervention. DESIGN AND METHODS: A parallel convergent mixed-methods design was used to collect data from a convenience sample of children with ADHD (N = 20) ages 7 to 11 years old. This article focuses solely on the qualitative data obtained through semi-structured interviews using the art-based approach draw-and-tell conversation (DTC). The DTC data were analyzed using qualitative content analysis. In addition, each parent (N = 20) independently completed demographic and health-related forms to provide descriptive and contextual variables. RESULTS: Three themes were discerned in the DTC analysis-activity, nature, and connections. Most children (90%) described engaging in some form of activity, often outdoors, and with others; though the focus of activity was varied. Nature was evidenced directly and indirectly in many of the children's (85%) stories. Over half (65%) of the children described some variation in relational connection across a continuum that contributed to, or detracted from, their sense of well-being/life satisfaction. PRACTICE IMPLICATIONS: Children shared that doing things, outdoors, with others, [emphasis added] made their life "really good". Children's stories yielded insightful and actionable information that is relevant to each individual child/family, and to nursing assessment, intervention, and advocacy. These child-granted insights also extend our attention beyond pharmacological and behavioral focused interventions, to include the children's own innate health promoting interests that help to make their life really good.

Is Mindful Parenting Associated with Adolescents' Well-being in Early and Middle/Late Adolescence? The Mediating Role of Adolescents' Attachment Representations, Self-Compassion and Mindfulness.

There is some evidence that mindful parenting, a parenting approach that involves the practice of bringing mindful awareness to the parent-child relationship, is associated with several positive psychosocial outcomes in adolescents. However, only a few studies have investigated the mechanisms that may underlie that association. This study explores whether the link between mindful parenting and adolescents' well-being is mediated by adolescents' attachment representations, self-compassion and mindfulness skills. The sample comprised 563 parent-child dyads (95.6% mothers). Adolescents (61.5% girls) had a mean age of 14.26 years (SD = 1.66, range = 12-20). Parents completed a measure of mindful parenting, and adolescents completed measures of attachment representations, self-compassion, mindfulness, and well-being. Mindful parenting was indirectly associated with adolescents' self-compassion and mindfulness through a more secure perception of the relationship with the parents, and was indirectly associated with adolescents' well-being through perceived attachment security, self-compassion and mindfulness. The path model was invariant across stages of adolescence but some relations in the model varied across gender. Self-compassion and mindfulness seem to develop within a parent-child relationship characterized by affection, self-regulation, and mindful awareness. These two resources, along with mindful parenting and positive representations of the parent-child relationship, are associated with adolescents' well-being.

Improving outcomes for babies and toddlers in child welfare: A model for infant mental health intervention and collaboration.

Children under three comprise a sizable and growing proportion of foster care placements. Very young children who enter the child welfare system experience disruptions of critical attachments that are essential to this formative stage of brain development, as well as other traumatic events, leaving them at great risk for lifelong impairments. To reverse these concerning outcomes, babies who have been removed from their homes require intensive, relationship-based interventions that promote secure attachment to a primary caregiver and holistic attention the child's developmental needs. Child welfare decision-makers must be informed of infant brain development and knowledgeable about the particular needs and circumstances of each child. This article describes a model with these features that has been developed and tested in the Bronx, New York, one of the nation's poorest urban counties with high rates of foster care. The Project utilizes evidence-based Child-Parent Psychotherapy (CPP) as its core intervention, and emphasizes collaboration and information sharing- driven by the CPP clinician- with judges, child welfare workers, attorneys and other social service and mental health providers, thereby encouraging developmentally and relationally informed case planning and permanency decisions. The model is evaluated using pre and post treatment psychosocial measures and program outcome data. Results indicate improvement in parenting interactions, positive child welfare outcomes (including increased rates of reunification, fewer returns to foster care), and improved safety and wellbeing. Results highlight the need for child welfare practices to be more closely aligned with the current science of infant brain development, and to incorporate a specialized approach to address the unique needs of infants.

The Human Coparental Bond Implicates Distinct Corticostriatal Pathways: Longitudinal Impact on Family Formation and Child Well-Being.

Alloparental care, the cooperative care of offspring by group members other than the biological mother, has been widely practiced since early hominin evolution to increase infant survival and thriving. The coparental bond-a relationship of solidarity and commitment between two adults who join their effort to care for children-is a central contributor to children's well-being and sociality; yet, the neural basis of coparenting has not been studied in humans. Here, we followed 84 first-time co-parents (42 couples) across the first 6 years of family formation, including opposite-sex and same-sex couples, measured brain response to coparental stimuli, observed collaborative and undermining coparental behaviors in infancy and preschool, assayed oxytocin (OT) and vasopressin (AVP), and measured coparenting and child behavior problems at 6 years. Across family types, coparental stimuli activated the striatum, specifically the ventral striatum and caudate, striatal nodes implicated in motivational goal-directed social behavior. Psychophysiological interaction analysis indicated that both nodes were functionally coupled with the vmPFC in support of the human coparental bond and this connectivity was stronger as collaborative coparental behavior increased. Furthermore, caudate functional connectivity patterns differentiated distinct corticostriatal pathways associated with two stable coparental behavioral styles; stronger caudate-vmPFC connectivity was associated with more collaborative coparenting and was linked to OT, whereas a stronger caudate-dACC connectivity was associated with increase in undermining coparenting and was related to AVP. Finally, dyadic path-analysis model indicated that the parental caudate-vmPFC connectivity in infancy predicted lower child externalizing symptoms at 6 years as mediated by collaborative coparenting in preschool. Findings indicate that the coparental bond is underpinned by striatal activations and corticostriatal connectivity similar to other human affiliative bonds; highlight specific corticostriatal pathways as defining distinct coparental orientations that underpin family life; chart brain-hormone-behavior constellations for the mature, child-orientated coparental bond; and demonstrate the flexibility of this bond across family constellations and its unique contribution to child well-being.

Music-making for health and wellbeing in youth justice settings: mediated affordances and the impact of context and social relations.

Young people in the criminal justice system experience significant health and wellbeing issues that often stem from poverty and disadvantage and, in turn, are linked with offending and reoffending behaviour. There is ongoing interest in interventions such as participatory music programmes that seek to foster social reintegration, support mental wellbeing and equip young offenders with life skills, competencies and emotional resilience. However, there is a need for a situated understanding of both positive and negative experiences that shape potential outcomes of music projects. This article reports on a research study undertaken between 2010 and 2013 with 118 young people aged 13-21 years across eight youth justice settings in England and Wales. Using mixed methods we explored the experiences of young people and their responses to a participatory music programme led by a national UK arts charity. Here, we explore the impact of young people's encounters with music and musicians with reference to the notion of 'musical affordances' (DeNora , ). We examine the ways that such affordances, including unintended outcomes, are mediated by features of the youth justice environment, including its rules and regulations, as well as issues of power, identity and social relations.

'Yarning up with Koori kids' - hearing the voices of Australian urban Indigenous children about their health and well-being.

OBJECTIVE: Australian Indigenous children experience some of the most substantial health inequalities globally. In this context, research regarding their health and well-being has overemphasised physical illnesses with limited exploration of a diverse range of dimensions and determinants, particularly those based on Indigenous holistic understandings of health and well-being. This deficit-based approach has thus missed many strengths and assets of Indigenous children. This research aimed to gain insight into the perspectives of Indigenous children about their health and well-being in an urban setting in Australia. It joins a limited international literature examining views and experiences of non-majority children. DESIGN: Participatory and qualitative child-friendly research methods were utilised. The project was developed in partnership with Indigenous community organisations and members. Photo-elicitation activities and focus groups were conducted with 31 Indigenous children aged 8-12 years. Qualitative data were analysed thematically, combining focus group and interview data. RESULTS: It was evident an urban Indigenous child perspective of health and well-being includes rich understandings of the interconnectedness of physical, social-emotional and cultural dimensions of holism, as well as the integral importance of family and community relationships. The study also found that specific worries regarding loss of loved ones and racism were highly salient in Indigenous children's lives. CONCLUSION: The overwhelming conclusion to be drawn from this research is that Indigenous children in urban areas need ongoing recognition of both their agency and resilience in the face of adversity, within a wider context of historical and contemporary racialisation and racism.

Protective factors associated with resilient functioning in young adulthood after childhood exposure to violence.

Children may be subjected to many forms of violence and a significant number will experience multiple victimizations. These children are at high risk for developing psychological and emotional difficulties that may last into adulthood. Despite the increased risk for psychopathology, a substantial percentage of young adults exhibit resilient functioning following a history of childhood violence. This study examines the role of social support, spirituality, and emotional intelligence in promoting resilience during emerging adulthood. Participants included 321 young adult American college students, age 18-24, who experienced childhood violence, including community violence, interpersonal aggression, child maltreatment, peer/sibling victimization, and/or sexual assault. Findings revealed that this sample was highly victimized, with an average of 9 violent experiences reported during childhood. Hierarchical multiple regression analyses indicated that after controlling for exposure to childhood victimization, other potentially traumatic events, and current depression and anxiety symptoms, higher resilience during emerging adulthood was associated with greater spirituality, greater emotional intelligence, and support from friends (but not from family). Findings suggest that the potency of protective factors outweighs that of adversity and psychopathology when predicting resilient functioning. By identifying variables that can enhance resilience, this study offers unique insight into how functioning may be improved by both individual and environmental factors.

Supporting parent-child interactions: music therapy as an intervention for promoting mutually responsive orientation.

BACKGROUND: Music therapists working with families address relationship and interpersonal communication issues. Few controlled studies exist in the literature but a growing body of documented practice is emerging. This study makes a contribution by documenting how music therapy supports mutuality and reciprocity in parent-child interactions. OBJECTIVE: This study investigated mutually responsive orientation (MRO) behaviors of young children (aged 3-5) and their family members during music therapy. METHODS: Participants were 4 families with low income and history of maternal depression as common risk factors. Data were collected by videotaping sessions, creating field notes and analytic memos, conducting parent interviews and reviewing parent journals. A cross-case analysis using MRO theory as a conceptualizing framework was used for the purpose of data reduction. RESULTS: Greeting and farewell rituals, and the flexibility of music-based therapeutic applications facilitated development of coordinated routines. Therapist's actions (e.g., encouraging and modeling musical interactions) and bidirectional parent-child actions (e.g., joint attention, turn-taking, being playful) facilitated harmonious communication. Behaviors promoting mutual cooperation were evident when adults attempted to scaffold a child's participation or when children sought comfort from parents, engaged in social referencing and made requests that shaped the direction of the session. The novelty of musical tasks captivated attention, increasing impulse inhibition. Parent actions (e.g., finding delight in watching their child participate, acting silly) and parent-child interactions (e.g., play exploration, shared excitement, cuddling) contributed to positive emotional ambiance. CONCLUSION: Music therapy assisted development of MRO within parent-child dyads by providing opportunities to rehearse adaptive ways of connecting with each other. Results of this study may serve as an archetypal model guiding clinical treatment planning.

ACHESS--The Australian study of child health in same-sex families: background research, design and methodology.

BACKGROUND: There are an increasing number of children in Australia growing up with same-sex attracted parents. Although children from same-sex parent families do in general perform well on many psychosocial measures recent research is beginning to consider some small but significant differences when these children are compared with children from other family backgrounds. In particular studies suggest that there is an association between the stigma that same-sex parent families experience and child wellbeing. Research to date lacks a holistic view with the complete physical, mental and social wellbeing of children not yet addressed. In addition, most studies have focused only on families with lesbian parents and have studied only small numbers of children. METHODS/DESIGN: The Australian Study of Child Health in Same-Sex Families (ACHESS) is a national study that aims to determine the complete physical, mental and social wellbeing of Australian children under the age 18 years with at least one parent who self identifies as being same-sex attracted. There will be a particular focus on the impact that stigma and discrimination has on these families. Parent and child surveys will be used to collect data and will be available both online and in paper form. Measures have been chosen whenever possible that have sound conceptual underpinnings, robust psychometric properties and Australian normative data, and include the Child Health Questionnaire (CHQ), the Strengths and Difficulties Questionnaire (SDQ) and the Kessler Psychological Distress Scale (K10). DISCUSSION: ACHESS aims to be the largest study of its kind and will for the first time produce a detailed quantitative analysis of Australian children with same-sex attracted parents. By inviting participants to take part in further research it will also establish a valuable cohort of children, and their families, to launch future waves of research that will help us better understand the health and wellbeing of children with same-sex attracted parents.

Drawing cure: children's drawings as a psychoanalytic instrument.

This essay deals with the special case of drawings as psychoanalytical instruments. It aims at a theoretical understanding of the specific contribution made by children's drawings as a medium of the psychical. In the influential play technique developed by Melanie Klein, drawing continuously interacts with other symptomatic (play) actions. Nonetheless, specific functions of drawing within the play technique can be identified. The essay will discuss four crucial aspects in-depth: 1) the strengthening of the analysis's recursivity associated with the graphic artifact; 2) the opening of the analytic process facilitated by drawing; 3) the creation of a genuinely graphic mode of producing meaning that allows the child to develop a "theory" of the workings of his own psychic apparatus; and 4) the new possibilities of symbolization associated with the latter. In contrast to classical definitions of the psychological instrument, the child's drawing is a weakly structured tool that does not serve to reproduce psychic processes in an artificial, controlled setting. The introduction of drawing into the psychoanalytic cure is by no means interested in replaying past events, but in producing events suited to effecting a transformation of the synchronic structures of the unconscious.

Effects of yoga on inner-city children's well-being: a pilot study.

OBJECTIVE: To examine yoga's effects on inner-city children's well-being. METHODS: This pilot study compared fourth- and fifth-grade students at 2 after-school programs in Bronx, New York. One program offered yoga 1 hour per week for 12 weeks (yoga) and the other program (non-yoga) did not. Preintervention and postintervention emotional well-being was assessed by Harter's Global Self-Worth and Physical Appearance subscales, which were the study's primary outcome measures. Secondary outcomes included other measures of emotional well-being assessed by 2 new scales: Perceptions of Physical Health and Yoga Teachings (including Negative Behaviors, Positive Behaviors, and Focusing/relaxation subscales). Preintervention and postintervention, physical wellbeing was assessed by measures of flexibility and balance. Subjective ratings ofyoga's effects on well-being were evaluated by an additional questionnaire completed by the yoga group only. RESULTS: Data were collected from 78% (n=39) and 86.5% (n=32) of potential yoga and non-yoga study enrollees. No differences in baseline demographics were found. Controlling for preintervention well-being differences using analysis of covariance, we found that children in the yoga group had better postintervention Negative Behaviors scores and balance than the non-yoga group (P < .05). The majority of children participating in yoga reported enhanced wellbeing, as reflected by perceived improvements in behaviors directly targeted by yoga (e.g., strength, flexibility, balance). CONCLUSIONS: Although no significant differences were found in the study's primary outcomes (global self-worth and perceptions of physical well-being), children participating in yoga reported using fewer negative behaviors in response to stress and had better balance than a comparison group. Improvements in wellbeing, specifically in behaviors directly targeted by yoga, were reported. These results suggest a possible role of yoga as a preventive intervention as well as a means of improving children's perceived well-being.