ABSTRACT
Children affected by HIV/AIDS are at high risk for multiple placements as the adults in their lives are often too incapacitated to provide stable, consistent care for them. This article provides a historical overview of child caregiving, describes the complex needs of HIV/AIDS affected children and their relative caregivers, usually grandparents, and suggests that with necessary supports, placement with relatives can be a thoughtful, realistic option for permanency.
Subject(s)
Acquired Immunodeficiency Syndrome/psychology , Caregivers/psychology , Child of Impaired Parents/psychology , Family/psychology , HIV Infections/psychology , Adolescent , Adult , Child , Child Custody/legislation & jurisprudence , Female , Foster Home Care/psychology , Humans , Legal Guardians , Male , Maternal Deprivation , Middle Aged , Paternal Deprivation , Personality DevelopmentABSTRACT
The authors introduce the Yale Intensive In-Home Child and Adolescent Psychiatric Service, a model of home-based care for children with severe psychiatric disturbances. This model synthesizes the principles and method of the wrap-around paradigm and in-patient child psychiatric practice within the reality of the managed care system. A clinical team, under the direct supervision of a child psychiatrist, works directly within the family to understand and address the multilevel transactions that have affected the child's ability to function in various domains and resulted in recommendations for intensive intervention, including psychiatric hospitalization. This article suggests that if the psychiatrist is to provide the highest level of care, cognizance of and involvement in the child's ecology are as essential for the child and adolescent psychiatrist as other aspects of the child's world and life. In the days of ever shortening patient lengths of stay, this model of care offers promise for both clinical and fiscal effectiveness.
